The client’s theory of change: Consulting the client in the integrative process

This article casts a critical eye upon the integration literature and asserts that, as in psychotherapy in general, the client has been woefully left out of the therapeutic process. An alternative that privileges the client’s voice as the source of wisdom and solution is presented. It is proposed that conducting therapy within the context of the client’s own theory of change offers ways of integrating multiple therapy perspectives. An argument is made for not only recasting the client as the star of the drama of therapy, but also giving the heroic client directorial control of the action as it unfolds. KEY WORDS: client’s theory; theory of change; integration; common factors; client directed. We feel that it would be fruitful to explain patient’s own ideas about psychotherapy and what they expect from it. Hoch (1955) Many therapists have made the disappointing discovery that any given model that purports to ameliorate human suffering is limited. One size does not fit all. The field’s response has been rival schools, brand names, and high fashion in the therapy boutique of techniques. Thus, therapists have not suffered a dearth of models from which to choose; indeed, there are now more choices than Baskin and Robbins and Howard Johnson’s com-bined. The up side, of course, is that under certain circumstances a given flavor may really hit the spot. The lure of increasing the efficiency of therap