The future of social work in Japan is confused, unclear, and stagnant. A lot of social workers experience burnout because they have to help a wide variety of clients without the benefit of a consistently effective method. In Reconstructing Meaningful Life Worlds: A New Approach to Social Work Practice, co-authors and practicing social workers Dr. Yumi Oshita and Kiyoshi Kamo present the fruitful results of ten years of researching social constructions and other related theories to develop a new paradigm of social work theory and practice.

Reconstructing Meaningful Life Worlds

A New Approach to Social Work PracticeBy Yumi Oshita Kiyoshi Kamo

iUniverse, Inc.

Copyright © 2011 Yumi Oshita, PhD, and Kiyoshi Kamo, MSW
All right reserved.
ISBN: 978-1-4620-0617-5

Contents

FOREWORD........................................................................................................................................................................................................viiPREFACE.........................................................................................................................................................................................................ixPART 1..........................................................................................................................................................................................................1Chapter 1 Outline for the New Social Work Kiyoshi Kamo.........................................................................................................................................................3Chapter 2 A New Perspective on Helping Principles Fumie Yamagishi..............................................................................................................................................20Chapter 3 New Perspectives on Problem Solving Skills and Research Methods Kiyoshi Kamo and Yumi Oshita.........................................................................................................41PART 2..........................................................................................................................................................................................................61Chapter 4 Social Work Practice for the Abused Child with Hyperventilation Syndrome at a Residential Care Institution for Children Yumi Oshita, Kiyoshi Kamo, Kayo Maeda and Harumi Okamoto.....................63Chapter 5 Social Work Practice for the Client with Hyperosmia Yumi Oshita......................................................................................................................................79Chapter 6 Medical Social Work Practice for the Patient with the Chronic Pain Yumi Oshita and Kiyoshi Kamo......................................................................................................102EPILOGUE Toward the Creation of a New Approach to Social Work Yumi Oshita and Kiyoshi Kamo.....................................................................................................................137APPENDICES......................................................................................................................................................................................................143Appendix A: Framework for Assessment, Intervention and Measurement of Social Work Models Kiyoshi Kamo and Yumi Oshita..........................................................................................145Appendix B: Measurement Method of Intervention Effect Yumi Oshita and Kiyoshi Kamo.............................................................................................................................157REFERENCE.......................................................................................................................................................................................................163INDEX...........................................................................................................................................................................................................169

Chapter One

Outline for the New Social Work

Kiyoshi Kamo

Social Work Reconstructed

The most serious problem that exists in traditional social work practice is the absence of a systematized social theory. This basic problem goes beyond the level of systematization of theory to something deeper. Even the idea that the construction of a theoretical system is a necessary condition for understanding social phenomenon is not necessarily shared by social workers in Japan. Naturally, the absence of an adequate social theory results in the absence of a coherent social work methodology. Therefore, a second problem is the absence of an effective practice theory. Following this is the absence of a method to measure the effects of practice. The single case design has been a refined research method used in social work intervention (Theyer and Wodarski, 2007), however, this is a research model to measure behavioral change of the individual. This research model cannot measure the transactional process in life situations.

How can we then provide an adequate theory for social work practice? The answer to this question is not easy. The procedure for problem solving in the natural sciences is summarized as follows: the subject doing the observation objectively analyzes the mechanism of the generation of the problem, identifies the cause of the problem generation, and tries to remove it. This whole approach is epistemologically denied in the social constructionist approach. For starters, social constructionism denies the concept of the real existence of a 'problem'. Furthermore, it denies the possibility of objective observation; it is thus a kind of metaphysics. The idea of pure observation not influenced by outer conditions is actually metaphysical, because in the circuit of human communication the sender's message is processed and realized by the receiver, who punctuates the sequence of messages of the sender based on the context of his reality construction (Wilden, 1980, pp. 112-117). This theory asserts that the 'problem' is the unique construction of the life situation by the client (Gergen, 1985). This new theoretical frame transforms the 'problem' of the client by the solution focused method. Transforming the method of the problem construction of the client is the strategy for solving the 'problems' of the client of this theory. In this approach the authors of this book have shifted the philosophical basis of the practice from logical empiricism to a social constructionist perspective. In following chapters practice theory, practice technique, and the research method based on the social constructionist theory are discussed. We begin by asking the question, what is precisely social theory which is based on social constructionism?

