Social work practice requires a full understanding of people in all contexts. Romantic partnerships are an important aspect of many client’s lives and social worker practitioners should be knowledgeable on how to work within this context. This chapter discusses theories and interventions that help inform social work practitioners when working with couples. With an estimated 50% of all relationships ending in divorce and the documented negative impact of divorce on the family, the necessity for social workers to have at minimum precursory idea of couples theory and interventions is high. With many approaches to couples counseling available, this chapter focuses on the most widely used current approaches as well as discusses some of the newly emerging models. This chapter explores attachment theory, sound relationship house theory, Imago theory, transgenerational theory, and structural theory as related to couples counseling. Case studies are provided to give contextual glimpses into these theories’ use in practice. The chapter also seeks to describe the role of couples’ work in the context of the generalist-eclectic framework and its alignment with the National Association of Social Workers Code of Ethics (2018). It is of the utmost importance, both academically and ethically, that social work practitioners maintain competence in the area of couples work as romantic relationships comprise an important portion of many clients’ lives.

Focusing on challenging oppressive systems and structures and creating a more inclusive and egalitarian society, anti-oppressive theory and practice (AOP) is an important recent addition to social work theory and practice. Developed over the last few decades in response to growing economic and social inequalities, AOP directs social workers to explore the role that individual, cultural, and structural oppressive systems and contexts can play in creating and reinforcing human problems in our society. AOP also provides important insights to help social workers address oppression within their own practice. As a lens for practice, AOP draws from a number of theories and perspectives to provide social workers with a holistic framework for generalist social work practice that is congruent with social work values. While broad in scope, AOP provides social workers with a dynamic and useful framework for working with diverse populations in a more inclusive manner and helps social workers to be more responsive to ever-changing practice and social realities. The chapter begins with an overview of AOP and describes some of the key concepts of this approach. A review of the opportunities and challenges of using AOP to guide practice in multiple settings is also discussed. A case study is used to illustrate how AOP can be used in practice.

The first two chapters (Part I) of this book dealt with the major elements and basic principles of the generalist-eclectic approach to direct social work practice. Given the fact that the last chapters have focused on various theoretical perspectives for direct practice, for purposes of review and integration it is important to revisit the generalist-eclectic approach in this final chapter.

In the first part of this chapter, we review conceptualizations of levels of theory and broad classes of mid-level practice theory (psychodynamic, cognitive behavioral, humanistic, critical, and postmodern) that were discussed in Chapter 1 and revisit how these conceptualizations can facilitate an eclectic use of theory in practice. Second, the compatibility between the various mid-level practice theories reviewed in Part III (Chapters 7–22) of the book and the generalist-eclectic approach is considered. The third part of the chapter revisits how the problem-solving model is a useful framework for integrating the eclectic use of theory with the artistic, reflective, intuitive-inductive elements of practice. Finally, some of the challenges to generalist-eclectic practice are identified and strategies for dealing with these challenges are suggested.

In this chapter, eye movement and desensitization and reprocessing (EMDR) is explained from its theoretical construct to its methodology in clinical practice using adaptive information processing as a basic tenet. Evidence exploring its efficacy and a step-by-step process of the eight-phased protocol used to help clients suffering from posttraumatic stress disorder, anxiety, substance use disorder, and many more common psychological issues are explained in detail. Three case examples help readers to understand how EMDR is used and its healing of trauma symptoms.

Cognitive behavioral theory (CBT) and treatment has evolved over three phases: (a) behavioral principles of human behavior, (b) cognitive constructs and cognitive mediation, and (c) mindfulness including acceptance and commitment. The principles are firmly based in evidence-informed and evidence-based practice. The concepts describe how behavior and cognitions are learned and how they can be changed. CBT principles provide practitioners with effective interventions for a variety of issues such as child and adult development, cognitive processing, as well as addressing problematic behavioral and mental health issues.

There is no question that Sigmund Freud, the founder of the theory that underlies ego psychology, was a genius. Freud used observations to develop his theory in the context of his cultural and religious milieu. Over the years, many have discounted his theory as being sexist, homophobic, and biased toward the more affluent.

Yet, given all of these limitations, what he came up with was the first comprehensive theory to explain human behavior. In addition, he developed a concurrent theory of personality development that was integrated into the theory. To this day, there has not been another psychological approach integrating a personality theory that directly connects to the practice of psychotherapy. It is important to understand the history of ego psychology theory and practice as it still seeps into the current practice of clinical social work. Ego psychology terms are still part of our therapeutic vernacular, such as defense mechanisms, ego strengths, and insight. Even active listening, so commonly used in therapy, has its roots in ego psychology. This chapter gives an overview of ego psychology theory and practice, showing its historical and current influence in the practice of clinical social work.

