Direct Practice in Social Work - Assignment Example

Direct Practice in Social Work The goal of therapy is to create a non judgmental environment within which the therapist is able to communicate to the client, a sensitive and accurate understanding of the client’s perceptions of a situation. (Clark, 2007:70). As Corsini states however, prior theories which have set out the technique and methods of therapist interactions may not necessarily be the most important concern; rather, they may sometimes need to be subordinated to the clinician’s sense of what needs to be done for a client that is likely to be most effective (Corsini and Wedding, 2008:10). Therapy is likely to be most effective when a therapist is fully integrated into the treatment relationship; hence a therapist’s ability to fully and honestly express feelings and perceptions may be helpful in dispelling the notion of a “false front” being put forward by the practitioner (Clark, 2007:71). The objective of treatment is to gain authenticity in the therapist-client relationship, but these disclosures should be “purposeful and well timed” if they are to be beneficial (Clark, 2007:71). If on the other hand, such self disclosure is not purposeful and is done in a judgmental sort of way, it could be problematic because it could undermine the efficacy of the treatment and thereby, the therapist’s objective of gaining authenticity in the relationship. 2. The client Linda is a sexually abused person with a very negative perception of herself. Hence, it may be much better to focus upon the client herself and work towards helping her deal with her negative perceptions of herself rather than involving the therapist’s personal reactions to the client. Linda sees a rift between the therapist and herself, she perceives the therapist as being in a position of superiority. Hence if the therapist talks to Linda about her personal reactions to her client, then it needs to be done in a positive, focused manner. Rather than the therapist using a self involved statement such as “right now, I’m feeling a little cornered”, it may be more effective to couch the therapist reaction in a more positive and honest way. For example, if the therapist had responded more honestly by stating, “I have not personally been through such a shattering experience as you have but as I listen to you, I am impressed by the strength and courage you have displayed in this situation. While you may feel that I am in a superior position, I tend to view this situation differently; I feel that you are far superior to me because you have displayed strength of character and the will to recover from a terrible experience which I could never have done. 3. One of the weaknesses of the interview is the therapist attitude; she has allowed herself to be placed in a defensive position with the client rather than remaining neutral as a good clinician would have. The therapist may have made a self invoking statement which may have demonstrated a higher level of negativity than is desirable. This kind of self invoking statement is not likely to be helpful in establishing the kind of authenticity that would be useful to the client and create an atmosphere of genuine interest and empathy on the part of the researcher. Rather, it may have conveyed an impression to Linda that the therapist is vulnerable and may not therefore be in a position to help her because it only reinforces the client’s own feelings about the lack of empathy the therapist has with her specific problem. One of the positive aspects of this interview is that the therapist has successfully encouraged the client to speak openly and honestly about her experience of sexual abuse and the feelings of inferiority, shame and lack of self worth that it has generated. In honestly expressing these feelings, Linda has made the start towards facing up to the experience and moving beyond it to live the rest of her life. 4. The therapist’s interview with George appears to have been beneficial in that it has provided George an opportunity to air the underlying grievances he has against his employees which have in turn conditioned his attitude towards them. The therapist has not resorted to any self involving statements but has focused rather upon encouraging the client to express his frustrations. The strengths of this interview lie specifically in the therapist’s ability to impersonally discuss the ramifications of George’s actions in a positive manner and to allow George to express his feelings in a non judgmental forum. One of the weaknesses of the interview however, is that the therapist may not be providing an adequate level of empathy with the client’s problem, so that the client is encouraged to develop a sense of trust in the therapist’s ability to solve his problems. Short answers: 1. Based upon the responses generated in the study by Murphy et al which is discussed in the article by Lambert and Bagley, one of the implications for social work practice is the importance of the therapist being able to communicate empathy to the client. While it could be affective - “I felt that she felt what I was telling her” or through a personal response from the therapist depending upon the therapist’s assessment of client needs, establishing empathy is likely to be most important in achieving successful results. Another important implication for social work practice is the need to reduce the incidence of negative behaviour on the part of the therapist. While some of the best therapists may demonstrate negative behaviour, nevertheless when there is a greater incidence of positive behaviours and less negative behaviour like belittling, attacking and rejecting, better clinical outcomes are likely to be achieved. 