You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
After an introduction by Dr. Louis Schwartz, the chairman, Dr. Robert Waelder contributes a penetrating discussion of the similarities and differences between psychiatric casework and psychoanalytic therapy. he divides psychotherapies into three types: analytic, which presupposes a relatively intact ego and superego as well as the wish to change; environmental manipulation, which attempts to change the environment to fit the patient's needs; and 'taking sides', in which the therapist reinforces one pole of the patient's conflict. Casework he defines as a short term psychotherapy which tries to solve current problems by supportive and educational measures rather than by completely rehabilitating the personality. The prerequisites for successful casework are the same as those governing the choice of patients for analysis, with the difference that casework can influence character traits but not crystallized neurotic symptoms. Casework, however, has an advantage over analysis in that old age or constitutional bisexuality are not necessarily obstacles to success. The data of casework are the interview material obtained by asking relevant questions rather than by the more diffuse method of free association. Such material should permit the social worker to understand the analytic structure of the case in terms of the patient's main conflicts, his attempts to solve them, and his typical behavior patterns. The infantile origin of symptoms should be neglected because the necessary data are not usually made available by the casework method. The emphasis should be kept on the patient's current problem, on his history, on his expectations from life and from treatment, on his daydreams, on his relationships between his fantasies and reality, on the transference, and on the relationship between interviews. Casework is thus basically a nonanalytic therapy which is, however, guided by analytic insight. Dr. Waelder emphasizes that understanding on the part of the worker sh