Why One-Size-Fits-All Approaches Fail

Recovery programs must reflect individual over diagnosis.

Personal recovery from physiological dysfunction and discomfort (disorders/neuroses) is an individual process. Just as there is no one right way to do or experience recovery, so also what helps us at one time in our life may not help us at another. It is myopic of recovery programs to lump us into a single niche. Individually, we are a conglomerate of personalities―distinct phenomena generated by everything and anything experienced in our lifetime.

Every teaching, opinion, belief, and influence facilitates our personality development. It is our current and immediate being and the expression of that being. It forms itself by core beliefs and is developed by social, cultural, and environmental experiences. It is constant yet fluid, singular yet multiple. It is our inimitable way of thinking, feeling, and behaving. It is who we are, who we think we are, and who we believe we are destined to become. It is expressed by the simultaneous mutual interaction of our mind, body, spirt, and emotions working in concert.

Any evaluation and treatment program must comprehensively address the complexity of the individual personality. The insularity of cognitive-behavioral therapy, positive psychologies, interpersonal and regression therapies, and other approaches cannot address the dynamic complexities of our personality. We are better served by the integration of multiple traditional and non-traditional approaches, including those defined as new (third) wave (generation) therapies, developed through client trust, cultural assimilation, and therapeutic innovation. Our environment, heritage, background, and associations reflect our wants, choices, and aspirations. If they are not given consideration, then we are not valued.

In the disease model of mental healthcare, we are treated as the diagnosis rather than the individual with concerns and issues. Unfortunately, the traits, characteristics, and symptoms defined by diagnosis are subject to substantial deviations in definition, epidemiology, and treatment. Mental health experts maneuver among eight or nine types of depression, several anxiety disorders, nine obsessive-compulsive disorders, five types of stress response, and ten personality disorders sharing similar traits and symptomatology with varying degrees of impact. A cumulation of experts has social anxiety disorder comorbid with avoidant personality disorder, panic disorder, generalized anxiety disorder, depression, substance abuse, eating disorders, OCD, PTSD, and schizophrenia. Of U. S. adults with any mental disorder in a one-year period, 14.4 percent have one disorder, 5.8 percent have two disorders and 6 percent have three or more. 60% of those with anxiety also have depression and vice versa, and both are regularly comorbid with substance abuse. 

The disease model of mental health focuses on what is wrong with us. It is based on the history of our negative behavior. The Wellness Model  of mental health focuses on our character strengths and virtues that generate the motivation, persistence, and perseverance to recover. A battle is not won by focusing on incompetence and weakness; it is won by knowing and utilizing inherent strengths and attributes. That is how we successfully recover―with pride and self-reliance and determination―with the awareness of what we are capable of. 

All treatment programs are flawed to some extent; integration into a platform of approaches can compensate for that ineffectiveness. Let us use the example of cognitive-behavioral therapy. Almost 90 percent of the approaches to recovery involve cognitive-behavioral treatments. However, many critical studies dispute CBT’s efficacy, claiming it fares no better than non-CBT programs. They argue its effectiveness has deteriorated since its introduction, concluding it is no more successful than mindfulness-based therapy for depression and anxiety. 

Despite these criticisms, the program of thought and behavior modification pioneered by Beck in the 1960s is still useful in modifying the irrational thoughts and behaviors that sustain a disorder when used in concert with other approaches.

One such integration is utilizing positive psychology in the cognitive behavioral therapy model supported by other approaches. CBT would modify automatic negative self-beliefs, thoughts, and behaviors, and positive psychology would emphasize the potential mindfulness of inherent strengths, virtues, and attributes as positive replacement. The Wellness Model’s chief facilitator, positive psychology has its critics, too. They claim positive psychology is still in its formative stage and, despite recent scientific attention to the positive spectrum of human potential, has yet to be integrated into mainstream theory, assessment, and treatment options.

Until recently, the focus on optimal functioning’s positive aspects ignored the individual’s holism by neglecting their negative aspects. The emergence of PP2.0 rectified the lacuna. Positive psychology now emphasizes the positive while managing and processing the negative to increase wellbeing.

Platform Integration.

Focusing on the individual personality would compensate for the statistical failures of diagnosis based on the disease model’s reliance on DSM criteria. Even mainstream medical authorities have begun to recognize the unreliability of conventional psychiatric diagnosis. A recent Canadian study reported, of 289 participants in 67 clinics meeting DSM-IV criteria for social anxiety disorder, 76.4% were improperly diagnosed. The Anxiety Institute in Phoenix reports an estimated 8.2% of clients had generalized anxiety, but just 0.5% were correctly diagnosed. Experts cite the mental health community’s difficulty distinguishing different disorders or identifying specific etiological risk factors due to the fluidity and ambiguity of the Diagnostic and Statistical Manual of Mental Disorders. 

The massive number of revisions, substitutions, and changes from one DSM to the next is never universally accepted. Psychiatrists, psychologists, and researchers who specialize or survive by funding are justifiably protective of their territory. Even under the best circumstance with a knowledgeable and caring clinician, it is difficult to get a proper diagnosis. What is lacking is communication and collaboration between subject and clinician, eliminating the power dynamic of the diagnostic process. 

We are better served by the integration of multiple traditional and non-traditional approaches, including those defined as new (third) wave (generation) therapies, developed through client trust, cultural assimilation, and therapeutic innovation. Our environment, heritage, background, and associations reflect our wants, choices, and aspirations. If they are not given consideration, then we are not valued.

We must address the individual over the diagnosis and create individual-based solutions. Training in prosocial behavior and emotional literacy might be useful supplements to typical interventions. Behavioral exercises can be used to practice the execution of considerate and generous social skills. Positive affirmations have enormous subjective value as well. Data provide evidence for mindfulness and acceptance-based interventions. Motivational enhancement strategies could help clients overcome their resistance to new ideas and concepts. Many therapists tout the benefits of positive autobiography to focus on our positive life experiences. Evidence-based solutions must address issues of self-esteem.

The best solution is establishing an integrated platform of approaches as a general solution for the problem, then further customizing as determined by personality. Diagnoses must be vigorously challenged by individual concerns and experiences, and treatment programs must reflect this dynamic. 

Why is your support essential? ReChanneling is dedicated to research and development of methods to alleviate symptoms of physiological dysfunction and discomfort (disorders./neuroses). Our vision is to reshape the current pathographic emphasis on diagnoses over individual, which fosters a deficit, disease model of human behavior. Treatment programs must disavow ineffective, one-size-fits-all approaches and target the individual personality through communication, empathy, collaboration, and an integration of historically and clinically practical methods. All donations support scholarships for workshops and practicums.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s