Choosing a Major: Clinical or Macro? A Spotlight on Macro Social Work

Hi, I'm Lizzy. I graduated from BUSSW's MSW program in 2018 and am currently in my last semester of the dual degree Master of Social Work/Master of Public Health Program at BUSPH. I'm also a full-time Admissions Advisor here at the School of Social Work, so you have probably heard from me before! As a macro social worker, my career goal is to work for the federal or state government – or possibly a large nonprofit – designing programs and policy interventions that address poverty.

Macro and Clinical: The Differences

If I could describe the difference between macro and clinical social work in one sentence, I would say that macro social work prioritizes systemic change, while clinical social work is focused on working directly with individuals.

A lot of students coming into MSW programs struggle with the question, Am I a clinical person or am I a macro person? For me, choosing macro practice was a no-brainer. Why? Here were a few key factors.

My Story

From a very young age, I knew I wanted to be in a helping profession. In high school, I planned to be a lawyer so that I could help advocate for other kids like myself who were caught in the middle of difficult divorce cases. When I got to college, however, I quickly realized that practicing law wouldn't enable me to improve lives the way I wanted to. Suddenly, I had no idea what I would do when I graduated. While this new reality was somewhat daunting, I knew that whatever career path I chose, it would be in a profession where I could have a direct, positive impact.

In my senior year of college at Brandeis University, I attended the school's social impact career fair and stumbled into an experience that would ultimately set me on a whole new path. A Brandeis alum I met at the career fair worked at a food pantry and invited me to spend a day there helping out. My job was to stand at the bread station and tell visitors that they could take two pieces of bread home with them. An older gentleman came up to the table and I told him what I had been instructed to say. He turned to me and said, "I know. I've been coming here every day for years."

This may sound silly, but it was truly an "aha" moment for me. I thought to myself, what great purpose am I serving standing at this table, telling people things they already know and doing work that anyone could do? While it may sound insignificant to some, it was a pivotal moment in my professional development. I realized I need to be fixing the systems that aren't working instead of trying to plug holes in the system's massive problems. Yes, giving out bread is an important service – we need people with their boots on the ground helping those who are most marginalized in society, but the more important problem I saw was that people were suffering day-in and day-out from broken systems. I walked away that day with a clearer sense of purpose and direction on how I would become part of the helping profession.

I completed my undergrad degree at Brandeis and enrolled in Boston University's dual degree program in social work and public health, knowing I had finally found a career path that made sense for me. At BUSSW, I automatically gravitated towards macro social work – the "systems" approach. If you see a system that's not functioning, macro social work is the means through which you can unearth root causes and fix inequities from the ground up.

Benefits of Both

When you're choosing your major, keep in mind that clinical and macro social work are both helping professions and the most successful practitioners have both sets of skills. The difference between clinical and macro social work is the lens and scope you apply when analyzing situations and assisting others. In clinical social work, you're focused on the individual and helping them function best within an external environment that is outside of their control. In macro social work, it's flipped. You're focused on improving the external environment that people live in, so that you can indirectly help them live better lives. While macro social work is not about directly working with individual people, it is focused on improving the world in which we all live.

Another way to metaphorically describe the difference between clinical and macro social work is to think of the two as existing at two ends of a river. At the top of the river there are macro social workers developing strategies that prevent people from falling into the river and getting caught up in the currents. These macro social workers are designing policies and programs aimed at helping people by providing systemic change and prevention work. At the bottom of the river are the clinical social workers, rescuing the people macro social workers weren't able to catch at the top. These clinical social workers play an important role in pulling people out of the river and assisting them by providing case management and direct therapeutic interventions. In order to help everyone, society needs people at both ends of the river.

It's Your Choice

At the end of the day, you should choose the major that most aligns with your interests and career goals. While macro social work isn't for everyone, it's a great option for people like me who want to tackle big problems and make society more just. It's also great for those seeking a versatile degree that will allow you to practice social work in many different arenas. With either major, students will gain essential knowledge in social justice issues, person-first and strength-based approaches, and skills on how to strategically analyze societal structures.

Career Opportunities

There are also a wide variety of career opportunities in macro social work. You'll find macro social workers working in nonprofit and government organizations, for-profit industries managing people and programs, in community organizations and action groups, as well as in research, advocacy, and policy-making.

If you are reading this blog and thinking that you still don't know exactly which major you want to pursue or how you want to be part of the helping profession, that is totally fine – our MSW program is designed to help you further refine your interests. Plus, you have your whole career to figure out how to make an impact that fits who you are and who you want to be.

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