Reconciling paternalism and empowerment in clinical practice: an intersubjective perspective

The focus of this article is on illustrating how the differences between the paternalistic and empowerment approaches embedded within social work have unnecessarily evolved into competing approaches to practice. Tracing the historical evolution of both paternalistic and empowerment approaches, the article posits that social work is more amenable to an integrated holistic approach to practice than to either a diagnostic or strengths-based approach. Building on G.WE Hegel's notion of recognition and feminist psychoanalystJessica Benjamin's theory of intersubjectivity, the article considers how a simultaneous focus on both strengths and vulnerabilities provides an integrated framework that embraces the joint social work values of personal caring and social justice. Clinical case vignettes are provided to illustrate the limitations of focusing too narrowly on either clients' pathology or clients' strengths. Social workers are encouraged to acknowledge their own vulnerabilities to better appreciate clients' vulnerabilities and strengths.