Humanistically-oriented clinical/counseling PhD

[RR808]

Hi All,

I'm interested in pursuing a clinical/counseling PhD program that emphasizes and values humanistic psychotherapy and ideals. This might include therapy that is process-oriented, emotional-focused and mindfulness-oriented. I've discovered a couple clinical programs that fit the bill (Duquesne for its phenomenology and York University for its EFT), but these are few and far in between. Counseling Psych programs may fit better what I'm look for and I've found a handful that look interesting - UMass Boston, University of Maryland, Columbia, University of Wisconsin in Madison, possibly NYU.

To give some background personally, I started in an analytical field studying chemistry in college and then worked in data analysis at a couple tech startups. I then jumped ship and got a Masters in counseling psychology at CIIS. This is a school that is often criticized on these forums, but my experience there was positive and transformative. Their philosophy is far from scientific, but was one I've come to deeply value. Moving forward, I'm interested in pursuing a more academically established PhD program to try and bridge the world of CIIS, which I view as spiritual and humanistic, with research and funded clinical care.

I suppose what I am looking for in writing this post here is to hear the community's take on humanistic psychology and on what programs might most value humanistic ideals. Cognitive and behavioral approaches appear to be most common in PhD programs, and while I'm interested to learn about these, I do not want to work under someone (nor, ideally, within a program) that so highly values or emphasizes these kinds of approaches. This is a rather strong preference of mine which I understand goes against the grain of most contemporary clinical psychology research, but it is where I stand. My question here is where can I find a program that is most in alignment with the humanistic and even spiritual ideals that I hold. Suggestions I've read often emphasize finding a faculty member whose work is relevant. I've done research on this, but I would ideally join a program which is itself steeped in humanistic thought and attracts humanistically-oriented students.

Thanks for reading. I look forward to hearing your responses.

Robbie

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[LadyHalcyon]

I would definitely look at counseling Ph.D programs. Also, certain locations tend to be more favorable to different orientations. Are you location bound or are you able to move anywhere?

 

[WisNeuro]

What is it that you want to do when it's all said and done?

 

[Justanothergrad]

There are some philosophic reasons that you will likely find counseling programs to fit better with what you want.

The d12 (clinical) approach to evidence based standards to evaluate therapy favors CBT approaches. They are more easily manualized and rely on different assumptions of critical ingredients. Counseling draws from a different philosophy of change. this gets reflected in training model design (more focus on micro skills in counseling v EBP in clinical) and critique of therapy(its no surprise Bruce Wampold is a counseling psychologist).

That said, I would discourage you from approaching graduate programs with an assumption of your orientation. The debate on them is far more complex than you've gotten up til this point and there are good reasons to be critical of all of them. I think the best programs include diverse rather than specific training (in general and specific to orientation as well).You are unlikely to align with a single orientation anyway.

What do you want to research? This will be a better side in finding programs for many reasons, including those above.

 

[YoungFrancis]

Sounds like counseling programs would be a fit for you, as other have said. Though you will definitely find plenty of professors researching mindfulness in clinical programs.

I would also suggest considering the diversity of practicum sites available. Depending on the location, a school may have limited options for practicum.

 

[Ollie123]

Perhaps not quite what you are looking for, but Motivational Interviewing is the classic example of the bridge between CBT and humanism. Grew out of humanistic traditions, but has survived empirical testing. UNM was the original "place to be" for this, but there are tons of folks who do work on it.

May not quite be what you are looking for, but its a start.

 

[RR808]

Thank you, everyone, for the thoughtful replies. LadyHalcyon, I'm not location bound. WisNeuro, after graduating, I'd like to provide psychotherapy and possibly any of the following which are more PhD-specific: teach, research, write/develop theory, lead a clinic, get involved in broader-scale policy work (possibly at the academic, clinical, political, or social levels)

Justanothergrad - I feel quite set on pursuing my humanistic inclination. I'm open to learning more about other orientations, but my roots in the humanistic feel quite deep, affirmed by what I've read and who I interact with. Generally speaking, behavioral and psychodynamic folks tend to not speak to me as much as humanistic folks. In terms of research, I think psychotherapy process would be interesting, along with trauma, social justice (as vague as that is), and mindfulness-based work.

Ollie, thanks for mentioning MI. I am familiar with it, though I haven't explored UNM's program much. My one gripe with MI is that while I think it's great in generating motivation and agency, I don't get a sense that it reaches as deeply into one's psyche. This kind of depth work, which is vaguely defined and not often used in academic spheres, is a core part of my clinical and research interests as well. Terms that relate to depth work, as far as I can tell, include exile healing (IFS), schema healing, unconscious repatterning, memory reconsolidating, emotion schematic processing, etc.

 

[WisNeuro]

If you want to exclusively focus on long-term "depth" work, then you'll want to get a good business background. Major insurances don't cover longer term therapy, so you're looking at a cash only practice. And, in a world of midlevels saturating the market with low rates, that's an arena I wouldn't want to bother with. Better find a pool of rich, worried well clients to work with.

