Shaping psychiatric paradigms: Clinical social work in Chicago's South Side, 1970-1990

• In Event: Science, Knowledge & Technology Section Roundtables
  In Refereed Roundtable (60 minute): Table 9: Technology Mastery: The Professional Social Production of Medical Knowledge

Abstract

In the 1970s and 1980s, dramatic transformations in psychiatric science, psychotherapeutic modalities, and the contexts and value of psychiatric care triggered a ‘biomedical revolution’ in the psychiatric professions. Unlike in psychiatry, where the biological psychiatrists and the psychoanalysts battled for control of the profession, clinical social workers adopted a pluralistic pedagogical and practical approach to mental health treatment. The changes in clinical social work theory and practice at the University of Chicago’s School of Social Service Administration and surrounding psychiatric field sites in Chicago’s South Side exemplify this structural shift in the profession. I use archival research and in-depth interviews to explain the effects of the biomedical revolution on clinical social workers and examine the ways patient population, training, methodologies, and licensure influence their use of emergent approaches to psychological care. On a theoretical level, this work seeks to explain differences between contemporary and retrospective accounts of paradigmatic shifts can reveal about why knowledge systems change. I find that clinical social workers integrated new forms of psychotherapeutic and biomedical knowledge in ways that were continuous with the founding values of social work—pragmatism, humanism, and pluralism. These findings suggest that clinical social workers manage the epistemic tension between biomedical and psychoanalytic conceptions of mental illness differently than psychiatrists. In interviews, my interlocutors attributed the change in psychotherapeutic practice to the biomedicalization and financialization of health care. In the archives, however, there was little evidence that the same actors interpreted this shift as transformative, indicating a disjuncture between historical and contemporary perspectives that reflects the Gestalt-switch of Kuhn’s theory of scientific change. This work offers not only a new perspective on the ascendance of contemporary views and treatments for mental illness, but also a method of conceptualizing social change within and between professional jurisdictions.

Author

• Zoe Zephyr Phillips, University of Chicago