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Published in final edited form as: Glob Soc Welf. 2014 Mar 1;1(1):1–8. doi: 10.1007/s40609-014-0011-z

Bi-directional Exchange: the Cornerstone of Globally Focused Social Work

Gary Parker 1,✉, Samira Ali 2, Kassia Ringell 3, Mary McKay 4
PMCID: PMC4208070  NIHMSID: NIHMS600979  PMID: 25346884

Abstract

Social work holds a unique place relative to other professions in that it prioritizes the elimination of human suffering as its primary goal. The roots of the profession are firmly planted in Western theories, historically and culturally specific perspectives, and knowledge. History has repeatedly demonstrated an association between the arrival of Westerners and the subsequent control of natural resources. Some argue that the development of global social work practice has serious pitfalls, including diverting needed resources away from local contexts and inadvertently spreading western world-views, paradigms and practices. However, the social work profession is uniquely positioned to offer expertise and collaborate with those experiencing the serious consequences of social inequity and the dearth of economic and social resources locally and across the globe. Grounded in anti-oppressive theory, guided by the difficult, yet acute awareness of western privilege and racism, and drawing from social/collective action and collaborative paradigms, a bi-directional exchange and action are detailed as the foundations for globally focused social work. The skills and knowledge base for global social work are essential as populations locally and worldwide are impacted by a global economic system that innately increases serious social inequity. Comprehensive training and preparation for globally focused social work, critical to successful engagement in global practice are outlined.

Keywords: Global social work, Bi-directionality, Social work education, Social work practice

Introduction

Social work holds a unique place relative to other professions in that it prioritizes the elimination of human suffering as its primary goal. The roots of the profession are firmly planted in Western theories, historically and culturally specific perspectives and a knowledge base largely derived from Western Europe and North America (Gray and Webb 2008; Healy and Link 2012; Midgley 2001; Sewpaul 2007). As schools of social work expand in number across the globe and more social work practitioners are interested in contributing to global human service and relief efforts, debates and tensions have emerged. Notably, there has been debate about the role and even the appropriateness of social work theories and practice paradigms in global contexts, particularly given the colonial practices associated with the professions’ countries of origin (Gray 2005; Midgley 2001; Sewpaul 2005; Webb 2003). Some scholars have argued that it is essential to (1) deconstruct the history of the profession, (2) critically examine its underlying values, and (3) discard theories and practices in order to prevent inherent bias and avoid oppressive practices (Razack 2009; Sewpaul 2005).

Associated with attempts to reach consensus on the relevant and scope of global social work, challenging questions have been raised, such as (1) what distinguishes social workers from other helping professionals when working with the same population in a global context; (2) what evidence exists to support the application of specific social work practice methods in country and cultural contexts distinct from their origin; (3) as the science of social work is strengthened, must these methods be adapted across cultural and country contexts; and (4) as new practitioners are prepared to deliver services within social welfare organizations and government supported programs, either locally or globally, are they being prepared to think critically and have the necessary skills not to unintentionally become agents for social control?

Given that these are just a subset of the challenges facing the profession, some question whether social work should be confined to its countries of origin in order to remain ethical (Webb 2003). Rather than forge ahead globally and tackle issues related to globalization, cultural relevance, indigenization, localization, or colonialism, social workers should stay home (i.e., focus on local issue and immediate context) and continue to build on the core values, knowledge, and theoretical base of the profession. Certainly, there is plenty of human suffering to be addressed within the U.S. and other western industrialized countries.

Additionally, history has repeatedly demonstrated an association between the arrival of Westerners and the subsequent control of natural resources and exploitation of populations, particularly workers. Some argue that the development of global social work practice and its implementation is unavoidably compounding global suffering and aiding the proliferation of western oppression (Ghose 2012; Sewpaul 2005, 2006).

