Theoretical orientation

Theoretical orientations are approaches to understanding individuals, their goals, and how to help them heal and grow. Some providers strictly adhere to one orientation. I utilize what is known as a prescriptive or "integrative" approach. (You can read more about prescriptive/integrative therapy here.) This means that rather than implementing interventions as dictated by the theoretical model, I tailor my interventions to the specific client, presenting problems, and goals. This does not mean my work is not grounded in theory. Rather, I have become versed in multiple theories from which I draw my interventions and conceptualizations to meet the needs of my clients.

Cognitive behavioral therapy (CBT) offers a strong foundation of organizing the interaction between our thoughts, behaviors, emotions, and physiological reactions. (You can read more about CBT here.) CBT boasts a strong research base and can be easily integrated with other theories and principles. 

In short, person-centered therapy (or Rogerian therapy) assumes people are good. It is a humanistic approach that provides guidelines for relating to clients in a way that assumes they have the capacity and desire for change. (You can read about humanistic approaches here and person-centered therapy here.) Person-centered techniques center the client in the clinical work. The person-centered therapist is empathetic, actively listens, and is authentic. (Fun fact: neuroscience supports the idea that authenticity and congruence fosters a sense of relational safety that is critical for therapeutic change!) Person-centered principles beckon the therapist to collaborate with the client in decision-making and goal-setting, hold their client in unconditional positive regard, and consider the individual needs and preferences of the client in treatment planning and intervention.

Family systems approaches beckon us to consider people within the context of their family and recognize how relationships within the family system impact each family member. (You can read more about family systems here.) Even when I am not providing family therapy, I consider the individual client within the context of their family system. This perspective helps me orient to the environment in which the individual is developing (or has developed.) 

Two other frameworks help me contextualize my clients: Bronfenbrenner’s ecological and Hayes’s ADDRESSING models. Bronfenbrenner organizes the environments of the individual’s life in to levels. (You can read more about ecological theory here.) This approach links the child’s environmental impacts to other programs of care, such as therapy, for comprehensive and holistic interventions. Hayes’s ADDRESSING model outlines ten cultural influences that shape us all. (You can read more about the ADDRESSING model here.) This model promotes cultural responsiveness in my work by guiding me to consider multiple aspects of my client’s internal and external worlds. 

I implement a prescriptive approach in my application of play therapy as well. In general, play therapy techniques can be placed on a spectrum of directiveness—that is, the degree to which the therapist chooses and guides interventions. In some situations, a more directive intervention may be indicated (read about directive play therapy here), while other times a child-led intervention may be best. I blend directive and non-directive techniques, selecting play therapy interventions based on the client’s needs, goals, the stage of therapy, and/or the theory I am applying in the specific case. 

Cognitive behavioral play therapy (CBPT) draws from CBT (see above) to help a child learn about and manage the interactions between thoughts, behaviors, emotions, and physiological reactions. (You can read more about CBPT here.) These interventions tend to be more directive, or led by me. In general, the more verbal a client is, the more I apply CBPT in conceptualization, treatment planning, and intervention. 

On the other end of the directiveness spectrum is child-centered play therapy (CCPT; you can read more about child-centered play therapy here.) As the name indicates, this form of play therapy is led by the child, who is treated as the expert. Though the child is leading, I am not a passive observer, remaining actively engaged in the child’s play. While some play therapy practitioners are strictly child-centered, I merely borrow from the wisdom of child-led play therapy to guide how I relate to the client, and utilize child-led play to achieve specific goals, such as exploring themes, helping the child communicate, learning how they see themselves and the world, and building rapport. In general, the earlier in the therapeutic relationship we are and the less verbal and/or the younger the child is, the more I will draw from child-led theory and apply non-directive techniques.

Finally, Synergetic play therapy (SPT) is an approach to play therapy that leverages neuroscience and play to promote growth and healing. (You can read more about SPT here.) SPT is woven into every aspect of my work with children and adults. While I have not yet pursued SPT certification, I have completed introductory coursework that has informed how I conceptualize and treat my clients, and provide support to their families. Most theories recognize the mind-body connection and address the nervous system, but SPT provides not only a framework for understanding, but also concrete tools and interventions to support the integration of the nervous system. 

If you have any questions, please do not hesitate to ask. I have been known to enthusiastically talk about my theories at great length!