Wednesday, August 3, 2011

Social Work Vs. Psychology and a Taste of Hypnotherapy

3682832859_16862d3040_m

Ari Hahn, LCSW, is an experienced mental health professional who has been trained as both a social worker and a psychologist. In addition to having a private practice, Ari teaches psychology at TCI College of Technology in New York. 

I had the pleasure of interviewing Ari this week. In this interview, Ari clarifies the main differences and similarities between psychology and clinical social work vis a vis the client. In addition, he provides us with a brief introduction to hypnotherapy, one of the techniques that he uses in his work with clients.


So without further ado, Ari, can you briefly describe your educational career trajectory and what led to your initial interest in the field of mental health?

I have been interested in helping people for as long as I can remember. I cannot recall another career path in my youth after I realized that I was not going to be a baseball player. At eighteen years old I became an Israeli citizen and while at Hebrew University I took courses that enabled me to work in the psychology unit of the Israeli Defense Forces (IDF). We worked in educational psychology and built contingency-based behavioral programs for the various training camps.  

That was great training as a behavioral modification specialist and that got me started for my next stage. I wanted to have as much input as possible in my children's education. So I took responsibility for a pre-school. The school had six children enrolled for the previous five years. I taught the teacher (later teachers) the principles of applied behavioral modification and spent a lot of time learning and meeting the needs of the families. I added to my professional perspective the importance of family and family systems.

I ran the school for a dozen years. It grew from six children to about 400 in about five years. (Today it has grown to a system with over two thousand students.) When I returned to the USA in the mid 1980's I began to work as a counselor in elementary schools. 

However, I lacked a professional degree. I considered getting a psychology license but it would have meant 4 years in school and two years internship. With five children at home, the two years in social work school was more practical.


But I quickly realized that it is social work that actually fit my treatment philosophy. Psychology is more academic and research based. I love that and could be happy in that field also but while research is fun, helping people is more satisfying. 

Social work is based on integration: integration of self, integration of self in family, integration into the various social structures and systems. That idea of utilizing simultaneous multiple perspectives seems essential for effective helping. And my training at the Ackerman Institute for Family Therapy crystalized the systems perspective in my work.

One other development that I should share is that since about 2003, I began to have many clients who were ex-abused adults and adolescents. Although I was never a psychodynamic therapist, I found that it is impossible to help these people without employing psychoanalytic principles.

In light of your training from both disciplines of social work and psychology, could you share your view of how clinicians from these two fields tend to be similar in many ways but are different in their orientation/emphases with their work with clients? 

There are many differences between social work and psychology but they are not always apparent. That is because it mostly depends on who is looking for the differences.

From the point of view of the psychotherapy client, there is essentially no difference. That is true for two reasons. First, but less importantly, many schools of social work teach train their students in slight variations of therapeutic schools developed by psychologists. Twenty years ago, the NYU School of Social work trained people in psychodynamic therapy. That means that the veteran social workers of today had that type of training. 

But more importantly, therapy is mostly about the relationship and personality. The patient is much more interested in those issues than the "technical" aspects of therapy. The relationship that helps a client is really independent from the fact that a therapist is a social worker or psychologist.  



The difference is more significant for the professional, herself. There are two basic vectors of difference. It can be conceptualized directionally: how the profession can influence the inner aspects of your work and how it might influence the framework of your work.  

What do I mean? Let's say you are working with a woman who is contemplating divorce. While much of what you will focus on should be determined by the client, the salient aspects of her story will be influenced by your training. 

For a psychologist, the interpersonal issues will be salient. Self-esteem, personal history, and communication styles can be used to assess the possible outcomes of proposed plans of action and the struggles and difficulties that need to be taken into account.

For a social worker these issues are important but the social milieu also captures time and attention. If it will be too difficult to survive financially after divorce, a social worker will, typically notice that before a psychologist and give it more weight.
Similarly, if there is a stigma attached to divorce in the woman's perception, a psychologist would focus on the perception and a social worker would focus on the stigma. Since a competent therapist will eventually follow both lines, to the client the difference is minor. To the therapist, it is more a matter of preference and training.  

