Theodore Millon has stated that the task of the therapist is not only to identify the particular problem or issue and to select the matching treatment modality but to be sure the treatment modality fits and flows from the theory of that particular person.

One must put together treatment modalities that mirror the different domains in which that specific patient's pathology is expressed and configured. Domains might include self image, mood, temperament, interpersonal relationships, etc..

Millon believes that therapy needs to be integrated rather than just eclectic. There is progression among diverse techniques. He describes two basic synergistic procedures which results in change.

First there is potentiating pairings which consists of treatment methods that are combined and used at the same time. A popular example is cognitive-behavioral. It is believed that used in combination they are more powerful than used separately.

Second there is catalytic sequences which are interventions used in a timing series in order to produce change. For example, one might use an intervention to build self esteem and then follow it with a behavioral intervention. Without the self esteem building intervention being used first the client may not have the motivation to effectively use the behavioral technique.

Millon reminds us that one action or one intervention does not necessarily result in change. Instead a combination of interventions or a sequencing of interventions are more likely to result in change as most clients don't have just simple problems or issues. To what degree do you agree or disagree?

READING: Identify print or web-based resources that you are using or may incorporate into the strategies for sequencing interventions. The aim is primarily to reflect on one's own practice. Be sure to cite your source(s) in your posts to the discussion.

Topics for All Practicum Students: (CHOOSE ONE)

Find two articles (one from a refereed journal and one from the web) related to Prochaska and Diclemente's Stages of Change Model. Offer your personal reflections on this model and its usefulness or potential usefulness in your practice.

Discussion

Working with clients can be like unlocking a combination lock. We may have to turn one way and then another trying to discover what combination of strategies and interventions finally "opens the door" and allows the client to make progress. Building a connection or trust with a client is often the first "intervention".

Describe the "sequence" you use, citing the empirical or other resources that have helped you build a useful strategy? How do you work? Some people start with "What's up?" and others start more formally, loosening up later. How about you?