Social Theory

Social Theory as the Precondition for the Social Work Practice

The object of social work intervention are human transactions where new social situations are continually being generated anew. Analyses of these transactions are impossible without using some theoretical framework. The social worker often drowns in a flood of information without this theoretical framework to help make sense of what transpires. It is necessary to reconstruct the client's discourse about the problem by using a theoretical framework for problem solving. The purpose of an analysis of a transaction in social work practice is to clarify the contradiction amplifying mechanisms in the social situation based on this new theoretical framework of problem solving. This theoretical framework should have the power to explain the amplification process of the case. Structural social theories that are often used to explain the transactional social process in social work are highly systematized theories. These grand theories translate the dynamics of the daily life situation into refined concepts of systems theory (Bertalanffy, 1968). These are overarching theories, however, and their power to prescribe a method to change the transaction process of daily life is weak. Theoretical reconsideration of systems theory to construct the practice theory, without falling into excessive abstraction, is required by the social worker. The specific problem imposed on us as theorists, is to construct a clinical systems theory that can adequately stand up to, and be effective for new practice.

Construction of a Clinical Social Systems Theory

According to systems theory, the concept of the social is defined as a human system which has a set of various elements which are interconnected. This aspect of interconnectedness of elements is the structure; continued interaction develops between elements. Therefore, the social is defined as the system which has both structure and process (Constantine, 1986, pp. 45-68). The whole of the relationship between elements in the system is the structure. For instance, a husband who is the elemental ingredient of the family system and a wife who is a basic constituent, mutually unite. This is the marital system. In addition, a unique transaction develops between the family system and outer systems. The structure between systems of this family and outside the family is called as the supra system. When the child is born, the parent and child subsystem is generated within the family system and the structure and process of the family system then changes.

By process, we mean the dynamics of the transactional movement of the system. The dynamics of the transaction between these elements is analyzed by using the concept of the feedback loop. This loop is composed of two loops which mutually perform different functions. One is the positive feedback loop that explains a circular deviance amplification process between elements, and the other is the negative feedback loop that decreases the deviance. The system constructs the moving stability by circular dynamics between these two loops. Usually small contradictions are generated in this balanced system. When this small contradiction cannot be solved, the deviance amplifies in the system. This is the positive feedback loop. The transformation of the deviance amplifying process begins by the differentiation of old solution behavior in the system. This differentiation expands in the system, and the balance of system becomes perturbed. This perturbation of the structure and the process in the system is the beginning of the second-order change (Watzlawick, Weakland and Fisch, 1974, pp. 77-91).

Concept of Difference and System Change

If we accept Bateson's definition of the system, the system is defined as a set of differences where information as the difference flows in a circular fashion (Tomm, 1985, p. 38). The system transformation begins when the difference in this system is activated. Actualization of difference triggers a change in the whole system. The purpose of analysis of the transaction is to clarify the contradiction amplifying mechanisms in the social situation based on this new theoretical framework. For instance, let's assume the transactional system consisted of A and B. At first A sends the message to B. A gives B visual stimulation, aural stimulation, and tactile stimulation. But the message of A is not a physical quantity for B. B processes this message as information that transmits difference, and constructs meaning from it. A similarly handles the message B sends. In a word, system process is defined as the circular process that generates differences. This dynamic cannot be analyzed by the linear causal relationship that considers physical power to be cause. When the structure and the process of this subsystem differentiate, this change influences the movements of other subsystems. As a result, the total system will change. A minor change of elements of the system produces entire system changes. This is the principle of intervention in the minimalist approach.

Social Network

The interconnectedness of subsystems forms the social network. The simple structure of a social network is represented in the Figure 1.1. (Hartman and Laird, 1983, Laird and Hartman, 1985).

This is a network system that has seven network subsystems. Each network subsystem functions according to the principle of maintaining homeostasis, or negative and positive feedback loops. Activating the transformation power of the subsystem of the network is the intervention strategy into the problem maintenance system.

For example, let's assume the first daughter has anorexia. If any of the subsystems is transformed, a force to change her behavior will be generated in this system. If the social worker changes the mal-adaptation processes of one or more network subsystems to a more adaptive position, the dynamics of groups of interconnected subsystems will also be transformed, and this girl's adaptation level may improve. The principle of the intervention to the network is to generate minute differences in the network subsystem. Let us take for example, the mother and the daughter subsystem as the target of the intervention. The change of mother's message or the differentiation of daughter's way of understanding her mother transforms the dynamics of this dyadic system. By effective professional intervention, the frequency of exchange of positive messages may increase. Furthermore, messages having the force to solve the problem might increase among two persons by this intervention. When the structure and the process of this subsystem change, this change influences the movements of other subsystems. Then the transformation of this network subsystem will expand to the transformation to the entire network system.