 

[deleted106747]

Thank you, everyone, for the thoughtful replies. LadyHalcyon, I'm not location bound. WisNeuro, after graduating, I'd like to provide psychotherapy and possibly any of the following which are more PhD-specific: teach, research, write/develop theory, lead a clinic, get involved in broader-scale policy work (possibly at the academic, clinical, political, or social levels)

Justanothergrad - I feel quite set on pursuing my humanistic inclination. I'm open to learning more about other orientations, but my roots in the humanistic feel quite deep, affirmed by what I've read and who I interact with. Generally speaking, behavioral and psychodynamic folks tend to not speak to me as much as humanistic folks. In terms of research, I think psychotherapy process would be interesting, along with trauma, social justice (as vague as that is), and mindfulness-based work.

Ollie, thanks for mentioning MI. I am familiar with it, though I haven't explored UNM's program much. My one gripe with MI is that while I think it's great in generating motivation and agency, I don't get a sense that it reaches as deeply into one's psyche. This kind of depth work, which is vaguely defined and not often used in academic spheres, is a core part of my clinical and research interests as well. Terms that relate to depth work, as far as I can tell, include exile healing (IFS), schema healing, unconscious repatterning, memory reconsolidating, emotion schematic processing, etc.

I am from a counseling psychology program, and while I do think that many are humanistic in nature, mine was pretty heavily CBT. I do find that humanistic/existential work is quite helpful with patients, particularly in my specialty. It helps to answer the "why" questions. That said, CBT is an important part of my practice because once the "why" has been addressed, the "how" needs to be addressed as well. If I don't do that, I find that there's a lot of conversation but not a lot of change. This is not the bent I had when I entered the field; it's something I learned as I began to work with patients on a regular basis (I was, and remain, humanistic/existential in orientation, but also CBT). I'm telling you this partially because while it's important to know who you are from a theoretical background, actually doing the work will teach you a lot and I am agreed that it's better at this point to not write off something until you've been able to explore its efficacy. Also, a lot of mindfulness work does fall broadly under CBT.

 

[deleted343839]

I agree with others' advice to hold lightly to what kind of therapist you think you are supposed to be. In general, program faculty are less enthusiastic about working with people who are unwilling to be trained in certain fundamentals of the discipline. Willingness is part of the package. For most of us training entails a process of re-examining various assumptions and beliefs about ourselves and others.

Our discipline is grounded in the scientific tradition, and as such it is important to learn how to formulate and test hypotheses even in N-of-1 situations. It is also important, in my view, to be willing to engage with behavioral and even neurological understandings of what happens in therapy even if the form of the intervention itself carries a different label. In other words, you can call your work whatever you wish to call it, but avoid indulging in the fantasy that your work with patients is something so qualitatively different that other behavioral paradigms can't begin to explain it. That's marketing (to oneself or others), not science.

 

[RR808]

If you want to exclusively focus on long-term "depth" work, then you'll want to get a good business background. Major insurances don't cover longer term therapy, so you're looking at a cash only practice. And, in a world of midlevels saturating the market with low rates, that's an arena I wouldn't want to bother with. Better find a pool of rich, worried well clients to work with.

I'm aware of this, which is why I'm doing a private practice-oriented internship at the moment. Unfortunately, depth work is where my interests lie, though part of my career ambitions are to make this kind of work more affordable/reimbursable clinically, more accepted academically, and more streamlined in research without making it too reductionist. When you say midlevels, I presume you're talking about masters level clinicians?

I am from a counseling psychology program, and while I do think that many are humanistic in nature, mine was pretty heavily CBT. I do find that humanistic/existential work is quite helpful with patients, particularly in my specialty. It helps to answer the "why" questions. That said, CBT is an important part of my practice because once the "why" has been addressed, the "how" needs to be addressed as well. If I don't do that, I find that there's a lot of conversation but not a lot of change. This is not the bent I had when I entered the field; it's something I learned as I began to work with patients on a regular basis (I was, and remain, humanistic/existential in orientation, but also CBT). I'm telling you this partially because while it's important to know who you are from a theoretical background, actually doing the work will teach you a lot and I am agreed that it's better at this point to not write off something until you've been able to explore its efficacy. Also, a lot of mindfulness work does fall broadly under CBT.

I certainly agree with the more pragmatic piece of therapy. Many of the newer, non-academically oriented modalities I like such as IFS and AEDP (and also EFT which is embraced in academic spheres) do seem to incorporate these 'how' pieces as well. Perhaps it's this integration of humanistic and behavioral that I am looking for. It's also the reason why I'm not so interested in psychoanalytic work, which is certainly depth-oriented, but is rather slow-moving.

I agree with others' advice to hold lightly to what kind of therapist you think you are supposed to be. In general, program faculty are less enthusiastic about working with people who are unwilling to be trained in certain fundamentals of the discipline. Willingness is part of the package. For most of us training entails a process of re-examining various assumptions and beliefs about ourselves and others.

Our discipline is grounded in the scientific tradition, and as such it is important to learn how to formulate and test hypotheses even in N-of-1 situations. It is also important, in my view, to be willing to engage with behavioral and even neurological understandings of what happens in therapy even if the form of the intervention itself carries a different label. In other words, you can call your work whatever you wish to call it, but avoid indulging in the fantasy that your work with patients is something so qualitatively different that other behavioral paradigms can't begin to explain it. That's marketing (to oneself or others), not science.

