Therapeutic Use of Self

Originally Written for the publisher Wiley’s client: https://www.socialworkdegrees.org/

Social workers teach clients how to regulate their emotions, understand their thoughts, and evaluate their feelings because these techniques can positively impact their mental health.

A critical way social workers help clients is through the “therapeutic use of self.” This means practitioners utilize knowledge and facts about the client as the primary tools guiding therapy.

Likewise, practitioners use self-expression through non-verbal language and self-disclosing dialogue to aid in the therapeutic process. Self-understanding, therefore, goes both ways in the therapeutic process.

The central concern is getting clients to think about themselves. This is so clients can actively participate in the therapeutic process, helping to provide practitioners with more vital information and themselves with valuable insights.

What is Therapeutic Use of Self?

The therapeutic use of self is used not only in social work and psychotherapy but also by nurses, occupational therapists, and, increasingly, the general field of medicine under the guise of “personalized medicine.”

Personalized medicine is a new attitude in healthcare that treats patients according to their distinctive needs and constitution.

In other words, because all bodies are slightly different (whether because of environmental or genetic factors), all should be treated slightly differently when under a doctor's care.

It’s not exactly throwing out the rulebook so much as altering it to account for human differences. 

The same principle applies to the therapeutic use of self.

Because all minds and personalities are slightly different, clinicians must approach each client differently based on their unique features.

All humans possess different thoughts, personality traits, emotions, abilities of emotional regulation, and judgments. This is why our species seems capable of producing infinite ideas and creative output.

But it is also why each human being is so unique. It is why person A will laugh at a joke person B finds horrifying, and person C finds neutrally unfunny.

These radical differences across individuals psychologically are the most relevant source of therapeutic information.

You cannot treat all clients alike because they are not all alike.

Likewise, practitioners cannot act as if all clients bring the same feelings and thoughts in their minds because they don't.

Clients who act differently will make practitioners feel and think uniquely different things. Therefore, part of the therapeutic use of self involves expressing these unique feelings to clients in therapeutic ways.

For example, suppose a client has had little social interaction in the past decade and utters an offensive remark. In that case, if the practitioner naturally must gasp, they should do so in a way that makes the client notice.

Part of the therapeutic process in social work and psychotherapy involves getting clients to understand how their behavior and speech affect others.

Some clients have so little social contact in their lives that to reintegrate themselves socially, they must first practice recognizing how others react to their behavior and speech with a therapist.

And for such practice to work, therapists must be willing to openly express their natural reactions to clients, which is the essence of the Therapeutic Use of Self technique.

Therapeutic Use of Self in Social Work

Social workers must understand themselves as unique individuals just as they should understand their clients that way.

For social workers to successfully understand clients, they must be sensitive to the inner on-goings of their minds.

In other words, successful social work is enabled when clinicians understand the belief systems, personality traits, and mental states of both their clients and themselves.

Knowing others requires that we first know ourselves.

And knowing ourselves is easier said than done. Of course, we are uniquely equipped to detect when we are hungry or in pain, but therapeutic self-awareness requires conscious effort.

Introspection is one method of improving this ability. Introspection involves shifting our focus on our thoughts and feelings and evaluating them –almost as if we are in dialogue with them.

Likewise, others sometimes perceive our mental states better than we do. Have you ever been, for example, angry but unaware of it until a friend pointed it out?

Reflecting on what others tell us about ourselves is, therefore, also important when we are trying to understand ourselves.

Social workers must understand themselves before trying to understand others because it allows them to more clearly articulate self-disclosive utterances and signals from body language to clients, making these articulations more conducive to the therapeutic process.

Therapeutic Use of Self Examples

How a concept as complicated as the “self” can be therapeutic is an abstract idea that is better understood through concrete examples:

Example 1

A client with a history of childhood abuse tells their social worker that it makes him feel uneasy when people walk behind him. This is due to a specific incident in which he was physically assaulted from behind.

The social worker responds, “I’d feel uneasy too if I’d been through the same.”

Example 2

While a client recalled a story of a traumatic experience, the social worker experienced some emotional discomfort that paralleled the traumatic experience.

The social worker opens up to the client by saying, "I felt what you experienced at my core."

Example 3

A client tells a social worker a story of an immoral thing they did. This story has left the social worker deeply uncomfortable with this client.

The social worker responds by motioning slightly in their chair and gently pulling on their shirt’s neck for cool air.

Therapeutic Use of Self Tips

Opening up to clients to get them to self-reflect can sound intimidating. Moreover, it is a highly vulnerable way of facilitating therapeutic outcomes. Nevertheless, it is a requirement for successful clinical social work.

Self-Protection: While letting clients know how you are reacting to their behavior is essential for therapeutic purposes, there are limits clinicians should impose on their transparency toward clients.

For example, some clients may signal their consciousness of a clinician's self-disclosure and view it as an opportunity to delve more deeply into their personal life.

In such instances, clinicians must place boundaries between themselves and their clients for safety purposes and to ensure the maintenance of a healthy therapeutic relationship.

Non-Verbal Communication: Example 3 above is an instance where non-verbal communication can work just as well as vocalized self-disclosure.

This is because some clients do not understand non-verbal communication. It is much more productive for them to learn it in a therapeutic environment without judgment than out in the world where judgment is guaranteed.

These are essential social skills that social workers can help clients learn to reintegrate into civil society.

Additionally, sometimes what a clinician thinks is opposed to the relationship's therapeutic progress and should therefore remain without utterance toward clients.  

Listening: The most critical skill clinicians must have is listening –first to themselves and then to others.

Do not think about what you will say next when others are speaking. If you are, that means you are not listening. Instead, you have an internal monologue that distracts you from what others say.

This method of listening is better suited to therapy because it primes clinicians to have genuinely natural reactions to what their clients say or do.

If you are thinking about what you'll say next while your client is speaking, you will miss details that would have altered your response had you heard or seen them.

Real listening will sometimes mean your answer is nothing more than a nod or a head shake, and other times it will mean an unplanned advice-giving session.

Pay Attention to Yourself:  Either way, make sure you listen instead of thinking.

Thinking and listening, however, are only distinguishable through self-reflection.

In other words, if you cannot tell the difference between thinking and listening to yourself, you need to pay more attention to yourself.

Being alone with your mind paying attention to it is necessary for becoming a stellar social worker. It permits you to listen genuinely and naturally react to clients.

Why Therapeutic Use of Self is Important

Since ancient times, “know thyself,” as Socrates once said, has been regarded as a noble virtue.

And the reason it has always been regarded as a noble virtue has almost always been the same:

To know others, you must know yourself.  

Knowing yourself as a practitioner is arguably the golden virtue of clinical therapeutic practice because it permits clinicians to understand others safely.

Social workers who know themselves will not be fazed when dangerous clients threaten or hurl vulgarities at them.

That is because these social workers can look into themselves, identify feelings that arise, and mindfully allow them to subside.

Likewise, understanding that such threats and vulgarities come from a place of ignorance that isn’t necessarily the client's fault can prevent social workers from taking things too personally.

Many of these facts become evident when practicing social work and even when getting educated as a social worker.

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