Power and Authority in Clinical Practice: A Discourse Analysis Approach to Narrative Process

Issues of power and authority in the treatment relationship are explored using concepts from discourse analysis. Negotiative and heuristic processes of narrative co-construction are described. These concepts, which highlight issues of power and vulnerability in narrative co-construction in ordinary conversation, are then applied to a clinical case. Implications for clinical social work treatment are developed based on an expanded understanding of, and sensitivity to, the sharing of narrative power in the treatment relationship.     

A Working Model of Cross-Cultural Clinical Practice (CCCP)

A long-standing gap between clinical and cultural practice can lead clinicians to feel overwhelmed by the task of integrating clinical practice with a culturally sensitive approach, while working toward changes in clients’ lives. This article attempts to assist clinicians in their efforts to achieve this task. Using a Task-Analysis approach in the alliance research (Safran et al. 1994), this article discusses the development of Cross-Cultural Clinical Practice and proposes a detailed working model for its possible application. A case example is presented to highlight key components of the model. Limitations and implications of the model in clinical social work practice are also described.     

How a Therapist Responds to Cultural Versus Noncultural Dialogue in Cross-Cultural Clinical Practice

A therapist's capacity to respond appropriately to a client is crucial in fostering positive therapeutic relationships and outcomes in general but it is even more important in cross-cultural therapy. Given the clinical significance of the dyad-specific and dynamic nature of the therapist's responsiveness, our study explores one white female therapist's responsiveness with three racial/ethnic minority clients in the beginning phase of therapy sessions. Using the structural analysis of social behavior and conversation analysis, the turn-by-turn intensive analysis of culturally relevant and nonrelevant talk in therapy illustrates how a therapist, who is appropriately and positively responsive to clients in other contexts, becomes disengaged and even negatively oriented during culturally relevant talk. This finding illustrates the challenges involved in maintaining positive engagement and responsiveness in cross-cultural therapeutic communication. Our findings also highlight the usefulness of focusing on moment-to-moment interactions in cross-cultural clinical practice.     

Therapeutic Dilemmas in Cross-Cultural Practice with Asian American Adolescents

The following study proposes that differences in traditions and values between Western clinicians and Asian American clients manifests in therapeutic dilemmas, and offers recommendations for cross-cultural practice with Asian American adolescents and their families. The themes that will be examined are independence vs. acculturation/individuation, equality vs. hierarchy/authority, and supportive vs. dynamic treatment.     

Engagement: A Critical Aspect of Family Therapy Practice*

Engagement must be appreciated as an integral ongoing aspect of therapy. It can provide therapists with a wealth of information about the structure and functioning of the family. Engagement/counter-engagement, assessment and interventions are essential, interdependent processes which occur throughout treatment. Ways of enhancing the engagement process are discussed.     

Understanding And Misunderstanding In Cross-Cultural Practice: Further Conversations With Suwanrang

Understanding is an essential clinical practice skill, one which draws upon cognitive and affective, conscious and unconscious abilities. This paper explores the challenges posed by cross-cultural understanding. Using concepts from anthropology and data from anthropological field work and clinical practice, it examines cultural differences in the experience and communication of affect. Clinical examples from Northern Thailand are used to illustrate the ways these subtle and complex differences in clients’ affective worlds challenge our capacity to understand those who are culturally different. Implications for cross-cultural social work practice are addressed.Catherine Nye received her MSW from Virginia Commonwealth University, and her PhD in psychology from The Committee on Human Development at the University of Chicago. She is currently Associate Professor at Smith College School for Social Work.     

Youth Civic Engagement in the Twenty‐First Century

We enter the 21st century contending with the end of the Cold War's legacy of political uncertainty, expecting youth to play a significant part in the search for new principles that will bring about stability in the world political order. In forging the future, youth will have to collaborate with adults, but on terms more fitting of the historical circumstances that lie ahead than those of the past. This was the framework adopted by a group of social scientists who held several discussions to reflect on the issues and opportunities that bear on youth's civic engagement and development in the century that has just opened. The present article describes the results of those conversations, starting with the issue of defining civic competence, and the finding that an expansive definition is needed to match the real‐world circumstances that affect its development for youth internationally. Specific conditions, such as globalization, information – communication technology, and immigration, are emphasized as forces that affect youth and need to be taken into account by educators and policy makers. In this regard, responsibilities of schools, government, the commercial sector, and community organizations are outlined. Each is viewed as a potential constructive force for promoting engagement insofar as youth's strengths are recognized and focus is placed on building on youth's proven capacities. As always, it is youth’s task to make history in the future and society's obligation to provide youth with sufficient resources and an honest basis for hope in carrying out this task. The authors' policy recommendations are founded on this reciprocal relation that binds the youth generation with its elders in the common task of preserving, while transforming, society for the good of humanity.     

