Bridging the Dichotomy between Micro and Macro Practice in Social Work: A Study of Clinical Social Work Practice with Domestic Violence Survivors

Abstract

This dissertation used qualitative interviews with social workers working with domestic violence (DV) survivors to explore how social workers integrate micro and macro practice in their daily practice. Clinical practice in DV organizations was chosen as the focus of this study because of the heavy influence of social change movement in the development of this practice setting as well as the historical criticism of therapeutic approach to DV as victim-blaming. The findings of this study showed that DV work continues to struggle to categorize its identity between service delivery and grassroots advocacy. Moreover, clinical social workers continue to experience tension between the clinical and non-clinical workers in DV organizations, a by-product of professionalization in the field. Clinical social workers have been attempting to circumvent the tension by conceptualizing therapy as another essential service for DV survivors to address the impact of abuse on these clients' psychological wellbeing. They also attempted to integrate micro and macro practice by building comprehensive, survivor-defined practice models based on existing models such as trauma-informed care model and Transtheoretical model. In addition, they have created alternative mental health service delivery systems in which clinicians explicitly address negative consequences of diagnosing for clients and critically evaluate exiting therapy models while considering power relations as the primary guideline for constructing domestic violence-specific therapy. Finally, working in the DV organizations with social change orientation seemed to influence these social workers' professional identity. Realizing that clinical social work is more than providing therapy, they have adopted advocacy as one their core practice components. By reconnecting clinical social work to social change work, clinical social workers are crossing the boundaries between micro and macro practice, shedding some light on the age old question of how to connect these two practice levels in social work.