Which Theoretical Orientation Should You Choose?

Curt and Katie chat about how therapists typically select their clinical theoretical orientation for treatment. We look at the different elements of theoretical orientation (including case conceptualization, treatment interventions, and common factors), what impacts our choices, the importance of having a variety of clinical models to draw from, the types of practices that focus on only one clinical theory, and suggestions about how to approach choosing your theories for treatment, including some helpful assessments.
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In this podcast episode we talk about how therapists pick their theoretical orientation
We received a couple of requests to talk about clinical theoretical orientation and how Curt and Katie chose their own. We tackle this question in depth:
Choosing a clinical theoretical orientation
The problem with the term “eclectic” when describing a clinical orientation
How Curt and Katie each define their clinical orientations
“Multi-modal” therapy
The different elements of clinical orientations
Case conceptualization
Treatment interventions
Common Factors and what actually makes therapy work
What impacts which theoretical orientation we choose as therapists
Clinical supervision
Training
Personal values and alignment with a theoretical orientation
Common sense (what makes sense to you logically)
Choosing interventions that you like
The importance of having a variety of clinical theories that you can draw from
Comprehensive understanding is required to be able to apply and know when not to apply a clinical orientation
Avoid fitting a client’s presentation into your one clinical orientation
Deliberate, intentional use of different orientations
Why some therapy practices operate with a single clinical model
Comprehensive Dialectical Behavioral Therapy (DBT) therapists run their practices and their lives with DBT principals
Going deeply into a very specific theory (like DBT, EMDR, EFT, etc.) while you learn it
Researchers are more likely to be singularly focused on one theory
Suggestions on How to Approach Choosing Your Clinical Theoretical Orientation
Obtain a comprehensive understanding of the theoretical orientation
Understand the theory behind the interventions
Recognizing when to use a very specific theory or when you can be more “eclectic” in your approach
Deciding how fluid you’d like to be with your theoretical orientation
Find what gels with you and do more of that
The ability to pretty dramatically shift your theoretical orientation later in your career
Instruments for Choosing a Theoretical Orientation
Theoretical Orientation Scale (Smith, 2010)
Counselor Theoretical Position Scale
Our Generous Sponsor for this episode of the Modern Therapist’s Survival Guide:
Buying Time LLC
Who we are:
Curt Widhalm, LMFT is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making "dad jokes" and usually has a half-empty cup of coffee somewhere nearby. Learn more at: www.curtwidhalm.com
Katie Vernoy, LMFT is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt's youthful energy, so that she can take over the world. Learn more at: www.katievernoy.com
A Quick Note:
Our opinions are our own. We are only speaking for ourselves - except when we speak for each other, or over each other. We’re working on it.
Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

[@MMRatty]

I just had my faculty review board session and absolutely got slaughtered over saying I was leaning toward Eclectic-- I am so glad I found this podcast!

[@DigitalPsyche]

The biggest criticism I have had of our clinical competency exam as a clinical psychologist is that it is exactly as you described; a post-hoc rationalization. In fact, I have described it as such on many occasions. I’m only halfway through my doctoral progamme and I do not have a Master’s degree but I have considerable clinical and life experience. I have been told I am at a ‘different developmental level’ than my peers (no shit, I’m over 40).
My dissertation is on this topic and the development of common factors for trainees but I am in the early stages of the work.

[@javiermontiero4982]

That elimination game y'all briefly mentioned sounds interesting. I would love to know what game this is so I can look into it and maybe check it out with my friends and colleagues. Could y'all tell me where to find this game and/or what exactly it's called or anything more to help my search? I haven't found it across a few search ideas I had.

[@melissalemke8614]

I don't know about the game but this is one of the two scales they referenced. study.sagepub.com/system/files/Theoretical%20Orientation%20Scale%20Online_0.pdf

[@pugninja7037]

I'm in the UK doing my level 4 and there's so many types of therapy, and all theories seem so similar just different words.. that when I do talk to a c person online with a issue it can be hard.im thinking of a question to ask and I get lost. This helped.thank you.