Social Constructivist Practice with Youth - Springer Link

Child and Adolescent Social Work Journal, Vol. 20, No. 4, August 2003 ( 2003)

Social Constructivist Practice with Youth

Rich Furman, M.S.W., Ph.D., Robert L. Jackson, Ph.D., Eleanor Pepi Downey, Ph.D., and Jeffery Shears, Ph.D. ABSTRACT: Social constructivism is an important and creative perspective for helping social workers in their work with adolescents. This paper demonstrates how theoretical orientations and clinical techniques that adhere to a social constructivist perspective can be integrated with the developmental realities of adolescence to provide effective social work interventions. Fundamental assumptions are discussed and are related to problems of practice. Case studies are utilized to demonstrate social constructivist principles in clinical work with adolescents. KEY WORDS: Adolescent Social Work; Social Constructivism; Clinical Social Work. The growing and developing youths, faced with this physiological revolution within them, and with tangible adult tasks ahead of them, are now primarily concerned with what they appear to be in the eyes of others, as compared with what they feel they are, and with the question of how to connect the roles and skills cultivated earlier with the occupational prototypes of the day. (Erik Erikson, 1963, p. 261)

Introduction Theorists and practitioners agree that social work practice with youth should be congruent with research on adolescent development (Bogenschneider, 1996; Family & Youth Services Bureau, 1997). While knowlRich Furman is Assistant Professor, University of Nebraska–Omaha. Robert L. Jackson is Associate Professor, Eleanor Pepi Downey is Assistant Professor, and Jeffery Shears is Assistant Professor, all in the School of Social Work, Colorado State University. Address correspondence to Rich Furman, M.S.W., Ph.D., Assistant Professor, School of Social Work, University of Nebraska–Omaha, 6001 Dodge St., Omaha, NE 681820293. 263

 2003 Human Sciences Press, Inc.

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edge about adolescent development is voluminous, perhaps less has been written in social work literature connecting this research to social work practice theories. At times, researchers and clinicians may even appear to be at great odds, with vulnerable children and adolescents dangerously in the middle (Kenemore, 2001). When this gap does exist, it may hinder social work practice with adolescents. The purpose of this paper is to demonstrate how paradigms and clinical techniques that adhere to a constructivist perspective can be integrated with the developmental realities of adolescence to provide effective social work interventions. Recently, several authors have identified social constructivism as an important integrative perspective for modern social work practice in general, and with culturally diverse clients in particular (Allen, 1993; Dietz, 2000; Lee & Greene, 1999; Sands & Nuccio, 1992). This paper will demonstrate how social constructivism can be utilized as an integrative conceptual framework for social work with adolescents, and as a useful lens that can guide the actions of social work practitioners. Social constructivism is highly congruent with various frameworks that have been useful in working with adolescents, including narrative theory (Freedman & Combs, 1996; Freeman, Epston & Lobovits, 1997) existential theory (Krill, 1986; Yalom, 1980) cognitive theory (Beck, 1976; Wilkes, 1994), rational emotive theory (Ellis et al., 1999; Wilde, 1992), and reality therapy (Glasser, 1965; Glasser & Wubbolding, 1995). While the treatment of adolescents has been addressed from each of these perspectives, this paper will describe how the organizing perspective of constructivism helps guide social workers in providing services to youth and their families. First, the perspective of constructivism will be discussed. Second, the relationship between constructivist principles and adolescent development will be addressed. Third, clinical interventions congruent with this approach will be explored. Lastly, case examples written as clinical narratives will illustrate the application of many of the principles.

Constructivist Perspectives The origin of social constructivism can be traced to the publication of Berger and Luckmann’s (1966) sociological classic, The Social Construction of Reality that elucidated the principles of social constructionism. It should be noted that there is an active debate in academic circles about the differences between constructivism and constructionism (Franklin, 1995). The authors of this article argue that the differ-

