Two fundamental currents of action and thought have borne social work on its winding course during the last 125 years: adjustment and social reform. Concern with adjustment and functioning — whether at the personal or family level — is embodied in the tradition of social casework. The settlement house movement, political and legal advocacy, and community building embody concern with changing the broader environmental conditions under which people live. Over the course of the 20^th century, social work has oscillated between these two conceptions of itself and its role.

• The Progressive Era up to the 1920s was dominated by concern with reform.

• The 1920s saw the ascendance of psychiatric social work and the decline of the settlement house movement.

• The Depression ushered in a new radicalism with many initiatives targeted on improving the employment, health and educational level of poor people.

• In the 1940s and 1950s most social workers returned to a concern with casework and technique and withdrew from involvement in social action and reform.

• The 1960s witnessed a resurgence of social engineering.

• The later 1970s, 1980s, and 1990s have been distinguished by a focus on professionalism and clinical practice.

The last great reform phase — the end of the 1960s and beginning of the 1970s — brought major changes that seem foreign in today’s casework-centered environment. The National Association of Social Workers changed its bylaws to state that the profession had a dual obligation to use "both social work methods [i.e., casework] and … social action" to prevent and alleviate "deprivation, distress, and strain." The Community Service Society of New York, an Alliance member, announced that it is discontinuing casework. Its director, James Emerson, said, "If you don’t deal with the pathology of the ghetto, all the individual counseling you do with a person is not going to help."

In words that presage contemporary advocacy for community-centered practice he continued, "The situation is not just a matter of persons with problems, but rather of whole areas afflicted with social ills. If the individual is to be helped, someone has to deal with the complex of social ills that bears on the individual, not just on the individual himself. We are convinced that an approach that focuses primarily on individuals may help some people, but will not really alleviate the basic problem of a sick community. Instead of starting out by saying that the individual is the client, we’re going to say the community is the client."

Among the major historical influences causing these shifts in our field are the following:

• The drive for professionalization of the field in the early 20^th century generated a preoccupation with method in social work.

• The failure of the War on Poverty in the 1960s fueled the perception that poverty was intractable.

• The lure of money in behavioral health and efforts to qualify for associated funds supported the broad adoption of a medical model for practice, even in public social services.

• Micro- and macro-practice, never theoretically coupled, were pursued as separate tracks in schools of social work.

Broadly viewed, when progress was made in addressing the conditions under which poor people live it came in response to pressure "from below," from advocacy by private groups and individuals, often arising out of great public crises such as the Depression. Retrenchment occurred when the voices and influence of advocates waned, and government policy making was left to operate more or less according to its own lights, via the conventional political process. If this observation is true, then advocacy and mobilization of constituencies are the key to progress at the national level. And this, in turn, has proven to be the key to broad progress at the local level.