This paper explores a citizen-based approach to social work which may counter modern negative managerialist pressures on practice. It links the discourse concerning the growth of user involvement in public policy with the discourse about participation in political activity and suggests a role for social workers in supporting service users in initiatives such as self-help, campaigning and community action which offer a new interpretation of community-based social work. By engaging in this activity, health and social care professionals can support people to participate in emerging forms of active and inclusive citizenship. While participation in traditional political activity such as voting and political party membership is declining in the UK, people in marginalized groups are finding ways to have their voices heard about issues which directly concern them. Increasingly, groups such as disabled people, older people and mental health service users/survivors are taking part in activity which marks a shift of focus to include both self-help and campaigning. In contrast to their disillusion with traditional political activity, people across a range of groups have gained strength and encouragement from campaigning achievements. The paper draws on a national research study which offers fresh insights on these issues as a basis for exploring participative approaches to social work practice.