3663687588_08388842fb_m

The other difference is in the types of helping opportunities available. Social workers can reach out to broader systems and bring in broader systems into their work. Home visits are not unusual for a social worker.

Social workers can use their time and energy to influence organizations. That is not the usual mode of practice for psychologists. I would not have learned about how a family lives with chronic schizophrenia if I had not spent a year in the homes of these people.  

Of course there are professional opportunities in psychology that are less available in social work. I'm referring to areas like research and academia.  

Some say that the longer mental health professionals are in practice (regardless of their original training/orientation), the more similar they become to one another. Do you believe that this is true?

I think that in the aggregate and on the average one can say that the longer different mental health professionals are working they become more similar. But that conclusion obscures a more important reality. And that is that within the professional populace there are individuals who distinguish themselves to a greater degree as time goes by.

These are the trailblazers that propel each profession in its own direction. Usually these people are ensconced in academia, but in social work most academics are also in the field. That is not as true for the other professions.

I noticed that you don’t describe yourself as a psychologist but rather as a humanistic coach. Could you explain what you mean by that?

I am licensed as a social worker, trained as a psychologist and family therapist and am currently using a treatment modality called coaching. There are a few distinct advantages to this, but it also has some practical considerations. 

Let's talk then a little bit about coaching and it's relationship to therapy. If you open the want ads and look for a job in therapy you will find all sorts of therapeutic professions including things like physical therapy or even  "cleansing" therapy. The word implies curing from illness.

We try not to call the people we work with "patients" because it implies that they need to be cured when we turn around and do therapy on them. I have found that even some of the most dysfunctional people can find healthful solutions when given the proper environment. That, by the way, is the basic tenet of humanistic psychology.

So why work as a coach? Actually I have had coaching in my repertoire for years.  In coaching we work with basically healthy people or work on the healthy aspects of people whom others would call dysfunctional. We focus on the present and future rather than the past. And we build on positive qualities rather than restructure negative traits.

Since, in coaching, we do not work on deep issues, the advantage or necessity of meeting only once a week becomes a moot point from a treatment perspective. So the work can become more flexible. Meeting by phone or "Skype" once or twice a week with as needed email contact becomes both logical and efficient. The only drawback is that coaching is an unregulated non-licensed profession. So there is a plethora of unqualified coaches out there. 

I understand that you have been trained as a hypnotherapist. What made you decide to take this training? 

Hypnotherapy seems to be something that intrigues everybody...My students also have a myriad of questions about it. In class, I compare it to other altered states of consciousness like meditation and flow. In that sense, one might say that in meditation one separates one's self from the physical world, in flow one merges one's self with the physical world while in hypnosis, one allows one's inner self to be guided by the hypnotherapist. The person never gives up control. And a responsible hypnotherapist will enhance his or her client's sense of control, as well as self-efficacy.

As a matter of fact, one of the things I really like about hypnosis is that it is much less invasive than other methods. Since you work directly with memory, you can rescript the memories without ever hearing the whole story.

   An Intro to Hypnosis from the Tulsa Hypnosis Clinic



Let's say you are working with an ex-abused adult who has intrusive memories. It might be overwhelming for her to tell the story out loud. With hypnosis, you can prepare to change aspects of the story like imagine if that child could react the way you, as an adult, would want her to react. Then, while in a trance, she can reprogram her memory in a way that is less likely to retraumatize her. 

I have to admit that that level of hypnotherapy has been a rare occurrence in my practice because one needs extreme care and complete willingness from the patient to go that way. I've done that less than have a dozen times.
 
Usually I use hypnosis to teach relaxation or guided imagery. I have had clients that have used the first 20 minutes of the session just to relax, focus, and set the stage for successful tackling of their immediate goals. You must remember that hypnosis is not a school of therapy but merely one tool that can be used within a more complete process. 
 
And do you feel that one has to have many years of experience before getting this training or can one go soon after one has graduated?

