As I enter the therapy room, I bring with me a presence. This presence is comprised of personality traits, physical appearance, culture, privilege and oppression, and experiences. As therapists, our job is not only to share knowledge and apply theories we have studied. Our responsibility is also to navigate how we use our presence, our Self, to better serve our clients. Instead of trying to remain “neutral” by attempting to leave our Self behind, we must engage with all of its facets in ways that aid the therapeutic relationship (Kumsa, 2007).
In this paper, I shall use the heart, head, hand and feet model (QUT Field Education Unit, n.d.) to articulate the key parts of my therapeutic Self to outline my professional practice framework. I will pay close attention to how my professional framework might serve me when working with children, parents and families, the population I am most interested in serving throughout my career.
My Feet: What Ground my Practice
In Canada, I am working in a land colonized by a multitude of cultures, a land that welcomes refugees, and a land which is nevertheless still controlled by white supremacy. Therefore, I am grounded in a societal context that is marked by trauma, loss, and cultural insecurity. I believe that whatever family I am working with, I must challenge normative whiteness and white supremacy through a practice that is trauma-informed and culturally safe. I will describe both of these concepts below.
Trauma-Informed Practice
As a trauma-informed therapist, I understand the effects of trauma on the brain (Fishbane, 2007). I know it causes the traumatized individual to remain in a heightened state of fight or flight and heightens reactive sensitivity to triggers. I am also aware that epigenetic research has demonstrated that trauma can be passed down generations (Park & Kobor, 2015). As a white settler in Canada, this knowledge must remain at the forefront of my mind, especially when working with First Nations populations and racial minorities who have histories of slavery, exploitation, or refugees who have fled war and danger.
When working with any marginalized or oppressed population, I maintain sensitivity to the effects of trauma on individuals, and my participation in the therapeutic relationship is molded by this sensitivity. Not only am I cautious about imposing my beliefs and views on traumatized individuals, but I go above and beyond to reach out to these clients and make them feel as comfortable as possible. This means that I deconstruct social constructions of unacceptable or disordered behavior that pathologize individuals that have been traumatized. In our therapeutic relationship, their trauma is a part of their story, not something we work to conquer.
Cultural Safety
I grew up as a cultural minority in Canada as a French-Ontarian, and I also grew up as a cultural minority as a bi-cultural child in a very homogenous rural area. I understand the feeling of being an outsider, and I know the feeling of losing one’s culture to the strong and harsh dominant culture. I know the vulnerability one feels when they enter a hostile culture that often does not allow space for difference. Therefore, cultural safety is a huge part of my professional practice framework.
However, being married to a Chinese man and having lived in China for years also taught me that it is impossible to reach a level of cultural competence with all the cultures we encounter, even when we are immersed in that culture (Dean, 2001). Therefore, my practice of cultural safety can be best defined as a radical openness and a ruthless curiosity for the families I encounter. Although I will be challenged by thoughts that judge, compare and contrast, I must maintain a mindful stance of non-judgment which I practice through mindfulness and everyday experiences in my multi-cultural family. I believe it is imperative that clients not only feel safe, but feel that their whole self is embraced through the therapeutic alliance. My clients deserve not to have to censor who they are in the therapeutic relationship to fit in with the dominant culture.
My Head: The Theories and Beliefs Guiding my Practice
My clinical practice is influenced largely by later feminisms and postmodernism.
I have a deep passion for all types of feminism and the ever-growing body of feminist literature. Feminism informs my understanding of clients’ intersecting identities and how those identities shape their everyday experiences. It is also through my feminist lens that I interpret personal issues as political. I tend not to pathologize individuals but rather look at the context and environment which led them to their lack of well-being (Todd, 2016).
When uncovering the impact of the environment on the individual, I prefer using a postmodern stance of not-knowing and of deconstruction. I see value in challenging normative assumptions about the world we live in, and I encourage my clients to take on “what if” perspectives to unearth alternative and more empowering perspectives. I identify as an “affirmative” postmodernist (Parton & O’Bryne, 2000) who sees hope in our ability to re-construct identities for empowerment.
