Tag Archives: Change

Practical Application of Theory

What are some ways that a development theory could be useful to you in the field of work you are interested in?  What about your personal life?  What do you want a theory to tell you?  What specific problems should/could a theory help you solve?

The adoption of one or more developmental theories could have significant implications on implementation of real world therapy practices.  Our theoretical worldview has the potential to bias our views of developmental change and the antecedents that drive that change.  Will the therapist sitting across from you attribute your current situation to biological antecedents?  Is nature responsible for (insert any psychological condition here)?  Or, instead, will your therapist choose to focus on the environmental and societal factors that have influenced your personal developmental trajectory?  Before any of us engage a therapist, or any of us engage in the practice of therapy, we should consider the theoretical underpinnings that form the foundation of our helping professionals’ worldview.  Obviously there’s a good reason why individual therapists choose the theories they do… conscious consumers should not be afraid to ask for the reason.

When change occurs in my personal life, I usually attribute it to entropy.  The illusion of being able to control my environment is tempting to say the least, but I believe self realization comes as a result of accepting that you have little or no control over the sequence and timing of developmental change.  For me, clinical counseling represents a vehicle by which individuals learn to control reactions to a constantly changing chaotic world.  My goal for all of my clients, and for myself, is to be able to embrace change and employ it as a springboard to drive structural, functional, and behavioral growth.  To me, it’s almost irrelevant as to whether it is “governed by nature (i.e., genetics, maturation or biological structures) or nurture (i.e., child rearing methods, cultural values, planned learning experiences, unplanned life events).” (Bergen, 2008, p. 3)  Regardless of the governance, the reality is that we have the opportunity to change tomorrow by acting today.

As I continue to process and refine my own theoretical perspective on human development, my expectation is that the theory provides individuals I serve with an outcome that can be predicted with reasonable certainty.  For example, if we engage dialectical behavior therapy (DBT) I should be able to predict with reasonable certainty that you will experience an increase in mindfulness.  If DBT fails to produce that result, I am content to attribute that failure to individual variability… to me, it doesn’t much matter if it’s nature or nurture… so long as we identify the point of failure and try again (this time modified to fit the individualized participant).  Perhaps we could integrate religious and metaphysical concepts into the effort to increase the traction of our DBT efforts.  Or, perhaps we will go in a parallel direction and focus more on interpersonal effectiveness or emotion regulation since they are contributing factors to the overall efficacy of DBT?  Maybe we abandon DBT altogether and take another angle?  The options are endless… but a theory some provide some direction, some purpose, to the decisions that are made in that process.

Applied Behavior Analysis (ABA) meets all of my expectations for a theoretical construct.  ABA is committed to resolving real world issues not theoretical quandaries.  Practical importance is at the forefront of my interest.  ABA focuses on the behavior that needs improvement, not just any behavior.  Good results must be measurable, conceptually systematic, and able to be replicated.  Finally, a good theory must possess generality of the in the respect that it lasts over time and it appears in environments other than the one in which… it was implemented.  (Cooper, Heron, & Heward, 2007, p. 18)

As a sidebar…

Does anyone out there have any real world examples of entrainment?  (juxtaposition of one or more systems to form new combinations)

What strategies do you use to ensure you are employing “activated knowledge” as defined by Bergen (2008) on page 33?

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Bergen, D. (2008). Human development: Traditional and contemporary theories. Upper Saddle River, NJ: Pearson Prentice Hall.

Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis (2nd ed.). Upper Saddle River, NJ: Pearson Education.

