Our Practice Framework, Part 2: Theory.
Featured Image: Courtesy of Self-Love Rainbow.
In Part 2, of our Practice Framework presentation, we explore behind the scenes about different theories and models that inform the CoastMind approach. It’s a bit of a longer read, but helps keep you informed as to how we work together!
Let’s start with a little more of a dry definition of what a ‘theory’ involves.
Further down, I’ll be applying theory to one of my personal favourite interests (and a good analogy) - music!
A good definition of theory is considered as follows:
A theory is a systematic set of ideas or principles that explains, predicts, and helps understand patterns or relationships within a specific area of knowledge or practice.
For those in professions such as Psychology, Social Work, Occupational Therapy, Psychiatry and the like, theory is very important.
Whether it’s case management, advocacy, counselling, intake, medical, social or other interventions, theory provides a knowledge-base and capacity for mental health professionals to form appropriate treatment plans, use the latest available scientific and clinical
Put more simply, and in less clunky wording - it’s the toolkit from where we can identify the most effective, efficient, safe and relevant techniques, skills and ways of working with you.
Theory is based upon many years (decades, often!) of repeated studies in the community/professional settings, in both trial and real-world situations. It involves skills, research and training that has been time-tested to best suit clinical practice, academia and more.
Applying Theory To Example - Music:
Another nice way of thinking about theory is like learning the guitar, bass, or any other instrument - I’m showing my musician bias, here!
I’m not sure about you, but there aren’t that many people out there who’d expect someone who had never heard of, learnt or seen chords being played, to know where to place their fingers on the fretboard, how to hold the guitar neck, and the like, to produce the desired outcome (music)!
Applying that to counselling practice - you’re likely wondering where this is going - you can think of your desired outcomes, and how someone such as myself might be able to work alongside you to produce the outcomes you define with your therapy goals.
It’s a combination of years of intensive training, study and real-world practice (and just like a musician, always keeping that practice going) that helps establish a successful outcome.
And, like music, there’s all sorts of styles and flavours to suit different tastes. From blues, rock and heavy metal to funk, disco and R & B, we might have our own opinions or thoughts about which style is ‘good’ or ‘bad’ but essentially, it’s about which style suits the listener.
I could talk at length about theory, truly I could! I’m a bit of a nerd in that department, which might sound strange but I also take ownership of, too.
When providing you a service, my process is treated with diligence. That is, I won’t be borrowing techniques just taken from a random Youtube user or one of the many online courses floating about. Not, at the very least, without such a source being ‘fact-checked’ thoroughly for having an evidence-base behind it.
Not to say this makes my style rigid or mechanical. If anything, I have an eclectic and creative approach to therapy. There’s a lot that can be done and adapted working within the boundaries theory provides, and counselling itself is as much an art-form and learning experience for the practitioner as it is for the consumer.
If you’re to engage with me as a consumer, whether that’s as a member of the general community, a mental health/disability peer/Participant/consumer, or a coaching client, I take this responsibility very seriously. After all, I am operating a service and would expect similar of myself as a consumer, as I would walking into a public/private clinic elsewhere.
So, all that said - let’s dive into my theoretical model and the main pillars of knowledge that guide how I work with individuals, groups and the wider community!
Broad-Strokes: The ‘All Of Us’ Model/s Which Inform My Practice.
The Multidimensional Approach to Social Work (Harms, 2005)*
See below for a lecture on the multidimensional approach, care of Cassie Dinecola on Youtube - note, this is an American context and thus refers to the NASW not AASW, but the principles and theory align to this article:
You’ll see this slightly less used/referenced to in American/overseas literature ,as this primarily an Australian grown and refined strategy, but it exists as a solid academic principle the world over.
Multidimensional theory is a bit of a whopper. Simply put, it’s ensuring that, as best as possible, practitioners have an awareness of how individual-level factors (occupation, family, physical environment) interact with much broader variables (government policy changes, law, social trends, culture, etc) to inform what’s going on for the person, how these may be intersecting to cause issues, and where these may be addressed with techniques, resources, referrals and advocacy.
Paulin & Matis (2019)’s fantastic resource Social Work: A Competency-Based Approach includes a number of neat diagrams to help all these intersecting lines connect a bit better visually.
Below is a great diagram to demonstrate the multiple dimensions involved in everyone’s lives:
Obviously, not all of these will apply at all times to everyone’s circumstances, but it helps to have both the ‘micro’ and ‘macro’ systems in mind when working in the community. It helps guides appropriate mindfulness of broader issues, direct consumers to appropriate external formal/natural resources which may help improve conditions, and more.
If you yourself have been involved with care in the community, e.g. through a public mental health service, private practice, working with a case manager/NDIS Support Coordinator etc, the following model you might’ve seen around the place or even described to you in some form about how a service aims to work with you.
Bringing the focus lens down a little, the next model I feel accurately represents how I ‘see’ a person’s circumstances - from assessment, formulation and treatment planning, through to the factors I’m looking to keep an eye on during our work together where relevant to you and your goals.
2. Biopsychosocial Model
The biopsychosocial model is a holistic framework that, like the multi-dimensional model above, recognises that our lives are dynamic and shaped as much between internal (biological/psychological) as social-envionmental factors in determining our overall health and wellbeing.
From a social-work and counselling perspective, using the biopsychosocial model allows us to explore the person as whole, assessing and addressing immediate symptoms and presenting problems with additional useful perspectives such as genetic predisposition/familial health history, chronic illness, up social conditions such as unemployment, poverty and stigma/discrimination/isolation in the community.
It also helps mental health professionals to work alongside consumers to plan and enact collaborative care that is empowering, thought-out and relevant for the person in their immediate and broader social environment. Having an overview of your home environment, social relationships, community connectedness and other factors can help us work together on any related barriers, as well as tailor care towards goals you might have in this space, prompt appropriate referrals and resources, etc.
