Heather's Paper on Intution

8/2/2019 Heather's Paper on Intution

1/22

Running head: UNDERSTANDING INTUITION IN SOCIAL WORK

Understanding the role of intuition

in clinical social work practice

Heather Mackay

University of Calgary

Social Work 679.67


2/22

Understanding intuition in social work 1

Understanding the role of intuition in clinical social work practice

Intuition and concepts constitute... the elements of all our knowledge,

so that neither concepts without an intuition in some way corresponding

to them, nor intuition without concepts, can yield knowledge.

Immanuel Kant

Intuition is a concept that is rooted in epistemology. Although its roots are in philosophy,

intuition is a term can be found in most science and social science disciplines, including

medicine, mathematics, business, psychology, education, economics, politics and social work. A

quick search of the term in different academic databases returns of a long list of articles.

Research about intuition accelerated in the 1990s and is still on the rise, mostly thanks to

advances in psychology and neuroscience research (Sinclair 2010, p. 378). Indeed intuition is a

concept that most would agree is a part of the human make-up to a greater or lesser extent.

Although intuition is a cited source of information for social workers (McLaughlin et al.

2010; Gilgun 2005) it is not a well understood concept (Jeffery & Fish 2011). The lay definition

is simplistic: immediate knowing orlearning of something without the conscious use of

reasoning (Websters English Dictionary). However, the literature reveals a more complex

picture of this multi-faceted idea (e.g. Rathunde, 2009; Evans, 2010; Baylor, 2001; Sinclair,

2010). It is this writers suspicion that social workers in all areas of practice, frequently rely on

intuition to guide their work. Although it is beyond the scope of this paper to test that hypothesis,

this paper will begin the process of unravelling when and where intuition and clinical social

work overlap.

To this end, I will briefly examine a number of ideas and then attempt to draw them together

to discuss the implication to social work. First, in order to understand the use of intuition in

social work practice, one must first understand the context of current social work practice in

mental health. Second, using the literature I will briefly examine different models for
http://www.brainyquote.com/quotes/quotes/i/immanuelka152151.htmlhttp://www.brainyquote.com/quotes/quotes/i/immanuelka152151.html


3/22


understanding intuition with a brief note on heuristics and intuition. Third, I will look more

specifically at intuition in action in mental health drawing on two articles to cite examples.

Finally, I will attempt to draw together the models of intuition and their application to current

social work practice with a focus on the implications for social work and directions for further

research.

The context of current social work practice in mental health

The role of social work in mental health has changed over time (Aviram 2002), but today

includes everything from assessment to social action (Regehr & Glancy 2010). Social workers

play a role in client assessment and treatment both in the community and in hospital settings.

Social workers can perform risk assessments, diagnostic assessments and inform decisions for

hospital admission (Naumburg 2010) and for hospital discharge (Godin 2004). In the expanding

domain of what constitutes mental illness (Aviram 2002) social workers are also a part of direct

treatment in the form of counseling and psychotherapy with individuals and families (Regehr &

Glancey 2010). Although social workers are involved in many areas including family liaison

work, public education and advocacy, as well as planning, implementing and evaluating

interventions (Regehr & Glancey 2010), for the purpose of understanding the use of intuition, the

focus here will stay focused on decision making, specifically in risk assessment and diagnostic

assessment.

Evidence based practice (EBP) is a dominant construct in social work in mental health as well

as other areas. It is important to understand the meaning of EBP and the range of interpretations

of it as it is the application of reason, considered by definition the contrast of intuition. EBP is

based on a modernist philosophy of science valuing rational means of knowing largely thought

empirical studies (Jacobs et al 2010). Originating from medicine, a commonly accepted


4/22


definition is: the conscientious, explicit, and judicious use of current best evidence in making

decisions about the care of individual patients (Sackett et al. 1996 cited by van de Luitgaarden

2009). The understanding of best evidence is taxonomy of empirically based studies where

randomized clinical controls are the gold standard (van de Luitgaarden 2009). When EBP is

understood in this limited way in assessment in mental health, it includes only the use of

actuarial methods for assessing risk (Godin 2004) or making diagnoses Srivastava & Grube

(2009).

