Previously I have discussed the many layers that are present in a therapy session. One of those layers is which therapeutic technique to use at any given time. Most clinicians are taught more than one in graduate school and then we learn more as we attend trainings, read books and research, and work in different settings that expose us to more options. This is one reason that a lot of clinicians say they use an “eclectic” approach. But what does that mean?
My first clinical supervisor, Marty Weems, had a profound influence on me. She mostly uses CBT and motivational interviewing and dislikes to the phrase “eclectic approach” since it’s really vague and sometimes means “I don’t know what I’m doing.” And it’s true there are a number of clinicians who use it to mean they go with their instincts, provide supportive therapy and give practical feedback in the absence of real psychotherapeutic interventions. But other clinicians are intentional about which techniques they use and when they use them.
How do you know which kind of therapist you’re seeing? The therapist should be able to tell clients what techniques they are using and why. I’m a very transparent therapist for two main reasons: I believe in empowering clients with information and I know the importance of placebo effects. Placebo effects? What do those matter when using evidence-based treatment?
They matter a lot. We know that even real pain medication, for example, is far more effective if the person receiving it is told “here is some pain medication and it will help.” I concluded that the same is probably true in psychotherapy, so I tell clients what it is that we’re doing and why exactly it’s supposed to be helpful.
Marty instead prefers to call this an “integrative” approach, meaning that if a clinician is going to graft pieces of different therapies together, it’s done thoughtfully and intentionally. Whatever someone chooses to call the blending of different therapies, there should be consistency for the client and logic to the flow.