Nili Tannenbaum and Michael Reisch*
The development of social work in the United States reflects an ongoing synthesis of ideas derived from many different cultures. While terms such as charity and philanthropy have Greek roots and are based on Biblical principles, modern social work concepts owe much to the influence of the Koran and the mutual aid practices of Native Americans, the African-American community, and immigrants from all over the world.
Before the American Revolution, formal systems of poor relief, child welfare, and even mental health services had been established in North America. These systems served a dual role of compassion and protection. By the early 19th century, states began taking responsibility for distributing relief from towns and counties. Since government responses proved largely insufficient or ineffective in addressing growing social problems, private benevolent societies and self-help organizations the predecessors of modern social service agencies played increasing roles in this regard.
The roots of US social work date back to this period and the efforts of upper-class women and men in church-based and secular charitable organizations to address the consequences of poverty, urbanization, and immigration. These untrained proto-social workers, known as "friendly visitors," sought to help poor individuals through moral persuasion and personal example. Organizations such as the Association for the Improvement of the Condition of the Poor and the Children's Aid Society began investigating social conditions in areas such as tenement housing and child welfare.
The Civil War stimulated the emergence of large-scale private social welfare initiatives, such as the US Sanitary Commission and the Red Cross. In the War's aftermath, the short-lived Freedmen's Bureau (the first Federal social welfare program) provided assistance to newly emancipated slaves. State boards of charity arose to improve the management of institutions constructed during the previous generation.
In the half century after the Civil War, rapid industrial expansion produced a dramatic increase in individual and community needs. The most notable social changes of this period included a series of economic depressions (known then as "panics") and their consequences; new manifestations of racism following the end of Reconstruction in 1876; and a dramatic increase in immigration from Southern and Eastern Europe.
Using concepts derived from business and industry, reformers attempted to respond to some of these developments by regulating public relief distribution through so-called "scientific charity." In 1877, the first American Charity Organization Society (COS) based on such principles was founded in Buffalo, New York. Many COS clients, however, particularly poor Jews, Catholics, and African Americans, preferred more personal systems of self-help and mutual aid established by their own communities.
Settlement houses reflected a different type of organizational response to the impact of industrialization and immigration and introduced an alternative model of a social service agency a form of urban mission. The first US settlement, the Neighborhood Guild in New York City, was established in 1886. Three years later, Jane Addams and Ellen Gates Starr founded Hull House in Chicago, which became the most famous American settlement.
Unlike the individually oriented COS, settlements focused on the environmental causes of poverty and expanding the working opportunities of the poor. They conducted research, helped establish the juvenile court system, created widows pension programs, promoted legislation prohibiting child labor, and introduced public health reforms and the concept of social insurance.
By 1910, there were more than 400 settlements, including those founded by African Americans to provide services denied by segregated agencies. Settlement activities soon expanded beyond specific neighborhoods and led to the creation of national organizations like the Women's Trade Union League, the National Consumers' League, the Urban League, and the National Association for the Advancement of Colored People (NAACP). Settlement leaders were instrumental in establishing the Federal Children's Bureau in 1912, headed by Julia Lathrop from Hull House. Settlement leaders also played key roles in the major social movements of the period, including women's suffrage, peace, labor, civil rights, and temperance.
While the settlements focused on what later became group work and community organization, social work in the COS increasingly focused on casework with individuals and families. Sub-specialties in the areas of medical, psychiatric, and school social work began to appear in the early twentieth century. The growth of casework as a distinct area of practice also stimulated the creation of a formal social work training program in 1898.
This program, created by the New York COS in partnership with Columbia University, evolved into the New York School of Philanthropy and, eventually, the Columbia University School of Social Work. Early curricula emphasized practical work rather than academic subjects.
Settlements like the Chicago Commons also developed educational programs as early as 1901. By 1908, it offered a full curriculum through the Chicago School of Civics and Philanthropy (now the University of Chicago's School of Social Service Administration).
Formal methods-oriented training programs spread through major urban areas, most of them affiliated with private charitable organizations interested in standardizing the practices of their volunteers. By 1919, there were seventeen schools of social work affiliated as the Association of Training Schools of Professional Schools of Social Work the antecedent of today's Council on Social Work Education (CSWE).
Despite these efforts, in 1915, in an invitational lecture at the National Conference of Charities and Corrections entitled "Is Social Work a Profession?" Dr. Abraham Flexner, the nation's leading authority on professional education, asserted that the field lacked specificity, technical skills, or specialized knowledge and could not be considered a profession. His lecture further stimulated efforts already underway to consolidate experiential casework knowledge into a standardized format. Consequently, by the 1920s, casework emerged as the dominant form of professional social work in the United States.
During World War I, the expansion of government agencies led to increased professionalism in public-sector departments devoted to social welfare. Through the Red Cross and the Army, the War also provided opportunities for social workers to apply casework skills to the treatment of soldiers with "shell shock." Social workers were now sought as specialists in the social adjustment of non-impoverished populations.
