Reconciling Paternalism and Empowerment in Clinical Practice: An Intersubjective Perspective

Cassandra L. Bransford
The focus of this article is on illustrating how the differences between the paternalistic and empowerment approaches embedded within social work have unnecessarily evolved into competing approaches to practice. Tracing the historical evolution of both paternalistic and empowerment approaches, the article posits that social work is more amenable to an integrated holistic approach to practice than to either a diagnostic or strengths-based approach. Building on G.W.F. Hegels notion of recognition and feminist psychoanalyst Jessica Benjamins theory of intersubjectivity, the article considers how a simultaneous focus on both strengths and vulnerabilities provides an integrated framework that embraces the joint social work values of personal caring and social justice. Clinical case vignettes are provided to illustrate the limitations of focusing too narrowly on either clients pathology or clients strengths. Social workers are encouraged to acknowledge their own vulnerabilities to better appreciate clients vulnerabilities and strengths.
Key WordS: empowerment; intersubjectivity; paternalism; strengths; vulnerabilities

merican social work has characteristically embraced at least two differing streams of practice. one has emphasized a paternalistic approach akin to the medical model. In these approaches, a clients right to self-determination may be superseded by what the social worker determines is in the clients best interest (reamer, 1983). Thus, in these approaches, the worker is in an overtly superior hierarchical role to the client or patient and is viewed as the expert. The second model has originated from the empowerment approach. In this model, social workers view clients as possessing inherent strengths, resources, and knowledge, which the social worker, by dint of her or his authorized role, may be in a position to help foster (Simon, 1994). In empowerment approaches, the client or patient is viewed as the expert. Although there is considerable overlap between these two divergent streams of social work practice, they do, nonetheless, represent two distinct helping paradigms. The focus of this article is based on the assumption that the dichotomy between these two streams of social work practice is artificial and that social workers should, therefore, consider how best to integrate these approaches to support client development. An intersubjective perspective is considered for the ways it provides a basis for better understanding the importance of integrating a focus on both client strengths and client vulnerabilities.

Paternalistic Model

The early model of social work embodied what may be conceptualized as an emphasis on a clients vulnerabilities, a type of environmental medical model. Indeed, Goldstein (1992) noted the distinction even in the root derivations of the words pathology and strength. Pathology is derived from the early Greek concept of pathos, which is associated with the elite and scholarly and is typically detached from worldly experience. However, strength is derived from an Anglo-Saxon root and depicts the natural world of the living.Within the paternalistic tradition, social works origins may be found in the concept of moral deficiency. In the late 1800s, the Charity organization Society (CoS) saw moral conversion as its unifying mission. Poverty was attributed to drunkenness, intemperance, ignorance, and lack of moral will. Change was to come about not through provision of monetary assistance, but through persuasion and friendly influence (Weick, rapp, Sullivan, & Kirsthardt, 1989, p. 350). Consequently, social workers were labeled as friendly visitors within the CoS, and the early focus of social work was on the frailty of human beings. With the advent of the social sciences and the empirical method, social workers sought to discover the causes of clients problems. Focusing on a clients problems forged the development of a problem-solving, linear approach to

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practice.This shift toward a scientific basis to social work practice secured the worker in the position of superiority, as the worker defined the problem, identified its cause, and was positioned to either provide or withhold crucial resources to a needy client. The client assumed a dependent position in relationship to the worker. Later, the adaptation of social science methodology by social workers provided a so-called neutral standpoint from which to practice, in contrast to the religious/moral base that had preceded it, and offered social work a chance to standardize its methods and legitimize itself as a profession, and not just a calling. (The same issue was raised by former NASW executive director Josephine Nieves when she objected to Newsweek columnist Joe Kleins characterization of social work as a calling and not a profession [Newsweeks Klein Called on Gaffe, 1996]). In its promise that virtually any problem could be solved if it were properly identified, social work sought to incorporate what Schon (1983) later termed the myth of technical rationality into its repertoire of helping skills. Weick et al. (1989) also noted that in some respects, the scientific imperative simply replaced the moral one and essentially became a new and improved secular approach to social work practice, cloaked in the supposed neutral garb of scientific reasoning. Badly shaken by Flexners charge, in 1915, that social work was not a profession, Austin (1983) and others suggested that social workers then sought to claim a unified, scientific, communicable body of knowledge and methods. According to this perspective, social workers then found themselves persuaded to identify with other professions, particularly medicine, to adopt a medical, diagnostic model of social work practice to invigorate their fledgling self-esteem and professional status. When Freud came to the United States to lecture on psychoanalysis, he quickly found a ready audience in social work practitioners who were seeking a scientific foundation for their rational and logical approach to practice.The co-opting of psychoanalysis by the U.S. system of medicine served to relegate the social work profession to the position of handmaiden to the more legitimate medical profession. The use of medical thought and language (for example, pathology, diagnosis, symptoms, prognosis), which permeated the process of traditional helping, further contributed to the hierarchical disparity between worker and client (rappaport, 1985).