I've tried to make it clear that I am open and curious to learn about the fundamentals of the discipline. But obviously I'd like to find an advisor and ideally a program that is most closely aligned with what drives me, ie humanistic psychology. Again, I am not saying I am unwilling to learn the fundamentals of cognitive, behavioral, neurological psychology and I am certainly interested in learning the scientific methods used in the field. I don't think I've said otherwise, and I wouldn't be interested in pursuing an accredited clinical/counseling PhD program if that was the case. If I said I was interested in a behaviorally-oriented program, would you be providing the same feedback? Perhaps you would, but given the perception of humanistic psychology I see on these forums, I can't help but feel somewhat defensive.

Ultimately, the point is that I am not willing to budge on my preference for a humanistically-oriented advisor/program, which seems like an entirely reasonable preference. For this reason, I would not apply to a program which was purely behavioral. My preference here is especially pronounced because humanistic orientations in accredited programs are sparse these days, which also contributes to a certain defensiveness on my end around this area (which I hope is not coming off too strong in my replies).

Again, I appreciate everyone's feedback. This is a fruitful conversations for me to at least further develop/express my interests.

 

[RR808]

One more thought here. MamaPhD - you mention the tradition being grounded in scientific discipline. This is a valid point, but how this discipline is perceived can differ quite a bit between programs. For instance, Bruce Wampold's work, from my understanding, takes a very different view of clinical research compared to most other work being done. Thus, there's likely a big difference in doing work with Bruce and his colleagues at UW-Madison vs. work being done at a behaviorally-oriented clinical program, the former of which would be of interest to me and latter of which would not, mainly due to the philosophies that these program would be steeped in.

 

[deleted106747]

I'm aware of this, which is why I'm doing a private practice-oriented internship at the moment. Unfortunately, depth work is where my interests lie, though part of my career ambitions are to make this kind of work more affordable/reimbursable clinically, more accepted academically, and more streamlined in research without making it too reductionist. When you say midlevels, I presume you're talking about masters level clinicians?


I certainly agree with the more pragmatic piece of therapy. Many of the newer, non-academically oriented modalities I like such as IFS and AEDP (and also EFT which is embraced in academic spheres) do seem to incorporate these 'how' pieces as well. Perhaps it's this integration of humanistic and behavioral that I am looking for. It's also the reason why I'm not so interested in psychoanalytic work, which is certainly depth-oriented, but is rather slow-moving.


I've tried to make it clear that I am open and curious to learn about the fundamentals of the discipline. But obviously I'd like to find an advisor and ideally a program that is most closely aligned with what drives me, ie humanistic psychology. Again, I am not saying I am unwilling to learn the fundamentals of cognitive, behavioral, neurological psychology and I am certainly interested in learning the scientific methods used in the field. I don't think I've said otherwise, and I wouldn't be interested in pursuing an accredited clinical/counseling PhD program if that was the case. If I said I was interested in a behaviorally-oriented program, would you be providing the same feedback? Perhaps you would, but given the perception of humanistic psychology I see on these forums, I can't help but feel somewhat defensive.

Ultimately, the point is that I am not willing to budge on my preference for a humanistically-oriented advisor/program, which seems like an entirely reasonable preference. For this reason, I would not apply to a program which was purely behavioral. My preference here is especially pronounced because humanistic orientations in accredited programs are sparse these days, which also contributes to a certain defensiveness on my end around this area (which I hope is not coming off too strong in my replies).

Again, I appreciate everyone's feedback. This is a fruitful conversations for me to at least further develop/express my interests.

I've found that the combination of humanistic and behavioral makes a powerful vehicle for change.

Also, it's great to see on here an applicant who has read & researched the field. You will be an excellent candidate.

 

[WisNeuro]

I'm aware of this, which is why I'm doing a private practice-oriented internship at the moment. Unfortunately, depth work is where my interests lie, though part of my career ambitions are to make this kind of work more affordable/reimbursable clinically, more accepted academically, and more streamlined in research without making it too reductionist. When you say midlevels, I presume you're talking about masters level clinicians?

Masters level clinicians and those who graduated from diploma mills. Same skill level, just different levels of debt.

 

[ClinicalABA]

...If I don't do that, I find that there's a lot of conversation but not a lot of change...

Well put! Problem is, in the moment, those conversations can be very reinforcing to both the client and therapist, even when they don't lead to noticeable changes outside of session.

OP- lots of good advice here. Only thing I'd add is to not discount the "process orientation" aspects of BT/CBTs, etc. You'l find that if you do those things correctly, the "process" should be and is a big component.

 

[foreverbull]

I would also add that this is can be a little nuanced because your supervision will change from year to year and supervisors (outside of the university) have their own approach of choice (regardless of type of program) that they will espouse and operate from. Some types of settings may follow certain trends in terms of approaches.

I came from a counseling psych program but had supervisors who were CBT-oriented and some were interpersonal therapy-based. My program generally espoused both of those approaches most predominantly (with multicultural aspects interwoven into all), but that isn’t to say that a supervisor can’t espouse a different approach than that from your program when supervising you. And naturally, when being supervised, we tend to adapt to the supervisors’ expectations and their approach to some extent, which is part of the learning process. So it can vary by supervisor, as well.

