Whatever's being transported has to go against the concentration gradient. So depending on whether the concentration gradient is lower inside the cell or out, that would determine the direction of the active transport. But at any given concentration gradient/situation, the active transport could only go in one direction.
But, I don't believe the concentration gradient of the thing being transported has to go in the same direction as the Na+ concentration gradient.... symport/antiport both possible. Somebody correct me if I'm wrong.