A more flexible and inclusive understanding of EBP acknowledges the relativist post-

modern world (McNeill 2004) and the need for anti-oppressive practice in mental health (Larson

2008) and includes the use of best practice assessment methods and treatment interventions, but

also considers the more subtle aspects of practice, such as the interplay between research,

professional judgement, and the unique circumstance presented by each client (McLaughlin et

al. 2010, p.156). Evidence based practice is the use of best evidence integrated with the

expertise of the worker and the values and circumstances of the client (van de Luitgaarden

2009, p. 248). Gilgun (2005) proposes that there are four cornerstones of EBP in social work:

research and theory; what we have learned from our clients including our practice wisdom and

professional values; what we have learned from personal experience and what clients bring to a

practice situation (p.52).

The recovery model is prevalent in the field of mental health and, very briefly, it includes

four key components: person orientation (not the disease); person involvement (full participation

of the person); self-determination/ choice (with goals, outcomes, services); and growth potential

(focus is on the potential for recovery) (Regehr & Glancey 2010). Aligning the given

understandings of EBP and the prevalent recover model: EBP in mental health social work


5/22


practice can be understood then as a three pronged model that includes: 1) best practice research;

2) clinician expertise and judgement and 3) client circumstances, values and equal participation.

Intuition

Intuition is an elusive concept (Jeffery & Stone 2011) and although most will know what is

meant by intuition it is not a concept easy to define (Srivastava & Grube 2009, p.100). As

described earlier, the lay definition of intuition is knowing in the absence of reason. We

understand intuition then by understanding what it is not (Hammond 2010). In the psychology

literature, there appears to be little agreement about what constitutes intuition (see Appendix A).

A common understanding of intuition is: knowing without knowing how one

knowsunconscious information processing (Epstein 2010). A simple definition of intuition

then holds it in contrast to reason and as an unconscious process. It is the unconscious or

nonconscious nature of intuition that makes it difficult to study. Even the person who may be

engaged in an intuitive process is not always aware of it (Kline & Bloom, 1995).

Srivastava & Grube (2009) go further describing intuition as unconscious knowing based on

the synthesis of information- both internal (memory and expertise) and external (the

environment). This definition and others similar to it (e.g. Myers 2010; Nooney 2008 and

Sinclair 2010, see Appendix A), view intuition as the process of quickly synthesizing a lot of

information through ones own experience and expertise in a given area. In this way of seeing

intuition, concepts such as practice wisdom and clinical judgement or expertise begin to overlap.

Some understandings of intuition characterize the role of affect: the surprise, clarity and

beauty of an intuitive perception that can leave a person inarticulate (Noddings & Shore 1984

cited by Baylor 2001). Intuition as a source of guidance and information that comes from

maturation and experience as well as spiritual promptings from a higher power (Jeffery & Fish


6/22


2011). In these notions of intuition, the unconscious knowing of something is awe-inspiring and

perhaps the result of a higher powers intervention. Intuition is a kind of revealing about what the

ultimate truth in our existence may be. It is a glimpse behind the current of our perceived

reality. However, as psychology researchers point out, this intuition is less understood and less

amenable to study (Baylor 2001; Sinclair 2010; Sinclair & Ashkanasy 2005; Hammond 2010).1

There are other models of intuition that are more complex. Baylor (1997) outlines a

conceptual model that has intuition at the intersection of immediacy, sensing relationships and

reasoning. In order to understand the concepts Baylor (1997) asks the reader to imagine a

software designer who awakes in the middle of the night with the realization of how to convey

the complexity of DNA with a simple animation. Immediacy refers to realization occurring

suddenly without planning. Sensing relationships describes how the designer put together two

concepts in a new way. And reasoning refers to the thought processes that led to the realization

and lack metacognitive control.

In this understanding of intuition, it is an outcome (rather than a process of information

processing) and it overlaps with the intuition we prescribe to genius discoveries and inventions.

