PhD/PsyD What is your theoretical orientation?

[SaraLance]

Title. Previous threads with this question are typically more than 5 years old.

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[WisNeuro]

CBT

 

[Fan_of_Meehl]

Title. Previous threads with this question are typically more than 5 years old.

I've always been fairly devoutly cognitive-behavioral (with a preference for more Beckian cognitive therapy emphasis for some conditions/cases).

Recently, I've been trying to better integrate a motivational interviewing perspective (especially early on in therapy) prior to getting down to the more nitty gritty elements of treatment to ensure proper motivation and commitment to trying to change.

However, the more I practice over the years the more I realize that my theoretical orientation is slowly edging toward anarchist.

Rules/manuals/protocols are awesome tools for what they are but battle plans don't always survive beyond the first few minutes of actual engagement.

 

[PsychPhDone]

Title. Previous threads with this question are typically more than 5 years old.

CBT, big B

 

[RCCH11]

I am a strong proponent of psychodynamic theory as a foundation for treatment. Behavioral approaches are absolutely imperative but only when coupled with an exploration of the origins of maladaptive thinking.

Motivational Interviewing is an interesting technique. I work at a center that specializes in suicidality and implements Rogerian positive regard when dealing with high risk patients. Motivation Interviewing seems to be effective when prompting the patients to make changes, particularly if there is a substance abuse disorder co-morbidity. We might want to pressure to them to make changes, but those changes are only lasting if they are the product of the patients psyche is the idea.

 

[smalltownpsych]

I use whatever works for me and the patient and am constantly learning and adjusting my strategies. CPT for trauma, empathic responding to develop therapeutic alliance and work on interpersonal and relational skills, DBT for Borderline PD. Motivational Interviewing for any patients who struggle with motivation to change (that might be all of them ). Supportive psychotherapy for lower functioning patients with minimal positive social support. Identifying negative and irrational core beliefs and challenging them. I tend to be more Ellis than Beck in this arena. Play therapy to teach kids how to follow rules, interact well with others, and express emotions. Exposure Response Prevention for patients with compulsive behaviors. Some of these I am better at than others. DBT and MI and developing rapport are probably what I am best at. ERP and CPT I could use more training and experience with, I think. Sometimes when I am learning a new skill or technique, I find out that I was already doing it fairly well to start with. MI was like that for me.

 

[WisNeuro]

Trained in general CBT and psychodynamic. Specific training in PE and Panic disorder. By far the most effective and lasting treatments I observed were the behavior focused ones.

 

[Therapist4Chnge]

While I don't provide therapy services, I still utilize different orientations in my clinical practice.

CBT...but small "c" and big "B". Sometimes I am straight behavioral (with my acute brain injury patients) and with more cognitively intact patients I utilize a lot of MI. I sprinkle I'm some DBT concepts when providing feedback to pts, but it is far from true DBT.

If I had to choose one orientation...I'd say Behaviorism.

 

[deleted343839]

Broadly cognitive behavioral, though I lean behavioral. I also have psychodynamic training and I think it filters in at times but not in a systematic way. With couples I also use emotion-focused therapy concepts at times.

 

[singasongofjoy]

similar to several above, generally CBT with a big B - sprinkling in things pulled from others (e.g., MI, DBT, ERP) but I tend to work with folks with DD so cBt is where the needle lands most of the time.

 

[PsyDr]

For conceptualization and treatment of Axis I pathology: behavioralism. maybe throw in some of cloninger's stuff about personality.

For self discovery and improvement/idiographic: the techniques of psychoanalysis as understood from the works of Dollard, and Miller; and re-conceptualized in FAP.

 

[pediatric_psydoc]

CBT mostly. I have also had training in REBT and I like that approach as well.


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[aly cat]

CBT, bigger emphasis on the B but delivered within an MI framework.

 

[NeuroLady]

CBT, MI, ACT - I especially appreciate the behavioral influences of these.

 

[futureapppsy2]

Behaviorism, both "pure" and third wave

 

[Justanothergrad]

CBT. Pretty even split between the B and the C.