Although the Progressive movement declined after World War I, social work practice with individuals and families continued to flourish. By 1927, over 100 child guidance clinics appeared in which teams of psychiatrists, psychologists, and social workers provided services primarily to middle-class clients. A parallel development was the emergence of the Community Chest movement, which rationalized charitable giving at the community level and led to the creation of the United Way and its Health and Welfare Councils.
In 1930, the US social welfare system was an uncoordinated mixture of local and state public relief agencies, supplemented by the modest resources of voluntary charitable organizations. Public agencies, however, did not necessarily provide the same services, or relate to one another administratively. Nor did voluntary organizations possess sufficient resources to address the growing needs which the Great Depression created.
The response to the Depression profoundly influenced social work practice and redefined the role of government as an instrument of social welfare. The public began to view poverty as the result of economic circumstances rather than personal failure. The idea that social welfare assistance was a government responsibility rather than a private charitable function gained wider acceptance. These changes led to the creation of a wide range of government programs under the Roosevelt Administration the New Deal which ultimately evolved into a complex national social welfare system. The New Deal also enhanced the status of the social work profession, particularly through the contributions of individuals like Harry Hopkins and Frances Perkins.
The centerpiece of the dozens of social welfare programs that comprised the New Deal was the Social Security Act of 1935. It expanded and improved standards of social welfare throughout the country and provided recipients with some sense of individual freedom and dignity. It helped establish a regular, unprecedented role for the federal government as a source of aid and introduced the concept of entitlement into the American political vocabulary. The scope of social welfare expanded beyond financial relief to the poor to include housing, rural problems, recreation and cultural activities, child welfare programs, and diverse forms of social insurance to Americans of all classes.
These policy developments significantly affected the social work profession by: enhancing the field's visibility in the area of public welfare and creating expanded work opportunities beyond private agency venues, introducing public welfare and public policy as integral aspects of the profession, expanding the practice of social work beyond previous urban limits to rural areas, and reintroducing an emphasis on social reform. The growth of public welfare programs also necessitated the recruitment of thousands of new social workers, whose numbers doubled from 40,000 to 80,000 within a decade and became considerably more diverse. This expansion led to recognition of the need for improved salaries and working conditions and enhanced educational requirements.
During World War II many social workers accepted war-related assignments, spurred by the establishment of a special classification for military social work and the development of services for war-impacted communities. In the decade after the War, considerable efforts were made to enhance the field's professional status. These included increased standardization of agency practices, the development of interdisciplinary doctoral training programs, and the creation of core MSW curricula. The formation of CSWE in 1952 and the establishment of the National Association of Social Workers in 1955 further strengthened the profession's status of the profession.
The post-war period was also one of significant change in US social welfare, highlighted by the establishment of the Department of Health, Education, and Welfare (HEW) in 1953. The primary beneficiaries of social policy changes between 1940 and 1960, however, were middle- income, white workers and, by the early 1960s, the United States lagged considerably behind other Western industrialized nations in the degree of social provision. At the same time, voluntary and public sector agencies shifted the focus of services from low-income to middle- and upper-income groups and reduced the role of community-based volunteers in organizational decision making and service delivery. In a hostile political environment, social activism declined and openly anti-welfare attitudes reemerged.
In the early 1960s, well-publicized exposes of poverty and the emergence of new "structuralist" perspectives on social problems forced Americans to rediscover the over 40 million people, approximately one third of them children, whose lives had been bypassed by modern economic and social progress. They inspired the development of new kinds of social service organization, such as Mobilization for Youth in New York, and led to President Johnson's proclamation of an "unconditional war on poverty" in January 1964.
The primary instrument of the "War on Poverty" was the Economic Opportunity Act (EOA) which included such programs as the Job Corps, Upward Bound, the Neighborhood Youth Corps, Community Action, Head Start, Legal Services, Foster Grandparents, and the Office of Economic Opportunity (OEO). In 1965, Congress enacted Medicare and Medicaid, established the Department of Housing and Urban Development (HUD), funded an array of services for the aged through the Older Americans Act, and created the Food Stamp Program under the auspices of the Department of Agriculture. The Elementary and Secondary School Education Act overturned longstanding precedents and directed federal aid to local schools in order to equalize educational opportunities for children. In 1966, the Model Cities Act targeted certain urban areas with comprehensive services and emphasized the concept of community control. Although the social work profession did not influence public policies on the scale it had in the 1930s, social workers played key roles throughout the 1960s in various anti-poverty and community-action programs and helped train individuals in new organizations like the Peace Corps and VISTA.
President Nixon shifted the administration of anti-poverty programs to states and localities. In 1972 and 1973, Congress passed the State and Local Fiscal Assistance Act and the Comprehensive Employment and Training Act (CETA). This legislation established the concept of revenue sharing and led ultimately to the dismantling of the Office of Economic Opportunity. The most significant social policy accomplishments of the Nixon Administration, however, were the Social Security Amendments of 1972, which centralized and standardized aid to disabled people and low-income elderly and indexed benefits to inflation. Food stamps, child nutrition, and railroad retirement programs were also linked to cost-of-living rates.