Flexner (1915) had criticized social workers as being the ones who summoned experts rather than ones who possessed their own expertise (Austin, 1983). In response, the social work profession may have moved away from its person-in-environment moorings and adopted a method that focused on individual pathology rather than environmental stress. By adopting an approach to practice that sought to legitimize social work as a profession, social work may have unwittingly joined hands with the same dominant political forces that were contributing to the oppression and marginalization of its clientsnamely, the social inequities that social work had historically opposed and legislatively battled. That is, to establish its credibility as a profession, social work had to own a knowledge base (Abbott, 1988) and, thus, elevate itself above the local knowledge of its clients (Geertz, 1983). Foucault (1980) referred to disqualified, lowranking knowledge as subjugated knowledge. Indeed, social workers, in their adherence to externally defined notions of professionalism, may have allowed their knowledge to become subjugated as well. Bourdieu and Passeron (1977) coined the term misrecognition to describe the process whereby the authority of any particular knowledge system and the power relations supporting it and benefiting from it come to be perceived not as socially constructed, relative and coercive, but as rational, legitimate and in the best interest of all the parties (p. 171). Arguably, in its quest to secure externally defined notions of professional legitimacy, social work may have become an unwitting partner in the devaluation of its own locally derived knowledge and values-based authority. examples of ways that social workers might abrogate their own authority may be observed in efforts by some to secure professional or academic legitimacy through the stockpiling of effective, quantitatively tested practice techniques or, conversely, through the development of empowerment approaches that may serve the purpose of denying the authority inherent in any professional status or role. Critical theorists, who seek to study the question of subjectivity, have suggested that this kind of unwitting complicity is unavoidable in the development of a profession. It is the socio-cultural matrix . . . capable of constructing the very form that developing takes regardless of the direction in which it moves (Broughton, 1987, p. 14).

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Interestingly, a more recent examination of Flexners (1915) speech, suggests that he may have been misrecognized by social workers who interpreted his words through a modernist epistemology. Morris (2007) offered a critique of modernist interpretations of Flexners speech. She contended that Flexners epistemological roots in social evolutionism negate contentions that he was promoting scientific positivism or somehow relegating social reform ideals to the margins of a professional imperative:
If Flexners criteria of a profession are framed within a 1910 social evolutionary perspective, they demonstrate his emphasis on inductive problem solving in knowledge building, pedagogy, and practice. They also demonstrate his interest in the ethical responsibility of professions and professionals. Flexner asserted that such responsibility obligates members of a profession to advance social ends over professional interests. (Morris, 2007, p. 54)

Solomon identified empowerment as an intervention and a strategy. However, empowerment has been defined in a number of different ways, including as an intervention, a skill, and a process. Pinderhughes (1983) characterized empowerment as an individuals feeling of increased power and capacity to influence forces that affect his or her life force, which meant less of a focus on changes in the social structure.This conception of empowerment stresses self-assertion, upward mobility, personal advancement, and the psychological experience of power. others have offered definitions of empowerment that acknowledge the power relations in society (Gutirrez, Parson, & Cox, 1998; Langan, 1998;Townsend, 1998). Gutirrez, GlenMaye, and deLois (1995) offered a working definition of empowerment practice:
The goal of effective practice is not coping or adaptation but an increase in the actual power of the client or community so that action can be taken to change and prevent the problems clients are facing. Because the effects of powerlessness can occur on many levels, efforts toward change can be directed at any level of intervention or can include multiple levels of intervention. (p. 250)

