Therapy models have changed considerably since I first began seeing clients in 1986. At that time, psychoanalytic and humanistic approaches were still widely practiced, along with increasing deference to the medical model and continuing influence from approaches such as existential and gestalt therapy. Over time, behavioral and cognitive-behavioral methods became more prominent, and today cognitive behavioral therapy is often cited as one of the most effective forms of treatment.

At a certain point in a therapist’s career, however, one hopes to offer something more than the application of a single therapy model. For many complex or sophisticated clients, symptoms are often subtle, layered, and embedded in social, developmental, occupational, medical, and biological circumstances that also need to be understood. In such cases, the specific therapy model may matter less than the therapist’s breadth of knowledge, clinical judgment, life experience, and capacity to relate to the patient as a thoughtful and engaged human being.