CRITICAL CLINICAL SOCIAL WORK Book Review BY JIM MORTON, MSW, RSW
In Critical Clinical Social Work: Counterstorying for Social Justice, the book’s editors, Catrina Brown and Judy E. MacDonald, offer what they describe as “an original critical clinical approach to social work practice” (p. 2). The book includes both their own perspectives and those of 29 other contributors, most of whom are affiliated with the School of Social Work at Dalhousie University. The editors rightly point out that this focus on clinical practice is significantly overdue because radical social work, for the last fifty years, has viewed “clinical practice as focusing on the individual and not contributing to social change” (p. 2). Their timeline is unerringly correct. In March 1969 the Committee on Psychiatry and Social Work published a monograph expressing alarm that “during the past decade...especially in the schools of social work…adequate training in the methods of casework is being or soon will be dangerously curtailed by the increasing focus on social theory and techniques at the expense of attention to the problems of the individual client” (Group for the Advancement of Psychiatry, p. 36). Books like Critical Clinical Social Work are indeed overdue and urgently needed. Critical clinical practice is an “approach to social work practice that intentionally ensures that critical theory and understandings of problems or struggles people experience are reflected in the approach to therapeutic conversations” (p. 16).
Feminist and narrative methods of therapy are emphasized, and problems are understood to emerge in a social context. This context is influenced by neoliberalism, which tends to medicalize human problems, placing responsibility for difficulties on individuals, while ignoring larger structures that generate troubles. In addition to the editors’ introductory and concluding commentary, the book’s 17 chapters cover content that ranges from critical clinical theory to mental health issues, violence against women, substance abuse, child welfare,
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immigration services, spirituality and African Canadians, chronic pain and an interesting overview of the functioning of the Dalhousie School of Social Work Community Clinic. Critical Clinical Social Work has many strengths. The content choices speak to matters that regularly confront social workers and these issues are, for the most part, deftly handled. Clinical problems are ‘unpacked’ with a clarity that demonstrates the authors’ familiarity with the research and their commitment to scholarship. Each of the chapters explores its theme with reference to professional social work roles and principles and links individual experience to community and the larger socio-economic and political environments. The critical clinical approach to practice describes a refreshing commitment to listening deeply and to collaborating with clients who are understood to bring essential expertise to the clinical encounter. In this valuing of clients who find themselves struggling in the neoliberal vortex, Critical Clinical Social Work offers an important alternative to the prescriptive and dominant biomedical model and calls on our profession to double down on its commitment to social justice. The book also left me wishing for more in three key areas. I was surprised that so little is said about the connections between biology, epigenetics, social relationships and individual functioning in the discussion of human challenges. Critical clinical practice links problems, and the solutions it offers, to language, philosophy and the creation of new, more hopeful narratives. In this sense the approach is largely cognitive, ignoring advances in neurobiology and its implications for individuals and the family systems and communities they inhabit (Noone and Papero). This area of science is clearly relevant to clinical practice, as well as to social work’s core concern with the person in society. Secondly, I was struck by the extent to which the authors ignored families. “There were 14.1 million private households in Canada in 2016, 9.5 million (67.7%) of which were composed of at least one census family” (Statistics Canada) yet it is
