The Creation of Meaning in Clinical Social Work

Book excerpt: Reflecting the trend of constructivist thinking across the sciences, this volume provides a framework for integrating newer ideas with the traditional practice of clinical social work. Its underlying assumptions are that construction of a mutual meaning system between therapist and client is essential for treatment, and that identity complexity is essential to healthy adaptation. Relating to former notions of process and content in treatment, this volume by Carolyn Saari illuminates these concepts. In her previous book, Clinical Social Work Treatment: How Does It Work?, Saari demonstrated the importance of a shared meaning system in treatment. In this significant new work, she offers a detailed examination of the manner in which such meaning is constructed. She also shows how this theory more adequately bridges the gaps between the intrapsychic and the interpersonal as well as between the individual and the social structure. As she explains in her introduction: ...the adaptive point of view has provided an inadequate foundation for clinical social work theory. A theory of meaning in which psychological health is indicated by a constructed personal meaning system (or identity) that is highly differentiated, articulated, and integrated is proposed to take the place of conceptualizations about adaptation. This theory of meaning, which includes the idea that what the child internalizes is his or her experiences with the world, is believed to hold more utility for understanding the psychological effects of phenomena such as racism and social oppression. In an intellectual climate involving much heated debate between treatment methodologies based upon scientific empiricism and those based on hermeneutics, Saari argues that clinical theory must rely on both a causal, developmental science and on a theory of meaning that involves the narrative construction of the possible. Her work lays the foundation for sorting out the aspects of clinical theory that involve each of these ways of thinking, and for exploring their interaction. Providing the basis for a deeper understanding of the complexities of human functioning and clinical practice, this volume is an enlightening guide for advanced graduate students and an invaluable resource for practicing clinicians.