Therapy is not one size fits all

Psychotherapy :: Therapy is not one size fits all

The new school of thought is that there is not just one correct school of thought when it comes to counseling people. In actual practice, therapists mix theories and methods in order to produce best practices for helping clients.

Experienced therapists tend to base their practices upon the core processes that define psychotherapy across the theories. However, textbooks are still divided into specific theories.

A new book, written by two University of Missouri-Columbia experts, aims to revolutionize the way psychotherapy is taught and break the pattern. These scholars encourage students to recognize that the strength of the therapeutic relationship is highly associated with therapeutic outcome, and that therapy proceeds through the basic stages: engagement, pattern, search, change and termination.

"Traditionally, psychotherapy has been driven by specific theoretical orientations and their corresponding techniques. However, these specific orientations rarely coincide well with the needs of clients," said Glenn Good, associate professor of educational, school and counseling psychology in the MU College of Education. "Complex theories often have very limited application."

Only about a third of all people who seek therapy have a favorable outcome to the first intervention, according to Good. It is important for therapists to have a variety of ways to treat people.

"A therapist stuck in just one school of thought is not going to have enough tools to help every client," Good said. "We are not trying to sell a Ford, Chevy or Toyota. We are just trying to make the best car we can, and that is good therapy."

A client may seek therapy because a series of set backs in life. The client may be discouraged or depressed because the future seems bleak. Drinking may be the short-term solution being used to combat anxiety in this situation.

"This client does not need to have their childhood experience analyzed. Instead, he or she needs some tangible solutions in order to feel better now," Good said. "There are some basic life skills and formulas that can be derived from several schools of thought that could help in this situation. It is important that a therapist not try to make each client fit into a certain mold."

The book - Counseling and Psychotherapy Essentials: Integrating Theories, Skills, and Practices - will be highlighted in an upcoming edition of Yale Medicine. Bernard Beitman, co-author of the book and chair of the Department of Psychiatry in MU's School of Medicine, is a Yale alumnus.