 

[Mindfulpsych22]

On another note- based on your career goals, it may serve you to be open to learning more than just “the fundamentals” of other orientations and therapy. Being well-versed in the most common approaches is very helpful so that you can differentiate between clinicians doing skilled or poor versions of these therapies. If you hope to be in hiring, supervising or referring roles in the future, knowing these differences will be crucial. There are many clinicians out there who tout out labels for their work (CBT, psychodynamic, etc) and orientation-specific jargon that obscure sloppy therapy and mislead clients about the services they are getting.

I was lucky enough to have supervisors who worked from a variety of different approaches- CBT, third wave CBT, developmental, solution-focused, psychodynamic, humanistic and it has been so helpful in recognizing when someone is truly doing strong theory-grounded work vs working from an incoherent conceptualization and set of strategies.

I think it is common when you enter the field to overestimate the impact of meaningful conversation on the problems many people are coming to therapy for. As was mentioned before these conversations can be extremely reinforcing and may keep a client coming back, which gives the therapist the impression they are being helpful.

On another note, there are many types of clients where this type of approach may maintain problematic patterns they already have. Many of my GAD or ruminative-depressed clients get lost in thought for hours considering existential questions and sometimes pull for these types of sessions in such a way that it functions as an avoidance strategy and keeps them stuck. It’s important to have a strong foundation in multiple approaches so you are not locked into offering something that may be contraindicated for a particular symptom presentation.

 

[WisNeuro]

I think what people are trying to say is, beware of only having a hammer in your toolbox, or everything will start looking like a nail.

 

[deleted343839]

I've tried to make it clear that I am open and curious to learn about the fundamentals of the discipline. But obviously I'd like to find an advisor and ideally a program that is most closely aligned with what drives me, ie humanistic psychology. Again, I am not saying I am unwilling to learn the fundamentals of cognitive, behavioral, neurological psychology and I am certainly interested in learning the scientific methods used in the field. I don't think I've said otherwise, and I wouldn't be interested in pursuing an accredited clinical/counseling PhD program if that was the case. If I said I was interested in a behaviorally-oriented program, would you be providing the same feedback? Perhaps you would, but given the perception of humanistic psychology I see on these forums, I can't help but feel somewhat defensive.

I'm sorry I misinterpreted your previous statements. To answer your question, if they were expressing their training interests in the same manner as you, then yes, I might be a little concerned. I do pay attention to curiosity/openness to other systems and modalities in my trainees, though you may be surprised to learn that more often I find myself making this point to people who are rigidly behavioral or cognitive-behavioral in their approach to therapy. What's usually going on is that inexperienced clinicians/trainees are more committed to forms than principles. Collectively I think the field of behavior therapy has begun to recognize this tendency (which, as you'll learn, is partly shaped by a history of DSM-centric research funding models) and has started to pull back.

One more thought here. MamaPhD - you mention the tradition being grounded in scientific discipline. This is a valid point, but how this discipline is perceived can differ quite a bit between programs. For instance, Bruce Wampold's work, from my understanding, takes a very different view of clinical research compared to most other work being done. Thus, there's likely a big difference in doing work with Bruce and his colleagues at UW-Madison vs. work being done at a behaviorally-oriented clinical program, the former of which would be of interest to me and latter of which would not, mainly due to the philosophies that these program would be steeped in.

Different research questions require different methods and levels of analysis, so this is a fair statement. But what you'll also find is that these different research traditions are in a lot of cross talk with one another, and Wampold himself has acknowledged that they are parallel rather than opposing "camps" if you will. In other words, "going against the grain" might not describe what you're looking for as much as you think.

It might be challenging to find a mentoring fit for you, but certainly not impossible. I agree that counseling psychology programs are probably on average a better fit with your interests. Community psychology has long been on the wane but would be another place to look for training if you were open to a non-clinical career. Best of luck.

 

[RR808]

I've found that the combination of humanistic and behavioral makes a powerful vehicle for change.

Also, it's great to see on here an applicant who has read & researched the field. You will be an excellent candidate.

Thank you

Well put! Problem is, in the moment, those conversations can be very reinforcing to both the client and therapist, even when they don't lead to noticeable changes outside of session.

OP- lots of good advice here. Only thing I'd add is to not discount the "process orientation" aspects of BT/CBTs, etc. You'l find that if you do those things correctly, the "process" should be and is a big component.

This is a good point. Admittedly (probably not surprisingly) I do have a bias leading me to believe that behavioral approaches are less process-oriented. I am open to changing this perspective.

On another note- based on your career goals, it may serve you to be open to learning more than just “the fundamentals” of other orientations and therapy. Being well-versed in the most common approaches is very helpful so that you can differentiate between clinicians doing skilled or poor versions of these therapies. If you hope to be in hiring, supervising or referring roles in the future, knowing these differences will be crucial. There are many clinicians out there who tout out labels for their work (CBT, psychodynamic, etc) and orientation-specific jargon that obscure sloppy therapy and mislead clients about the services they are getting.

I was lucky enough to have supervisors who worked from a variety of different approaches- CBT, third wave CBT, developmental, solution-focused, psychodynamic, humanistic and it has been so helpful in recognizing when someone is truly doing strong theory-grounded work vs working from an incoherent conceptualization and set of strategies.

