Conceptualization in Psychotherapy: The Models Approach

Conceptualization in Psychotherapy: The Models Approach

Conceptualization in Psychotherapy: The Models Approach

Conceptualization in Psychotherapy: The Models Approach

Excerpt

This book emerged from a dissatisfaction with the manner in which psychotherapists and clinical researchers were thinking and writing about clinical problems. In the professional lifetime of the senior author, there have been major and dramatic advances in knowledge about the nature of psychopathology and the techniques of intervention. However, it seemed clear that information on selection of treatment for a particular person was insufficient when compared to the great wealth of information on techniques of treatment. The process of conceptualization in psychotherapy was not being discussed adequately.

We saw this inadequacy expressed clinically by an overreliance on one's "school" of training and/or overreliance on diagnostic categories when selecting treatment for an individual. Thus, we would see clinicians treating all their clients in a manner congruent with their specific theoretical predilections, or alternatively, treating all persons who fit a particular diagnostic category using the same techniques. The lack of attention to conceptualization came out in clincial research by an overemphasis on "horse-race" comparisons between one treatment and another administered to randomly assigned groups, with little concern about determining the characteristics of individuals for whom a particular treatment might be effective. The inadequate attention paid to conceptualization was perhaps expressed most lucidly in the training of clinicians. Students were taught piles of information on the techniques of assessment and therapy, but very little on how to conceptualize a case in a manner which would suggest the correct treatment to use. Over and over in supervision, students would be at a loss as to how to pick a treatment, or they would present a "shotgun strategy" of hitting the client with as many techniques as possible in the hope that one technique was on target. They were bright and were very sharp on research findings and techniques; however, they had had no training in how to apply this knowledge clinically. There appeared to be no systematic way of teaching conceptualization skills. This book is an attempt to articulate a system of conceptualization which acknowledges a wide variety of biological and psychological influences on human behavior.

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