2. One of the important implications of the example explained by Corsini is the importance of using methods that are geared towards improving the self concept of the client. Since most of the clients who approach clinicians for treatment are victims of negative experiences and a negative self concept, a simple solution to the problems may lie in reversing the negative self concept in order to generate a positive self concept. Secondly, it also highlights the importance of exploring different methods in social work that could potentially lead towards the development of a positive self concept. Sometimes, the solution to a problem may lie in applying an approach that indirectly addresses the purported deficiency in the client, such as the IQ test which addresses the client’s perception of himself as stupid based upon what others had told him. 3. One of the theories which does not appear to have a high level of merit is the theory that drawing out the client’s emotions is likely to address the problems he or she is facing. In the psychodrama approach, the therapist’s words and behaviour will be directed towards the client in a manner that generates strong emotions. However, the efficacy of this method is questionable because when a client is already feeling negative about something in his or her life, unearthing the client’s strong emotions about this event could backfire by only increasing those feelings. Moreover, it is not possible to manipulate the emotions of a person in the same way that a person’s thinking or behaviour can be manipulated. One of the theories which may be relevant is that learning occurs through action. By actually applying physical behaviour in solving a problem, the attention of the client can be directed away from the negative experience and indirect means used to address that negative experience by directing physical action against it. Physical action could be therapeutic, for example, since conditions of the body affect the mind, hence working from outside through physical activity may help to ease the troubles of the mind. 4. Two basic differences between cognitive therapy and rational behaviour therapy are: (a) Cognitive therapy uses information processing as a means to rectify distorted selection and processing of information. While Cognitive behaviour therapy identifies the source of anomalies in behaviour patterns as arising out of distortions in information absorption, the RB theory identifies the source of such anomalies as irrational beliefs. (b) Applying the cognitive behaviour theory, each disorder has a specific cognitive content, hence each kind of disorder has its own specific profile. Rational behaviour therapy does not focus on the specific cognitive profile but on the imperatives – the musts and should that condition behavioural patterns 5. The cognitive behavioural approach theorizes that children’s behaviour is conditioned by the inner perceptions and processing of environmental events. Hence, helping a child to externalize his emotions through physical activity may be helpful in addressing his or her emotional problems. The shake ‘em up approach in effect, seeks to provide an opportunity for the child to engage in a vigorous physical activity. The underlying idea is that when the body is affected, it also has an impact upon the mind. Hence, by providing an opportunity for the angry child to engage in a vigorous physical activity, there is an opportunity provided for the child to externalize the anger that may be inherent internally. As a result, the external physical activity may act upon the inner mind and address the feelings that are inherent by providing an opportunity to express it. Through role playing or coping models, the child is being taught a variety of self coping strategies which may be helpful. 6. One additional factor that may play a role in the development of aggressive behaviour is the lack of existence of certain skills, such as the ability to communicate one’s needs to others or a difficulty in standing up for oneself. This causes frustration to the individual because of the lack of interpersonal skills, which in turn leads to the development of anger as a means to cope with the situation. Another factor that could develop aggression in youngsters is the feeling that no one understands them, as a result of which they feel that if they do not attack first, they may be attacked. The aggression becomes a means of defense against being attacked or belittled by others. 7. Using Kingdon and Turkington’s suggestions, a client who is not sleeping well and experiencing hallucinations may benefit at the outset from taking some tranquilizers or medication to promote sleep. This could help the patient to be more relaxed, which could mitigate the inner mental tensions that are being reflected as hallucinations which symbolize the inner fears and anxiety of the client. 8. A corrective emotional experience is one where the therapist recreates in the client, the original feelings of fear, anxiety or guilt which are the source of the problem. The rationale behind this kind of therapy is that by reawakening the same emotions that were the cause of the trauma, those same strong emotions can function as an agent of healing because they can be powerful agents of change. 9. The non-directive approach may be used by teachers and counsellors to help students resolve their problems by encouraging them to think about and reflect on their problems. This method has been found to be helpful, however one of the limitations of this approach is that the person functioning as a counsellor or facilitator to help the young person solve problems may not be adequately trained or possess the necessary clinical training to correctly identify the symptoms of the underlying problem. 8. References: Clark, Arthur J, 2007. “Empathy in counselling and psychotherapy: perspectives and practices”, Routledge Corsini, Raymond J and Wedding, Danny, 2008. “Current Psychotherapies”, Thomson. Read More