Despite the inherent risks of exporting western constructs, including social work, a compelling argument that emphasizes the imperative of a deliberate and measured social work response to global suffering can be made. The social work profession is uniquely positioned to offer expertise and collaborate with those experiencing the serious consequences of social inequity and the dearth of economic and social resources locally and across the globe.

Further, social work practice and the profession itself will be enhanced and strengthened by what is learned via partnerships in culturally and geographically distinct country contexts outside the birthplace of the profession. In fact, the profession, as well as individual social workers may greatly benefit from global exchange and intensive interaction that afford the opportunity for two-way learning, the basis for bi-directional social and professional exchange and ultimately transformation. This exchange benefits international practice, as well as improves and informs social work’s more localized efforts.

Grounded in anti-oppressive theory, guided by the difficult, yet acute awareness of western privilege and racism (Dominelli 1996; Sakamoto 2005; Gray et al. 2012), and drawing from social/collective action and collaborative paradigms (Israel et al. 1998), bi-directional exchange and action are the foundations for globally focused social work. Additionally, comprehensive training and preparation for globally focused social work is critical to successful engagement in global practice. The skills and knowledge base for global social work are essential for all in the profession as populations locally and worldwide are impacted by a global economic system that innately increases serious social inequity.

A Glimpse of Human Suffering Across the Globe: a Call for Local and Global Social Work Action

To begin, the only profession with the explicit commitment to ending human suffering is confronting a set of local and global facts. In developing regions, 22% of people lived on less than $1.25 a day in 2010, with about 1.25 billion living in poverty (United Nations 2013). Worldwide, the mortality rate for children under five was 51% in 2011 (United Nations 2013). Almost 15% of all people in 2010–2012 were undernourished with approximately one in eight people going hungry every night (United Nations 2013). Two and a half million people will be trafficked across country borders this year and be forced to engage in uncompensated labor or participate in sex trade, exposing them to a myriad of threats to their health and well-being (International Labour Organization 2008).

Disparities related to race and gender emerge across health conditions, education, employment, and access to needed support services. In the U.S., communities of color are burdened by elevated rates of substance abuse, HIV infection, asthma, diabetes, and heart disease (Attar et al. 1994; Brooks-Gunn et al. 1997; Horowitz et al. 2005). Americans spend nearly 2 trillion dollars on health care, yet millions of marginalized, low-income communities of color will suffer from the consequences of preventable illnesses this year (Centers for Disease Control and Prevention 2010). In the U.S. alone, nearly 16% of all households with children were food insecure sometime during a year (Nord 2009). Poverty-impacted communities and families, as well as a subset of under-resourced social work practitioners and advocates, both in the U.S. and globally, will make valiant attempts to address these avoidable losses, as well as cope with the consequences of substandard housing, under-resourced responses to natural and manmade disasters, and health epidemics (Abramovitz and Albrecht 2013; United Nations 2013).

The Social Work Response to Human Suffering in the Context of a Globalizing World

The global capitalist economy, rooted in colonial western theory and values, often compounds human suffering and encourages exploitation of resources and labor both in the U.S. and worldwide. While globalization has produced some gains, it has historically perpetuated inequality throughout the world, stripping many people from access to basic supports of water, food, and shelter and putting many at risk for deadly diseases (Amin 2001; Bond, 2004; Hart 2002; Saul 2006; Sewpaul 2006).

In response to these devastating circumstances, a range of social safety net and emergency service systems have emerged within western influenced contexts. In the U.S., social workers represent one of the largest sectors of the workforce within these systems. For example, professional social workers, in large numbers, provide services within public mental health systems, child safety and welfare organizations in the U.S., and western influenced nations. Further, social workers make significant contributions in healthcare, education, justice, housing and homelessness (National Association of Social Workers 2005).