R. FURMAN, R. L. JACKSON, E. P. DOWNEY, AND J. SHEARS

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ences between these two perspectives are largely academic in nature, and are often irrelevant at the level of practice. Since this paper is designed to inform clinical practice, the core precepts that underlie both perspectives are addressed as they pertain to clinical work with adolescents. The term used throughout this paper is social constructivism, as this term is typically associated with clinical practice (Dietz, 2000). On the other hand, social constructivism is utilized as a concept to emphasize the importance of social factors in the manner in which individuals construct their own reality. Social constructivism is a perspective that evolved out of the postmodern movement of the 1940s and 1950s. Many of the tenets and constructs supported by the perspective have been evident throughout the history of the profession of social work, including the importance of clients’ perceptions about the nature of reality and the importance of context in the assessment of human emotion, cognition and behavior (Goldstein, 1990). While social constructivism is not a perspective that has been widely accepted in social work’s mainstream, it has been steadily growing in influence since the early 1990’s (Chambon & Irving, 1994; Howe, 1994; Payne, 1997). Social constructivists challenge the notion that an objective, external reality can be known apart from the manner in which it is socially viewed, understood and constructed (Mahoney, 1995). Social constructivism eschews notions of determinism. The perspective contends that there are multiple stories or perceptions of reality, and that an individual or family’s experiences concerning events are more important to social workers than the nature of their given reality (Guidano, 1995). Instead, knowledge is constructed from language and words that give meaning to human experience and objective reality. Understandings of people based on intra-psychic or social determinism are seen as limited. Constructivists hold that knowledge is constructed by individuals in concert with their social, political, and cultural environments (Greene, 1994; Payne, 1997). In order to understand individuals, one must learn how they construct their worlds, not how they compare to predominant social norms. For example, Brown (1994) argues that the diversity of experience and the interpretation of socially constructed meaning are common among women dealing with oppressive factors. That is, the manner in which an individual woman perceives her situation is a synthesis of the various social group values and beliefs and her own idiosyncratic and personal interpretations. Unlike perspectives based on positivist precepts, social constructivism rejects a simple, linear, cause and effect relationship between peo-

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ple and their environments. The relationship between an individual and his/her social environment is complex and reciprocal, each affecting the other. Therefore, social forces are seen as greatly influencing individuals. The individual constructs his/her own meaning based on shared norms, values and experience. Green (1984) suggests that: Culture thus is not recognized as a monolithic stereotype of groups of people. Attempts to draw broad cultural pictures of peoples does injustice to any particular individual who does not match this stereotyped version of a culture (pp. 115–116).

Similarly, Keesing (1975) sees culture as texts that can be read differently by different individuals. Each individual has his/her own reading of culture based on his/her own biological predispositions, personality tendencies, family history, and life experiences.

The Construction of Reality in Adolescence Many of the behaviors that social workers must confront in working with adolescents are confusing to interpret, and often difficult to deal with. Social constructivism offers a helpful way of understanding these behaviors. While it is important to understand the world views of all clients and to start “where the client is” (Goldstein, 1983), when working with adolescents it is essential due to the very nature of their development. Adolescent development leads youth to be more sensitive to interventions that can be interpreted as personal criticisms (Smith, Moorehouse & Trist, 1998). Interventions that attempt to alter the way adolescents think, without respecting their world views, may lead them to feel alienated from counseling. In their minds, the worker may become just another adult who “does not understand.” It is essential to remember that it is developmentally normative for adolescents to view their thoughts, beliefs and attitudes as being more “correct” than that of others (Elkind, 1966). As adolescents develop formal operational thought, they are increasingly able to engage in abstract thinking and hold ideas about the world separate and distinguishable from the external reality (Elkind, 1968; Piaget, 1954). As a result of the development of these abilities, adolescents often construe their beliefs and empirical reality as being equivalent. This adolescent egocentrism can manifest in two ways: the imaginary audience and the personal fable (Vartanian, 2000). The develop-


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ment of a personal fable, a subjective story that adolescents have about themselves that is largely exaggerated and unrealistic, is understood to be part of the developmental process that is largely responsible for the common adolescent dictum “you don’t understand” (Atwater, 1996). In the adolescent’s eyes, their pains are the most painful; their lives are the most meaningful, the most important. To the adolescent, others, especially adults, could not possibly understand the uniqueness of their feelings or beliefs. Adolescents feel especially invalidated and alone when those in their lives do not hear and respond to important aspects of their personal fables, such as the special nature of a love interest or the feasibility of a career path. The personal fable may also form the basis for behaviors that place adolescents at risk, such as becoming convinced of their own invulnerability and immortality (Buis & Thompson, 1989). In regard to adolescent emotional development, lability is characteristic of the emotional state of early adolescence. Working from a constructivist perspective, a therapist may help an adolescent accept the idiosyncratic and volatile nature of his or her emotions. That is, since the constructivist therapist helps each individual to accept their interpretations of reality as valid, the feelings and beliefs of adolescents can be normalized through therapy. In addition to quickly shifting emotions, adolescents commonly experience emotional peaks and valleys (Nueman & Nueman, 1991). Both the lability and intensity of adolescent emotion is developmentally appropriate (Furth, 1969). Nevertheless, therapists may also tend to pathologize the emotions of adolescents, or may be intimidated by these strong feelings. What adolescents most need is someone who can both be witness to these strong emotions without being overwhelmed, and a centered adult who can set limits for the appropriate expression of these emotions. Thus, the overall task for the social worker is to help the adolescent validate their story, which includes beliefs as well as strong and vacillating feelings. Further, when the youth’s current story or construction on the world is not working well, the social worker’s task is to help the adolescent understand the connection between their beliefs about self and the world around them, and the consequences of such beliefs.

