Some might argue that in the contemporary clinical practice of psychotherapy, evidence-based intervention and effective outcome have overshadowed theory in importance. Maybe. But, as the editors of this series, we don’t propose to take up that controversy here. We do know that psychotherapists adopt and practice according to one theory or another because their experience, and decades of good evidence, suggests that having a sound theory of psychotherapy leads to greater therapeutic success. Still, the role of theory in the helping process can be hard to explain. This narrative about solving problems helps convey the importance of theory:
Aesop tells the fable of the sun and wind having a contest to decide who was the most powerful. From above the earth, they spotted a man walking down the street, and the wind said that he bet he could get his coat off. The sun agreed to the contest. The wind blew, and the man held on tightly to his coat. The more the wind blew, the tighter he held. The sun said it was his turn. He put all of his energy into creating warm sunshine, and soon the man took off his coat.
What does a competition between the sun and the wind to remove a man’s coat have to do with theories of psychotherapy? We think this deceptively simple story highlights the importance of theory as the precursor to any effective intervention—and hence to a favorable outcome. Without a guiding theory, we might treat the symptom without understanding the role of the individual. Or we might create power conflicts with our clients and not understand that, at times, indirect means of helping (sunshine) are often as effective—if not more so—than direct ones (wind). In the absence of theory, we might lose track of the treatment rationale and instead get caught up in, for example, social correctness and not wanting to do something that looks too simple.
What exactly is theory? The APA Dictionary of Psychology defines theory as “a principle or body of interrelated principles that purports to explain or predict a number of interrelated phenomena” (2nd ed., VandenBos, 2015, p. 1081). In psychotherapy, a theory is a set of principles used to explain human thought and behavior, including what causes people to change. In practice, a theory creates the goals of therapy and specifies how to pursue them. Haley (1997) noted that a theory of psychotherapy ought to be simple enough for the average therapist to understand but comprehensive enough to account for a wide range of eventualities. Furthermore, a theory guides action toward successful outcomes while generating hope in both the therapist and client that recovery is possible.
Theory is the compass that allows psychotherapists to navigate the vast territory of clinical practice. In the same ways that navigational tools have been modified to adapt to advances in thinking and ever-expanding territories to explore, theories of psychotherapy have changed over time. The different schools of theories are commonly referred to as waves, the first wave being psychodynamic theories (i.e., Adlerian, psychoanalytic); the second wave, learning theories (i.e., behavioral, cognitive–behavioral); the third wave, humanistic theories (person-centered, gestalt, existential); the fourth wave, feminist and multicultural theories; and the fifth wave, postmodern and constructivist theories (i.e., narrative, solution-focused). In many ways, these waves represent how psychotherapy has adapted and responded to changes in psychology, society, and epistemology, as well as to changes in the nature of psychotherapy itself. Psychotherapy and the theories that guide it are dynamic and responsive. The wide variety of theories is also testament to the different ways in which the same human behavior can be conceptualized (Frew & Spiegler, 2012).
It is with these two concepts in mind—the central importance of theory and the natural evolution of theoretical thinking—that we developed the American Psychological Association (APA) Theories of Psychotherapy Series. Both of us are thoroughly fascinated by theory and the range of complex ideas that drive each model. As university faculty members who teach courses on the theories of psychotherapy, we wanted to create learning materials that not only highlight the essence of the major theories for professionals and professionals-in-training but also clearly bring readers up to date on the current status of the models. Often in books on theory, the biography of the original theorist overshadows the evolution of the model. In contrast, our intent is to highlight the contemporary uses of the theories as well as their history and context. Further, we wanted each theory to be reflected through the process of working with clients that reflect the full range of human diversity.
As this project began, we faced two immediate decisions: which theories to address and who best to present them. We looked at graduate-level theories of psychotherapy courses to see which theories are being taught, and we explored popular scholarly books, articles, and conferences to determine which theories draw the most interest. We then developed a dream list of authors from among the best minds in contemporary theoretical practice. Each author is one of the leading proponents of that approach as well as a knowledgeable practitioner. We asked each author to review the core constructs of the theory, bring the theory into the modern sphere of clinical practice by looking at it through a context of evidence-based practice, and clearly illustrate how the theory looks in action.
Each title in the series can stand alone or be grouped together with other titles to create materials for a course in psychotherapy theories. This option allows instructors to create a course featuring the approaches they believe are the most salient today. To support this end, APA Books has also developed a DVD for most of the approaches that demonstrates the theory in practice with a real client. Many of the DVDs show therapy over six sessions. For a complete list of available DVD programs, visit the APA website (http://www.apa.org/pubs/videos). Most programs are also available in streaming video format.
Throughout the history of psychotherapy, there have been spirited debates about what exactly psychotherapy actually is. Other questions have focused on whether psychotherapy actually works and if so, why. Like any form of healing practice, the field of psychotherapy was created in a social context that has influenced the parameters of what psychotherapy (and its various theories of practice) is and what it is not. Of course, over time, the field of psychotherapy has evolved in response to the context in which it is practiced.
The APA Theories of Psychotherapy Series examines specific models, yet before digging deeper into the various forms of psychotherapy, it is prudent to develop a foundational understanding of the history of psychotherapy practice and an appreciation for the role of theory in that history and modern practice. Like its predecessor, the second edition of The Basics of Psychotherapy: An Introduction to Theory and Practice should be considered the opening book in the Theories of Psychotherapy Series and, as such, forms the cornerstone book in this series. As one of the preeminent contemporary psychotherapy researchers and critics, Bruce Wampold takes a wide view of the history of psychotherapy theory and locates the field’s philosophical underpinnings and assumptions. He also places psychotherapy as a unique form of healing practice and examines how the field has advanced as applied psychological science and research has evolved and the clientele treated has diversified. Importantly, Dr. Wampold teaches the reader to better understand psychotherapy outcome research and notions of what effective psychotherapy actually means.
The vastly updated book will provide readers with a deeper understanding of the science and practice of psychotherapy. It is our hope that reading this book will give readers the basic understanding to evaluate and understand the many theories examined in the Theories of Psychotherapy Series and thus gain the perspective to compare and contrast the many valuable theoretical approaches available. This book can be used in conjunction with the other existing titles in the series to form a textbook package for a course in modern psychotherapy theory.
—Jon Carlson and Matt Englar-Carlson