I think it is common when you enter the field to overestimate the impact of meaningful conversation on the problems many people are coming to therapy for. As was mentioned before these conversations can be extremely reinforcing and may keep a client coming back, which gives the therapist the impression they are being helpful.

On another note, there are many types of clients where this type of approach may maintain problematic patterns they already have. Many of my GAD or ruminative-depressed clients get lost in thought for hours considering existential questions and sometimes pull for these types of sessions in such a way that it functions as an avoidance strategy and keeps them stuck. It’s important to have a strong foundation in multiple approaches so you are not locked into offering something that may be contraindicated for a particular symptom presentation.

This is something I've thought about. My program does a good job, I believe, in training us towards depth, but I do recognize how such an approach can be a contraindication in many cases.

I think what people are trying to say is, beware of only having a hammer in your toolbox, or everything will start looking like a nail.

I certainly agree with this. Perhaps my perception is wrong, especially given some of the answers I've read so far, but it seems like many accredited programs do take a 'hammer-only' approach by emphasizing symptom reduction via behavior/cognitive change. As an example, I work at a research lab in a prestigious school. One of the faculty members there, who herself graduated from a strong clinical psych program, has had no training in psychodynamic therapy. As far as I can tell, she has a very strong knowledge of behavioral/cognitive principles and she has some grasp of the humanistic. This leads her approach to research and clinical work to focus very heavily on the hammer.

I'm sorry I misinterpreted your previous statements. To answer your question, if they were expressing their training interests in the same manner as you, then yes, I might be a little concerned. I do pay attention to curiosity/openness to other systems and modalities in my trainees, though you may be surprised to learn that more often I find myself making this point to people who are rigidly behavioral or cognitive-behavioral in their approach to therapy. What's usually going on is that inexperienced clinicians/trainees are more committed to forms than principles. Collectively I think the field of behavior therapy has begun to recognize this tendency (which, as you'll learn, is partly shaped by a history of DSM-centric research funding models) and has started to pull back.



Different research questions require different methods and levels of analysis, so this is a fair statement. But what you'll also find is that these different research traditions are in a lot of cross talk with one another, and Wampold himself has acknowledged that they are parallel rather than opposing "camps" if you will. In other words, "going against the grain" might not describe what you're looking for as much as you think.

It might be challenging to find a mentoring fit for you, but certainly not impossible. I agree that counseling psychology programs are probably on average a better fit with your interests. Community psychology has long been on the wane but would be another place to look for training if you were open to a non-clinical career. Best of luck.

I appreciate your continued contact here. It makes sense to me that the more CBT-oriented folks are less open to learning other modalities. That's what I'd expect. The piece around form vs. principle is interesting. I presume by form you mean technique and manualization, whereas principle is the underlying philosophy. I am actually far more open to learning about principle, it is the focus on form that I resist . I'm also somewhat familiar with the history of DSM-centric funding models and believe this paradigm has been problematic. The field definitely needs to be open to moving away from thinking only in terms of symptom treatment/reduction.

It's interesting to note the cross talk, which I agree would be important. It still seems to me, though, that someone like Bruce would be open to other principles, but is himself still rooted in Common Factors theory. Likewise, someone invested in CBT-oriented research might be open to discussing other traditions, but would still be rooted in cognitive-behavioral philosophy. In a case like this, even though there is open communication, I would not want to work under the CBT-oriented advisor since the main philosophy from which we operate would differ. I understand this main philosophy requires some flexibility, but it seems to me it is still there amongst research faculty.

I agree, finding a fit will be hard, which is likely the main reason I've taken such an alternative route.

 

[Ollie123]

If you have not read up on ACT yet, I would do so. I'm by no means an expert, but it certainly incorporates concepts from humanism more closely than traditional CBT. Perhaps more importantly, although it has certainly been manualized, I find it somewhat more principle-oriented versus activity-oriented. I don't necessarily consider this a positive clinically, but from a purely academic standpoint it also has several seemingly never-ending theory rabbit holes on things like language/communication, eastern philosophy/mindfulness, etc. one can dive into. It has stood up to empirical testing/validation on symptom reduction, but in listening/reading how the developers and thought leaders on it discuss it...their views on symptom reduction certainly differ a fair bit from classic CBT in ways that I suspect at least loosely align with your views.

Not trying to talk you out of your plans since you seem quite set on what you are going to do and I don't think that working with Hayes or Wilson would necessarily be a great or even good fit, but it might be worth looking into and its possible you could find a workable level of overlap with someone from that world.

 

[ClinicalABA]

If you have not read up on ACT yet, I would do so. I'm by no means an expert, but it certainly incorporates concepts from humanism more closely than traditional CBT.

Yet ACT is strongly rooted in contxtualism, Skinner’s analysis of verbal behavior, and other ABA related endeavors (e.g. relational frame theory; stimulus equivalence). Hayes et al., IMHO, did a masterful job of giving it a new agey sounding name, but when you’re doing ACT, you’re doing ABA.

 

[foreverbull]

Yet ACT is strongly rooted in contxtualism, Skinner’s analysis of verbal behavior, and other ABA related endeavors (e.g. relational frame theory; stimulus equivalence). Hayes et al., IMHO, did a masterful job of giving it a new agey sounding name, but when you’re doing ACT, you’re doing ABA.

