Academic journal article Journal of Social Work Education

Reshaping Clinical Practice for the New Millennium

Academic journal article Journal of Social Work Education

Reshaping Clinical Practice for the New Millennium

Article excerpt

HOW SHOULD CLINICAL SOCIAL WORK practice enter the new millennium? Oppression in the forms of racism, sexism, heterosexism, classism, ableism and abuse will continue to affect the lives of the people with whom practitioners work (Rose, Peabody, & Stratigeas, 1991; Wyatt, 1990). To challenge these forms of oppression, clinical practice must be political, addressing the dialectical relationship between private troubles and public issues (Mills, 1959; Sessions, 1993) while deconstructing and transforming professional relationships that replicate relations of domination and subordination (Miller, 1992; Pinderhughes, 1989, 1995; 1989; White, 1995).

Unfortunately, clinical practice as usually taught reinforces rather than challenges oppression. Practice models that focus on diagnosis and treatment of so-called mental disorders legitimate the power of social workers as experts in clients' lives. The intrapsychic focus of the dominant discourse of clinical social work individualizes social problems, leads clients to internalize pathology, and fails to intervene at the societal level (Dietz, 1996, 2000; Garcia & Van Soest, 1997; Karger & Stoesz, 1993; McMahon & Allen-Meares, 1992; Rosen & Livne, 1992; Walz & Groze, 1991). Oppressive social relations are rarely addressed (Dietz, 1996; McMahon & Allen-Meares, 1992).

Challenging oppression requires that social workers support individuals in naming their experiences of oppression, examining the effects, and responding both personally and politically. This method of practice is informed by the feminist practice of consciousness-raising (Middleman & Wood, 1993), Freire's practice of conscientization (Freire, 1993), and White's (1995) work in narrative therapy. The role of social workers in this process is to help individuals understand their experience in its social and political contexts, externalize pathologizing discourses, and resist oppressive practices in personal and social relationships. This therapeutic method requires joining individuals in naming oppression and abuse, breaking free from their effects (White, 1995), and transforming relationships of domination, whether on the individual or social levels.

This article describes a second-year MSW clinical practice sequence that incorporates feminist, poststructuralist, postmodern, and social constructionist perspectives (Allen, 1993; Dean, 1993; Laird, 1993a, 1993b, 1995; Lee & Greene, 1999; Morell, 1987; Pozatek, 1994; Sands & Nuccio, 1992; White, 1995). The systems of thought presented in this sequence were chosen for their common core values, response to oppression, and congruence with the mission of the school. They are supported by the strengths perspective (Saleebey, 1992) and the empowerment tradition in social work (Pinderhughes, 1989, 1995; Rose, 1990; Simon, 1994), which are infused throughout the curriculum.

The opening sections of the article give an overview of the epistemological perspectives (feminism, poststructuralism, postmodernism, and social constructionism) which inform the teaching and practice of the clinical sequence described. The next sections show how these perspectives contribute to an understanding of clinical social work as a response to oppression and abuse. The article goes on to discuss ways to transform clinical practice so that it challenges oppression. The final sections of the article describe how the sequence incorporates these ideas, and discuss ways of adapting this approach to other social work programs.

Epistemological and Theoretical Perspectives

Feminism, Poststructuralism, Postmodernism, and Social Constructionism

Key insights from feminism, poststructuralism, postmodernism and social constructionism inform the approach to clinical practice presented here. Among these are the erasure of the voices and experiences of marginalized groups and the link between power and knowledge. Analysis and critiques of these insights come from many directions and will be briefly presented here. …

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