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ORIGINAL PAPER
Educating a New Generation of Social Workers:Challenges and Skills Needed for ContemporaryAgency-Based Practice
Diane M. Mirabito
Published online: 30 December 2011
� Springer Science+Business Media, LLC 2011
Abstract Schools of social work are continually chal-
lenged to provide professional training which effectively
prepares students for the ever-changing and increasingly
demanding contemporary practice context. This paper
provides an overview of emerging clinical, organizational,
and research trends and challenges within agency-based
social work practice in the past decade. Implications of
these changes for the profession will be discussed and
recommendations will be offered for ways in which aca-
demic and field educators can best equip social work stu-
dents with the skills needed to meet these challenges of the
current agency-based practice context. These recommen-
dations for social work practice, education, and research
include the development of an integrated set of clinical,
organizational, and research skills; directions for curricu-
lum renewal and expansion; and academic field partner-
ships for future research.
Keywords Contemporary agency-based practice �Social work skills � Challenges � Trends �Recommendations for social work education
Introduction
Schools of social work are continually challenged to pro-
vide professional training which effectively prepares stu-
dents for the ever-changing and increasingly demanding
contemporary practice context. Significant growth and
changes in specific areas of practice such as aging (Baskind
and Briar-Lawson 2005; Berkman et al. 2000, 2005; Geron
et al. 2005; Silverstone 2005), employment (Reisch and
Gorin 2001) schools (Bailey 2000; Franklin 2000, 2005;
Frey and Dupper 2005; Greene and Lee 2001), health care
(Bronstein et al. 2007; Keefe et al. 2009; Pecukonis et al.
2003; Vourlekis et al. 2001), and mental health (Johnson
2001; Newhill and Korr 2004) necessitate that social work
education focus on new areas of content and skills (Allen-
Meares 2000; Pomeroy 2009, 2010).
Challenges in academic and field education are descri-
bed in studies focused on the impact on social work
practice and training of agency organizational changes,
heightened attention to evaluation of practice effectiveness,
and managed care (Birkenmaier et al. 2008; Bogage et al.
1995; Bogo 2005; Brooks and Riley 1996; Raskin and
Blome 1998). As client problems have become increas-
ingly more complicated, agency resources for service
delivery and training have dramatically decreased.
Recommendations have been made for ways in which
academic programs can keep pace with these changes in
the field (Berger and Ai 2000; Hoge et al. 2004; Jarman-
Rohde et al. 1997; Lager and Robbins 2004; Reisch and
Jarman-Rohde 2000; Strom and Gingerich 1993; Strom-
Gottfried and Corcoran 1998). These authors underscore
the need for students to gain skills in comprehensive and
rapid assessments; short-term, time-limited and problem-
focused interventions; cognitive-behavioral social skills
training; discharge planning; continuity of care; psycho-
educational groupwork; case management; multidisciplin-
ary teamwork strategies; organizational change; and
outcome evaluation. Berger and Ai (2000) recommended
that social work practitioners and students thoroughly learn
about the complex administrative issues in managed care
systems, including fiscal management, cost containment,
and reimbursement.
D. M. Mirabito (&)
New York University Silver School of Social Work,
1 Washington Square North, New York, NY, USA
e-mail: [email protected]
123
Clin Soc Work J (2012) 40:245–254
DOI 10.1007/s10615-011-0378-6
Similarly, in a 2001 study which projected practice
trends for the next 5 years, 59 field educators across fields
of practice and settings reported that while client problems
were becoming more severe and staff caseloads were
increasing, client services, programs, and resources were
shrinking. As a result, social work practitioners and stu-
dents were being asked to ‘‘do more with less’’. They
reported that the impact of managed care had resulted in
not only significantly fewer services for clients, but, most
notably, greater restrictions placed upon clients eligible to
obtain services from students-in-training. Further, field
educators reported that agencies and organizations experi-
enced continual change and flux, marked by increased
financial instability, staff reorganization, downsizing,
turnover, and reduced supervision for practitioners and
students. These changes led to increased demands for
social workers, at all levels, to understand accountability
and reimbursement issues related to the funding and
delivery of services and increased expectations to evaluate
and demonstrate the effectiveness of interventions and
services in order to justify, maintain, and expand funding
(Mirabito 2001).
The social work literature notes the rapidly changing
nature of social work practice, stressing the need for aca-
demic programs to continually seek empirical information
about current practice trends in the field in order to remain
relevant (Bogo 2005; Jarman-Rohde et al. 1997; Lager and
Robbins 2004; Shera and Bogo 2001). Building on existing
knowledge about the future of social work practice, this
paper provides an overview of emerging clinical, organi-
zational, and research trends and challenges within agency-
based social work practice in the past decade. Implications
of these changes for the profession will be discussed and
recommendations will be offered for ways in which aca-
demic and field educators can best equip social work stu-
dents with the skills needed to meet these challenges of the
current agency-based practice context. These recommen-
dations for social work practice, education, and research
include the development of an integrated set of clinical,
organizational, and research skills; new directions for
curriculum renewal and expansion; and academic-field
partnerships for future research.
