Indiana University Research & Creative Activity

Working

Volume XXIX Number 2
Spring 2007

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Barry Cournoyer
Barry Cournoyer
Photo by Rocky Rothrock, Office of Visual Media, IUPUI

Working in Circles

by Lauren J. Bryant

When Barry Cournoyer describes a child abuser, he says this: "A 'child abuser' is a human being who on one or more occasions mistreated a child. That person has many other aspects; there is much more to him or her than the abuse alone. Just as a map is not the territory, the label is not the person."

A clinical social worker and Indiana University professor of social work, Cournoyer does not deny the seriousness of child abuse, but his language captures the essence of the social work perspective--a stereoscopic focus on person and society. Labels such as "child abuser" reflect a simplistic triangular view of human nature, Cournoyer (pronounced 'coor nwhy A') says. "It's a highly moralistic view in which there is a victim, a persecutor, and a hero. It's good guys and bad guys."

It's a social worker's job to add dimension to this simple picture by drawing difficult distinctions. "Of course we hold people responsible for certain behaviors," Cournoyer says. "But we start with the presumption that a person is a complex human being with many dimensions and facets. People have connections to spouses or partners or children or parents or work or school or church. Social workers look at the impact of the person on the system and the system on the person. We think in terms of social circles and the interactions between them."

Limiting intervention efforts to personal characteristics is often ineffective, according to Cournoyer. The common notion that a personal counselor is the most powerful tool for change in a person's life "is ludicrous," he says. The most powerful way to make change "is to influence the environment in which a person lives day to day."

Complex Compassion

Compassion is at the center of social work, but it's considerably more complicated than a kind-hearted, do-gooder's impulse to help. In fact, acting on the impulse to help may sometimes be exactly the wrong thing to do, Cournoyer says. He calls this "the rush to save."

Social workers, especially people new to the profession, are "often tempted to offer solutions prematurely, before they have a complex systemic understanding about what's going on," he says. He points to the earliest social workers--Jane Addams and other crusading women of the early 20th century. These "extraordinary people saw the problems of immigrants and did their best to help," he says, "but very soon, it became clear that helping on the basis of only heart or compassion was risky. For one thing, you can end up confusing personal values and agendas with the values and agenda of the client."

A social worker's compassion must be tempered with realism and perception: "If we take more time to understand what is going on systemically," Cournoyer says, "we're a lot slower to rush to save." He notes that the negative effects of "rushing to save" (and "rushing to blame") are evident beyond the world of social work. He suggests, for example, that if policymakers stopped to understand the complex, systemic nature of poverty--who the human beings affected by poverty really are and what their actual needs are--policies would be much different.

"Whether it's social workers or parents or national leaders, we're much better off taking time to recognize complexity and taking action on the basis of systemic understanding," Cournoyer says. "Premature action based on simplistic understanding almost always yields unintended consequences and unanticipated outcomes."

On Evidence

When it comes to social work, Cournoyer knows a lot about what works. In independent practice since the mid-1970s, he currently serves clients with mental health and addiction issues in the Indianapolis area. He has also been a faculty member of the IU School of Social Work on the IU-Purdue University Indianapolis campus since 1979, teaching courses on the practice of social work and the skills it requires. (The school operates on IU campuses in Bloomington, Richmond, Gary, and South Bend, too.) After a five-year stint in the late 1990s as the school's associate dean for quality improvement, Cournoyer is also in demand as a "curriculum analyzer"--that is, an expert in assessing social-work education programs.

Social work, he says, has always been concerned with "helping people across the spectrum of human experience," or in the words of the IU School of Social Work's mission statement, "the alleviation of poverty, oppression, and discrimination, . . . the enhancement of the quality of life for all people, . . . and the advancement of just social, political, and economic conditions."

In recent decades, though, the techniques for accomplishing those tasks have changed. As it has in most fields, technology has significantly altered the work of social work. Many social workers now use laptops or personal digital assistants (PDAs) to help them manage their caseloads. Social service agencies employ software programs that neatly organize clients' problems, the plans to address those problems, and the means to assess progress. Spreadsheets help track progress systematically over time. "The feedback that technology allows us is wonderful," says Cournoyer.

But the information explosion of the Internet age has had a far more profound impact on social work. It has enabled the profession to become more evidence-based.

In its earlier decades, as Cournoyer describes it, social work was largely based on theories--educated guesses about what would work for a particular client's problems. "Some theories were useful, but often their safety and effectiveness were not supported by research. Social workers were essentially experimenting with clients as they tried to help them," he says.