Haha! I would also argue than when you’re doing ACT, you’re also doing Zen Buddhism (nonattachment to thoughts/decision, being present, etc.).

 

[ClinicalABA]

Yep- can’t throw a rock at UNR psych without hitting someone with Buddhist tendencies.

 

[WisNeuro]

I certainly agree with this. Perhaps my perception is wrong, especially given some of the answers I've read so far, but it seems like many accredited programs do take a 'hammer-only' approach by emphasizing symptom reduction via behavior/cognitive change. As an example, I work at a research lab in a prestigious school. One of the faculty members there, who herself graduated from a strong clinical psych program, has had no training in psychodynamic therapy. As far as I can tell, she has a very strong knowledge of behavioral/cognitive principles and she has some grasp of the humanistic. This leads her approach to research and clinical work to focus very heavily on the hammer.

If you perceive CBT/BT as only involved in symptom reduction, your perception is indeed not correct. Any therapy is focused on some symptom reduction at first to minimize impairment and distress. Psychodynamic therapy is not necessary to treat underlying causes.

 

[Justanothergrad]

If you perceive CBT/BT as only involved in symptom reduction, your perception is indeed not correct. Any therapy is focused on some symptom reduction at first to minimize impairment and distress. Psychodynamic therapy is not necessary to treat underlying causes.

+1

No therapy / orientation has a monopoly on process work either. Or rapport.

 

[Ollie123]

Yet ACT is strongly rooted in contxtualism, Skinner’s analysis of verbal behavior, and other ABA related endeavors (e.g. relational frame theory; stimulus equivalence). Hayes et al., IMHO, did a masterful job of giving it a new agey sounding name, but when you’re doing ACT, you’re doing ABA.

And Ive heard folks from numerous other traditions argue the same thing Based off components that were not central to ABA (psychological flexibility, present moment awareness, even the values focus is a component of contemporary behavioral activation but not something I see ABA folks touch on very often). Hayes doesn't seem to be in denial about any of this. He has more or less said in interviews its a tweak and amalgamation of stuff that has been around for decades.

Anyways, my main point was just that it may offer slightly more appeal to the OP than classic CBT and more room for potential overlap with mentors.

 

[RR808]

Pardon my delayed response here. Currently tapering off Venlafaxine which is doing weird things to my brain.

If you have not read up on ACT yet, I would do so. I'm by no means an expert, but it certainly incorporates concepts from humanism more closely than traditional CBT. Perhaps more importantly, although it has certainly been manualized, I find it somewhat more principle-oriented versus activity-oriented. I don't necessarily consider this a positive clinically, but from a purely academic standpoint it also has several seemingly never-ending theory rabbit holes on things like language/communication, eastern philosophy/mindfulness, etc. one can dive into. It has stood up to empirical testing/validation on symptom reduction, but in listening/reading how the developers and thought leaders on it discuss it...their views on symptom reduction certainly differ a fair bit from classic CBT in ways that I suspect at least loosely align with your views.

Not trying to talk you out of your plans since you seem quite set on what you are going to do and I don't think that working with Hayes or Wilson would necessarily be a great or even good fit, but it might be worth looking into and its possible you could find a workable level of overlap with someone from that world.

I know a little about ACT, and I enjoy hearing Hayes talk about it. It's interesting how heavily it relies on behaviorism and Buddhist principles since the two don't obviously go hand in hand. This is certainly something that will be worth looking into further, but I think I have been somewhat turned off by how behaviorally-focused it seems, as others have mentioned. Ideally I could talk to someone heavily involved in this work to further ascertain how the behavioral and Buddhist influences play off each other. I think I'll do this.

If you perceive CBT/BT as only involved in symptom reduction, your perception is indeed not correct. Any therapy is focused on some symptom reduction at first to minimize impairment and distress. Psychodynamic therapy is not necessary to treat underlying causes.

Perhaps it's worth teasing apart the two predominant trends I am wary of. The first is an emphasis on the medical model, which, from what I can tell, results in a focus on symptom reduction. I agree that some focus on symptom reduction is important, especially with those whose lives are severely impaired. But with a heavy reliance on the medical model, treatment seems to become solely focused on symptom reduction, rather than underlying mechanism. I think this speaks to the DSM-centric research funding models that MamaPHD spoke of.

The second trend I am wary of is the focus on behavior and cognition in leading to change. I think what you're saying is that these approaches are not only involved in symptom reduction since they are developed to target the behavioral or cognitive mechanisms that underly the symptom, thus enabling change. It's helpful for me to write about this to further develop my thoughts here, which are that I don't quite like this mechanistic approach. I am open and curious to learn about cognitive/behavioral approaches, but I'd like to work with someone like Les Greenberg who believes that emotion is a more fundamental driver of our psyche rather than thought and behavior. Likely there's lots of mechanistically-driven work being done in the affect-focused clinical world, which is another hurdle I'd need to work through.

What I think is most important to me is that if I am to do a clinical/counseling psych PhD and learn about these concepts, I'll need to feel like I can learn about them with the support of a faculty member or department who at least partially share my belief of the human condition (ie with an alignment toward emotion or even the 'soul'). This way, when learning about behavioral approaches, for instance, it will be easier to take them with a grain of salt, rather than feeling the need to integrate these approaches as the definite form of treatment, which I'll likely feel the need to do if working under someone who aligns themselves with the behavioral philosophy.