Trends, Challenges and Skills for Agency-Based Social
Work Practice
Clinical Trends, Challenges, Skills
In the past decade, new trends and challenges in agency-
based social work practice have emerged as a result of
numerous social, political, economic, and educational
changes nation-wide and within the social work profession.
Changes include national and international disasters, the
wars in Iraq and Afghanistan, continued flux within agen-
cies and organizations, demographic shifts, a new admin-
istration in Washington, adoption of new healthcare policy,
the economic recession, unprecedented technological
advances, and the prominence of evidence-based practice
as a major focus of attention and debate within the social
work profession (Pomeroy 2009, 2010).
As a result of the changing social, political, and eco-
nomic landscape, new populations have emerged as pri-
orities for social work practice and new practice
approaches have developed to respond to these popula-
tions-at-risk. Due to shifting demographic trends, social
work practice with older adults and their families has
become a major focus of practice in a range of health and
community-based settings (Baskind and Briar-Lawson
2005; Berkman et al. 2005; Pecukonis et al. 2003). More-
over, Geron et al. (2005) indicate that as a result of the
increase in intergenerational families, skills in practice
with older adults will be needed across all fields of prac-
tice, including health and mental healthcare, schools, child
welfare, and family services.
Other populations-at-risk include increasingly diverse
youth who may be immigrants, teen parents, gay/lesbian/
bisexual/transgender, and homeless (Franklin 2005); vet-
erans and their families (Pomeroy 2009, 2010); individuals
who experience the impact of the economic recession, such
as those who are living in poverty, the unemployed and
disabled, homeless adults and families (Pomeroy 2009);
and those impacted by chronic mental illness, substance
abuse, AIDS, domestic violence, and child abuse. Dra-
matically increasing immigrant populations have created
an even greater need for cultural sensitivity and compe-
tence in working with varied racial and ethnic groups
(Lager and Robbins 2004).
Since the national crisis of September 11, 200l, social
work services have increasingly addressed people who
have experienced a wide variety of disasters including
hurricanes, school and violent mass shootings, and other
public emergencies (Patterson 2009). Disaster mental
health has become an area of expertise for social work
practitioners across all fields of practice (Callahan 2009;
Carp 2010; Rosenthal-Gelman and Mirabito 2005; Mirab-
ito and Rosenthal 2002; Pomeroy 2009). Carp (2010)
emphasizes that this work requires social workers to
develop additional skills and an enlarged vision of practice
which focuses on the strengths and resilience of the indi-
viduals, organizations, and communities that have experi-
enced chaos. Patterson (2009) highlights the need for skills
in the provision of both micro interventions for victims and
survivors of disaster and collaboration with first responders
as well as macro interventions to intervene with complex
systems and entire communities.
246 Clin Soc Work J (2012) 40:245–254
123
Emerging practice trends throughout the past decade
include approaches which focus on health promotion,
wellness, and disease prevention across fields of practice
(Berger 2000), such as with older adults (Berkman et al.
2005), in healthcare (Pecukonis et al. 2003; Vourlekis et al.
2001), and schools (Franklin 2005; Frey and Dupper 2005);
neurobiological approaches to address co-occurring mental
health and substance abuse disorders (Johnson 2001); use
of the internet for on-line, or ‘‘e-therapy’’, counseling and
support to clients (Giffords 2009, p. 414); the recovery
movement; culturally relevant services (Hoge et al. 2004);
and the proliferation of evidence-based approaches within
all fields of practice.
Several studies conducted with field educators describe
significant changes in agency-based social work practice
and identify clinical skills that social work students need in
order to meet these practice challenges. In a study con-
ducted with 59 field educators from 42 field settings,
Mirabito (2001) reported that clinical skills needed for
agency-based practice included broadly defined clinical
practice; practical, diverse intervention strategies; and
flexible, creative, versatile practice. Field educators
emphasized that students need to broaden their definition of
‘‘clinical’’ social work to encompass a wide spectrum of
activities including outreach, home visits, advocacy, case
management, and program development. They conveyed
strong convictions that students need to know how to
conceptualize and value these activities as integral com-
ponents of ‘‘clinical’’ social work and to appreciate the
need for interventions that integrate clinical and concrete
approaches. Further, they believed that the combination of
clinical and concrete interventions may be more valuable to
clients than the ‘‘50-min psychotherapy hour’’. They
described the challenges of teaching students to appreciate
that each contact with a client, whether in the context of a
home visit, a school hallway, or a structured psychothera-
peutic setting, was valuable and required that they think
clinically.
The themes about clinical practice reported in this study
are supported by Goldstein’s (2007) description of clinical
social work which ‘‘… encompasses a broad knowledge
base, diverse practice roles and a wide range of interven-
tions’’ (p. 15). Similarly, Homonoff (2008), in a qualitative
study of 10 ‘‘master’’ field instructors, reported that social
work students were taught a wide variety of skills, ranging
from clinical interviewing to fundraising, program plan-
ning, and advocacy.
In a study conducted with 31 field instructors from 29
agencies, Birkenmaier et al. (2008) found that as a result of
time constraints in agency environments characterized by
short-term treatment, it was critical for social work students
to develop accurate and effective assessment and DSM-IV
diagnostic skills. Further, these authors reported that
students provided case management, crisis intervention,
short-term treatment, group therapy and advocacy more
often than individual, couple and family treatment.