The universe of information now accessible through the Internet means social work practitioners can easily locate relevant research articles and use the findings--along with input from their clients--to guide their service approaches. "We know so much more about safety and effectiveness than we ever did before," says Cournoyer, who published The Evidence–Based Social Work Skills Book in 2004. (He is also author or co-author of The Social Work Portfolio, The Social Work Skills Workbook, and Social Work Processes.) "Contemporary social workers increasingly look to research studies as a source of information for practice."

That's particularly true when it comes to current life sciences research--discoveries in human genetics, brain science, and other areas are expanding the social worker's toolkit. Cournoyer cites the case of a former client as an example. During an office visit, a male client shared his concerns about angry outbursts he'd been experiencing. The man was worried he would suddenly go over the edge and become violent toward his girlfriend. During the conversation, Cournoyer's client happened to mention that he'd lost his sense of smell after a car accident. That reference prompted Cournoyer to refer the client to a neurologist.

"From reading research studies, I recognized that loss of smell is associated with certain brain centers," Cournoyer says, "and lo and behold, the neurologist discovered that my client had indeed suffered some neurological damage. That increased my understanding and my client's. Instead of seeing himself as a bad person flawed by anger, he could understand that as a result of the accident, he had slight brain damage, and his ability to control his emotions was reduced because of that damage."

How We Suffer

Although technological tools and contemporary research findings have produced enormous changes in the social work profession, the biggest change may be in the clients themselves.

Today's clients are different from those of 20 or 30 years ago, Cournoyer says. To illustrate, he sketches a scenario: A child lives in a rundown neighborhood, fragmented by poverty and crime. He lives with a single parent who uses drugs and leaves the child to rely mainly on himself for survival. Across town, in a well-to-do community, a child returns from school to a house filled with the latest electronic devices. She skips her homework to text-message with friends on her cell phone while she gets in a few rounds on her PlayStation. Her parents will not be home from work until much later, logging on to their own laptops and PDAs shortly after they arrive.

The situation of the family in poverty is more perilous, but both families reflect an escalating social isolation. As families shrink, neighborhoods break up, and communities come apart, Cournoyer says, people are losing the benefits of social interaction. They are, in short, less socialized, less equipped to comprehend how their behavior affects others. As Harvard University political scientist Robert Putnam put it in his best-selling book, more and more of us are "bowling alone."

"Years ago, social work clients were primarily people who suffered internally--they were anxious or depressed or ashamed or guilty," Cournoyer says. "Now we see a lot more people who create more pain than they experience. They cause others to suffer through their violence, abuse, neglect, or narcissistic behavior. In effect, they externalize their pain."

Today's social work clients need help understanding the consequences of their actions for their relationships and for the systems in which they live. "We often have to educate people about how to relate to others," Cournoyer says. "We're challenged not only to relieve individual suffering, but also to help clients recognize their impact on others and develop the skills they need for social engagement."

A Moral Obligation

According to the U.S. Department of Labor's Bureau of Labor Statistics, as the Baby Boom generation ages, social work employment is predicted to increase by nearly 30 percent over the next decade, especially in settings such as assisted living facilities, nursing homes, and hospices.

In short, more social workers are needed. And given the complexity of contemporary problems, not to mention the complexity of ever-changing regulations and record-keeping demands, social workers will need to be "more knowledgeable, more ethical, more accountable, and more proficient than ever before," Cournoyer says. That's why he has turned his attention to evaluating educational programs offered by social work schools and departments across the country, a task he calls "a moral obligation."

"As an educator, I hope my students will accomplish certain learning goals, just as I hope my clients will accomplish certain goals," he explains. "In both cases, I have an obligation to evaluate the degree to which those goals are achieved. Otherwise, how do I do know I haven't rushed in and offered them something that does not help?"

Cournoyer has developed a software program called The Curriculum Analyzer to assess how well individual courses support a social work program's overall goals and objectives. He's used the software to evaluate dozens of programs over the last three years. On the downside, he's encountered many courses that are "intellectually not very sophisticated," he says. The good news is that "more and more schools are recognizing the similarity between practice and education. Just as we expect contemporary social workers to be accountable for the quality of their service to clients, we professors must do the same in social work education. We can not assert that social workers should be evidence-based, and not be so ourselves."

Cournoyer acknowledges a danger in this digital, evidence based approach--it is possible to become too formalized and technocratic, approaching social work practice and education in such a prescribed way that the basic elements of human connection and social relationship are lost.

How does he guard against that?

"Conceptually, it's pretty easy, although I often fail in the application," he says. "I try to listen carefully and view each person as a complex, dynamic, and unique human being who is involved in dozens of social systems.

"It does make sense to practice what you preach."

Lauren J. Bryant is editor of Research & Creative Activity magazine.