 

[RR808]

One more thing to add here in response to this:

Yet ACT is strongly rooted in contxtualism, Skinner’s analysis of verbal behavior, and other ABA related endeavors (e.g. relational frame theory; stimulus equivalence). Hayes et al., IMHO, did a masterful job of giving it a new agey sounding name, but when you’re doing ACT, you’re doing ABA.

I see a lot of these kinds of comments. Are you claiming that Hayes is not really adding anything new with ACT and is instead repurposing ABA to sound more new agey? I don't know enough about ACT to make an academically-informed argument about this, but it seems to me that when Buddhism or mindfulness is introduced, there's a layer of subtlety that actually makes an approach quite different from those that do not incorporate mindfulness. As a fairly serious student of mindfulness practice myself, it seems to me that Hayes himself embodies mindfulness and has incorporated it into ACT to make the treatment significantly different from something like traditional ABA, even if the treatment steps look similar. I've seen many claims of people criticizing some of the newer, non-academically oriented treatment modalities likes IFS, Hakomi and AEDP as not adding anything new and instead just repurpose existing modalities. But I just don't believe this, and I think those that make these claims fundamentally do not understand the layer of subtlety that these mindfulness-based approaches rely on. This would be an interesting area of research

 

[WisNeuro]

What I think is most important to me is that if I am to do a clinical/counseling psych PhD and learn about these concepts, I'll need to feel like I can learn about them with the support of a faculty member or department who at least partially share my belief of the human condition (ie with an alignment toward emotion or even the 'soul'). This way, when learning about behavioral approaches, for instance, it will be easier to take them with a grain of salt, rather than feeling the need to integrate these approaches as the definite form of treatment, which I'll likely feel the need to do if working under someone who aligns themselves with the behavioral philosophy.

The key is to work with people sand learn multiple approaches. Your comments right now make it seem like you want to work with someone who will merely confirm your per-existing biases.

 

[erg923]

What I think is most important to me is that if I am to do a clinical/counseling psych PhD and learn about these concepts, I'll need to feel like I can learn about them with the support of a faculty member or department who at least partially share my belief of the human condition (ie with an alignment toward emotion or even the 'soul'). This way, when learning about behavioral approaches, for instance, it will be easier to take them with a grain of salt, rather than feeling the need to integrate these approaches as the definite form of treatment, which I'll likely feel the need to do if working under someone who aligns themselves with the behavioral philosophy.

Your belief about the human condition is far less important than your patient's beliefs about the human condition, at least in terms of spurring initial change behavior(s) in therapy. This is just reality of working with people in real-world clinical settings.

 

[ClinicalABA]

One more thing to add here in response to this:

I see a lot of these kinds of comments. Are you claiming that Hayes is not really adding anything new with ACT and is instead repurposing ABA to sound more new agey?

Nope- I’m saying:

A)The theoretical roots of ACT lie solidly within behavior analytic theories and concepts (e.g., relational frame theory; stimulus equivalence) which in turn are strongly rooted in Skinner’s analysis of verbal behavior. ACT was a novel treatment- not just a renaming or behavioral interpretation of exist stuff

And, B) “Acceptance and Commitment Therapy” is a much more and wider appealing name than something like “Derived Relational Responding Therapy” or “Applied Stimulus Equivalence”

 

[foreverbull]

Pardon my delayed response here. Currently tapering off Venlafaxine which is doing weird things to my brain.


I know a little about ACT, and I enjoy hearing Hayes talk about it. It's interesting how heavily it relies on behaviorism and Buddhist principles since the two don't obviously go hand in hand. This is certainly something that will be worth looking into further, but I think I have been somewhat turned off by how behaviorally-focused it seems, as others have mentioned. Ideally I could talk to someone heavily involved in this work to further ascertain how the behavioral and Buddhist influences play off each other. I think I'll do this.

Perhaps it's worth teasing apart the two predominant trends I am wary of. The first is an emphasis on the medical model, which, from what I can tell, results in a focus on symptom reduction. I agree that some focus on symptom reduction is important, especially with those whose lives are severely impaired. But with a heavy reliance on the medical model, treatment seems to become solely focused on symptom reduction, rather than underlying mechanism. I think this speaks to the DSM-centric research funding models that MamaPHD spoke of.

The second trend I am wary of is the focus on behavior and cognition in leading to change. I think what you're saying is that these approaches are not only involved in symptom reduction since they are developed to target the behavioral or cognitive mechanisms that underly the symptom, thus enabling change. It's helpful for me to write about this to further develop my thoughts here, which are that I don't quite like this mechanistic approach. I am open and curious to learn about cognitive/behavioral approaches, but I'd like to work with someone like Les Greenberg who believes that emotion is a more fundamental driver of our psyche rather than thought and behavior. Likely there's lots of mechanistically-driven work being done in the affect-focused clinical world, which is another hurdle I'd need to work through.

What I think is most important to me is that if I am to do a clinical/counseling psych PhD and learn about these concepts, I'll need to feel like I can learn about them with the support of a faculty member or department who at least partially share my belief of the human condition (ie with an alignment toward emotion or even the 'soul'). This way, when learning about behavioral approaches, for instance, it will be easier to take them with a grain of salt, rather than feeling the need to integrate these approaches as the definite form of treatment, which I'll likely feel the need to do if working under someone who aligns themselves with the behavioral philosophy.

