Integration of Therapeutical Theory in Practice

Introduction

Change is a pivotal component of therapy. It is usually the major reason people seek therapy with the majority of people seeking to implement it in their own lives and a sizeable number yearning to see it occur in the lives of others. In therapy, change usually implies the process of slowly discarding old dysfunctional behaviours, irrational beliefs, and dysfunctional relationship patterns and replacing them with a more elaborate mode of operation that seeks to prioritize wellness and happiness. Change is, however, a difficult experience as it involves questioning and attempting to rectify patterns that most clients believe are core to their existence. It is further complicated by the fact that most human beings tend to naturally gravitate towards familiarity and regard the unfamiliar with fear and apprehension. In therapy, the process of change is guided by theoretical frameworks that provide the 'how'- with the facilitation of therapists- of the implementation of change. The theory is an inalienable component of therapy as it informs the approach taken by the therapists in facilitating the change the client so much desires. Theory, in addition to being a crucial conduit for research, provides a consistent framework through which the therapist can view the client's problems ensuring that the issues at hand are addressed in the most efficient way. Integration of theory in practice is, therefore, a necessary skill for therapists. In this essay, I will in the best way possible attempt to outline my ideas about the therapeutic process.

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Major Assumptions About Change

While the unique human process, sometimes beautiful, can also prove to be a challenge through entrapment in jobs we do not like, relationships that are unhealthy, and daily activities that leave us feeling numb is something we have all experienced at one point or another. But why, when options are endless, and the world holds so many possibilities do we become stuck? In my experience, this is because despite possibilities being endless, an individual's perception of what is possible can become very limited. Although I do believe that each person is doing the best they can with what they have, sometimes what they have is not enough. Families' pass along generational patterns of dysfunction and often the idea of what is possible becomes very narrow, leaving them unchanged. Each personand family system has all the strength and resources within; it is a matter of accessing that hidden potential.

Another likely reason people become stuck in unhealthy patterns is a lack of material resources. We live in a culture where the rich are becoming richer and the poor, poorer. A sense of community and lending a hand to your neighbour is slowly decreasing. If a family does not have enough food to eat or a safe place to sleep they could easily become trapped in an undesirable situation.

The Change Process

It takes great strength and humility to accept a problem and courage to examine why the problem exists. By looking within oneself or one's family, there is a chance that what you see will be scary. The chance for change occurs when one is willing to take a step forward, regardless of how messy it looks, in hopes of something better. So central to creating change is the realization that there is a possibility for growth. The next step to that would be a willingness to try something new or have a new experience. This part of the process will look different for each but could include anything from recreating harmful experiences from the past to form new memories or simply trying a different discipline style with a child. Another part of the change process is creating a healthy support system. Whether this is family, friends, or simply your dog, it will be important to surround yourself with souls who accept and support your growth and are there to provide support on the days when growth seems impossible.

Change in Therapy

The change process in therapy will take on many different shapes and sizes depending on who the client is, and what their goals for the treatment consist of. First, I think it is important to have all of the elements I listed above; willingness to accept that there is potential for growth, openness to new experiences, and a support system that promotes the transformation that could take place. For progressive change to begin a therapeutic relationship has to take hold. Because this relationship is one that should be characterized by openness and acceptance, it is important that the client feel comfortable with the therapist and vice versa. For the client or family to begin their transformation process they have to feel understood. What specific needs the family brings will determine which level of change is prioritized but second order change or change in the system itself is only possible when all three levels are affected.

Responsible for Change

Both the therapist and the client or system is responsible for the change. When the therapy begins, it is critical to successful treatment that the therapist builds a strong connection with the family or individual. The therapeutic alliance is also the vehicle through which almost all treatment strategies in psychotherapy are delivered. Further, it also serves as the central ingredient in determining the acceptability of those interventions by the client receiving them. As these authors state, it would be very difficult to have success in interventions without first forming a relationship with the client. The client and their motivation level also play a role in the change process. They have to follow through with therapeutic suggestions and complete any home work if given, without the client's participation it will be difficult to gain new experiences. Because I believe the client is the expert in their situation therapy will be most beneficial if the family can be active in shaping the treatment. In the end, I do believe it is the therapist's job to alter and adapt to the client. If something is not working, we should figure out our part in the problem and shift our thoughts, feelings, or behaviors. If we expect clients to try new things we have to model that for them through the therapeutic change process.