 

[ClinicalABA]

Behavior analytic

 

[psydreams]

I'm super interested in ACT and existential


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[StellaB]

For conceptualization, I use biopsychosocial. Interventions are largely behavioral, within a Rogerian therapeutic approach. Also do full model DBT and some MI. Have not found introspective approaches to be effective with a low functioning / forensic population, but I certainly know people who like those approaches with this population.

 

[bcliff]

behavior analytic/third-wave behavioral


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[MCParent]

In training students, I find that the B parts are really often overlooked. I think students often want to try to find the magic thing that makes a client act some way, or some magic formative event. It becomes particularly challenging when students have a tendency to try to find "the event" that caused depression or anxiety as though it were like a PTSD criterion A event. I've found a lot of value in encouraging students to look at the simple behaviorism parts (What does patient get out of staying in bed all day? Realize that patient will never get out of bed until an alternative is more rewarding or staying in bed is less rewarding.).

 

[WisNeuro]

In training students, I find that the B parts are really often overlooked. I think students often want to try to find the magic thing that makes a client act some way, or some magic formative event. It becomes particularly challenging when students have a tendency to try to find "the event" that caused depression or anxiety as though it were like a PTSD criterion A event. I've found a lot of value in encouraging students to look at the simple behaviorism parts (What does patient get out of staying in bed all day? Realize that patient will never get out of bed until an alternative is more rewarding or staying in bed is less rewarding.).

But I want therapy to be more like the movies!!! Where is my "A-ha!" moment?

 

[MCParent]

But I want therapy to be more like the movies!!! Where is my "A-ha!" moment?

There's a popular book on basic helping skills in which almost every vignette ends with the patient going "Wow, that's exactly it! I want to be a therapist now!" I am not exaggerating.

I tell them that the closest thing they're likely to hear is:
Patient: "It really hit me when you said (blah blah blah)."
You: (Thinking): I never said that.

 

[BuckeyeLove]

CBT. With group, I tend to be more interpersonal process-oriented (i.e., Teybor).

 

[dynamicdog]

I conceptualize and work primarily psychodynamically (interpersonal/relational) but incorporate various behavioral interventions throughout the treatment, ala Paul Wachtel.

 

[smalltownpsych]

There's a popular book on basic helping skills in which almost every vignette ends with the patient going "Wow, that's exactly it! I was to be a therapist now!" I am not exaggerating.

I tell them that the closest thing they're likely to hear is:
Patient: "It really hit me when you said (blah blah blah)."
You: (Thinking): I never said that.

Ain't that the truth.
As I look back at my more successful cases over the years, I don't know if there have ever been any real "aha" moments. Dramatic changes made over time and occasional moments of shift from one stage of change to another that are a bit more dramatic. "I finally realize that I can't keep doing A over and over, I have to do something different.", but the next question is "how do I do that?" and that is where the work begins and the change actually begins to happen.

I think a lot of the misconception arises from the old Freudian model of catharsis still being so much a part of the culture. Although more and more I am seeing something akin to a reductionist view of CBT. "Maybe you can teach me some coping methods" is one phrase I hear that signals that.

 

[ela]

Psychodynamic (relational) integrated with ACT. Very interested in experiential avoidance (esp emotional avoidance), interpersonal process, and meaning-focused narrative co-construction.

 

[jmiah717]

CBT (Beck), PE, existential, MI, some process oriented focus for group and individual (more so group), mindfulness slant to some CBT work but not so much without the C and the B. MBCT for depression is great. CBCT for PTSD is also relatively new and something that I've found works well with couples.

Sat beside a lady at a Beck training who said, "I just let them come in and talk." I've never been good enough to have that work for any patient that probably wouldn't have just gotten natural recovery with enough time.

 

[calimich]

Within a Rogerian therapeutic framework, I generally conceptualize dynamically and work interpersonally. Depending on the client's presenting concerns and goals, I'll use techniques from MI, CBT, and emotion-focused modalities such as AEDP.

 

[ClinicalABA]

behavior analytic/third-wave behavioral


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Nice to see I'm not alone over here on this side of the skull!