Theory and Practice
by Amy Cappiccie, PhD, LCSW
In Master of Social Work programs, students often hear an abundance of information centering on the importance of connecting theory to practice. Professors spend copious amounts of time preparing readings and assignments that help support this connection. However, many students and new graduates struggle with making the leap between theory and practice in a way that is helpful for working with client populations. Practice wisdom ends up taking precedence over theory and model guiding intervention, which is problematic for funding sources as well as what client systems deserve in evidence-based treatment methods. In addition, questions tend to arise, and feelings of confusion can lead to being overwhelmed as a new clinician.
Which model of practice am I using when I do a particular intervention? What is evidence-based for working with a particular client system issue? How do I proceed with this client’s needs? The questions can go on and on when new to micro- and mezzo-level social work practice. Use the following five tips to help with making this connection between models and practice a bit less stressful.
1. Popular media examples can help.
First, popular media examples can help us to easily connect the basics of specific models with the model name. One example is found in Disney’s movie Inside Out. In this popular children’s movie, there is one scene that is an example of the basics of Narrative Therapy. I use this in my MSW classes to help students remember Narrative Therapy beyond the end of their classroom experience. In this scene, the memories of the child are being shaped by the “happy” feeling. The specific memory is one in which the main character is part of a soccer team that loses the game. However, the team rallies together around the loss and has a meal together afterwards.
The memory of loss is encoded as “happy,” because that specific emotion is in control of the memories at this time. Multiple memories start coming quickly at this point, and “happy” is finding it hard to keep up. “Sad” comes over to help and catches the soccer memory when it would have fallen and otherwise broken. When “sad” touches this memory, it rewrites the previously positive memory to one of defeat and hopelessness. The soccer loss is now looked at completely differently by the young girl after “sad” touches and thus rewrites the story.
Although this is the opposite of what we might focus on in our time with a client system (happy to sad re-storying), it still provides an example of how we remember our personal stories as snapshots in time and that our stories can be changed by the impact on our lives (i.e. trauma, change, new experiences). Claiming and telling our stories provides value and meaning to our stories. Helping clients re-write their stories to a place of acceptance and/or realistic perspective helps to connect to the stories in a different way that can open up future possibilities.
This is just one example of how you can connect popular media portrayals to a model. Start finding others that may help you to easily remember the various models of practice. This technique will also be helpful when moving forward in licensure in your state toward an independent clinical level. You can then use your memory tricks during the exam to help you remember models you are less familiar with.
2. Start out using 2 or 3 models on a regular basis.
Second, if you find yourself stressed about remembering the details of all the models discussed in your MSW classes, keep in mind that you will initially become proficient in two or three models that you use on a regular basis. These will fit the client populations that you tend to work with from day to day. If you are doing frontline mental health services, you may be working with individuals with anxiety, depression, and other mood disorders. Learning interventions based in Cognitive Behavioral Therapy (CBT), Mindfulness Based Cognitive Behavioral Therapy, Problem Solving Therapy, or Interpersonal Therapy might be a solid basis for much of your work. Having a limited number of models to learn will reduce the stress of being new to the field.
One helpful resource can be Psychology Today, which provides a starting place to find materials on various models (Psychology Today, 2019). Although basic, it provides a starting point. Other helpful resources are your old MSW textbooks. There is a tendency to sell back used textbooks. However, I typically suggest keeping many of these books to start building your professional library. You can then pull these books off the shelves and re-familiarize yourself with the content you need for a particular client system. If you plan to do micro-level social work practice, you will want to keep practice books, theory books, and any DSM-focused books.
3. Seek out continuing education to develop your expertise.
As you narrow in on your two or three models of practice, seek out continuing education to further develop your expertise in these particular areas. Continuing Education Units (CEUs) are one way to do this and have the added benefit of getting needed hours toward state licensure renewal. Reading new journal articles in the field helps you to stay current on changes or additions to your model of choice. If you no longer have free access to research databases, you can consider joining the National Association of Social Workers (NASW). One of the many benefits of membership is having access to a database of journal articles. Another option might be to get access from your alma mater’s library, if they provide access to graduates.
At some point, you might consider getting certification in one of your models. This will be helpful in gaining useful knowledge, as well as allowing for a further credential. Many social workers work toward certification in areas such as Trauma Focused Cognitive Behavioral Therapy (TFCBT), Reality Therapy, Play Therapy, Eye Movement and Desensitization Reprocessing (EMDR), and Brainspotting, to name a few.
4. Keep a file of interventions that have worked.
Keep a file of various interventions that have worked with your client systems. The first year is the hardest, in that you are doing a great deal of “homework” to prepare for each client. If you diligently commit to making a file (hard copies or electronic) in the first year, you will find future years less challenging.
I always recommend writing on the back of your copy or keeping electronically what the underlying model is for a particular activity. This is useful both for helping to link interventions to the model of choice and for charting about your evidence-based treatment methods. For example, you might be working with a client using Thought Records, and on the back of your file, you would write Cognitive Behavioral Therapy.
5. Use clinical supervision wisely.
If your state licensure requires clinical supervision, use it wisely. You have the guidance of an expert for a number of hours. The supervisor is there to support you in understanding the process of clinical work. If you are struggling, talk to your supervisor about the most appropriate model of practice for a client system, the linkage of your intervention to a specific model, and understanding the basics of a specific model. This discussion is a natural part of the supervision experience. Being a consumer of your clinical time only helps make you a more solid clinical social worker.
Hopefully, using these tips will help you find success in your new clinical practice. In a short period of time, you will feel more confident as you apply models of practice to your work. Keep in mind, though, that even with many years of practice, a unique client system may come in your door, and you may feel a bit unsure of how to proceed. Instead of finding yourself again quite overwhelmed, go back to the basics you learned in the beginning, and they will help you be successful in setting up an appropriate treatment plan and working toward mutually agreed upon goals. The process of learning and growing is lifelong in clinical social work.
Reference
Psychology Today. (2019). Types of therapy. https://www.psychologytoday.com/us/types-of-therapy
Dr. Amy Cappiccie earned her MSSW (1999) and PhD (2006) in social work from the University of Louisville. She is a professor of social work at Western Kentucky University. She served as the Region IX (Kentucky, Iowa, Illinois) representative for the National Association of Social Workers Board of Directors.