Which Theoretical Orientation Should You Choose?

Which Theoretical Orientation Should You Choose?

Curt and Katie chat about how therapists typically select their clinical theoretical orientation for treatment. We look at the different elements of theoretical orientation (including case conceptualization, treatment interventions, and common factors), what impacts our choices, the importance of having a variety of clinical models to draw from, the types of practices that focus on only one clinical theory, and suggestions about how to approach choosing your theories for treatment, including some helpful assessments.

In this podcast episode we talk about how therapists pick their theoretical orientation

We received a couple of requests to talk about clinical theoretical orientation and how Curt and Katie chose their own. We tackle this question in depth:

Choosing a clinical theoretical orientation

• The problem with the term “eclectic” when describing a clinical orientation
• How Curt and Katie each define their clinical orientations
• “Multi-modal” therapy

The different elements of clinical orientations

• Case conceptualization
• Treatment interventions
• Common Factors and what actually makes therapy work

What impacts which theoretical orientation we choose as therapists

• Clinical supervision
• Training
• Personal values and alignment with a theoretical orientation
• Common sense (what makes sense to you logically)
• Choosing interventions that you like

The importance of having a variety of clinical theories that you can draw from

• Comprehensive understanding is required to be able to apply and know when not to apply a clinical orientation
• Avoid fitting a client’s presentation into your one clinical orientation
• Deliberate, intentional use of different orientations

Why some therapy practices operate with a single clinical model

• Comprehensive Dialectical Behavioral Therapy (DBT) therapists run their practices and their lives with DBT principals
• Going deeply into a very specific theory (like DBT, EMDR, EFT, etc.) while you learn it
• Researchers are more likely to be singularly focused on one theory

Suggestions on How to Approach Choosing Your Clinical Theoretical Orientation

• Obtain a comprehensive understanding of the theoretical orientation
• Understand the theory behind the interventions
• Recognizing when to use a very specific theory or when you can be more “eclectic” in your approach
• Deciding how fluid you’d like to be with your theoretical orientation
• Find what gels with you and do more of that
• The ability to pretty dramatically shift your theoretical orientation later in your career

Instruments for Choosing a Theoretical Orientation

• Theoretical Orientation Scale (Smith, 2010)
• Counselor Theoretical Position Scale

Resources for Modern Therapists mentioned in this Podcast Episode:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

Institute for Creative Mindfulness

Very Bad Therapy Podcast

Petko, Kendrick and Young (2016): Selecting a Theory of Counseling: What influences a counseling student to choose?

What is the Best Type of Therapy Elimination Game

The Practice of Multimodal Therapy by Arnold A. Lazarus

Poznanski and McClennan (2007): Measuring Counsellor Theoretical Orientation

Relevant Episodes of MTSG Podcast:

Unlearning Very Bad Therapy

Interview with Dr. Diane Gehart: An Incomplete List of Everything Wrong with Therapist Education