Constructivist Clinical Practice with Adolescents Perhaps the most important aspect of a social constructivist perspective is the notion that individuals respond to people and events in

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accordance with their own beliefs or perceptions of reality. In other words, while the relationship between beliefs, feelings, and behavior is complex, perceptions and beliefs are understood to have a strong impact on feelings and behavior. In order to change difficult affective states, such as depression, it is necessary to alter the way a client constructs reality. The implications of this principle are far reaching. Therapy is seen as a collaborative practice in which the therapist and client explore the client’s view of their world and examine the effects these perceptions have upon his or her feelings and behavior. The therapist assists the client to explore the relationship between the way he or she constructs reality and understands his or her presenting problems, strengths, and larger life issues. Constructivist practitioners help clients alter their constructions of reality in order to change emotions and behaviors that are problematic. Since adolescents’ construction of reality is often driven by important developmental issues, these issues should be woven into clinical practice. Understanding the nature and dynamics of the personal fable and of individual and adolescents’ specific stories is paramount. Given the importance and centrality of youth’s beliefs and world view, utilizing a constructivist perspective can be an invaluable tool. The constructivist practitioner recognizes and validates the world view of the adolescent. For instance, utilizing narrative approaches the practitioner helps the adolescent see his or her life as an evolving story. Lives are stories in which the adolescent is the primary author and actor. The adolescent is encouraged to be an active participant in the drama of their lives. This often appeals to the adolescent, whose developmentally appropriate desire for autonomy is fostered and validated by this metaphor. Rational emotive and other cognitive techniques, in addition to narrative techniques, are useful when there are disruptions in normal developmental tasks. Adolescents can be helped to see the relationships between their personal stories and beliefs, and the behaviors that are getting them in trouble. For instance, a rebellions adolescent may hold the beliefs that all adults do not care and cannot be trusted. They therefore might not feel invested in listening to adults for guidance and help. Helping them evaluate instances when adults may actually be caring and other tactics of correcting this over-generalization can help change their story, thus their behavior. It is also essential in clinical work to understand the social context through which the adolescent has created their world view. Therapists must find out who the most formative people have been, and currently are, in a youth’s life. Peers must be included in this assessment. Too


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often, clinicians focus on family issues and neglect the powerful impact that friends and other social influences have on an adolescent’s life. Since the beliefs that adolescents hold are socially constructed, it is also important to include members of the systems that have been influential in their lives in the therapeutic process. The person and the environment simultaneously influence one another (Lerner, 1992). Healthy friendships are essential to adolescent development (Mason et al., 1994). Helping adolescents have healthy socializing experiences can help them overcome various social and emotional problems (Werner & Smith, 1994). Therefore, case management that assists adolescents in finding social outlets that work for them are essential. It is essential that clinical social workers hold a broadly inclusive view of what therapy is. Adolescent development is often most powerfully stimulated by ordinary life events. Participation in sports, extracurricular activities, hobbies, community service and other “normal” experiences are often the best “therapy” for adolescents (Earls, Cairns & Mercy, 1993; Youniss, 1980). Clinical social workers therefore must see the therapeutic process extending far beyond “the fifty minute hour.” While clinical social workers often do a good job of including families, friends and peers are often neglected in treatment. Including peers in therapy, however, can be a very valuable tool. For instance, an adolescent is more likely to listen to a peer about their inherent worth than an adult, of whose motives they may be suspicious. Also, understanding the cultural context of the adolescent is important in framing the helping relationship (Lee & Greene, 1999). As adolescent identity is shaped through the filter of culture, understanding the degree to which adolescents are aligned with their culture of origin, or are assimilated into the dominate culture, can help a therapist understand the meaning of “helping” to the client. For instance, in some cultures, accepting professional help is a sign of weakness (Leininger, 1987). In others, accepting professional help is perceived as bringing shame onto the families (Iwasaki-Mass & Geaga-Rosenthal, 2000). These cultural factors may interact with the paradoxical need that adolescents have for individuation and separation. Case Examples Jose Jose is a twenty-year-old young man who lived in residential treatment centers from ages 13 to 18. For the majority of these years, Jose engaged in ag-

