A model of therapy...

What are the benefits and problems associated with being true to one specific therapy model in contrast to being more “eclectic” in one’s clinical orientation?
 
While there are hundreds of theoretical positions, techniques, and models therapists can possibly use when working with clients, there are differing ideas as to whether there are benefits to being true to the practice of one specific model of therapy or not. Those therapists who strictly adhere to one model understand that models were developed through well-designed studies based on proven empirical data and evidence. Following one model allows for easier evaluation, implementing routine procedures and techniques, and can be practiced in any situation where there may be doubt in regards to problem identification or case management.

Therapists understand each model as including a theory, an explanation of human behavior, a unique understanding of key techniques that lead to change, and goals of therapy. This presupposes an over-simplification of problem identification and leads one in thinking of clients in statistical, not human, terms. Basic psychology teaches us that each person is built of differing experiences, perceptions, beliefs, cultures, and relationships. Those that oppose the idea of operating under one theory, approach therapy from an “eclectic” clinical orientation, believing that models do not offer a “one-size-fits-all” solution. To take an “eclectic” approach means to view an individual as a whole complex picture and to introduce multiple models of therapy that address all the aspects of a clients’ needs in any given moment. These therapists take a diversified view and argue that there is no single approach to treating clients; since every person, situation, and experience is unique. After all, “the whole is more than the sum of its parts”.

The benefits of an eclectic approach allow therapy to be tailored to the client’s specific goals (not the therapist’s), take into account the client’s personal and emotional limits, physical constraints, and introduce techniques that empower the client to set goals that make sense to the client (not the therapist). The key advantages to an eclectic approach are its flexibility and its focus on the whole individual. In this way, therapy can meet the client/s where they are. I believe, just as it is generally believed, that the most effective component of therapy, above any specific technique, is the quality of the relationship between the therapist and the client. Research finds that factors such as empathy, warmth, and the therapeutic alliance to be stronger predictors of client engagement and success as compared to any specialized treatment focus or intervention (Lambert & Barley, 2001). When an “eclectic” approach is taken, it forces the therapist to look beyond empirically based interventions and ask what else about this person (i.e., their strengths, their vulnerabilities) do I need to know? However, being “eclectic” means that one cannot ever be an expert in any one or all therapeutic disciplines. In essence, they are a “jack-of-all-trades, and masters of none”.

Is there one right answer? Of course there is no one right answer to this debate. While there are proven benefits to each therapeutic model, “it has not been possible to show that one therapeutic approach is clearly superior to another” (Grencavage & Norcross, 1990, p. 372). Therapists have to understand that each approach to therapy, i.e., a strict practice or allegiance to one specific model or integrating various models, has an equal amount of inherent benefits and potential limitations. Therefore, taking and either/or position would neglect the benefits of operating in accordance to either one. On one hand, when one becomes too fixed on techniques, they can inadvertently lose sight of the power of human experience and individuality. Research has found that the more technically focused a therapists becomes, they less effective they are in maintaining a therapeutic alliance, and thus, unintentionally interfere with creating therapeutic change (Castonguay, Godfried, Miser, Raue, and Hays, 1996). On the other hand, a theory or model offers clinicians an essential road map; a guide to understanding a clients problem and in their search for solutions. Just as patients would seek out the expertise of a cardiologist for a heart problem, clients need therapists to act as experts in their field.
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In the end, therapists cannot dismiss one approach over the other and must be true to each side equally in accordance to what is needed by the client in the moment. As a practicing marriage and family therapist I have come to understand when a client needs me as the “expert”, and the will give them this side of me (As best I can, meaning I may have to refer them to another clinician depending on their needs). Other times, they need me to understand a part of them, and at that point, I allow them to be their own expert. I see the true answer in practice as honoring the whole of the profession and the whole of the client.