I think that anybody who is considering hypnotherapy training needs to keep in mind that it is one technique used in the course of therapy.  It needs to be used as a tool for achieving goals that could also be achieved in other ways but in that particular situation hypnosis is deemed more efficient. There is no magic here. So for instance, there are numerous ways of helping your client to relax or feel at ease and hypnosis is one of them.

There are numerous ways to access repressed memory (none reliable but all useful in therapy) and hypnosis is a good technique. There are many avenues to change the perception of smoking, food etc. and hypnosis is often the way to go. But it is merely a tool that can be chosen to implement a treatment plan. 

With that in mind, I actually suggest that training in hypnosis be deferred until a therapist is proficient in a treatment modality. This is because hypnotherapy can be powerful and is too often perceived as a school if therapy.  If a professional is drawn into this trap his or her thinking can be constricted. That can be devastating.  

Lastly, what career advice would you offer recent MSW graduates either looking for work or working in their first position as a licensed social worker?

I know you have a lot of newbie social workers reading your blog. It is an exciting stage of professional development. I would suggest that they see themselves as just beginning to learn.

Graduation makes you a neonate and now is the time to really delve into something exciting.  Whatever job you get, there are two or three main goals to keep in mind.

First, learn as much as possible about some specialty in social work or therapy. Second, don't marry that specialty or theory, since it will not always serve you well.

And third, recognize that with a lot of hard work and good supervision, you can become really good at your profession in only six short years. (Don't worry - there will come a time when those six years will be perceived as short!)

Thanks so much, Ari, for clarifying some of the differences between the social worker's vs. psychologist's approach to helping a client, as well as for the fascinating introduction to hypnosis.

You can follow Ari on twitter @arihahn or visit his site/blog at www.arihahn.com

What questions and/or comments come to your mind regarding mental health treatment from the psychologist and/or social worker perspective? Do you have questions or thoughts about hypnotherapy?

You May Also Enjoy:
Embarking on a New Career 
All About Hypnosis and Hypnotherapy 
What is Eye Movement Desensitization and Reprocessing (EMDR)?
Drama Therapy – Healing Through Role Playing/Storytelling
Family/Couples Therapy - Improving Relationships
What Is Social Work in Child Welfare Like?

Art Photo Credit: Patrick Hoesly
Color Tile Texture
Green Bar Code Texture 

6 comments:

  1. Dorlee,

    Really interesting interview. Thanks so much for thinking of the topic and for putting it together.

    Jonathan

    ReplyDelete
  2. Hi Jonathan,

    I'm so glad that you enjoyed this interview with Ari :)

    Thanks so much for your kind feedback,
    Dorlee

    ReplyDelete
  3. Hi, Dorlee! I'm getting in on the conversation a bit late but wanted to say that I think each discipline brings different strengths to the clinical hour.

    For example, I believe that social workers' training really allows you guys to excel in terms of systemic thinking. You guys really rock at pulling in external resources for clients!

    And, I think that psychologists' training makes them particularly adept at assessment of problems and reading research with a critical eye.

    And, for professional counselors, I think our training really emphasizes preventive measures, a wholistic view, and a client-education approach.

    Of course, each of us can acquire those skills along the way and, I suspect, most of us do. However, Ari is right in stating that those foundational training experiences in our respective disciplines certainly do color the lenses through which we see our clients.

    Thanks so much for another thoughtful post, Dorlee!

    ReplyDelete
  4. Hi Tamara,

    Thanks so much for sharing your perspective on some of the key differences in the training/approach that social workers, psychologists and counselors bring to the table, at least at the outset of their careers.

    You pointed them out quite succinctly!

    Best,
    Dorlee

    ReplyDelete
  5. Hi I'm just finishing my psychology degree in Israel- and now will soon be joining the IDF. Could you please tell me what the psychology unit in the IDF is? And how I can try to get into it?

    Thanks
    Gabriella Lerner
    lernergm@yahoo.com

    ReplyDelete
  6. Hi Gabriella,

    My suggestion is that you check out the IDF blog at http://www.idfblog.com . I think they should be able to provide you with information about the psychology unit in the IDF.

    Good luck!

    ReplyDelete