Mirabito (2001) reported that field instructors believed it
was more useful for students to possess skills in cognitive
behavioral, crisis intervention, short-term treatment, and
pragmatic, rehabilitative, ‘‘reality-oriented’’ services such
as anger management and activities of daily living, than
skills in insight-oriented psychotherapy.
Bronstein et al. (2007) conducted a study with one
hundred seventy-nine social workers in healthcare settings
which sought to identify critical skills to be taught in social
work programs in order to prepare students for effective
practice in health care. They found the most important
areas of direct practice knowledge and skills to be brief
treatment models, case management, crisis intervention,
ethics, death/dying, and grief/loss.
Organizational Trends, Challenges, Skills
Throughout the decade, agencies and organizations have
been dramatically influenced by welfare reform and man-
aged care. As a result, more time and resources are now
focused on generating revenue, and evaluating and docu-
menting services delivered (Rubio et al. 2000). Birkenmaier
et al. (2008) describe the changing environment for non-
profit agencies, including the devolution of services from
federal to state governments, the decline of federal and state
funding, structural changes such as downsizing, merging,
decentralizing, and shifting to less costly outpatient and
home-based services, and significantly increased require-
ments for accountability, with reimbursement policies
increasingly driving practice decisions.
Several studies have addressed the challenges inherent
in negotiating within organizations, and recommend the
skills that are needed for social work students to work
effectively within complex and ever-changing organiza-
tional contexts. Mirabito (2001) identified the key organi-
zational skills needed as negotiating within complex
systems, interdisciplinary leadership skills, and knowledge
about administration and reimbursement of services. Field
educators in this study emphasized that students need a
solid understanding of organizational dynamics and change
in order to work effectively within systems and to be
change agents within agencies and the larger community.
They also cited the need for strong leadership and inter-
disciplinary collaborative skills, to assume a central role in
educating other professionals about psychosocial issues. In
response to increased demands for accountability and
documentation, field educators reported that students nee-
ded to be knowledgeable about the ‘‘business’’ aspects of
agency life and to understand how services are adminis-
tered, regulated, reimbursed, and funded.
Clin Soc Work J (2012) 40:245–254 247
123
Kane (2004) emphasized that social workers will need
specialized knowledge and skills to navigate the managed
care system and well-developed advocacy skills to nego-
tiate complicated utilization review systems. Further,
Bransford (2005) suggested that social workers will need
skills in organizational change to be able to develop
strategies to challenge managed care policies within
organizations.
In their study exploring how to best prepare social
workers for practice in health care settings, Bronstein et al.
(2007) found that the three most important areas of
knowledge and skills pertaining to organizational practice
in healthcare settings included teamwork—communication
with colleagues, knowledge of other disciplines’ training,
and teambuilding leadership; organizational dynamics; and
accreditation and business-related content pertaining to
health outcomes, health care financing, reform and reim-
bursement. Similarly, in a subsequent study conducted by
Birkenmaier et al. (2008), field instructors reported that
social work students need knowledge and skills about
agency contexts in order to work effectively in the political
climate of organizations and leadership skills to work in
multidisciplinary settings.
These findings from research conducted with field edu-
cators throughout this decade suggest the value of teaching
social work students a set of ‘‘organizational skills’’ which
are needed to understand, assess, and negotiate within
organizational settings, and for interdisciplinary collabo-
ration, leadership, and interpersonal communication.
Bronstein (2003) identified interdisciplinary collaboration
as ‘‘imperative’’ (p. 304) for effective social work practice
across all fields of practice, particularly in multidisciplinary
settings. In healthcare settings, Vourlekis et al. (2001)
recommended that social work students ‘‘be skilled and
self-confident collaborators and communicators with other
health care professionals, capable supervisors and trainers
of other personnel, and workers prepared to exercise lead-
ership in program development and marketing’’ (p. 188).
Franklin (2005) maintained that since school social workers
have expertise to work with all kinds of diversity, including
racial, ethnic, religious, sexual, and political, they should be
‘‘diversity specialists’’ (p. 175) for the school community,
who can be called upon to train and guide other school
professionals to effectively work with diverse student
populations.
Research Trends, Challenges, Skills
Over the past decade, there have been major advances in
the field of social work to address the issue of practice
effectiveness. Across all fields of practice, attention has
been directed to learn how to find, and utilize, the best
available evidence about the outcomes of social work
practice (Drake et al. 2007; Thyer 2008). The emerging
trend toward implementation of evidence-based practice
in ‘‘real-world’’ agency and community settings is an
important challenge and change in this decade.
The environment within agencies of cost containment,
accountability, and evaluation has intensified over the past
decade. As the service delivery system has become
grounded in outcomes and goal attainment, evaluation and
documentation play a vital role in service delivery (Bir-
kenmaier et al. 2008). Further, as evaluation of practice is
conducted on a regular basis, agencies seek social work
students and staff with performance and practice-based
research skills to evaluate, demonstrate, and document the
outcomes of interventions and services (Mirabito 2001) and
to facilitate program and treatment evaluation (Birkenma-
ier et al. 2008).
