Good psychotherapists continually ask themselves questions — questions about theory, and questions about practice.
Theory: “How do I understand this?” That is, what is my understanding of my client’s presentation, and how did they arrive here? What is my theory of how their suffering began, how is it maintained, and what are my beliefs about how people change?
Practice: “What should I do?” Given my understanding, how should I proceed? How do I conduct a course of therapy for this person and, most urgently during a session, what is my next move?
Theory exists to support the therapist in their work. Theory brings structure and clarity to what can seem like a confusion — or even a chaotic eruption — of thought, feeling, and behavior. And theory helps to translate our understanding into appropriate, ethical, and helpful therapist practices.
While there are a great variety of appealing theories available to the clinician, I believe it can be quite organizing to be supervised from a specific theoretical perspective — and, if possible, to join a cohort of people learning a similar approach to the work. This allows the clinician to muster a significant degree of competence in a particular area without being diverted toward other, perfectly good but possibly contradictory, directions.*
At GETME, I supervise from the perspective of experiential therapy.
In particular, I mean Client-Centered Therapy, Gestalt-Therapy, and Emotion-Focused Therapy (EFT begins as an integration of Client-Centered and Gestalt therapies). These approaches share philosophical assumptions about personhood, the causes of suffering, and what processes might be helpful — though they can differ in the interventions they offer to engender these processes.
I run Supervision Groups that meet twice a month: An in-person group that meets Thursdays from 1 to 2:30; and one on Fridays on Zoom from 11 to 12:30. Please contact me if you are interested in joining us.
Note: At this time I’m not able to take on any additional individual supervisees. I do have room in my new Thursday afternoon supervision group.
*One popular meta-theory holds that clinicians should learn as many theories as possible in the belief that this gives them the biggest set of tools with which to help. I have some sympathy with this position, but not because of the number of tools it affords. The trouble is that owning a tool and knowing how to use it are not the same — and the difference can be dangerous.
Like undergraduates taking required “core courses” freshman year, or counseling students taking the “counseling theories” survey course, I believe wide exposure is, up to a point, an excellent thing. But somewhere along the way it’s advisable to pick an approach and get really good at it.
My meta-theory is this: Each of the major counseling theories has its own way of addressing most of the major client presentations. Thus, becoming truly expert in a particular way of working will prepare you for the vast majority of clients who come to see you.
Now, if you’re working with someone, and things aren’t going well, you could switch your approach on the grounds that this client requires another form of therapy.
Another possibility is that you aren’t yet as skilled in applying your initial approach as you could be. This is where supervision comes in. If you’re struggling with a client, it’s better to take the case to supervision than to immediately assume a client/theory mismatch. Supervision will help you figure out where the problem is.
If you’re really good at something, and it isn’t helping, refer. But it won’t happen too often: All the theories work. The best way to gain competence in a particular theory is study, training, and ongoing supervision.