Integrative Family Therapy With Childhood Chronic Illness: An Ethics of Practice

A challenge for contemporary family therapists is negotiating differences between modern and postmodern frameworks in the practice context. Modernists espouse a systemic metaphor; use evidence‐based and interventive approaches, including strategic, structural‐ or solution‐focused techniques, and believe in the therapist's knowledge, expertise and power to influence individuals or families to change. On the other hand, postmodernists follow a social constructionist, dialogical or narrative paradigm, which identifies the main ingredient of therapy as language, conversation, understanding and the therapist's ‘not knowing’ stance in eliciting a person's expertise and story Yet many practitioners adopt a middle way between these paradigm polarities, one that is less theory‐driven and more pragmatic, flexible, integrative and practice‐based. This is consistent with evidence‐based practice and research demonstrating common factors across all therapies. The value of preserving systemic thinking in family therapy is recognised while reaching forward to a postmodern social constructionist and dialogical approach. The article describes this integrative stance in family therapy as paramodern based on an ethics of practice. This is illustrated by a detailed case study of integrative family therapy, which addresses anxiety, anger and sleeping issues associated with a chronic childhood illness called Perthe's disease.     

Limits and Possibilities of the Postmodern Narrative Self

The task of theorising the self has been of little interest historically in systemic therapy, yet becomes more interesting in the postmodern turn to the narrative metaphor and social constructionist ideas. Within this frame, the self is theorised as relational, fluid, and existing in narrative. The ‘postmodern narrative self’ counters modernist assumptions of self as an autonomous and fixed ‘internal’ entity, and brings with it theory and practice possibilities. However, any theory also brings limits, and this paper explores the limits of the central ideas of the postmodern narrative self. Through questioning and discussion, an argument is made for holding a dialectic in our thinking about the relational and autonomous self, for acknow-ledging very real boundaries on the fluidity of self, and for thinking of narrative as one way of knowing self, rather than exclusively constituting the ‘being’ of self.     

The power of discourse: Michel Foucault and critical theory

Abstract

The debate that contrasts Marxism and the work of Michel Foucault often overlooks that both projects share a political and ethical commitment. Both have moreover engaged that commitment by challenging what Marx called ‘traditional ideas’, viewing them as historically compilcit with the exercise of power. This ‘radical rupture’ with traditional ideas has been the hallmark of the critical theory project since The Communist Manifesto. By challenging traditional notions of power and language, however, Michel Foucault went further than the Marxist tradition in carrying out the critical theory project. Foucault's alternative ideas of discourse/practice and of power as ‘positive’ are moreover intricately linked in a way that has not been sufficiently appreciated. This is evident in a genealogy of Foucault's early work, where neither notion is able to take hold in the absence of the other. It only after The Archaeology of Knowledge, where Foucault rethought the relationship of language to reality, that he was able to formulate the notion of power as positive in works to come. This link should cause us to rethink our relationship to Foucault's work, of it to Marxism, and of the critical theory project to the power.     

Time,Space and Gender: Understanding ‘Problem’ Behaviour in Young Children

The following article reports on a small‐scale, exploratory study of aggressive and ‘problem’ behaviour in pre‐school children. This project was conceived in the wider context of anxieties about childhood and New Labour’s policy focus on ‘anti‐social’ behaviour in children. Based on interviews with nursery staff and parents in addition to participant observation undertaken in nursery playrooms, this article examines the relevance of time, space and gender for understanding problem behaviour in young children. Taking a social constructionist perspective and drawing on Foucault's ideas in particular, it examines the social processes which regulate and normalise behaviour in young children. © 2006 The Author(s) Journal compilation © 2006 National Children's Bureau.     

Igniting Constructionist Imaginations: Social Constructionism’s Absence and Potential Contribution to Public Sociology

Why have social constructionists remained absent from debates over public sociology? I argue that constructionist scholarship would be particularly amenable to Michael Burawoy’s notion of ‘organic’ public sociology, given the ability of constructionist scholars to orient awareness contexts in order to help engender constructionist imaginations. This approach requires that constructionists take on a different view of the role of the analyst. I also discuss some of the problems Canadian academics have had engaging with the media in their efforts to engage in ‘traditional’ public sociology, as well as what a constructionist public sociology may look like practice. I conclude by addressing potential challenges to a constructionist public sociology within Canada, including reference to sociology’s disciplinary coherence and how we can approach—and what we mean by—‘publics’.     

