July/August 2011 Issue
A Decade of Social Work Today — 10 Trends That Transformed Social Work
By Christina Reardon, MSW, LSW
Social Work Today
Vol. 11 No. 4 P. 10
When Social Work Today was first published in August 2001, it would have been difficult for readers to imagine the massive societal changes that lay ahead.
Could readers have imagined America would soon witness the worst terrorist attack in its history, followed by wars in Iraq and Afghanistan? What about the economic exuberance that would succumb to financial despair as the country faced its worst recession since the Great Depression? Could they have imagined that new technology that would bring about a revolution in global communication and collaboration?
Both societal and professional trends have transformed social work since 2001. In recognition of the magazine’s 10th anniversary, Social Work Today asked social workers around the country to reflect on 10 of these trends.
The Impact of Trauma
The 9/11 terrorist attacks in New York, Pennsylvania, and Washington, DC, not only traumatized victims and their families—the whole country seemed to suffer a deep psychological wound. And it recently became apparent how long-festering that wound was based on the jubilant reaction many people had upon hearing al-Qaeda leader Osama bin Laden was dead.
The nation saw its share of natural disasters, too, when Hurricanes Katrina and Rita struck in 2005, forever changing life along the Gulf Coast.
Social workers’ importance in assisting victims of trauma is not new, but what has changed is the growing appreciation by the general public for how trauma affects individuals and communities, says Raymond M. Scurfield, DSW, LCSW, ACSW, professor emeritus of the University of Southern Mississippi School of Social Work. “Modern communication has brought the horror right into people’s living rooms,” he says. “The level of media coverage has been so amazing that it’s been hard for people to ignore.”
Awareness of the impact of posttraumatic stress disorder has also increased, especially as many veterans returning from the wars in Iraq and Afghanistan struggle to reintegrate into their home life. That means social workers have a growing role in serving the mental health needs of veterans and their families, says Valvincent Reyes, LCSW, BCD, a clinical assistant professor and military field education coordinator at the University of Southern California School of Social Work’s Military Social Work and Veteran Services Program.
Reyes believes advances in military social work will lead to advances in care for victims of other forms of trauma. “You can apply the same concepts to civilians affected by disaster, whether natural or manmade,” he says. “The treatment of trauma can be generalized to deliver effective mental health services on a large scale.”
Mental Health/Substance Abuse Parity
Years of bipartisan efforts by legislators, including the late Sen. Edward Kennedy, resulted in the passage of the federal Mental Health Parity and Addiction Equity Act of 2008. The law, which took effect in 2010, requires large companies providing insurance coverage for mental health services to offer the same level of coverage for these services, including copays, deductibles, and treatment limits, as are offered for medical services. State legislation to ensure parity has become more common over the past decade, although how parity is accomplished varies.
Parity makes mental health and substance abuse services more accessible and affordable for many individuals and families who might have otherwise struggled financially to pay for services or would not seek them at all, says Laura W. Groshong, LICSW, director of government relations for the Clinical Social Work Association. The long battle for parity also demonstrated the power of advocacy groups, such as the National Alliance on Mental Illness, to raise public awareness of behavioral health issues, she says.
“[These groups] did a great job of making this issue something people had to pay attention to,” Groshong says.
“Over the past decade, the words ‘evidence-based practice’ have become omnipresent in social work,” says Joan Levy Zlotnik, PhD, ACSW, director of the NASW Foundation’s Social Work Policy Institute. The factors behind the change include increased efforts to build social workers’ knowledge of the importance of evidence-based practice, increased demands for accountability from funders, and growing competition among agencies for resources.
As evidence-based practice has become more recognized in the profession, the focus has shifted to showing social workers how to implement evidence-based practice in a way that promotes best practices but also complements clients’ experiences and adapts to community needs, Zlotnik says. One such effort is NASW’s SHIFT project, which provides a tool kit to help agencies transition to evidence-based practice in providing suicide prevention services to adolescent girls.
