Populations and Practice Settings

This chapter summarizes literature and research related to advances in direct practice work with adolescents. Social workers are on the forefront of developing and utilizing a variety of evidence-based practices to address complex client and community needs.

African Americans number about 35 million or 12% of the U.S. population. Their life expectancy is lower than that of White Americans, and despite the educational gains made since mid-1980s, the unemployment gap between African Americans and Whites has increased. Similarly, although the number of African Americans working in white-collar occupations has increased, the disparity in wage earnings between African American and White workers continues. Regardless of social class African Americans are made to be cognizant of their race at all times. Today they are still at risk for social issues such as substance abuse, teen pregnancy, incarceration, poverty, high rates of female headed households, infant mortality that is twice as high as Whites, residential segregation, racism, and discrimination. As daunting as these problems are, the strengths of the African American community have allowed it to thrive even amid arduous circumstances.

Social workers address older adult issues at all levels of service planning, policy-making, and delivery and across a wide range of community and institutional settings. While various models of practice intervention with older adults exist, more recently the focus is on the integration of micro and macro strategies with an emphasis on strength-based perspectives to geriatric social work practice. The older adult population will expand dramatically and become increasingly culturally, racially, and ethnically diverse in the future and social work services will need to be sensitive to the variety of issues faced by a more heterogeneous and sophisticated older adult population.

Alaska Natives represent less than 1% of the U.S. population but reside in more than 229 Native villages and account for 40% of federally recognized tribes. Most Alaska Native communities shared common Euro-American contact experiences: exposure to western religions, education, and disease. Historical trauma contributes to many of the social welfare problems Natives experience today: low educational attainment, unemployment, inadequate health care, substance abuse, and violence. Service delivery mechanisms, lack of cultural appropriateness, and isolation compound these pressing issues. Locally delivered social welfare services that take into account traditional Native worldviews, values, languages, and intergenerational relationships are effective in addressing many of these issues.

This entry describes the diversity among Asian American populations, setting the context to understand the need for different practice interventions. It explains the role of cultural values in the underpinnings of the selection of theoretical frameworks that guide chosen practice interventions. Indigenous and biculturalizations of interventions (Fong, Boyd, & Browne, 1997) are discussed as they relate to general and specific problems relevant to this population. Challenges and dilemmas are raised as ethical decisions are made among practitioners, who serve the Asian American native born, immigrant, and refugee populations.

Social workers are increasingly working in authoritative settings—that is, settings where they have the power to mandate conformity by the client to the normative and often legal requirements of the organization. Such settings may be residential, such as jails, prisons, and rehabilitation facilities, or community-based organizations that are part of the criminal justice system, the mental health system, the health system, and the child welfare system. The exercise of power derived from the authority vested in the setting’s objectives may and often does alter the total life situation of an individual, such as when a client is compelled to move to supervised care without the client’s consent. Under an outpatient civil commitment order or mental health court supervision, the patient may be told where to live and with whom to associate as well as be required to participate in interactive treatment and to take medication. In authoritative settings, social workers are working with “involuntary” clients—clients who understand, whether or not it is explicitly stated, that the social worker possesses the power to effect unwanted change in their life circumstance. Since the early 1990s, the field has been developing new ideas and skills that are equally useful in working with voluntary and involuntary clients. In the process, social worker authority is now viewed less as a way to gain client compliance and, instead, is understood more as an opportunity to build partnerships with clients that lead to changes that are enduring and more meaningful to clients.

Cognitive therapy is a perspective on social work intervention with individuals, families, and groups that focuses on conscious thought processes as the primary determinants of most emotions and behaviors. It has great appeal to social work practitioners because of its utility in working with many types of clients and problem situations, and its evidence-based support in the literature. Cognitive therapies include sets of strategies focused on education, a restructuring of thought processes, improved coping skills, and increased problem-solving skills for clients.

Private independent practice (known historically as private practice) is a growing segment of the social work profession. Social workers entering this context are providing a range of services, including clinical and nonclinical. Major considerations for establishing, maintaining, and marketing a successful and ethical private independent practice will be discussed. Existing tensions and challenges in the social work profession and in the field of social work education will be briefly examined. Future directions for private independent practice of social work will be explored.