What Is a
If you're new to the counseling field, in your first practicum, or interviewing for a job fresh out of grad school, it's likely you will be asked, "What's your theoretical orientation?"
If you're like me, you will probably pause and wonder, "what the heck is a 'theoretical orientation', and how do I figure out mine?" In a nutshell, the "theory" part of theoretical orientation provides a framework for understanding how people develop and maintain problems, and how those problems are best treated. The "orientation" part refers to the alignment of your beliefs with a particular theory.
For visual learners, the video below provides a brief overview theoretical orientation that you may find helpful.
There are a number of psychology and counseling theories out there. Most often, you will find theories falling under the three umbrellas listed below: behavioral (which has been merged with cognitive), psychoanalytic, and humanistic. For a brief definition, hover over each theory. If you click on the box, you will be directed to more resources on each theory.
What's the Difference Between a Theory and a Therapy?
One thing that isn't always made clear is the difference between theories and therapeutic modalities (therapies). Above we explain that a theory is like a guide for conceptualizing a client's problem, the origin of their problem, and how to best treat said probelm. A therapy is the process you use to treat the actual problem. Your "theoretical orientation" will guide the type of therapy you will use with a client.
For example, if my theoretical orientation is cognitive behavioral, then I believe that a client's problems are caused by their thoughts and behaviors. Therefore, I may employ cognitive behavioral therapy or dialectical behavioral therapy which specifically targets problem thoughts and behaviors.
Check below for a brief overview and links to training, resources, and certifications for various therapeutic modalities.
Diagnosis is a controversial topic in the field of mental health. Mental health diagnosis is based on diagnostic criteria outlined in the Diagnostic Statistical Manual 5th Edition (DSM-5). The controversy of diagnosis lies in its inherently deficit-based nature, the assumption of one (Westernized) culture in which "normalcy" is based, the dismissal of psycho-social stressors and influences, ignoring client strengths, and the potential self-fulfilling prophecy that can accompany a diagnosis.
Criticism aside, diagnosis is an important aspect of clinical practice for a few reasons:
The DSM 5 organizes information and symptoms into categories that can be helpful in determining the best course for treatment.
Diagnosis can help a client better understand their experience by linking clients to resources and research that provide explanations on the possible course and causes of what they are experiencing.
On a practical level, diagnosis is often required for service reimbursement (aka getting paid).
Differential diagnosis essentially refers to "ruling out" other disorders or conditions that might cause a particular set of symptoms. When making a differential diagnosis, consider the following:
Are the symptoms real?
Could the symptoms be caused by a substance (medications, drugs / alcohol, toxins)?
Could a medical condition be causing symptoms (example- brain tumor)?
What chief psychiatric disorder(s) are involved?
Rule out adjustment disorders.
Do symptoms cause impaired functioning (social, occupational, educational) OR clinically significant distress?