“It’s misunderstood that evidence-based practice means a one-size-fits-all approach,” Zlotnik says. “It’s really a much more nuanced process. You can’t just take something that someone else developed for a different population or a different type of agency and just open up a manual and do it.”
Social Work With Older Adults
The number of Americans aged 65 and older has increased from 35 million in 2000 to more than 40 million a decade later, according to the federal Administration on Aging. In response, the demand for social workers to provide services to older adults has grown significantly.
Not only has the number of older people seeking social work services increased, but several trends have affected how services to these clients are delivered, says Patricia L. Moore, ACSW, LCSW, assistant vice president of business development for Comprehensive Care Management, a New York-based long-term care organization. These trends include a shift in care away from the nuclear family to society at large, a move away from institutional care to community-based care, and a growing understanding of the importance of cultural competency in serving older immigrants.
Social workers no longer can see older adults as one homogeneous group, Moore says. Working with today’s older adults requires social workers to be able to serve specific populations, such as older adults with health problems, those with mental health conditions, older adults needing end-of-life care, and older adult immigrants.
“The need is going to increase for social workers with specialized skills to work with older adults,” Moore says. “Social work is in a good position to grow with that need and adapt to it.”
School Violence and Bullying
The Columbine High School massacre in 1999 and the Virginia Tech massacre in 2007 brought the issue of school safety to the forefront of the public consciousness. What is not often realized is that violent crime in schools has declined significantly since the mid-1990s.
So why does the public perceive school violence as a growing problem? Much of it has to do with increased media coverage of school shootings and incidents of bullying, says Ron Avi Astor, PhD, the Richard M. and Ann L. Thor Professor in Urban Social Development at the University of Southern California. That’s not necessarily bad, Astor says, because it boosts public support for increased resources for school safety, including school social workers.
Astor hopes social workers’ role in ensuring school safety will evolve from trying to eliminate violence to making schools warm, caring, and loving environments. “That should be our real goal,” he says. “I would like our profession to push the envelope and look at what the ideal school setting would be.”
One way social workers have been trying to create compassionate school environments is in preventing bullying targeted at lesbian, gay, bisexual, and transgender (LGBT) youths. Such bullying has gained national attention in the wake of several instances of gay teens driven to commit suicide.
Not all cases of bullying against LGBT youths result in suicide, but the media attention has made the public more aware of the long-term impact of such victimization, says Caitlin Ryan, PhD, ACSW, director of the Family Acceptance Project at San Francisco State University. In May, the project released a study showing links between violence and bullying against LGBT youths and the risk of depression, suicide, HIV, and sexually transmitted diseases.
“It’s not just an event that occurs in one point in a person’s life,” Ryan says. “As time goes on and we can show more of the costs, it will be harder for jurisdictions to justify not addressing it.”
Children’s Mental Health
Diagnosing mental health problems in children—particularly autism, attention-deficit/hyperactivity disorder, and bipolar disorder—has become more common, as has the use of medication in treatment. Whether this trend marks a much-needed recognition of children’s mental health needs or an epidemic of overdiagnosis is up for debate.
There are various reasons DSM diagnoses are being used more frequently for children, says Denise Duval, PhD, LCSW, of Child Therapy Chicago, a practice serving children and young adults. Among these reasons are increased awareness of how mental health conditions affect children, managed care policies, and parents’ need to explain their children’s behaviors. “Parents want an answer. They want a label. They want to know what it is,” Duval says.
In response to these trends, Duval says, social workers must stay true to the profession’s focus on looking at the underlying issues that influence children’s behaviors. “The biggest thing is not to forget to understand the people and the families and the nuances that form who the kids are,” she says.
After years of prosperity in the mid-2000s, the recession that struck in 2007 was a blow both to people’s pocketbooks and to their psychological well-being. The stress related to job loss, home foreclosures, and altered lifestyles led many people to seek behavioral health services.
