This series of writings is dedicated to the brave of heart. It’s for aspiring “practitioners” of psychotherapy- therapists and clients alike- particularly those with a high growth and transpersonal interest. In the articles you’ll find principles which should encourage exploration and self-development. The important point that is central to making psychotherapy a deliberately developmental practice is this: it involves
practicing some things, many things, over the long haul. And to be clear, I mean practicing something chosen, challenging and worthwhile. Deliberately Developmental Psychology (DDP) is a paradigmatic shift for how to approach and view the therapy journey with ideas which should apply across most modalities.
I believe the term the term “Deliberately Developmental” first showed up in Robert Keagan’s Book,
An Everyone Culture, which has been applied mostly to organizational development. The book is deliberately developmental in its attempt to offer principles which might serve individuals at varying levels
of development. Though it is primarily written for those who have maximum agency to apply the principles offered, I believe that with some effort, the concept can be appropriately reframed by clients and therapists alike, to tailor therapy in a way that is not only developmentally appropriate but deliberately developmental for all- it’s ultimately an “everyone culture”.
The literature, culture and research of psychotherapy has sometimes unconsciously placed clients and patients in a disempowered role, by inferring that the right modality, medication or counseling relationship is what will ultimately heal them. Obviously, this isn’t all wrong. When suffering, it’s good to follow impulses to seek guidance, support and nurturance. But research clearly suggests that outcomes in therapy are much more largely determined by “client factors” than might be expected. Good therapeutic stance, then, should encourage clients to take a larger, developmentally appropriate share in power to foster optimal healing and growth.
First some good news: Therapy works! The efficacy rate is somewhere around 75%- 80%. So the majority who partake show some progress and the more sessions one does, the better the outcome. What is shocking is the effectiveness has not appeared to change in the last 40 years in spite of an explosion of new treatment modalities and many more rigorous standards for psychotherapist credentialing. We would imagine that in the last 40 years, therapy would have gotten much better as a result of the “New Age” but it appears we are still in the “Dark Age” of knowing how it all works.
On average, 40% of factors of efficacy are called “extra-therapeutic”, in other words who the client is outside of the therapy room. Another 30% of the efficacy factors are based on client’s motivations, attitudes, paradigms/models of change. Bundling these then, up to 70% of change clients make in psychotherapy is based on what the client brings to the table. The therapeutic alliance and other “therapist factors” is on average just 30% responsible for effectiveness. So at most, what the therapist is doing, in terms of modality or relational stance is responsible for less than half- likely much less- of the changes a client makes.
And surprisingly, modality accounts for anywhere from just 1% to 15% of therapy effectiveness. Modality is in fact the lowest factor of efficacy in 40 years of research, this in spite of massive evolutions in treatment modalities. This is obviously not to dismiss the role of modality entirely; if one is having issues around sexuality, they’d not contact a career counselor. And of course, the style and competence of therapists must matter a good deal. But the issue I’m pointing to is that in searching for the magic bullet in the psychotherapeutic process, we might do much better to look what might help clients become better at doing therapy rather than putting most of the weight on making the therapy or therapist better.
I’m under the impression that there is a growing body of individuals who want to grow, who want to undertake an ongoing “masterclass” in their development because development itself is discovered as a joyful and positive affair. The skillset of “cleaning up” the negative aspects of earlier levels of development is essential but it is not the same as cultivating positive developmental aspects. Psychotherapy, by in large, has also not put much attention to offering people principles which will help them to a great degree over the entirety of the developmental journey. I argue it’s not done a particularly good job in truly engaging clients to truly “self-help” as much as paying lip service.
And what of these principles? Are there truly ways of engaging a series of practices, including psychotherapy, that seem to make a difference? What is it that makes certain people excellent practitioners of development rather than mere “students” or “clients”, let alone “patients”? This is our inquiry. In the series that follows I propose several principles which can be distilled into practice at virtually every level of development. These are not ultimately to be taken up individually, in a siloed fashion, but as a whole system of deliberately developmental practice.
This series is not a practical emphasis on how to practice as much as how to think about practice itself. At first glance, the principles may seem abstract and that is what principles are, high level but useful abstractions. With time, with a good ground of knowledge in these principles, practices should be able to be distilled from them quite easily and creatively. I hope you enjoy.
Comments