Documenti di Didattica
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MatthewB.Drake
Introduction
YouareaLicensedClinicalSocialWorkerinalargemetropolitan
area. You specialize in mens issues and have received an
EmployeeAssistanceProgram(EAP)referraltoworkwithScott,a
36yearold Caucasian male, who was recently laid off from his
job. He described depressive symptoms and difficulty finding
meaninginhislife.Heismarriedandhastwochildrenunderfive
years old. You have five sessions with Scott to assess, treat, and
referifnecessary.Youarenotrequiredtodiagnosis.
After receiving the referral, you call Scott and set an
appointment to meet at your office. He is engaging and cordial,
stating he looks forward to meeting with you. The sessions are
freeforScottandwillbepaidforbytheEAP.Heisnotrequiredto
filloutanyEAPmandatedpaperworkotherthanreceiptofHIPPA
regulations.
YoubeginthinkingaboutyourfirstsessionwithScottand
youarestruckbythedescriptionthatScottwashavingdifficulty
finding meaning in his life. You are trained in narrative therapy
and believe it provides the best means to create meaning in a
clients life. Because of this, you decide to implement narrative
interventions with Scott. The narrative approach acknowledges
humanbeingsaremeaningseekers(Polkinghorne,2004)anditis
thecreationandattachmenttodysfunctionalstoriesthatleadto
difficulty in the lives of individuals. Furthermore, narrative
therapyisbuiltupontheassumptionsofconstructivismandsocial
constructionism.Constructivismandsocialconstructionsharethe
beliefthatrealityisaconstructthatiscreatedbyanindividualor
group(Phipps&Vorster,2009).Constructivismsactofknowingis
interpretive and subjective; therefore the individual can never
possess an objective knowledge (Phipps & Vorster, 2009). Social
constructionism is a development of constructivism and
postulates that reality is an artifact of communal knowledge
(Phipps&Vorster,2009).Therefore,itisaconstructsharedbya
community.Socialconstructionismisconsideredadevelopment
beyond constructivism because reality goes beyond the
individualssubjectivemindandisturnedintoacreationofsocial
interchange(Phipps&Vorster,2009).Youbelievethistheoretical
framework will provide you with an avenue to help Scott make
changesinhislifeandconstructanewmeaning.
As you are contemplating the conceptual frameworks of
narrative therapy and the emphasis of social construction of
reality,yourealizenarrativetherapyrecognizespowerimbalances
and its impact upon the creation of stories. Narratives often
changegiventheaudienceandthestorytellersassumptionsofthe
listener. Because of this, it is extremely important that you, a
narrative therapist, areaware of the setting you create before a
wordisspoken.Withinthefirstfewminutesofthefirstsessiona
presentation is made and assumptive realities are constructed
influencedbyculturalbackgroundsthatshapeappearance,dress,
postureandsexuality(Winslade,Crocket,&Monk,1997).
Questions
1. As a social worker you are encouraged to identify as a
professional and conduct yourself accordingly. It is
necessary to become selfreflexive and consider your
presentation and actions within your professional role.
Simpleexpressionsofselfsuchasdress,officedcor,and
greetingswillinfluencetheoutcomeoftreatment.Please
reflectonhowyouwillpresenttoyourclient.Whatwill
youwear?Whatdoesyouofficelooklike?Howwillyou
greetyourclient?Thesequestionsarejustthebeginning;
whatelsemayyouthinkaboutwithinyourpresentation?
What does the professional literature say about the
topic?Pleasecriticallyreflect.
2. Now, take it a step further and reflect deeper by
exploringtheimpactofyourvaluesandbeliefsuponyour
social work practice. How will your values and beliefs
impact your expression of self and the direction of
treatment?There is noright or wrong answer here, just
the necessity and goal of personal awareness through
selfreflection within your social work practice. This is a
vitalskillthatwillbeatremendousassetforyouinyour
future.Pleasetakeafewminutestocriticallyreflect.
3. Narrative therapy dismisses the belief that clients are
objects and that a detached therapist, in the role of
expert, dictates the course of treatment based on a
medical model of diagnosis and treatment. Narrative
therapyrecognizestheclientashuman,fullofweakness
andstrength,allowingtheclienttobetheexpertofhisor
herownnarrativesandthetherapisttobetheexpertin
the process of therapy. Please critically assess your
thoughtsregardingconstructivistthinkingandthelackof
an objective truth in relation to your role as a therapist
and the process of treatment. Is this conceptual
frameworkcomfortableforyou?Pleaseexplain.