This recession is of particular concern because many of its effects linger, particularly the high rate of chronically unemployed people, says Arthur H. Goldsmith, PhD, the Jackson T. Stephens professor of economics at Washington and Lee University in Lexington, VA.
Even though many people initially see unemployment as a chance for a new start, research shows that optimism is often replaced by hopelessness, depression, anxiety, and low self-esteem as unemployment drags on.
“People are very scared, especially mature adults with children and families to support,” Goldsmith says.
The economic squeeze has hit social workers, too. Many therapists have seen their revenues drop as clients lose insurance coverage, are unable to pay out of pocket, or cut back on appointments, says Lynn Grodzki, LCSW, MCC, of Private Practice Success, a business coaching firm in Silver Spring, MD. The changing economic climate has forced social workers to turn to new avenues, such as the Internet and social networking, to market their practices.
“We’re shifting more to a consumer-driven market,” says Grodzki. “Part of a therapist’s job now is being able to articulate who they are and what they have to offer.”
Web-Based Social Work Education
In one decade, the Internet has grown from a curiosity to something that is part of daily life for many Americans. Schools of social work have taken notice, and a growing number are offering classes online and making online education an integral part of their MSW programs.
Web-based social work education is growing in popularity because new technology makes it easier to connect students, particularly students in rural areas who otherwise would not have access to social work programs, says Mary Jo Garcia Biggs, PhD, LCSW, an associate professor and MSW distance education coordinator at Texas State University-San Marcos. Online education also allows students who cannot afford to quit their jobs to take classes on a schedule convenient for them.
Many concerns remain about online social work education, such as how schools handle field placements and whether Web-based learning builds adequate camaraderie among students and instructors. But Biggs believes online education is here to stay.
“It’s becoming more and more accepted,” she says. “When our program started, there weren’t many others doing it, and now it seems that there are quite a few universities moving in that direction.”
A decade ago, social networking sites, such as Facebook, Twitter, and LinkedIn, didn’t exist. Today, these sites attract the time and attention of hundreds of millions of users worldwide. People spend a whopping 700 billion minutes each month on Facebook alone, according to the site.
Social networking has enabled different client populations, such as those battling addictions, to form online support groups with a worldwide reach. Many social workers and social service agencies use social networking to market their services and to educate clients and potential clients about topics such as mental health, substance abuse, and family dynamics.
But questions have been raised about social networking’s ethical use in social work. Although social networking can be a useful tool, social workers using it must think carefully about how their activities could violate boundaries with clients, lead to unrealistic expectations from clients, and promote identity fraud, says Frederic G. Reamer, PhD, a professor at the Rhode Island College School of Social Work. Reamer believes these questions will persist as social networking’s popularity continues to grow.
“This is a train we’re not going to stop,” he says. “The onus of responsibility is on social workers to identify the issues, educate each other about the issues, and come up with appropriate risk management strategies.”
As technology and communications make the world an increasingly connected place, social workers are becoming more aware of how global events affect the profession. Even social workers who never practice abroad recognize how global trends affect the lives of their clients, and migration patterns mean social workers are increasingly encountering clients who are immigrants or refugees.
Social work has responded to these trends with a greater emphasis on international collaboration, a renewed focus on cultural competency, and the addition of international content to social work curricula. But there is much more work to be done if American social workers want to effectively address issues that are global in scope, such as aging and human trafficking, says M. C. “Terry” Hokenstad, Jr., PhD, the Ralph S. and Dorothy P. Schmitt Professor at the Mandel School of Applied Social Sciences at Case Western Reserve University in Cleveland. Social work educators need to incorporate more international content into foundation-level classes and increase the opportunities for students to do international-related field placements, Hokenstad says.
“All social workers need to be exposed to an international environment, whether they’re interested in careers in international social work or not,” he says. “We have made some progress, but we have a long way to go.”
— Christina Reardon, MSW, LSW, is a freelance writer based in Harrisburg, PA, and a contributing editor at Social Work Today.
To see a chart of major changes that have influenced social work over the last ten years, click here.