Insider/Outsider: A Muslim Woman's Adventure Practicing ‘Alongside’ Narrative Therapy

The following paper centres on my unique experience as a white Australian therapist who is able to sympathise with a Western world view while being immersed in an Islamic world view. The goal is to share my journey as a Muslim Australian via an auto‐ethnography reflexive method. Using diaries, intentional reflexive positioning, and multiple modes of supervision, I contemplate an Islamic identity and value system while negotiating poststructural therapies such as solution‐focused collaborative, and in particular, narrative therapy as viable approaches to working with the Muslim community. There are two inquiries which are of interest. The first is to reflexively describe the experience of being a Muslim practitioner and wondering whether core differences in epistemological views between social constructionism and Islamic doctrine can be overcome. Secondly, this enquiry explores Quranic guidelines about how to perceive ‘problems’ in life, based on the premise that understanding how an Islamic world view addresses life's troubles may add to deeper conceptions of the role of difficulties. I propose that adherent Muslims have a natural metaphorical way of thinking that connects with some of the poststructural therapeutic skills and techniques and at the same time draw on past Quranic solutions for contemporary problems. Little has been written on narrative therapy as a suitable approach to working with Muslim clients. In the current paper I review my personal experience as a veiled Muslim therapist striving to implement narrative therapy alongside an Islamic epistemology.     

Institutionalizing Scientific Knowledge: The Social and Political Foundation of Empirical Economic Research

Scientific knowledge is an essential component of modern society. Consequently, sociologists are interested in its production process and have conducted a broad variety of studies showing how social patterns influence the definition and the boundaries of scientific knowledge. In this paper, I ask how social factors influence the transformation of a ‘normal’ field of knowledge into a ‘scientific’ one. First, I give a brief overview of the development of the sociology of scientific knowledge exploring different approaches to the social foundations and boundaries of scientific knowledge. Second, I present a case study of the transformation of empirical economic research in the 1920s from a field of knowledge produced by journalists and civil servants into a prestigious scientific domain. I use neo‐institutionalist ideas to show that knowledge needs a socially legitimated organizational frame in order to count as ‘scientific’ and I examine how political needs to ‘manage the economy’ build boundaries around economic knowledge and define it as ‘scientific’ in order to control its production, distribution, and communication.     

The narrative self in autobiographical accounts of illness

The paper analyzes autobiographical acounts of the experience of chronic illness and its treatment to develop a sociological theory of the self. It is suggested that ‘self’ is not a biologistic or psycologistic thing. Rather self is autobiographical narrative – hence the narrative self. It is argued that four elements constitute such narrative selves in autobiographical discourse: evaluative relationships between events in time; cosmology; power relationships; and conceptualisation of self as object.     

Suicidal Ideation in the Palliative Care Patient: Considerations for Health Care Practice

In the present study, I outline how four social workers, with experience in working with women who self-starve, commonly known as anorexia nervosa, conceptualise this phenomenon. I conducted single, in-depth interviews with each worker and feminist discourse analysis was chosen as the method of text interpretation. Alternative (non-psychiatric) ways of understanding women's self-starvation were explicitly privileged. Hence, the alternative discourses of feminist and poststructural theories were used to design the research and analyse the data. The literature review outlines the historical ‘discovery’ of ‘anorexia nervosa’ as a discrete illness category. Contemporary and dominant ‘pathological’ perspectives and marginalised ‘cultural’ perspectives are presented. Three dominant themes emerged from the interviews. They were ‘control and perfection’, ‘femininity’ and ‘self-destruction/self-preservation’. These themes are presented, as are their critical implications for social work.     

A Foucauldian Analysis of Old Age and the Power of Social Welfare

Abstract

It is argued that the question of social welfare is a key, if often overlooked, component in the construction of power relations and identities in later life that can take its place next to debates on bioethics and consumer lifestyle. Foucault's (1977) claim, that identities are kept in place through the deployment of integrated systems of power and knowledge and a routine operation of surveillance and assessment, is critically examined in this context. Trends in social welfare in the United Kingdom are used as a case example that sheds light on wider contemporary issues associated with old age. Finally, implications for the creation of particular narratives about later life are discussed and grounded through Foucault's (1988) notion of “technologies of self.”     

Reshaping Clinical Practice for the New Millennium

In the new millennium, oppression will continue to affect social workers’ clients. This article discusses training clinical practitioners to address oppression. Drawing on poststructural, postmodern, feminist, and social constructivist theories, the article argues that to challenge oppression, clinical practice must address the dialectical relationship between private troubles and public issues while transforming professional relationships that disempower clients. The article describes a second-year MSW clinical practice sequence taught from feminist, poststructuralist, postmodern, and social constructionist perspectives, where students learn to assess the impacts of oppression, discover clients’ strengths, and respond in personal, social, and political contexts.     

'The State': A Comment on Abrams, Denis and Sayer

Abstract This paper answers the question,‘what is the state?’as posed in Abrams (1988) and Denis (1989), by examining Sayer's (1987) realist reconception of ‘relations of production’ and their ‘ideal superstructures’. It suggests that Sayer's alternative to ‘traditional’ marxism warrants a reappraisal of the relationship between Marx and Foucault. It concludes that ‘civil society’ and ‘the state’ are Janus-faces of production relations, generated by Foucault's ‘disciplinary practices’.     