Reimbursement for services requires that social workers
demonstrate and document treatment outcomes. Increas-
ingly, outcome data is required, as evidence that practice
approaches yield positive results. Such demands for
accountability necessitate that social workers develop
strong skills in measuring the effectiveness of interventions
and services. Research skills are necessary to determine the
most effective and efficient services for various problems,
to develop more valid and reliable measures for evaluating
outcomes, and to evaluate and demonstrate practice
effectiveness (Franklin 2005). Table 1 provides an over-
view of the clinical, organizational, and research trends of
the past decade and the social work skills needed to address
these trends.
Implications and Recommendations for Social Work
Practice, Education, and Research
An Integrated Set of Skills for Agency-Based Social
Work Practice
Social Work literature in the past decade underscores the
need for a broad repertoire of clinical, organizational,
research, communication, technological, and critical
thinking skills to meet the demands of contemporary
agency-based social work practice. This integrated set of
social work skills includes broadly and flexibly defined
clinical and programmatic skills to serve disenfranchised
populations and negotiate within complex agency, organi-
zational and community environments; communicate
effectively verbally and in writing; and conduct practice-
based research and program evaluation.
Given the realities of contemporary practice, strong
clinical skills are essential, but not sufficient, for effective
agency-based social work practice. The integrated set of
social work skills needed includes clinical skills which
248 Clin Soc Work J (2012) 40:245–254
123
utilize the person-in-situation (Goldstein 2007; Simpson
et al. 2007), diverse conceptual frameworks and treat-
ment strategies (Goldstein 1996), and a ‘‘contemporary’’
biopsychosocial perspective (Simpson et al. 2007). The
necessary clinical skills include case management, group-
work, advocacy, evidence-based practice and cultural
competence to work with diverse, vulnerable populations.
These critically important clinical skills need to be com-
bined with political skills for analyzing and negotiating
difficult organizational environments and engaging in
‘‘systems work’’ as well as skills in interdisciplinary
teamwork, collaboration and leadership. The changing
Table 1 Clinical, organizational, and research trends affecting agency-based practice, 2000–2010: social work skills for contemporary practice
Trends affecting agency-based practice Social work skills
Clinical • Changing demographics
• Impact of war, economic recession, global disasters
• Impact of HIV/AIDS, poverty, domestic violence, chronic
mental illness, child abuse
• Increasing diversity
• Expertise with priority populations
Aging adults/families
Diverse youth/families
Veterans
Disabled
Poor
Unemployed
Immigrants
Racially/culturally diverse clients
Chronically mentally ill
• Mental health recovery movement • Broadly defined clinical practice
• Practical, diverse, flexible, creative, versatile, measurable
interventions
• Increased service needs/shrinking resources
• Continued impact of managed care
• Proliferation of evidence-based practice models
• Focus on health promotion/disease prevention/wellness
• Clinical skills
Assessment
Crisis intervention
Case management
Short/Long-term interventions
Evidence-based practice
Disaster mental health
Health promotion
Ethical and critical thinking
Organizational • Changing agency contexts
Devolution of services
Decline of funding
Downsizing
Reorganizations
Decentralizing
Increased requirements for accountability
• Impact of welfare reform & managed care
• Increased demands to generate revenue and document/
evaluate services
• Organizational skills
Understand, assess, negotiate complex, organizational
dynamics and systems
Interdisciplinary leadership/communication/collaboration
Teambuilding
Knowledge re: accountability, reimbursement,
documentation of services
Program development
Grant writing
Organizational change
Systems advocacy
Diversity management
Community education
Verbal/written communication and technological skills
Research • Heightened attention to evaluation of practice effectiveness
• Development of most effective and efficient services
• Implementation of evidence-based practice models
• Evaluate, demonstrate, document intervention and service
outcomes
• Performance and practice-based research skills
• Evidence-based practice skills to search, retrieve, evaluate and
apply evidence in practice
Clin Soc Work J (2012) 40:245–254 249
123
organizational environment presents unique opportunities
for social workers to take leadership roles in shaping and
developing services and programs. Social workers must
maintain a strong identity to contend with the potential
encroachment of other professions.
Hoge et al. (2004) refer to this integrated set of skills as
‘‘Clinical, Clinical Management, and Administrative’’
(p. 98). In this typology, clinical skills include problem-
oriented treatment planning, effective communication and
collaborative decision-making with consumers and fami-
lies, and a repertoire of highly diverse interventions such as
rehabilitative, recovery-oriented approaches as well as
preventive and community education strategies. Clinical
management skills include interdisciplinary collaboration,
advocacy, coordination of care across modalities, mea-
surement of outcomes, and implementation of quality
improvement techniques. Administrative skills focus on
abilities to negotiate and interface regarding the utilization
review process and maintain adherence to documentation
and compliance requirements.
Curricula Renewal, Revision and Expansion
Findings from the literature of the past decade suggest the
need for continued curriculum renewal, revision, and
expansion in social work programs. To ensure that social
work students are trained effectively for contemporary
agency-based practice, there is a need for continual devel-
opment, updating, and revision of curricula focused on an
integrated set of clinical, organizational, research, com-
munication, and technical skills. According to Birkenmaier
et al. (2008), ‘‘Students must be able to succeed in a fast-
paced and resource-scarce nonprofit environment by gain-
ing knowledge and skills in case management, crisis inter-
vention, short-term treatment and group therapy’’ (p. 143).
