Publication Date


Document Type

Masters Thesis


School for Social Work


Social workers-Attitudes, Physical-appearance-based bias, Size bias, Attitudes and behavior, Size oppression


This qualitative study provides in an-depth exploration of clinical social workers' experiences with their overweight and obese clients. As the "War on Obesity" rages on, clinical social workers have come to occupy a unique position in understanding and addressing the needs of this population. This study seeks to add to the growing clinical literature on size bias in psychotherapy and intends to explicate the clinician's experience in both establishing and maintaining therapeutic relationships with these clients. Nine licensed clinical social workers were interviewed about their attitudes towards their overweight and obese clients and their experiences as they worked with them. The findings demonstrated that clinicians' relationships with their clients were marked with great challenge and complexity. Clinicians felt overweight and obesity could be highly problematic to clients psychologically, physically and socially. At the same time, implicit anti-fat attitudes were frequently revealed in clinicians' narratives and may have been unintentionally communicated to clients. An overarching theme was the strong negative countertransference reactions that clinicians experienced in their work with these clients, primarily around weight-related discussions. This research suggests that social work clinicians may benefit from cultural competence training in their work with overweight and obese clients and could benefit from examining their own relationships to their bodies and the ways this relationship enters the therapeutic space.




iii, 79 p. Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2012. Includes bibliographical references (p.63-72)

Limited Access until August 2017