Behaviorist at a Psychdynamic School?

[Student4Life0]

Hi all, I have a question about Widener's PsyD program. It looks like a pretty solid program, and I am considering applying in the winter. However, my heart sank when I read this on their website:

"While the primary theoretical orientation of the program is psychodynamic, students are also exposed to a number of other orientations, including cognitive/behavioral, social constructionist, interpersonal, and family systems."

My orientation is CBT, and I'd say I am more interested in the behavioral aspects. Would this program be wrong for me? It does say that cbt is represented, and further down on the page it states that a "curricular cluster" is possible in CBT. But what exactly is a curricular cluster? Is this like a concentration?

Any advice would be apreciated!

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[stigmata]

You need to get a solid education in all orientations, so that seems logical to me.

 

[Student4Life0]

You need to get a solid education in all orientations, so that seems logical to me.

While I agree with this, it makes me uncomfortable to think that a school's major orientation is psychodynamic. I went to Hofstra's PhD open house yesterday, and it is very clear that they are 100% CBT oriented and proud of it. This appealed to me. But at the same time, Widener looks like a well respected and put together program, with gauranteed internship placements.

 

[IT514]

As long as there are a good handful of people there that are doing the kind of clinical work and/or research that you see yourself doing in the future, I wouldnt worry about what the website says. Plus, from a neuroanatomical perspective, I think there are some good applications of psychodynamic therapy that can do what CBT cannot do. That is, unless you want to be one of those people who will take anything that works (like emotion-focused therapy) and call it CBT.

 

[Zigman]

...from a neuroanatomical perspective, I think there are some good applications of psychodynamic therapy that can do what CBT cannot do...

Would you point me in the direction of some literature on this? Thanks!

To the OP:

I am in a program which apparently has a reputation for being quite psychodynamic. I've received excellent rounded training covering the range of all major psych theories/models. I've also worked closely with two behaviorist faculty and developed my concentration there. I'm familiar with Widener, and would think you would get excellent rounded training there as well.

 

[KillerDiller]

Plus, from a neuroanatomical perspective, I think there are some good applications of psychodynamic therapy that can do what CBT cannot do.

Can you clarify what you mean by this?

 

[docma]

The term "psychodynamic" is used by a fairly broad range of folks these days and is no longer "owned" by the classical psychoanalytic crowd. I think you would be making a mistake to rule out the program based on this terminology alone. Many practitioners work in a CBT framework in terms of interventions but integrate biopsychosocial formulations and draw on attachment theory, control mastery theory, self psychology and interpersonal models, all of which are in the "psychodynamic" lineage. It is far more relevant to look at faculty bios and areas of research and application to get a sense of the program. And their guaranteed internship program is unique and takes a lot of stress out of the graduate school process.

 

[IT514]

Would you point me in the direction of some literature on this? Thanks!QUOTE]

These two can serve as primers:
Shevrin, H. (2001). Event Related Markers of Unconscious Processes. International Journal of Psychophysiology, 42, 209-218

Liddell, B., Williams, L., Rathjen, J., Shevrin, H., & Gordon, E. (2004). A Temporal Dissociation of Subliminal versus Supraliminal Fear Perception: An Event-related Potential Study. Journal of Cognitive Neuroscience, 16(3), 479-486.


Here is a link to the April 2006 issue of psychiatric annals. I'm referring to the two articles by Viamonte and Beitman.
http://www.psychiatricannalsonline.com/view.asp?rid=20682

 

[KillerDiller]

Would you point me in the direction of some literature on this? Thanks!QUOTE]

These two can serve as primers:
Shevrin, H. (2001). Event Related Markers of Unconscious Processes. International Journal of Psychophysiology, 42, 209-218

Liddell, B., Williams, L., Rathjen, J., Shevrin, H., & Gordon, E. (2004). A Temporal Dissociation of Subliminal versus Supraliminal Fear Perception: An Event-related Potential Study. Journal of Cognitive Neuroscience, 16(3), 479-486.


Here is a link to the April 2006 issue of psychiatric annals. I'm referring to the two articles by Viamonte and Beitman.
http://www.psychiatricannalsonline.com/view.asp?rid=20682

Nobody with a working knowledge of the brain would argue that psychotherapy does not elicit neuroanatomical changes. Everything we experience has neurocorrelates. We, as a field, also know that learning changes the brain and that psychotherapy facilitates learning along with growth and other positive effects.