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gressive behaviors towards other residents and staff and caused thousands of dollars in property destruction. The fable or story that was created about Jose was that he was a bad, crazy teen who did not have the capacity to control his emotions or behavior. Through the interactions between Jose and his social system (i.e., in the past, his family; at present, the group home staff) he constructed a vision of himself as destructive and hopeless. Since he was hopeless, there was no reason to try in school and no point in working toward behavioral control. Over the years, his behavior and the verbal cues from group home staff provided him with enough reinforcement for his story to become so deeply ingrained that the concept of bad was nearly as comfortable to him as his name. He believed to the core that he was hopeless, helpless and incorrigible. In conjunction with his social environment, he had constructed an identity that limited his behavior and shaped the possibilities for who he could be. One of the first goals in working with Jose was to help him deconstruct his internalized belief system about his self. One constructivist method used to help him challenge his current self-conception was to demonstrate to him that the beliefs he had learned about himself were not entirely accurate. They represented but one conversation about who he was. He had developed many positive attributes that he was not able to see as his social environment reinforced a negative construction of his sense of self. He was asked several questions to help him question these perceptions. Was he always “hopeless, helpless and bad”? Was it true that he never had choice about his behavior? Was it a fact that he was this way, or was a label applied to and accepted by him? Therapeutic techniques of rational emotive and cognitive therapy became useful tools in helping to challenge his entrenched social constructions. When practicing from a constructivist perspective, it is important to use cognitively based techniques in a flexible, individualized manner. Some rational emotive and cognitive ways of practicing do not take into account the idiosyncratic, socially constructed ways people construct their thinking, and may lead to pigeonholing client problems in narrowly defined ways. This at times may lead to an adolescent to feel judged and “pathologized.” At first, it was difficult for him to accept that his internalized view of the world was not indeed an actual fact. As discussed in a previous section, it is developmentally appropriate for adolescents to confuse their constructs with absolutistic fact. To help penetrate an adolescent’s normal, although sometimes undermining, egocentric belief system, it is often useful to first teach that many people have beliefs that they find out are not true, that beliefs are merely social constructions, and are sometimes inaccurate. A teaching story that I use to help youth understand this is I call “Columbus the Crazy.” Prior to 1492, most everyone in the world believed that the world was flat. I asked Jose if the world was flat. Of course he understood it to be round. How than, I asked, was it possible that everyone believed that the world was flat when in fact it was round? After a few minutes of dialogue, we decided that it was most likely due to having inaccurate information. He conceded that it is thus possible for people to strongly hold false beliefs, and that this was not indicative of inferiority. I than asked him if it was it possible that his believing that he was hopeless, helpless and bad were similar to the beliefs of those who thought the world was flat? He was unsure. Perhaps, I suggested, what he


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needed was some evidence to show that the ideas that others had about him that he believed about himself might not be true. It was important at this time to help him challenge his own constructions, and be responsible for reconstructing new, more self-affirming beliefs. Since he was now open to the possibility that his beliefs about himself were falsely constructed, we decided to conduct a “study” to see if he could find evidence to disprove his story. Given the assignment to develop a way to study himself, Jose created a chart on which he would log evidence for and against the old vision of himself. Each day he marked down evidence for him being bad, helpless and hopeless, and evidence for him being good, kind, helpful, and effective. He soon learned that even on his worst days, he was not always engaging in misbehavior, and that he often was compliant, helpful and did what he was supposed to do. He learned that he treated people well most of the time, and that he could reconstruct a more positive vision of himself based on new information. Since both adolescent development theories and social constructivism emphasize the importance of learning from the context of one’s social environment, it was likely that the information that would most effectively challenge his negative conceptualization could be derived from peers. I presented this theory to him, and he agreed that it would be important to get feedback from others. During several sessions of group therapy, we conducted an exercise where the group told the stories of each other’s lives, making each the hero. As in other tales of heroes, the group was to focus on the good and positive things about each other. When the group worked on the tale of Jose, they created the story of a young man who worked hard at overcoming difficult obstacles. They were able to see him as doing the best he could given where he came from. For the first time in years, Jose was able to cry as he was touched by the empathy the other group members had for him. This experience helped greatly in his learning to see himself in a new light. As he reconstructed his identity, he slowly began to develop increased self-control and saw new possibilities for his life. He learned that he was ultimately the author and creator of his life, and became invested in being responsible for his own choices and actions.