An emphasis on client strengths within social work practice can be traced back to the work of Jane Addams and the settlement house movement. In modern practice, an aspiration for strengths-based approaches can be seen across all areas of the social work profession. Yet translating an ideological emphasis on strengths-based approaches into the provision of strengths-based services has been hampered by a lack of clarity around concepts and application. To reconcile these challenges, it is helpful to conceptualize strengths-based practice (SBP) as a metatheory that organizes and names the otherwise unspoken rules embedded within lower level practice theories. Underlying all theories that take a SBP approach is the charge to build upon available strengths and apply social work interventions within a positive paradigm. More specifically, the tenets of SBP promote individual well-being and reduce social problems by building upon the strengths possessed by clients (e.g., capabilities, skills) and by the client systems in which clients interact (e.g., assets, resources). The purpose of this chapter is to categorize SBP as a metatheory for social work practice by first briefly describing SBP, including the historical evolution of the use of strengths in helping relationships. Then, the central values, theoretical constructs, and major tenets guiding social work research and practice are addressed. Finally, applications of SBP across the phases of helping are presented with a case example illustrating the way SBP can be observed in various aspects of practice.

Theories of individual and family development provide an important knowledge base for direct social work practice. These theories are particularly helpful in the data collection and assessment phase of helping because they direct the practitioner to explore the potential significance of issues that individuals and families commonly face at different stages of development. Although individual and family development theories are primarily explanatory, they often provide general ideas for intervention.

Individual and family development theories can best be studied together, as families are made up of individuals and 66% of individuals live within families. This chapter focuses specifically on the individual development theory of Erikson, and the family life cycle theory of Carter and McGoldrick within a changed and continually changing social context. There are also discussions of Kohlberg’s moral stages of development and Gilligan’s feminist perspective on moral development.

Because the United States is increasingly culturally diverse, these developmental theories are viewed through a cultural lens. Family assessment tools including the ecomap (Hartman & Laird, 1983), genogram and culturagram that can help clinicians apply development theories to their work with individuals and families are presented.

Borderline personality disorder (BPD) causes significant mental distress and impairment in psychosocial functioning. The condition is marked by emotional dysregulation, unstable personal relationships, impulsivity, chronic anger, and identity disturbances. A person with this condition often engages long-standing patterns of maladaptive coping responses that can include substance use, self-injury, suicidal behavior, aggression, and other reckless behavior. The condition is often comorbid with other psychiatric conditions including mood and anxiety disorders, eating disorders, substance abuse, posttraumatic stress disorder, and other personality disorders. While prolonged impairment in psychosocial functioning and symptom relapses are common, lasting improvement in a wide range of areas can be expected over time. Dialectical behavior therapy (DBT) is an intensive psychotherapy based on the cognitive behavioral model that uses individual and group sessions to help people with BPD develop adaptive coping strategies to manage symptoms and improve functioning. DBT has been widely studied and has been found to be an effective psychotherapeutic approach to treating BPD.

This chapter introduces motivational interviewing (MI), which guides clients toward resolving their hesitations about behavior change. Initially developed in the 1980s by William Miller for use in alcohol treatment, this approach has gradually infiltrated all areas of health behavior change. The model represented a dramatic shift from coercive and punitive approaches toward recognizing ambivalence as a key determinant for stagnant behavior. MI displaces denial as a personality trait while respecting client autonomy and empowerment to resolve their self-identified problems. Instead of blaming clients for their “therapeutic failures,” MI-trained clinicians, in alignment with social work’s core values, listen to their clients’ narratives, empathize with their stories, and share responsibility for behavior change. Over a period of three and a half decades, motivational interviewing’s theoretical framework increasingly centered in cultivating change language in a highly empathic environment. Empirical tests supported the approach in a variety of settings for a variety of problems. We focus this chapter on exploring MI and examining the role of the social worker in incorporating MI-consistent techniques into their practice. This chapter first explores the historical development of MI and its theoretical underpinnings, including the incorporation of psychotherapeutic relational- and change-based frameworks. Next, we discuss the components of MI, bolstered by case scenarios of skilled clinicians employing MI-consistent techniques throughout the helping phases. Finally, we examine critiques and share recommendations for incorporating the approach into generalist-eclectic social work practice.