Eating PIE

My field placement in substance abuse services is a very demanding workplace with staff who hail from a multitude of backgrounds and professions. Each brings his/her own unique and valuable skills and insights to the work we do. But it wasn’t suprizing to me that I didn’t have to be there very long before I could easily identify all the social workers from the rest of mix. I didn’t need to see their name tags or read their credentials on some memo. I only needed to listen to their comments about agency mission, client systems, service delivery, problem solving, and program outcomes.


You’ve probably heard the phrase, “they all drank from the same kool-aid.” I’d like to propose that the social worker’s version of that should be, “We all ate from the same PIE,” and indeed, we have! PIE: Person-in-Environment perspective.  The NASW Standards for Clinical Social Work handbook states, “This orientation views the client as part of an environmental system. It encompasses reciprocal relationships and other influences between an individual, relevant others, and the physical and social environment” (p.10).


In a culture that embraces a medical model designed to evaluate the client in terms that are measured and articulated by pathology, dysfunction, disorder and diagnosis the transactional processes enveloping the client in his/her world can be soon overlooked.  Corcoran and Walsh (2010), Pargament (2007), and others have explicate this distinction quite well by focusing our attention on addressing the biopsychosocialspiritual factors which directly and systemically influence the quality of human functioning rather than concentrating all our attention on the presence or absence of so called “normal” personal characteristics.


While many mental health professionals, programs and service plans may concentrate on the Axis I, II and III of the Diagnostic and Statistical Manual of Mental Disorders (DSM) (APA, 2000) , it has been my experience that social workers are perhaps even more focused on Axis IV psychosocial and environmental problems. It is certainly not that the previous axes are unimportant, but rather that they can be better understood and addressed recognizing that they exist and are expressed within a particular physical and social environment, context and system. It is here on this essential level that clinical social work shines.


To my fellow MSW candidates who now have their eyes fixed on the month of May I’d like to say, please help yourself to another large helping of PIE.  And to those of you considering the profession, I encourage you to look at the world around you that you aspire to change. Ask yourself how you could do that if you did not see the contextual conditions and interactions of those you long to help. And then, by all means, please pull up a chair, grab a plate, and have a delightful slice of this PIE.



American Psychiatric Association (2000). Diagnostic and statistical manual for mental disorders (4th ed. Text revision). Washington, DC: American Psychiatric Association.

Corcoran, J. & Walsh, J. (2010). Clinical assessment and diagnosis in social work practice. New York, NY: Oxford University Press

National Association of Social Workers (NASW) (2005) NASW standards for clinical social work in social work practice. Washington, D.C.: Author.

Pargament, K.I. (2007). Spiritually integrated psychotherapy: Understanding and addressing the sacred. NY, NY: Guilford Press





About Marguerite Keil

Ancora Imparo! To sweet endings, new beginnings and live long learning! I have now finished my third and final year of the UNC-MSW program and it has exceeded my expectations! I completed the first two years through the Winston Salem Distance Education program that was phenomenal and have now just finished an equally great year here on campus. Certainly I leave the program with more knowledge, but more importantly, I leave with more personal insight and a clearer sense of myself. But this is not the end - only a new beginning. In a few weeks I embark on a new career - not the one I envisioned with the full-time employer I had when I first enrolled. Instead, these years of academic training and field work have blazed a new path and opened new doors of opportunity. They have brought new people and a new scope of practice into my life. I owe a good part of this to the certificate program (Substance Abuse Certificate in my case), which is why I want to encourage others to pursue some certification or licensure along with their MSW. Yes, it does mean more work, but in the end I am quite sure you will be glad you did. And the experiences you share with those pursuing the same path will make your time at Carolina that much sweeter and memorable. Blessings! ~mk
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