Parental abandonment: A unique form of loss and narcissistic injury

This paper presents an overview of the effects of parent loss, looking initially at the voluminous and significant research regarding institutionalized children, and children who have lost a parent by death> In contrast to the considerable literature and information about these child populations, less has been written regarding the abandoned child. Otto Kernberg's and Heinz Kohut's newer theories of the psychology of the self, and narcissistic personality disturbances are viewed as providing useful new insights about the abandoned child population. Two cases are presented, followed by application of Kohut's and Kernberg's treatment approaches. These newer treatment interventions offer more optimism for work with abandoned children, who are an ever increasing population.     

The self-psychology of Heinz Kohut: An existential reading

The origin and technique of Kohut's self-psychology are compared with Freudian and existential thought, and a relationship to existential thinking is observed. This is discussed by Joseph Palombo, a member of Kohut's study group, one who had the opportunity to raise the issue with Kohut.     

Why Kohut endures

Both critics and followers of Kohut's ideas have often misunderstood the true significance of self-psychology within the context of the history of psychoanalytic psychology and clinical practice. Self-psychology has frequently been equated with the discovery of the narcissistic personality disorders and thus critiqued by those who insist on the clinical and theoretical usefulness of the concept of the psychoneuroses. When the importance of the empathic mode itselfis recognized, however, empathy is often misunderstood and thus not seen as a significant and lasting clinical contribution. By tracing the development of Kohut's thinking, with special emphasis on the interweaving of his views on empathy and his metapsychology, and by examining the ramifications of the use of empathy in actual clinical practice, it is hoped that the reader will more fully appreciate its crucial and central importance for psychoanalytic psychotherapy.An earlier version of this paper was presented to the Graduate Clinical Psychology Department at Xavier University on April 30, 1987.     

Can Klein and Kohut work together in a group?

This paper addresses the usefulness of recent contributions of psychoanalytic theory to treatment in groups. Current concepts of Klein and Kohut are described and illustrated with clinical examples. The Kleinian emphasis upon innately destructive features of personality, such as envy, is juxtaposed with Kohut's attention to the need for emphathic responses to deficits in mirroring, soothing and identification. Reconciliation of these differing points of view is considered practical and worthwhile.     

Split or Synthesis: The Odd Relationship Between Clinical Practice and Research in Social Work and in Social Work Education

The relationship of practice and research in social work has often been characterized as a ‘split’ in interests and in professional purposes. The same split also appears in social work education. This article examines several issues related to better integrating clinical practice and research in social work and in social work education. The article opens with a historical exploration of the origins of the social work profession as based in differences between practitioners and researchers. Second, differences in the purposes, professional cultures and professional organizations of clinical social workers and social work researchers are examined. Third, the processes and methods of clinical practice and research are systematically compared and contrasted. A chart outlining their similarities and differences is offered. The article closes with several recommendations to improve social work education in both areas that can lead to better integration of clinical practice and research in social work.     

The Existential Side of Kohut's Tragic Man

This article explores the way in which Kohut's concept of Tragic Man functions as a response to criticisms of self psychology as proffering a partial, utopian, strife-denying theory of human development. After citing several representative critiques in this respect, I review the concept of Tragic Man as defined by Kohut, and then seek to deepen the clinical usefulness of this concept through a discussion of affects, empathy, and free association. A clinical vignette concludes the paper, through which some of these ideas find illustration.     

Survival dilemmas: Case study of an adult child of a schizophrenic parent

This article describes aspects of the treatment of an adult child of a schizophrenic parent. Many theories on irrationality in the family setting illuminate the range of impingement on the child's reality when a parent is disturbed in this way. Current research has absorbed itself in interpretations of data on risk, vulnerability, disorder, and early trauma, which have implications for prevention as well as therapeutic treatment of the adult survivor. Profound effects on Ms. P's early development are elaborated in the therapy, in which the treatment stance is influenced by Kohut's theories of the self, particularly as applied to the establishment within the holding environment of specific transferences that facilitate reconstructive work.     

Kohut's tragic man: An example from “death of a salesman”

Willy Loman, the tragic hero of Miller'sDeath of a Salesman, powerfully illustrates self psychology principles governing profound deficits, shame, and the possibilities of self-restoration. When conditions of birth and upbringing are unsuited to establishment of a strong self structure, an adult is unable to maintain psychological equilibrium, most often experiencing profound shame as a consequence. Heinz Kohut's self psychology framework, and Andrew Morrison's definition of shame, are invoked to examine Willy's self, his increasing awareness of shame, and ultimately his choice of suicide. Willy Loman serves as a dramatic, if hypothetical, case study. Accurately described by self psychology, he is authentic to the lay audience; he reaffirms an inherent strength in self psychology theory, reducing the distance between theoretical appreciation and clinical application.     

Irmgard Wessel: The Making of a Clinical Social Worker

Irmgard Wessel is a unique woman whose quiet, hard-working way generates ideals that are inspirational. With little fanfare, Irm's work has had a major impact in the field of clinical social work and clinical social work education. As each of us is inspired and encouraged by the knowledge of such exceptional social work clinicians, the discipline, as a whole, is enhanced. This paper describes not only Irmgard Wessel's career, but also adds a biographical understanding of her development from childhood to clinician, educator, and activist. It is about the making of an extraordinary clinical social worker.     

The new old guard: Beliefs and values of members and nonmembers of societies for clinical social work

Opinions on educational and practice issues relating to clinical social work were solicited from three groups of professionally active, masters level social workers: (1) members of state societies for clinical social work [N=43]; (2) nonmember clinical social workers [N=38]; and (3) nonmember social workers who were not clinicans [N=20]. Results indicate that members of state societies for clinical social work firmly endorse traditional social work values, but differ systematically in their opinions from masters level clinicians who are not members of state societies for clinical social work, and from nonclinicians with masters degrees. Implications for formal organizations in social work are discussed.     