The passage of Title XX of the Social Security Act in January 1975 reinforced the popular concept of federal "revenue sharing" which provided states with maximum flexibility in planning social services while promoting fiscal accountability. During the Ford and Carter administrations, Title XX shaped the direction of both public and nonprofit social services, with a particular focus on issues of welfare dependency, child abuse and neglect, domestic violence, drug abuse, and community mental health.
While poverty continued to decline among the elderly in the 1970s, largely as a consequence of benefit indexing and Medicare, a virtual freeze on Aid for Families with Dependent Children (AFDC) benefits after 1973 and a decline in the purchasing power of wages produced a steady increase in poverty among children, particularly children of color. In the late 1970s, the Carter Administration's creation of block grants that combined formerly categorical programs into broad programmatic areas and established a ceiling on total state expenditures in return for increasing state control of spending patterns was a particularly significant development that had major implications in the 1980s.
Although most social reforms stagnated by the mid-1970s, there were considerable changes in the social work profession throughout the decade, including the beginnings of multicultural and gender awareness, which led to the development of new course content and efforts to expand minority recruitment; the growth of multidisciplinary joint degree programs with Schools of Urban Planning, Public Health, Public Policy, Education, and Law; the recognition of the BSW as the entry-level professional degree; and the growth of private practice among social workers.
The policy changes that were inspired by the so-called "Reagan Revolution" of the 1980s compelled social workers to rely increasingly, if not exclusively, on private-sector solutions for social welfare problems. Entire programs were reduced, frozen, or eliminated. Additional block grants were created in such areas as child welfare and community development. A looming crisis in the funding of Social Security and Medicare was forestalled in 1983 through modest tax increases and benefit reductions. At the same time, ballooning federal deficits precluded any major new social welfare initiatives. Consequently, during times of overall prosperity poverty rates soared, particularly among children, young families, and persons of color. By the early 1990s, the number of people officially listed as "poor" had risen to 36 million.
Major cutbacks in government funding of social welfare created new challenges for social workers and social service agencies, as they confronted new and more complex social problems such as the crack cocaine epidemic, the spread of HIV/AIDS, domestic violence, and homelessness. Social workers focused increased attention on developing effective management skills and increased their advocacy activities.
From the outset, President Clinton's policy options were severely constrained by the budget deficits his administration inherited. Stymied in the development of an ambitious social welfare agenda, such as a comprehensive national health insurance program, he focused instead on budgetary restraint and the promotion of economic growth. After considerable debate, he signed a controversial welfare reform bill in 1996 which replaced AFDC with block grants to states that included time limits and conditions on the receipt of cash assistance (now called Temporary Assistance for Needy Families [TANF]). The legislation also devolved responsibility for welfare program development to states and increased the roles of private-sector and faith-based organizations in program implementation.
President Clinton left office in January 2001 with several major social welfare issues unresolved. While some progress was made in providing health care for children in low-income families, over 43 million Americans still lacked coverage. The soaring cost of prescription drugs threatened the economic well-being of elderly Americans. Proposals to provide this benefit through Medicare and prevent a future crisis in funding for the Social Security system when the "baby boomer" generation retired made little progress in the 1990s because of political gridlock. Nor was any substantial progress made in addressing the growing HIV/AIDS epidemic, particularly within the African-American community, or the persistent problems of homelessness and drug abuse. Finally, looming on the horizon were the potentially catastrophic consequences of enforcing the five-year lifetime cap on TANF recipients as the nation's economy cooled.
Policy developments in the 1990s had serious consequences for the social work profession. Welfare reform led to the restructuring of public welfare departments and to greater pressure on nonprofit organizations to fill gaps in service provision. The advent of managed care in the health and mental health fields dramatically altered the practice of many social workers, as did changes in child welfare policies. Although political opposition to Affirmative Action programs grew during these years, social workers, particularly in university settings, increasingly emphasized racial, gender, and ethnic diversity in their curricula and recruitment policies. NASW revised its Code of Ethics to make the pursuit of social justice an ethical imperative, and CSWE required all programs to teach students how to work for economic and social justice.
At the same time, organizations such as Americorps were established in 1994 to promote greater involvement of young people in communities. With the support of the NIMH Center for Social Work Research and the Society for Social Work and Research, schools of social work significantly increased their funded research and evaluation activities in such areas as mental health, aging, domestic violence, and child welfare.
For over a century the profession of social work has grown and reinvented itself in response to rapid economic and social changes while maintaining its focus on advocating for the needs of the most vulnerable segments of society and improving their well-being. Today, social workers comprise the largest percentage of professionals working in the fields of mental health and family services. It is estimated that by 2005, there will be about 650,000 social workers, more than a thirty-percent increase over ten years. Despite recent changes in society and its commitment to social welfare, the primary mission of social work, as articulated in the NASW Code of Ethics, remains "to enhance human well-being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty." In the future, this mission may inspire development of a new social welfare synthesis in which the state largely finances the provision of services but delegates their delivery to other sectors. New forms of practice and new venues for social workers are also likely to appear. In an increasingly multicultural society, community-based organizations could play an important role in enhancing client participation in the design and delivery of social services while expanding and revitalizing the nature of social work itself.
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* This article was originally printed in the Fall 2001 issue of Ongoing Magazine