The critical-practitioner model in therapy

Abstract

As insurance companies and governments demand biopsychosocial forms of managed and evidence-based care from psychologists, the scientist-practitioner model has become more dominant in therapy. According to this model, what is to count as knowledge in psychology and as efficacious in therapy is established solely through controlled scientific experiment or clinical trial methodology. Yet there is an inherent tension between this kind of academic outcome research and the practice or art of psychotherapy in its natural setting. Recent discussion in the psychology literature concerning what works in the real world of therapy suggests that a broader, more flexible interpretation of the scientist-practitioner model is required, one that combines empirically supported psychological techniques and clinical wisdom as an awareness of therapeutic context and relationship. This integration of scientific and critical perspectives is evidence-based and consistent with best therapy practice. Thus, practitioners who apply cognitive-behaviour therapy may also draw on narrative, psychodynamic, interpersonal, and systemic therapy and other critical frameworks in their psychological work. The paper proposes a critical-practitioner model in therapy that introduces relational and contextual factors into the scientific therapy equation. A critical psychology that addresses the cultural, spiritual, emotional, subjective, physical, and discursive foundations of psychological life invites psychologists to consider qualitative, collaborative, meaning-focused, and person-sensitive methodologies in scientific therapy and its research. This is discussed in terms of deconstructing the violent logic of either/or thinking in a modern theoretical psychology.