It is a model for describing the creative Ah-ha! moment. Baylor (1997) goes on to differentiate

between insight (immediacy and sensing relationships) and analogy (reasoning and relationships)

and action-oriented reasoning (reasoning and immediacy). These are helpful to further

understand intuition as different from other ideas such as insight.

1The overlap of intuition and spirituality is valuable and fascinating and may even be relevant to clinical decision-

making, but it takes the concept of intuition in another direction. Literature searches for the current paper were

conducted solely in the popular academic databases for social work, psychology and sociology. Perhaps searches in

religious studies and other kinds of humanities databases would have revealed more papers conceptualizing intuition

in this affective and spiritual manner. However, the current discussion of intuition explores the idea in fairly strict

cognitive terms and primarily as its described in psychology.


7/22


Another way to think about intuition is as types. Sinclair (2010) describes intuition as having

three types and asserts that comprehensive nature of her model helps settle some of the elements

of debate about the nature of intuition. Sinclair (2010) states that there is consensus that intuition

represents direct knowing that results from non-conscious holistic information processing (p.

378), but the debate is regarding whether intuition is a quick pattern recognition and synthesis

of stored information (p. 378) or a sensory and affective process that enables connecting

patterns in a new way (p.378).

The first type of intuition is intuitive expertise. This is the similar to what I described earlier

based on Srivastava & Grube (2009). Intuitive expertise relies on a persons experience and

stored information and to recognize patterns and come to a conclusion quickly. Sinclair (2010)

offers the example of professionals in crisis management and life threatening situations. It is a

process so fast you cannot see it and it is associated with decision-making. Intuitive creation, on

the other hand, is a slower process and used more in problem solving. There is a prolonged

period of incubation before intuition is complete and can emerge, often in the so-called ah-ha

moment while taking a shower, or sleeping (Sinclair 2010, p. 383). The third type of intuition is

intuitive foresight. This involves future events and the author states not much is known about its

workings. Examples are given from entrepreneurs who seem to have the ability to sense

opportunities hidden to everyone else they see a seed of a future pattern (Sinclair, 20101, p.

383). This type of intuition may relate a little closer to the idea of affective-spiritual intuition

described above.

In relation to the idea of intuitive expertise, Baylor (2001) outlines a U-shaped model of

understanding intuitive expertise across time. Baylor offers that intuition is most available when

someone is a novice and when someone is an expert- the ends of the U. Intuition is the least


8/22


available to the intermediate learner who is most focused on the rules and theories of the given

area. Baylor (2001) defines in intuition of a novice (think of a new math student easily solving a

difficult equation) as immature intuition. The expert who has the years of experience and training

is said to have mature intuition. This is a more complex way of understanding intuitive expertise

and is an understanding of intuition that most resembles the concepts of practice wisdom (Scott

1990; Klein & Bloom 1995) and clinical judgement or expertise (Mulvey & Iselin 2008).

Another frequently drawn-on model of intuition is the continuum concept of intuition

(Hammond 2010). This model describes pure intuition on one end of a continuum and pure

reason at the other end. The idea is that cognitive activity takes place somewhere between these

poles. The benefit of this is model is that it removes the categorical thinking of either reason or

intuition and posits that we use something in between most of the time. Hammond (2010) refers

to this as quasirationality, but not to mean that it is flawed rationality, but rather an adaptive

variability of cognitive behaviour (p.330).

The last way of thinking about intuition that I will offer here comes from dual processing

theory. Evans (2010) describes two types of information processing that occur separately. Type I

Intuitive is fast and has a high capacity for processing information. It is an initial response that

can feel right, but should not be considered valid until the Type II Reflective system is used to

confirm the feeling. Type I is evolutionarily linked to animal cognition, in that it is experientially

based. Type II Reflective is a slow process with limited capacity for information. It is a second

level of processing that is accessed only as needed. It is thought of as superior and includes the

ability to think about the future and make hypotheses about potential outcomes. An outline of the

differences between the Type I and Type II is further described in Appendix B.


