1. Training in Pluralistic Practice
Brief introduction to pluralistic practice
Key aspects of training provision
Kate Smith, Julia Mcleod, Mhairi Thurston, John McLeod

2. Key reading – published by Sage, 2011
Key reading for those unfamiliar with the approach

3. The concept of pluralism
‘…the doctrine that any substantial question admits of a variety of plausible but mutually conflicting responses’ (Rescher, 1993: 79)
Consistent with postmodern and poststructuralist positions: no foundational truth
Allows for the development of an equal relationship, where the client perspective can take priviledge in a shared understanding

4. Why develop ‘Collaborative’ pluralism?
Many practitioners describe themselves as eclectic or integrative
Role of client preferences
Clients are selective and creative in using what therapists offer (Bohart and Tallman, 1999)
Collaboration between client and therapist is a key factor in therapy effectiveness - ‘meta-communication’
Effectiveness of ‘extra-therapeutic’ activities

5. Pluralism in a nutshell
Working within a collaborative relationship
On what the client wants
Using a shared understanding of the clients’ situation
Using a range of methods
And drawing on the clients personal and socio-cultural resources

6. Training in integration
Lowndes and Hanley (2010)
Theoretical ambiguity
Putting theory in to practice
Sense of professional identity
Many practitioners become integrative post-qualification e.g. Castonguay (2006); Norcross (2006)

7. Training context UK University Masters-level professional training
Mature students
Range of backgrounds – psychology degree not needed
Teaching and learning, placement, supervision

8. Pluralistic Practice Training
Conceptual engagement
Skills in a variety of approaches
Skills in creating a collaborative relationship – build bridges
Respond to feedback, monitor process and outcomes
Creative case-formulation (Goals, tasks, methods)
Cultural resources
In order to train practitioners we have to…
Develop an understanding of the philosophical approach
Variety of approaches
Garner and respond to feedback in a range of forms

9. Conceptual engagement
Examine own assumptions and beliefs
Recognise these are different from clients
Plurality of beliefs within the group
Invitation to the post-modern approach
Recongise theoretical concepts as narratives

10. Skills in a variety of approaches
Meta-theory of approaches..
Each approach to counselling and psychotherapy:
Ways of understanding problems
Ways of resolving problems
Intervention styles and methods

11. Skills in a variety of approaches
Humanistic foundations (PCC and existential)
Psychodynamic approaches
Cognitive behavioural therapy
Transactional analysis
Solution focussed therapies
Narrative therapy
Core theory training comes in first year,
Students required to be active learners, and readers of literature and research
Theories are sources of explanation and understanding -

12. Skills in creating a collaborative relationship
Examine preferred relationship style when helping
Personal learning goals to enhance repertoire
Authentic chameleon (Lazarus, 1993)
Feedback conversations, responding to client
Power imbalance, deference, and cultural and interpersonal silencing (Wang, 2012)

13. Respond to feedback, process and outcome monitoring
Teach how to give and receive feedback
Examine ‘defences’ in PD groups
Structure client use of feedback tools
E.g.
Therapy personalisation form (Bowens, Johnstone & Cooper, 2009)
Helpful aspects of therapy (Cooper, 2008)
Outcome rating scale (Miller and Duncan, 2000)

14. Creative case-formulation (Goals, tasks, methods)
Getting a sense of the client story
Get an understanding of desired client outcome (goal/s)
Talk through and plan what needs to be done (tasks)
Talk through what ways the tasks can be addressed (methods)
All done in the context of the relationship with the client – careful skills training at this stage.
Students have all got foundational skills in listening, e.g. Egans Skilled Helper
The trick of establishing a goal – language is tricky here
How it might be addressed can make students feel deskilled ‘What can I do?’ and presents problems for curriculum planning

15. Goals, tasks and methods

16. Goals, tasks and methods
Goal, e.g. Stop bingeing-purgeing
Find alternative ways of coping with emotion
Trying new activities (cultural resources)
Finding my ‘triggers’ (homework)
understanding my relationship with my parents
Reflective listening, core conditions (conversation)
Collaborative relationship

17. Tasks making meaning problem-solving, planning and decision-making
changing behaviour
negotiating life transitions
dealing with difficult feelings and emotions
undoing self-criticism and enhancing self-care 
dealing with difficult or painful relationships
Tasks are generally not specific to theories, but involve an understanding by the client, with suggestions from the counsellor

18. Cultural resources Not just about well-intentioned suggestions!
Recognition of ‘otherness’
Allow therapy to not be the answer

19. Collaborative training?
The philosophy of pluralism leads the training
Respond to student learning and development needs
Individual approach
Community of practitioners
Flexible and responsive to feedback

20. Assessments Example 1: Philosophy of counselling
Students own socio-cultural background
Principles and philosophy
Affinity with particular theoretical approaches
Understanding of problem causation, treatment and outcomes

21. Assessments Example 2: Case-studies Grounded in pluralistic practice
Cases from student placement
Triangulation of data presented (case-discussion, supervisor reports, client feedback)

22. Challenges Jack of all trades and master of none….?
Context of placements
Iterative development, cart before the horse
Students who don’t buy in to model

23. In summary… Pluralistic counsellors training
Collaborative formulation and meta-communication
Range of methods
On-going professional development
Aware and able to state position and skills
Professional self-doubt (Nisson-Lie et al, 2010)

24. ?

25. E. Van Deurzen-Smith (1988) Existential Counselling in Practice
“Every approach to counselling is founded on a set of ideas and beliefs about life, about the world, and about people...Clients can only benefit from an approach in so far as they feel able to go along with its basic assumptions.”
E. Van Deurzen-Smith (1988) Existential Counselling in Practice

26. psychotherapy integration
Eclecticism: therapist decides what seems to be best for the client
Technical eclecticism (Lazarus): therapist assess clients and decides what is best on the basis of research evidence
Common factors: good outcome depends on achieving non-specific factors such as hope, expression of emotion, etc
Theoretical integration: select concepts and methods from existing approaches to create a new approach
Assimilative integration: therapist is trained in a core model, then learns about other approaches and gradually integrates them into a unique individual style
Pluralism: therapist and client collaboratively work together to decide on the goals, tasks and methods that will be most effective at each stage of the therapy; theories of therapy function as resources for understanding the problem