Psychotherapy practice in a pluralistic world: Philosophical and moral dilemmas.

Abstract

Although the "new" philosophy of science, social constructionism, postmodernism, feminism, and multiculturalism represent relatively distinct intellectual trends, they converge on 1 theme: Human knowledge cannot be completely disentangled from sociocultural influences, and, therefore, multiple, conflicting viewpoints predominate. From this perspective, forms of eclecticism and integrationism have emerged as responses to the pluralism of the psychotherapy field. Yet, because of a bias toward systematization, these models largely act, paradoxically, to constrain pluralism. Moreover, existing models do not acknowledge that therapists also live in a pluralistic world, thereby imparting their belief and value systems to clients. Consequently, the central dilemma of psychotherapy can be formulated in R. J. Bernstein's (1992) terms as an enduring tension between affirmation and critique: the therapist's conviction, which grounds the therapeutic exchange, pitted against the therapist's uncertainty, which questions all assumptions. A dialectical approach is recommended as a means of clarifying, but not resolving, this dilemma.Because "pluralism" introduces a relativistic element into our conceptions of what is real, good, and true, there is no consensus in psychology or psychotherapy regarding its nature or value (

Beyond the approaches: tendencies in Clinical Psychology that transcend theoretical barriers

“…La primera (Junk Science) es el testimonio y consejo de expertos, refiriéndo-se a la divulgación de discursos no calificados o faltos de soporte científico, que se difunden a través de los medios de comunicación masiva y en el contexto de procedimientos legales. La segunda amenaza (Antiscience) es tomar la verdad como un concepto ilusorio, entendiendo que la ciencia constituye solamente un modo de discurso entre muchos otros igualmente válidos, como la intuición o la experiencia personal (aspecto que se relaciona con el planteamiento descrito por Downing, 2004). La tercera (Pseudoscience) trata propiamente de la pseudociencia, indicando que la diferencia con la ciencia legítima es de grado, por lo que el concepto de pseudociencia no es categórico sino prototípico (i.e.…”

“…Downing (2004), por ejemplo, señala la importancia de que el psicólogo clínico emplee tratamientos que se hayan probado efectivos, a pesar de ser casi evidente. Ello implica necesariamente abandonar aquellos que hayan probado lo contrario, que es donde muchos profesionales muestran renuencia (Lilienfeld et al, 2013).…”

Systems of Psychotherapy

“…The need to question practices constantly is reinforced by confirmatory bias research demonstrating how people attend selectively to information congruent with existing beliefs. Downing (2004) summarizes the situation as follows:…”

Facts and values in psychotherapy—A critique of the empirical reduction of psychotherapy within evidence‐based practice

“…In this sense, the aim of psychotherapy is clearly normative because the whole enterprise hinges upon the assumption that some ways of living are preferable to others. In addition, the psychotherapy processes involves normative concepts such as character, virtue, ethical dilemmas, and notions of the good and righteous life …”