These national efforts have influenced global humanitarian efforts, including church-based and non-governmental organizations, and fueled the expansion of emerging care systems into developing nations. Yet, both locally and globally, relief and service systems have encountered serious challenges to addressing pressing needs with problems frequently encountered in key areas: access (Anderson et al. 2006; Miranda et al. 2003); engagement of populations in highest need (Gopalan et al. 2010; McKay and Bannon 2004); delivery of care aligned with the felt need of a population (McKay and Paikoff 2007; McKay et al. 2000); designing and providing culturally and contextually relevant care (Gray et al. 2012); reducing stigma associated with a range of difficulties, as well as seeking help from a professionalized system, rather than local, indigenous resources, i.e., family, friends, church (Gray et al. 2012); and achieving observable, measureable, high impact outcomes (McKay et al. 2010; McKay et al. in press). Therefore, the challenge to the social work profession is to target human suffering with existing and limited tools, as well as learn from missteps, partial successes, and outright failures in both local and global efforts.

Some scholars note that social work efforts in the west can actually have negative consequences. At the extreme, the western approach to social welfare has been criticized as an attempt to reinforce the social order and consolidate the social control of those in power. Capitalism thrives on low-wage workers, and social welfare can be seen as an attempt to ensure that this human resource continues to exist (Day and Schiele 2013). Services then regulate the vulnerable and prevent communities from demanding a more just distribution of society’s resources (Woodward 2013). These long-debated charges alert the profession to the need for constant critical examination, as well as the infusion of new knowledge, perspectives, and practices.

In order to truly eradicate human suffering, local and global social work needs to be influenced bi-directionally. Any social work response needs to be collaboratively designed and implemented in order to address the known limitations of responses, as well as to prevent the sometimes unintended negative consequences of social welfare interventions. Whether considering social work practice in the U.S. or globally, there is a substantial need for intensive input from (1) the potential consumers of or those who are expected to benefit for interaction with social workers; (2) those with intimate knowledge of local strengths, resources, needs, and perspectives, upon which a relevant, potentially effective and sustainable social work interventions can be built; (3) those sensitive to acceptable or stigmatizing community responses; and (4) those who can advise on new solutions that potentially address the challenges outlined above (Hoagwood et al. 2010; McKay and Paikoff 2007). This collaborative stance potentially takes advantage of a key set of social work ideals, including shared decision making, action plans tailored to unique strengths and needs, and respect for diversity of perspectives (Reamer 2013; Gray et al. 2012). However, it also implicitly acknowledges that social work theories, perspectives and skills have limitations that require a continuous process of self and professional awareness. At times, these deficiencies may serve to extend human suffering inadvertently through the development of interventions that neglect to address the root causes of social inequities, and instead focus exclusively on remediating the immediate consequences of devastating social exposures and experiences.

Global Social Work Definitions, Theories, and Methods

The profession is struggling with defining what it means to practice global social work. A universally accepted definition does not exist. The International Federation of Social Work, International Association of Schools of Social Work, and the International Council on Social Welfare, among others, have been meeting for years in an attempt to better understand the scope and principles that will shape a global agenda to address human suffering (Jones and Truell 2012). This ongoing global debate resulted in the development of an agenda to prioritize the following areas: (1) promoting social and economic equalities; (2) promoting the dignity and worth of peoples; (3) working towards environmental sustainability; and (4) strengthening recognition of the importance of human relationships (Jones and Truell 2012).

These priorities align with the historic and contemporary values and principles of the profession. Yet again, all are susceptible to cooption by a dominant culture and demand an understanding of the far ranging and sometimes insidious history and impact of western oppression (Khan and Dominelli 2000). Accordingly, there is a need for continual awareness of the possibility of oppression resulting from the choice of theories and methods in order to avoid the replication of social systems that are in drastic need for revision and change (Webb 2003).

For example, the profession of social work has adopted, adapted, and refined sets of ecologically focused theories to guide multilevel practices meant to decrease human suffering (Bronfenbrenner 1979; Unger 2002). Yet, serious debates have emerged as to whether targets of social work interventions should be more to less focused on “the person” or the “the environment” (Gray et al. 2012). This debate has serious implications for global social work.

