Collaborative therapy

Collaborative therapy is a philosophy in psychotherapy that emphasizes the need for a solid relationship between the therapist and the person or persons receiving therapy. It is based on the idea that since many of the problems that result in people seeking therapy are caused by problematic relationships, the problems can best be solved by fostering new relationships and better interactions. In collaborative therapy, the focus is on conversation between the therapist and the person receiving therapy. Each person seeking therapy is considered the expert of their own situation. The therapist’s role is to facilitate the conversation in a way that helps a person transform how they respond to their situation.

Background

The collaborative therapy philosophy was developed by American psychologist Harlene Anderson in the early 1990s. Anderson was concerned about why some people responded to traditional psychotherapy and others did not. After conversation with people in therapy and other psychologists, Anderson arrived at a postmodern approach to psychotherapy. Postmodernism is a movement developed in the latter part of the twentieth century. It is based on skepticism towards sweeping theories that tend towards an “all or nothing” approach in science, the arts, and other fields. Postmodernists believe there can be more than one reality or truth and accept the presence of uncertainties and variations over universal truths.

Anderson developed her approach to psychotherapy with Harold Goolishian. Goolishian shared Anderson’s view that therapists should not act as if they were they experts and that all patients seeking therapy for a particular issue were similar. His earlier work with adolescents and families helped pave the way for the development of collaborative therapy. The process is called collaborative therapy because it focuses on the therapist and the person being helped as a team. Collaborative comes from the Latin collaborare, which means “working together.”

According to this philosophy, psychotherapy does not work for some people because it focuses on fixing a problem instead of helping the person learn how to overcome the things that created the problem. Patients who have had issues similar to those the therapist has dealt with in the past may be treated in the same way as previous patients, without consideration that their circumstances and life experiences may be different. In keeping with the postmodern view that there are no “one size fits all” generalizations, collaborative therapy focuses on uncovering the unique circumstances that caused a problem for the individual patient.

Overview

Collaborative therapy is a form of talk therapy where a therapist and a person seeking help engage in conversation in order to find a resolution to the person’s concerns. However, unlike some other forms of talk therapy, collaborative therapy focuses more on building a relationship between the therapist and the person or persons seeking help. This relationship is fostered through two-way conversation and dialogue.

An important factor in these conversations is that the therapist strives to avoid acting as if they are an expert. Instead, the therapist facilitates the conversation, asking questions and actively listening to the other person’s responses. The person seeking help is seen as the expert in their particular situation. While listening and responding, the therapist avoids applying generalizations that imply they have a higher level of understanding of the person’s issues or experience.

The therapy includes a significant amount of interactive dialogue, with the therapist listening intently to what the other person has to say. The therapist will ask questions to help ensure full understanding of what the other person is saying. However, instead of forming these questions in ways that come across as clinical or inquisition-like, the therapist focuses on taking an approach of interested curiosity. The patient is seen as the ultimate authority on how and why their condition has developed while the therapist concentrates on helping uncover aspects of the situation that the person may not have considered in the past. The therapist will then collaborate with the person to help find ways to overcome the roadblocks and problems that the situation imposes on their life.

For instance, in traditional talk therapy, a therapist assisting a person with an eating disorder might draw on past experience with other patients to assume that the person was at some point ridiculed or shamed for their weight. The therapist might then ask probing questions seeking the source of this ridicule to address it. In collaborative therapy, the therapist instead allows the person to share their story, including how and why they think the condition arose. Instead of interjecting the idea that the patient had been ridiculed, the therapist would ask questions that allow the person to add their own conjectures on the condition’s cause. This may help them uncover the true cause of the disorder.

Success in collaborative therapy is dependent on building a relationship of mutual trust between the therapist and the person being helped. Situations in a person’s childhood or young adulthood may have led to problems with self-image, forming attachments, or feelings of insecurity. These can be at the root of many different types of psychological problems and cause people to seek therapy. By focusing on forming a relationship with the therapist that treats the person as a co-author of their own healing plan, collaborative therapy helps the patient find a new model for future relationships. This supports a transformation in attitudes towards other relationships that can change a person’s perspective and help them overcome their issues.

Though it was developed as an alternative for people for whom other forms of psychotherapy were not effective, collaborative therapy is not necessarily effective in all situations. There are no specific diagnoses or types of mental health conditions for which it is indicated or works best. Its uses will generally be determined by a therapist versed in multiple methods who thinks the collaborative approach will work best for a particular individual. It may also be chosen by a patient who seeks out a practitioner of collaborative therapy because they favor the type of empathetic relationship and cooperative treatment it involves.

Bibliography

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Grove, Debbie. “Collaborative Counseling—Working Together Toward Change.” Canadian Counselling and Psychotherapy Association, 11 May 2011, www.ccpa-accp.ca/collaborative-counselling-working-together-toward-change/. Accessed 10 June 2019.

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Tuerk, Elena Hontoria, Michael R. McCart, and Scott W. Henggeler. “Collaboration in Family Therapy.” Journal of Clinical Psychology, vol. 68, no. 2, February 2012, pp. 168-178. www.ncbi.nlm.nih.gov/pmc/articles/PMC4490859/. Accessed 10 June 2019.