Why Liberation Health?

(Adapted from Belkin Martinez, D. (2014) Liberation Health: An Introduction.  In Belkin Martinez, D. & Fleck-Henderson, A. (2014). Social Justice in Clinical Practice: A Liberation Health Framework for Social Work.  London, Routledge.

Why Liberation Health:  Our Historical Moment.

  • Today, the top 1 percent of all US households earn seventy times as much as the bottom twenty percent of households. This is more than three times what it was thirty years ago.   In the United States, the share of national assets owned by the richest one percent of households has grown from one fifth to over one third of all private wealth; this represents the most unequal distribution of the nation’s wealth since 1928, the beginning of  the great depression.  There are now 50 million people who are officially poor, the largest number of people living in poverty since the United States began to measure poverty (Reisch, 2013, p 71; US Census Bureau, 2012).
  • Crisis in the housing: Home foreclosures have increased nine percent since 2011 -2012. While is difficult to obtain specific statistics regarding the number of homeless individuals, it is estimated that there are at least 630,000 people on any given evening that are considered homeless.  These figures don’t include an estimated 6.8 million who are currently doubled up with friends and families (National Alliance to End Homelessness, 2013).
  • An increase in food insecurity:  According to the U.S Department of Agriculture, there are currently fifty million people in the US, one out of every six Americans, who experience food insufficiency. (Resich, 2013; US Department of Agriculture, 2012).
  • Growing incarceration rates: Today, there are more African Americans that are under the control of the criminal justice system (prison / jail, probation/parole) then were enslaved in 1850.  As of 2001, one in six African American men has been incarcerated.  If current trends continue, one in three African American males born today can expect to spend time in prison during his lifetime.  (Alexander, 2010; NAACP, 2013)


Social Work and Social Justice:

“The primary mission of the social work profession is to enhance human well being and help meet the basic human needs of all people…with particular attention to people who are oppressed… fundamental to social work  is attention to the environmental forces that create, contribute and address problems in living” (NASW Code of Ethics, 2002)

While our commitment to social justice is a key component of our code of ethics, neo-liberalism’s impact on the social work profession has been on-going and dramatic. Many social workers find themselves overwhelmed by the number of clients they are required to see at the same time that they face reduced resources and limited options in the way of services they can provide. The shredding of the social safety net, a hallmark of the former New Deal welfare system, has dramatically altered the institutional context in which much social work occurs.

Our current historical moment of Neo-liberalism, in theory and practice, is fundamentally antithetical to social work’s ethical foundations. Its ideological assumptions run counter to what the best of traditional social work taught. It promotes individualism – the belief that individuals are fundamentally on their own.  It argues that whether an individual sinks or swims is up to that individual; and society, much less the government, has no obligation to lend a helping hand. It insists that the “invisible hand” of the market, if left alone to do its work, will provide benefits for all who conform to its norms.This ideology has had a corrosive impact on social work theory, influencing practitioners’ values, beliefs, assumptions and attitudes. And it has had an equally harmful impact on the profession’s practice, compelling clinical social workers to increasingly devote their attention to assisting clients to adapt their thinking and behavior to the “new normal” of the neo-liberal social order rather than working with them to challenge it.

The combination of increased social dysfunction resulting from implementation of the neo-liberal agenda in society at large and the challenges of the mainstream social work response have resulted in a growing crisis in the profession and the proliferation of opportunities for new and alternative theories and approaches in social work to gain a hearing.

  Liberation Health Social Work What is Liberation Health:  A Two Sentence Summary.

  • A theory of human behavior which conceptualizes that the problems of individuals and families cannot be understood in isolation from the economic, political, cultural, and historical conditions which give rise to them.
  • A method of practice which helps individuals, families and communities understand the personal, cultural and institutional factors that contribute to their problem and act to change these conditions; to liberate themselves from both internal and external oppressions

Previous generations of social workers, particularly during the Great Depression and again starting in the 1960’s, worked in periods of deep social crisis similar to the present, and the challenges of their times moved them to call into question many of social work’s dominant paradigms. They pointed to inadequacies in mainstream social work models and struggled to develop effective alternatives (Brake and Bailey, 1980; Corrigan & Leonard, 1978; Ferguson, 2009; Fook, 1993; Lavalette, 2011; Lee, 1994; Reisch & Andrews, 2002; Specht & Coutney, 1994.)  Their critiques targeted in particular the profession’s focus on individualizing social problems and, as a consequence, developing individualized solutions, while minimizing the structural and institutional factors contributing to clients’ problems (Reisch, 2013). And they looked to a range of social movements outside the social work field to ally with in a common fight for a more just and equal world.   These social workers forged a rich radical tradition, the memory of which has largely been forgotten today.

The Liberation Health social work model is a product of the current social, economic, and political crisis. Believing that “another social work is possible!” (Ferguson, 2009), it builds on past radical traditions while seeking to develop new paradigms for social work appropriate for our current crisis.  It shares this goal with a significant number of social workers around the world who are also looking for critical and radical ideas to help explain the problems social workers and clients experience and offer a guide to an alternative social work practice (Ferguson & Lavalette, 2013)

The Liberation Health social work model seeks to provide practitioners with practical tools for effective clinical work in the era of neo-liberalism. Embedded in these practical tools, however, are broader visions of what social work should be.  Liberation Health envisions a new practice of social work that is:

  1.       Holistic: situating individuals’ problems in their full matrix of personal, structural, institutional and ideological determinants.
  2.       Critical: refusing to accept neo-liberalism and refusing to accept the notion that social work ought to subordinate itself to its social agenda.
  3.        Empowering: seeking to liberate clients and social workers from the confining belief that current conditions are inevitable and beyond our power to change: seeking to support their becoming active allies of individuals and movements working for social change.
  4.       Hopeful: rescuing the memory of and valuing “the collective human capacity to create change” (Reisch, 2013, p. 68).


Finally, it is important to note that the vast majority of clinical situations presented in this book can be considered “success stories;” that is, the client or family member found the work to be helpful.  As with all practice theories, there are many examples of clients not finding the work to be helpful.  For the purposes of this book, we deliberately chose examples which would help teach this theory of practice and offer hope that another model of clinical social work is possible.  In every case, we hope that our asking the kinds of questions described in this book plants a seed for both clients and social workers to think about clinical issues differently; to see themselves and their problems as part of a much larger sociopolitical system and to take action, in whatever way they feel will be helpful.  To paraphrase Reisch & Andrews (2002), the road to liberation practice might be the road not taken, but this road not taken lies ahead (p. 235).