Specifically, Midgley (2001) asserts that social workers have the option of taking on remedial, activist or developmental roles in the global context. Currently, in the U.S. and other western industrialized nations, a majority of social work professionals fulfill direct practice roles (Gray et al. 2012; Reid 2002). Midgley (2001) suggests that this practice is rooted and guided by psychological and other individual-centric theories. In contrast, in developing countries, remedial practices are frequently focused on ensuring access to basic supports, food, clean drinking water, and medical care. Although critically needed functions, sole focus on addressing individual needs fails to align with the ultimate mission of social work, eliminating human suffering (Ssewamala and Sperber 2012; Ssewamala et al. 2010). Midgley (2001) argues that globally focused social work, whether practiced locally or in poverty-impacted country contexts, needs to focus on addressing the root causes, not just the consequences of poverty and social inequity. Social workers with the commitment and skills necessary for development-focused and activist work are needed, particularly those focused on community mobilization and organizing private/public/citizen partnerships, political activism and contributing to social movements aimed at equity-focused reforms (Midgley 2001; Sewpaul 2005).

Globalization and Social Work

On the surface, these macro-focused skills appear appropriate to guide globally focused social work, yet simultaneously, a deeply concerning narrative that runs through the discussion of global social work has to be addressed. More specifically, globalization has been characterized as fundamentally eroding the ethical premise of universalism in global social work (Gray 2005). There remains the unanswered question of whether a world that operates under a global economic system built on the principles of capitalism is capable of social justice and equality (Coates et al. 2006). Scholars assert that social workers seeking a universal definition, set of theories or approach can unintentionally contribute to colonizing populations, communities, or even countries made vulnerable by poverty and social inequality (Midgley 2008; Sewpaul 2005, 2006, 2007). Consequently, universal definitions and approaches to social work seem to directly contradict underlying social work values when the argument is dichotomized in this way. These well-placed critiques have inspired the profession to seek new, more socially just paradigms for global social work, including models of collective and social action, social work political, organizational, and social activism. The profession need not stand still, tied in a set of ethical paradoxes that are difficult to completely resolve.

It is not necessary, or even recommended that the profession attempt to resolve these serious challenges, particularly in isolation. It is presumptuous to think that it is possible for the profession to even do so, given the inherent constraints that accompany any guild. The definition of globally focused social work needs to be infused with intensive input and collaboration from sources outside the profession. This input needs to emanate from country contexts that can extend the parameters of social work practice based upon localized knowledge of acceptable options and potentially unconsidered alternatives in order to address serious social issues. What is learned will undoubtedly influence the next steps for social work practice, and the profession in the U.S. and western-influenced countries, as well as across the globe.

Bi-directionally Defined Definition of Global Social Work Responses to Serious Social Ills

It is essential for social workers to embrace continually a collaborative framework. Previous authors have outlined a set of collaborative processes that can become the foundation for new solutions to serious global problems (McKay and Paikoff 2007; Sperber et al. 2008). Such a collaborative framework is based on Brazilian educator Paulo Freire’s concept of critical consciousness, in which those who are oppressed should act on the roots of the oppression they face (Freire 1970), and social workers should work with those who have faced oppression (Carroll and Minkler 2000). Working with such populations using a bi-directional approach eliminates (or greatly diminishes) the possibility of paternalistic practices that often reinforce colonialism and seek to save “victims” of oppression (Chowdhury 2009; Escobar 1995; Mutua 2002).

Although collaborative efforts have been characterized in numerous ways, there are at least five core principles that could serve to guide strong collaborations between social workers and global and local stakeholders (e.g., government officials, in-context providers of services, social activists, members of the affected community, etc.; see McKay et al. 2010 for additional details). More specifically, collaborative social work efforts can be characterized by the extent to which there is (1) agreement and investment in shared goals; (2) equitable distribution of power, including fair involvement in decision making and opportunities to change aspects of the action plan; (3) recognition of skills and expertise associated with both social work expertise, but equally incorporating local knowledge and perspectives; (4) ongoing opportunities for communication based upon commitment to honest exchanges and willingness to raise concerns without blame and; (5) trust.

