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Article 5

Doing Counseling

Bridging the Modern and Postmodern Paradigms

James Rudes and Jeffrey T. Guterman

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In recent years, postmodernism has emerged as an influential intellectual movement in various disciplines, including the field of counseling. Postmodernism is a philosophical framework that holds that knowledge is socially constructed and language- based (Lyotard, 1984). The postmodern perspective is to be contrasted with traditional modernist conceptions that endorse an objectivist approach. Numerous counseling models have been developed in keeping with a postmodern perspective. These postmodern models all tend to emphasize the important role of language and a collaborative approach to working with clients.

The postmodern movement has also been occasioned by a proliferation of eclectic counseling models. This trend is reflective of a growing realization that no single clinical theory is adequate to account for all types of problems and clients. Held (1984) has developed a model called strategic eclecticism that incorporates theories and techniques from virtually any clinical system within the change process of another model. According to Held, strategic eclecticism allows for the systematic selection of disparate theories and techniques within a process-oriented model that emphasizes a theory of change rather than the content to be changed. For example, Held has shown how the theories and techniques from various clinical systems can be incorporated within the change process of the Mental Research Institute’s interactional therapy. In Held’s model, interactional therapy serves as a meta theory that allows for the incorporation of virtually any content within its change process.

In this article, we present solution-focused counseling (de Shazer et al., 1986), a clinical system informed by postmodernism, as a process model that serves as a framework from which to develop a strategic approach to eclecticism. Our approach speaks to the need for convergence between the modernist and postmodernist schools and, in particular, an increased respect and understanding of other clinical models. According to Linares (2001), such an effort involves “moving beyond postmodernism in an integrative way” (p. 410). Strategic eclecticism addresses this need by allowing for the systematic and compatible use of a multitude of theories and techniques.

A Strategic Approach to Eclecticism

The clinical theory of solution-focused counseling, the process model or metatheory used in our strategic approach to eclecticism, is informed by a postmodern position that holds that there are no clinical problems independent of social interchange that occurs between counselors and clients. Accordingly, clinical problems are cocreated in language. De Shazer (1991) has noted, however, that the notion of problem necessarily implies the existence of nonproblem or exception, that is, “times when the . . . problem does not happen even though the client has reason to expect it to happen, and, of course, the space between problem and nonproblem or the areas of life in which the problem/nonproblem is not an issue and is not of concern to the client” (p. 83).

In solution-focused counseling, the notion of problem begs the notion of solution as there are always exceptions. Hence, a clinical problem is conceptualized as problem/exception. The change process results from identifying and amplifying exceptions. Clinicians use interventive questions toward this end; for example, “When has there been a time when you have coped better with this problem?” Exceptions may be amplified by encouraging clients to do more of the behaviors that have led them to solve the problem in the past, to observe times when they are dealing better with the problem, or to ascribe meaning to exceptions. The criterion for problem resolution in solution-focused therapy is that the presenting problem is sufficiently improved or sufficient progress has made been made in the direction of the goal.

In solution-focused counseling, the client and counselor collaborate to define a problem and goal. The problem definition is then subsumed by the problem/ exception conceptualization. In many cases, problem resolution is attributed to the client’s own view that he or she is no longer experiencing the problem. This might be related to an increase in exceptions or an increase in the client’s awareness of exceptions. In each case, however, change is facilitated by the client’s ascribing significant meaning to the exceptions. As de Shazer (1991) has suggested, “for the client, the problem is seen as primary (and the exceptions, if seen at all, are seen as secondary), while for therapists the exceptions are seen as primary; the interventions are meant to help clients make a similar inversion, which will lead to the development of a solution” (p. 58).

Held (1984) has suggested that strategic eclecticism allows for the systematic application of diverse theories and technique within a process model or metamodel. Hence, if the theories and/or techniques from another clinical approach are fitting with a client’s worldview or if the client initiates presentation of such content, it may be used within the change process of solution-focused counseling. Held (1984, 1992) has used the content/process distinction as a lens through which to describe strategic eclecticism. Content refers to the object of change. Process refers to what is done to bring about change (i.e., interventions). Two levels of content have also been defined by Held (1992): formal content and informal content.

Formal content refers to the counselor’s assumptions about the causes of problems (i.e., “explanatory concepts that must be addressed across cases to solve problems” [Held, 1992, p. 27]). Informal content refers to the client’s own assumptions about the causes of problems (Held, 1992). All clinical theories necessarily take a position regarding formal content. For example, in Skinner’s behavior therapy, formal content is defined as environmental contingencies. Furthermore, all models tend to fit informal content within their formal content during the change process. Thus, in behavior therapy (and virtually all models), the client’s informal content is reframed in terms of formal content.