The devolution of social work knowledge

I am interested in the conditions under which practice knowledge can be used and developed in social work. I argue that the images we tend to have of how social workers apply theoretical knowledge, or appeal to practice wisdom, are misleading because they exaggerate the epistemological significance of individual experience. The concept of ‘practice theory’ is not of much help here because its attempts to codify implicit knowledge, quite apart from begging several questions, illegitimately confer paradigmatic status on the individual's relationship with a text. Instead, we need to begin with a collective analysis of experience, an example of which is offered in the second half of the paper. In effect, this illustrates a systematic process of induction which subjects both personal impression and encounters with theory to some stringent intellectual tests.     

‘Listen: This Really Happened’: Making Sense of Social Work Through Story‐telling

The use of guided critical reflection and analysis is increasingly popular in the education and training of social workers, especially when students embark on their practice learning opportunities. This paper explores the use of structured story‐telling in tutorials as a way of helping students make sense of social work practice. By focusing on a narrative shared with a tutor group, the argument will be made that tutorials are important places to ‘monitor’ the self (and others) in social contexts, and are helpful places for students to identify their personal values and how these might link with their future professional selves.     

A toolbox for public relations: The oeuvre of Michel Foucault

In this article, we provide a brief introduction to the work of Michel Foucault. Our focus is on the major themes of Foucault's work: discourse, power/knowledge and subjectivity. We demonstrate the rich contribution that Foucauldian theory can make to public relations practice and scholarship by moving beyond a focus on excellence towards an understanding of public relations as a discourse practice with power effects.     

‘Building Bridges’

Abstract

‘Building bridges’ is a metaphor we have used to describe a collaborative research process involving social work academic and senior practitioners from government and non-government child protection and family service organizations in Victoria, Australia. The purpose of the research was to develop a ‘practice-generated approach to policy implementation’ in child protection practice. The research sought to explore the appropriateness of social constructionist approaches for child protection practice that might enhance the existing risk paradigm. This article aims to critically evaluate the process of ‘building bridges’ and its outcomes, by focusing on how potential and actual differences between organizational contexts, namely universities and various service-providing organizations, may influence relationships between theory and practice. We critically reflect on our research process comparing it with idealized forms of collaborative research discussed in the literature.     

The systems' approach and social work methods

Many social work courses are now using ‘system theory’, or as I prefer to call it, ‘a systems' approach’, in teaching social work method on a unitary basis. Most social work techers recognise that the systems' approach is not enough on its own and that traditional methods have a place in practice. What is not clear is how these methods relate to the systems' approach.

In this article the relationship between the systems' approach and various methods and theories of intervention is explored in a number of different ways. Firstly, there is an examination of the relationship of various client, target and action systems. Secondly. Lippitt's analysis of the ‘diagnostic orientations’ of change agents is discussed and related to strategies aimed at changing the goals and the power structures of target systems. Then certain counselling and casework methods are considered in relation to Lippitt's analysis, leading on to a brief comment on methods of intervention based on systems' theory. Finally, an educational strategy for presenting this approach is discussed.     

Is there a European social work identity?

The aim of this paper is to examine whether at this point in time the notion of a ‘European social work identity’ can be sustained. The paper commences with some brief consideration of theories of identity, and particularly draws attention to social constructionist identity theory, highlighting its focus on identity as a process. Ideas about what constitutes ‘collective identity’ are then examined. From this, two particular models of collective identity are presented which are helpful for understanding cultural identities. These are the more ‘traditional’ notion of collective culture being evidenced by the presence of shared histories and traditions, and the more social constructionist view of collective processes and action to form identities – whether imposed by the state or generated by the people – as constitutive of identities in themselves. ‘European identity’, and then ‘European social work identity’, will then be examined using these models of collective identity. The paper concludes that using social constructionist versions of identity (identity as a process of collectivisation), European social work identity can certainly be established.     

The Integration of Personal and Professional Selves: Developing Students' Critical Awareness in Social Work Practice

How social work students incorporate personal and professional selves in the contexts of field education represents a cornerstone of effective and sustainable practice. This paper presents a qualitative component of a study that tracked 15 third-year bachelor of social work students across their first field placement to document their use of self, critical reflections and experiential learning. The project examined students' assessed ‘use of self’ assignments to understand their capacity for and development of critical awareness across this placement. Students were most articulate in being able to identify stressful situations that arose from placement in terms of what they were thinking (mind) and feeling (emotion) and to a much lesser extent to what they were sensing (body). Over time, students demonstrated a growing critical awareness to better identify and respond to their self-reported tensions. The findings provide developmental insights into how students integrate personal and professional selves and potentially shift from reflective and reflexive practices to incorporating praxis in their work. Through considering the linkages between self and practice, this paper explores student experiences whilst on placement and the associated developmental tasks of critical awareness.