Each of these collaborative principles can be assessed along a continuum, spanning from the most intensive level of collaboration to low levels of collaboration (see Hatch et al. 1993; Hoagwood et al. 2010 for a more complete description).

  1. Shared Goals

    First, the development of shared goals that are mutually acceptable to ensure productive collaborative efforts may be necessary to specify the role of the globally focused social worker (Israel et al. 1998; Labonte 1994; Reed and Collins 1994). Specifying the goals that will guide specific partnerships and focus efforts can require a melding of perspectives and priorities that often appear divergent initially. Members of collaborative partnerships must wrestle with these divergent perspectives in order to negotiate goals that incorporate (McKay et al. 2007). Further, there is an extra burden that can influence the development of shared goals, namely that the professional social worker often represents larger organizations that have needed resources and funding. Therefore, navigating this high impact power dynamic is vital so that collaborators can articulate their priorities, needs, preferences in the context of least coercion.

  2. Distribution of Power

    Not only do shared goals and the processes by which these goals are achieved have to be decided upon, but decisions regarding how power is distributed in relation to the decision-making process is a chief concern in the formation of collaborative partnerships. Wood and Gray (1991) identify sharing of power as being critical to the creation of longstanding partnerships. Many authors have voiced concern that unless power is shared among partners, rather than being largely held by professionals or organizational representatives, then the collaboration is essentially a facade (Hatch et al. 1993; Israel et al. 1998). Ideally, collaborative partnerships bring their collective power to bear in order to achieve the agreed upon goals. However, as the level of collaboration intensifies, there is also recognition that each party has some level of veto power and that compromise will often be necessary to proceed forward.

  3. Recognition of Skills and Competencies

    Distributing power among the partners does require both the recognition and a value for the skills and competencies of all involved. An important activity early in the partnership might be to concretely identify what skills and competencies each partner brings to the collaboration (McKay et al. 2007). The elevation of the importance of these skills is critical in collaborative research efforts in comparison to more traditional research approaches where scientific knowledge and skill might have been given primacy.

  4. Communication

    The development of shared goals, processes by which power is shared, and individual and collective skills are recognized, all require ongoing communication between members of the partnership and a willingness to engage in productive conflict resolution.

  5. Trust

    Closely linked with the necessity for ongoing opportunities to communicate is one of the key elements of collaborative partnership, that of the building of trust between members (Friend and Cook 1990; Wood and Gray 1991; Singer 1993).

Preparing Global Social Work Practitioners in the Bi-directionality Approach

In order to prepare globally focused social workers to establish shared goals, navigate the process of power sharing, recognize skills and competencies of all parties, communicate, particularly in situations which can be defined by misunderstanding and conflict, and engage in initial and ongoing trust building, extensive commitment of time, energy, and resources is necessary (Rogers and Palmer-Erbs 1994). At the same time that these critical skills are being taught, new professionals need to be prepared to move to the right on the continuum by gaining comfort with the need to have all needed knowledge and retain control over process and associated outcomes.

If social work educators are to meet the urgent need to prepare the next generation of global practitioners (Gray and Fook 2004; Sewpaul and Jones 2004), a heightened awareness of the historic western approach to addressing social issues is needed. Specifically, there is frequently a reflexive application of clinical, individualistic practice skills to global work (Caragata and Sanchez 2002). Such individualistic practices are not compatible with the collective cultures of many nations. In preparing globally focused social workers, both students and faculty must face a myriad of personal and professional paradoxes.

Additional core skills needed to address these complexities and to develop a bi-directional approach to global social work include (1) self awareness; (2) self reflexivity; and (3) knowledge of the “host” country’s social, political, economic, religious, and military systems (Dominelli 1996; Gray et al. 2012; Razack 2009). Social work educators have a number of options in building these core skills with an increasingly popular option being the study of social welfare and social work service delivery at global education sites (Caragata and Sanchez 2002; Sewpaul and Jones 2004; Simpson 2009).

