Eclecticism
According to Carter, (2006), one cannot conclude that particular treatments are clearly better than other treatments or clearly better than treatment as usual in the community. The research literature thus supports clinicians’ experiential knowledge that psychotherapy works but does not offer them specific information about what to do when or with whom to provide effective psychotherapy.
Carter, (2006), further states that theoretical models play a significant role in psychotherapy. Clinicians may rely on theory to explain change processes, and theories are valuable because they provide rationales for treatment, help organize it, and guide appropriate therapeutic goals for the particular clinical context. Clinicians also rely on a range of techniques drawn from multiple theoretical perspectives that research has found to be effective for particular symptom pictures or particular patient types and that the clinicians have found to be effective through their own experience and expertise.
In Carter’s, (2006), viewpoint, the clinician needs to be adaptive and conversant with multiple theoretical perspectives that may guide his or her ability to integrate clinician worldview and patient worldview to match the particular patient. The clinician must be prepared to incorporate additional or different theoretical components to achieve better fit for the patient. In other words, the clinician’s effectiveness rests in part on maintaining theoretical pluralism and the ability to be integrative in those theories.
Currently, theoretical integration, technical eclecticism, and common factors are receiving considerable attention, reflecting dissatisfaction with individual theoretical approaches and attempts to develop more flexible approaches. Theoretical integration is problematic if it becomes its own model, because it then has all of the problems that are associated with a single theoretical model. According to Carter, (2006), technical eclecticism alone as a response to the poor fit of theoretical models is limited, because it takes only interventions into account and ignores the relevance and role of theoretical models. From an integrative or theoretically eclectic perspective, however, it is important for clinicians to be skilled in techniques drawn from the multiple theories from which their own theoretical perspective is derived. Clinicians are expected to modify models as needed to be responsive to patients (Carter, 2006).
Nevertheless, according to Carter, (2006), techniques do matter. Interventions are the tools through which psychotherapy occurs within the context previously described. They are the expression of the belief system arising from theoretical models. They operationalize the therapeutic tasks that are part of the alliance. They are
the medium by which the relationship is developed and maintained. They build hope in the patient through active engagement in the tasks of therapy. They effectively alter specific symptoms. Hence, it is essential for clinicians
to be technically eclectic and prepared with a wide range of tools to address the needs of patients in the continually changing world of psychotherapy.
Lazarus and Beutler, (1993), present a case study which demonstrates how and why a combination of theories, and a smorgasbord conception of eclecticism, yields clinical confusion rather than therapeutic precision. They claim that unless counseling and psychotherapy are tied to empirical efficacy, the field is likely to become or remain a quasi-religious philosophy rather than a scientific enterprise. They explain why a theoretical or mechanistic procedures must be replaced by specific types of theories with a view to prescriptive matching on the basis of diagnosis, problem clusters, and interpersonal characteristics of clients.
They propose two approaches as alternatives to ragtag, shotgun collection of miscellaneous methods known as unsystematic eclecticism. These alternatives are called theoretical integrationism and technical eclecticism. These two approaches are not equivalent, and the authors favor technical eclecticism as having by far the greatest promise for the future.
Lazarus and Beutler, (1993) further claim that unsystematic eclectics and theoretical integrationists attempt to meld disparate ideas into harmonious wholes. They desire to construct a superordinate umbrella and build a coherent framework by blending the best elements from different theories, such as, for example, blending psychodynamic theory with cognitive-behavioral framework. The main problem is that, on close scrutiny, even theoretical tenets that seem to be interchangeable among different theories often turn out to be totally irreconcilable.
In contrast, technical eclectics select procedures form different sources without necessarily subscribing to the theories that spawned them (Lazarus and Beutler, 1993): for example, utilizing relaxation training, guided imagery, self-monitoring, role-playing, interpersonal exploration, assertiveness training, sexual counseling, cognitive restructuring, and mindfulness training. These techniques can then be coupled with a single theoretical framework such as REBT or CBT.
This learner sides with Lazarus and Beutler, (1993), and leans toward technical eclecticism where specific techniques are combined with a single theory, simply because the authors provide a better argument, the article was more readable, and made more sense. Until this learner reads or learns about a better approach through experience, she will stick with technical eclecticism and a single theory. It is good to have an arsenal of intervention techniques for different client needs.
References:
Carter, J. E., (2006); Theoretical Pluralism and Technical Eclecticism; Evidence-based psychotherapy: Where practice and research meet. Goodheart, Carol D. (Ed); Kazdin, Alan E. (Ed); Sternberg, Robert J. (Ed); pp. 63-79. Washington, DC, US: American Psychological Association, . xi, 295 pp.
Lazarus, A. A., Beutler, L. E., (1993); On Technical Eclecticism; Journal of Counseling and Development; Volume 71.
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