As a young clinical social worker, I worked in the for profit sector, starting as a direct clinician and moving rapidly into management. It twisted my brain and opened to me a whole new world of idealism-smashing experiences.

Going to social work school, getting an MSW, doing internships… these were easy choices for me. Having majored in psychology, I knew that if I wanted to make a decent living, I would need a master’s degree. I knew I wanted to improve the world, to help under-served, marginalized, exploited, suffering people. I had a knack for talking to people and I developed that knack into a professional identity: MSW! LCSW!

I was quickly recruited.

Working at a for-profit sector health-services organization really threw me for a loop. As a clinician, I was pressed to make the company more money. The company was primarily answerable to investors and shareholders who cared little about the people working on the ground floor and the people they were helping.  We were selling a service, sure, but the ultimate goal was profit for investors. The disconnection between senior management, and the actual work of helping people was devastating. I was promoted to management because I was good at my job; however I soon found that I was caught between my values/ethics and what the company wanted.

It is my firm belief that the profit motive and social work are at odds with one another. My clients were those most negatively impacted by our capitalist society. Working with them, helping them, I was part of the sector that had produced so many of their problems.

I was constantly confronted with systematic obstacles, such as how do you help someone get what they need if they don’t have health insurance? Sure, there is the Affordable Care Act – but quite frankly, it just mandates enrollment into the profit-making system of healthcare. At the end of the day, I concluded that we need “Medicare for all”. We need to get the money out of healthcare. Then we can do the real work of social work.

Not-for-profit agencies may be best for you. It’s a tough world we live in, and we are all trying to make sense of it, including the helpers. Scrutinize the websites. Do some research into who owns the company. Don’t be drawn into a bigger wage or bonus if it compromises your ethics. I did, and I quit. You came into clinical social work to help, right?


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