In order to prepare and maximize these global experiences, social work educators need to develop course content that focuses on (1) definitions and controversies of global social work; (2) impact of a globalized economy and western systems; (3) understanding the history of specific country contexts, including pressing economic and social issues; (4) applied experiential activities that cultivate self, other, and contextual awareness; (5) learning activities that allow for thoughtful reflection, rather than instinctual reaction to interactions with local community; and (6) debriefing opportunities that allow for safe place to explore steps and missteps.

First, through discussion, critical thinking, and self-reflective process with course instructors and peers, students can gain an important understanding of who they are in a “foreign” context. Discussions designed to safely encourage honest reflections about personal identity should also be included and regularly exercised in these discussions (Razack 2009).

Next, in terms of self-reflexivity, there is emerging evidence that students who benefit most from studying abroad are those who approach their learning experience openly and with some degree of flexibility for change. They are eager to learn, listen, and observe course and site offerings, regardless of their personal preferences. Course instructors may benefit from addressing students expectations, through ongoing group discussions, where they can discuss stressors and coping skills as many international learning experiences trigger unexpected feelings and reactions that are sometimes negative.

Finally, in order to gain knowledge of “host” country’s political, economic, social, religious, and military systems, emerging social workers may benefit tremendously from learning about non-western social systems while at home and in country. Course instructors should include a systems perspective as part of their curriculum, at home and in country, as a way for students to critically examine this very useful and powerful point of comparison. A critical look at this point of comparison (e.g., U.S. and host country), offers students an abundance of knowledge that they can use for their personal and professional growth. Specifically, Razack (2009) asserts, “as we continue to teach from texts that are still by and large Western and Eurocentric, we must strive for a balance through postcolonial critiques to resist the stranglehold of colonization and hegemony which could easily be sustained through complicity in benevolent responses to social issues” (pg. 19).

Summary

This paper attempts to outline the rationale for social work to advance as a globally focused profession and most importantly, emphasizes the imperative for the profession to address human suffering locally and globally. As a result, the values, theories, and methods of social work need room to evolve via examination, adaptation, and extension. Barlow (2007), emphasizes that “the most dominant challenge in developing (global social work)…is freeing them from abiding exclusively by dominant western paradigms and helping them ‘confront different views of human behavior, learn different systems of social welfare and see different ways to remediate social problems” (Barlow 2007, 243).

A bi-directional approach benefits the social work profession by informing practice models that recognize the worth of values outside of a western paradigm. Further, social work organizations can continue to work towards a definition of global social work and to develop new theories and methods applicable to populations outside the West. Without the infusion of knowledge and perspectives that are “outside” social work and lacking input from the global context and local stakeholders impacted by the specific social ill, multilevel social work interventions could be misaligned. Collaborative action models of global social work are based on the premise that in order to generate new solutions to global human suffering, bi-directional exchange is needed. The outcomes of this exchange are more likely to be able to produce practices, service models, and policy level interventions that are accessible, relevant, effective, and sustainable within community and countries of highest need.

Contributor Information

Gary Parker, Adjunct Faculty, Silver School of Social Work, Deputy Director, McSilver Institute for Poverty Policy & Research, New York University, New York, USA, gary.parker@nyu.edu.

Samira Ali, Post-doctoral Fellow, McSilver Institute for Poverty Policy & Research, New York University, New York, USA, sa1112@nyu.edu.

Kassia Ringell, Research Scientist, McSilver Institute for Poverty Policy & Research, New York University, New York, USA, kr487@nyu.edu.

Mary McKay, McSilver Professor of Poverty Studies, Silver School of Social Work, Director, McSilver Institute for Poverty Policy & Research, New York University, New York, USA, mary.mckay@nyu.edu.

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