Raymond Fox

The Effects of Suicide on the Private Practitioner: A Professional and Personal Perspective

A patients suicide has a profound effect on the therapist and psychotherapy with a chronically suicidal patient is particularly troubling. Guilt over ones failure to recognize the warning signs, fear of ones incompetence or irresponsibility, shame that one has failed, and fear of being blamed by the patients loved ones and by colleagues are feelings that frequently surface and that can result in isolating a practitioner from the very sources of peer support that are necessary in order to resolve the trauma. This article explores the effects of suicide on the private practitioner. It discusses how burnout and vicarious traumatization impact upon the therapist who treats the chronically suicidal patient. Two clinical examples illustrate the impact of working with imminent suicide and the aftermath of a patients death from a personal perspective. Recommendations are made to help private practitioners maintain equilibrium when working with these overwhelming case situations.

What is meta for

Metaphors provide bold, rich and distintive windows on the world. They offer dynamic and dramatic views beyond the surface of things into their deeper significance. This paper offers guidelines for discovering and developing metaphors in clinical practice with individuals and families. It also demonstrates how dramatization techniques are used to extend, enlarge and shape metaphors for effective diagnosis and treatment. It builds upon real case material of active metaphorical work with individuals and families for illustrative exposition.

Relationship: The Cornerstone of Clinical Supervision

SUPERVISION IS A critical activity in social work. It serves as the nexus for the practical, personal, and theoretical elements of professional functioning. Much attention has been directed recently to the managerial functions of supervision. Numbers and accountability are highlighted, but little attention has been focused on the development of self-awareness and interpersonal clinical skills-the very lifeblood of professional practice. It is time that professionals reexamine and reaffirm the central goal of professional supervision-the enabling of clinicians to function to their fullest capacity as disciplined practitioners who have integrated the key dimensions of the helping role. This goal requires that supervisors interact with clinicians in such a way as to create a paradigm of the helping relationship. The medium is the message. In supervision, the clinician should experience firsthand the interest, empathy, acceptance, freedom, and openness from the supervisor that he or she is expected to deliver to clients. The impact of supervision is dependent on how well the supervisor uses himor herself and employs sensitivity to guide the clinician’s journey in developing a professional self. The most important vehicle for this professional development is the supervisor’s ability to model behavior, reflect attitudes, and explore thoughts and feelings that the clinician is expected to draw upon in his or her work with clients. Supervision is a helping relationship. In the context of this relationship the clinician learns about the special form of listening that is the hallmark of professional intervention. If it is true, and this writer believes that it is, that clinicians must try to identify with their clients and somehow give them the feeling that they are understood, it is equally true that supervisors must identify with clinicians and somehow give them the feeling that they are understood. The essence of successful supervision is nurturing the clinician’s ability to trust himor herself as a therapeutic instrument. For trust to occur, the clinician needs to experience his or her relationship with the supervisor as a process similar to that which he or she experiences with clients. If this experience does not occur, the outcome of supervision will be thwarted. If it does occur, stability and identity as a professional helper are achieved.

Therapists' Collusion with the Resistance of Rape Survivors

Based mostly upon a qualitative study of nine rape survivors, but also upon intensive review of the literature devoted to countertransference, vicarious traumatization, compassion fatigue, and burnout, this article examines collusive resistance, a process whereby therapists join clients to avoid confronting painful issues. It offers guidelines for the therapist to follow in the therapeutic dance to avert such collusion, and thereby to intervene more effectively especially with traumatized clients to facilitate their recovery actively, and, ultimately, to contribute to their true survivorship.

Field Instruction and the Mature Student

Abstract As increasing numbers of mature students enter schools of social work, it is a challenge and an obligation for field instructors to discover ways to recruit and sustain them in the educational endeavor. Building upon three theoretical perspectives-Freires pedagogy of the oppressed, Knowless andragogy, and Schons reflective learning and teaching, this paper highlights ways in which field instructors can build upon the strengths of mature students to enhance their development as professional social workers. It discusses “parallel process”, “learning styles”, and “contracting” as proactive strategies to fully engage mature students in attaining a graduate degree.

Process Recording: A Means for Conceptualizing and Evaluating Practice

Abstract Despite the wide array of advances in recording technology, process recording remains an effective means for enabling students to conceptualize and evaluate their practice and for field instructors to track student progress toward educational goals. This article discusses process recording as both a productand a processand highlights its enduring importance in social work education as a learning and teaching tool. Building upon previous models, an updated structured outline for recording is offered which goes beyond more familiar traditional formulations to emphasize both the students conceptualization of practice and the evaluation of student performance throughout the educational process.

The personal log: Enriching clinical practice

This article discusses ways in which the keeping of a log by the client may provide perspective and direction to clinical practice. It presents the log as a practical, systematic, economic, and unobtrusive method to supplement face-to-face clinical work. Drawing upon illustrative case examples, the article outlines the logs many forms of expression and exploration which can broaden and deepen self observation and analysis. It offers guidelines to maximize the logs effectiveness when introduced into an array of treatment approaches and suggests its viability with different kinds of clients. A powerful tool for facilitating the development of self awareness, the log also improves communication with the therapist, supplying important information that might not otherwise be available.

Short-Term, Goal-Oriented Family Therapy

Short-term, goal-oriented family therapy is an innovative, time-limited, contract model that structures intervention around observable, measurable, and mutually acceptable goals. The author describes this type of therapy and discusses its advantages and disadvantages.

Preparing parents for children with special needs: A three-part approach

Abstract This paper describes a community-based educative-small group method for working with prospective foster and adoptive parents. As an educational approach, the program prepares applicants to be substitute parents. The small group process method provides the applicants with an atmosphere conducive to discussing fears and frustrations while gaining peer and professional support. Community-centeredness not only allows the agency to recruit much-needed minority parents, but to make a contribution to the community in the form of prevention of problems through availability and education. Evaluation of the program demonstrates that the combined communitybased, small group approach is an effective and efficient method for “screening-in” foster and adoptive parents for children with special needs.