ABSTRACT Although the field of clinical social work has historically distinguished itself among the helping professions by its attentiveness to the ecological systems within which client struggles are embedded, the role of structural factors in shaping the professional activities of clinicians themselves often goes under-theorized. This paper argues that the erasure of structure and political economy from clinical social workers’ accounts of their own career trajectories and treatment decisions is not oversight. Rather, it occurs in response to social workers’ ambivalence or guilt regarding their aspirations to upward class mobility – feelings that arise, in part, out of a set of contradictory imperatives into which workers are socialized through their clinical training. By disavowing the impact of structural constraints on their own work, clinicians preserve a sense of professional integrity and moral agency under what are often compromised, frustrating, or heart-wrenching working conditions. However, this tactic of self-preservation may lead clinical social workers to inadvertently naturalize and reproduce some of the very structural inequalities that the profession is committed to redressing.

中文翻译：

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临床社会工作者对职业道路和治疗决策的描述中通过结构擦除来恢复道德能动性

摘要 尽管临床社会工作领域在历史上因其对客户斗争所嵌入的生态系统的关注而在帮助专业中脱颖而出，但结构因素在塑造临床医生自身专业活动中的作用经常被低估。本文认为，从临床社会工作者对其职业轨迹和治疗决定的描述中删除结构和政治经济学不是疏忽。相反，它是对社会工作者对向上阶级流动的渴望的矛盾或内疚的反应——这种感觉部分来自一系列相互矛盾的要求，工人通过他们的临床培训社会化。通过否认结构性限制对他们自己工作的影响，临床医生在经常受到损害、令人沮丧或令人心碎的工作条件下保持职业诚信和道德能动性。然而，这种自我保护的策略可能会导致临床社会工作者不经意间自然化和重现该行业致力于纠正的一些结构性不平等。