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Psychoanalytic Theory for Social Work Practice Psychoanalytic Theory for Social Work Practice Written by practicing social workers and social work educators, this is the first book in over twenty years to introduce psychoanalytic theory to social work practitioners. The loss of psychoanalytic theory has left social work without a model to fully understand the impact of trauma and deprivation on the inner world of their clients and to make sense of behaviour which may be disturbing and self-destructive. Psychoanalytic Theory for Social Work Practice analyses psychoanalytic and psychosocial approaches to social work and relates them to current practices and values. Focusing on working with children and families, the text covers salient issues in social work practice including risk assessment, dealing with patients with drug and alcohol problems, and supervision and management of emotional stress. It also examines the research evidence for this approach. With psychoanalytic and psychosocial approaches becoming increasingly popular this text will be a welcome addition for both professionals and students in the social work field, promoting analytical thinking and presenting practical examples of how psychoanalytic theories can be applied in practice. It offers a new perspective on understanding clients and discusses realistic ways in which clients can be helped to change. Marion Bower is a Senior Clinical Lecturer in Social Work in the Child and Family Department at the Tavistock Clinic. She has worked in child, adolescent and adult mental health services for over twenty years. She is on the editorial boards of the Journal of Social Work Practice and the British Journal of Psychotherapy. She is co-editor of The Emotional Needs of Young Children and Their Families published by Routledge. She is an Associate Member of the Lincoln Clinic and works in private practice as an adult psychotherapist. Psychoanalytic Theory for Social Work Practice Thinking under fire Edited by Marion Bower LONDON AND NEW YORK First published 2005 by Routledge 2 Park Square, Milton Park, Abingdon, Oxfordshire, OX14 4RN Simultaneously published in the USA and Canada by Routledge 29 West 35th Street, New York, NY 10001 Routledge is an imprint of the Taylor & Francis Group This edition published in the Taylor & Francis e-Library, 2005. “To purchase your own copy of this or any of Taylor & Francis or Routledge's collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.” © 2005 Marion Bower All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book has been requested ISBN 0-203-34115-5 Master e-book ISBN ISBN 0-415-33799-2 (hbk) ISBN 0-415-33800-X (pbk) Contents List of contributors vii Foreword Olive Stevenson ix References xvii Preface Andrew Cooper xix How to use this book Marion Bower xxi Acknowledgements xxix PART 1 A framework for practice 1 Psychoanalytic theories for social work practice 3 MARION BOWER 2 Psychoanalytic research in the era of evidence-based practice 15 STEPHEN BRIGGS 3 Racist states of mind: an attack on thinking and curiosity 32 NARENDRA KEVAL PART 2 Understanding and working with children and young people 4 Observation in social work practice 49 BIDDY YOUELL 5 ‘Thinking in and out of the frame’; applying systemic ideas to 61 social work with children GWYN DANIEL 6 Individual brief psychotherapy with sexually abused girls and 73 parallel support work with parents and carers JULIE LONG, JUDITH TROWELL AND GILLIAN MILES 7 Double deprivation 92 GIANNA WILLIAMS 8 Psychoanalytic perspectives on emotional problems facing 106 parents of children with learning disabilities DAVID SIMPSON PART 3 Parents, families and professional networks 9 The court, the couple and the consultant: is there room for a 118 third position? JUDITH FREEDMAN 10 Dangerous cocktails: drugs and alcohol within the family 131 MARTIN WEEGMANN 11 Working with borderline personality disorder 143 JOSEPH MISHAN 12 Working with families who see help as the problem 157 MARION BOWER 13 Re-enactment as an unwitting professional response to family 169 dynamics RONALD BRITTON PART 4 Professional stresses and supports 14 Who cares for the carers: Work with refugees 181 MAUREEN FOX 15 The containing function of supervision in working with abuse 189 DICK AGASS Appendix Helpful organisations 201 1 Index 203 Contributors Dick Agass, formerly a mental health social worker, is a BCP-registered psychoanalytic psychotherapist in private practice and a part-time consultant psychotherapist in the Bradford District NHS Care Trust. He is an associate member of the Lincoln