Morris (2007) further suggested that it may have been Porter Lees (1915) report on Flexners speech, rather than Flexners speech itself, that initiated social workers misrecognition of what Flexner actually had to say about social work in his speech. Nonetheless, and for whatever reason, paternalistic approaches continue to dominate much of social work practice and may be most notable in current reimbursement procedures, wherein social workers are required to identify DSMIV (American Psychiatric Association, 1994) diagnoses for their clients, to secure funding for continuing services. examples of contemporary paternalistic approaches include problem-solving approaches, behavioral approaches, ego-psychological and other one-person psychodynamic approaches, and evidence-based practice approaches that privilege experimentally derived scientific knowledge sources (reid, 2002) over ethnographic methods or practice wisdom.
eMPowerMent Model

Feminist critiques have objected to an emphasis on the individuals or communitys garnering of power and domination and instead have preferred a focus on relatedness and connection. Still, others have characterized empowerment as more than a product but a process in which social workers assist clients in helping themselves (Browne, 1995). In the Empowerment Tradition in American Social Work, Simon (1994) provided one version of a feminist interpretation of empowerment practice and emphasized five components to the empowerment tradition within U.S. social work practice: 1. collaborative partnerships with clients; 2. an emphasis on capacities, rather than on incapacities; 3. a dual focus on the individual, and the physical and social environment; 4. a view of clients as active subjects; and 5. the direction of professional energies in a consciously selective manner toward historically disempowered groups and their members. (p. 24)

More recently, however, empower ment and strengths-based approaches have gained ascendancy (de Jong & Miller, 1995; M. y. Lee, 2003; McQuaide & ehrenreich, 1997; rapp, 1998). The empowerment model originated, at least in part, when Barbara Solomon coined the word empowerment in her 1976 book, Black Empowerment.

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Simon (1994) further provided a historical grounding for what has come to be known as the empowerment tradition in American social work, citing the contributions of such diverse sources as the Protestant revolution, merchant and industrial capitalism, Jeffersonian democracy, transcendentalism, utopian communities, and anarchism. She further cited the influence of populism, the social gospel, unionism, feminism, pragmatism, the Niagara movement of W.e.B. du Bois, Freudianism, Black Nationalism, existentialism, Marxism, and socialism. According to Simons (1994) accounting of the empowerment tradition, settlement house workers and charity organization workers both worked toward Progressive-era social reforms; they were ever cognizant of the ubiquitous tension between viewing clients or neighbors as active agents of their own lives, working with the help of others on their own behalf and as victims of social pathologies of long standing (p. 69). Simon was particularly sensitive to the important nuances of an empowerment perspective. That is, empowerment must not be conceived as ignoring the realities of human limitations, nor is it content to view the individual as merely a bit player subject to overwhelming and impenetrable political forces. Paradoxically, an empowerment perspective can be seen as paralleling conservative political ideology, in the sense that an individuals choice is optimally exercised with limited government intervention, although other perspectives provide a broader, systems-oriented approach (Zippay, 1995). In 1992, Saleebey first edited a book on the strengths perspective approach to social work practice. This perspective was developed to provide a focus on client strengths, rather than vulnerabilities, and to determine how these strengths can be further developed. It was modeled on the dual premise that the self has the power to heal and that a client needs to experience hope. It was also viewed as a model of practice that emphasized the future rather than the past and posed the question What kind of life does one want? rather than What kind of life has one had? (Weick et al., 1989). Furthermore, it sought to give credence to the clients local knowledge and was devised to promote the clients independence and exercise of authority. developers of the approach recognized the placebo effect in medicine as providing persuasive evidence of a clients ability

to mobilize self-healing processes, separate from prescribed medical treatments (rappaport, 1985). Furthermore, human development was viewed as proceeding in a multidimensional, rather than a linear, fashion. Since 1992, a strengths-based approach has been used increasingly, both within professional social work education and within the larger practice community, fostering an important paradigm shift in how social work is now conceptualized and practiced. Kondrat (1995) suggested, by referring to Habermass conceptualization of the three domains of human activity (work, interaction, and power), that empowerment practice can be a way to embrace both epistemological approaches to practicethe technical approach and the practical approach through a process of emancipation. Kondrat conceptualized the technical approach as referring to the body of knowledge that is taught in the academy and the practical approach as referring to the knowledge that is gained through practical application of ones skills in the field. Kondrat viewed the process of emancipation as exemplifying Habermass notion of power in that individuals and groups who are served by social work practice become as free as possible to decide for themselves what is in their best interest and how they wish to pursue that interest (Kondrat, 1995, p. 416). However, Hartman (1993) cautioned social workers to examine the power dynamics within the workerclient relationship and suggested that if clients are to become empowered, workers must shed some of their power. Simon (1994) provided a similar caveat and recommended that workers be aware of both their power and their powerlessness. Similarly, wellness theory offers a holistic approach to social work practice and emphasizes social, psychological, biological, and spiritual factors. Within this paradigm of practice, the client is seen as the expert who defines her or his problem, and the practitioner collaborates on the identification of solutions. (This paradigm may resonate with the problem-solving focus that has been challenged by the strengths perspective, but it differs from deficit models of treatment in its emphasis on the client as expert). Within this approach, clients are taught to create new narratives. The social workers skill is focused on encouraging a client to tell a story and to link clients to resources. other approaches that emphasize client strengths include the solution-focused approach (oHanlon