Embedded Levels of the Context of the Social Structure

Cronen and Pearce (1985, p. 72) define the social structure as the embedded levels of the context. These are represented as follows:

1. Speech acts: relational meanings of the person's messages.

2. Episodes: connected patterns of the speech act.

3. Relationships: subject's definition of the relationship of the two or more persons.

4. Life script: subject's definition of the self.

5. Family myth: abstract conception of the family, society.

A Modified Version of Coordinated Management of Meaning (CMM)

Original definitions of speech act emphasized the importance of the receiver's relational meaning construction of the sender's utterance. To this definition we incorporated the sender's relational meaning construction of his or her own message. Thus, we have a modified version of CMM, and we have named this new theoretical system: MCMM (modified CMM). The sender's relational meaning construction of his or her own utterance is shown as 's' and receiver's relational meaning construction of sender's utterance is shown as 'm'. Figure 1.4. in this chapter shows a practice model to transform deviance amplifying transactions based on this modified speech act theory of Coordinated Management of Meaning (MCMM). A concrete example of an intervention using this theoretical framework is shown in Figure 3.2., Figure 3.3., and Figure 3.4. in Chapter 3 we provide a coherent research model based on MCMM.

Each level functions as the context of the movement of other levels. For example, episodes of life events function as the context of the meaning construction of the actual utterance selection. The speech act level operates as the context for the construction of the new relationship. The mother's new selection of the message may change the daughter's definition of the relationship. Therefore this is a multilayered social system theory.

Mind and Matters

Of course, people cannot always be well adapted under very poor material conditions. Human transaction is also always embedded in particular material conditions. However, these conditions don't exist alone as a material in the process of the interaction. The physical world is the world personified by the subject of the transaction. For example, the taste of coffee for the couple who hates each other is greatly different from the taste of coffee of the loving couple. The bitterness of the relationship is the context that produces the bitterness of coffee, and the bitterness of coffee produces feedback into the bitterness of the relationship. A circular relationship exists between the personal elements and external environmental elements in the human communication. These material conditions influence the dynamics of the interpersonal relationship. At the same time the mind decides the meaning of the external world. Viewed from this perspective, linear explanations that presuppose a single one-way cause of the mal-adaptation are inadequate theories which fail to take into account the integrative nature of mind (Bateson, 1979). The necessary condition to analyze the mal-adaptation of a client is a detailed analysis of the dynamics between individual mind and material context.

Social Work as a Practice to Improve Problem Solving Skills

The Transformative Power of Micro-level Analysis

As said earlier, a human system is composed of interconnected subsystems. The minimum basic subsystem is an individual who constructs meanings of others' acts, then acts on the basis of this interpretation. This is where the intervention point of the social constructionist approach comes in. When the person's method of giving the meaning to the message and the way of act selection differentiate, this micro level change spreads to the entire macro system. If the theoretical frame to analyze the micro process of the meaning construction and the act selection is used, the accuracy of the systems analysis of daily life increases. MCMM that can explain the process of increasing deviance as a transactional process between micro, meso, and the macro levels is indeed, a useful theory for social work. MCMM explains a system transformation as follows: First of all, the difference in the meaning composition and the act selection is generated at the micro level. This minor change at the speech acts levels operates as the force to transform the other levels. For example, the daughter with an eating disorder says to her mother, "I do not like this bread". Mother abandons the usual critical attitude to the daughter and responds to her positively, saying that, "You can clearly insist on the flavor of the meal." Mother's positive reframing of the anorexic behavior of the daughter will become the context for change of the former daughter's definition of the relationship. In this transaction, the mother's minor change of behavior operates as the higher context for the daughter's acquisition of the new definition of the relationship. In the next meal scene, this new definition of the relationship will operate as the context for the selection of the new utterances of the daughter. That is, the minor change functions as the context for the change of the entire system. This is the epistemology of the system oriented social worker.

A Social Constructionist Approach to Solving the Client's Problems

Usually the complaint of the client can be expressed as follows: "I have desperately tried to solve problems. I have continued to ask for advice from others and have tried to change the situation. Still, my own problem has not been solved. What should I do?" Unfortunately, the more he or she tries to find a solution, the more the problem becomes amplified. This is the 'pseudo-solution' process which the client has produced (Watzlawick, Weakland and Fisch, 1974). The client amplifies a contradiction inherent in this process. Therefore, the problem of adaptation can be defined as a situation where the client perpetuates conflict in the interaction process. From the social constructionist perspective, the problem is not considered to be an actual discrete entity, but is defined as the socially constructed story by clients. Through the process of the pseudo solution, the client doesn't see the utterances and meaning construction that have power to solve the conflict. In other words, the social constructionist offers an entirely new definition of what constitutes a 'problem' and this new perspective opens up the possibility for deep resolution of client issues.

(Continues...)

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