Pluralism as a model of Integration


18 Sep 2014 |  for counsellors | by Bill, writer at UK & Ireland Counsellor Directory


"I think any theoretically based psychotherapy is mistaken because each person is different." - Milton Erickson

Cooper and McLeod (2011) adopt a pluralist approach to integration. Pluralism “refers simply to the belief that there is no, one best set of therapeutic methods. It can be defined as the assumption that different clients are likely to benefit from different therapeutic methods at different points in time, and that therapists should work collaboratively with clients to help them identify what they want from therapy and how they might achieve it.” (p7).

They suggest that: “At the heart of a pluralist approach to counselling and psychotherapy is a commitment to a mutually involved, collaborative client-therapist relationship, based on dialogue.” (Cooper & McLeod 2011:56).

In this approach, the client’s goals are the basic starting point for therapy, reflecting the humanistic philosophical underpinnings of their approach. Goals in this model are conceptualised as being hierarchically classified, from the highest-level meanings to the most concrete, contextually-based ones. (p80) Some goals may be unconscious, and working with transference and countertransference may be valuable tools in this case to help the client identify and articulate those. (p64).

Cooper and McLeod cite as a key aspect of a pluralistic approach the need for the therapist to explain to the client how they see the therapy as working, and to enlist the client’s involvement in deciding how to proceed. “In our experience, the concept of ‘task’ is extremely valuable in respect of being able to do this.” (p90). They suggest that the concept of task is provides a way of thinking and talking about therapy that is accessible and non-pathologising. Tasks are identified by drawing on theoretical models, but are guided by the client’s sense of what will be most effective for them.

They summarise their approach as follows:

“The pluralistic approach to therapy holds that different clients are likely to benefit from different things at different points in time, and that therapists should work collaboratively with clients to help them identify what they want from therapy and how they might achieve it. This overarching pluralist outlook can be translated in to a pluralistic therapeutic practice, where therapists draw on a range of methods to help clients work towards their goals. The pluralistic approach emerges from a desire to transcend schoolism and binary thinking in the counselling and psychotherapy world, advocating an attitude of prizing to the wide array of methods and concepts that different orientations have to offer. The approach is supported by a pluralistic philosophical outlook, and is rooted in the humanistic commitment to deeply valuing the Other in all their otherness. Support for the approach also comes from psychological research, which shows that no one therapy is most effective, and that clients tend to do better when they get a therapy that matches their characteristics and preferences. It is also consistent with a contemporary health and social care policy agenda. At the heart of this pluralist approach is a commitment to a collaborative approach between therapist and client. There are many ways in which therapists can help build on this, and the pluralistic approach particularly emphasises the use of negotiation and metacommunication around the goals, tasks and methods of therapy.

In terms of actual practice, pluralistic therapy, or therapy that is informed by a pluralistic perspective, will start by working with clients to help them identify their goals for therapy. Whether the client can clearly articulate these, or whether they only have a vague glimpse of them, this conversation will serve as the orientating point for the ongoing therapeutic work. Early on in the therapy, the therapist is also likely to invite the client to explore the particular foci that they may want for work, and the methods and ways of working that they may find most helpful. Once the therapeutic activity gets under way, the therapist is likely to draw from a range of methods and skills, depending on the training and the client’s particular wants and preferences, but they will continue to try to provide clients with opportunities to feed back on, discuss, and decide the best ways forward in the therapeutic work.

This pluralistic approach to therapy has the potential to change the way we think about, and conduct, research, focusing on specific micro-change processes rather than large-scale cause-effect relationships. It also has implications for the supervision and training of therapists, with an emphasis on collaborative client-therapist activity and an openness to a diversity of methods.” (Cooper & McLeod, 2011:154-155).

References

Cooper, M., & McLeod, J. (2011). Pluralistic counselling and psychotherapy. London: Sage.


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