These authors also recommend curriculum development
in areas of practice evaluation, accurate, efficient docu-
mentation skills, grant writing, program design, and
fundraising.
Bronstein et al. (2007) recommend further training in
the political and business aspects of working within orga-
nizations. Specifically, they emphasize the need for skills
to navigate the complex challenges of managed care and
accountability as well as sophisticated advocacy skills to
obtain services for clients. Vourlekis et al. (2001) suggest
that practice courses should ‘‘prepare students with
administrative, leadership, and practice accountability
skills’’ (p. 188).
Homonoff (2008) reported that although field instructors
were teaching skills of case management to students, these
instructors did not believe that social work schools placed
adequate emphasis on teaching these skills in the class-
room. Hoge et al. (2004) provide guidelines for education
and training in mental health and addiction services, which
include the development of competency with manualized
therapies and the use of teaching methods which are evi-
dence-based. Clements (2008) reports that many students
do not obtain adequate groupwork education in graduate
school and recommends continued groupwork experiences
in the classroom and further training for field instructors in
groupwork.
Equally important in social work curriculum develop-
ment are skills in communication, the use of computer and
technological literacy, as well as ethical and critical
thinking. Excellent verbal and written communication
skills are essential for effective social work practice with
clients to document clinical practice and to write proposals
(Alter and Adkins 2006; Mirabito 2001). Alter and Adkins
(2006) believe that students must possess the ability to
clearly express their professional judgments and provide
compelling arguments to persuade policy makers, funders,
and other professionals in order to advocate effectively for
their clients. Richards et al. (2005) maintain that inade-
quate attention has been paid to the importance of com-
munication skills training for the contemporary practice
environment. These authors advocate for the training of
verbal and non-verbal communication skills including
writing; interviewing, information gathering, and investi-
gative skills; and skills to communicate effectively with
professionals from varying disciplines and with those who
command higher status, power, and influence.
Parker-Oliver and Demiris (2006) recommend that
schools of social work equip faculty and students with
technological skills across curriculum areas, such as
teaching groupwork skills which can be applied to online
groupwork practice. They further advocate that students
gain an understanding of how various types of clients can
benefit from technology, how and when to use various
technologies, and how to measure the effectiveness of
practice which utilizes technology for intervention. Stu-
dents also require well-developed technological skills to
manage computerized systems of client services (Mirabito
2001).
Finally, of equal importance are skills in critical and
ethical thinking, to integrate clinical, organizational, and
research knowledge, and to apply these integrated skills
to new and constantly changing practice challenges.
Bransford (2005) recommends further incorporation of
critical thinking skills in the curriculum to better equip
students to be effective client advocates for social justice in
managed care contexts.
Emerging areas which present new challenges in ethical
decision-making include complex end-of-life choices in
healthcare, and with older adults; managing the interdis-
ciplinary team (Bronstein et al. 2007; Keefe et al. 2009);
and issues regarding communication of information and
250 Clin Soc Work J (2012) 40:245–254
123
confidentiality in the context of technological advances
(Brill 2001; Lager and Robbins 2004; Pomeroy 2009). In
addition, ethical challenges related to the quality of care in
service provision have resulted from larger caseloads,
limited resources, and restrictions imposed by managed
care and accountability demands (Brill 2001).
Training for Evidence-Based Practice in Classroom
and Field Settings
Drake et al. (2007) recommend that training in evidence-
based practice be infused throughout the curriculum, so
that students obtain skills in phrasing empirically answer-
able questions, and learn how to search for, evaluate, and
apply empirical evidence in their practice. Wheeler and
Goodman (2007) believe that social work students need
additional skills in the retrieval, evaluation, and synthesis
of information for decision-making in clinical social work
practice. Woody et al. (2006) address the importance for
field supervisors and instructors to be actively involved in
curriculum development and agency-based training in
evidence-based practice and evidence-supported interven-
tions. Finally, Howard et al. (2007) advocate that schools
of social work provide field instructors with training in
evidence-based practice methods and provide access to
websites with links to searchable computerized biblio-
graphic databases in order to enhance the ability of social
work students to deliver treatments that are supported by
research evidence.
Training social work students in the use of evidence-
based practice models and the implementation of these
models in ‘‘real world’’ agency settings pose significant
challenges for both academic and field educators. A sig-
nificant challenge remains to educate and train faculty and
field educators about the value and benefits of evidence-
based practice models, and the ways in which these
approaches are consistent with social work values and
ethics, provide quality services to clients, and improve
service delivery. Thyer (2008) recommends the adoption of
‘‘an evidence-based approach to social work education’’
(p. 343) which involves students, practitioners, and
researchers learning to ask ‘‘answerable questions’’ related to
assessment and intervention, finding the best available evi-
dence, critically apprising it, integrating this knowledge with
client circumstances, making the best decisions about inter-
ventions, and evaluating the success of these interventions.
