Episode 37: Defining Eclectic Practice: Practical Solutions to Therapeutic Problems with Krista Osborne

Welcome back to Your Clinical Supervisor’s Couch podcast. And I’m your host, Kayla Das.

In today’s episode, Krista Osborne, registered clinical social worker, will define eclectic practice and explain how it can provide practical solutions to therapeutic problems.

Hi Krista, welcome to the show. I’m so glad to have you here today.

Hi, Kayla. I’m glad to be here. I’m very excited for this.

Krista, before we dive into today’s episode, please introduce yourself and tell us a little bit about you, your practice, and your clinical supervision journey.

My name is Krista Osborne. I am here wearing many hats, but today the one you’re going to hear about the most is I am a clinical social worker in Alberta. So I’m a registered clinical social worker. I also am approved as a clinical supervisor through the Alberta College of Social Workers. I do that kind of work. I also have a small private practice that does therapy too. So I work a lot with young and emerging adults. I also have done some work with first responders and a lot of trauma work. And my specialization in terms of my training is a lot around grief and loss, narrative work, those kinds of things.

I also am an assistant professor at the University of Calgary, and so there I am also what they call a team lead for the trauma-informed practice specialization. And so I do a lot of work teaching master’s level students about clinical therapy. So that is one of my favorite things in the world to do, is to help emerging social workers and clinical social workers specifically get grounded in clinical practice.

Oh, I love that. So for any listener who has not heard of the term before, what is an eclectic approach to therapy?

I think we talk about eclectic approaches a lot. I don’t know if there’s a formal definition, but I can tell you what I think about it. From my perspective, eclectic social work is really about being responsive to the person that’s in front of you. And so I have particular models that I like to work with, but that’s actually irrelevant.

What’s relevant is what does the person in front of you need? I’ll give you a good example. If somebody comes into my practice and says, I think I have clinical depression. I’m wondering about meds. Now, firstly, I’m not going to give them information about medication that’s not within my scope of practice, but I will look at their problem from more of a medical lens because that’s how they are defining the problem. And so we’ll tend to talk in language that starts there at least. Depending on where their needs are, we may shift. If somebody comes to me and says, I really just want to tell you the story of what’s going on in my life and I want you to just listen, then I’m probably going to take a more narrative approach to it.

And so what is eclectic practice to me is it’s trauma informed. But really starting where the client is at and working from there. And so it’s not about adhering to any particular modality from start to finish necessarily, but actually really looking at a toolbox, right? What kind of tool is useful in this particular situation.

And so I do have ones that I tend to use more often than others. But I think an eclectic approach from my point of view is really centering other people, not my lens. A lot of practitioners will pick a particular modality and then they tend to work from that modality constantly. And there’s that old saying, if you have a hammer, everything looks like a nail.

And so what I want to do is challenge that belief because I do think that there are different things that work for different people. And when we talk about diverse backgrounds, people who come from different communities than perhaps the practitioner comes from, then the research really shows that it’s important for us to actually start where the client is at. And so that’s why I choose to work from an eclectic lens is so that I can really start with them and then move forward from there.

I love that. When we think of eclectic practice and having it support and create practical solutions to therapeutic problems, what do we mean by that exactly?

Keep in mind that from a clinical social work lens and certainly a trauma-informed lens, there’s really no definition of how long we should be working with clients, but we still have the ethical obligation to not work with them longer than we need to. So it’s not that psychodynamic approach that sometimes they’re in practice for 30 years. Although in trauma work, sometimes people are with us longer then might be ideal from other points of view.

And so looking for practical tools to me is about figuring out what’s going on and using the most appropriate tool for the most appropriate situation, right? So if a person is only with you for five sessions, Because that’s what they have for funding, then how do we get to the biggest impact in the shortest, a myriad of time for that particular client. And that to me is really about ethical practice.

The other thing is to keep in mind clients don’t necessarily need to be fixed. I think so many of us have ascribed to the model of therapy that, we may have come with our own stuff or we just came with this like Cape, we want to wear to become this hero. And we come up with these elaborate sort of intervention plans when often our clients don’t need that. They just want to feel a little bit better, right? And they just want to deal with something in a smaller package. And so just figuring out what tool makes the most sense, giving not just the individual, but the whole context. That person and environment approach around the structural issues around them so that they can get what they need, not necessarily what we want them to need.

And so what do I mean by pragmatic? I listen very closely to what my clients are saying because that usually tells me the lens of which they are coming at a problem with, right? And if somebody is saying things to me like, the problem is in my relationship then I’m probably going to use more relational models.

If they’re saying things like, I’m just not thinking clearly, I might look at more CBT approaches, right? And the reason why is because I’m not trying to fight and convince the client of a particular way of working. I’m actually just letting them give me how they see the problem. And my guess is their internal structure around what the problem is going to fit with that particular lens. So it just seems way more pragmatic from my point of view.

