SOCIAL JUSTICE

CRITICAL CLINICAL SOCIAL WORK

Counterstorying for social justice in Nova Scotia

BY DR. CATRINA BROWN, RSW & DR. JUDY MACDONALD, RSW

We have co-edited a book entitled Critical Clinical Social Work: Counterstorying for Social Justice which will be published by Canadian Scholars’ Press in May, 2020. The book is an edited collection by the faculty from the School of Social Work at Dalhousie University and includes their respective colleagues across Canada covering topics such as critical clinical theory and ethics, working with complex trauma and diagnosis; men who use violence; women who struggle with substance use; girls and women who experience violence; women suffering with chronic pain; veterans; and older people. We also explore animal informed intervention, intercultural child welfare practices and critical risk assessment, post-colonial, decolonizing and Africentric spiritual practices, AIDS and HIV criminalization, and the development of the School of Social Work Community Clinic.

Case vignettes are used to demonstrate approaches to critical clinical practice. Consistent with social justice based approaches to mental health and addiction, these approaches do not medicalize or pathologize people’s struggles, but situate them within the social contexts and inequities in which they emerge. As such, there is a focus on making sense of people’s struggles and adopting a relational and collaborative approach to the clinical relationship.

The book seeks to reconcile the long-standing gap between social justice and equity-based theory and clinical work. The School of Social Work at Dalhousie, like other schools in Canada, Britain, Australia and New Zealand, has made significant contributions to anti-oppressive theory with a deep commitment to social justice. However, attention has lagged for intentional social justice based mental health, addiction and general clinical practices in social work.

While feminist empowerment and narrative approaches have been well developed for some time, there has not been a full integration of critical clinical practice into social work.

Further, under the institutional and social climate of neoliberalism and its emphasis on fiscal constraint and the rationalization of all practices, we have begun to risk our social justice based professional identities when the workplace requires social work practitioners to adopt the knowledge and practices of other disciplines rather than our own.

Resilience, strengths and empowerment have been important to social work practice, but under neoliberal institutional practices these are too often taken up in individualizing and decontextualizing ways. The emphasis becomes one of selfmanagement and self-recovery which does not address the resources and supports people need, nor the social contexts and inequities which often increase the likelihood of struggle. The specific impact of neoliberalism on social justice in mental health is reflected in dominant medical model approaches to mental health which reinforce social injustice through its bio-medicalized and depoliticized emphasis on disorders, diagnosis and mental illness. These individualized, decontextualized, and pathologizing approaches fail to address the social and political contexts in which people live and the responsibilization of individuals to solve their own problems is reflected in the increasingly reduced provision of adequate social welfare services and supports.

Economic restraint has pressured social workers to adopt medicalized, short term, and often decontextualizing strategies, with a limited number of sessions. Allocating five or six sessions for many of our clients is simply inadequate. Baines and Waugh argue, “One of the main victims of this rationalisation of practice has been the hallmark trust-based, dignity-enhancing, time-intensive relationships generally thought to form the impetus and means for change within social work endeavour.”

We know that many experience complex trauma in their lives, face extreme social and economic disadvantage, and/ or struggle with co-occurring mental health and addiction issues which require more long term practice and the building of a trusting therapeutic relationship. Instead, social workers spend increasingly more time on case notes, increased caseloads, adopting assessment tools not designed by social work, and being supervised by non-social workers.

On the whole, dominant neoliberal discourse is at odds with a social justice approach to mental health practice in social work. This leads us to ask: what is happening to our identities as social workers when we must practice in these ways with little opportunity to shape the workplace differently? Critical Clinical Social Work: Counterstorying for Social Justice offers both a critique of the impact of neoliberalism on social work practice through illuminating dominant socially constructed and oppressive discourses, and providing alternative visions of social work clinical practice.

With growing social inequities and injustices, there is now an even greater need to intentionally advocate for and adopt critical clinical practices.

REFERENCES:

1. Baines, D., Bennett, B., Goodwin, S. & Margot Rawsthorne, M. (Eds.). Working across difference. Social work, social policy, and social justice (pp. 247-260). Australia: Red Globe Press.

2. Baines, D., & Waugh, F. (2019). Afterword: Resistance, white fragility and late neo-liberalism. In Baines, D., Bennett, B., Goodwin, S. & Margot Rawsthorne, M. (Eds.). Working across difference. Social work, social policy, and social justice (pp. 247-260). Australia: Red Globe Press.

3. Brown, C. (2016). The constraints of neo-liberal new managerialism in social work education. The Forum. Canadian Review of Social Work. 33, (1), 115–123.

4. Morrow, M., & Weisel, J. (2012). Towards a social justice framework for mental health recovery. Studies in Social Justice, 6(1), 27-43. 5. Pease, B., Goldingay, S., Hosken, N., & Nipperess, S. (2016). (Eds.). Doing critical social work. Transformative practices for social justice. Australia: Allen and Unwin.

CATRINA BROWN (PHD, RSW) is an associate professor at the School of Social Work at Dalhousie University. Her teaching, research and writing focuses on women’s health and mental health issues, including “eating disorders,” substance use problems, depression, trauma and post-trauma and sexualized violence within a feminist postmodern/narrative lens. She is a private practitioner psychotherapist, and adopts a feminist, narrative, discursive and collaborative approach.

JUDY E.MACDONALD (PHD, RSW) is a social work academic and the director at the School of Social Work, Dalhousie University. Judy’s areas of research are (dis)Ability rights, inclusion and access, and she continues to support students with (dis)Abilities through their research and life story writings.

BOOK: Critical Clinical Social Work: Counterstorying for Social Justice