Refugee Resettlement and Macro Practice in the United States

Resettlement-related macro practice reflects a complicated history of immigration and refugee resettlement in the United States, as well as international and domestic policies that shape opportunities and services available to refugees who resettle through these mechanisms. Four intersecting domains of resettlement macro practice are (a) community organizing and community development, (b) advocacy, (c) policy analysis and development, and (d) community-centered management and program planning. To engage meaningfully in macro social work requires a grasp of the history and policies that drive decision-making of individual practitioners and shape the experiences of people resettling to the United States in search of safety and new beginnings. Research and participatory approaches are integral to resettlement macro practice to ensure refugee communities are at the center of all efforts to inform structural and systemic change.

Homelessness and Macro Interventions

The emergence of social work and macro practice is often associated with the eradication of poverty and prevention of homelessness through the efforts of 19th century settlement houses. Structural violence and social determinants of homelessness are often grounded in unequal social, political, and economic conditions. Health and mental health were affected by the lack of stable housing, causing and increasing the complexity of health and human service needs and services. Furthermore, due to inequities, some populations are inadvertently more likely to face chronic homelessness, which can be mitigated through the role community-engagement and macro practice interventions.

Deinstitutionalization in Macro Practice

The deinstitutionalization policy sought to replace institutional care for populations in need of care and control with prosocial community-based alternatives. U.S. institutional populations, however, have increased since the policy’s inception by 205%. As implemented, with the assistance of advocacy and cost-cutting factions, it has succeeded only in enabling the divestiture of state responsibility for target groups. It sought to prevent unnecessary admission and retention in institutions. As implemented, deinstitutionalization initiated a process that involved a societal shift in the type of institutions and institutional alternatives used to house its target groups, often referred to as trans-institutionalization. For many in need of institutional placements, it has succeeded in preventing all admissions, expanding admissions for others. In seeking to develop community alternatives for housing, treating, and habilitating or rehabilitating its target groups, it has succeeded in establishing a variety of alternative living arrangements and showcase and model programs illustrating what can be done; yet, it has failed to deliver on investments in such programs to serve the majority of its target groups. It has resulted in the abandonment of substantial numbers to homelessness. It has been documented, from political, economic, legal, and social perspectives, how this policy has affected the care and control of populations such as older adults, children, people with mental illness or developmental disabilities, people under correctional-system supervision, and, more recently, individuals without a home. Suggestions for a truer implementation of deinstitutionalization’s initial aspirations are available.

Evidence-Based Macro Practice in Social Work

Evidence-based macro practices (EBMPs) rely on the best available evidence to promote system change. The field of social work needs to develop, implement, and disseminate EBMPs to respond to increasing public accountability to deliver cost-effective interventions that promote health and well-being among vulnerable populations. There are several evidence-based macro practices at the community and organizational levels that have potential to improve the effectiveness of social work practice. These EBMPs, their components, and the critical role they play in improving interventions and enacting change at a macro level are important. Building science in social work, informing practice in the 21st century, and effectively responding to system-wide challenges (e.g., epidemics, institutional racism, growing inequality) that disproportionally impact the health and well-being of the most vulnerable members of our society are important areas to explore.

Civil Society in Macro Social Work

The connection between macro social work practice and civil society is inextricable. Macro practice focuses on forming and strengthening people’s organizations, communities, and other collectivities that make up the structure and foundation of civil society, defined as the sphere outside of the state and market where people can exercise their right to participate in decision-making on political, social, and other matters that affect their lives. Working with civil society can compensate for some of the limitations of working within state institutions. Civil society’s potential and ability to serve as an arena for realizing individual and community well-being, human rights, and social justice warrant positioning it on equal footing as the state as an area of practice for the social work profession.

Gentrification

Gentrification can be understood as the process through which geographical areas become increasingly exclusive, which disproportionately harms people living in poverty and people of color, as well as the elderly, families, and youth. As such, this article argues that macro social work practitioners should view gentrification as a key concern. Thus, to help guide macro interventions, the article begins by first defining gentrification and describing ways to measure it, while emphasizing its difference from revitalization. Second, the article explores causes of gentrification, including its relationship to systemic racism. Third, the article explores the consequences of gentrification on individuals’ and communities’ well-being, considering how these consequences can influence macro practice. Finally, the article provides insight into ways that macro practitioners can strategically with others to prevent gentrification, mitigate its harms, and proactively support community well-being in areas threatened by gentrification.

Conflict Theory for Macro Practice

Conflict theory encompasses several theories that share underlying assumptions about interlocking systems of oppression and how they are maintained. The relevance of Marx’s theory of class conflict, C. Wright Mills’s power elite, and pluralist interest group theory are all important to understand and address social and economic gaps and informing policy for macro practice. Conflict theory can provide an understanding of health disparities, racial differences in mortality rates, class relationships associated with negative outcomes, poverty, discrimination in criminal justice, as well as numerous factors that are broadly associated with inequality embedded in social structures. Social workers play a significant role in addressing disparities in research, curricula, primary and secondary intervention, and public policy, and conflict theory can provide the framework necessary to enrich this understanding.

Organizational Wellness and Macro Social Work Practice

The profession of social work increasingly experiences the damaging impact of professional burnout, staff turnover, and compromised services. Organizational wellness involves planful efforts to address these concerns and promote employee well-being. A rationale for organizational wellness is articulated, including its value for social work. The evolving paradigm of a holistic, systemic approach to organizational wellness is then discussed. Next, how social work is ideally situated to lead organizational wellness efforts is detailed as an arena of macro practice and as providing a framework for designing and developing an organizational wellness culture. Using social work competencies, social workers can use this framework to provide leadership in conceptualizing, planning, implementing, evaluating, and sustaining organizational wellness. Further critical considerations underscore how this leadership promotes the profession’s mission, supports the profession’s viability, and establishes a vital arena for ongoing macro practice.