Re: Multimodal Therapy case study available on-line
The PCSP is a fantastic idea, and I hope it doesn't go the way of Prevention and Treatment. I'm a little concerned that we're still only seeing a single case study on the site, but I can't seem to find a publishing schedule so it's hard to know whether that's really a bad sign or not.
When I first started reading about the various approaches to therapy, I was searching mainly for differences -- in other words, what makes these approaches distinct? The more I read, however, the more obvious the similarities became. It's remarkable how many popular approaches recognize the same facets of human existence. The primary difference is in which of these facets can/should serve as "access points" for intervention.
For example, I don't think a Reality Therapist would quibble too much with Lazarus's "BASIC I.D." schema as a way of conceptualizing the client -- but he or she would insist that Action (or "Behavior" in BASIC I.D. terms) is the primary (only?) access point for change. A CBT therapist would expand that to include an access point for cognition as well as behavior. A Gestalt therapist would probably declare emotion (or "affect" in Multimodal terms) as the primary access point.
What seems to set Multimodal Therapy apart is the idea that all of these aspects (behavior, affect, sensory experience, interpersonal, cognition, imagery and biological) can be access points. In execution, however, the real differences between Multimodal and Cognitive therapy seem fairly minimal - at least after the initial assessment is completed. Is it possible that differences in terminology make these two theories seems more different than they actually are?
For example, isn't it fair to say that a Cognitive therapist's conception of "cognition" would also include what Lazarus calls "imagery"? (Perhaps more importantly, is it clinically useful to seperate the two into distinct categories?) Is "interpersonal" truly an independent "mode", or is it just a superset of behavior (talking with others, embracing them, etc.) and the cognition associated with that behavior?
Another aspect of multimodal that seemingly seperates it from CBT is the enthusiastic embrace of "technical eclecticism". In reality, however, the disciplines from which Multimodal therapists seem to draw are mostly cognitive and behavioral. As for the occasional Gestalt and Rogerian technique, that seems to be pretty common among Cognitive therapists as well.
At the risk of making this post ridiculously long, another idea that strikes me is the "relationship flexibility" of the Multimodal therapist -- an attempt is made to determine what kind of therapist the client wants (i.e. very warm and "soft", or "all business", etc.) and to adjust the clinical style appropriately. A couple questions: does CT have an "official" clinical style? Does anyone out there adjust their clinical style radically from client to client, and does this present any problems for them?
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