Some common sayings we have are things like “no man is an island” and “it takes a village to raise a child”; sayings you’ve probably heard said aloud/in media. Well, the aim of the biopsychosocial model is also to ensure this is put into both consideration and action! As well, it helps ensure every person worked alongside CoastMind receives relevant, appropriate support, as opposed to more generic one-size-fits-all interventions.
Going a bit further - these above two models also help social workers and our consumers take the next step to look to solutions beyond ourselves and the immediate counselling session. Whilst this may not be part of our direct work together, having this model in mind at all times often spurs both practitioners and community alike to self-advocate and challenge the powers-that-be where needed. Additional funding, resources, service gaps, systemic issues - this model is purpose-built to assist there, too, and so can be powerful for consumers, carers and natural/formal supports alike.
Together, we can work where possible to empower ourselves and each other!
See below for Self-Love Rainbow (a fantastic resource in general, by the way)’s diagram which puts all the terms into a neater and nicer graphic.
See here for link to the related article - credit to Self-Love Rainbow.
It should be noted, too, that both of these models are examples of what is defined with Social Work academic circles as ‘ecological’ systems-theory.
For a neat explainer on Ecological Systems Theory, see this link here!
3. Getting More Specific - Models That Inform My Counselling Practice:
So as to not to take up too much more of your time, here’s a list of some of many models that inform my clinical practice, philosophy, ethics and more in any potential working relationship - be that yourself, a trusted carer/advocate, related services, etc.
I encourage you to have a read of the links below, and if you have further queries don’t be afraid to get in touch!
a) The PERMA Model/Strengths-Based Practice:
Positive psychology can leave a bit of a cynical taste in one’s mouth at times, however it’s important to note that this field of psychology doesn’t discount the challenges, symptoms and barriers consumers and society often face.
It’s more readily thought of as an additional lens in practice, where we can look at any person’s case and identify existing or potential strengths within the person and their support network.
The five core factors as per the acronym are: Positive Emotion, Engagement, Positive Relationships, Meaning and Accomplishments/Achievements.
From Maslow’s work in the 1960’s through to Martin Seligman’s more recent academic and clinical work, strengths-based practice has grown from a fringe idea to a commonplace default in many public and private human-services settings. Turns out, identifying and validating, strengthening and building the innate resources, character traits, behaviours, relationships that you have and/or want to develop works well alongside treating symptoms! Who’d have thought?
See here for an explainer on the PERMA Model, and here for a follow-up on the Strengths-Based Approach, both courtesy of clinical/research initiative PositivePsychology.com.
See below for a great diagram from the University of London that demonstrates some specific examples of PERMA in action for wellbeing, by a range of life-domains:
b) The Cognitive-Behavioural Model - CBT/ACT/DBT
The cognitive behavioural model of psychology posits that thoughts, emotions, and behaviors are interconnected, and that changing maladaptive thoughts and behaviors can improve emotional well-being and functioning. This model focuses on identifying and challenging negative or distorted automatic thoughts, restructuring core beliefs, and modifying unhelpful behaviors through techniques such as cognitive restructuring, behavioral activation, and problem-solving skills.
More recently, therapeutic modalities such as Dialectical Behaviour Therapy and Acceptance & Commitment Therapy expand on these core CBT skills to suit a broader and/or more complex range of situations and consumer demographics.
ACT uses mindfulness, acceptance, and values-based action to increase psychological flexibility—the ability to be present, open to experience, and to act in line with one’s values even in the face of difficult thoughts or emotions. This is an approach based in cognition and behaviour, but often takes a very different slant in practice such as cognitive defusion and acceptance, to help build skills around natural thoughts and emotions that may arise in both day-to-day and challenging circumstances alike. I’m trained in this model as well as CBT, and often find it very useful for consumers who may not gel with the more thought-challenging approach of traditional CBT.
DBT integrates standard cognitive-behavioural techniques with mindfulness and distress tolerance skills, emotion regulation strategies, and interpersonal effectiveness training. DBT was developed specifically for individuals with borderline personality disorder but is now widely used for other emotional regulation difficulties. While CBT focuses on changing maladaptive thoughts and behaviours, DBT places special emphasis on accepting and validating current emotional states while simultaneously working toward change.
DBT can be a bit more intensive, but is highly useful for situations where there is a high degree of difficult challenges in regulating emotions, or engaging in behaviours that may be beyond the scope of traditional CBT to address. Again, I am trained in and have experience in delivery of this modality, however am upfront and selective around where it is utilised.
See here for a great article that pieces apart both shared factors and differences between CBT and ACT, via PsychCentral.
See here for a useful explainer on Dialectical Behaviour Therapy, via Harvard Health.
I could keep going, with examples such as the solutions-focused model, Motivational Interviewing and the like, but today’s article is more to provide you with a thorough background around how theory drives everything we do regarding consumers of CoastMind and the broader community.
Stay tuned, as with Part 3 I’ll be detailing specific tools and techniques (such as those listed above) that may be agreed upon in counselling to use as the most appropriate for your care.
In the end, it’s the relationship between counsellor and consumer that is of utmost importance, which is why collaboration and input is baked into every step of the CoastMind journey.
Once again - if you’ve got any questions about the contents of this article, please feel free to reach out to us!
Kind Regards,
Brady Irwin, CoastMind.
References:
Harms, L (2005). Understanding Human Development: A Multidimensional Approach. (See here for a link for an academic article doubling as a review/summary of said book, by Frank Tesoriero (2005)).
Paulin, J. & Matis, S (2019). Social Work: A Competency-Based Approach. (See here for link to summary of the book, courtesy of Springer Publishing).