Social Work: Finding A Personal Balance

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Social Work Finding A Personal Balance

• Catherine F. Schryer, PHD
• SSHRC grant 34199

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Methods

• Review of professional literature
• Observations 13 supervision sessions
• in 6 hospital and agency settings
• --7 transcribed
• Semi Structured interviews with 16 participants
  (8 interns and 8 supervisors)
• -- 5 transcribed
• Preliminary data analysis

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Supervision

• A dyadic encounter between supervisor and
  supervisee wherein supervisee provides accounts
  of practice
• Purposes Administrative, educational,
  supportive
• Can occur throughout a social workers career

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Supervision Rationale Kadushin,1992

• Supervision necessary because work is
• Unpredictable
• Non-routine
• Non-standard
• Highly individualized
• Unobservable
• SW requires ongoing individualized monitoring

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Case Presentations

• Occur within context of supervision sessions
• Consist of
• Identification of patient/client problems
• Assessment/diagnosis of problems
• Intervention/ Treatment strategies
• Follow up

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Field History

• Biopsychosocial (Nason, 1990, p. 13) origins
  rather than bio medical
• Supervision practices parallel field history of
  social work

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Stage 1Early History

• 1880s to 1910
• Origins in Charitable Organizations
• Friendly Visitors supervised by staff
• Main emphasis of supervision accountability
• Secondary emphasis--training

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Stage 2Growing Professionalism

• 1910-1920s
• Training programs develop first in agencies then
  in universities
• Professional organizations emerge in US and
  Canada by middle of 1920s
• Main emphasis of supervision -- education

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Stage 3Growing Medicalization

• 1920s-1940s
• Many associated with hospitals and mental health
  clinics
• Adopt medical models of case presentations
• Insight theories psychoanalysisbasis of
  diagnosis
• Supervision--therapeutic--supportive

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Stage 4Growing Challenges

• 1950s-1970s
• Disillusionment with psychoanalytic approach
• Development of many other theoretical
  perspectivesempowerment, environmental (person
  in situation)
• Growing divisions between individual, group and
  community approaches
• Supervision training and support

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Stage 5Administrative Accountability

• 1980s present
• Cut backs in all areas
• Competition between helping organizations
• Government demands for accountability
• Supervision administration, teaching and support

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Areas of Tension

• Knowledge basis
• Process seems stable
• Theory basis unstable and competing a
  developing profession
• Relationships
• Long term investment versus short term reality
• Professional Identity

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Knowledge Basis Social Work Process

• History/Discussion
• Assessment
• Intervention repertoire
• Key termsprocess, relationship, person in his or
  her environment

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Knowledge/Theory Basis Unstable

• History of adopting various theoretical
  frameworks (similar to education, composition and
  rhetoric)
• Debate re value of theory
• Eclectic mixchoice according to agency or client
  circumstances
• Consequence difficult to navigate for newcomers

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Examples Medical

• Intern 1 Shes functioning, shes able to do
  things, her energy level is low, and the desires
  are not there, but I think in terms of my
  assessment I think its reactive depression that
  she cant be a mom
• SW 1 So you think, shes more reactive
  depression than a major depression.

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Example Psychoanalytic

• Intern 2 Its a self-object function. This is
  just a word that Dr. H. taught us, but it does
  something for him to kind of like what you were
  saying
• SW Is it a tease?...But you cant ask that
  directly, but you can help him come to (an
  understanding), but that takes longer, more
  psychodynamic takes longer..

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Example Social Work

• sw 4 Okay, so this is the clinical case that
  were going to do the ten consonants with.
• translate, negotiate
• Content
• Solve versus manage problems
• Personal versus political
• Visitor, customer, complainant

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Area of Tension Relationships

• Value of long term relationships. Reality of
  short term interventions.
• For student/interns necessity and tension of
  termination
• Personal Boundaries

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Example Terminations

• SW 1 I sense a lack of confidence
• Intern 1. ..Just in my whole placement here, I
  think Ive learned that with people that I think
  I do well with tend to come backif I hit right
  on the nail, I scare them off.
• Intern 2 I dont want to transfer my people to
  other students

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Personal Boundaries With Clients

• Intern 1 So I kind of saw a little reflection of
  myself
• SW 1 Counter-transference. Its good you have
  the insight to see you know..

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Personal Boundaries Supervision

• SW 6 Well I think its really good that youve
  identified some of those things, and we can talk
  more abouthow youre doing and how youre
  feelingObviously, my role is not to be your
  counselor
• Intern 6 No, I know
• SW 6 But to be open to the issues that youre
  dealing withfor the development of self, and
  self-reflection, that is part of a placement.

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Professional Identity

• Negotiating Professional Boundaries
• Standing ones personal ground
• Establishing professional ethos or credibility

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Example Professional Boundaries

• Intern 4 Just an aside, I saw (x) this morning.
  He insulted me to my face..
• SW 4 So what did he say?
• Intern He said whats the matter with you that
  you dont have enough influence and competency to
  have influence over your co-workers?...
• SW 4 I would let him know that you cant be held
  accountable for something that someone else is
  doing. All you can do is give them the
  information and they make their own choices and
  then I would deal with him in terms of how he
  feels about it.

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Implications

• Professional identity is a shifting ground.
• Supervision/case presentations reflect history
  and status of profession.
• Tensions of field present in supervision and case
  presentations
• Social work practice varies according to setting
• Interns must design a personal balance to suit
  each context