One of the highest traditional social work values is the maximization of client self-determination. In actual practice it is a difficult ethic to uphold, especially in this time of budget cuts and overwhelming caseloads. This article examines an orientation toward practice that places consumers at the center of decision making and control. The author examines current trends in the consumer movement, including advances among the aging, disabled, and mental health client populations. A comparison of medical-rehabilitation and independent living paradigms is presented to demonstrate fundamental philosophical differences. The author introduces suggestions to enhance participation by consumers for direct service workers, administrators and supervisors, and social work educators.
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