1. *Theoretical orientation. Mental health professionals articulate their beliefs about what causes human distress, how people respond to their needs and experience change and how the therapist can best intervene to assist clients. This set of beliefs is expressed as their theoretical orientation. From my perspective, the most satisfying and effective psychotherapy adapts to individual needs. Matching the treatment to the

   

   client symptoms and personality is an orientation called integrative psychotherapy. (Sometimes called Multi-Theoretical Psychotherapy.) It means understanding more than one approach to treatment, so theories may be applied thoughtfully, rather than utilizing the same therapy for every client in every circumstance.
   
   The approaches I’m most fond of bringing together in session are interpersonal, psychodynamic and cognitive behavioral therapies. I also value aspects of humanistic therapy and motivational interviewing and utilize these as helpful.  In short, I believe that how adults process thoughts and feelings and behaviors -- both past and present, both privately and in relationships -- are all helpful to discuss. They’re all avenues to understanding patterns, to making important decisions and to feeling better; with integrative psychotherapy we try not to neglect any of these angles.
   
   Why this works. My theoretical orientation suggests there are many ways we might understand why things are less than ideal for you at present. For example, it could be that you have had some unmet needs for many years...or that you experienced something incredibly difficult just recently. It could be that you tend to remain in unhealthy situations too long...or rather that you tend to bail out of uncomfortable situations impulsively. It could be that you think too hard about things and become perfectionistic...or just the opposite, that you don’t give enough thought to your actions and create chaos. It could be that you have inherited an emotional health issue from family...or that your difficulties have come primarily from life experiences (or both! Lucky you!) It may be that you need someone to listen closely and without judgment...or even more than that, you need someone to be active and challenge you. The process of finally doing this detective work, in therapy, can be incredibly productive (and can feel so relieving.) People begin feeling better long before their problems are solved, because they’re getting to the bottom of things.
   
   The feel of therapy sessions.  I hope you’d find sessions are collaborative, characterized by a balance of underst

   

   anding of your distress, insight about your relational patterns, and changing thought or behavior patterns that sabotage you. Most of us have a tendency to either over-rely on contemplating things (and have trouble taking action) or leap to taking action when upset (and have trouble with insight.) I hope to help clients understand the root causes of issues and to make meaningful changes that will stick. Expect to bring some gritty emotional honesty, a sharp mind for the patterns in your life, and your sense of humor. You may be struck by how concretely useful psychotherapy can be, despite it feeling like a conversation.
   
   How seeing a specialist can backfire. Want to forego years of reading dry scientific journals? Here’s the skinny on psychotherapy research: the most curative factor is the strength of the client-therapist relationship. This is so well-documented, it’s not a controversial statement.
   
   This means it’s more important for you to find someone who “gets you” than it is to find someone who does X treatment for Y condition. If your doctor says “...You have panic attacks, so you should seek someone who specializes in cognitive therapy...” consider it a red flag.
   
   To run with this example, a therapist who practices only cognitive-behavioral therapy would help with  one piece -- your immediate symptoms -- but because that theory steers clear of focusing on past trauma or current insights, the chances of your panic attacks re-occurring later are fairly high. For the most lasting effects, your best bet would be to see someone who utilizes cognitive behavioral therapy among other things. That way, you’d enjoy the immediate relief of symptom reduction but also avoid the frustration of having similar issues pop up later.
   
   That’s why integrative psychotherapy, when done well, is tremendously helpful; you’re not limited to the strengths and weaknesses of any one approach.
   
   

                              Dana R. Falk, Ph.D.       
                           6518 Phinney Avenue N
                                         Suite A
                        Seattle, Washington  98103   

                                  (206) 926-3866
                               

                       dfalk@u.washington.edu
                     www.seattlesoundview.org