9/22


CEST is the Cognitive Experiential Self-Theory (Epstein 2010) is often used as the example

of a dual processing model (Sinclair 2010). This model appears slightly more evolved in that the

experiential/ intuitive system, although it is based on associative learning and is affective in

nature, it is not as inclusive as the Type I/ Type II theory described above. In CEST the

experiential/ intuitive aspect does not include all irrational fears or the unconscious processes

(e.g. driving). Further the view is that intuitive beliefs, although not valid through the

rational/analytic system, are valid within the context of experience. For example, a woman who

had been sexually assaultedperceiving a mans hug as an advance and not simply a gesture of

seeking comfort (Epstein 2010, p 305).

In CEST, the rational/analytic system operates with conscious reasoning and is affect-free. It

is the ability to see cause and effect and operates on a verbal and symbolic level. It is a slower

process for deliberating. In sum, it is what we mean when we talk about reason. See Appendix C

for a more complete description of characteristics of CEST.

A note about intuition and heuristics

Even without understanding the process of intuition, there is value in the knowing that is

intuition. This is only true however, if the knowing is valid. The idea of intuition as a valid

source of knowledge varies. Some say that intuition is defined as such only in retrospect when

understood to be valid (Epstein 2010) and others include even invalid beliefs (e.g. irrational fears

and superstitions) as part of the same intuitive system (Evans 2010). Heuristics generally

involves the use of single cue (or rule) in judgements involving multiple cues (Hammond 2010).

Intuition has been mistakenly associated with heuristics, in large part because the accuracy of

intuition has been tested on logical analytic tasks (e.g. Evans 2010). In such cases intuition does

poorly and becomes thought of as simply faulty judgement (Sinclair 2010).


10/22


Not all heuristics involve bias, but the danger is that they may lead to bias. Some common

clinical judgement biases include: anchoring (all future information is biased by the initial

belief); confirmation bias (using information that only supports what you believe while failing to

use information that contradicts); and memory bias (using information that is most easily

recalled) (Elstein 1999; Falvey et al. 2005). Dual processing theories would state that although

there are two separate processes, the role of the rational/ analytic system is to check-out if initial

feelings of the intuitive/ experiential system (prone to anchoring bias) are true and that this

creates a more comprehensive and reliable system of knowing (Epstein 2010). The continuum

concept of intuition would say that the activity of quasirationality allows for other sources of

information to be used and integrated without relying solely on pure intuition (Hammond 2010).

It is another topic in itself to look at heuristics and bias related to clinical judgement, but suffice

it to say that there is overlap with these ideas with the use of intuition in clinical practice.

Intuition in action

Although there are a lot of papers about intuition, these are primarily conceptual pieces that

talk about intuition. There are relatively few studies that examine how and when intuition is used

in mental health practice across all the professions. Two articles are offered here: Godin (2004)

is a study and the other, Srivastava & Grube (2009) does a good job of summarizing other

studies.

Godin (2004) offers a glimpse into the community mental health nurses (CMHN) in Britain in

the context of intense political pressure to use rigorous and explicit methods of risk assessment

(p. 347). The author states that after a number of studies exposed the unreliability of traditional

clinical methods of judging mental patients future potential to behave violently (p.348), a

number of actuarially based risk-assessment tools were developed. The author states in this


11/22


practice environment, traditional clinical methods refer to all methods that are not actuarially

based. Actuarial methods are based on probability and statistics and rely on risk assessment

check lists. In an actuarial method, a patient is understood more as member of a group population

than as an individual. The question of the study was to what extent the CMHN relied on the risk

assessment tools.

The results found that although most of the CMHNs used actuarial methods to some extent to

assess risk, the key value in identifying risk was intuition. One participant said:

Its all about professional intuition, looking at their home

and looking at their history, family background, the kind of things

they did as a kid (Godin 2004, p. 352).

Many of the CMHNs felt that risk assessment tools informed and helped justify the professional

decisions they took. Though they could make claims about the value of gut feelingsuch claims

might not go down as well at a homicide inquiry (p. 353). Of note, is that when a CMHN was

assessing his or her own safety, she relied mostly on intuition. One participant said: Eighteen

years in doing this work is enough to know that when I feel afraid I should pay attention to that

(p. 355).

