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Health Practice Shifts Base to Community

Public Health Social Workers Are in a 'Unique Place'

Changes have brought about a new emphasis on community-based care.

Social work is a dynamic, changing field. Among many changes in the profession, one major shift has been the move from health-related social work that is focused on traditional, hospital-based care to practice that is more community based and linked to public health paradigms.

This shift has come about for a number of reasons. Managed care has made a big impact on treatment and the role of social workers. In the mental health arena, a strong movement changed the pattern of psychiatric hospitalization. And as society has changed, a focus on interdisciplinary, community-based care has emerged.

Changes in health care. Betty Ruth is the director of Boston University's dual-degree program in social work and public health. She explained that there have been significant changes in the health care field that have altered the role of social workers. These changes have brought about a new emphasis on community-based care, short-term interventions, prevention and health promotion.

"Part of what I'm talking about is the entire transformation that's gone on as we've moved to managed care," Ruth said. "The emphasis on managed care [results in] the need for us to really be able to talk about program outcomes, to talk about the evidence base for the work we're doing, to be able to suggest that our interventions are meaningful," Ruth explained.

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