Reclaiming Self

In this article I use performance poetry pieces to reflect upon my experiences of living with a disability as a person of color, a woman, and an immigrant. It is my firm contention that, although listening to the stories of the clients we meet on our journeys is integral to creating individual and structural changes and raising awareness of mental health issues, as social workers it is just as important to share our own personal and collective stories of mental health, stigma, and recovery. As helpers and change makers, it is unlikely that we can influence mental health policy purely from behind the wall of positivism. Stories of clients as well as stories of our lived experiences are critical to challenging the strong divide that characterizes the social work academy: the us/them, service provider/service user, and the expert/client. Furthermore, my hope is that this article will add to the literature concerning the traumas experienced by immigrant women in their private domains.     

Ways of knowing in clinical practice

Concepts developed by Polanyi regarding personal knowledge and the tacit dimension have particular relevance for social work clinicians. The concept of personal knowledge changes our understanding of the use of theories and points to the imprecision in our use of language. It leads to a relativistic view of knowledge through which the client's story is seen as a constructed narrative rather than a set of facts to be objectively recorded, therapeutic neutrality is considered a myth and difficult ethical questions about value differences and the clinician's influence over clients are brought to the fore.     

Clients as Teachers: Reciprocal Influences in Therapy Relationships

The value of the continuing education industry for therapists is questioned, as is the usefulness of therapy books and journal articles, as a means of engaging therapists in life‐long learning. Instead, it is argued that our clients are our best teachers and that therapists learn most effectively from their clients. Drawing on research studies with prominent theoreticians and therapists, and on case studies from clinical work, a number of important themes are identified as ways in which therapists are influenced by their therapeutic encounters with their clients. The themes explored in this article include: (1) intimacy and high emotional arousal with clients as we witness profound change; (2) being challenged by clients; and (3) allowing for boundary ‘crossings’ in order to develop more flexible ways of working with clients. The implications for professional development are discussed.     

Youth workers' use of Facebook for mediated pastoralism with juvenile delinquents and youths-at-risk

Youth work seeks to rehabilitate juvenile delinquents for re-entry into mainstream society and to prevent youths-at-risk from falling into delinquency, thus necessitating that youth workers assiduously monitor their clients. With the avid use of social media by youths, youth workers must also adopt these communication platforms to reach out to their young clients. Drawing from interviews with youth workers, this study analyses how they use Facebook to communicate with their clients and monitor their activities. Surveillance forms a key thrust of youth workers' professional use of Facebook, enhancing their ability to oversee these youths' personal development for the purposes of mentoring and rehabilitation. Contrary to dystopian, power-centric conceptions of surveillance, the study finds that the youth workers' surveillance of their clients is undergirded by care and beneficence, better understood using Foucault's concept of pastoralism. Through mediated pastoralism via Facebook, these youth workers can derive a more extensive picture of their clients, including their emotional state and peer interactions. With this knowledge, the youth workers can then calibrate their interventions more strategically and only step in when their clients engage in behaviour that poses significant risks or danger. In so doing, the youth workers foster sustainable social capital with their clients that they can still leverage over time. Facebook communications also help the youth workers to bridge communication gaps with these youths. The study also examines how the youths resist the youth workers' oversight in various ways.     

Shit is good: Mental health social work with lives of squalor

This paper investigates the phenomenon of three clients living in squalor, all of whom have severe and enduring mental health problems, and are on the caseload of a mental health social work team. By thinking about the clients both individually and as a group, within a psychoanalytic framework, it attempts to understand their squalor in a new way, with particular regard to the transference and countertransference experienced by the practitioner. By making use of social work literature as well as that concerning organisations and community care, it also discusses the impact these clients make on the wider community around them, and examines some of the dilemmas faced by the practitioner. The implications for social work are serious and far-reaching and these are discussed with regard to long-term intervention as well as professional and personal scrutiny.     