I do not see any evidence in the citations you provided, however, that leads me to think that "there are some good applications of psychodynamic therapy that can do what CBT cannot do." This is a huge leap. These aren't comparative studies. Also, the model of the unconscious that is used in the first two articles you cited is much closer to the model employed in cognitive psychology than it is to Freud's concept of the unconscious.

I think such studies will be interesting in the future, but considering we are just now beginning to understand the exact effects that therapy and medication have on the brain, studies that can tease apart any differences between therapies are a ways away.

 

[IT514]

I wasnt trying to say that psychodynamic therapy is superior to CBT for all patients of all ages and with any disorder. Perhaps these are better citations, though I dont find as helpful as the ones I previously posted from a cognitive and affective basis. And no, they arent comparative.

Leichsenring, F., Hiller, W., Weissberg, M., & Leibing, E. (2006). Cognitive-Behavioral Therapy and Psychodynamic Psychotherapy: Techniques, Efficacy, and Indications. American Journal of Psychotherapy, 60(3), 233-259.
Lanza, M., Anderson, J., Boisvert, C., LeBlanc, A., Fardy, M., & Steel, B. (2002). Assaultive Behavior Intervention in the Veterans Administration: Psychodynamic Group Psychotherapy Compared to Cognitive Behavior Therapy. Perspectives in Psychiatric Care, 38(3), 89.
I'm not trying to sell anyone here on psychodynamic therapy. If someone made me pick a orientation for therapy, I would probably say that I'm a behaviorist. I'm just saying that the the brain does not conform to a CBT only framework, thus a clinical approach should focus on other things in addition to the cognitive, like emotions and drive models. Or, like I said earlier, if you are one of those people who takes anything that works and calls it CBT, I guess you can do anything you want. This seems to happen a lot with emotion focused research that somehow gets labled as CBT.

Regarding the Shevrin articles, I didnt conceptualize them as either psychodynamic or cognitive. How about both?

 

[stigmata]

I think the assumption that CBT only affects cognitive and/or behavioral issues and the corresponding brain structures does not make sense at all.

 

[IT514]

Me either, stigmata. I guess it comes down to how wide you want to cast your CBT net.

 

[deleted176373]

my heart sank when I read this on their website:

"While the primary theoretical orientation of the program is psychodynamic, students are also exposed to a number of other orientations, including cognitive/behavioral, social constructionist, interpersonal, and family systems."

My orientation is CBT, and I'd say I am more interested in the behavioral aspects. Would this program be wrong for me? It does say that cbt is represented, and further down on the page it states that a "curricular cluster" is possible in CBT. But what exactly is a curricular cluster? Is this like a concentration?

Any advice would be apreciated!

I had the following thoughts on the matter:

1. It might be premature to stake out an "orientation" prior to getting trained as a clinician.

2. I would keep an open mind. Stating that your heart sank is informative, are you that invested in CBT that the thought of having to use non-CBT techniques is a source of anxiety for you? If so, do you think that's a problem?

3. Would this program be wrong for you? I think only you can answer that question, but if you are rigid in your beliefs and unwilling to rely on anything that is not CBT, then yes, it might become a disaster. On the other hand it might be the catalyst needed for significant growth.

Good luck.

Mark

 

[KillerDiller]

Me either, stigmata. I guess it comes down to how wide you want to cast your CBT net.

I'm confused . Are you arguing that if therapy affects any neurological system that is not specifically addressed by a CBT model, that the mechanism of action must not be something within CBT therapy?

Those who practice CBT would not claim that emotions and interpersonal issues don't exist and aren't represented neuroanatomically in the brain. You consider yourself mostly a behaviorist. So do I. That means we prefer to work within the modality of behavior--it doesn't mean that we deny the existance of other modalities. In fact, we work within behavior and expect that emotions and cognitions will change as learning takes place. The purists among us may conceptualize all these modalities as types of behavior, but they do not deny that they all take place physically within the brain's circuitry.

Perhaps I'm misinterpreting what you are saying, though?

 

[Student4Life0]

I had the following thoughts on the matter:

1. It might be premature to stake out an "orientation" prior to getting trained as a clinician.

2. I would keep an open mind. Stating that your heart sank is informative, are you that invested in CBT that the thought of having to use non-CBT techniques is a source of anxiety for you? If so, do you think that's a problem?

