Carol Tosone

Relational social work: Honoring the tradition∗

Abstract For social work clinicians trained in psychoanalysis there may be a tendency to disavow their earlier social work training and to identify themselves solely as psychoanalysts. This article addresses this tendency and introduces the term relational social work as a way to describe the intrinsic relational roots of social work theory and practice. A definition of relational social work is offered and its distinguishing features are outlined in comparison to relational psychoanalysis.

Professional Posttraumatic Growth After a Shared Traumatic Experience: Manhattan Clinicians' Perspectives on Post-9/11 Practice

Clinicians who live and work in natural and man-made disaster-prone areas are often exposed to trauma primarily as citizens and secondarily as a result of their professional practice. In an attempt to better understand this increasingly common experience of collective trauma, this study explored the long-term impact of September 11 on the professional lives of 201 Manhattan clinicians. Participants reported that 9/11 was the impetus for enhancing self-care, changing clinical modality, and forging new skills. Positive changes were also reported within the therapeutic relationship, including increased compassion and connectedness with clients. Negative effects included feeling ill-equipped to work in the gravity of 9/11, an increased sense of vulnerability, and disappointment with professional organizations.

Therapeutic Intimacy: A Post-9/11 Perspective

Abstract This essay describes therapeutic intimacy as a deeply personal and evolving definition of what each therapist finds uniquely curative. The author arrived at her definition following the events of September 11, 2001, and notes that constructs such as vicarious traumatization do not adequately convey the profound impact that such a catastrophic event can have on the clinicians personal and professional life. She introduces the term “shared trauma” to describe the lasting, transformative changes in ones self-concept taking place when the clinician and client are exposed to a collective trauma. The arbitrariness of professional boundaries is captured through discussion of client narratives.

On being a relational practitioner in an evidence-based world

Contemporary clinical practice requires social workers to keep abreast of and apply evidence-based practice approaches. This may be a more difficult challenge for psychodynamically oriented social workers who focus on the therapeutic relationship as the principal mechanism of change. Research supporting the efficacy of the therapeutic relationship is presented, as is a case vignette that illustrates the core principles of relational social work, a postmodern contextual approach that focuses on the mutuality inherent in the therapeutic endeavor. Emphasis is placed on examining the ‘client and clinician-in-situation’ and the interactional nature of the intrapsychic, interpersonal and macro social systems in which the client and clinician operate.

Sotto Voce: Internalized Misogyny and the Politics of Gender in Corporate America

A business man is aggressive; a business woman is pushy. A business man is good on details; she’s picky. He loses his temper because he’s so involved with his job; she’s bitchy. He follows through; she doesn’t know when to quit. He stands firm; she’s hard. His judgments are her prejudices. He is a man of the world; she’s been around. He drinks because of the excess job pressure; she’s a lush. He isn’t afraid to say what he thinks; she’s mouthy. He exercises authority diligently; she’s power mad. He climbed the ladder of success; she slept her way to the top. He’s a stern taskmaster; she’s hard to work for.

Revisiting the “Myth” of Feminine Masochism

Masochism, an enigmatic concept and clinical entity, has long posed one of the most difficult therapeutic challenges. Clinical observation supports the view that both men and women can exhibit masochistic traits. However, by virtue of their gender specific developmental paths, men and women may differ in their respective masochistic manifestations. Female patients often report a tendency to inhibit aggression which can lead to its somatic expression. Women also tend to be more prone to certain types of self-defeating behaviors and affective states, such as eating disorders, depression, and victimization. Factors contributing to the development of masochism in women include the influence of pre-oedipal and oedipal relations with the parents, narcissistic needs, and the internalization of societal attitudes toward women.

Through their own eyes: a media-based group approach to adolescent trauma.

Abstract This paper describes the process of two groups of students from high schools located in the immediate vicinity of the World Trade Center grappling to make sense of the events of September 11 through the creation of a documentary chronicling their experiences. The process of creating these videos mirrored the process and curative factors of a psychotherapy group in a non–stigmatizing, innovative, and accessible format, one generated by the students themselves with the assistance of professionals in the visual and performing arts. After reviewing the literature on the potential impact of violence on adolescents and the use of group treatment, especially in school settings, as an optimal choice for this population, we describe the distinctive process of the two separate groups of students, each culminating in different expressions of their very personal experience of September 11. We understand and contextualize their process through the lens of the therapeutic dynamics and elements of group work.

The Shared Traumatic and Professional Posttraumatic Growth Inventory.

Purpose: While there are established instruments offering psychometrically sound measurement of primary or secondary trauma, none capture the essence of dual exposure for mental health professionals living and working in traumatological environments. Methods: This study examined the experience of 244 mental health workers who lived and worked in New Orleans during Hurricane Katrina. An instrument, the Shared Trauma and Professional Posttraumatic Growth Inventory (STPPG), a 14-item, Likert-type scale composed of three subscales (Technique-Specific Shared Trauma, Personal Trauma, and Professional Posttraumatic Growth), was developed to understand the nature of dual trauma exposure. Results: The STPPG supports the reciprocal nature of shared trauma and correlates well to existing measures for posttraumatic stress, secondary trauma, shared trauma, and posttraumatic growth. Discussion: The STPPG suggests that personal traumatic experience can impact professional practice, and client traumatic narratives influence one’s personal trauma responses. Implications of STPPG for practice and future research are discussed.

Narrative and Meaning-Making Among Manhattan Social Workers in the Wake of September 11, 2001

This qualitative study was a thematic analysis of categories of meaning-making contained in the written narratives of 139 clinical social workers living and working in New York City on September 11, 2001 (9/11) related to their personal and professional experiences of the World Trade Center attack. Themes included personal growth and benefit found in the wake of 9/11, the ongoing experience of adversity, and professional growth and lessons learned. Situated in the context of the literature on narrative and meaning-making, the findings offer further support for meaning-making as an intrinsic human activity and shed light on the various ways clinicians integrate an experience of shared trauma. Implications for theory, practice, policy, and future research are suggested.

Clinical social work education, mental health, and the DSM-5

ABSTRACT Since the inception of social work in the late nineteenth century, there has been an ongoing debate as to what constitutes the essence of social work practice. Does the social worker maintain a macro or micro focus, serving as an agent of social change or social control, respectively? This article explores the perennial debate in the context of social work education about mental health in the United States, particularly as related to the classification and treatment of mental disorders for the diverse range of underserved clients.