Room for emotion in helping professions; Shulman discusses paradigm shift in talk for UB at Sunrise

Reporter Staff

In a speech both humorous and heartfelt, the new dean of the Graduate School of Social Work last week outlined the "paradigm shift" he sees taking place in social work and the helping professions.

Shulman speaking Speaking on March 24 as part of the UB at Sunrise program, Lawrence Shulman argued that the "medical model" for the helping professions is in the process of a necessary transition to a more "interactive model." In Shulman's view, the medical paradigm encourages the separation of the personal and the professional, whereas the new paradigm encourages social workers, psychologists and doctors to bring their genuine emotions to the job, to reveal to their clients what they think the client is really saying and to view honest mistakes as preferable to strict professionalism.

While he was quick to point out that the new model does not mean workers are supposed to share everything with every client, Shulman said it does mean personal emotions and intuitions can be expressed "professionally and appropriately."

By contrast, said Shulman, when the medical paradigm of "study, diagnosis and treatment" is dominant, it leads to the belief that social work is "something we do to people instead of something we do with people."

Under the medical paradigm, he noted, social workers are advised to shift personal questions back onto the client. Phrases such as "We're here to talk about you" and "This is what I hear you saying," can mask the social worker's own discomfort, indifference or fear.

A better strategy, said Shulman, begins with honesty. "We've tried everything else," he said. "Maybe we should give honesty a shot."

Providing illustrations from his own experience and those of his students, Shulman outlined the various ways honesty can "help the real work to begin." In some stories, honesty meant something as simple as answering the client's personal questions directly and sincerely; in others, it meant something as controversial as expressing emotion-even momentary anger-in front of a client. "Not everyone agrees with me," said Shulman, "but I have not found ways to train social workers to learn how to trust their instincts other than by teaching them to take risks, to learn by their mistakes, to do things differently, and then to make better mistakes. And I think that's what we do most of our lives."

Shulman also encouraged the many social workers in the audience to make guesses as to what their clients are "really saying," and to express those guesses to the clients. This "preliminary empathy," he said, allows the helping professional to stay one step ahead of the client, noting that even wrong guesses are often seen as evidence of the social worker's humanity.

"I was taught never to do this," said Shulman. "I was told it would be putting words into the client's mouth. But my research and my experience have told me that we make more mistakes of omission-when we fail to take a guess-than we make mistakes of commission."

According to Shulman, another component in the new paradigm is the recognition that clients are partially responsible for the results of social work. "The people we work with have a part to play," he said, "and sometimes they can't hear us, no matter how honest or genuine we are. That's a very crucial concept, because we often take responsibility for the outcome of our work when we should only take responsibility for our part of the work."

The inadequacies of the medical paradigm became evident to him, said Shulman, when he tried to lead a bereavement group for widows. "I began by saying, 'The purpose of this group is to work through your grief.' And one of the members said, 'You don't work through your grief, Sonny. You learn to live with your grief.' And my education started."

Contending that, for many social workers, this "education" includes learning how to get around the pressure to conform to the old paradigm, Shulman argued that the new paradigm has been a covert part of social work for years. As an example, he described a woman who was sent to a social worker just after she learned her child had leukemia.

"The social worker said to her, 'What did the doctor say?' And the woman said, 'He just told me my baby is going to die.' That young social worker reached out, took her hand, and sat and cried with her. In my view, the worker was making a gift, saying, in her own way, 'I'm going to try to be with you at probably the worst moment of your life. Words will come later. Right now you don't need words.' Her supervisor, walking by the open door, trained in the same paradigm I was trained in, pulled her out and criticized her. I asked the social worker what she learned from her experience," said Shulman. "She said she learned to keep her door closed."

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