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& Weiner-davis, 1989), in which clients are encouraged to search for exceptions to the problem, and the narrative approach (White & epston, 1990), in which clients are encouraged to identify unique outcomes to the resolution of problem-saturated stories. These approaches are relatively new to social work and, undoubtedly, more research is needed to understand what promotes wellness (Jones & Kilpatrick, 1996). Moreover, the solution-focused approach, in particular, has been faulted by some for its insistence on focusing exclusively on solutions, with no apparent interest or concern for a persons past struggles (rossiter, 2000) and for promoting a one-model-fits-all (Stalker, Levene, & Coady, 1999) approach to human suffering.
Hegels notion of recognition

power.This free recognition is freedom (p. 129). In distinguishing between paternalistic authority and autonomous authority, Sennett suggested that neither position of authority allows for the recognition of the mutual existence of lord and bondsmen within individuals. The unhappy consciousnessthe stage at which one initially comes to recognize the internal existence of both master and slaveallows one to value authority without bestowing virtues of salvation or omnipotence on those who occupy positions of authority.
BenjaMins tHeory of intersuBjectivity

Theories of intersubjectivity may offer social work practitioners a rationale for the importance of developing practice approaches that explicitly integrate a focus on both strengths and vulnerabilities. In explicating her understanding of intersubjectivity, Benjamin (1988, 2000) elaborated on Hegels (1807/1994) notion of recognition, which included the idea that individuals have both a need to express their will or human agency (that is, strengths) and a need to be cared for by others (that is, vulnerabilities). Hegel (1807/1994) stated that human beings exist only through a process of mutual recognition. Part of the recognition involves the acknowledgment of differences. In discussing a chapter titled Lordship and Bondage from Hegels Phenomenology of Spirit, sociologist richard Sennett (1980) elaborated the point that there is an irony in the fact that the lord depends on his bondsmen for his pleasure and selfconfirmation. As Sennett commented, The irony culminates in the fact that the work the bondsman does for his master ultimately takes him outside the terms of pure dominance and obedience (p. 128). Hegel defined the birth of liberty as the bondsmens consciousness of his work. Hegels (1807/1994) four stages of liberty are as follows: stoicism, skepticism, the unhappy consciousness, and rational consciousness. Movement to the next stage occurs when the bondsman negates his prior beliefs. The fourth stage (rational consciousness) is achieved when the individual recognizes that the lord and bondsmen exist in everyone. In paraphrasing Hegel, Sennett (1980) stated that the ethics of recognitionsympathy, sensitivity, modesty about oneselfshould control the interpretation of

Building on Hegels work, Jessica Benjamin (1988, 2000), a feminist social theorist and psychoanalyst, provided an elucidating account of the ways in which infant research (Beebe, 1985; Beebe & Stern, 1977) identified an infants need for both self-assertion and mutualityin particular, recognition from caretakers. Benjamins (1988) notion of intersubjectivity argued for the possibility of maintaining an internal tension or balance between the two conflicting needs of self-assertion and mutual recognition without necessarily succumbing to the split dualities of subject and object relationships. Benjamin critiqued Hegel for concluding that the human psyche cannot tolerate the tension between the dual needs of self-assertion and mutual recognition and must necessarily resort to subject and object relationships (Hegel, 1807/1994). By finding a way out of this dilemma, Benjamin (1988) articulated her notion of intersubjectivity, which establishes the relationship between two interdependent subjects. She asserted that by splitting the dual human needs for mastery and mutual recognition into binary categories of subject and object, respectively, the coordinates are placed for creating polarized gender relations of male domination and female submission. Similarly, both paternalistic and empowerment approaches that emphasize the expertise of either the therapist or the client may unwittingly replicate relationships where one participant is seen as dominant (subject) and the other as submissive (object). Instead, as Benjamin suggested, intersubjectivity acknowledges that both participants are subjects who need and seek both self-assertion and mutual recognition from the other. The ability of both participants to tolerate the tension of dual needs within themselves and others results in experiences of mutual recognition. An