The participants in this study refer to intuition in a way that closely aligns with intuitive

expertise (Sinclair 2010), specifically mature intuition (Baylor 2001). It is a knowing that comes

from years of experience in the field. This is confirmed by another study examining how nurses

assessed for suicide risk- of the two nurses who reported using intuition, they had the most years

of nursing experience compared to other participants (Aflague & Ferszt 2010).

When the CMHN nurses refer to assessing their own risk based on honoring the feeling of

being scared, that seems more like the intuitive/ experiential (Epstein 2010) or Type I processing

(Evans 2010). This paper also shows the wide net that is included when the term intuition is


12/22


used: environmental assessment of looking at the home and the patients history in terms of

family background and childhood. The relative lack of agreement on what constitutes intuition is

another reason that it is difficult to study.

Another example from the literature is the role of intuition in psychiatric diagnostic decision

making. Srivastava & Grube (2009) refer to the psychiatrists overall feel of the patient (p.100)

and ask: Is such a feel, which we call intuition, a legitimate diagnostic tool? (p. 100). The

authors cite a few studies before discussing their experience with intuition in one specific case

example. The value of the article to the current paper is in the number of studies they cite.

First, Srivastava and Grube (2009) describe the praecox feeling as the sense of social

detachment (p. 101) used in the diagnosis of schizophrenia. It refers to the psychiatrists

inability to establish contact with a patient. The authors describe the praecox feeling as felt even

before one has spoken to the patient it is intuitively felt (p. 101). A study (Grube 2006 cited

by Srivastava & Grube 2009) measured the psychiatrists use of this intuitive feeling in

diagnosing compared with blind raters diagnosing of patients based on the DSM-IV and the ICD-

10 and found that intuitive reasoning demonstrated a high positive predictive value of .94 and

a negative predictive power of .70 (p.101).

Another study (Thomas-McLean et al. 2005 cited by Srivastava & Grube 2009) describes a

survey of 20 Canadian family doctors regarding their process for diagnosing depression. The

results indicated that although most used a screening checklist, an unspecified number also

mentioned intuition (p. 102). Further another study mentioned (Walters et al 1998 cited by

Srivastava & Grube 2009) demonstrates the relative accuracy of 60 psychiatrists judging

malingering (exaggerating symptoms) in psychotic patients using clinical judgement against the


13/22


results of the Minnesota Multiphasic Personality Inventory (MMPI): the actuarial approach

tended towards superioritybut failed to produce statistically significant results (p. 102).

The understanding of intuition in the three studies referred to by Srivastava & Grube (2009)

appear range from a simple one: the unconscious knowing in the absence of reason to the slightly

more complex definition offered by the authors: a non-conscious synthesis of internal- memory

and expertise- and external- environmental- information (p. 100).

These two papers are offered to ground the idea of intuition within social work practice,

specifically risk assessment and diagnostic assessment. They demonstrate that not only do some

mental health professionals (in this case community mental health nurses and physicians), use

intuition in their practice, but it is an important part of how decisions are made.

Intuition and implications for social work practice

A search for articles published in the last twelve years related to the use of intuition in social

work yields zero results. However using the above studies one can see that intuitive expertise

(Baylor 2001) seems most relevant to practice decisions that require assessment. Where lots of

information needs to be processed quickly, the intuition described as the non-conscious synthesis

of internal and external information (Srivastava & Grube 2009; Sinclair 2010) is most

appropriate. As found in Godin (2004) and Aflague & Ferszt (2010), the studies of nurses

involved in risk assessments, this is kind of intuition is augmented by years of experience. It

seems most closely related to what other articles refer to as practice wisdom (Kline & Bloom,

1995). This may also be the quick feeling based on a slice of information (Myers 2010) that

allows for making sense of the praecox feeling in diagnosing schizophrenia or diagnosing

depression (Srivastava & Grube 2009).


