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Demystifying Therapy

Collins Nwabunike

Social Work 699

Family Therapy II: Post Structural Approaches

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This paper focuses on three key ideas and principles related to collaborative therapy and

reflecting processes. My aim is to discuss some of the key concepts between these theoretical

frameworks and how they have and continue to impact my emerging practice as a clinical social

worker/therapist.

Collaborative therapy is an approach that focuses on the development of a collaborative

and egalitarian relationship between the therapist and the client to facilitate dialogues that leads to

positive change (Anderson & Goolishian, 1988). The key principles of this approach are to develop

a collaborative relationship between the therapist and the client in therapy and engage in dialogues

that encourage growth and change. Anderson & Goolishian, (1988) believed collaborative therapy

facilitates transformation for both the person in therapy and their therapist. As meaningful

conversations occur and various perspectives are explored, both parties may gain new knowledge

and understanding (Anderson & Goolishian, 1988). Typically, both the client and therapist develop

a partnership in which they talk with each other, not to each other. The therapist actively listens

and seeks to understand the client’s perspective while being in sync with the client and taking a

non-expert stance (Anderson & Goolishian, 1988).

The reflecting processes require working with a therapeutic team. This therapeutic team is

called the reflecting team, and they are tasked to observe the client’s session and then have a

discussion about things they noticed during the session (Andersen, 1987). The client would be

introduced to the team before the session and then the reflecting team will observe using a one-

way mirror (Andersen, 1987). After the session is done the therapist and client will switch sides

with the reflecting team but this time the client will observe the reflecting team discuss the session

(Andersen, 1987). Then finally both parties will switch sides again, but this time the client and

therapist will discuss and respond to some comments that resonated with them (Andersen, 1987).
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It is also the client’s choice to decide if they agree or disagree with some comments, thus bringing

the power back to the client (Andersen, 1987). The magic in switching sides is that it allows both

parties to easily assume the role of the observer without feeling any pressure to respond in the

moment but instead allow time to listen and reflect. It is often used as a way for the therapist and

the client to obtain multiple discourses or stories to the problem (Andersen, 1987). As therapists,

we are not perfect or experts in multiple realities. We can easily get stuck or fail to notice a new

or important aspect. We can also easily get fixated on one idea we think is the answer for our client

when it may not really be helpful for our client at all. Reflecting teams help us to break out of our

own thinking and get more creative in our work with clients.

Both the reflecting processes and collaborative therapy are rooted in

poststructuralism/postmodern philosophy (Combs & Freedman, 2012). Poststructuralism is a

response to expert knowledge as it seeks to go beyond the structuralism of theories that implies

universal truths or an all-encompassing reality (Combs & Freedman, 2012). Poststructuralism

instead focuses on the contextualized meaning-making, such as culture, language and multiple

realities/stories (Combs & Freedman, 2012). Over the years our identities are defined and

constructed through stories. The stories being told by us and/or about us are socially constructed.

Embedded within our stories is power; power dictates the dominant discourse; it decides which

stories will be told and retold and which will not. Our stories give meaning to lives and

relationships, privileging some people and relationships and making others invisible (Combs &

Freedman, 2012). The sharing and circulation of different stories contribute to building different

communities. Both collaborative and reflective processes are interested in meaning, complexities

and multiple possibilities rather than in facts, standardization, and uniformity. Both theoretical
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frameworks value and respect the expert knowledge and skills brought forth by our client in an

egalitarian/anti-oppressive stance of not knowing (Combs & Freedman, 2012).

Collaborative therapy and reflective processes offer meaningful aspects to relationship

building and the therapeutic process. For this paper, I will discuss important pieces to be included

in these approaches including language as a contextual and fluid process, therapist as a guest/non-

expert, and postmodern ideals in therapy sessions. I will also discuss the implications of

collaborative therapy and reflecting processes, and how their principles and ideals align with my

emerging practice, social works values, and an anti-oppressive practice.

Language as a contextual and fluid process

Language, as the medium of knowledge, refers to the mean we choose to interact, with

others and ourselves, using verbal and nonverbal forms of communication. It is often perceived as

an important piece of therapy (Anderson, 2012). Language allows us to engage in dialogue with

those we wish to support, who may carry different realities from ourselves. As a postmodern view

on therapy would support the idea of multiple worldviews, so should language. Anderson (2012)

explains that any knowledge or dominant discourse should be subject to question or doubt,

regarding its claims to truth. This same act should be in our thought processes and actions as

clinicians.

Both Andersen (1996) and Anderson (1988) discuss the idea of being “in language” as a

dynamic social operation. In Andersen’s (1996) chapter Language is not innocent, he talks about

how our language is a part of us and it is often loaded with strong emotions, feelings and multiple

realities/stories. Our thoughts lead to words, and our words become actions, our actions become

habits, and our habits dictate our reality. Therefore, it is of high importance for us to be reflective

about the language we have constructed for ourselves. According to Andersen (1996), language is
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like hands; they can be both constraining and empowering depending on the way they are used.

