Clinical social workers are becoming a major presence in the psychoanalytic establishment. Not only are more social workers being accepted for training in the institutes of the American Psychoanalytic Association, but also social work clinicians have a political voice in the psychoanalytic consortium through the inclusion of the National Membership Committee on Psychoanalysis in Clinical Social Work (NMCOP). There are now ninety-two social worker candidates and forty active social worker members of the APsaA. In contrast, only ten years ago the APsaA had just two active members who were social workers; there are no statistics regarding social work candidates from that period.
On the surface, therefore, it would appear that psychoanalytic theory and practice is alive and well in social work education and that schools of social work would naturally include psychoanalytic concepts and psychodynamic technique as a standard part of their curricula. Although that was true in the heyday of psychoanalysis, from the 1930s through the 1950s, it is far from true today. In fact, with some notable exceptions such as the Smith College School of Social Work, many mainstream schools of social work see psychoanalytic theory as antithetical to the objectives of social work education. This discipline emphasizes the development of policies, services, and programs that strengthen human development and functioning and help eradicate social and economic injustice.
To help understand this opposition to psychoanalysis, I spoke to Jean Sanville, a clinical social worker and psychoanalyst who served for forty years on the faculty of the UCLA School of Social Welfare and who co-edited with Joyce Edwards the textbook Fostering Healing and Growth: A Psychoanalytic Social Work Approach. The book was published in 1996 in cooperation with the NMCOP, with the intent of providing a psychoanalytic perspective in schools of social work.
Sanville says that the accrediting body for schools of social work, the Council on Social Work Education (CSWE), has actively discouraged the teaching of psychoanalytic theory in schools of social work. “They see problems differently,” she explained. “They look for them in the social surround. They don't understand that psychoanalysis doesn't deny the importance of the larger context but attends to the dialectic between inside and outside.”
In examining the curriculum required for accreditation by CSWE, it is obvious that the whole body of clinical work, both theory and technique, accounts for only about one-eighth of the total required courses. The rest of the curriculum encompasses other aspects of social work, such as policy, social welfare, diversity, and research. Even within that clinical fraction, schools of social work are required by the CSWE curriculum primarily to teach “empirically based theories and knowledge that focus on interactions between and among individual groups, societies, and economic systems,” such as systems theory, social learning theory, and cognitive behavioral techniques.
Ira Colby, dean of the University of Houston Graduate School of Social Work (my alma mater) confirmed that this is one source of the difficulty in providing an adequate clinical education to those social workers who desire to be clinicians, especially psychoanalytically informed clinicians. He explained that most schools of social work provide a generalist education that emphasizes this “macro” focus on the systems with which humans interact.
“We only have two years,” he pointed out, “and in that time we have to teach content in nine areas for everyone. That doesn't leave much room for an in-depth approach to the interior of the person. We provide a basic framework, and we want to stimulate our students to keep learning once they leave here.”
Colby believes that things will change. “Including the inclusion of psychoanalytic theory?” I asked.
“Yes,” Colby replied, “because there are students who come here looking for it.”
I know some of these Students well. For the past several years I have taught a two-term course in psychodynamic theory and practice to the handful of University of Houston social work students who have been selected to do their field practicum in the Outpatient Clinic of the Baylor College of Medicine, where the psychoanalytic perspective is still very much alive. These students, although very well trained in systems theory and social policy, are frustrated by the unavailability of courses that stress development from the perspective of an internal life and the theories and techniques that would help them gain access to a client's inner world. They understand the importance of the dialectic referred to by Sanville, and they are hungry for whatever our clinic can provide educationally to make up for what cannot be offered in their master's program. As Colby indicated, these students know what they want and are determined to get it somewhere. It is unfortunate that social work students with clinical aspirations must so often seek training in such a dichotomous fashion.
Photo by George Feder
There are places where this is not necessary. The Smith College School of Social Work is one of a handful of programs that see themselves as primarily training clinicians. “We are a clinical program which is policy informed,” explained Carolyn Jacobs, the dean of the School of Social Work. She described how policy and practice were integrated at Smith: “We want our students to use theory well — to understand resistance, transference, and countertransference in the therapeutic relationship — but in a relational context that considers the larger environment.”
I was pleased to see the numerous and varied courses in Smith's curriculum that incorporate developmental and psychodynamic concepts without sacrificing social work values. For example, a course titled “The Adolescent in Context: Dynamics and Treatment Issues” was described in the Smith course catalogue as
Hinda B. Simon, M.S.W., is a graduate of the Houston-Galveston Psychoanalytic Institute and a member of that institute's faculty. She is also a clinical assistant professor at the Baylor College of Medicine in Houston.
using “Psychodynamic, Jungian, Object Relations Theory and the Self In-Relation Model of Female Development [to] provide a framework for the examination of the adolescent in the contexts of family, peer relationships, and the larger world of social institutions.”
“Our faculty is deeply committed to dynamic work and developmental theory,” Jacobs asserted. She and Sanville both mentioned Simmons College, Loyola University in Chicago, and New York University as examples of schools that have moved away from the polarized trend described above. Jacobs noted that this polarization extends to doctoral programs in social work. Most doctoral programs are research-oriented and non-clinical. Smith offers a doctorate that is clinically based.
Until the internal and the external are more widely integrated in the curricula of schools of social work, social workers will continue to do what they have been doing in increasing numbers. They are taking their solid grounding in the larger context of the human environment — their understanding of cross-cultural issues, systems theory, and human diversity — to their post-graduate education in psychoanalytic institutes. This background adds richness to the training experience for all candidates, even as psychoanalytic training enriches the candidate who is a social worker.
While the dearth of psychoanalytic training in schools of social work leads to an increase in the number of eager candidates for psychoanalytic institutes, psychoanalysts must also pay increasing attention to the critical need for psychoanalytically oriented education within social work training. This could lead to more opportunities for collaboration between psychoanalytic institutions and schools of social work, which are struggling to balance the needs of their students with the requirements of accrediting organizations.