14/22


Although a literature search for social work and intuition was unfruitful, a search related to

decision making and risk assessment in social work practice resulted in a number of articles and

studies (e.g. Hurst 2011; Phillips et al. 2011; Mulvey & Iselin 2008). Many of the articles were

related to the importance of actuarial methods in risk assessment, particularly in mental health

and child protection. The practice environment described in the literature (Godin 2004; Hurst

2011) is one of increasing blame and lower tolerance for risk. There is an apparent lack of

effective actuarial tools for assessment and a call for better assessment tools (Phillips et al.

2011). Reading the literature it appears that there is a desire for measures that will increase

certainty about decreasing risk. In this environment, it is easy to understand why a researcher

would not set out to study the role of intuition in decision making and risk assessment.

Although not specific to mental health alone, McLaughlin et al. (2010) found that social

workers and other allied professionals use five sources of information for decision making in

practice: colleagues, self, the client, professional values and professional literature and research.

Although it is used, academic research is far from a primary source in decision making in

practice (McLaughlin et al. 2010; Fox 2003; Godin 2004). The reasons for not relying more on

the research component of EBP includes lack of time and access (McLaughlin et al. 2010) and

also the view that the research will not be relevant either to the client population or to the

practice environment (Zayas et al. 2010).

Another reason that social workers and other allied professionals do not use the research is

that it is unpractical for certain types of decision making (Luitgaarden 2009, p. 244). The

experimental strand of EBP and its foundation in a rational choice decision making model, is

unnatural to our way of interpreting the world as humans (Luitgaarden 2009). Indeed dual-


15/22


processing theory would support that idea. The main system of engagement is the intuitive/

experiential system and humans rely on the rational/ analytic system to check out if what we

know from experience is rational (Epstein 2010). Luitgaarden (2009) goes on to describe a

naturalistic decision-making model that fits better for social workers as people working with

people. This model including developing ideas for

Evans (2010) claims humans are cognitive misers. He explains that in reviewing the case

for the two minds hypothesis, I was struck over and over by the dominance of intuition in control

of our behavior. The belief that we have in ourselves as conscious controlling agents does seem

to be largely illusory (p. 323). This too seems to support that the research strand alone as a

focus of study in EBP will not offer what is needed to clinical social workers as primarily

intuitive/ experiential beings.

It seems to this writer that social workers and other professionals are likely using actuarial

methods to assess risk, but that these alone are not the basis of practice. Given what can be

understood about intuition and human nature in this present paper, it appears that there needs to

be greater study of what is actually taking place in practice. There are excellent research models:

collaborative (Kline & Bloom 1995) transgressive (Fox 2003) and translational (Jacobs et al.

2010) for this kind of inductive study that could blend the current modernist approach to research

with the nature of practice as a relative and phenomenological experience of an ever changing

and uncertain reality. These are the kind of studies that will be most relevant to the practice

environment and therefore of the most value to mental health practitioners.

Naumburg (2010) expresses mental health professionals understanding of risk in her

examination of the difficult decision of when to hospitalize a person or not. She states: there is a

fairly common saying in the mental health profession: there are two kinds of clinicians- those


16/22


who have lost a client to suicide and those who will (p. 280). Although that sounds terrible on

one hand, it shows that social workers and allied mental health professionals know that even with

the use of best practice tools and intuitive expertise, the world is uncertain and there is always

risk.

In a practice environment of blame and low tolerance for risk, there is a sense that clinician

intuition is not only hard to study, but not of value. The focus on best practice evidence and on

individual client circumstances and values is important, but the third prong of EBP should not be

forgotten. Intuitive expertise is an important part of clinical judgement and clinical judgement

and expertise is foundational to what makes professional mental health workers professional.

Hogarth (2010) offers that when thinking of intuition related to decision making that

intuition can educated (p.348). The author refers to three primary guidelines of how a person

can be taught how to improve judgements by: 1) selecting the appropriate environment to

provide experience; 2) seek feedback about the judgements; and 3) making the scientific

processes intuitive. Hogarth (2010) states that although this may seem like an obvious process

and parts of it (the scientific method for understanding ) are taught in school, it is one that allows

for a greater understanding into how humans process information, specifically related to intuitive

expertise, and come to accurate decisions.