Social Work Education and Clinical Learning: Yesterday,Today, and Tomorrow

Social Work Education and Clinical Learning by Simpson, Williams, and Segall is a welcome and timely statement about the nature of clinical social work and its implications for educational curricula. The authors took on an awesome task. Educating students for clinical practice is increasingly more daunting than it has been previously and is in considerable disarray, if not a state of crisis. In addition to amplifying and expanding some of the major points the authors make, this discussion considers where we have been, where we are, and where we are going. It describes the educational landscape today, which the author views as bleak with respect to its preparation of students for clinical social work practice. In keeping with clinical social work’s inclusive definition that encompasses a broad knowledge base, diverse practice roles, and a wide range of interventions, this discussion emphasizes the importance of numerous unifying themes that help to distinguish clinical social work from other approaches or from the use of a fragmented assemblage of techniques. The paper considers the role of evidence-based practice and makes some suggestions about future emphases in clinical social work. It concludes with a call to alter the educational landscape.     

Social Constructivist Practice with Youth

Social constructivism is an important and creative perspective for helping social workers in their work with adolescents. This paper demonstrates how theoretical orientations and clinical techniques that adhere to a social constructivist perspective can be integrated with the developmental realities of adolescence to provide effective social work interventions. Fundamental assumptions are discussed and are related to problems of practice. Case studies are utilized to demonstrate social constructivist principles in clinical work with adolescents.     

The Clinical Aspects of Case Management and its Role in Graduate Field Education

In graduate social work education, faculty advisors together with practice instructors can improve social work students' skills to link the practical aspects of ‘work responsibilities’ to the clinical underpinnings of case management. Often students are taught the direct services (case management) with a view solely focused on the practical aspects of care, and this curtails the students' opportunity to learn the clinical interventions that exist in all components of social work: to identify, understand and apply clinical dynamics to presenting problems. The authors discuss their work in addressing case management from a clinical perspective with MSW students and recommendations for its inclusion in graduate social work programs.     

50?Years and the Future of Agency-Based Clinical Social Work Practice: Introduction to the Special Issue

This special issue is a celebration of the Silver School of Social Work??s 50th Anniversary in 2010?C2011. The articles in this issue celebrate the School??s distinct reputation for excellence in clinical social work. They also celebrate the school??s current mission, which includes knowledge development for social work practice, with an emphasis on urban problems, poverty and social justice, and agency-based practice. The majority of the submissions focus on contemporary and future social work practice. This paper concludes with a discussion of several issues that confront the future of clinical social work practice including workforce trends, technology, and the scientific basis for practice, wealth disparity and race as contemporary American issues that affect clinical social work, the globalization of social work and mental health services, and education for tomorrow??s clinical practice.     

Social Workers’ Perspectives Regarding the DSM: Implications for Social Work Education

There is a decades-old debate in social work regarding the appropriateness of the use of the Diagnostic and Statistical Manual of Mental Disorders (DSM) by clinicians in this profession. Despite often contentious perspectives, there has been very little study regarding clinical social workers’ experiences, attitudes, and beliefs about the use of the DSM in their work. In this qualitative inquiry, 20 clinical social workers who had recently completed master’s of social work coursework and were working with children were interviewed using grounded theory methods. Results of the inquiry are presented and implications for social work education are discussed.     

Feminism and Family Social Work

The intent of this paper is to explore the applicability of a feminist model for clinical social work mactice with couples and families. A brief overview of the literature relating to feminism social work is presented in preparation for the examination of clinical issues. The feminist critique of traditional family systems theory is summarized and other areas of concern in clinical work with couples and families are explored including family theory and healthy family functioning. A brief overview of feminist family therapy practice literature is provided along with a summarization of training recommendations.     

Enhancing Competence in Health Social Work Education Through Simulation-Based Learning: Strategies From a Case Study of a Family Session

ABSTRACT

Simulation-based learning (SBL) is a powerful tool for social work education, preparing students to practice in integrated health care settings. In an educational environment addressing patient health using an integrated care model, there is growing emphasis on students developing clinical competencies prior to entering clinical placements or clinical practice settings. This article highlights the importance of SBL in the development of the clinical competencies of graduate social work students enrolled in a Social Work Practice in Health course. The development and implementation of an educational initiative using a family-based simulation scenario to enhance classroom learning for health social work practice is described, and recommendations for future educational initiatives using SBL are provided.     

Practice theory for clinical social work

It is suggested that practice theory for clinical social work practice is in a state of disarray. Six new books on clinical social work practice are reviewed, with an identification of their contributions to the development of clinical practice theory. The expanded societal functions of clinical social work have resulted in major changes in method and in practice activities, without commensurate development of appropriate theory, as about environmental-situational interventions. Good theoretical advances have been made, as about a basic ecological systems model, though with need for a greater openness to new theories and to an eclectic approach. Advances have also been made in clinical research and knowledge building, handicapped though this may be by current critical inadequacies in the professional schools, particularly in the continued resistance to the development of clinical doctorate programs.     

Using phenomenology in clinical social work: A poetic pilgrimage

This article demonstrates how phenomenological theory from sociology can be applied to clinical social work practice through the use of poetic self-analysis. Areas on phenomenological theory that provide support for the use of poetry in clinical social work are identified and described. Examples of the use of poetic self-analysis are presented. The authors, citing research from phenomenologica theory, raise some questions with respect to the limitations of traditional clinical settings and processes. The legitimacy of some new directions in clinical social work based upon phenomenological theory are also presented.