Social Justice in Clinical Practice: A Sytematic Review

Background and Purpose

Social work identifies social justice as a foundational ethical value of the discipline. However, though the NASW Code originated in 1960, it was not until 1996 that “social justice” was added as a core value (NASW, 2018). Since the profession’s expansion beyond community work to re-oriented its focus to include clinical practice, the connection between social justice and clinical practice has not been clearly articulated, with social justice often relegated to macro practice. This issue becomes more urgent with the release of the Grand Challenges—particularly the challenge of achieving equal opportunity and justice for all—which re-emphasizes the role of all social work in the pursuit of social justice. For that reason, this paper engages in a systematic review of the literature to ask: 1. What is the current scholarship on social justice and clinical practice? 2. What proportion of the literature on social justice and clinical practice is generated by social work vs other disciplines? 3. Do the salient themes in the literature differ between social work articles and those from other disciplines?

 

Methods

This systematic review examined academic literature on social justice and clinical work, within social work and related disciplines. Inclusion criteria was limited to articles published in peer-reviewed, English-speaking academic journals from January 1990 through December 2017. The strategy for this systematic review included searching six common abstract indexing search engines, using a total of 286 unique search strings using two sets of search terms. Following, an iterative screening process was undertaken to determine article eligibility. Titles and abstracts were examined independently by two researchers, with discussion to consensus, to identify duplicates and relevant studies.  This process yielded (N = 68) suitable articles.

 

Results

Among the articles (N = 68) found in this systematic review, nearly all (n=54) were “think pieces,” with little empirical work. Just 26% (n = 18) were specific to social work. The majority of journal articles that focused on social justice in clinical work were from the companion fields, including psychology (n = 20), counseling (n = 22), marriage and family therapy (n = 5), education (n = 2), sociology (n = 1). Two prominent themes were identified across the social work literature (1. cultural competence; and 2. finding congruence between clinical work and social justice) and two overarching themes in the literature of the companion fields (1. integrating social justice training into clinical curriculum; and 2. Integrating social justice theories into clinical work).

 

Conclusions and Implications

These results reveal there is a major gap in the social work literature concerning social justice in clinical social work. Very little is known about how social justice is actually operationalized in clinical practice. While the social work profession, which promotes social justice as a core value, should be leading the discussion on incorporating social justice into clinical practice, companion disciplines are having this discussion with greater frequency in the literature. Furthermore, the literature of social work and its companion fields seem to be focused on different aspects of this conversation.