Directions for further study

There are obstacles to the further study of intuition in social work practice. These include: 1) it is

a nonconscious process that isnt even always recognized by the person having the experience

(Kline & Bloom 195); 2) varying definitions of intuition make it difficult to ensure a shared

understanding of the concept (Godin 2004); and 3) the current practice environment valuing


17/22


empirical studies and actuarial methods. However, despite these difficulties there is a need to

better understand how intuition, in particular intuitive expertise, is used in practice.

Areas for further study should look more closely at decision making theory, the role of

schema and heuristics as related to assessment decision-making in mental health. This kind of

decision making is specific and brings the cognitive psychology literature out of theory and into

real world mental health practice. Hammond (2010) asserts that intuitive expertise can be learned

and this would be an area for further inquiry to see if there is value in this for social work

practice.

Further, the idea of intuition as a spiritual process that can be made conscious in order to

facilitate insight or receive information on an intuitive level would be interesting to study. This

may relate to the use of intuition in psychotherapy, both for the therapist and the client and have

cultural implications to First Nation people or religious practices that use meditation or prayer.

Intuition is a fascinating construct that has multiple implications in its understanding relative

to social work. As it related to clinical judgement and intuitive expertise it holds great value in

being further understood and developed. As stated inductive and collaborative research methods

would be useful in further understanding this elusive concept.

Conclusion

Evidence-based practice in mental health can be understood then as a three pronged model

that includes: 1) best practice research; 2) clinician expertise and judgement and 3) client

circumstances, values and equal participation. Intuition, when considered as part of clinical

expertise and judgement, comprises a significant base of practice in mental health for social

workers and other allied professionals. Although, as much that has been written about intuition

and intuitive expertise there are relatively few studies to demonstrate how this looks in practice.


18/22


The quote offered by the Emmanuel Kant at the beginning of this paper states: neither

concepts without an intuition in some way corresponding to them, nor intuition without concepts,

can yield knowledge. This quote recognizes that ideas, including best practice research ideas,

are best understood within the context of the practitioner as a whole person who brings

experience and intuitive expertise to his or her social work practice. We are all better served:

clients, their families, practitioners and researchers when this is recognized and valued.


19/22


References

Aflague, J. M. F., Ferszt, G.G. (2010). Suicide assessment by psychiatric nurses: A

phenomenographic study.Issues in Mental Health Nursing, 31(4), 248-256.

Aviram, U. (2002). The changing role of the social worker in the mental health system. Social

Work in Health Care, 35, 615-632.

Baylor, A. L. (1997). A three-component conception of intuition: Immediacy, sensing

relationships and reason.New Ideas in Psychology, 15 (2), 185-194.

Baylor, A.L. (2000). A U-shaped model for the development of intuition by level of expertise.

New Ideas in Psychology, 19, 237-244.

Elstein, A.S. (1999). Heuristics and biases: Selected errors in clinical reasoning.Academic

Medicine, 74 (7), 791-794.

Epstein, S. (2010). Demystifying intuition: What it is, what it does, and how it does it.

Psychological Inquiry, 21(4), 295-312.

Evans, J. S. B. T. (2010). Intuition and Reasoning: A Dual-Process Perspective. Psychological

Inquiry,21(4), 313-326.

Fox, N. J. (2003). Practice-based evidence: Towards collaborative and transgressive research.

Sociology, 37(1), 81-102.

Falvey, J.E., Bray, T.E. & Hebert, D.J. (2005).Case conceptualization and treatment planning:

Investigation of problem solving and clinical judgement.Journal of Mental Health

Counseling, 27 (4), 348-372

Gilgun, J. F. (2005). The four cornerstones of evidence-based practice in social work.

Research on Social Work Practice, 15(1), 52-61.

Godin, P. M. (2004). You dont tick boxes on a form: A study of how community mental


20/22


nurses assess and manage risk.Health, Risk & Society, 6(4), 347-360.

