I use the term “eclectic therapist” when describing my counseling style. This means that I use a variety of counseling methods in order to build rapport, assess for issues and to help clients discover their own answers to their problems. I’m asked to describe which techniques and approaches I use on various marketing directories and when I speak with potential clients. I have mixed feelings about this line of questioning.
On one hand, transparency is good. It can feel empowering to be able to ask a potential therapist which styles they tend to gravitate towards and hear their answer. Knowledge is power, right?
On the other hand, unless one has studied mental health counseling, or have been engaged in the work for awhile, jargon is jargon. The “buzz word” of today is CBT- Cognitive Behavioral Therapy. Doctors recommend it. The internet loves recommending it. I understand how to practice CBT, and with an eclectic/multifaceted approach, I will use it if I believe it will help my clients.
I don’t think that CBT is the best therapy, however, when treating trauma. Much of CBT involves looking at one’s thought processes and examining the effects thoughts have on emotions. Pessimistic thoughts? Probably gonna lead to a lower mood compared to someone who actively cultivates a more “balanced” or positive viewpoint. CBT asks that clients be on the look-out for irrational thought patterns, or “cognitive distortions”, when going through day-to-day experience. I think that CBT philosophy can be dismissive of a client’s traumatic experiences. I believe that CBT’s focus on the present day can marginalize the stories clients tell about their past. Negative thoughts and, therefore, feelings about having been attacked? Ohhhh, cognitive distortion!!! With its homework assignments, “scientific approach” and mood charting, CBT can be tedious, formulaic, and boring.
I think that Emotion Focused techniques, along with body work, self-compassion, narrative therapy and IFS (Internal Family Systems) “Parts Work” are better, more compassionate, approaches to healing trauma compared to CBT. Cognitive Behavioral Therapy is the known buzz word right now because insurance and pharmaceutical sales companies have paid for studies that demonstrate CBT’s effectiveness. Perhaps CBT is appealing for these industries because it is supposed to be a short-term treatment modality. As our society moves farther into its embrace of the medical model, long term use of medications and short-term use of talk therapy becomes the norm.
A professor pointed out to me that many times clients who want to immediately use a lot of jargon at the start of therapy (“Alia, I want to focus on using DBT and CBT in our sessions…”) are using such intellectualization as a form of defense. It might be difficult for these folks to trust the therapeutic process, to trust that I’ve done my research. It’s something for me to consider during my on-going assessment.
As someone who is self-employed and *not quite* at a full caseload, I am trying to give my clients what they want! I am willing to be flexible and am confident in my abilities to define various techniques if asked. As I do fill up my practice, though, I can imagine myself becoming more selective with which clients I will take on. I know I will become firmer about which techniques I will and will not use. Frankly, an over-reliance on CBT and DBT worksheets bores me. Who wants their clinician to feel stifled and bored?