Clinic and Centre for Psychotherapy. Marion Bower is a senior clinical lecturer in social work in the Child and Family Department at the Tavistock Clinic. She is co-editor of The Emotional Need of Young Children and their Families (Routledge, 1995). She is also an adult psychotherapist in private practice. Stephen Briggs is a senior clinical lecturer and Vice Dean in the Adolescent Department of the Tavistock Clinic. He is the author of Growth and Risk in Infancy (Jessica Kingsley, 1997), Working with Adolescents; a contemporary psychodynamic approach (Palgrave, 2002). Ron Britton was a consultant child psychiatrist and Chair of the Child and Family Department at the Tavistock Clinic. He is a training analyst of the British Psychoanalytic Society. Andrew Cooper is professor of social work at the Tavistock Clinic/University of East London. He is also an adult psychotherapist. Gwyn Daniel is a senior clinical lecturer in social work and systemic psychotherapist at the Tavistock Clinic and Co-Director, Oxford Family Institute. She is the author (With Charlotte Burck) of Gender and Family Therapy and (with Gill Gorell Barnes, Paul Thompson and Natasha Burchardt) of Growing up in Stepfamilies as well as articles (with Kirsten Blow) on therapeutic court assessments and (with Bernadette Wren) on children and parental mental illness. Maureen Fox is a consultant clinical psychologist in the Child and Family Department at the Tavistock Clinic and the convenor of the Refugee Workshop. She is an adult psychotherapist. Judith Freedman is consultant psychiatrist in psychotherapy at the Portman Clinic. She regularly serves as an expert witness in family court proceedings. Dr Freedman is a Fellow of the Royal College of Psychiatrists and a psychoanalyst. Naz Keval is a consultant clinical psychologist and adult psychotherapist in a primary care setting for Hertfordshire Partnership NHS Trust. He also runs a private practice and does some medico-legal work. Julie Long is a child psychotherapist who has worked for a number of social services departments and is also in private practice. Gillian Miles (now retired) was employed at the time of the research study on sexually abused girls as a senior clinical lecturer in social work at the Tavistock Clinic, working with families in a multidisciplinary setting, and involved in training and research. She was centrally involved in the work with the parents within the study. She is a psychotherapist in private practice. Jo Mishan is a psychoanalytic psychotherpist and mental health nurse and works at St. Anns Hospital in the outpatient department of the Halliwick Psychological Therapies Department. For six years he was the unit manager of the Day Hospital which specialises in the treatment of personality disorders. David Simpson is joint head of the Tavistock Learning and Complex Disabilities Service. He is a consultant child and adolescent psychiatrist at the Tavistock Clinic. He is a member of the British Psychoanalytic Society and works in private practice as a psychoanalyst. Olive Stevenson CBE is Professor Emeritus of Social Work Studies at the University of Nottingham. She studied at Oxford University, the London School of Economics and the Tavistock Clinic. She began her career as a child care officer and has researched and published widely on child welfare, latterly particularly in relation to child abuse and neglect. She has also undertaken work on the protection of vulnerable adults. Judith Trowell is a consultant child psychiatrist in the Child and Family Department of the Tavistock Clinic. She is also a psychoanalyst. Martin Wegmann is a consultant clinical psychologist and group analyst. He worked at the Gatehouse Drugs Service, Southall, Middlesex. He now works at the Henderson Hospital. Gianna Williams is a consultant child and adolescent psychotherapist at the Tavistock Clinic. She founded the Eating Disorders Workshop at the Tavistock Clinic and has written and lectured extensively on these themes. Biddy Youell is a child psychotherapist based in the Child and Family Department of the Tavistock Clinic. She is also head of training at the Northern School of Child and Adolescent Psychotherapy in Leeds. A former teacher, Biddy retains a particular interest in the application of psychoanalytic thinking in nonclinical settings. Foreword I am pleased to have been asked to write a foreword to this book. Yet it is a challenge and not without discomfort. It involves a journey back to the 1950s when social work was establishing itself as a profession and when education
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