ABSTRACT
A focus on the ego in individual treatment has been associated more with analytically oriented social casework than with the other professions engaged in psychotherapy. The emphasis probably occurred because of the nature of social work’s traditional clientele and the circumstances under which they are often seen. A social worker’s offer of help to a mother—for the sake of her children as well as herself—is made without regard for the presence or absence of severe ego deficits in the mother. Moreover, the attempt to engage the client does not depend very much on the client’s recognition that something about herself is in need of change. Such recognition as a motive for treatment implies a level of intactness beyond the ability of many clients, certainly when beginning contact. So, at a time when analysts were screening out patients as unanalyzable because of their fragility, some social workers were beginning to talk of strengthening the ego as a goal of treatment (Garrett 1946, 1958). The process might well include strengthening defenses that seem workable, rather than seeking to dissolve them.
