Academic journal article Journal of Humanistic Counseling

The Orientation Model: A Dual-Process Approach to Case Conceptualization

Academic journal article Journal of Humanistic Counseling

The Orientation Model: A Dual-Process Approach to Case Conceptualization

Article excerpt

The orientation model incorporates 4 psychological constructs and empirically informed measures of dispositional tendencies into a single case conceptualization framework. Grounded in the tenets of the dual-process theory and combined with a matrix for visualizing client-specific patterns, it provides counselors with significant information on client strengths and limitations before treatment.

Keywords: model, case conceptualization, dual process, assessment


Recent studies indicate that counselors are increasingly making use of assessment instruments, despite some hesitancy and uncertainty regarding alignment between counselor identity and the testing process (Cashel, 2009; Neukrug, Peterson, Bonner, & Lomas, 2013). The measures typically taught in assessment courses required by the Council for Accreditation of Counseling and Related Educational Programs and used in mental health settings include five key areas (Neukrug et al., 2013): symptom severity (e.g., Beck Depression Inventory), diagnostic criteria and psychopathology (e.g., Minnesota Multiphasic Personality Inventory), problem behaviors (e.g., Child Behavior Checklist), general intelligence (e.g., Weschler Adult Intelligence Scale), and personality-oriented career compatibility (e.g., Myers-Briggs Type Indicator).

Although all of these assessment categories provide valuable information on client-specific behaviors and traits, each one provides relatively little information for use in conceptualizing how clients actually process their experiences. In other words, such assessments shed little light on how clients uniquely interpret and internalize their interactions within the world. Measures for symptom severity, diagnosis, and problem behaviors provide insight into client limitations, but typically neglect client strengths (Elkins, 2009). General intelligence measures may establish a client's capacity to engage in certain treatments, but this is clinically useful for only specific segments of the population (Seligman, 1996). Personality testing can illuminate client strengths, but it is widely agreed that such models and measures do not significantly contribute to the practical therapeutic endeavor (Boyle, 2008; Epstein, 2010).

The purpose of this article is to introduce the orientation model as a counseling-specific tool to address this issue. It was designed as a versatile and humanistically oriented assessment framework for case conceptualization. A major strength of this model is its use of well-established measures, each of which was developed by psychologists using confirmatory factor analysis to gauge within-individual differences. In other words, each measure (a) was designed to test a specific hypothesis based on an overarching theory and (b) is meant to provide insight into variables within a single individual. This is in contrast to personality measures, which typically use the atheoretical process of exploratory factor analysis to determine differences between individuals (J. Block, 1995; Boyle, 2008; Cervone, 2005). It has been well argued that proper psychological models should address "the organization and interaction of variables within individuals" (Epstein, 2010, p. 35) or should be "situated within a coherent, intraindividual theoretical framework" (J. Block, 2010, p. 5). The orientation model represents just such a client-specific framework.

It is proposed that client-specific information derived from the constructs of cognitive processing, attachment, empathy, and introspection can be effectively used to supplement humanistic and experiential counseling approaches. The guiding principle of the orientation model is that client processes of thinking and feeling--a dichotomy supported by the dual-process theory--manifest in strikingly different ways and with distinctive consequences. The constructs used in this model align with the dual-process approach insofar as each distinguishes between cognition and emotion in a unique way. …

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