My field placement in substance abuse services is a very demanding workplace with staff who hail from a multitude of backgrounds and professions. Each brings his/her own unique and valuable skills and insights to the work we do. But it wasn’t suprizing to me that I didn’t have to be there very long before I could easily identify all the social workers from the rest of mix. I didn’t need to see their name tags or read their credentials on some memo. I only needed to listen to their comments about agency mission, client systems, service delivery, problem solving, and program outcomes.
You’ve probably heard the phrase, “they all drank from the same kool-aid.” I’d like to propose that the social worker’s version of that should be, “We all ate from the same PIE,” and indeed, we have! PIE: Person-in-Environment perspective. The NASW Standards for Clinical Social Work handbook states, “This orientation views the client as part of an environmental system. It encompasses reciprocal relationships and other influences between an individual, relevant others, and the physical and social environment” (p.10).
In a culture that embraces a medical model designed to evaluate the client in terms that are measured and articulated by pathology, dysfunction, disorder and diagnosis the transactional processes enveloping the client in his/her world can be soon overlooked. Corcoran and Walsh (2010), Pargament (2007), and others have explicate this distinction quite well by focusing our attention on addressing the biopsychosocialspiritual factors which directly and systemically influence the quality of human functioning rather than concentrating all our attention on the presence or absence of so called “normal” personal characteristics.
While many mental health professionals, programs and service plans may concentrate on the Axis I, II and III of the Diagnostic and Statistical Manual of Mental Disorders (DSM) (APA, 2000) , it has been my experience that social workers are perhaps even more focused on Axis IV psychosocial and environmental problems. It is certainly not that the previous axes are unimportant, but rather that they can be better understood and addressed recognizing that they exist and are expressed within a particular physical and social environment, context and system. It is here on this essential level that clinical social work shines.
To my fellow MSW candidates who now have their eyes fixed on the month of May I’d like to say, please help yourself to another large helping of PIE. And to those of you considering the profession, I encourage you to look at the world around you that you aspire to change. Ask yourself how you could do that if you did not see the contextual conditions and interactions of those you long to help. And then, by all means, please pull up a chair, grab a plate, and have a delightful slice of this PIE.
American Psychiatric Association (2000). Diagnostic and statistical manual for mental disorders (4th ed. Text revision). Washington, DC: American Psychiatric Association.
Corcoran, J. & Walsh, J. (2010). Clinical assessment and diagnosis in social work practice. New York, NY: Oxford University Press
National Association of Social Workers (NASW) (2005) NASW standards for clinical social work in social work practice. Washington, D.C.: Author.
Pargament, K.I. (2007). Spiritually integrated psychotherapy: Understanding and addressing the sacred. NY, NY: Guilford Press