TheFirstSession
YougreetScottandinvitehimintoyouroffice.Hetakesaseat.He
is dressed casually and neatly. His affect and mood appear
normal. Scott is relaxed and sitting straight in his chair. You will
begin with his story and its deconstruction. Deconstruction is
definedas:
The process of unpacking the takenfor granted
assumptions and ideas underlying social practices that
masqueradeastruthorreality.Itisachievedbybringingtolight
thegapsorinconsistenciesinatext,discourse,ordominantstory
so that acceptance of the storys message or logic no longer
Thefollowingquestionsarepossibleoptionstobeginthe
deconstructingprocesswithScottandaredesignedtoexplorehis
history,itsinfluence,andeffect(Brown&AugustaScott,2007).
Whatbringsyouheretoday?
Howhastheproblemimpactedyourdailylife?
Whateffectdoestheproblemhaveinyourlife?
Howhastheproblemaffectedyourlife?
Howhastheproblemaffectedyourviewofself?
Whendidtheproblembegin?
Questions
Itisimportantyouchooseastylethatiscomfortableforyouand
notforcedordetached.
1. Whichoftheabovequestionsfeelsmostnaturalforyou
andyourstyle?
2. Are there ways to change them to become more
meaningfultoyou?
3. Pay special attention to the process of externalization
withinthequestions.Asyoubegintodevelopyourown
questions make sure that the problem is externalized
fromtheclient.Forexample,Iamdepressedbecomes
the depression. Remember within narrative therapy
theclientisnottheproblem,theproblemistheproblem.
TheFirstSessionContinued
Youbegintreatmentbystating:
You:
Whatbringsyouheretoday?
Scott:
Itallstartedwiththelayoff.Ihadknownaboutthe
possible layoffs months before it happened. Each
day I would go into work wondering if someone
wasgoingtogetlaidoff.Therewastalk...people
wereonedge...eversincetheeconomytanked.I
hadbeenwiththecompanyforalmosttenyears.I
held a management position, lots of friends . . .
goodtimes.And...Ihavechildren.Ithoughtthere
is no way they will let me go. And then one
morning, last September, I got the tap on the
shoulderasmybosswalkedby.Hesaidweneeded
to talk in his office. I still remember what I was
wearing,thesmellofthecoffee...itwasVerona
BlendfromStarbucks.I lovedthatstuffandnowI
cantdrinkthatshit...God!Whatahorribleday!I
justremembergettingupandgoingintohisoffice.
HetoldmetheywerereducingstaffandIwaspart
ofthegroup.HethankedmeforallIddone.Hesa
good guy . . . you know. It wasnt his fault. So, I
stood up . . . shook his hand, and walked out the
door. I couldnt even think. It was like I got
punched by Mike Tyson. I was blank . . . like in
shock.Iffeltlikethewindwasknockedoutofme.
You know that feeling? I somehow made it to my
deskandcomposedmyself...andgotthehellout
ofthere.Soon,Icouldntgetmymindtoshutoff.
WhatthehellwasIgoingtodo?Mywife,mykids.
. . I just kept thinking, why? You know . . . I was
goingtogobackandgetmyMBA...thecompany
was going to pay for it. Yeah . . . And now I get
scared about losing the house, losing what we
have.NowIapplyforjobs...Ihavetoeveryweek
...tomeettheobligationsofunemployment.Iam
tired of applying to these jobs and my
unemployment is going to run out soon. I keep
thinking about these big time CEOs and their
salaries.Itssick...disgusting!
YouprovideanempathicresponseandScottcontinues.
Scott:
IamnotthesamepersonIwasayearago.Ithink
Imdepressed.There...Isaidit.Ifeellikeshit!I
have no job . . . How am I suppose to feel? We
pulledourkidsfromdaycareandnowIguessIma
stayathomedad.Thatsme.ThatwillbemeuntilI
can find a job . . . that may be forever. I cant
believehowthingshavechanged.Isometimesfeel
likemydaysareajoke.Imean...itcanbehardto
getoutofbed.IgotoparkswiththekidsandIam
the only dude there. Its so damn isolating and
peoplelookatmelikeImsomekindoffreakshow.
Iplaywithmykidsbutitshard...likeIamgoing
throughthemotions,youknow.Honestly...like
goingthroughthemotions.Andthen,Ifeelguilty.
My wife comes home and Im like . . . hey babe,
you want a piece of your manly man. God, its
frustrating. Kim is always saying be present and
enjoyyourtimewiththem.Shesaysthekidsdont
careifIhaveajob...Imjustdaddytothem.But
it is hard, you know. She has a life and I dont. I
want that back. Where is my life? I tried to be
active . . . I would go to the pool and the guys
would ask how my vacation was going.
