Contemporary Clinical Practice

The Holding Environment Under Assault

  • Ellen Ruderman
  • Carol Tosone

Part of the Essential Clinical Social Work Series book series (ECSWS)

About this book


Ongoing wars, a sinking economy, growing inequities—more than ever, the outside world leaves a large footprint on patients’ psyches. Not surprisingly, therapists are experiencing increased tension between sociopolitical realities, the inner world of the treatment hour, and their own anxieties, training, and ethics. How does one maintain trust and authenticity? Should the concept of therapeutic neutrality still apply at a time of widespread societal trauma and grief?

The contributors to Contemporary Clinical Practice have grappled with these and related questions, and offer stimulating answers. Beginning with its subtitle, The Holding Environment under Assault, the book gauges the extent to which modern life impinges on the therapeutic relationship, and offers steps for clinicians to reconcile these inner and outer worlds in practice and find healing for themselves as well as their clients. Skillful analysis and illustrative case examples bring modern perspective to existential dilemmas common in therapy, from transference, countertransference, and boundary difficulties to challenges posed by new technology. Thought-inspiring topics include:

  • Integrating the interior and exterior worlds of clinical social work.
  • Grief and loss in an age of global trauma.
  • Virtual intimacy: help or hindrance?
  • Considerations for psychoanalytic treatment in time of war.
  • What happens to confidentiality when the government enters the treatment room?
  • The loss of dissidence in psychoanalysis.
An owner’s manual to 21st-century therapy, Contemporary Clinical Practice: The Holding Environment under Assault will be hailed by social work professionals, counselors, and policymakers as provocative, sobering, and ultimately career-affirming.


Adult psychotherapy Attachment in clinical social work Clinical Social Work Confidentiality in social work practice Global trauma Globalization Government in the treatment room PTSD Post-traumatic stress disorder Social work education Socio-political holding environment Therapeutic process Treating grief

Editors and affiliations

  • Ellen Ruderman
    • 1
  • Carol Tosone
    • 2
  1. 1.EncinoUSA
  2. 2.School of Social WorkNew York UniversityNew YorkUSA

Bibliographic information