I Have A Beef.. With The Word Therapy


It's a loaded word. And what does it even mean?

Depending on what movies, tv shows, stories, experiences you've had... it can wildly vary. And really I blame us, the therapists, for this. If you sat 10 therapists in a room and asked them "What is therapy?" You'd probably get at least 4 vastly different responses.

You see, therapy has different schools of thought (called theoretical orientations). Hundreds actually! (Although many of them group under umbrella headings).

One brilliant therapist could say that therapy ought to be "brief" and "solution-focused" while another therapist could say its an "insight-oriented process" (read: "longer") and still another could brag that their longest client relationship spans decades! (Yes, I have heard this).

So how do you know what you're getting? And how do you know what you need or want up front? If I were a potential client, I'd be confused!

Like many other areas, I find the turf-wars to be tiring. I don't know why we have to act like "effective therapy" can only be one thing.  Actually, recent research suggests that (more than any theoretical orientation) the "goodness of fit" with the therapist is what matters most for a successful outcome.

Highly respected, intelligent, experienced theorists have resorted to screaming matches over this issue. I can't pretend to have The Answer. But I can tell you what I think... and do with it what you will.

I think that it's crazy to act like the same issues bring everyone into therapy... so it's crazy to act like the same kind of therapy will help all clients! (*ducking... as I'm sure I'll take heat somehow*)

If you come in with trauma from a car accident (and had a perfectly functional life before the accident), I don't think it's worthwhile to deeply explore your childhood. I think- lets get this trauma fixed! Let's apply some rapid and research-oriented solutions, like EMDR or Hypnosis. Similarly, simple phobias, chronic pain, or panic disorders are not the same thing as a long-term childhood chaos. And on the flip side, if you are a pretty satisfied and healthy individual who is in a troubled family relationship, my response is going to be different than if you are deeply depressed and dissatisfied with life. 

Sometimes people need a quick solution- either because their problem is specific and acute, or because that is all they have the energy for at the moment. And sometimes people need time, space, processing, and insight. They don't want to be rushed through their process. Much like a spa day for the mind, they enjoy that therapy is a retreat from ordinary life where they are free to focus entirely on their own health. How on earth could one word- therapy- apply to all that!? Who better than the client, to decide what they need?

So I think I'll begin to use different vocabulary. After all, who knows what you need better than you?

Some ideas, and I'm just spit-balling here:

Therapy: Insight-oriented, deeper addressing of complex issues through specific techniques
Strategizing: Solution-oriented, short-term addressing of a specific issue 
Counseling: A longer-term, "walking beside" of a person through life transitions or for support.
Relationship Work: A workshop for a family or couples' systemic issues which focuses on improving connectedness and communication.

I'm wondering if we started teasing out the different reasons people go to therapy then maybe it would become clearer for all involved. Maybe clearer labels would lead to clearer benefits and a better therapy/client fit?

What do you think? What labels would you give to therapy?

Is there a label above that you like better than "therapy"? A label that would convince you to give it a try? Or one you recommend? I'm taking ideas here! Really!

I think the clearer we therapists can be with potential clients, the better. 

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