Conversations with Suwanrang: The Treatment Relationship in Cultural Context

Due to the changing cultural composition of the U.S., social workers are increasingly working with clients from different cultures. As a result of globalization, our schools of social work are training international students who return home to work in their native countries and take with them our theories and models of practice. It is essential that, as a profession, we address questions about the relevance of our models to work with clients from different cultures. This paper will use theoretical concepts from anthropology and data from field research with Suwanrang, a social worker in Northern Thailand to address these issues. The implications of the debate between universalist, relativist, and cultural pluralist perspectives within anthropology for psychodynamic, developmental models and social work treatment will be explored. The paper will focus on the ways the treatment relationship is shaped by and varies with culture     

Gate‐keeping for professional social work practice

The profession of social work has difficulty terminating students for non‐academic reasons because of an inability to define suitability for the profession and to formulate concrete criteria. Although discerning who is, or is not, personally suitable to practice social work is bound to be challenging, there is a growing realization that this task must be undertaken. This study was undertaken in response to this challenge, and seeks to increase our knowledge base about the personal and professional dimensions of social work, which result in suitable and unsuitable practices among social work students and practicing professional social workers. This article examines data gathered on the subject of professional suitability from a focus group and a series of individual interviews with social work field instructors. The authors attempt to broaden our understanding of personal suitability for the practice of social work and to achieve greater operational specificity to guide decision making for social work educators, as social work educators ultimately must make the critical decision about who should be admitted to the social work profession. It is hoped that this study can serve as a building block for further research. It seems clear that the choices to be explored must meet our obligation to society in general, to social work employers, and especially to clients.     

Creative Solutions and Development for Social Workers Treating People with Serious Mental Illness - Contributions from Supervision

Social workers who are engaged in a therapeutic work with clients who have serious mental illness often face specific challenges and find themselves in crisis states in therapy, which stem from the return of the clients’ symptoms and their cognitive impairments as well as social stigma. These crisis states cause dramatic changes in the way social workers mentalize their clients and they are propelled to draw from covert, unformulated, and dissociated knowledge that they have about the client’s experience, which contributes to achieving new, surprising, and creative ways to mentalize the client. Such crisis resolutions enhance therapists’ personal and professional development and serve as an identification model for their clients.     

A new nursing medium: computer networks for group intervention.

The PLWAs and the caregivers of persons with AD were similar in their adaptation to this new technology as a communication medium with nurses. Both groups availed themselves of the resources, both technological and personal, on the computer network. Although different in demographics, they also were similar in their ability to form and work in a traditional group structure. Nurses have historically intervened with groups, and this article demonstrates that nurses can intervene on a computer network with groups. Yalom's therapeutic factors exist in both non-face-to-face groups and traditional groups. The benefits of this technology to nurses are numerous: they can access clients in an efficient yet supportive manner; they can respond to multiple levels of need in multiple clients; and they can attend to emotional as well as more concrete needs of clients. The benefits to clients are also numerous: they can use the system at a time, frequency, and duration of their choice; they have the opportunity to be supported in self-care efforts versus being in a more dependent role; and they can engage in a normalization of their experiences. Computer networks can enhance nursing's ability to intervene with clients experiencing clinical problems.     

Touch: its use in psychotherapy

The use of touch as a therapeutic intervention is a matter of controversy. While the literature reflects the healing potential of touch, it also identifies concern that touch can be harmful to our clients. This article reports the results of an exploratory research project on how social work therapists are touching their clients, as well as their reasons for using touch or not using touch. The results of the study show that the therapists sampled use touch with their clients, but have received little education, training or supervision on the use of touch. The authors encourage further dialogue and research about this potentially powerful but complex intervention.     

