Case Study

Case Study

Beyond Clinical Correctness: Unearthing the logic of the client’s solution

By Michael Ungar

January/February 2012

As a clinical social worker and resilience researcher, the children I treat have been my most important coresearchers. They’ve taught me to be careful about what I consider “pathology” and to reconsider the belief that there’s only one clinically “correct” way to help them. By showing me how they see the world, my young clients have made me understand that respecting the underlying reasons for their behavior is usually the best way of helping them find alternative solutions to the challenges they face.

Jake’s story of resilience is a good example. I first met the moody 13-year-old, who had dull, expressionless eyes, 18 months after his parents separated. He came to see me at the community clinic where I worked. His guidance counselor at school had warned his mother that he’d fail 8th grade if he kept skipping school. Jake grudgingly agreed to meet with me, but refused to have his mother or his father in the room. I’d soon learn that he didn’t want to count on anybody but himself to make things right, which was reflected in his choice to see me alone.

Over the course of two meetings, I learned that Jake’s father, Patrick, had made several suicide attempts before he and his wife had separated—the last attempt while his son was home with him alone. With remarkable emotional calm, Jake described the episode that had happened when he was 11. “I found my father hanging from a hot water pipe in the basement,” he said, avoiding my eyes and saying little else. When I…

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1 Comment

Wednesday, January 11, 2012 2:56:47 PM | posted by Manny Munoz
It was refreshing to read Ungar and Sasson Edgette’s discussion in "Beyond Clinical Correctness" (Jan/Feb 2012) about a holistic treatment approach that emphasized beginning where the client is, respecting the client’s strengths, establishing a collaborative relationship to problem solving and utilizing the resources of the larger system in contrast to the curriculum, manual driven, evidence based treatment approaches that many clinicians in community based programs are being "strongly encouraged" and in some cases forced to use. The approach described a disciplined, economical, sophisticated and effective therapeutic intervention. Sounds like evidence based practice to me. How do we get it funded?
Manny Munoz, LCSW-R