Unlike clinical models operating consonant with a modernist perspective, the formal content in solution- focused counseling is stated generally; that is, the specifics of the problem/exception are not specified, and instead, informal content is the principal guiding metaphor used in treatment. Because the formal content in solution-focused counseling is so general, it allows for the conceptualization of formal contents of other clinical systems as informal contents (i.e., as metaphors rather than as objective depictions of the domain of problem formation and change) that are, in turn, incorporated at solution-focused counseling’s formal content level. The use of formal contents from other schools as informal contents within solution-focused counseling need not be restricted to instances when clients initiate such ascriptions. If fitting with the client’s problem and worldview, counselors may introduce to clients theories and/or techniques from other clinical systems at the informal level, in hopes of then using these at solution-focused counseling’s formal level during the change process. A case example is provided to illustrate the use of strategic eclecticism in solution- focused counseling.

Case Example

A 24-year-old married man with no children presented to counseling with the complaint that he had been unemployed for the past 18 months. After completing an undergraduate degree in business, he took a sales position. He resigned from that job after 1 year due to low commissions. He took a second sales position shortly thereafter and was terminated due to poor performance. Since then, he had made little effort to seek employment. His wife urged him to get counseling to deal with the problem. During the first session, the client reported that he remained committed to working in sales and considered that he had not yet found the right position. The client reported that his goal was to stop procrastinating and begin seeking employment. The counselor conceptualized the presenting problem in keeping with the problem/ exception theory used in solution-focused counseling.

During the first session, the client stated that he had seen two counselors in the past year; both had offered practical strategies for dealing with his unemployment, but he did not find either to be helpful. The client stated that he felt there was some underlying psychological cause that was contributing to his procrastination and avoidance and, moreover, that it was necessary for him to gain insight into this cause in order to effect a change. After discussing various aspects of the problem, the counselor presented rational emotive behavior therapy (REBT) principles as a basis from which to understand the problem. The client was shown how REBT, a model that has been placed in the modernist camp, holds that irrational beliefs consist of demands that humans escalate from strong desires. The client agreed that he held irrational beliefs that had been contributing to his procrastination and avoidance. At the end of the first session, the client was asked to purchase an REBT self-help book and begin using the disputation method of thinking and acting against irrational beliefs.

During the second session, the client stated that the REBT principles made sense to him. He reported that he had begun questioning the irrational beliefs that were identified in the first session. The client reported, however, that he had not taken any action in the direction of the goal. At this point, the counselor educated the client with regard to REBT’s most important insight, namely, that “there is normally no way but hard work and practice . . . to change yourself and to keep yourself . . . more functional” (Ellis, 1999, p. 111). At the end of the second session, the client was encouraged to implement concrete job-seeking activities.

Prior to the third session, the client called the counselor to report that he had an upcoming job interview that necessitated his canceling their next appointment. The client said he would call back to reschedule. When 2 weeks passed without hearing from the client, the counselor called to followup. The client reported that he was now gainfully employed and had forgotten to reschedule. The client informed the counselor that he took a salaried position as a banking specialist. He also stated that he was considering going back to school to get a graduate degree in history. The client felt that further sessions were no longer needed.

Conclusion

The model described speaks to one of the main rationales for eclecticism, namely, the need to tailor conceptualizations and techniques to fit with the unique aspects of each client and problem. Indeed, the solution- focused model provides counselors with a great deal of choice as a result of its positing such a general theory of problem formation at the formal content level. This preference to avoid imposing predetermined formal content during the change process can result in the counselor feeling less than grounded during the change process. Hence, a strategic approach to eclecticism affords the counselor with many theories and techniques that might not have otherwise been considered within a solution-focused model. Questions remain, however, regarding precisely how counselors might be guided in their selection among so many disparate theories and techniques. Future research could focus on identifying the criteria from which counselors choose theories and techniques within a solution-focused approach to strategic eclecticism and the effectiveness of their choices.

Finally, it is reaffirmed that strategic eclecticism and, in particular, the approach set forth speaks to the call that has been made for convergence between the modernist and the postmodernist schools (Linares, 2001). Indeed, strategic eclecticism holds promise for development, refinement, and expansion of numerous counseling models. Counselors can follow the process set forth of invoking pertinent rationales for using theories and techniques from other models, and then modifying those theories and techniques as necessary in order to retain while, at the same time, enhancing the integrity of the model of their choice.