On Choosing a Therapist: Part Two
In the first post, we explored levels of qualification and ethical body membership. Now, we turn to the important area of counselling approach. If you’re looking to enter counselling/therapy (remember these terms are often used interchangeably) for the first time, then you it can hard to know what might work for you. As a person centred counsellor, it seems logical for me to advocate for my own approach, but I’m going to resist the temptation, and give a little context to the discussion. Please forgive the diversion. If this doesn’t interest you, please feel free to skip ahead to part three, where we discuss person centred and integrative approaches to therapy.
The science/art of modern therapy has been developing for many years, and continues to do so. From the early days of the psychodynamic tradition, think Freud, Jung and Adler, the therapist’s couch and the role of the unconscious in our daily lives. Through the behavioural and cognitive revolutions of Skinner, Beck, and Ellis, who argue that all behavior is conditioned by the environment we find ourselves in, to the the humanist approaches of Maslow and Rogers, who value free-will and personal meaning making. There are a multitude of frameworks of understanding, and an ever evolving depth (and complexity) to it. Yet, even as these developments continue, through MRI imaging and technological advancements in neuroscience, pharmacology and biology, we increasingly find ourselves turning to ancient wisdom for help, think yoga, mindfulness, and stoicism, to which much of modern CBT owes its roots. Yes, yes, you might be asking. A fair question. My point, if I have one at all, is to notice that there is no one set path to wellness, unless we choose it.
This notion isn’t revolutionary and, in terms of therapy is well established in therapy literature. The so called dodo bird effect, which suggests that, providing a good therapeutic relationship exists, different therapy models are, on average, just as effective as each other, but more on this later. Back on topic!
For a while now, Cognitive Behaviour Therapy (CBT) has been in the ascendency, and, if you have sought support through your GP, its likely this was what you have been offered.
In brief, CBT, as name implies, takes the approach that what we think (cognitions) strongly influences how we behave and feel. As CBT can often be delivered quiet quickly (and therefore relatively inexpensively) it has been the darling of the NHS for some time. That’s not to say that it isn’t effective, it certainly can be. The problem (as with many modalities) is how successful it is hard to determine. With research studies often conducted by converts (CBT practitioners), controlling for researcher bias can be difficult. If efficiency and cost savings are the driving force behind its adoption, well, I don’t think any of us would be too surprised in today’s world.
All that being said, therapists from other orientations, such as person centred, or integrative (again, more on these later) will often incorporate ideas from CBT, recognising that clients can find them really helpful. CBT has been found to be particularly effective for certain issues, people struggling with phobias, for example. But also, anecdotally, some people find that, though CBT framings of problems make sense to them, they may not be enough on their own.
In the next post, we’ll look at the role of relationship, especially in the context of person centred and integrative approaches.
