Customer Reviews

Paradigms Of Clinical Social Work .

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Educated through the addictions counselor, MC/CP and Psy.D route, I came to wonder why it was that I often ran into instances of miscommunication with LCSWs about treatment methods and what seemed to me to be well-established, basic and common theories of pathological behavior. So when I saw this at a flea market for a dollar, I bought it immediately. I'm glad I did. Because I now understand a =lot= more about my former mystery.

Dorfman's collection of articles by evidently reputable MSWs and DSWs of the '80s makes it clear to me that the DSW is to a Psy.D. more or less what DO is to an MD: The ultimate grasp of "healing" may be as functional and effective, but the method of arriving at that grasp follows a significantly different philosophical tradition.

For one thing, the MSW/DSW comes from a basic belief in socialization to cultural norms as a route to healing that is decidedly =not= the case in the unadulterated, post-Freudian traditions of traumatology, existentialism, object relations, psychodynamics, behaviorism, cognitivism, neo-Easternism (e.g.: mindfulness and acceptance), or neuropsychology.

From "our" point of view, what is =is=, regardless of whether or not it fits into "societal" beliefs or values. If the upshot is an irresolvable conflict, we deal with acceptance thereof, not with trying to =reconcile= ambiguities that cannot =be= reconciled unless one surrenders his discoveries in favor of "cutural reality." But I surely understand why that may be the only "solution" for those who cannot break out of their cultural paradigms.

This is not to say that there are no "cross-overs." One of the book's contributors examines Minuchian family therapy, for example. But oddly (at least to me) ignores Murray Bowen, and barely mentions the Palo Alto gang. Another contributor digs into Skinnerian behaviorism. Another into Ellis, Beck and cognitive therapy. But =objectives= for the use of those methods are very different from the sense of objectives I have. =Then= there was an article on existential therapy that did a fine job of explaining May, Yallom, etc., but oriented it towards a =social= existentialism. (I was left cross-eyed.)

I think the essential philosophical difference between the social welfare and clinical orientations comes down to "their" goal of problem-solving and symptom reduction (even if the client is left in fantasy) vs. "our" goal of cognitive and behavioral de-construction and re-construction as the path to a greater grasp of reality that will serve the patient to deal with his problems in the future. Stated another way, it might be =adaptation= for the sake of psychic comfort and "fit" with the values of society vs. =reality= for the sake of ego strength to deal with the social environment's numerous fabrications and confusions.

I'm glad I read this book. I may not =agree= with parts of it or support its various contributor's filtrations of mental structures, Adlerian schemata, radical behaviorism, cognitive or family therapy; but it surely helped me to understand that the people with framed MSWs or DSWs above their desks have a different way of seeing things because they were evidently taught from considerably different organizing principles.