Clinical vs. Macro in the BU On-Campus MSW Program

Hey there, my name is Mae and I am a second-year clinical student at Boston University School of Social Work.

When it came time for me to choose between a Clinical or Macro Practice major, I thought of the famous phrase, “To be or not to be? That is the question…” I thought I had to choose one or the other and couldn’t do both. Luckily, I was wrong! At BUSSW, you can be a Clinical major with a Macro minor or major in Macro and declare a specialization like Behavioral Health or Trauma & Violence. There are a total of four specializations for students to choose from. I know many people who have chosen a minor, a specialization, or even pursued a dual degree such as the MSW/MPH (social work/public health) to bring together macro and clinical social work practice.

Given all these options for degree customization, choosing a major can still be a very hard decision. One thing to keep in mind is that social work is an amazingly wide-ranging profession that encompasses a huge variety of jobs. The possibilities are endless, and although choosing a major can feel like you’re selecting your future career path, you’re not.  If you are having a hard time choosing a major, know that there is time to change your mind after you begin the MSW program and that all students will get exposure to both clinical and macro social work in the foundation classes.

Mae (right), BUSSW student ambassador, pictured pre-COVID with friend and classmate Jordan.

For me, choosing between clinical and macro came down to these questions: Do I ever want to be licensed, and do I possibly want to open my own private practice someday?  After a lot of thought, I realized my answer was yes. I chose the Clinical Practice major so that I can build a strong “toolbox” of clinical intervention skills and keep open the possibility of having my own private practice.

I was lucky to go through this confusing experience with my friend and classmate Jordan (pictured on the left) and we both took different paths. Jordan decided to major in Macro and pursue the Lowy Specialization in Aging Practice, Policy and Social Justice. In his first year, he completed a clinical field placement and now, in his second year, he is in a macro placement.

Macro social work is focused on changing the systems in which people exist rather than focusing on the individuals within the systems. Students in the macro major learn about community organizing, program development and implementation, policy work and much more.

I was able to start in a clinical placement during my first year and then transition to a macro placement for the second half of the year. Now in my second year and having ultimately chosen the Clinical major, I am back in a clinical placement building my clinical toolbox.

Clinical social work focuses on working one-on-one with individuals and in groups, and a Clinical student’s goal is to gain the skills needed to work in a clinical social work setting, which can be based anywhere from a hospital or school to a private practice or a mental health clinic. Skills that Clinical students learn include therapeutic intervention, strength-based approaches, and motivational interviewing.

Although I am a Clinical major, I have been able to also practice macro social work by engaging in extracurricular activities. I am a member of BUSSW’s student organization, Student Union, and I’m also the MSW student representative for the board of the National Association of Social Work (NASW) Massachusetts Chapter. Additionally, I’ve witnessed my BU-MSW friends choose a variety of different paths and have found that getting to know your classmates can lead not only to wonderful conversations but to new perspectives.

To sum it up, you are going to have exposure to both Macro and Clinical in your first year, through classes and internship options. As an MSW student, it is important to learn what you can about the profession, career options, and the important roles that social workers perform in society. So take your time picking your major and, as you work towards becoming a social worker, remember that you get to decide what the profession means to you and pursue what you want to get out of your MSW degree.


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