Toward an Integration of Ideas About the Self for the Practice of Clinical Social Work

Abstract

This paper presents ideas for understanding the self that is responsive to contemporary trends in professional practice. In addition to psychosocial factors, which have been associated historically with the practice of clinical social work, the paper integrates neurobiological factors into the discussion. The intent of the paper is to offer practitioners a conceptual framework for thinking biopsychosocially about clients. The framework underscores diagnostic understanding as the basis for the choice of specific interventive modes and techniques, and the centrality of a therapeutic relationship as the vehicle through which a new sense of self may emerge for clients.

Mindfulness: The Present Moment in Clinical Social Work

“…According to Germer, ''In the coming years, mindfulness practice may prove to be a tangible means for building empirically supported relationship skills'' (p. 12). Mackey (2007) emphasized the importance of the therapeutic relationship stating, ''For clinical social workers, the professional relationship is not just the vehicle of intervention to change behavior(s) but an empathic resource for acceptance, support, validation and understanding of clients, which may be among the most important factors in making therapy therapeutic''.…”

“…In their list of clinical skills, Simpson et al (2007) emphasized the importance of the development of self awareness and empathy for clinical social workers. Mackey (2007) described research at Harvard Medical School which supported the ''centrality of empathic relationships… as a vehicle for amelioration of damage to the self'' (p. 5). Clinician empathy is necessary to establish the ''holding environment'' of the therapeutic alliance (Applegate and Bonovitz 1995).…”

Using Social Work Theory for the Facilitation of Friendships

“…Because even highly skilled and experienced clinicians can behave in a hostile, counterproductive manner with their clients after succumbing to inevitable countertransference enactments, clinicians need to develop the self-reflective capacity to understand how and why clients may trigger their own countertransferential emotional responses (Murphy & Dillon, 2003). The relational dynamics in the treatment process offers clinicians the opportunity to use their own reactions as a means of understanding the client and intervening effectively (Arnd-Caddigan & Pozzuto, 2008;Aron, 1991;Mackey, 2008). Therefore, an important component of helping clients develop nurturing friendships is for clinicians to understand and come to terms with their own issues around friendships.…”