Anderson & Goolishian, (1988) explain that with language, we can shift the meaning we find in

communities to which we belong, which ultimately create our own subjective realities. This means

that there can be multiple understandings and uses of language depending on the context. It is

therefore fair to say that as therapists; we need to resist relying upon language as carrying the same

meaning for us as for those we support. Without this open-mindedness to language, we risk

misunderstanding our clients’ struggles, and instead imposing our own ideas. This in itself can be

an execution of power over, or the “expert” therapist imposing their view onto their client

Anderson & Goolishian, (1988). Reflexivity is a crucial component of social work, and thus

becomes no different in language. Without reflection on our language, where it came from, and

how we use it, we risk further imposing harmful biases, stereotypes, and even colonial ways onto

Indigenous populations. Being conscious of the differences that can exist between peoples realities

that can be one way to continuously and meaningfully engage in this reflection.

Anderson (2012) talks about how knowledge and language help to inform and form the

types of relationship we have towards one another. She refers to these as collaborative relationship

and dialogical conversations (Anderson, 2012). Collaborative relations are the way in which we

position ourselves that invites others to participate mutually. It creates a environment in which all

participants have a sense of belonging and mutual ownership of the space (Anderson, 2007).

Language and dialogue can also open doors for us to grow and explore our own downfalls as social

workers. As humans, we are not perfect or absent from harmful values and prejudices. When the

therapist and client engage in collaborative dialogue, reflection can occur on personal ideologies,

values, and views (Anderson & Goolishian, 1988). If the therapist is engaging in a true diffusion

of power within the professional relationship, they can allow themselves to learn from their client.
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To truly be in a collaborative dialogue means that the therapist can let go of the traditional view

of the need to be “right” and deepen their willingness in negotiating a new validity (Anderson &

Goolishian, 1988). An important aspect of letting go of our need to be right is, in fact,

acknowledging that language can carry multiple meaning and contexts and that one fixed notion

of a singular reality does not exist.

Therapist as a guest / not an expert

As students, we attend school in hopes of becoming an expert in tools to help others when

in reality the main purpose of therapy should be quite the opposite to an expert position. Therapists

should be striving to be the role of a guest in the room. A guest in your house typically does not

seek to control the ways in which you act, speak, set your dining room table, or interact with your

family. Therefore, a guest is much similar to that of a therapist with their client. The therapist acts

as a support in creating language and meaning to keep the dialogue going to move toward

dissolving of the problem (Anderson, 2007) In this effort, the therapist is not assuming the role of

an expert, but rather working to support the client within their unique context and understanding

of reality. As therapists, we should be more interested in the who, what, when, and how of clients’

situations rather than searching for why-based explanations for their behaviors (Gehart, 2018). By

not taking on an expert stance, we put clients at ease to share more openly and to speak

uninterrupted (Gehart, 2018).

Both the therapist and the client bring an expertise to the session, in which the client is the

expert of themselves and their reality and the therapist is an expert on the process and space for a

collaborative relationship and dialogical conversation (Anderson, 2007). Further, this means

creating a collaborative mutual owning of space, sense of belonging, and collaborative definition
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of the problem (Anderson 2007; Anderson & Goolishian, 1988). This mutual dialogue allows for

divulging realities to intersect and create meaning within that particular context (Anderson &

Goolishian, 1988). As emerging social workers our work should be drawn towards collaboration

and more on understanding and listening rather than creating change (Gehart, 2018). This

intersecting of realities and understandings is an ongoing process in therapy, both for the therapist

and client. In this act, the therapist takes themselves out of the role as the expert, reflecting on their

own understandings to allow for flexibility, openness, and adaptability in the therapeutic process.

Taking a stance of not knowing and uncertainty does not deny the expertise of the therapist, it

just simply helps us to not lose sight of our client’s expertise that they bring to the session

(Anderson, 2007).

This idea of diffusing the therapist as an expert can be challenging in a Western world full

of diagnosis and labels (Anderson & Goolishian, 1988; Anderson, 2005). Placing a social worker

in the role of a clinician can be challenging as it opposes concepts of self-determination of the

client where the “therapist has the special status of an expert with access to information and

knowledge regarding the client” (Anderson & Goolishian, 1988, p.9). Further,diagnoses

themselves are based upon a therapist’s private observations and self-experiences of the client’s

behaviors, they are not in essence of any certainty (Anderson & Goolishian, 1988). This is not to

say diagnosis acts as a negative aspect of therapy, but rather as a reminder that it should be a

collaborative process as much as possible. This means that the client should be intentionally

included in conversations in defining their problem as they see it, and not exclusively as the

therapist believes it to be. As therapists, we must work extra hard to not overlook the effects of our

often-unconscious active participation in imposing our own understandings of a client’s situation

(Anderson & Goolishian, 1988).