Constraints to Change

The change process is complex, and there is a multitude of things that could hinder growth. In highlighting the importance of the therapeutic relationship, I will imply that without this connection therapy will be nearly impossible. If either the therapist or the client is too rigid or their styles of relating clash it might be beneficial to transfer the client to another therapist. Also, if the client or family is going home to a chaotic environment that is not involved or does not support the transformation of therapy, change can become very inhibited. Regardless of the work done in the therapy session, it will become ever more difficult to maintain and work towards change in such an environment. In this case, the therapist should encourage other members of the client's direct system to join the therapeutic process. Additional constrains consist of time and intervention limitations when working within an agency setting.

Theoretical Tenet

Theory or Model

Many intelligent and insightful theorists have hypothesized into what type of therapy works best with couples and families. After spending the past two years studying different theories, I feel as if there are two that I align with my belief system. I have combined aspects of narrative therapy and experiential therapy to form my theoretical views. The portion of narrative therapy that I prescribe to is the idea that rewriting stories is important and that it is often our beliefs that create our reality. By recognizing the underlying message, we tell ourselves about whom we are and how the world works we can begin to shift into a more accurate and healthy way of thinking. Where my views differ from the narrative approach is that I believe in many cases simply externalizing the problem is not a strong enough experience to rewrite a story. At this point, I incorporate experiential therapy. I want to help clients rewrite their stories through experiences, not externalization. Although there are some issues that are easily externalized, this cannot be applied to therapy in general. Also, by using externalization, we make the assumption that the person has internalized their problems, which is often not the case. Separating a person from their "problem" sounds strength based and solution focused but can these shifts in thinking become enough to redraft a person's experience? They have these negative interpretations for a reason and helping them to experience the event, accept it for what it was and that it did play a role in their lives, and then helping them to rewrite the story could be much more powerful and long-term then simply telling them they are separate from the problem.

Integration of Other Models

What is Integration?

Integration is combing part or elements of something whole to create something new. When we think about integration regarding the therapeutic process we are looking at combing different theories to create something that fits well with the therapist as an individual and the type of client they see. We are also talking about combing a variety of factors beyond the theory alone that aide in creating change.

What Type of Therapeutic Integration?

After learning about different forms of therapeutic integration, I feel like the Common Factors model most aligns with my belief system. In this type of integration, there is a distinction between broad and narrow common factors. The narrow category of factors includes, "common aspects of interventions found in disparate models under different names. This view looks at what is common among all the theories such as cognitive, behavioral, and emotional shifts. The broad view looks at other parts of the treatment setting such as, "client, therapist, relationship, and expectancy variables." This view looks at the client's motivation and actual factors of the therapist (not therapy) as important in therapeutic change. This way of thinking about change and integration works well for me because I belief strongly that what can be attributed to change goes far beyond the model itself. The therapeutic relationship, the client's motivation, and remaining organized and focused on therapy are some of the most significant factors.

Empirical Findings

Over the last year, I have gained an appreciation for empirical findings and evidence-based practices. The research will always inform my practice, and I hope that I will have time to devote to researching best practice for particular things my clients are experiencing. What I really like about evidence-based practice is the three-circle model they take into account. By including practitioner wisdom and client preferences with research, we can come to the best conclusion about what works for certain clients.

Social Work and Marriage and Family Therapy

I am graduating from a unique program that combines marriage and family therapy with the field of social work, and the two have definitely become integrated for me. Without being able to help families access resources to fulfil their basic needs such as food and shelter therapy would be pointless. At the same time, humans have a basic need for relationships, and as a family therapist, I can help facilitate the formation of healthy bonds. As a social worker, I will be dedicated to serving disadvantaged populations and will be well equipped to work with a family beyond case management. By being able to help them on that level, there will be additional trust and hopefulness created during the therapeutic process. In my opinion, one without the other would be incomplete....