Eclecticism vs Specialization: An emerging specialty that changes how modern day mental health services are converted to the best interest of the client.
Implicit bias is believed to be, by literature, research and blinding analysis (those are my biases in this regard) very difficult to change. And those “believed to be” words are apart of the story. It’s possible that in the study of bias we “prefer” knowing that we have “it” right. And therein lies the irony. HOW you think may not change (the hippocampus, prefrontal cortex, etc do what they do). WHAT you think (outside of safety) is optional. Bias is SIMPLY changeable. Think about some of the words you use everyday. Think about how they direct you in all of your interactions with those around, in your work, in your families and in your judgments of self. Kurt LaRose LCSW, CHT, CSW SPRVSR and LICSW (TalkifUwant on Instagram)
I’ve tried a number of times to specialize. It’s a big big thing in medical professions and in mental health. First just as a clinical social worker – the profession where the clinician is trained in almost every form of intervention – such that we know a little bit about allot; and that’s the one thing we know the most about; it’s called the PIE perspective. Later the specialization bug kicked in as an expert in youth, addictions, sexual behavior, then onto hypnosis, next was online digital therapies, onto trauma – and even more as I expanded my work and licenses into two different states I began to promote my areas of specialization.
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What I’ve learned over time, and I’ve learned this every single time I’ve moved toward specialization – is the direction of specialization is inadvertently about my biases’ not necessarily my expertise. Specialization may limit my ability to effectively help the client sitting before me as I may attempt to direct them to what I have as opposed to the client directing me – to what they need. You see, my clients showed me that a specialty might not fit their case, particularly as the case gets increasingly unpacked over time. They would see my promoted specialty, assume that they fit, and then as we worked together trying to make it fit, many times the client would not progress. Why? Bias – not only mine, but theirs too. Frankly, the studies on implicit bias are not too promising in moving people out of their own … however science has a really cool way of shaping things and as such I am not back to my earlier training concepts – I am not a specialist at all anymore – I am a real social scientist using real science to shape all of my work.
Years ago,in 2011 on a blog in Merchant Circle (and my business facebook page, later to my Instagram, and my google business site too!), I first wrote about people being unique and lumping them into categories as a scientific flaw really — and it summarizes sooo much, why eclectic work is critical to helping:
In statistics when an extreme outcome is realized, it is often lumped into an “outlier” category, so as not to inexplicably alter the norm. The problem is that every person is quite unique, and not all outcomes can be standardized within a limited number of deviations. “Normal” is great – but so is the magic or the miraculous or the unexplained….people change, and many times against all kinds of odds — just because it looks like or sounds like an outlier – doesn’t make it un-true, false, or abnormal. It might just be wonderful! www.TalkifUwant.com Posted September 21, 2011 at 07:53 AM
Here’s what I’ve learned about specialization – from me, for me and to me (which is about my biases and about my goal of helping): Don’t do it. Sure, you will have clients you are really really good with – your biases are likely traceable in this regard. I’m not saying specialization is not needed – referring in a lack of progress client situation makes sense, especially after a clinical psychologist does psychometric testing (emphasis added on that psychometric part) – and at times medications are needed in psychiatric care (of which mental health experts must refer). Learn more here about other professionals in the mental health business…
But in talk therapy – non-specialization is my specialty. I’m eclectic.
What a talk therapist really needs, in my (ironic as it is to say) biased view, is not a specialty as the focus or the one area of certification and continuing education and repetitive credentialing (licensing standards assure minimum mental health qualifications are already met). Why? What ONE client presents with ONE set of things needing ONE form of care?
Clients are unique. They know their lives better than anyone. From fingerprints, to retinas, to DNA – one version, one size, one of anything cannot help everyone. Here’s how I’ve written about “help” – as a definition ….
To be what google definitions (and others on the web) calls “comprehensive” and eclectic (as eclectic is itself defined) and in my view to be an effective social scientist some basic training in key areas are needed. And this list is not exhaustive (and links are coming soon) but a high degree of credit and thanks can be attributed to many:
- a primitive understanding of areas of the brain involved in thinking and in feeling and how it is that thoughts are created and where they therefore originate (Dr. Atkinson and Emotional IQ).
