When Loss Becomes Gain: Transforming Women’s ‘Internal Saboteur’

Even as they strive for their, own self-definition, women hold onto old relational ties. In this paper, two ease examples are used to elucidate the complex relationships that women have with their earliest caregivers—mainly their mothers. The cases demonstrate how women remain fixed in early familial internalizations and identifications and find themselves repeating patterns of self-sabotage that impede their success. The relational approach to psychotherapy, furthered by the analyst’s use of the transference-countertransference paradigm, can create the gateway to explore and understand patients’ internal barriers to growth. The analysis can then help patients to achieve a more integrated self-view that allows them to enjoy success and fulfillment in both their private and public lives.     

Women Shaping Their Destinies: Psychoanalytic Perspectives and Contemporary Clinical Portraits

Using two case examples of women from different socioeconomic and cultural backgrounds, this article focuses on three central themes to explore women's fears and conflicts about success: the function of masochism as a protective device; the awareness and use of the transference-countertransference to inform both the patient's and analyst's relationship to the past; and the importance of both positive and negative influences in the cultural center. By attending to their own relationships to success, analysts can resonate with their women patients, promoting a more emancipated self-definition and mutual reparativeness.     

When Religion Enters the Dialogue: A Guide for Practitioners

Several factors, including Freud's debunking of religion and social work's discomfort with its religious roots, have resulted in a trend of avoiding religious issues in social work education. The result is compromised care. In this paper, clinical vignettes are utilized to illustrate some of the difficulties which may occur. A series of guidelines is offered, with the aim of increasing therapists' comfort level in negotiating religious issues in practice. Areas of discussion include assessment, resistances, object relations, and countertransference. Case examples demonstrate application of guidelines.     

Considering Improvisation: Play,Transitional Space,and Discovery

This article explores the concept of improvisation in the therapeutic setting as a complex construction when elaborated in the idiom of jazz music. A composite clinical case is offered that illustrates an impasse and how improvisational thinking offers a way forward. Improvisation has recently been conceptualized through the metaphor of theater improvisation, dance, and rhythm. The therapeutic hour is considered an improvisational dialogue with the main theme (melody) and counter melodies, and harmonic possibilities that underlie the rhythmic pulse of the hour. Improvisation requires a reflective/interpretive process that draws on patterns, structures, and experiences reformulated in the relational field of the participants. The client initiates the call and response pattern, from which improvisation emerges as a mutual process of discovery. A more relaxed, receptive, and reflective posture extends Winnicott’s 1971 notion of play to integrate classic understanding and relational interaction.     

The E.S.S.E. Group Model

Social work practitioners today are having to deal with ever-increasing numbers of families falling into the at risk category. At the same time, the issues and problems facing these family units are often overwhelming and challenging to resolve. The E.S.S.E. Group Model, outlined in this article, is a new research based approach that was designed to address the most relevant concerns facing families today. It is a unique program that combines family life education within a support group framework. Initially, the model was developed for several school districts in the midwest. Counseling personnel had identified a need for a parent training program that would elicit higher levels of participation. The E.S.S.E. Model accomplishes that goal through its structured yet individualized curriculum along with its parallel and conjoint group set-up. The specific content and process guidelines of this new approach make it easy for clinicians to duplicate in a wide variety of settings. One of the model's curriculums is outlined in detail in this article. Readers will find that the E.S.S.E. program serves as an excellent example of the type of group intervention needed today to help revitalize at-risk families.     

Listening for and Holding Traumatic Rage in an Intersubjective Intercultural Field

This article highlights various constructs from the perspective of D.W. Winnicott, trauma theories, intersubjectivity, and intercultural practice as guides for listening on multiple levels to inform the biopsychosocial–spiritual assessment and treatment. Using a clinical case composite, the author will illustrate the working alliance with a severely traumatized client, emphasizing the intense transference and countertransference rage and enactments that occurred during the course of the clinical social work practice. The therapeutic holding environment was challenged but maintained by working through relationship breakdowns, restoring intercultural subjective space and containing powerless rage.     

The Utility of Social Class,Race, and Gender in Clinical Practice: A Case Study Involving Intraracial Dyads

This article focuses on clinical work involving a male Black practitioner and a male Black client in which issues of social class, race, and gender were prominent in the treatment process. Three questions raised by the client early in the therapeutic encounter informed assessment, treatment, and the clinician's countertransference. Tenets from self-psychology, relational theory, intersubjectivity, and sociocultural factors relative to Black men are used to ground the discussion. Finally, the article illustrates why intraracial therapy should be understood in the context of the delivery of culturally competent services, highlighting how the intersection of a client's psychological issues, social class, race, and gender can emerge as functional features in psychotherapeutic work.     

The Effects on Clinician Identification when Clinician and Client Share a Common Ethnic Minority Background

ABSTRACT

A quasi-experimental study addressed the question of whether clinician identification with the client differs in therapeutic dyads in which clinician and client are from the same ethnic minority background than in therapeutic dyads in which clinician and client are from a different ethnic background. An availability sampling plan was used to obtain a sample of sixty Japanese American and sixty White social workers. Subjects watched one of two videotaped vignettes of either a Japanese American or White client. An identification inventory was used to measure range and intensity of identification. Findings demonstrated that match of ethnic minority background heightened range and intensity of identification. Additionally, match of generation, place of origin, and assimilation level also increased the respondent's identification with the client. Furthermore, feelings of vulnerability, a concern of overidentifying, and an added sense of investment occurred more frequently when the respondent and vignette client were from the same ethnic minority background.     

Sexuality,Boundaries, Professional Ethics,and Clinical Practice

Abstract

Gay male therapists often practice in milieus where it is virtually impossible not to have contacts with clients outside of the therapy room. The necessity of maintaining appropriate boundaries can be strained when client-therapist contacts occur in situations that are overtly or even potentially sexual. This Practice Note addresses professional challenges and various approaches to these situations while maintaining necessary therapeutic appropriateness.     

Abstracts of theses: Smith College School for Social Work,July 1954

Abstract

Many clients relate in ways that elicit emotional responses in practitioners and may also feel pressure to intervene when appropriate action is not yet clear. Practitioners must develop sufficient self-awareness so their own reactions do not interfere with the work they do with clients. Educators exhort their students to be self-aware, but locating methods that foster the capacity can be difficult. Infant observation is an elegant training model that helps to develop self-awareness. The method described here makes use of regular observation, supportive small groups, and repeated detailed examination of what is seen in training both generalist and specialized practitioners. It has become a prototype for the observational study of several kinds of specific populations. Because it attends to people in their own environments and demonstrates a flexible, reflective, multi-modal manner of information-gathering, infant observation is particularly useful in the education of social work practitioners.