April 17th, 2019

Structured Interventions: Tools to Aid the Healing Process

Many of the problems which we face in day to day life have relatively straight-forward solutions. When something breaks, we find the broken part and replace it. When a road is unexpectedly closed, we look for a new route to get to where we’re going. When our income changes, we adjust our spending to compensate. This is often the case with medical problems as well. When we go to the doctor, the doctor assess our problem and prescribes solutions such as medications, physical therapy, or surgery, among other things. As a result, many people enter psychotherapy with similar expectations, however, psychological healing isn’t as simple as replacing a part in your refrigerator. As a mentor of mine used to say, “there’s no paint by numbers.”

Many therapists become specialists in using particular therapeutic techniques to treat their clients while others become technically eclectic; employing a wide variety of approaches, depending on the client and the situation. Research has shown that the particular therapy techniques that a therapist uses is statistically insignificant in influencing outcomes of therapy, that therapy works, and that the relationship between the therapist and client, among other factors, is one of the most influential elements in determining outcomes (see common factors research in psychotherapy). In other words, specialization and technical eclecticism are both valid, techniques are helpful, but they are not “paint by numbers” cures.

In addition to technique, therapists rely on theory to help them understand how human psychology works and how to help people heal and achieve their goals. Theories of psychotherapy are built upon observation, research, and the collective clinical experience of practitioners in the field since the beginning of the profession. While there are hundreds of theories of therapy, and no unified theory, a great deal of overlap exists between theories to the point that they start to appear more like different metaphors to explain the same complex phenomena that is the human experience. Theory gives the therapist a way of understanding what is happening and what the healing process is, while techniques are tools which can help get the healing process moving.

Why isn’t healing more straight-forward? It sure would be nice, if it was, but people seeking psychological help face a multi-faceted problem: we are largely driven by unconscious patterns, we may have been hurt and find it hard to build trust, and healing often requires going through discomfort. Trust takes time, especially when we have been hurt, and a good therapist will earn that trust over time by the way that they relate to you; by being empathic, genuine, and non-judgmental. That trust is necessary in order to feel safe looking inward, tolerating and opening up about uncomfortable thoughts, feelings, or experiences, or trying the techniques that your therapist suggests.

When I treat clients, I use structured techniques as tools for self-regulation, to deepen self-awareness, and to practice for real life situations. There are many great techniques for helping us feel more calm when overwhelmed, or connected when we get disconnected. Other techniques are great at helping start to notice patterns and other elements of our experience that we didn’t see well before. Still others are great ways to practice things we want to do or say in our real life that we may not know how to do or say or that we may feel anxious about doing or saying. Techniques are an opportunity to try on new ways of looking at and dealing with our difficulties. Therapy is a unique and personal process, in a healing relationship, and techniques are tools the therapist uses to help that process along.

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