3. Would this program be wrong for you? I think only you can answer that question, but if you are rigid in your beliefs and unwilling to rely on anything that is not CBT, then yes, it might become a disaster. On the other hand it might be the catalyst needed for significant growth.

Good luck.

Mark

I actually am in a masters in clinical program right now, so I am being trained as a clinician, and am using cbt/behavioral interventions at my practicum. i have studied both orientations enough to know that while I see great value in both, I prefer cbt. I am certainly no expert, but I know where my interests lie.

I am open to learning all orientations and gaining a foundation, but I honestly do not like the idea of using a psychodynamic orientation in a clinical setting. I suppose it also depends on the population. For the population that I hope to work with, I believe that behavioral interventions are superior. I may be wrong, but this is my belief. However, the school does seem to be well rounded enough that it can offer me what I need.

 

[deleted176373]

I actually am in a masters in clinical program right now, so I am being trained as a clinician, and am using cbt/behavioral interventions at my practicum. i have studied both orientations enough to know that while I see great value in both, I prefer cbt. I am certainly no expert, but I know where my interests lie.

I am open to learning all orientations and gaining a foundation, but I honestly do not like the idea of using a psychodynamic orientation in a clinical setting. I suppose it also depends on the population. For the population that I hope to work with, I believe that behavioral interventions are superior. I may be wrong, but this is my belief. However, the school does seem to be well rounded enough that it can offer me what I need.

I am not doubting the power of CBT interventions, but I am questioning whether opening yourself to different styles will somehow hinder you. Even if you prefer to work from a CBT orientation, I believe that a lot can be gained by experiencing a wide range of intervention techniques.

Personally, I find it's like having tools in a tool box. A hammer is a hugely effective tool, and maybe you have several dozen different hammers (CBT interventions) but what happens when you encounter a screw? You certainly can hammer it in, or you can use the hammer in a fashion it wasn't designed to be used, or you might even modify the hammer... but it still isn't as effective as a screwdriver. I see the addition of other modalities like the addition of tools to a toolbox... some you will never or almost never use... but when you really need an intervention that will get a client unstuck, it's nice to have a lot tools at your disposal.

I think you've answered your question though, you really want to remain invested in CBT as a primary modality for therapy and you don't believe that you need or want extensive training in the psychodynamic model. That's great, as there are a great number of therapists that have made the same decision and are happy with that decision. The bottom line is that you have to feel that you are being the most effective therapist that you can be. I am not going to criticize those who feel that their CBT is the best therapy, it might be.

Mark

PS - It makes me think of the old Kung-Fu movies on TV, where Kung-Fu masters would beat their chests proudly and state, "Gold Dragon Kung-Fu is better Kung-Fu than your Drunken Chicken Style Kung-Fu." LOL, "You CBT-Fu is good young one, but my Freudian Psycho Analysis-Fu has never been defeated." In the end I think Bruce Lee was right, use what works.

 

[stigmata]

By the way , you will never hear these conversations amongst a group of practicing psychologists; it is academic and not a practical matter.

 

[KillerDiller]

I think you've answered your question though, you really want to remain invested in CBT as a primary modality for therapy and you don't believe that you need or want extensive training in the psychodynamic model. That's great, as there are a great number of therapists that have made the same decision and are happy with that decision. The bottom line is that you have to feel that you are being the most effective therapist that you can be. I am not going to criticize those who feel that their CBT is the best therapy, it might be.

I think the toolbox analogy is apt when we are talking about learning interventions. Hopefully most schools are open to teaching several different kinds of techniques as long as they have been demonstrated to be efficacious. I'm not sure whether most schools do this or not, I guess, as I only have experience with one .

Anyway, although I agree that learning a variety of techniques is a good idea, I think the OP is perfectly reasonable for wanting to learn one perspective at the conceptualization level. It is a useful exercise to sit in class and conceptualize a case from a variety of perspectives, but my experience has been that you can't develop very deep skills in working from all these perspectives simultaneously. You really have to choose at some point.

I guess the bottom line is that if the OP believes that Widener won't provide adequate supervision/training in conceptualizing from a CBT perspective, then it's not a good fit regardless of whether they teach the nuts and bolts of CBT techniques.