After reading your post, what strikes me is that your criticisms with ACT/CBT assume that you’d practice this as a standalone theory. I took the theories a bit literally in grad school until I had more exposure and practice under my belt and started to understand theories enough to integrate them to my liking, which is what I do in practice now. For example, CBT/ACT cover thoughts/behavior, EFT covers emotions, and interpersonal theory nicely covers relationships (this is oversimplifying it, but an easy way to explain to others who ask about theories of choice). Many therapists take fundamental parts of each theory and apply them. Or they just take surface interventions from different theories and have one favorite theory (eclecticism). Different supervisors will incorporate different elements from multiple theories, unless they are extreme followers of one theory only. Grad school should expose you to at least a few theories decently well via classes and supervision/training—unless my experience was rare (?). Internship is also a good training year for deepening theory/practice.

If you aren’t sure if a program will provide education/training in multiple theories, reach out to them and ask what theories their faculty espouse and what orientations their practica supervisors espouse (could also get this from current students/graduates). They should be able to tell you if it’s a well-rounded training or it’s purely aligned with one theoretical orientation.

 

[MCParent]

Different supervisors will incorporate different elements from multiple theories, unless they are extreme followers of one theory only.

I wouldn't assume that instruction in only one theory is due only to being an "extreme follower." I emphasize using one primary approach when I supervise. Not because I'm an extreme follower of it, but because I am EXTREMELY skeptical that in a few months of training any grad student can be really good at one approach, let alone good enough at several to be able to pick and choose among them rapidly and fluidly. As I tell the folks who want to be eclectic / integrative while in training, they have to show me they can be good at one thing before they can be good at four.

 

[foreverbull]

I wouldn't assume that instruction in only one theory is due only to being an "extreme follower." I emphasize using one primary approach when I supervise. Not because I'm an extreme follower of it, but because I am EXTREMELY skeptical that in a few months of training any grad student can be really good at one approach, let alone good enough at several to be able to pick and choose among them rapidly and fluidly. As I tell the folks who want to be eclectic / integrative while in training, they have to show me they can be good at one thing before they can be good at four.

Yes, that’s a fair point; students do need to sufficiently learn each orientation they’re exposed to. I was thinking of internship, in which my supervisors integrated two primary orientations. But at that point, I’d been exposed to the theories enough that I understood them decently well, and it was a good opportunity to deepen my understanding further.

Having said that, is it common to learn at least a few orientations decently well by graduation in your program and others? I had assumed this was standard, but perhaps it depends on the program.

 

[RR808]

Your comments right now make it seem like you want to work with someone who will merely confirm your per-existing biases.

I've said, more than once, that I want to learn what is being taught and researched across the discipline, so my hope is to not stay stubbornly and ignorantly housed in one particular theory. At the same time, I would like to have my home-base (ie advisor or program) rooted in some of the theories or philosophies that resonate with me so that I can more comfortably branch out. This is not for the purpose of confirming my pre-existing biases. For instance, look at the way Duquesne describes their program: Ph.D. in Clinical Psychology. This emphasis is drastically different than those of most other accredited programs. If this program description appeals to me more than others, that seems fine to me.

Your belief about the human condition is far less important than your patient's beliefs about the human condition, at least in terms of spurring initial change behavior(s) in therapy. This is just reality of working with people in real-world clinical settings.

I agree it is the clinician's duty to (usually) support the patient's beliefs. But, the clinician comes in with beliefs that set a foundation for the work that's provided. These beliefs might be grounded in scientific discipline, structured intervention, psychodynamic perspectives, spiritual inclinations, etc. To say that, as a clinician, my belief about the human condition is far less important than the patient might be overlooking something. We don't want to impose our beliefs on our patients, but we also don't want to underestimate the way our very presence, shaped by our beliefs, can affect the treatment.

Nope- I’m saying:

A)The theoretical roots of ACT lie solidly within behavior analytic theories and concepts (e.g., relational frame theory; stimulus equivalence) which in turn are strongly rooted in Skinner’s analysis of verbal behavior. ACT was a novel treatment- not just a renaming or behavioral interpretation of exist stuff

And, B) “Acceptance and Commitment Therapy” is a much more and wider appealing name than something like “Derived Relational Responding Therapy” or “Applied Stimulus Equivalence”

Got it, thanks for clarifying.

Yes, that’s a fair point; students do need to sufficiently learn each orientation they’re exposed to. I was thinking of internship, in which my supervisors integrated two primary orientations. But at that point, I’d been exposed to the theories enough that I understood them decently well, and it was a good opportunity to deepen my understanding further.

Having said that, is it common to learn at least a few orientations decently well by graduation in your program and others? I had assumed this was standard, but perhaps it depends on the program.

I appreciate hearing your perspective of your graduate experience.

My sense is that any accredited program will teach more than one orientation. Perhaps this integration is more appealing. I hear MCParent's point regarding the need to focus on and master a particular approach. What gives me some trepidation is seeing certain research and labs focusing exclusively on a behavioral or even EFT approach. Perhaps, however, there's more nuance and integration going on than meets than eye...