How to Choose Your Theoretical Orientation

OnlineCounselingPrograms.com presents a guest post by Myron Nelson, LCPC from Concentric Counseling and Consulting, outlining how to develop your theoretical orientation.

Myron Nelson is a Licensed Clinical Professional Counselor (LCPC), working in the heart of Chicago at Concentric Counseling and Consulting. Concentric is a therapy and counseling group practice in downtown Chicago offering individual therapy, couples and marriage therapy, child, adolescent and family counseling, teletherapy and online counseling as well as clinical supervision and consulting services.

The therapists at Concentric are compassionate and experts in relationship problems, marriage, couple, and family issues, addictions and compulsive behaviors, substance abuse, depression, anxiety, and bipolar disorders, and unresolved family-of-origin issues and varying degrees of trauma. Starting his career in community mental health and nonprofit work, Myron’s experiences and training offer an accessible perspective on psychotherapy.


Choose Your Orientation by Practice

It is easy to be enamored by an influential author or awestruck by a theory’s concepts but that does not automatically translate into successful treatment. I will pass on advice that was given to me and served me well.

Choose a theoretical orientation based on how comfortable and effective it is for you in practice. Explore the boundaries of what you understand and enjoy about using a theoretical framework beyond the textbook.

In therapy, words on a page are much easier read than realized. Abstract existentialist ideas may be the root of someone’s problems, but if you cannot connect that to their daily struggles, that conversation may do more harm than good. If you want to conceptualize systematically but do not naturally think broadly, try out a more symptom-focused approach. Use your training or transitioning as a time of exploration.

You are expected to, and hopefully encouraged to make some mistakes while you’re learning. You are not expected to be perfect, so embrace that freedom. Trying out different techniques and philosophies make the intangible elements of theories tangible. It’s very different reading about how to swim than actually jumping in the deep end. Additionally, keep in mind that you are not starting from absolute zero. You already have pre-professional years of conversation and self understanding to draw from, so use experience as your guide but implementation as your filter.

Be Careful of Influencing Factors

Each theory has had its heyday, and with it, ardent followers. Be mindful of why you are drawn toward certain orientations over others. Are you simply following the lead of your favorite professor? Or is your school steeped in a single framework? Maybe your supervisor is the perfect blend of charismatic and effectual which makes their orientation appear to be the best. Do not let your environment be the only factor. Recognize the biases in your professional community and investigate alternative approaches. Go beyond your one semester class that tries to cram the buffet of ever expanding theories into digestible bits and pieces. You may be surprised at what language or interesting ideas you find. At worst, you confirm your initial thoughts about your practice. At best, they give you an advantageous perspective on your work.

A theoretical orientation is almost as important as everything else in therapy.

Our profession places substantial weight on the decision of what orientation you choose, potentially more for ourselves than for the people we serve, but it’s a weighty task nonetheless. However, its importance is equaled to, if not surpassed by, the common factors of therapy (Laska et al., 2014; Rosenzweig, 1936). Depending on the research, the common factors of therapy, which include but are not limited to the therapeutic alliance, goal consensus or collaboration, and empathy, impact 30-70% of therapy’s success. Given that these factors play an unquestionable role in therapy, try to keep a balanced perspective when choosing a theoretical framework.

Your clinical orientation is extremely important to your work as it provides a foundation and language for therapy. At the same time, don’t let it overshadow the other critical factors of your work including how you present and relate to others.

Be Open and Evolve

Once you make a decision, it isn’t permanent. We are not married or beholden to our theoretical orientation. As you progress in the field, keep an eye out for training opportunities that differ from clinical information you normally consume. Every theory contains transformative and potent ideas. Or put more cynically, even a broken clock is right twice a day. If you subscribe to psychoanalysis, do not be afraid to take a seminar on family systems work or attend an art therapy workshop if you’re a strict behaviorist. Reexamining how you approach a clinical problem is only beneficial. The more angles from which you can view an object only gives you a better understanding of how it truly looks.

How I Chose

My graduate program at Boston University was atheoretical but different professors leaned toward psychoanalysis, cognitive-behavioral theories, and positive psychology. The diverse playground of the theories piqued my curiosity. I spent the summer in between my master’s program reading the big name theorists in search of an answer. But they all seemed to have something worthwhile to offer. Feeling stuck, I asked for informational meetings with professors and therapists in the community. It was then that I was given the advice I gave before. So I kept reading and kept practicing. I realized that my biggest strength in conversation is being able to understand the other person’s perspective, which fit well with person-centered therapy.

I delved further into Carl Roger’s work and recognized that this theory not only matched my worldview, but it was easy for me to communicate, and felt comfortable to implement. I have since adopted some cognitive-behavioral language and positive psychology interventions when needed. I have humanistic roots but I’m willing and ready to adapt based on new research and the needs of my clients. Theoretical orientations are our tools for the making so be open and be mindful.

References

Laska, K. M., Gurman, A. S., & Wampold, B. E. (2014). Expanding the lens of evidence-based practice in psychotherapy: a common factors perspective. Psychotherapy, 51(4), 467.

Rosenzweig, S. (1936). Some implicit common factors in diverse methods of psychotherapy. American Journal of Orthopsychiatry,6(3), 412.


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