Blending macro and micro practice and leaning into leadership

“If I’m going to be working so much, what do I really want to do with my life?”

That’s the question Paul Perales asked himself as he pondered his work with the Green Bay Packers. Now an LCSW who serves as an ASWB Exam Committee co-chair, Perales had finished his undergraduate degree and was working in the Packers’ corporate offices, coordinating sales and special events for the team. For Perales, the most engaging part of his job at the time was coordinating fundraising events for nonprofits or managing volunteer projects for the staff. As he considered what his next step would be, two paths seemed viable: public health and social work.

Stepping into an MSW program made sense, Perales says, because of an undergraduate research fellowship that introduced him to social workers involved in HIV prevention work in San Francisco. His mentor on that research, Raphael Diaz at the Center for AIDS Prevention Studies, had just written a book on Latino gay men and HIV prevention related to the sociocultural barriers to safer sex practices.

“Through that research I did in my honors project, I was looking at what professionals said the population needed and what the population said they needed, and coming up with recommendations based on that,” Perales says. “It was through those early experiences that I really got to know some social workers and the grassroots, not-for-profit work that was going on.”

This is a way that I can integrate what I'm doing on the micro level ... and then the more macro practice with the licensure exam and that sixth responsibility in our NASW Code of Ethics.

Perales enrolled in the MSW program at the University of Wisconsin Oshkosh, focusing heavily on clinical coursework and preparing for his career as a licensed clinical social worker. “I knew I wanted clinical classes,” Perales says, “because our generalist curriculum would really allow us to do anything.” His field education placements included working in a nonprofit agency’s intensive outpatient program for children and adolescents. Perales joined the agency full time after he received his MSW, but the realities of supervision requirements pointed him in a different direction. “I knew that I would be able to get my clinical license quicker if I went into an inpatient hospital,” he says. Though he was working with the same population, the experience was much more intensive, with a broader range of diagnoses. “I worked side-by-side with psychiatrists and nurses and [occupational therapists],” he says. Perales was able to complete his LCSW while he was employed with the agency, and after five years, he transitioned to working with adults in an inpatient setting. “I made the switch because I really enjoyed the work, and it was a whole new world for me.”

“I enjoyed working with adults because they have parents and they’re dealing with children. It really opened my eyes to that person-in-environment perspective of social work.” He also started supervising social work students for their field education — becoming a mentor to MSW students preparing for practice. The agency had provided field education before, Perales says, but the program had waned. “I was interested in it, and my supervisor kind of helped revive it.” The field education program grew from two students to about six students each year. “I was looking for a way to give back,” Perales says, “and really thinking more about how I can be a leader and a mentor.”

By that time, Perales had also become an item writer for the social work licensing exams. “This is a way I can give back to the profession and fulfill my ethical obligation to the broader society by protecting consumers through the licensing program,” he realized. Writing exam questions “flowed naturally with what I wanted to do,” Perales says, because it gave him an opportunity to exercise different social work skills and knowledge. “I had read and learned in school that sometimes social workers had a difficult time finding a way to do macro practice with the micro practice,” Perales says. “This is a way that I can integrate what I’m doing on the micro level … and then the more macro practice with the licensure exam and that sixth responsibility in our NASW Code of Ethics.”

Perales worked with his ASWB item development consultant, who became another professional mentor for him as he continued writing exam questions. “I was seeing leaders and mentors,” in working as an item writer, “and thinking ‘I have the same training that they do. How can I give back and lead and do a little bit more?'” In addition to supervising MSW students, Perales started guest lecturing at his alma mater. “I think [being involved with] ASWB really influenced me in the trajectory of my career.” Perales eventually opened his own private practice and, through that, discovered military social work, now his specialty.

Perales spent a year in Stuttgart, Germany, as a military family life counselor for the Department of Defense and took a break from writing exam questions. “When I came back to the States, I started writing again,” he says, having gained a broader perspective.

“My international experience, my military experience on an active-duty joint forces base, brought an ability for me to integrate that into my item writing,” Perales says. “I had an additional frame of reference to bring to the questions.”

“There was a time where I decided to stop item writing,” Perales says. He had talked to his item development consultant about stepping back from writing exam questions. “But I didn’t have to [leave the exam program entirely] because there was another role I was really interested in. I had heard about the Exam Committee,” Perales continues. “I wanted to be a part of it, and somehow it found me.”

At his first Exam Committee meeting, Perales says he “kind of knew what was going to go on — a little bit about the process.” As a new member of the Clinical committee, he was “sitting back and watching and listening and learning, [but] it was such a welcoming, open group that it was really easy to join in” as an active participant.

Perales’s experience in military social work led him to the role of director of psychological health for the Wisconsin Army National Guard, which gave him a different way to blend macro and micro practice. He noted that his international experience and his participation in the ASWB exam program gave him the confidence to pursue the new leadership role, responsible for the behavioral health of 1,500 service members.

In addition to direct practice, Perales was also involved in public health messaging and psychological public health messaging. “It was definitely an opportunity for me to do both macro and micro, which I had always been looking for in my work.”

Currently, Perales is leading a team of clinical social workers providing psychological health services to active duty service members with the State of Texas National Guard. Once again, he is blending micro and macro, teaching, mentoring, and providing supervision to other social workers.

Perales continues to explore new opportunities as a social work leader. In addition to serving as one of three co-chairs of the 2024 Exam Committee, Perales was recently elected to serve on the board of directors of the Wisconsin Chapter of the National Association of Social Workers. His involvement with the social work licensing exams has also inspired him to explore other roles in regulation. “One of my goals is to apply and hopefully get appointed to the Wisconsin Marriage and Family Therapy, Professional Counseling, and Social Work Examining Board.”

“Being a part of both the item writing program and the Exam Committee have really informed my practice,” Perales says. It has connected him “to a community of people who are very supportive.”

“It makes those parts of our practice — the evidence-based, the best practice, the code of ethics — less abstract,” he says. “I feel like ASWB has influenced my professional goals and my career trajectory.”