Educating faculty, agency administrators, field instruc-
tors, and students in evidence-based practice methods both
in classroom and field settings will take considerable time,
attention, and resources and it is likely that the imple-
mentation of this training will be a gradual and incremental
process. Faculty, agency-based practitioners, and field
educators who have expertise in and utilize evidence-based
models in agency settings can train colleagues and students
in the use of these models in agency-based practice.
Learning about and implementing evidence-based practice
models needs to be an integral component of instruction
across curriculum areas. Collaborative partnerships are
needed between faculty and agency field educators to
obtain funding for the use of evidence-based models in
agency settings for student training.
The goal of training and implementing evidence-based
practice models in real world agency settings will involve
significant commitment, funding, and support from faculty,
agency administrators, and field instructors, to train stu-
dents in implementing evidence-based practice models. As
suggested by Wheeler and Goodman (2007), advancing
knowledge development and implementing evidence-based
practice within the social work profession, requires bring-
ing together academics and practitioners with experience
about ‘‘real-world’’ conditions of agencies. In order for this
collaboration to succeed, faculty must partner with agency
administrators, practitioners, and field educators in a more
comprehensive and systematic way. Those social work
educators in academic and field settings with expertise and
experience in the use of evidence-based practice models
are well positioned to lead the training effort needed which
can ultimately benefit the profession by providing clients
and communities with effective services (Woody et al.
2006).
Balancing Clinical, Organizational and Research
Content in Curricula Development
A broad range of clinical, organizational, and research
skills are needed for future generations of social workers to
effectively engage in contemporary agency-based social
work practice. Integrating these skills presents challenges
for the development of curricula in social work education.
A fundamental challenge is how to incorporate each of the
three areas of curriculum content—clinical, organizational,
and research—in ways which achieve breadth while also
maintain depth and integrity of each discrete area. One
example is the need to teach clinical and critical thinking
skills while simultaneously balancing attention to organi-
zational, technological, and evaluation skills. Clear balance
and integration within the four areas of the social work
curriculum—Practice, HBSE, Policy, and Research—are
needed to ensure that the content taught in all of these areas
is coupled with integration across curriculum areas.
As discussed in this paper, strong and effective clinical
skills remain essential to meet current practice challenges
in agency-based settings. Equally important, as supported
by the literature reviewed in this paper, is the need to
combine strong clinical skills with competence in negoti-
ating, and thriving, in complex organizations. Teaching
Clin Soc Work J (2012) 40:245–254 251
123
students how to develop ‘‘organizational’’ skills can be
strengthened by further utilizing and integrating experi-
enced field educators in classroom settings and through
course assignments which focus not only on effective
practice with clients, but also on learning how to intervene
effectively within organizations.
Table 2 provides an overview of the key recommendations
for social work practice, education, and research discussed.
Conclusions and Directions for Future Research
This paper has highlighted current knowledge about the
changing context in agency-based social work practice. In a
review of the social work literature of the past decade,
significant changes and shifts have been identified in
populations-at-risk and priorities for practice, which have
important implications for social work education. Con-
straints and challenges in service provision created by the
ever-changing context of cost containment and limited
funding in agencies has endured and intensified over the
past decade. This context creates the need for social work
students to be equipped with a complex set of skills which
cross clinical, organizational, and research domains.
Likewise, the need for this merged skill set challenges
academic and field educators to integrate these skills within
practice, policy, research, and human development areas of
the social work curriculum. For example, while there may
be a need for social work educators to teach further short-
term and crisis intervention content, they will be
challenged to simultaneously equip students with the
ability to make in-depth biopsychosocial assessments and
to understand when to use short-term versus long-term
interventions.
The broad changes in practice throughout the past dec-
ade, as reviewed in this paper, suggest the need for future
research initiatives as a means to incorporate new knowl-
edge about trends and needs in all fields of practice to
ensure that the academic curricula in schools of social work
continue to be relevant to the demands of agency-based
social work practice. These changes in practice suggest the
need for academic and field educators to partner in con-
ducting ongoing research concerning the changing needs
and challenges within the field. Future field-based research
is needed that explores the skills required for contemporary
practice. This is best accomplished by utilizing field edu-
cators’ perceptions regarding current practice trends and
challenges. Such studies will enable schools of social work
to strengthen academic-field linkages, inform, renew, and
maintain the integrity of the curricula, and better prepare
students for the realities of the constantly changing and
increasingly challenging context of agency-based social
work practice.
References
Allen-Meares, P. (2000). Our professional values and the changing
environment. Journal of Social Work Education, 36(2), 179–182.
Alter, C., & Adkins, C. (2006). Assessing student writing proficiency
in graduate schools of social work. Journal of Social WorkEducation, 42(2), 337–354.
Bailey, A. (2000). A primer on school-based mental health practice:
Lessons from the literature. Smith College Studies in SocialWork, 70(2), 239–254.
Baskind, F., & Briar-Lawson, K. (2005). Advancing social work with
older adults. Families in Society, 86(3), 424–430.
Berger, C. (2000). Managed care: Challenges to survival and
opportunities for change. Smith College Studies in Social Work,71(1), 19–23.
