Therapy can be really effective for a variety of mental health concerns ranging from coping with stress to chronic mental disorders. In other words, therapy caters to your mental health, even if you do not meet the criteria for a psychological disorder. However, people still struggle with deciding to seek therapy, constantly being blocked by obstacles of social stigma and internalized beliefs of “I can solve this on my own; I don’t need anybody’s help,” or perhaps, “It’s not even a real problem.” Let’s say you manage to cross this hurdle. The next step would probably be chaotic mayhem, marked by acute confusion. I say this only to highlight the point that our awareness of how and where to seek psychological help is severely lacking. It’s a sad reality that, sometimes, people don’t know the right questions to ask about therapy, if not who to ask.
Let’s say you do manage to gather your confused wits and ask Google. Your search history may possibly involve questions of “What kind of therapist should I go to?” or “How do I find the right therapist for me?” Google is extremely informative. You should definitely ask these questions to its search engine. Let me propose another question to ask Google though: “What are the different kinds of theoretical orientations that exist, and which of them is the best fit for me?” A theoretical orientation is a philosophy held by the therapist about how problems develop in a person and how they can be treated. It’s a core philosophical assumption that a therapist abides by in their work. Examples include psychodynamic, behavioral, humanistic, feminist, and cognitive orientations. Theoretical orientations are not concrete throughout a therapist’s professional career, but they aren’t exactly fluid either. Depending on personal circumstances, current research, and changing worldview, a therapist can shift gears to a different theoretical orientation. It’s also not the case that every therapist only uses one theoretical orientation to inform their work. More often than not, therapists combine multiple orientations that work for them.
A question that might be on your mind now, framed in more specific terms: Why is knowing about a therapist’s theoretical orientation important?
Here’s my opinion: knowing which theoretical orientation your therapist aligns with is important. Like I mentioned previously, a theoretical orientation is a philosophical assumption that therapists hold. These orientations are not picked at random; a therapist’s theoretical orientation assumes certain core beliefs that are closely related to their own worldview and beliefs. But these aforementioned core beliefs may not align with your own. For example, you may be a person who believes that your past experiences play a crucial role in shaping and impacting your present concerns. A similar worldview is held by therapists who follow the psychodynamic orientation which suggests that early experiences shape who you are as a person today and that past patterns are repeated in your present. Having similar worldviews can help you gain more out of therapy because there aren’t major clashes in the way you and your therapist perceive problems. This can help you feel comfortable sharing your deepest thoughts, feelings, and experiences with your therapist.
Most therapists today favor integrating multiple theoretical orientations, each with their own worldviews. This implies combining techniques and theories from orientations that they feel their worldviews align with the best. Sometimes, therapists feel the need to combine techniques from other orientations with their own because of pressures from their employers for quick treatments or even due to mental health emergencies. Even with all that, therapists often have an orientation they align with more than the other. You could say that such therapists like most ice-cream flavors (their selected combination of theoretical orientations) but have a not-so-secret preference for a single flavor. So, it still helps you to learn about the different kinds of theoretical orientations that exist and choose the one that seems to fit your beliefs the best.
Here’s a word of advice though: there is no perfect theoretical orientation that will suit your worldview exactly. Can you imagine creating seven billion different theoretical orientations, one for each individual in the world? That’s a case of little to no efficiency right there. Jokes aside, even though theoretical orientations may not fit your beliefs like puzzle pieces coming together to make a beautiful picture just right, the gaps can be filled albeit imperfectly. Here’s where the therapist’s skills and your personal needs become vital players. Simply put, the therapist molds their theoretical orientation to flexibly understand and treat your concerns.
It’s perfectly okay to ask your therapist which theoretical orientation they align with the most. A good therapist would always be happy to tell you. If you’re uncomfortable asking them directly, you can always check out their official social media pages or refer to their website. If this information is not readily available, you can enquire the same through email or a phone call. While it is not one of the frequently asked questions, primarily because most people are unaware of theoretical orientations, it is certainly not a strange one to ask your therapist. Asking this question can also be quite helpful in understanding what therapy might look like for you personally.
Not knowing what theoretical orientation your therapist abides by can lead you to have a fairly negative experience of therapy. If you do not know your therapist’s orientation, there is a risk that over the course of therapy, you may realize that the way in which they conceptualize your problems and the parts they focus on do not really align with your views. If you’re a person who’s not very good at vocalizing what you want, it can get very difficult for you to tell your therapist it’s not working out for you. This can damage the relationship you have with your therapist, potentially causing you to lose trust in them or more drastically, stop having hope in ever getting better.
Theoretical orientations are also important in setting goals for therapy. Therapy goals provide a direction to the treatment of your concerns and are decided upon by both the therapist and you as therapy progresses. More often than not, you may have different ideas about your goals than that of your therapist. An effective therapist will help resolve differences and make both your goals align so that you benefit from therapy. The therapist’s orientation matters here because it informs therapy goals. A good therapist always backs up their goals with their specific theoretical framework. However, clashes are more likely to occur if a therapist’s theoretical orientation is drastically different from your beliefs. For example, you may prefer having rigorous goals in place and having a therapist who acts as the expert in the room so that they can tell you what to do in each therapy session. This is a worldview adopted by a cognitive-behavioral theoretical orientation as to how treatment proceeds. If you go to a therapist whose orientation does not match your preference, you may not find therapy as effective as you would have if you went to a CBT therapist.
While a good therapist would try their best to make therapy a fruitful and beneficial experience for their client, there’s an extent to which they can do that. Sometimes, their theoretical orientation just might not sit right with you. That’s okay. There is no right answer to this. But there are things that can help you make a better informed decision and make it passably right. Know the different kinds of theoretical orientations out there. Ask the right questions. Therapy can be a beautiful experience, if you let it. If that’s not enough for you to buy it, here’s a not-so-creative selling point: much time and money will be saved, simply by knowing more.
This article is Part 1 of a series on Mental Health and Therapy. Be sure to look out for the rest of the parts!