Technostress: Implications for Adults in the Workforce

The use of technology can enhance workplace efficiency, productivity, and flexibility; yet, technological tools can have negative effects on individuals’ cognitive, psychological, and physical health, as well as on organizations (e.g., lowered employee satisfaction, decreased employee commitment). The use of information and communications technologies (ICT) adds to existing work stress. The authors reviewed recent literature to identify ICT trends, define key terms, and gain insights to improve awareness of ICT issues related to career development, health and wellness, and job security. The potential for inquiry as it relates to career exploration, development, and advancement is relevant to counselors and clients in today's workplace. Research is needed to examine the effects of technostress across different industries, to identify workers at greatest risk of adverse effects, to explore the impact on career decision making, to help clients develop personal coping resources, and to determine strategies for career professionals to collaborate with workplace managers.     

Repositioning Risk in Social Work Education: Reflections Arising from the Threat of SARS to Social Work Students in Hong Kong during their Field Practicum

The social work profession has always been involved in dealing with uncertainty and risk in the life politics of clients. However, it is not easy for young social work students to translate this philosophical disposition into their real life practice with clients. In spring 2003, when the SARS epidemic broke out in Hong Kong, a group of social work students from the Chinese University of Hong Kong were doing their fieldwork practicum. Suddenly confronted by a collective sense of risk in their role as social workers, the students went through a period of unrest, as performing their helping duties brought with it a simultaneous exposure to personal risk. This paper is based on four focus group interviews with these social work students, to understand how they processed their experience of risk during their exposure to the SARS crisis, and how they connected the experience to their social work practice with clients. It is found that the predicament arising from the exposure to personal risk brought about by the SARS crisis during the students' field placement engendered the reflective process that enabled a renewed and personalized meaning of professionalism. The results provide a basis for reflection among social work educators on the role of risk in the training of prospective social workers, and on how social work education can better prepare students for practice in a high‐risk environment.     

REWARDS AND FRUSTRATIONS OF BEING A SOCIAL WORKER: A QUALITATIVE STUDY

This paper deals with aspects of actual professional experience of social workers, in order to grasp a framework for professional rewards and frustrations. A qualitative research tool was chosen, life histories, and ten social workers were interviewed. The subjects were women who graduated between the 1950s and the 1990s from schools of social work in Brazil, and whose practice, present or past, involves direct contact with clients. The reasons explaining satisfying professional situations are rooted in professional experiences which were translated into personal development, the establishment of personal ties and the acquisition of skills. Perceptions of having contributed towards solving a difficult situation and recognition from their clients were positively appraised. These are rewarding situations from which social workers derive the feeling of having created something which is positive for the clients and for themselves. Unpleasant situations were described as unfair situations experienced by clients, poor working conditions and difficulties concerning inter‐professional relationships. Inferences on the feminine role as influencing social workers' rewards and frustrations with the profession, as well as inferences on possible unconscious configurations underlying some of the data were drawn in the conclusions.     

Strength‐Based Narrative Résumé Counseling: Constructing Positive Career Identities From Difficult Employment Histories

The résumé is a fixture within employment counseling, often viewed as a necessary product for securing employment. Résumés can also be a powerful vehicle for facilitating the development of positive career identities. The complex interplay of negative societal narratives with personal narratives can make the development of a positive identity, and the execution of an employment search, difficult for clients who have work histories complicated by personal and economic challenges (e.g., homelessness, intimate partner violence, histories of incarceration). The authors present résumé counseling as an opportunity for clients to develop stories of strength, reveal stories of difficulty, solidify a positive career identity, and rewrite positive future narratives. This article describes the strength‐based narrative approach to résumé and employment counseling, illustrates its application with a hypothetical case, and offers practice recommendations.     

Constructing a Place for Religion and Spirituality in Psychodynamic Practice

A focus on spirituality has become in vogue for the media as well as for professional conferences, journals, and schools of social work. Likewise, our clients are struggling with how to integrate religion and/or spirituality with their therapy. The premise of this paper is that we have a role in assisting our clients with this integration and to consider some of the current postmodern approaches. However, in attempting such an integration it is important to retain certain parameters and guidelines that have been helpful to our clinical work. This paper will examine how to make room for religion and spirituality in psychodynamic psychotherapy and the ways in which constructivism can be helpful in this process. The influences of psychodynamic theories and postmodernism shape the discussion in the following areas: definition of terms, self-awareness, deconstruction of clients' narrative, assessment of strengths and vulnerabilities, and reconstruction of a useful narrative.     