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Postmodern Ideals in therapy sessions

We live in the age of information where there is a much greater awareness towards

“democracy, social justice, and human rights, the importance of the people’s voice, singular or

plural, and the necessity of collaboration” (Anderson, 2007). This access to information and

knowledge means opportunities for multiple truths to our realities to be exposed. According to

Anderson (2007) “Postmodernism is a complex set of abstract assumptions that form a framework

or perspective for the way we think about, create, use, and privilege knowledge” (p. 2).

Postmodernism challenges our inherited knowledge of universal truth (Anderson, 2007). It

challenges us to seek alternatives to the fundamental of knowledge (Anderson, 2007).

Modern-day therapy in a postmodern day world. Every day we are chipping away at the

dominant discourse of what it is to be a therapist. During my class lecture with Dr. Regine King,

a genocide survivor, who works with other survivors herself, she commented on how the people

of Rwanda were uncomfortable with a Western form of individual therapy. The one-to-

one sessions, in a room with a stranger, was uncomfortable. Instead they came up with unorthodox

ways to heal and instill hope from trauma. They preferred therapeutic group sessions that

incorporated dance when they felt happy, ceremonies of reconciliation with their perpetrators,

space to cry, laugh and feel raw emotions when needed and they took control of the session, while

Regine took part as a guest.

There are multiple ways in which diverse populations handle mental health, Dixon

Chibanda is one of the twelve psychiatrists in Zimbabwe for a population of over 16 million

(Chibanda, 2018). A population that went through dictatorship and is still going through
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hyperinflation and various forms of human rights violations. Realizing that Zimbabwe could not

be able to scale traditional methods of treating those with mental health issues, Chibanda helped

to develop a beautiful solution powered by a limitless resource - He decided to train grandmothers

to treat depression (Chibanda, 2018). Chibanda used the friendship bench program, which trains

grandmothers in evidence-based talk therapy and brings care, and hope, to those in need to reduce

the rate of suicide and mental health concerns (Chibanda, 2018).

As an emerging therapist in Calgary, my hope is to work with diverse populations and

families in our community. Canada is ever becoming more multicultural and diverse. The

therapeutic world should be expected to work with members of marginalized groups such as

immigrants, and refugees, in ways that are relevant and meaningful to them. This can be

challenging of course as stigma is strongly related to mental health in these communities. I see this

stigma as a barrier for marginalized people to asses mental health and one that stems from diverse

populations perception of therapy as not culturally relevant.

According to Andersen (1996), we are conditioned to look for realities that support our

own universal truth, even when presented with new information that challenges our own narrative.

Postmodernism challenges everyday clinical practice in opposing the often-hierarchical

relationship with our clients, in ranking our ideas as better than what is offered by our clients. The

reflecting processes, as mentioned earlier, helps breakdown this hierarchical relationship, by

letting our ideas about clients come out in the open (Andersen, 1996). To be postmodern is not to

discard our inherited knowledge of the truth but to prevent ourselves from holding unto universal

truths and instead be skeptical of them (Anderson, 2007). Postmodernism itself allows us to be

critical of our own inherent viewpoints and assumptions (Anderson, 2007). It helps to break down

the traditional ways of therapy. This is not to say that we should discard traditional forms of
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therapy, but instead bring in multiple ways of understanding and ‘doing’ counseling. This can help

better support diverse populations by having a range of approaches. As an emerging practitioner,

I am this knowledge reminds me to rethink the therapy process in terms of my role and my client’s

role in each counseling session.

Ethics, Implications and Emerging Practice

The principles and ideals on collaborative therapy and reflecting processes, that have been

discussed in this paper are very much aligned with social work core values, principles and anti-

oppressive practice. Social work values are founded on a long-standing commitment to respect the

inherent dignity and individual worth of our clients (CASW, 2005). As we strive to preserve our

client’s unique rights to self-determination, while in pursuit of social justice (CASW, 2005). Both

of the mentioned approaches work to respect and incorporate the clients voice, input and opinion.

Further, the therapist can work towards developing a enhanced social justice lens in the reflective

process involved with the client, that can allow them to deepen their understanding of social justice

issues outside of often dominant discourses found in textbooks or academic articles.

There is no single therapeutic approach that is appropriate for the vast and diverse

Canadian population. While some clients may respond well to postmodern therapy, others may

prefer a more structured or directive approach in which the therapist uses more specific tools or

techniques. Additionally, because postmodern therapy, such as collaborative therapy is

conceptualized as a philosophical stance rather than a specific treatment model, the way it is

practiced can vary widely. While most clients may benefit from having a reflecting team, we

should be aware that some clients may be nervous when they attend their first therapy session and

there is a need to be respectful of their individual choice to proceed or not. There is still a lot of
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stigma associated with mental health, in which many people are uncomfortable simply meeting

with a therapist for the first time, let alone a group of strangers.

Conclusion

This paper worked to bring forward three important components of social work and clinical

practice including postmodern ideas, language as fluid and avoiding the expert position. I believe

that in reminding ourselves of these important aspects, we can become more meaningful

practitioners that can walk alongside, rather than in front of those we wish to help.
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Reference

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Anderson, H. (2005). Myths about “not‐knowing”. Family Process, 44(4), 497-504.

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