The Queer Utility of Narrative Case Studies for Clinical Social Work Research and Practice

The author uses a queer critical lens to analyze the marginalization of case study research in the evidence-based practice model of clinical social work. He argues that narrative case studies are necessary for the production of context-dependent knowledge about social work practice and asserts that the method offers particular utility in conducting queer inquiry. The method is explored in relation to its capacity to describe non-normative phenomena and the impact of normative cultural pressures on queer subjects. An abbreviated case study by the author is included to demonstrate these capacities.     

The Timing of Cohabitation and Engagement: Impact on First and Second Marriages

Using a multistate sample of marriages that took place in the 1990s, this study examined associations between premarital cohabitation history and marital quality in first (N = 437) and second marriages (N = 200) and marital instability in first marriages (intact N = 521, divorced N = 124). For first marriages, cohabiting with the spouse without first being engaged or married was associated with more negative interaction, higher self‐reported divorce proneness, and a greater probability of divorce compared to cohabiting after engagement or marriage (with patterns in the same direction for marital positivity). In contrast, there was a general risk associated with premarital cohabitation for second marriages on self‐reported indices of marital quality, with or without engagement when cohabitation began.     

Hospitality in Family Therapy Practice: A Further Engagement with Jacques Derrida

Derrida's concept of hospitality has been proposed by some authors working from a collaborative perspective as an interesting tool to reflect on the therapeutic relationship as an ethical relationship in which the therapist develops a welcoming openness to the client. In this paper, we engage with this recent emphasis on the therapist's ethical position of welcoming the client's otherness and turn to Jacques Derrida's original texts with the aim of developing an in‐depth understanding of what exactly is at stake in this therapeutic position of hospitality. This reading evolves into an understanding of how Derrida's notion of hospitality invites clinicians to identify how the therapeutic position intricately intertwines healing and violence. The concept of hospitality calls on therapists to accept the complexity of therapeutic responsibility as a form of supportive presence that necessarily and simultaneously involves the violence of appropriation and power difference.     

The Application of the Culturagram in Cross-Cultural Practice with Elder Abuse Victims

ABSTRACT

This article discusses the application of the Culturagram, a screening instrument designed to assist practitioners to work more effectively in the assessment and detection of family abuse among immigrant elders. Case studies of selected immigrant groups are presented to illustrate how the Culturagram can be used to promote culturally sensitive practice with immigrant families where elder abuse may be a factor. Assessment, detection, and intervention strategies specific to selected immigrant groups are included in the discussion.     

Communicating Engagement in Corporate Social Responsibility: A Meta-Level Construal of Engagement

Organizations are increasingly seeking stakeholder support through engagement to demonstrate their corporate social responsibility (CSR) credentials. These credentials are, in turn, used to support claims of legitimacy for organizational operations. This article uses a process model of antecedents, implementation, and consequences to study the connection between engagement and CSR. CSR reports show organizations perceive engagement in CSR as both communication and activities between organizations and their stakeholders; and as a second, meta-level of communication about that engagement with stakeholders beyond those directly involved, thereby broadening the scope of organizational claims to legitimacy. Understanding what engagement is and how and why it is carried out in CSR provides a framework for understanding engagement in public relations.     

The Founding of the Clinical Sociology Association: A Personal Narrative

This paper discusses the rediscovery of clinical sociology in the 1970s and the founding of the Clinical Sociology Association in 1978. The author recounts his role in these events and traces their origin in his personal life.     

Case Studies as Narrative Accounts of Public Relations Practice

This article offers a narrative analysis of competition case studies, a genre of public relations discourse. The aim is to examine the representation of public relations expertise produced by practitioners in cooperation with a professional association. Using narrative concepts such as character, narrative function, plot, point of view, and time, the analysis identifies ways in which the actual experience of practice is narratively transformed, and reflects on the reasons behind this transformation. Findings are presented under 3 main headings: professional work, narrative transformations, and professional legitimacy; and they highlight the interplay of individual experience and professional group aims.     

Objectivity and Narrative in Contemporary Reporting: A Formal Analysis

Traditionally, Americans have held the ideal that newspapers should transmit knowledge to readers by giving “objective” accounts of official events. This article argues that many news stories have extended objectivity through the use of narrative. Stories attempt to evoke feelings in the reader by drawing on a shared stock of knowledge held by members of society through the use of narrative storytelling techniques rather than attempting to transmit neutral information through the form of objectivity.     

A Re-Conceptualization of the Working Alliance in Cross-Cultural Practice with Non-Western Clients: Integrating Relational Perspectives and Multicultural Theories

This article will addresses a gap in the literature regarding the working alliance in cross-cultural treatment. The paper draws on references from current relational theories and multicultural conceptual and empirical sources to re-conceptualize the definition of the working alliance to include cross-cultural dynamics between Asian clients and European-American therapists as a case in point. The paper includes an overview of the working alliance, and a proposal for the inclusion of specific relational domains that this author has found to be important for the definition of the working alliance. These domains are empathy, mutuality, the dynamics of power and authority, the use of self, and the process of communication. A case vignette is included to illustrate these discrete domains. The paper opens new directions for clinical practice and research in the area of the working alliance in cross-cultural counseling.