Health and Psychology

I was talking to my class today about how a theoretical orientation is the first part of a clinical case formulation. In basic English when someone calls me on the phone or meets me, or contacts me by email, I start developing ideas about who the person is, why they are contacting me, and what kinds of things I might be able to do to help them.  Those ideas are based on a way of thinking about people.  That way of thinking about people is called a theoretical orientation.  So especially for new students starting out doing therapy, it's essential to have one and to be able to articulate it.

There are a few very basic theoretical models of therapy.  The first is crisis intervention.  That theory presumes the person is contacting the therapist in crisis because of an event that has occurred.  It's a six to 12 week model of intervention designed to stabilize the person or to assist in helping the person find longer term treatment.  It taps into the resources the person has.  A second model of treatment is a cognitive behavioral model.  That model presents the idea that thoughts, feelings, and behaviors are all linked and that by changing thoughts, a person can change their behaviors and their feelings.  Active Listening is a technique that is used to help someone be able to hear what they are saying and to feel understood.  The theoretical orientation that uses Active Listening is an existential model.  Another theoretical model used by beginning students is a behavioral model.  That model helps people identify what is happening, what preceeded the behavior also known as antecedants, and what happened after the behavior or during the behavior that kept the behavior going or stopped the behavior, also known as reinforcers.  

Some students have other theoretical orientations such as psychodynamic, object relations,  and therapies named after the pioneers that developed them: Jungian, Imago, Gottman, Bowen, Freud.  Those aren't quite as basic and require much more reading to understand what's involved in doing treatment according to those theories.  But all treatment starts out with a theoretical orientation.  

The theoretical orientation guides the framework about how and where therapy is done, the types of interventions used by the therapist, the goals and objectives of treatment, how the presenting problem is thought about, the frequency of treatment, and whether or not a formal diagnosis is used.

The first session or two of therapy typically explains to the person seeking treatment what treatment based on that theoretical orientation is about and how it proceeds.  A history and background is taken, any information necessary for billing is collected, and some form of evaluation to ensure the person is able to participate in treatment with that therapist for that problem.  Rules and limits about confidentiality, the mandate for therapists to keep records, expectations about timeliness, payments for services, and collection of fees.  If an issue comes up where there may be some lack of clarity those issues may come up again in treatment.

The more someone knows about the various type of therapy they want the more informed they are and more able to make an adequate choice about a therapist.

All of the therapists at our office are either licensed to practice independently or have finished their doctoral education.  Our office focuses on breadth of theory and diversity of experience.  If you're interested in setting up an appointment for general psychotherapy contact Ziba Saatchian, M.A, (registered psychological assistant, working with evidence based treatments) at 818-275-0316.