A Survey-Based Study of Social Workers' Critical Consciousness and Practice With LGB Clients

Background and Purpose: Social justice, embraced by the social work profession and included as one of the principle values in the Code of Ethics, is difficult to define and even more difficult to operationalize.  Yet it is assumed to be present in a social worker’s practice.  Informed by structural, critical, and anti-oppressive theories that highlight the role of critical consciousness in guiding socially just work with historically oppressed populations, this research examines the intersection of social justice and direct social work practice as they relate to mental health and substance abuse service provision for lesbian, gay, and bisexual (LGB) clients.  This study investigates the specific question:  In what ways is critical consciousness manifested in practice with LGB clients?  The relevance of this research lies in the fact that social workers provide the majority of behavioral health services in the U.S., and consequently are at the forefront of service delivery to members of the LGB population who disproportionately utilize mental health and substance abuse services.

Methods: This is a cross-sectional survey of 220 BSW and/or MSW social workers who have provided mental health or substance abuse services in the past year. Respondents were recruited via a United Way 211 referral list for a large urban area in a Northeastern state and social networking.  Surveys were administered with Survey Monkey and face-to-face interviews.  The instrument was comprised of validated measures (e.g., Sexual Orientation Counselor Competency Scale; Heterosexism Awareness Subscale of the Privilege and Oppression Inventory), that capture aspects of critical consciousness (i.e., attitudes about social justice and heterosexism), and items developed specifically for this study.  Practice with LGB clients was measured with a series of questions that asked about skills, knowledge, and engagement with consensus-based practices.   Statistical methods included ANOVA (including post-hoc testing) and ordinary least squares regression.

Results:  Networking (92%), researching laws and policies (85%), and encouraging clients to vote (79%) were the most endorsed social justice activities.  Respondents with more critical consciousness as evidenced by awareness of heterosexism, positive attitudes towards LGB persons, and greater engagement in social justice activity in their personal and professional lives, including their encouragement of client engagement in social justice activity, have higher skills and knowledge scores and utilize more promising practices with LGB clients (two-tailed p value ranging between .001 and .05).

Conclusions and Implications: Social workers who have greater critical consciousness report more skills and knowledge related to practice with LGB clients.  While additional study is needed to replicate the results, they may be relevant for social workers who are engaged in direct service with LGB populations who wish to cultivate a practice that is reflective of the profession’s commitment to social justice.  Implications include the need for ongoing training on best practices with the LGB population, and development of critical consciousness in both academic and employment settings to facilitate the use of best practices.  Further exploration of social justice operationalization in a direct clinical practice is warranted.