Berger, C. S., & Ai, A. (2000). Managed care and its implications for
social work curricula reform: Clinical practice and field instruc-
tion. Social Work in Health Care, 31(3), 83–106.
Berkman, B., Gardner, D., Zodikoff, B., & Harootyan, L. (2005).
Social work in health care with older adults: Future challenges.
Families in Society, 86(3), 329–337.
Berkman, B., Silverstone, B., Simmons, J., Volland, P., & Howe, J.
(2000). Social work gerontological practice: The need for faculty
development in the new millennium. Journal of GerontologicalSocial Work, 34(1), 5–23.
Birkenmaier, J., Mcgartland Rubio, D., & Berg-Weger, M. (2008).
Human service nonprofit agencies: Studying the impact of policy
changes. Journal of Social Work, 2(2), 133–147.
Bogage, M., Homonoff, E., & Riley, P. (1995). Measuring the impact
of the fiscal crisis on human services agencies and social work
training. Social Work, 40(5), 701–705.
Bogo, M. (2005). Field instruction in social work: A review of the
research literature. The Clinical Supervisor, 24(1/2), 163–193.
Table 2 Recommendations for social work practice, education, and
research
Curriculum renewal, revision, and expansion
• Integrated social work skills
Clinical
Organizational
Research
Communication
Technological
Critical Thinking
• Balance and integration of clinical, organizational, and research
content in the MSW curriculum
Implementation of evidence-based practice models inclassroom and field settings
• Training for faculty, field instructors, students in evidence-based
practice models
• Training, resources, and technical assistance to support
utilization of evidence-based practice models in field settings
Academic/field partnerships
• Future research initiatives to incorporate ongoing trends and
needs in agency-based practice into the MSW curriculum
252 Clin Soc Work J (2012) 40:245–254
123
Bransford, C. (2005). Conceptions of authority within contemporary
social work practice in managed mental health care organiza-
tions. American Journal of Orthopsychiatry, 75(3), 409–420.
Brill, C. (2001). Looking at the social work profession through the
eye of the nasw code of ethics. Research on Social WorkPractice, 11(2), 223–234.
Bronstein, L. (2003). A model for interdisciplinary collaboration.
Social Work, 48(3), 297–306.
Bronstein, L., Kovacs, P., & Vega, A. (2007). Goodness of fit: Social
work education and practice in health care. Social Work inHealth Care, 45(2), 59–76.
Brooks, D., & Riley, P. (1996). The impact of managed health care
policy on student field training. Smith College Studies in SocialWork, 66(3), 307–316.
Callahan, J. (2009). School-based crisis intervention for traumatic
events. In C. Massat, R. Constable, S. McDonald, & J. Flynn
(Eds.), School social work: Practice, policy and research, 7thedition, chapter 34 (pp. 638–661). Chicago: Lyceum Books, Inc.
Carp, J. (2010). Resiliency: The essence of survival in chaos.
Families in Society, 91(3), 266–271.
Clements, J. (2008). Social work students’ perceived knowledge of
and preparation for groupwork practice. Social Work withGroups, 31(3–4), 329–346.
Drake, B., Hovmand, P., Jonson-Reid, M., & Zayas, L. (2007).
Adopting and teaching evidence-based practice in master’s-level
social work programs. Journal of Social Work Education, 43(3),
431–446.
Franklin, C. (2000). Predicting the future of school social work practice
in the new millennium. Social Work in Education, 22(1), 3–7.
Franklin, C. (2005). The future of school social work practice:
Current trends and opportunities. Advances in Social Work, 6(1),
167–181.
Frey, A., & Dupper, D. (2005). A broader conceptual approach to
clinical practice for the 21st century. Children and Schools,27(1), 33–44.
Geron, S., Andrews, C., & Kuhn, K. (2005). Infusing aging skills into
the social work practice community: A new look at strategies for
continuing professional education. Families in Society, 86(3),
431–440.
Giffords, E. (2009). The internet and social work: The next
generation. Families in Society, 90(4), 413–418.
Goldstein, E. (1996). What is clinical social work? Looking back to
move ahead. Clinical Social Work Journal, 24(1), 89–104.
Goldstein, E. (2007). Social work education and clinical learning:
Yesterday, today, and tomorrow. Clinical Social Work Journal,35, 15–23.
Greene, G. T., & Lee, M. Y. (2001). School social workers and
students’ mental health: Current trends and innovative programs.
Children and Schools, 23(1), 3–5.
Hoge, M., Leighton, H., & O’Connell, M. (2004). Best practices in
behavioral workforce education and training. Administration andPolicy In Mental Health, 32(2), 91–106.
Homonoff, E. (2008). The heart of social work: Best practitioners rise
to challenges in field instruction. The Clinical Supervisor, 27(2),
135–169.
Howard, M., Allen-Meares, P., & Ruffolo, M. (2007). Teaching
evidence-based practice: Strategic and pedagogical recommen-
dations for schools of social work. Research on Social WorkPractice, 17(5), 561–568.
Jarman-Rohde, L., McFall, J., Kolar, P., & Strom, G. (1997). The
changing context of social work practice: Implications and
recommendations for social work educators. Journal of SocialWork Education, 33(1), 29–46.
