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RUNNING HEAD: Final Reflection 1

Final Reflection

Social Work 659: Evidence and Clinical Practice

Collins Nwabunike

University of Calgary
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My Emerging Practice and Stance on Therapy

As I moved forward in my own social work practice, my hopes are to work with the

immigrant population and member of marginalized group taking an anti-oppressive lens.

Before starting this paper, I would like to acknowledge the prevalence of colonial ways in

Western therapy sessions. In recognizing this, I would like to bring forward that the notion of

creating a standard method of evaluating or assessing is a challenging one. While we should have

some mechanisms in place to know if our therapy is supporting our client, we should also be

reminded that these understandings need to be flexible and acceptable to changes as we work with

complex human beings.

Assessing the Relationship

Relationship is key in therapeutic alliances. It is the window into building an understanding

into our clients’ distress and concerns, as well as working collaboratively to work towards goals.

Having a poor alliance has repeatedly associated with therapeutic dropout (Anderson et al., 2018).

Factors such as body language, openness to participate and commitment to sessions can be

considered in assessing the comfort level between therapist and client. With that being said, the

therapist should always apply a critical lens with these factors. In the therapist mind, there should

be considerations of the impact of factors such as poverty, culture and religion, and past

relationships, that could have an impact on the current therapeutic process and overall outcome.

For example, if a client cannot make it to 3 sessions in a row, checking in to make sure, lack of

accessible transportation or childcare is not an issue that should be considered. Further, Western

understandings of comfort through body language may be different than certain cultures. Always

applying a critical lens to our own perception of reality is important in interpreting the relationship
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with our client. Therefore, engaging in dialogue with our clients about these pieces is of high

importance. If we have this openness in our sessions, it shows honesty and transparency, important

aspects to a trusting relationship.

Reduction in Client’s Distress

One of the clearest indications that therapeutic approach is working, should be to recognize

if there is a decrease in the client’s distress. This distress may look different for different clients.

The therapist should look towards symptoms which continue to interfere with the client’s daily

life, and these should be defined in conversation, but come from the client them self. In

understanding, if there has been a decrease in the client’s distress, it would be helpful to look

towards the clients own defined goals of what they would like to see change in order to feel better.

Tracking progress of these goals can be a value lens into understanding if the specific approach

and therapeutic alliance are inappropriate.

Evaluating Gaps and Strengths

How do we know whether the therapy we provide to clients actually works? Self-appraisal

and self-reflection are not enough, sometimes we still need critical feedback either from our clients,

supervision, or measurement tools (video recordings, noted, surveys) to ensure we are providing

competent service. Not being able to receive or seek out critical feedback can be both dangerous

and harmful, especially for our clients and the work we do as clinicians. One of our core value and

principles of social work is our competence in professional practice (CASW, 2005). Our clients

have the rights to seek and access competent therapy services, thus why we need to ensure that the

needs of our client are put first (CASW, 2005).


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By receiving critical feedback, we strive to maintain and increase our professional knowledge and

skills as social workers (CASW, 2005).

In an effort to understand my own gaps and strengths as a therapist, I do recognize the

value in my clients completing an anonymous evaluation survey of their time with me as their

therapist. These surveys could be used to evaluate my work as a therapist in terms of relationship

and comfort of client, clients feelings of progress and relief of distress and overall feedback of the

process.

Alternative Evaluative Methods

In my own future practice, I would like to have various approaches to evaluation outside

of the standardized measuring mechanisms such as surveys. A different evaluation tool I would

like to someday implement in my practice is a sharing circle. A process in which I could invite

clients to come and share their experiences both with me taking part in the circle, and without me

there and instead a colleague facilitating to allow for anonymity. These sharing circles would

involve my clients and could be open to my colleagues as well. This approach would be an effort

in recognizing the value in the client's voice and the reciprocity that should be part of any

therapeutic relationship.

The Notion of Evaluating

The very concept of measuring and evaluating a complex and multi-faceted aspect such as

a therapeutic relationship raises a bit of concern with me. How can you truly ‘measure’ human

elements? We should be asking ourselves why we always strive to contain these concepts to linear,

rigid Western thinking. Human beings are complex creatures and relationships may look different
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for some clients. Attempting to categorize specific qualities of a positive therapeutic relationship

and outcomes, could mean that we are excluding or missing other ways of knowing and

understanding the evaluative process.


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References

Anderson, S., Tambling,R., Yorgason, J., & Rackham, E. (2018): The mediating role of the

therapeutic alliance in understanding early discontinuance, Psychotherapy Research, DOI:

10.1080/10503307.2018.1506949

Canadian Association of Social Workers. (2005). Code of ethics. Ottawa, ON: Author.