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Despite a strong history of social justice–based social work professional education in Canada, there has not been an intentional integration of direct critical clinical mental health practice with social justice–based theory. Progressive social work has tended to view clinical work as focusing on the individual and failing to contribute to social change. In this article, I elaborate upon a critical clinical social work approach influenced by postmodern critique, and feminist-, narrative-, and collaborative-based practice rooted in critical theory. Critical clinical practice disrupts the individual/social binary through counterviewing unhelpful dominant social discourses and producing counterstories that participate in social resistance. I explore the constraints of neoliberalism on social work mental health practice and its influence on the ability of social workers to practice social justice–based social work. Neoliberalism constrains social workers' ability to address the social and structural determinants of mental health through its focus on economic rationalization, biomedicalization, and individual responsibilization, alongside rationalized practices that emphasize evidence-based and short-term efficiency-based models. I argue that social work is facing a crisis as a disempowered profession, as it attempts to reconcile its commitment to social justice and the importance of addressing inequity, marginalization, and oppression while often working in settings that demand the subordination of social work knowledge to neoliberal biomedicalism. Under these conditions, a critical clinical approach to mental health practice is needed now more than ever.

Women are at least twice as likely to experience depression as men, and up to 25% of women can expect to be depressed in their lifetimes. Depression is likely to recur in up to 85% of women, yet most women who experience depression cope on their own. Feminist research has explored the discursive, and social context of depression among women and acknowledges women's agency as they simultaneously struggle and cope with depression. "Getting on with life" is often an imperative, but begs the question what are they getting on with, especially if their lives have been significant in causing unhappiness and distress. I explore how depression is shaped by the discourse of self-management, gender performance and the notion "the good woman." Dominant depression discourses individualize, decontextualize, and emphasize personal responsibilization for the causes and treatment of depression. This produces an epistemic injustice for speaking about and coping with depression. Social work practitioners must make space for acknowledging women's resourcefulness and agency in their management of sadness and distress. We must also address not only the dangers of responsibilization, but the limitations of this approach to women's well-being.

Anti-oppression discourse has emerged within critical social work in an effort to address issues of diversity, difference, and inclusion. Drawing upon Audre Lorde's (1984) famous words "the master's tools will never dismantle the master's house" this paper will argue that modernist aspects of anti-oppressive discourse may unwittingly deploy the masters' or dominant conceptual tools. A critical reflexive lens identifies unintended, modernist conceptual practices of power which may reify dominant discourse. Specifically I focus on three modernist practices of power which may limit anti-oppression discourse: 1) the essentialism of the subject, 2) subjectivism or writing out the social, and 3) the reproduction of dominant social discourse. Through exploring these three related domains, I argue for a blending of modernist and postmodernist assumptions which holds onto the strengths of both modernism and postmodernism while abandoning their limitations. This blended approach will facilitate a critically reflexive anti-oppressive practice.
KEYWORDS: Anti-oppression, postmodernism, social work practice, reflexivity

Front Cover -- Half-title page -- Title page -- Copyright page -- Contents -- Foreword -- Part 1 Introduction -- Introduction -- Chapter 1 Critical Clinical Social Work -- Chapter 2 Critical Clinical Ethics -- Part 2 Critical Clinical Social Practice -- Chapter 3 Feminist Narrative Therapy and Complex Trauma -- Chapter 4 Critical Clinical Approaches with Girls and Their Experiences of Sexualized Violence -- Chapter 5 Exploring Trauma and Masculinity among Men Who Perpetrate Intimate Partner Violence -- Chapter 6 Strategies for Critical Clinical Practice in Veterans' Mental Health -- Chapter 7 Safety, Belonging, and Voice -- Chapter 8 Animal-Informed Social Work -- Part 3 Critical Social Welfare and Institutional Practices -- Chapter 9 The Whole or Part? Postcolonial Theory versus Clinical Approaches to Marginalized Groups' Quest for Social Services -- Chapter 10 Critical Intercultural Communication and Practice -- Chapter 11 Epistemic (In)Justice in Child Welfare Risk Assessment -- Chapter 12 AIDS Quarantine Revisited in British Columbia's Treatment as Prevention -- Part 4 Working in the Context of Marginalization, Oppression, and Diversity -- Chapter 13 Spirituality as a Resource for Well-Being in African Canadian Communities -- Chapter 14 (De)Colonizing Indigenous Social Work Praxis within the Borderlands -- Chapter 15 Counterbalancing Life with Chronic Pain through Storying Women's Experiences of (Dis)Ability -- Chapter 16 Validating Voice in Critical Clinical Work with Older People -- Part 5 Conclusion -- Chapter 17 Doing Critical Clinical Work from the Ground Up -- Conclusion Practices of Resistance through Counterstorying for Social Justice -- Contributor Biographies -- Index -- Back Cover.

Abstract
Though the rationalisation of health care has been well documented, less is known about its impacts on mental health social workers. Drawing on qualitative data collected from 120 interviews and the qualitative comments on a Canadian four-province survey, the article explores the shifting labour process through profession-linked and organisational care strategies. The article argues that power is shifted from mental health social workers to management through stratagems including managerialism, biomedical hegemony and team-based care. These processes are complex and dynamic, travelling along professional divisions and logics, appearing neutral and scientific rather than as conduits reinforcing neoliberalised approaches to health care provision. Social workers' resistance to these models of care is similarly complex and professionally based, though with strong elements of gendered altruism and social justice themes. Though this article draws on Canadian data, the analysis is likely highly applicable to other managerialised contexts including the UK. The article contributes to the intersection of Labour Process Theory and moral economy theory by highlighting the operation of a unique form of engagement referred to here as resistance-as-engagement. Overall, mental health social workers revealed strong oppositional narratives and identities pivoting on their marginalised position within team-based care, medical professional hierarchies and narrow, neoliberal approaches.

Summary Social workers are positioned to respond to clients with a history of trauma by practicing bio-psycho-social, trauma, and violence-informed care but frequently encounter systemic barriers to providing holistic care. The research presented in this article was initiated by a College of Social Work in Canada in response to concerns raised by social work providers that their practice was constrained by ideological, structural, and system limitations within publicly funded mental health and addiction services. Ideologically trauma-based social work care is defined by five principles of safety, trust, collaboration, choice, and empowerment and recognizes that what has happened to individuals, including early adversity, can influence their bio-psycho-social functioning across the lifespan. Structurally, trauma-based care recognizes the corrosive impact of poverty, systemic discrimination, and exclusion. Findings Our research included a literature review, an online survey (n = 115 completed surveys), individual interviews (n = 50), and three focus groups (n = 15). The findings consistently highlighted a dissonance between dominant bio-medical approaches and reliance on the Diagnostic Statistical Manual of Disorders and social justice–based practice. Primary themes included a recognition by social workers of the pervasive presence of trauma and its effects, including mental health and addiction challenges; intergenerational impacts of trauma; the limitations of the medical model; and the need to reposition social work practice. Applications Repositioning the role of social work within mental health and addiction settings to center social justice responses to trauma presents transformative opportunities to better meet the needs of service users and increase workplace satisfaction.