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absence of mutual recognition within the infant caretaker matrix can interfere with the infants and, later, the developing adults ability to achieve mutuality in relationships. According to Benjamin (1988), when the complementary nature of self-assertion and mutual recognition cannot be tolerated within an individual, then that person is at risk of assuming one-half of the split, such as seen in traditional, stereotypical gender relations or, more extremely, in sadomasochistic relationships, and, similarly, I would argue, in practice approaches that emphasize either a clients strengths or vulnerabilities.
discussion and case exaMPles

Although it is critically important for social workers to respect clients strengths and right to selfdetermination, a narrow application of an empowerment approach may serve to deny both workers therapeutic authority and clients universal need for protection and caretaking. For example, a worker may be confronted with a client who has never had a satisfactory, dependent relationship and who may not trust others. The client may have a need to idealize a worker for a time, as a precursor to a capacity for greater intimacy and interdependence. In such cases, a perception of the workers authority or expertise may provide help and comfort to the client. The following case example may serve as an illustration: When I first began seeing Meryl in psychotherapy, she was 22 years old and was living in the suburbs outside of New york City. I had a practice on the upper west side of Manhattan, and during our initial phone contact she expressed concern about taking the subway at dusk after our session to a station where she could catch a ferry back to New Jersey. She expressed concern about having an evening appointment and worried aloud about how she might get back home safely in the dark. A colleague of mine who had seen her at intake suggested that she was behaving in a regressive manner and should be encouraged to take the subway, just as New yorkers routinely did. He did not think that I should indulge her wish to be taken care of. Instead, I instinctively read her vulnerability and unspoken plea for protection as a basic need and a right. I suggested that she might want to take a taxi back to the station after our first session, and she agreed. over time, I learned that since her mothers death when she was three, and even likely before that, she had felt alone and unprotected. Although

she had difficulty engaging with prior therapists she had abruptly walked out on several after the first few sessionsshe was able to hang in there with me. She allowed herself to become dependent, which for her was a step forward, before she was later able to feel secure enough to navigate successfully, both literally and metaphorically, on her own. Ironically and tragically, the colleague who had earlier scorned the patients overtures for protection as regressive was later killed by a car while biking on vacation. I provide this example to illustrate the importance of recognizing the need that some patients may have to feel protected and cared about and to point out the very real nature of vulnerability that we all sharepatients and therapists, alike. Indeed, as I later became more familiar with the contours of Meryls life story, I discovered that she had a very real and deep-seated terror of the dark and of the dangers that lurked within it. To illustrate, Meryl remembered that as a girl she had lived in a beautiful house on the beach.The family had servants.They were middle class, but because of vast discrepancies in wealth in South Africa, they lived very well. She remembered feeling a sense of danger because her family had considerably more than some of the other people in the community. She recalled in particular an incident in which a little girl was murdered on the beach right in front of her home by what she described as a black man who had hit the child on the head with a rock. He had killed her and raped her. She told me that she thought she was six when this happened and that the girl was four. She remembered that in the television report the father of the child had said, I hoped he killed her first. She also recalled another incident in which a man had broken into her house. She said that those things happened frequently, not to her, but in general, and that she used to sleep with her radio under her pillow. She said that a man came into the house and stole the radios from under the pillows of everyone while they were sleeping. Her father woke up and discovered the intruder, felt sorry for him, and let him go. Whether or not these situations occurred in the way that Meryl remembered them or were more the products of a young girls fantasies is less important, in a sense, than the fact that she likely felt insecure and fearful at her very core. Thus, the very simple intervention described at the outset of treatment both recognized her fear (acknowledged her vulnerability) and validated her desire to protect herself