Unbelievable!Ijustquitgoing.Istillgorunning...
and it helps. But . . . I dont know. Sometimes,
when Kim comes home I just disappear into the
basement. I grab a beer and turn on the game. I
just try to not feel the frustration.
Soon,Iwillbeoutofunemploymentandthingsare
going to get crazy tight. I worry about the house,
the kids, college savings . . . everything. But, how
amIhelping?Ijustsitaroundalldayandwipemy
kidsbutts,dodiapers,andamlikesomepansyass
mistermom.Ithink...like,ifthishappenedtomy
dadhewouldhavehadajobwithindays.Hewould
Questions
1. What are some of the themes in Scotts opening
narrative?
2. Whatcouldbethegrandnarrativeordominantstory?
3. Critically examine how narrative therapys emphasis on
socialconstructionrelatestosystemstheory?Howdoes
it compare or contrast to the personinenvironment
approach? How do these frameworks shape Scotts
story?Howwillitshapethecourseoftreatment?
ItisevidentthatScottishavingdifficultywiththelossof
hisjobandheexpressessymptomsofdepressionsuchassadness
and despair. He clearly identifies with the dominant narrative of
hisculturewhereboysaresocializedtonotcryandbeproviders.
Thissubjectivetruthneedstobechallenged.
TherearesomepositiveswithinScottsstoryandnarrative
therapybuildsuponstrengths.Scotthasmany;themoststriking
is his selfawareness, which will be an asset in the creation of a
newnarrative.Healsodescribesastrongsupportnetwork,mainly
his wife, who is willing to help. Scott has also made an effort to
lookforjobsandmaintainsaphysicaloutlet.
YoudecidetobuilduponScottsstrengthsandaddressthe
overarching dominant narrative, gender role conflict. You begin
byassistingScottdiscoveranalternativestorytohisgenderrole
conflict and exploring the possibility of accepting his role. You
couldaskoneofthefollowingquestions:
Willyoutalkaboutatimewhenyoufeltgoodinyour
roleasastayathomedad?
Willyoudiscussatimewhenyoufeltmasculineinyour
roleasastayathomedad?
Willyoushareatimewhenthedepressionwasgone?
Willyoudiscloseatimewhenyoufeltinthemoment,
present,withyourchildren?
Or,oneofyourown.
TheSecondSession
Scottisontimeforthesession.Heisdressedcasually.Hismood
and affect appear within the normal range. He reports feeling
good about the last session and you process his thoughts and
feelings.Inthissession,youwanttoexplorehisrelationshipwith
masculinityandbeginwiththefollowingquestion.
You:
Willyoudescribeatimewhenyoufeltmasculine?
Scott:
You know this is an interesting question. Im a
masculineguy...Iwasacollegeathleteandhave
gained a lot through physical expression. But I
dontthinkthatisallIam...IguessatworkIwas
a good manager because I was a good listener.
Peoplewouldtellmethat...thattheycouldtalk
to me. I took pride in this . . . I guess I feel like I
need to bemore of a man now without a job . . .
Whateverthatmeans.Imdoingatonofpushups
and situps when Seth is doing tummy time. I just
crankemout!ItisfunandIfeelgood. Youknow
Im a protector . . . a daddy bear! That makes me
feel masculine. I like to feel needed in this way.
When Kim says I look good, it makes me feel
masculine.Whenshegivesmethatlook,youknow.
Thatfeelsgood.WhenIamplayingballwithSarah
Ifeelmasculine.Iguesstherearealotoftimes...
I guess there are a lot of times I feel like a man.
Workdoesnthavetobetheonlythingthatmakes
me a man. Being a provider and all . . . You know
thoseCEOsarentmen...theyvegotnothingbut
money.Shit!Idontknow...IfeellikeIamallover
theplacewiththis.Beingaman...Whatisaman?
Question
1. TohelpScottnotfeelaloneorisolatedinhisadaptation
andjourneyintohisnewroleasastayathomedad,you
haveaskedhimtolookonlinetoseeifhecanfindothers
in similar situations. You also decide to do your own
investigation into the professional literature. Please do
thisnowandapplyyourcriticalthinkingskills.Howmay
whatyoufindassistScott?
Question
1. Please reflect upon the importance of professional
literature within your practice. How does the above
informationshapeyourtreatmentprogression?Howwill
youimplementresearchintoyourpractice?
TheThirdSession
Scott reports he completed his homework and has
connectedwithafewgroupsofmenfromwebsitessuchasrebel
dads. It becomes evident that he is opening up to the idea of a
new masculinity. You report your literature review findings and
you and Scott decide a good goal for todays session will be to
continue to deconstruct traditional masculinity and the creation
ofanewnarrative.Youwanttofollowtheresearchandproducea
flexiblerelationshipwithmasculinity.
