The Therapy Turf Wars

“My therapeutic approach is better than yours!” All too often therapists with one particular approach criticize one – or all – of the others, and I’m sick of it. CBT is frequently involved in these turf wars, partly because it’s the favourite of the NHS. Some CBT therapists imply that their approach is vastly superior to all others, ignoring the evidence that supports the effectiveness of other schools of therapy. Humanistic therapists frequently respond in kind, suggesting that CBT is shallow, simplistic and unable to tackle deep rooted issues.

Ruby Wax is an especially irritating ‘turf war’ critic. Ruby is a passionate advocate of Mindfulness Based Cognitive Therapy, an approach I have a lot of respect for. Sadly Ruby feels it necessary to dismiss several of the most important ‘rival’ schools of therapy with funny parodies. Carl Rogers developed the Person Centred Approach (PCA) that unpins most Counselling in the UK today. According to Ruby the PCA is about repeating “whatever you said back to you like a parrot but with love” (Wax, 2013). She goes on to dismiss Gestalt, Existential and Psychoanalytic approaches. Ruby; it may be funny, but it’s not clever!

Triggering my ire today is a book about the Human Givens Approach, which claims that the PCA, Psychodynamic school and CBT are all “piecemeal approaches” and that none of them “are sufficient on its own” (Griffin and Tyrrell, 2007). Their solution is, of course, the Human Givens Approach! The research evidence suggests that PCA, Psychodynamic and CBT can all be effective in certain circumstances. In fact CBT make much of the robust research base that supports it and a Person Centred Approach is one of only four therapeutic modalities approved for the treatment of depression under the NHS.

All this frustrates and saddens me. The Human Givens Approach has a great deal to offer and I intend to integrate it into my own therapeutic practice. But I’m galled that those who developed it feel the need to dismiss other approaches as inadequate. It sometimes feels like I’m back in the school playground hearing one kid saying “My Dad’s bigger than your Dad!” Viewing all this though a psychodynamic lens, I wonder if some therapists have unresolved childhood issues!

Elephant parable ilustration

We need a wide perspective

Given that the human mind is the most complex system in the known universe, is it really plausible that one school of therapy will have the definitive and complete answer to every individual’s unique mental health problems? Maybe one day, but most certainly not yet. Meanwhile I’m adopting a pluralistic approach, learning as much as I can about as many different paths to healing as possible. I try to take a wide perspective, asking myself the question; for this particular client, at this specific moment, which therapeutic lens is going to be the most helpful? This is usually called having an ‘integrative’ approach, but I think I’m best described as a pragmatic therapist: My only interest is what works?

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