Roles of Cross Cultural Influences in Diagnosis

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Before we can begin exploring deviations from the norm as it relates to a specific culture, it is extremely important that we define exactly what is meant by the word culture.  Culture is defined as the customary beliefs, social forms, and material traits of a racial, religious, or social group.  It could also be defined as the set of shared attitudes, values, goals, and practices that characterizes an institution or organization. (culture, 2010)

As with any definition, it comes with limitations.    Given the changing nature of our social world and given the efforts of individuals to adapt to such changes, culture can best be viewed as an ongoing process, a system or set of systems in flux. (Lopez & Guarnaccia, 2000, p. 574)  Constant change is the rule with and within any given subset or group of people.  Any generalization regarding a population should come with a specific guideline as to whom it would apply, and more specifically, over what period of time the cultural generalization encompasses.   Attempts to freeze culture into a set of generalized value orientations or behaviors will continually misrepresent what culture is. (Lopez & Guarnaccia, 2000, p. 574)  While the representation may prove valid for a period of time, it is inevitable that the research will date itself; thereby propagating the perpetual need for new and innovative research.

A related limitation of the values-based definition of culture is that it depicts people as recipients of culture from a generalized “society” with little recognition of the individual’s role in negotiating their cultural worlds.  A viable definition of culture acknowledges the agency of individuals in establishing their social worlds. (Lopez & Guarnaccia, 2000, p. 574)  Simply because I am a white male from Omaha doesn’t necessarily mean that I have assumed all the traits that could be used to label or otherwise describe that general population.  Exceptions are abundant in every generalization about a specific populace.

An important component of this perspective is the examination of intra-cultural diversity.  In particular, social class, poverty, and gender continue to affect different levels of mental health both within and across cultural groups. (Lopez & Guarnaccia, 2000, p. 575)  In order to be truly inclusive of all the various aspects a culture has to offer, we would have to adopt a multi-layered approach to our cultural studies.  We all wear many hats, and it is a disservice to not examine all of them.  Similarly, it is unfair to assume that those intra-cultural differences affect different cultural populations the same.

Culture is linked to the way emotions, mental distress, social problems, and physical illness are perceived, experienced, and expressed.  Beliefs about what constitutes illness and what can be done about it vary considerably across cultures.  (Bhui & Dinos, 2008, p. 411)  We have established that in some cases a diagnosis has the potential to become a self-fulfilling prophecy.  Even a correct diagnosis may have a negative impact on a specific client.  The cultural connotations associated with a specific diagnosis can play a role in the effect it has on your individual client.  Before we diagnose, need to consider the socio-cultural context of the illness.  For example, a mental health diagnosis may have real implications for a member of the US Armed Forces.

As immigration into the United States continues to accelerate, we must ready ourselves for the influx of clients from the underdeveloped, or the developing world.  Mental health diagnostic constructs and subsequent treatment practices designed in developed countries are often used in the provision of care in the developing world and in care practices for ethnic minorities, asylum seekers, and refugees.  However, there are concerns about the limitations of using mono-cultural outcome measures in these culturally diverse contexts. (Bhui & Dinos, 2008, p. 411)  Our interview process is currently dependant on interviewing and subsequently interpreting the responses from our clients.  Given the complexities of our global community, it is suitably difficult to make underlying cultural assumptions.

In closing, while there are definitive benefits to the standardization of diagnosis techniques, we need to understand and appreciate that those standard one size fits all solutions may not always been the most appropriate way to proceed with accessing the mental state of a culturally diverse client.

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Bhui, K., & Dinos, S. (2008, Dec). Health beliefs and culture: Essential considerations for outcome measurement. Disease Management & Health Outcomes, 16(6), 411-419. Retrieved from http://ezproxy.bellevue.edu:80/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=36400847&site=ehost-live

Lopez, S. R., & Guarnaccia, P. J. (2000). Cultural psychopathology: Uncovering the social world of mental illness. Annual Review of Psychology, 51(1), 571-598. Retrieved from http://web.ebscohost.com.ezproxy.bellevue.edu/ehost/pdf?vid=6&hid=113&sid=f275d2f9-b3c8-458b-9968-29981a5cf4c1@sessionmgr114

culture. (2010). In Merriam-Webster Online Dictionary.  Retrieved March 16, 2010, from http://www.merriam-webster.com/dictionary/culture