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from danger (acknowledged her mastery). Perhaps by tuning in to our own vulnerabilities as humans, we are better able to respond to the vulnerabilities of our clients. At other times in our work, we may be confronted with clients who have never before had the occasion to truly narrate and reflect on their life story and may need their workers to bear witness to the struggles of their lives, despite the constrictions of a particular approach to focus on the future, such as a solution-focused approach (rossiter, 2000). As an example, I once worked with a 19-year-old who was admitted to a Long Island psychiatric inpatient unit for overdosing on antidepressants and minor tranquilizers. He had been found in his room by his mother and was taken to the emergency room, where he remained in a coma until shortly before his admission to the psychiatric unit. during his initial visit, he revealed to his worker that he was gay and was extremely fearful about coming out to his parents. This information was not relayed spontaneously or easily. The young man was not particularly reflective and tended to answer questions in monosyllables or by using very sparse language. Later, when the psychiatrist assigned to the case came to meet with the boy and his parents, he said to the boy, All you need is a positive attitude, right? and proceeded to slap him on the back in an apparent display of jocular camaraderie. After later meeting with the parents, the worker thought that they too were maintaining a positive demeanor, perhaps to distract the boy and themselves from the devastating reality that he had almost successfully taken his life. It struck me that this boy might have a particular need to articulate his history, both to better understand his predicament and to begin to identify and integrate feelings and thoughts about his burgeoning identity and place in the world. It struck me also that talking, in the sense of narrating a life history, was not something that he has been particularly encouraged to donot by his parents, who themselves seemed hampered in their ability to present a coherent autobiography; not by professionals, who chose to focus exclusively on finding solutions that were disconnected essentially from a problems root causes; and not by a culture that sought to anesthetize feelings through pharmaceutical agents or quick-fix psychotherapeutic remedies. Moreover, an inherent danger contained within an empowerment or strengths-based approach

might be that it gives the illusion of equality while in fact maintaining the authoritarian nature of the professionalclient relationship (Pease, 2002, p. 138). That is, to be unaware of the potential covert exercise of professional power and authority may be ultimately more dangerous than its overt expression (Bransford & Bakken, 2002). Indeed, some empowerment practitioners have been faulted for seeking to empower clients, rather than assisting clients in deciding how best to empower themselves (Simon, 1994). To illustrate, I recently had an experience in which I questioned a colleague on how she would handle a client who insisted on speaking about her history in the course of a solution-focused, strengths-based approach. Aware of the fact that solution-focused approaches typically concentrated on a clients future, rather than on her or his past, I reasoned that if a therapist truly acknowledged a clients strengths, the therapist would not foreclose a client-initiated discussion of past experiences. The colleague said that she would ask the client how a discussion of an event from the past would enable her to achieve a solution in the future. I then asked what she would do if the client could not answer that question, but simply wanted to talk about her past. My colleague said that she would then refer the client back to their original contract, in which they had agreed to work toward generating future solutions. I must admit that I was left with the feeling in the aforementioned example that the clients innate strengths and tacit ability to know how best to serve her own aims were discounted through the guise of a strengths-based approach. Perhaps the problem is not necessarily inherent in the approach, per se, but rather in a literal or too narrow interpretation of how the approach may be enacted.That is, to more truly convey faith in a clients strengths and capabilities, workers may need to be more flexible and creative in their conveyance of any approach. Blundo (2001) referred to the challenges that workers face in changing personal and professional frames that serve to pressure workers into assuming positions of therapeutic expertise and certainty. Indeed, as Blundo asserted, When the client is made the center of practice in a true sense, uncertainty and not knowing take center stage (p. 303). Moreover, at the same time that workers acknowledge their clients strengths, they might also consider acknowledging their own vulnerabilities. Indeed, Winnicott (1965, 1992) and Kohut (1977), among

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others, have written extensively on the immense power of reparation in the therapeutic relationship. According to Winnicotts clinical research, the therapists ability to acknowledge her or his own inevitable therapeutic failures may be the single most healing event that can take place in psychotherapy. In other words, acknowledging what one has done wrong can be the best thing a therapist can do and can help foster the therapeutic relationship, which has been found repeatedly to be the most salient factor in support of successful treatment outcomes (Brandell & ringel, 2004; Safran & Muran, 2000). Ultimately, social workers may provide far better modeling for their clients if they openly acknowledge the vulnerabilities and possibilities inherent in all of our lives. Moreover, it may be precisely the wish to avoid acknowledgment of ones own vulnerabilities that may lead therapists to wish to focus exclusively on clients strengths.
conclusion