At the end of the session you give Scott a homework
assignment to write a goodbye letter to traditional masculinity.
Youalsoinvitehiswifetothenextsession,hopingshewillprovide
supportandapprovalofhisnewnarrativeofmasculinity.
TheFourthSession
Scottbringsthefollowinglettertothesession:
DearMarlboroMan,
Iwastaughtlongagothatbecomingamanwouldbea
definingmomentforme.ThroughoutmychildhoodI
learnedIcouldntcry,couldntbetoojoyful,andcouldnt
expressanyemotion.LookingbackIrealizeItriedtoresist
you.Irejectedpartsofyou.Iallowedsomefeminine
aspectsofmyselftosurfacesuchasempathyandwarmth.
Ilikethosepartsofme.Theymakemewhole.Ihave
realizedIneverwantedtobeyou.Youareajoke.Youarea
lie.Youareacreationofanillsociety.Itisthisbattlewith
whosocietywantsmetobeandwhoIreallyamthatis
creatingproblemsinmylife.Thejobwillcome.Now,I
haveachancetodosomethingsubstantialinmylife.Iam
defininganewmasculinity.Onethatisnotrigid.Within
thismasculinityIcanbeexpressiveandIcanfeel.Itallows
metobepresentwithmykids.Itallowsmetocrywithmy
wife.Itallowsmetobewhole.ThisiswhatIwant.So
today,Istartfreshandanewchapterbegins.Itbegins
withalittleboywhowantstocryanddoes.Everythingis
okay,everythingisalright.Hegrowsuptobeatrueman.
Hehasnoguiltandlesspain.Iamthatnewman.Marlboro
man,itistimetosaygoodbye.
Scott
Question
1. Thinkaboutyourownsocializationinrelationtogender
roles.Howdoesthisimpactwhoyouaretoday?Howwill
your personal socialized values coexist with your
professional values? How may you utilize the use of
letterswithinyourpractice?Wheredoyougofromhere
withScott?
AsScottbeginstocreatethisnewnarrativeitisimportant
that his story be shared with others (Brown & AugustaScott,
2007).Bydoingthis,thestorybecomesmoreconcreteandanew
realityisborn.Toaccomplishthis,youhaveaskedKimtoattend
your session. Scott reads her his letter. She is in tears and
responds:
Kim:
Scott, you are a wonderful man. That is why I
marriedyou.Youknowithasntbeeneasythepast
year. Things were easy before the layoff, but I
believe things happen for reasons and you have
madethemostofthis.Ihaveseenyoustruggling.I
saw you wanting to be what you thought was
masculine, but you are more than that. You are a
wonderfulhusbandandfather.Justbe...justbe.
Goodthingsarecoming...youknow.Iamgrateful
for you. I am gratefulyou are allowing yourself to
grow.
TheFifthSession
ThisisyourlastsessionwithScottandyoucontinuetoprocesshis
identification with his new narratives of masculinity. He reports
he has joined a stayathome dads group and has been to one
outingwiththekids.Theyhadagreattime.Hedescribesfeeling
happyandisnotreportinganydepressivesymptoms.Heisreal
aboutthesituationandknowssomedaysarebetterthanothers,
but he is grounding himself in what he has learned and
accomplishedinthepastfewmonths oftreatment.Hefeelslike
the future is promising. He thanks you for your help and the
sessioncomestoanend.
Question
1. HowwouldyouendthesessionwithScott?
Conclusion
Scott, a 36yearold Caucasian male, entered treatment after
losinghisjob.Hedescribedsymptomsofdepressionandalackof
meaning in his life. You decided to employ narrative therapy
interventions because they are designed to create meaning. It
becameevidentthatScottwashavingdifficultywithgenderrole
stress. By deconstructing his identification with the dominant
narratives of his culture regarding masculinity he was able to
construct new meaning; one that allowed him to be whole. He
identified with other men and felt connected to those going
through similar situations. Scott joined a stayathome dad
support group and began feeling less isolated. Ultimately, he
wrote a goodbye letter to his socialized, traditional masculinity
andcreatedanew,lessrigidone.Hethenshareditwithhiswife
inacouplessession.Treatmentconcludedwithcontinueddialog
regarding his narratives and a bright outlook for positive
narrativestoguidehisfuture.
Question
1. Ifyouwereinasettingwheretreatmentwasdictatedby
a more traditional approach based on diagnosis and
treatment, could you apply the principles of narrative
therapy?Why,orwhynot?Howwouldyoudoit?
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