My Hands: My Preferred Models of Practice
While I have an overall eclectic framework, I have a preference for attachment, narrative, feminist, and emotionally-focused therapy models when working with families and children. I find that attachment theory helps me form a clear picture of the context in which a person learned about the world. It helps me understand the reason behind their behavior and the rationale behind their thoughts. However, I am aware that attachment develops differently depending on cultures and this is where cultural safety comes in.
Narrative therapy is useful in the process of helping families because it allows space for multiple truths to be expressed by family members. Because it is a postmodern therapy, it gives room for meaning-making and the re-construction of disempowering stories into empowering ones. It does not assume powerlessness in the client and truly views the client as an expert.
Feminist therapy is political and calls out the effects of oppression during the therapy session. I like to use this model in conjunction with narrative therapy and attachment therapy as it helps us identify how political structures have shaped experiences. It can also be very empowering for clients to raise-consciousness about issues that seemed to be so personal and realize that they are in fact political.
Lastly, I find that emotionally-focused therapy is a nice blend of attachment and feminist therapy as it challenges other models that see emotions as needing to be conquered, such as in narrative therapy or as needing to be ignored. Emotionally-focused therapy values interdependence rather than seeing it as a weakness which is a huge critique of patriarchal models. I find that the focus on emotion serves as a deconstruction of harmful social norms in white Canada such as the value of self-sufficiency, the nuclear family, and independence. Although it was developed as a model for couples’ therapy, I find that many of the techniques and skills can be applied to families as a whole to uncover harmful relationship patterns and attachment ruptures.
Alongside these preferred models, I also apply cognitive behavioural therapy techniques and have a generally strength-based approach with families.
My Heart: The Values at the Heart of my Practice
I will conclude my professional practice framework by explaining that, at the heart of my practice, lies a deep belief in equity and social justice. I believe that everyone deserves to be treated with dignity whatever their cultural background, their problematic behavior, and their appearance. All humans deserve to be respected and taken seriously.
I believe it is my responsibility, as a social worker to fight alongside those who are constantly fighting for their dignity. It is my responsibility to ruthlessly try to understand behaviours and perspectives that seem foreign to me because there are reasons behind those ways of being. Above all, I believe that as a clinical social worker, my most important task is to provide a space in therapy where my client feels safe, relaxed, and at ease to be who they are, as they are, no matter how flawed they have been made to feel.
Bibliography
Dean, R. (2001). The myth of cultural competence. Families in Society, 82(6), pp.623-630.
Fishbane, M. D. (2007), Wired to Connect: Neuroscience, Relationships, and Therapy. Family Process, (46)3 pp.395–412. doi:10.1111/j.1545-5300.2007.00219.x
Kumsa, M. K. (2007). Encounters in social work practice: Trying out the “use of self.” In D. Mandell (Ed.), Revisiting the use of self: Questioning professional identities (pp. 87-103). Toronto, ON: Canadian Scholar’s Press.
Park, M. & Kobor, M. (2015).The Potential of Social Epigenetics for Child Health Policy. University Of Toronto Press. 41(Supplement 2) pp. S89–S96. Retrieved from: http://www.utpjournals.press/toc/cpp/41/Supplement+2
Parton, N. & O’Byrne, P. (2000). Constructive social work: Towards a new practice. London: Macmillan Press Ltd.
QUT Field Education Unit Social Work and Human Services. (N.D.) Developing your practice framework template. Retrieved from: http://www.swiss.qut.edu.au/ documents/practice-framework-template-for-students.pdf
Todd, S. (2016) Feminist Theories. In N. Coady & P. Lehmann (Eds.) Theoretical perspectives for direct social work practice: A generalist-eclectic approach (3rd ed.) pp. 357-372. New York: Springer Publishing Company.