- a basic understanding of hormonal processes and influences in the body – from birth to senescence (thank you FSU College of Social Work), as well as the variations of hormones in times of varying forms of stress (illness, work, relationship, mental health, trauma, addictions, etc)
- a working knowledge about chemical and psychological equivalence – such as testosterone as confidence and cortisol as doubt (thank you Dr. Cuddy), dopamine as motivation and oxytocin as love, serotonin in incessant thoughts and tryptophan and melatonin in sleep and relaxation.
- a primitive understanding of how a happy brain and body work (thank you Dr. Brian King and Dr. Seligman) – via survey and brain scan research – where in science genetics are included in the emotional state by birth along with the impact of intentional activity (thought and action) with behavioral factors and steps as well. How can you help a person with a disordered brain get to having a working one, if you don’t have a primitive understanding of the science of happiness? This would be like taking your car to a mechanic and the mechanic saying we know what’s wrong, we know how it got messed up, but we don’t know how it was before it ever got damaged – so we’ll see you next week.
- An understanding of how implicit bias works (thank you Dr. Jussim for highlighting the pros here) and its impact on clients and providers in the narratives used to effect care (and sadly often to elongate it).
- An understanding of how psychosomaticism works, very basically, in that the misfiring of neurons into nerve endings may be a culprit, caught up in a perception that future happiness is not possible (thank you Dr. O’Sullivan).
- An understanding of diagnosis and the impact of stakeholders creating the standards by which they prescribe (thank you Dr. Ken Carter and Pharmacology) and the clouded possibility that even normal can be made sick (thanks to Dr. Joel Paris in talking about the full history of the DSM and the release of the DSM5) particularly his thoughts on “medicalizing normal.”
- A basic understanding of epigenetics – where and how these are break offs if you will, jumping genetics altered by environmental factors primarily (thank March 2012 issue of Scientific American)
- a basic understanding of nutrition, stress, exercise and sleep – with these 4 as tools to improve mental health (thank you mainly Dr. Nick Hall and the Brain Institute)
- a basic understanding of blue light on the brain (thank you for information sharing, Linda Graham, 2018 PSN Symposium)
- a basic understanding of the impact of simple carbs on the body, how the digestive system works in natural selection or maybe even reverse natural selection when diet changes are dramatic (controversial in those who support simple carbs and those who do not; my interest here emerged out of my own weight loss process of dropping 72lbs in a gradual process starting in 2004).
- the impact of words in creating a view, a perspective, a belief and how coding data as true/false in the brain might work as well as tidbits of information about the Reticular Activating System (thank you Dr. Price, Dr. Connoly, and Dr. Hall)
- substance / other addictions treatment (12 step self help models, non-faith and science based recovery models, life satisfaction models, the neuroscience of dopamine and opioid production and scans of addicted brains)
- a basic understanding of stage theories in key areas of the discipline: personalities and craig, crises and erickson, underlying factors hidden away and freud, adolescence and craig, faith and fowler, death and hospice, hypnosis, Westburg, and Kubler-Ross models, love and sex in addiction and in the affirmative (Carnes, Kerner, Cort and the LGBT community at large)
- A medical model view vs an environmental view (thank you Florida State College of Social Work, Steve Serventi, Dr. PAuline Chen in Final Exam)
- The Survivor Personality, by Seibert
- Post-traumatic growth in Option B, by Sandberg
- thought disorders (Dr. Leslie Parsons)
- personality disorders (Joel Paris again!)
- the brain and neurobiological stuff in and for the common uses with clients, patients and people (thank you Dr. Siegel, Dr. Siebert and most recently Dr. Arden, Mind-Brain-Gene!)
- A full understanding of domestic violence in all of its forms (thank you Dr. Wexler)
- A strong grasp of behavior and behavioral modifications (thank you to pioneers unnamed, but to Boystown National Training Center foremost and first and then to my clients who time and again change something – in behavior!).
Note: this page is under development as of March 2019. It is currently comprised of a small summary and more of an emerging bibliography. Links and updates will be added with various updates to this page.