The spirit of the empowerment tradition or of a strengths perspective can be used to encourage the development of each clients fullest potential. Social workers should be ever vigilant of the potential abuses of power inherent in their positions and the inevitability of their biases, distorted perceptions, and lapses into positions of therapeutic certainty. Social workers adoption of a collaborative working stance should not be an attempt to do away with those inevitable biases and distortions but, rather, a means of admitting their own vulnerabilities and human frailties as they go about the business of social work.
references Abbott, A. (1988). The system of professions. Chicago: University of Chicago Press. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, dC: Author. Austin, d. (1983). The Flexner myth and the history of social work. Social Service Review, 57, 357375. Beebe, B. (1985). Motherinfant mutual influence and precursors of self and object representations. In J. Masling (ed.), Empirical studies of psychoanalytic theories, vol. 2 (pp. 4972). Hillsdale, NJ: Lawrence erlbaum. Beebe, B., & Stern, d. (1977). engagementdisengagement and early object experiences. In N. Freedman & S. Frand (eds.), Communicative structures and psychic structures (pp. 3555). New york: Plenum Press. Benjamin, J. (1988). The bonds of love. Pantheon Books: New york. Benjamin, J. (2000). Intersubjective distinctions: Subjects and Persons, recognitions and breakdowns: Commentary on paper by Gerhardt, Sweetman, and Borton. Psychoanalytic Dialogues, 10(1), 4355. Blundo, r. (2001). Learning strengths-based practice: Challenging our personal and professional frames. Families in Society, 82, 296304. Bourdieu, P., & Passeron, J. C. (1977). Reproduction in education, society, and culture. London: Sage Publications. Brandell, J. r., & ringel, S. (2004). Psychodynamic perspectives on relationship: Implications of new findings from human attachment and the neurosciences for social work education. Families in Society, 85, 549557. Bransford, C. L., & Bakken, T. (2002). reflections of authority in psychotherapy: From Freud to feminism. Psychoanalytic Social Work, 9, 5784. Broughton, J. (ed.). (1987). Critical theories of psychological development. New york: Plenum Press. Browne, C.V. (1995). empowerment in social work practice with older women. Social Work, 40, 358364. de Jong, P., & Miller, S. d. (1995). How to interview for client strengths. Social Work, 40, 729736. Flexner, A. (1915). Is social work a profession? Proceedings of the National Conference of Charities and Corrections. Chicago: Hildmann Printing. Foucault, M. (1980). Power/knowledge: Selected interviews and other writings. New york: Pantheon. Geertz, C. (1983). Local knowledge: Further essays in interpretive anthropology. New york: Basic Books. Goldstein, H. (1992).Victors or victims? In d. Saleebey (ed.), The strengths perspective in social work practice (pp. 2136). New york: Longman.

rather than attending to either a clients strengths or vulnerabilities, a more reasoned approach to social work practice might be to continue in the generalists tradition of adapting ones practice perspective to each unique situation.There are times when it is more appropriate to focus on clients vulnerabilities, at other times, their strengths, and at still other times, a combination of both. At the same time, therapists should be aware that they too possess strengths and vulnerabilities. Indeed, as a wise supervisor once commented, in the psychotherapeutic relationship both participants grow but only one person gets paid for it. Moreover, although adopting an empowerment approach to social work practice may provide social workers with antioppressive methods compatible with the professions underlying values of social justice and self-determination, renunciation of a focus on clients vulnerabilities may result in the undesirable effect of discounting social works commitment to personal caring. As Lynn (1999) so aptly put it, personal caring is an essential part of the reality of social justice, and social justice [is] an integral part of caring (p. 940). Social workers should strive to see their clients holistically and work toward developing relationships in which both participantsworker and clientcan be seen as bringing their own unique perspectives and expertise to the enterprise as well as their unique vulnerabilities and strengths.

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Cassandra L. Bransford, PhD, LCSW-R, is associate professor, Department of SocialWork, Binghamton University, College of Community and Public Affairs, P Box 6000, Binghamton, .O. NY 13902; e-mail: cbrans@binghamton.edu.
Original manuscript received January 15, 2009 Final revision received July 14, 2009 Accepted July 30, 2009

Bransford / Reconciling Paternalism and Empowerment in Clinical Practice: An Intersubjective Perspective

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