This is my take on the toolbox approach to therapy/counselling.
Master of all trades?
Recently I added my practice details to two psychology service directories. Before I decided on these specific two, I looked at the profiles of currently subscribed members. In order to get an idea of what these directories offer.
I was astounded by the number of therapies (types of therapies / therapy modalities) offered by some therapists. Five types of therapies are not an exception, and here and there you will even encounter someone offering up to eight!
This is in line with the popular toolbox view of therapy/counselling. That the therapist should have a tool (type of therapy) in his/her toolbox that is best suited for every problem a client may present with.
Also, this looks very impressive to potential clients. Potential clients may view these therapists as very learned, competent, and advanced.
There are however a few problems with this approach.
Therapy as a skill
One should ask questions about the competence of the therapist in each of these types of therapies. Unfortunately, many therapists add a specific therapy to their skill set after attending a single workshop. Attending a workshop like this only, certainly does not qualify you to be a skilled therapist in a new approach.
The “10 000 Hour-Rule” originated with K. Anders Ericsson and was made widely known by Malcolm Gladwell in his book, Outliers. He stated that a person needs to spend 10 000 hours to master a skill. One can surely debate the exact number of hours, what types of skills are included in this generalization, the role that nature (vs nurture) plays etc. However, the principle remains true. To really become a master in a skill, you need to spend LOTS of hours practicing and honing your skill!
Therapy/counselling is no different. Professionals can have a lot of knowledge about multiple therapies. For example, they can know all the theory there is to know. However, to USE these therapies, is a whole different matter!
An engineer can know everything there is to know about planes and flying. He/she can know why and how a plane can stay in the air and all the technology to ensure a safe flight. However, unless he/she has not learned to fly and put in the required number of flight hours, he/she cannot fly a plane!
Therapists need to use the therapies. Also, practice and hone the skills for hours and hours on end, required by all the different therapies in his/her toolbox. Unless he/she does that, he/she will remain a Jack of all trades, but a master of none.
This concept of a toolbox approach, implies that the therapies in your toolbox are extremely limited in what problems they can “fix” – you need a different tool for every problem. It is disappointing if we cannot find modalities with a wider range of applications.
Evidence based approach
Many therapists using some version of this toolbox approach, will justify why they don’t need to practice so many hours on each approach, by saying that they use a combination of the therapies that they have “learned”. The so called eclectic approach. One of the problems with this is, as soon as you take only an aspect or element from an approach to “mix” it with another, it no longer qualifies as the original approach. Therefore, you can also no longer claim the researched effectiveness of the original approach. If a therapist uses an unique combination of bits and pieces of various therapies, there seldom is an evidence base for his/her approach. These therapies are no longer used in its original intended forms. Therefore, he/she cannot lay claim on the evidence base of any of the single therapies that form part of the mix.
Maybe you are fortunate enough to find an older and very experienced therapist. Someone who has mastered several approaches in his/her career. Consequently, you can probably feel comfortable when he/she uses several approaches to treat various problems you may present with.
Alternatively, you may find a therapist who uses an integrative approach. In other words, not different therapies for different problems, but aspects of therapies combined into an integrated whole. Additionally, this new combination has been researched and shown to be effective.
Unless it is one of these two exceptions, I would be very cautious of an apparent toolbox approach to therapy.
For my approach to therapy/ counselling, you can look at the following two videos on my Facebook page: https://www.facebook.com/320262548393244/posts/968983746854451/
To get more perspectives on therapy/ counselling, you can also read the following post: https://www.helderbergcounselling.co.za/no-pain-no-gain/