Have We Drifted Too Far? The Argument for Macro Social Work

Originally published on The Macro Lens, where I share essays and resources on macro social work. Visit the site for more articles and tools for changemakers.

Introduction

When most people hear “social work,” they think of therapy sessions, case management, or child welfare investigations. Few think of advocacy, systemic reform, or social justice. This perception is not an accident. Over the past several decades, the profession has leaned heavily into clinical practice, while our identity as justice-driven changemakers has faded into the background.

The danger? By defining ourselves too narrowly as clinicians, social work risks losing its unique identity. Unless we reclaim our roots in justice and systemic change, the profession will struggle to remain relevant.

The Clinical Competition

Consider the growth of the Clinical Mental Health Counseling (CMHC) field. The Bureau of Labor Statistics projects employment for mental health counselors and related counseling fields to grow 18–23% between 2022 and 2032, well above average for all occupations. By comparison, social worker employment is projected to grow by only 7–9% in the same period.

Nearly half of new MSWs now spend most of their time in mental health services. About 26% report mental health treatment as their primary role and almost two thirds deliver mental health services to most of their clients.

In other words, social work is already clinically dominated, and CMHC programs are growing faster on that front. If we define ourselves primarily as therapists, we risk being overshadowed by counseling programs designed exclusively for clinical practice.

What We’re Missing

What sets social work apart is not its ability to provide therapy. It is our historic and ethical commitment to justice. At its best, social work confronts the root causes of inequity and works to transform the systems that perpetuate harm. This is what drew many of us into the field, and it is what must define us moving forward.

The next generation of students and professionals is deeply justice-oriented. They grew up witnessing the racial reckoning after George Floyd’s murder, the disparities laid bare by COVID-19, and political polarization. They know something is profoundly broken. What they often lack is a roadmap for how to fix it. Social work is uniquely positioned to provide that roadmap.

The Case for Macro Social Work

Macro practice is not an optional add-on to our profession. It is fundamental. The 2022 EPAS identifies nine competencies that define professional practice: ethical and professional behavior, advancing human rights and justice, engaging anti-racism and equity, integrating research into practice, engaging in policy practice, engaging with systems at all levels, assessing needs, intervening effectively, and evaluating practice.

These competencies make clear that macro practice is not separate from the profession. It is the profession. Social workers are called to:

• Shape policy through legislative advocacy, analysis, and testimony.
• Lead organizations by designing programs, managing systems, and evaluating outcomes.
• Mobilize communities by building coalitions, addressing inequities, and engaging diverse stakeholders.

This is what differentiates us. Macro social work speaks directly to the passions of today’s youth: social justice, equity, and systemic transformation. If we make social work synonymous with social justice, we will attract a new wave of diverse and visionary students ready to leverage lived experience into leadership.

If instead we continue to center our identity narrowly around therapy, we will shrink into irrelevance, remembered more for our failures than our contributions.

Why We Must Reclaim Macro Now

1. Growth of Clinical Saturation

The clinical track is crowded and growing, but macro concentrations remain limited. As of 2010, less than 20% of MSW students specialized in community organizing or social policy, compared to over half in clinical tracks. Recent data suggests that only about 23% of macro concentrations report growing enrollment, with the rest stagnant or declining.

2. Mismatch Between Interest and Opportunity

A study showed that although many students enter programs interested in macro, 54% who wanted macro roles at admission graduated in clinical concentrations, often because macro tracks weren’t available or they feared lack of licensure.

These trends suggest that macro social work isn’t just under-resourced. It’s being deprioritized.

3. Society Needs More Macro Practitioners

Amid rising mental health crises and social unrest, our role in shaping policy, managing systems, and mobilizing community partnerships is more critical than ever. The profession must rise to the moment and equip macro-focused social workers to lead.

Reclaiming Our Identity

Social work cannot continue to be seen as a field of bureaucrats enforcing broken systems. Our Code of Ethics calls us to more. It calls us to action. To live our values even when difficult. To place justice, equity, and dignity at the center of our practice.

Imagine a profession where the title “social worker” evokes “justice professional.” Imagine conferences that focus on dismantling inequitable systems rather than reimbursement codes. Imagine classrooms preparing students not just for therapy but for program design, community organizing, and policy reform.

This is not a fantasy. The competencies already exist in our accreditation standards. The expectations are there. We simply need the courage to teach them, practice them, and embody them.

Conclusion

The question is no longer whether social work has drifted from its roots. It has. The real question is whether we will correct course.

If we want this profession to thrive, we cannot merely talk about justice. We must embody it. We must live it. Because at its core, social work has never been just another helping profession.

Social work is social justice in professional form.