Secondary Trauma: How Working with Trauma Survivors Affects Therapists

Secondary trauma, a relatively recent topic that has emerged in the field of social work, includes the emotional and psychological effects that working with traumatized clients has on therapists. Secondary trauma can seriously impact therapists' personal and professional well-being. Trauma therapists face major ethical dilemmas if their reactions to being traumatized enter into the therapeutic relationship, exposing clients to psychological harm or possibly re-traumatization. As many graduate programs in social work and social service agencies are still unaware of this phenomenon, recommendations are made for how to introduce the topic as priority and how to cope with and prevent secondary trauma.     

Linking research,theory and practice in personal and professional development: Gender and sexuality issues in social work education

It is important for social work students to learn how to articulate and develop their own personal theories for practice. It is also important for them to learn how to handle their own personal issues (which they often find difficult and prefer to avoid); and to incorporate them into their theories. In this paper we will explore some of the links between research, practice and theory by considering gender and sexuality issues in social work education. We offer some suggestions on introducing these issues to social work students in such a way that the development of personal social work theories is encouraged. Using examples from our current teaching practice about child abuse, bullying and domestic violence, it will be argued that the importance of theory for understanding and applying research, as well as for addressing difficult personal issues, has been seriously undervalued in social work education.     

Lesbian Therapists and Lesbian Clients

Abstract

The authors, on the basis of their own experience, explore issues specific to therapists working openly as lesbians with lesbian clients. Their discussion covers the structure of a private practice, the therapeutic relationship between lesbian therapist and lesbian client, and personal challenges for the lesbian therapist. Questions are raised and direction given with the aim of facilitating congruence among the therapist's personal capacities, the therapeutic setting, and the psychological intention of the therapeutic work. The authors note the therapist's need to tolerate the exposure of her personal life and the pressure toward fusion that are both entailed in work with lesbian clients, and they suggest that these special challenges, when the lesbian therapist's engagement with them is conscious, offer rich material that can deepen the therapeutic relationship and the therapeutic work.     

Video conferencing applications in social work: Work locally,think globally

Abstract

Video conferencing is a technology that facilitates the provision of high quality education, health-care and consultation to clients and families served by rural area health professionals via visual and audio transmissions. It also plays an important role in the education, and training of rural health professionals and the development of a multidisciplinary team dialogue between rural and metropolitan partners. This paper describes our experience of a video conferencing program conducted at the Goulburn Valley Mental Health Service and St George's Older Persons Mental Health Service. We have found a number of benefits of this technology for clients, their families and for health professionals themselves. The development of expertise in the use of video conferencing technology has empowered social workers in their work places. Video conferencing has been extended to other aspects of social work practice. A pertinent example of this is the use of video conferencing in Guardianship and Administration hearings for patients who would otherwise be unable to attend because of health problems (physical, mental and mobility).     

Ethical Dilemmas of Practicing Social Workers Around Psychiatric Medication

Abstract

It is acknowledged that social workers in mental health and other settings routinely experience client-related ethical dilemmas. Further, there is wide recognition of the potential impact of ethical dilemmas on social work practice with clients who use psychotropic medication. Little is know empirically, however, about the experiences of practitioners with these dilemmas. This article describes the results of a national survey of practicing social workers regarding the nature of ethical dilemmas they face related to their work with clients on medication issues. The results make it clear that social workers regularly confront a variety of ethical dilemmas in this type of practice. Many of these dilemmas are related to ambiguities around the knowledge base of practice, appropriate roles of providers, and basic personal and professional values. The authors present implications of these findings for social work practice and further research.