Hammond, K. R. (2010). Intuition, no...Quasirationality, yes! Psychological Inquiry, 21, 327-

337.

Hogarth, R. M. (2010). Intuition: A challenge for psychological research on decision making.

Psychological Inquiry, 21(4), 338-353.

Hurst, M. (2011). Professional judgement in the assessment of risk: Is there a role for systemic

practice?Journal of Family Therapy, 33, 168-180.

Jacobs, S., Kissil, K., Scott, D., & Davey, M. (2010). Creating synergy in practice: Promoting

complementarity between evidence-based and postmodern approaches.Journal of Marital &

Family Therapy, 36(2), 185-196.

Jeffrey, A., & Stone Fish, L. (2011). Clinical intuition: A qualitative study of its use and

experience among marriage and family therapists. Contemporary Family Therapy: An

International Journal, 33(4), 348-363.

Klein, W., & Bloom, M. (1995). Practice wisdom. Social Work, 40(6), 799-807.

Larson G. (2008) Anti-oppressive practice in mental health.Journal of Progressive Human

Services, 19 (1), 39-54.

McLaughlin, A., Rothery, M., Babins-Wagner, R., & Schleifer, B. (2010). Decision-making and

evidence in direct practice. Clinical Social Work Journal, 38(2), 155-163.

McNeill, T. (2006). Evidence-based practice in an age of relativism: toward a model for practice.

Social Work, 51(2), 147-157.

Mulvey, E. P., & Iselin, A.-M. R. (2008). Improving professional judgments of risk and

amenability in juvenile justice. Future of Children, 18(2), 35-57.


21/22


Myers, D. G. (2010). Intuitions Powers and Perils. Psychological Inquiry, 21(4), 371-377.

Naumburg, C. (2010). To hospitalize or not: Making difficult decisions in clinical practice.

Families in Society, 31(3), 280-286.

Nooney, G.L. (2008) Intuition: The bay leaf of the therapeutic stew. Conference presentation at

Third North American Conference on Spirituality and Social Work. Retrieved from:

http://www.stu.ca/~spirituality/documents/GregNooney-Intuition-TheBayLeaf of the

TherapeuticStew.pdf.

Phillips, N.L., Stargatt, R. & Fisher, L. (2011). Risk assessment: Predicting physical aggression

in child psychiatric inpatient units. Australian and New Zealand Journal of Psychiatry, 45,

638-645.

Rathunde, K. (2010). Experiential wisdom and optimal experience: Interviews with three

distinguished lifelong learners.Journal of Adult Development, 17(2), 81-93.

Regehr, C. & Glancy, G. (2010). Mental health social work practice in Canada. Don Mills, ON;

Oxford Press.

Scott, D. (1990). Practice wisdom: the neglected source of practice research. Social Work, 35(6),

564-568.

Sinclair, M. (2010). Misconceptions about intuition. Psychological Inquiry, 21(4), 378-386.

Sinclair M. & Ashkanasy, N.M. (2005). Intuition: Myth or decision-making tool?Management

Learning, 36 (3), 353-367.

Srivastava, A. & Grube, M. (2009). Does intuition have a role in psychiatric diagnosis?

Psychiatric Quarterly, 80(2), 99-106.

van de Luitgaarden, G. M. J. (2009). Evidence-based practice in social work: lessons from

judgment and decision-making theory. The British Journal of Social Work, 39(2), 243-260.
http://www.stu.ca/~spirituality/documents/GregNooney-Intuition-TheBayLeaf%20of%20thehttp://www.stu.ca/~spirituality/documents/GregNooney-Intuition-TheBayLeaf%20of%20the


22/22


Zayas, L. H., Drake, B. & Jonson-Reid, M. (2010). Overrating or dismissing the value of

evidence-based practice: Consequences for clinical practice. Clinical Social Work Journal,

39, 400- 405.

Date post:	05-Apr-2018
Category:	Documents
Upload:	heathermackay
View:	225 times
Download:	0 times

Heather's Paper on Intution

Documents