Therapeutic Models

Too often these days feelings of depression and anxiety are seen as evidence of medical illness. Psychologists have largely endorsed the medical perspective, joining psychiatrists and other doctors in diagnosing "disorders" in their "patients" and recommending a course of "treatment." Some professionals who subscribe to this framework suggest that depression, for example, is evidence of a "biochemical imbalance," a notion that was abandoned by most researchers long ago. While there are times when medical professionals can prescribe medication to alleviate acute distress, this action should not be seen as addressing fundamental causes. Moreover, biological and psychological complications arising from this treatment are largely disregarded, and there is strong evidence that the success of pharmacological interventions is wildly overestimated (See Kirsch, I., The Emperor's New Drugs, 2010).

Most psychotherapists do not subscribe to a purely biological explanation of human behavior, instead asserting the primary importance of environmental influences and advocating an interpersonal process that promotes self-understanding. However, while general assumption about counseling and psychotherapy may be shared, particular approaches vary. Sometimes seemingly subtle differences among therapists can have significant implications for a client's experience of therapy. My effort in the following will be to articulate my own assumptions about the therapeutic relationship and to offer an understanding of how real change comes about.