Chuck A deeply religious young man of 14, Chuck is precocious in many ways. Tall and handsome, he carries himself with pride and dignity. He is shy and respectful of adults. Below the surface, Chuck is deeply pained by his growing awareness of his romantic feelings towards men, which conflict enormously with his fundamentalist Christian beliefs. By the time that Chuck was seen for therapy, he was very depressed and started to contemplate suicide. As with many adolescents, he believed that no one else could ever possibly experience what he was going through. In a typical expression of adolescent egocentrism, he created a romantic story in his head his regarding his pain. He would carry the pains of the world. Several treatment goals for Chuck were identified. First, his depression needed to be attended to. Second, he needed to come to terms with his sexual-

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ity. A third and closely related goal for him was to accept himself. Since Chuck spoke of “the drama of his life,” the therapist helped Chuck evaluate his life as a story. One of the goals of constructivist practice is to help a client learn to understand his life as a social construction. That is, clients are helped to explore the various social and personal messages that have led to their way of viewing their selves and their worlds. To help Chuck deconstruct, and ultimately reconstruct his sense of self, he was given two assignments early in therapy. First, he was asked to write the story of his life. Second, he was asked to rewrite the story in a way that would lead to happiness. Some of the questions that he was asked to consider included: What have you learned about yourself from others that has been negative? To what degree have you believed these negative ideas about yourself? What would it be like for you to change them? What in your story was stopping you from achieving a happy ending? In what ways could you rewrite some of the descriptions of the protagonist (himself) that would be more realistic appraisals as well as lead towards feeling better? Chuck completed both assignments in several weeks. He painstakingly undertook the task of reconstructing his life story. Part of his new story was very difficult for him to accept. He had realized that he truly was gay, and that he needed to find a new means of worship that did not conflict with the essence of who he was. He had internalized many negative stereotypes about homosexuals and had a difficult time not judging himself. To help lend him support in his effort to reconstruct a positive identity as a gay man, local youth ministry that was supportive of gay teens was contacted. In time, he learned to accept both his faith as well as his affectual and sexual orientation. With his coming to grips with his sexuality, his depression began to abate. However, he was still plagued with normal insecurities stemming from normal adolescent issues, as well feelings of worthlessness stemming form his childhood. As with Jose, Chuck was helped in therapy to evaluate his perceptions about who he was. Using a gestalt “empty chair” technique that is congruent with constructivist practice, which is highly effective in helping youth look at their differing constructions of self, Chuck engaged in a role play where he assumed two personae: the hurt teen who could still hear his mother’s abusive criticisms, and the young man developing rational thinking who could see the lack of truth in the criticisms. Chuck was disturbed that his emotions could vacillate so easily depending upon which voice he was listening to. This was normalized for him as a typical feature of adolescence. He was helped to see that the goal was not to entirely eliminate the mood swings that occurred when he thought about the past, but that he could think about the truth of the messages he learned and minimize their effects. Over time, he both decreased his lability and learned to accept his changing and shifting feelings as being normal and healthy parts of his developing self. Both case examples illustrate not only techniques that may be used in constructivist practice, but also the stance of the clinician. Unlike more positivist approaches, the clinician does not assume the role of an expert who diagnoses and prescribes treatment. Instead, the social worker works in collaboration with the client to help them reconstruct their sense of selves and lives.


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Conclusion This article has demonstrated the utility of social constructivism as a perspective for social work practice with adolescents. The case studies illustrate some of the dilemmas experienced by adolescents. The emotional peaks and valleys, adolescent egocentrism, dilemmas of emancipation from parents and affiliation with peers, their emerging sexuality, and other developmental issues are given greater clarity and focus when viewed through this lens. The article also demonstrates how clinical techniques congruent with social constructivism are used to help adolescent clients cope with many of these normal, yet often difficult, developmental experiences. The perspective is also shown to be useful in working with more challenging clinical issues that fall outside of scope of normal development. Although the article focuses on adolescents, the application of the social constructivist perspective to other populations has been well documented (Lee & Greene, 1999; Payne, 1997). Social constructivism may be an especially useful perspective for working with disempowered, marginalized individuals since it gives primacy to the relationship between the social and cultural context and disempowered individuals. Clinical work with marginalized populations frequently neglects to take into account the often debilitating social forces that hamper individual growth and change. Practitioners working from a social constructivist perspective are able to give voice to, and validate, individual meanings and narratives, thus protecting the client from overly individualistic and pathologizing categoration. With its dual focus on individual and environmental factors, social constructivism is an excellent perspective for the practitioner hoping to put the “social” into clinical, social work practice.

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