Social work’s commitment to an environmental perspective has been its hallmark, the feature that has distinguished it from other helping professions. Yet the definition and utility of person-in-environment have been inconsistent and poorly conceptualized, varying by practitioner as well as by cohort and era. As this thematic analysis of interviews with 30 clinical social workers reveals, ‘environment’ has both broad and specific meanings in contemporary practice, with horizontal (current) and vertical (historical) dimensions ranging from situational triggers to cumulative adversity. Social work clients bring to the clinical encounter a personal and socio-cultural history that they live ‘with,’ as well as a multi-faceted present context that they live ‘within.’ While participants in this study agreed that inclusion of context was essential for understanding a client’s story and struggle, they did not find environment to have significant clinical ‘power’ for treatment decisions or as a guide to practice. These findings raise important questions about what constitutes a uniquely ‘social work’ intervention, particularly in an era when treatment is increasingly shaped around de-contextualized psychiatric diagnosis.