Johnson, H. (2001). Neuroscience in social work practice and
education. Journal of Social Work Practice in the Addictions,1(3), 81–102.
Kane, M. N. (2004). Correlates of preparedness among MSW students
for ethical behavior in us managed care environments. SocialWork Education, 23(4), 399–415.
Keefe, B., Geron, S., & Enguidanos, S. (2009). Integrating social
workers into primary care: Physician and nurse perceptions of
roles, benefits, and challenges. Social Work in Health Care,48(6), 579–596.
Lager, P., & Robbins, V. (2004). Field education: Exploring the
future, expanding the vision. Journal of Social Work Education,40(1), 3–11.
Mirabito, D. (2001). Wisdom from the field: Field instructors’
perceptions of skills needed for social work practice. Unpub-
lished Report.
Mirabito, D. M., & Rosenthal, C. (2002). Generalist practice in thewake of disaster: September 11th and Beyond. Belmont, CA:
Wadsworth/Thomson Learning.
Newhill, C., & Korr, W. (2004). Practice with people with severe
mental illness: Rewards, challenges, burdens. Health and SocialWork, 29(4), 297–305.
Parker-Oliver, D., & Demiris, G. (2006). Social work informatics: A
new specialty. Social Work, 15(2), 127–134.
Patterson, G. (2009). an examination of evidenced-based practice
interventions for public emergencies. Journal of Evidence-BasedSocial Work, 6, 274–287.
Pecukonis, E., Cornelius, L., & Parrish, M. (2003). The future of
health social work. Social Work in Health Care, 37(3), 1–15.
Pomeroy, E. C. (2009). The end of a decade: Challenges for a
changing world. Social Work, 54(4), 293–295.
Pomeroy, E. (2010). The beginning of a new decade: Social work
2010. Social Work, 55(1), 5–7.
Raskin, M., & Blome, W. W. (1998). The impact of managed care on field
education. Journal of Social Work Education, 34(3), 365–374.
Reisch, M., & Gorin, S. (2001). Nature of work and future of the
social work profession. Social Work, 46(1), 9–19.
Reisch, M., & Jarman-Rohde, L. (2000). The future of social work in
the United States: Implications for field education. Journal ofSocial Work Education, 36(2), 201–214.
Richards, S., Ruch, G., & Trevithick, P. (2005). Communication skills
training for practice: The ethical dilemmas for social work
education. Social Work Education, 24(4), 409–422.
Rosenthal-Gelman, C., & Mirabito, D. (2005). Practicing what we
teach: Using case studies from 9/11 to teach crisis intervention
from a generalist perspective. Journal of Social Work Education,41(3), 479–494.
Rubio, D. M., Birkenmaier, J., & Berg-Weger, M. (2000). Social
welfare policy changes and social work practice. Advances inSocial Work, 1(2), 177–186.
Shera, W., & Bogo, M. (2001). Social work education and practice:
Planning for the future. International Social Work, 44(2),
197–210.
Silverstone, B. (2005). Social work with the older people of
tomorrow: Restoring the person-in situation. Families in Society,86(3), 309–320.
Simpson, G., Williams, J., & Segall, A. (2007). Social work education
and clinical learning. Clinical Social Work Journal, 35, 3–14.
Strom, K., & Gingerich, W. (1993). Educating students for the new
market realities. Journal of Social Work Education, 29(1),
78–87.
Strom-Gottfried, K., & Corcoran, K. (1998). Confronting ethical
dilemmas in managed care: Guidelines for students and faculty.
Journal of Social Work Education, 34(1), 109–119.
Thyer, B. (2008). The Quest for Evidence-Based Practice? We are all
positivists! Research on Social Work Practice, 18(4), 339–345.
Vourlekis, B., Ell, K., & Padgett, D. (2001). Educating social workers
for health care’s brave new world. Journal of Social WorkEducation, 37(1), 177–191.
Clin Soc Work J (2012) 40:245–254 253
123
Wheeler, D., & Goodman, H. (2007). Health and mental health social
workers need information literacy skills. Health and SocialWork, 32(3), 235–237.
Woody, J., D’Souza, H., & Dartman, R. (2006). Do master’s in social
work programs teach empirically supported interventions? A
survey of deans and directors. Research on Social WorkPractice, 16(5), 69–479.
Author Biography
Diane M. Mirabito is Clinical Associate Professor and Director of a
post-masters program in Clinical Practice with Adolescents at New
York University Silver School of Social Work. She has a doctorate in
Social Work from the City University of New York, Hunter College
School of Social Work, an M.A. in Social Work from the University
of Chicago, and a B.A. in Social Work and Psychology from Syracuse
University. Two areas of her expertise in practice, teaching, writing,
and research are clinical practice and program development with
adolescents and their families and social work practice in schools. She
currently teaches foundation practice courses, groupwork, and social
work with adolescents in schools, and coordinates a focused learning
advisement program, Adolescents and Schools. Her publications
focus on health and mental health issues of urban adolescents and
crisis intervention. Her professional career in social work includes
extensive experience in clinical practice, supervision to social work
staff and students, and program development in a variety of
healthcare, school, and community-based agency settings.
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