Eric D. Ornstein

Beyond Parallel Process: Relational Perspectives on Field Instruction

This article explores the implications of contemporary relational perspectives for transforming our understanding and use of the concept of parallel process in supervisory relationships in social work field instruction. We review the history of the concept of parallel process, summarize current relational views in psychodynamic supervision, and critique the social work literature in light of the paradigmatic shift to a relational, constructivist viewpoint. We present two vignettes illustrating how relational sensibilities enrich our understanding and increase the effectiveness of the field instruction relationship. We relocate parallel process, which up to now has been a primary, organizing framework in psychodynamic supervision, in a larger relational matrix, where it is one element in a complex, interactive process and serves as a marker for further exploration in reflective social work practice.

A Sea of Trouble: A Relational Approach to the Culturally Sensitive Treatment of a Severely Disturbed Client

In this article we will show how a relational approach provides a conceptual framework that shapes and informs culturally sensitive practice with a severely disturbed client. We argue that a relational approach facilitates therapeutic action through the intense focus on countertransference, the close attention to enactments, and the therapists authenticity and self-disclosure. Additionally, we emphasize that a therapeutic matrix that includes the cultural, racial, socioeconomic, and institutional factors, increases the likelihood clinicians will attend to what Perez-Foster calls their “dissociated and disavowed personal values.” We present a case that had a less than satisfactory outcome where the therapist found herself in a “sea of trouble.” The case illustrates how a relational approach enhanced the therapists understanding of the case and allowed her to continue to work with a difficult and challenging client. We conclude by suggesting that our conceptual understanding of this case exemplifies a necessary and appropriate focus for future social work research and practice.

Mitchell's Relational Conflict Model: An Analysis of Its Usefulness in Clinical Social Work

This article examines the relational conflict model developed by Stephen A. Mitchell. The main concepts of Mitchells relational conflict model are discussed, particularly early patterns of connection to parental figures and the interactive treatment approach to understanding and changing those relational patterns. The model is contrasted with classical drive and developmental arrest theories in the psychodynamic treatment of psychopathology. We explain how Mitchells model, in keeping with a social work perspective, takes into consideration the social, cultural, and environmental factors as well as the intrapsychic. We discuss how patterns of relating are reworked throughout the life course, and we explore the potential for individual agency in constructing new patterns of relating. We also highlight the social constructivist aspects of Mitchells approach which are congruent with current contemporary trends in social work theory. A case vignette is presented to illustrate the viability of this model for clinical social work practice.

Goodness of Fit: A Relational Approach to Field Instruction.

This article uses the metaphor of “goodness of fit” to highlight the core features of a relational approach to field instruction. The distinctive attributes of this approach are contrasted with a traditional model of field instruction. The “teach or treat” dilemma is discussed to demonstrate the necessity for field instructors to maintain the delicate balance between a therapeutic and an educational stance in their work with students. The most compelling contribution of a relational approach to field instruction is when the fit between a field instructor and a student is problematic. At these difficult moments, a relational approach offers alternatives that might not be possible in other approaches to supervision. Vignettes are offered throughout the article to illustrate these points.

Supervision and self-disclosure: modes of supervisory interaction.

A conceptual framework is presented for thinking about supervisory issues raised by candidate self-disclosure. The process of dealing with self-disclosure in supervision brings into bold relief certain dynamics that operate in all supervisory encounters. In responding to these and other tensions stirred by analyst self-disclosure, the supervisory dyad moves in and out of various configurations, or “modes of supervisory interaction.” Why these dynamics are intensified when the focus of supervision is on an instance of candidate self-disclosure is explored. To illustrate these ideas, a supervisory hour that dealt with the issue of self-disclosure is presented. A nonjudgmental awareness of the various modes of supervisory interaction enriches the supervisory process.

Dialectical Constructivism in Clinical Social Work: An Exploration of Irwin Hoffman's Approach to Treatment

We explore selected concepts of Irwin Hoffmans approach to treatment as delineated in Ritual and Spontaneity in the Psychoanalytic Process. These ideas are drawn against the backdrop of the current climate of evidence-based practice and the trend toward prescriptive approaches to treatment. We discuss and explore Hoffmans conceptualization of the dialectics of ritual and spontaneity and of being and mortality, his discussion of collaborative exploration, and his delineation of the concept of liminal moments. Although these ideas were originally developed in a psychoanalytic framework, we argue that they are equally applicable in social work practice. We present a case vignette to illustrate the effectiveness of Hoffmans approach with a client who was in a transitional living program for homeless individuals and who had a 30-year history of alcohol and drug addiction as well as chronic mental illness. Finally, we discuss some of the unsettling implications of Hoffmans ideas, especially in terms of a transformed understanding of the opportunities and challenges for the therapists participation in the therapeutic dyad. We view Hoffmans contribution as an organizing framework for developing and expanding clinical social work practice in the 21st century.

[Ornstein & Ganzer] Response to Commentary on Relational Social Work: A Model for the Future

and Nelson’s (1985, 1986) works have not developed from a psychoanalytic tradition. Social work is free to draw upon these thinker’s constructs without fitting them to a psychoanalytic tradition. Equally, psychoanalytic relational notions, as well as relational constructs derived from other traditions, may inform social work practice beyond clinical interventions. In particular, Lakoff ( in Powell, 2003) has been focusing his work on what we in social work would call the “macro” arena. Relational social work could be informed by a number of different perspectives. If the term gains popularity it is possible that several relational social works will develop, as there are several relational psychoanalyses. Relational social work need not and should not be reduced to relational psychoanalysis.We appreciate this interesting and thought provoking response to our article.We are pleased that the commentators feel our article is a valuable and significant contribution to the profession of social work. However, we do not feel that their critique addresses the most important ideas and concepts that we emphasize in our article. The focus of our article is on showing how a relational redefinition of concepts of transference, contertransference, projective identification and enactment can enhance clinical social work. We present detailed clinical vignettes to illustrate how a social worker can effectively utilize these concepts in difficult practice situations.