Being an MFT

The Theoretical Orientation: Everything You Need to Know!

“Pay attention to these theories–

–one of them will become your theoretical orientation.”

“This will help you choose your theoretical orientation.”

“You’re going to need to know your theoretical orientation not just for your final case study, but for LIFE.”

My professors etched these words– the ones they started pushing from day one in grad school– directly into my brain. They really wanted us to know our damn theoretical orientation. At first, that seemed silly. Now here I sit, typing away about it as the subject of my first blog post on nicolelocorrieremft.com. Turns out, it’s crazy important for a therapist to have, and for a client to know about their therapist. 

A therapist’s theoretical orientation is often described as a lens with which to view clients and help them solve their problems. It’s somewhat of a guidebook, so to speak. Each one has it’s own way of explaining the client’s problem and it’s own group of interventions to solve it.

That’s all well and good, my first-year-self said. But why limit yourself to one theory when you could fill your metaphorical toolbox with EVERY theory’s interventions??

Try going into a session without any lens for looking at the case. See how it goes, my professors told me.

**The information on this website is purely educational and not to be used as therapy. While my post-grad job prospects are still in the air, if you think you might need a therapist, please check out BetterHelp! They have thousands of licensed therapists that you can meet with online for a fraction of the cost of in-person therapy.

Why It’s Important for a Therapist to HAVE a Theoretical Orientation:

I took the bait. My first clients were a recently married couple, both still in nasty court battles with their previous spouses. They hated each others’ families and exes, and spent the whole session bickering with each other and asking me to take sides. Because I never chose a lens, the insane amount of things to keep track of in the room completely overwhelmed me. Body language, interaction patterns, family patterns, boundaries, internalization, triangulation, oh my god.  Never mind all the things I was supposed to do as a therapist– good eye contact, validation, active listening, even just finding a place to get a word in with this couple seemed impossible. Unsurprisingly, they stopped coming after about three sessions. I wonder often if they’re doing okay.

It’s not uncommon for a new therapist to lose their very first clients. However, not having a theoretical orientation should not be the reason why.

Obviously, if I had chosen a lens with which to see this couple, I would’ve had a clearer idea of what was important. I may have even been more confident in interrupting them because I’d have known my words were important. This is not to say one theory will work for every client, or that a therapist can’t pull from several theories. But I am saying that therapy is impossible without some sort of guide. 

 

Why It’s Important for a Client to KNOW Their Therapist’s Theoretical Orientation

Now that I’m a hardcore advocate for the theoretical orientation, I want to help clients make more informed decisions about their choices in therapists. Some theories are just not going to work for some clients. Here’s an example:

When I was experimenting with structural therapy, I had a traditional Indian family whose son was spending a lot of time in the bathroom. They were afraid he was doing drugs. As it turned out, the poor kid never had a second to himself because his parents were so strict. He was in the bathroom relaxing. Just scrollin’ away on his phone, enjoying time to himself. They were stuck in this interaction pattern where the parents were strict, so the son rebelled. The parents got stricter because of the rebellion, so he rebelled more. Structural theory informed me that I should encourage them to loosen up their boundaries. But their culture didn’t really believe in this. They stopped coming because they felt like I didn’t really value their beliefs. I may have been right, but that didn’t matter as much as our therapeutic relationship.

This is why therapists should give their clients a basic understanding of their theoretical orientation ahead of time. If I’d had this conversation with the family in our first session, I could have either avoided offending them by using a more appropriate theory, or they could have chosen another therapist.

 

What is My Theoretical Orientation?

Now that I’ve blathered on about this for so long, I should share my own theoretical orientation, yeah? I usually work with a combination of Internal Family Systems and Narrative.

IFS

I think IFS therapy completes systems theory, the idea written on the homepage. IFS proposes that an individual is it’s own system. It says we have several parts- exiles, managers, firefighters and one’s core self.

Our core self is our inherently good traits– confidence, leadership, compassion, etc., and it’s meant to lead the internal system. We all have this part, but accessing it is a matter of how many other parts are vying for it’s job. They’ll do this when we’ve been through trauma.

The exiles hold pain. Sometimes, we need to sit with emotions so we can process them and move on. But these guys tend to wallow, so we need managers. Managers exile those parts to keep us from constant turmoil, allowing us to live our day-to-day lives.

Sometimes though, a trigger pops up, or there’s just too much pain to hold. If the manager fails at keeping exiles at bay, the firefighters come and well…put out the fire. Often, they choose unhealthy methods like binge drinking, violence, or reaching out to toxic people.

I find this theory helpful when a client is unable or unwilling to bring family members into therapy. IFS allows us to still work with them! As I always tell my clients, MFT works like a mobile over a baby’s crib. If you touch one little bobble, the whole thing moves. If one person changes, the whole system must adjust. 

 

Narrative

The second theory I incorporate into my theoretical orientation is Narrative. Narrative says people define themselves by one dominant story of their lives, even though there are infinite potential options. Often, that story becomes saturated with problems, which means we start defining ourselves as a problem! The narrative interventions usually involve helping people see that what they’re going through is something that happened to them, not something they are.

I also love narrative therapy because I’m a writer. I minored in creative writing when I was an undergrad! So the metaphor through which narrative therapists see the world was just a natural, beautiful choice for me.

For therapists and clients– have you ever been overwhelmed or stuck in the therapy room? Do you think a clear theoretical orientation may have helped?

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