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By Michael Zone, LCSW, MS, MEd  A familiar story
You’ve decided, “this is it!” I’m finally going to confront the obstacles in my life, overcome my fears and become the person I was meant to be. You enter therapy with optimism, hope and excitement. Perhaps, you even cry tears of happiness that you are going to put the years of failure, negativity, loneliness, and insecurity behind you. You begin the therapeutic relationship and it feels good for a while. After all, you are taking action. Doing something. Taking control of your life. Some progress is made, to be sure. But . . . But, you have not made the significant changes you were expecting and hoping for at the beginning of therapy. You continue to talk about the same issues endlessly with little, sustained progress. You feel better temporarily but it never lasts very long. Despite months and years of therapy you are essentially the same person. You are still depressed, or anxious, or lonely or OCD or phobic or insecure. Why haven’t you reached your full potential?
Therapeutic approaches (and limitations)
The theories of emotional disturbance and upset are legion – Psychoanalytic, Psychodynamic, Person-Centered, Gestalt, CBT, REBT, Transactional Analysis, NLP, EMDR, Reality Therapy, Psychodrama, Behavior Modification, Hypnotherapy and Biofeedback to name just a few. Most therapists consider themselves “eclectic,” which often means they have a little bit of training in several different theories and perhaps a full, multi-year training and certification in one theory. Often, the counseling relationship consists of a large dose of Carl Roger’s Person-Centered approach (unconditional positive-regard, empathy and genuineness) combined with a hodge-podge of other therapeutic interventions that are added as needed. Often, the focus of counseling changes from session to session depending on what the “crisis of the week” is and without regard for continuity of treatment.
Different counseling theories developed different understandings of the causes and etiologies of emotional difficulties and designed interventions to address those causes. Without a full understanding (and training) of those theories it is challenging to know when to combine interventions that developed in one theory but are being used in combination with another theory. After all, free association and challenging cognitive distortions developed as interventions for psychoanalytic and CBT, respectively. They were developed based on a unique understanding of what caused emotional disturbance from a psychoanalytic and cognitive-behavioral perspective. If there is not a clear understanding of why these interventions are used, then there is a risk that they will not be used effectively. It would not seem to be clinically appropriate to ask about a client’s dreams or “if you were a chair what kind of chair would you be” simply because it might be “interesting” or a continuing education class was taken on the subject or a therapist was stuck and didn’t know where to go.
Therapy should have a well-formulated goal and direction and a guiding theory that provides some kind of structure and focus. Otherwise, a therapist can be “all over the place” and struggle with helping a client stay on task. Most medical practitioners follow the disease model and prescribe interventions based on the accepted causes of physical maladies and after a diagnosis has been made. They have a guiding theory of disease and interventions based on that understanding. Usually, they do not prescribe a course of treatment and then suggest you “throw in” a couple of sessions of acupuncture because “it couldn’t hurt.”
The targeted use of multiple interventions
It’s an axiom that “one sizes does not fit all.” I am not suggesting that therapists cannot or should not be “eclectic” and combine different theories and interventions. On the contrary, I believe it to be therapeutically powerful and necessary to use a wide arsenal of therapeutic techniques in helping clients overcome problems, challenges and difficulties. However, it is important to have a full and complete understanding of the different theories in order to best understand how and when to use different interventions. The choice to use a particular intervention must be made consciously, thoughtfully and with an understanding of what effect that intervention will have on the client’s treatment. Understanding why that intervention was developed for the particular theory in question is essential. If that understanding is lacking, we run the risk of engaging in the therapeutic version of “just do it!” with no rhyme or reason.
Real and lasting change comes about when several approaches are brought to bear on whatever therapeutic issues our clients come in with. Cognitive-behavioral interventions can address issues at the conscious level, psychodynamic techniques can address unconscious obstacles to growth while hypnotherapy can target the sub-conscious. A person-centered approach can create a safe and supportive environment while social skills role-playing can provide some experiential practice. Being eclectic is vital to helping clients achieve their full potential. Being a “one trick pony” in regards to any psychological theory may lead to therapeutic stagnation and client failure.
Maximizing human potential
Being a therapist and helping people to overcome serious and debilitating emotional upset is one of the greatest privileges I can imagine. It is an honor to be allowed to share in the most personal thoughts and feeling that a person can have. I consider it a sacred trust to be allowed to help someone achieve whatever hopes and dreams they have and to utilize the best techniques, skills and knowledge available to reach that goal. Eclectic but targeted and well-understood therapeutic theories and intervention is essential for helping clients make real and lasting gains. I have had the privilege of helping people achieve their goals as a special education teacher, attorney (mediator) and social worker/mental health counselor. I am humbled by the responsibility and motivated to provide the best course of treatment available. Everyone deserves to achieve their full potential. About the Author...
Michael Zone, LCSW, MS, MEd is a social worker in private practice and a special education teacher. He specializes in working with professionals on work-related and interpersonal issues and children and adolescents on school and relationship challenges. Mr. Zone also works with people who have not had success or a satisfactory experience with counseling and therapy in the past. Last Update: 5/25/2017
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