That’s a really great way to look at it, because I think you’re right. A lot of us will look at what are the therapeutic modalities I enjoy, what I use more frequently, and in some ways that’s helpful, but really I totally resonate with what you’re saying because if the client is telling us it’s this, that they identify as the problem, that means we’re probably going to use more modalities that are within whatever they identified you gave the example of the medical model, or using more cognitive based type strategies. Using more relational. And like that makes so much sense and it is practical to follow that train to help our clients.

Yeah, I agree. Kayla. The only downside I see to it is that we end up being like generalists, right? It’s like being a GP versus a specialist in a particular thing. And so in my practice, as much as I do trauma work, which is a particular specialty. I do find that because I come from this eclectic lens, I need to know a little bit about a lot of things, just like a general practitioner in a medical practice and so that you can hear for them and then work.

Now, that doesn’t mean I don’t sometimes gently challenge a person’s thought process around it. They might think it’s a medical issue and I might actually see it as a more structural issue once I’ve got a full assessment done in my head. But it’s just where I’m going to start. Anyway, the whole concept of being really good at a lot of things, like you can’t be an expert.

And so one of the things that I do know is that when somebody wants, say EMDR from a very particular lens I have my training in EMDR, but because I use other things sometimes if I recognize that’s going to be their go-to all the time, then I would probably refer them off to somebody who specializes in more particular modalities.

That’s a really good point of view. How do you approach eclectic clinical work and supervision?

You just get layers on top of things, right? So not only do you have to understand what the client is doing, but in my clinical practice, when I’m doing supervision, I have to understand not just what the client may be thinking is their problem, but also how the practitioner sees the problem.

Because there’s multiple lens and the more lenses you put in front of each other, the more blurry sometimes things get or sometimes more clear, depending on how it’s all fitting. And so in my clinical practice, as a supervisor, one of the things I do is I really try hard to see where my supervisee is at and what kind of modalities do they like, and then I’ll start with their modalities as well.

So one of the things I try to do with my clinical supervision is pay attention to where my supervisee is at first see the lenses that they tend to use, right? Because all of us tend to go to these places that are pretty familiar to us. And also because of the way we’ve been trained, the mentors we’ve had in the past and even our own personal experiences can really have a huge influence on how we practice.

And so I want to start with my supervisees from that point of view, and then start to build a relationship with them to know what they need, right? And so just you have to have goals and therapy, you also have to have goals and supervision because the idea is to help a person build on their practice rather than being particularly judgy or telling them what it is I would do because the client went to them, not to me.

So having that idea of where it is their lens is, and then having them tell the story of who it is that they’re needing some consultation or supervision about. And then you start to hear what is the lens that maybe that client is having. So in clinical supervision, that’s what it’s talking about. And so often what I’ll do is just keep pulling out tools from my toolbox, right? And then seeing where my supervisee thinks it will work. My clinicians that I work with, they have their own skillset. And so they often know what is going to work for their client and what is not. So it’s this negotiation of where I’ll just say, Hey, I had a client in the past that this worked for, or this is the way it sounds to me like this individual is framing it. What do you think about this? And so I think my supervisees really love those approaches because so often they’re an intermingling of different things that have worked in the past, and then it gives them a broad base.

The other thing I like to do is group supervision because I think having different people who come from different modalities and different training is really interesting because they learn so much from each other about a different skill. And also, it takes a little bit of the weight off me. I’m not an expert in anything, like I said, general practitioner, so the people that come to me for clinical supervision often have really great experience in different areas.

And so if they can help support each other in ways that maybe I can’t without them. So that can be really helpful.

I like that you mentioned, groups is a really nice way for clinical supervision too, because another thing that I think about is the questions or the situations that come up that you might not have seen in your own practice, but you can learn from other people before they happen. So you’re like preparing in advance instead of not knowing what might come up. Something came up for somebody else and now you’re learning that approach or how to navigate that.

Yeah, I think group supervision, to me, the most useful way of supervising, new practitioners, students, regardless of what role I’m in, I’ve always found that group is really helpful and partly because of that collective brain that you’re talking about, Kayla. That it takes a lot of responsibility off of me or the clinician and we were able to collaborate in this group thought process. And it can help with creativity a lot.

Not only that, I think group supervision, because I’ve been doing this work for, like 13 years now. Lots of years. I started my MSW journey in 2010 is when I graduated. And so there’s been lots of clinical work since that period of time.

Anyway, I’ve had a ton of experience, but that also puts me in a position of power that’s different, right? A lot of my clinical supervises really look up to me in terms of my practice, and that’s great, but I’m not always right. And I also have been doing this a long time. And so when you put people in a group together, they get some of that expertise maybe that I bring and each other bring, but more importantly, they get that sense of collaboration, of feeling uncomfortable or I didn’t know what to do in this situation.

And when other people in that group can be like, I wouldn’t know what to do in that situation either. That can be really affirming and validating for practitioners to understand and to hear it, that it’s not just them. I really like group supervision and I like supervision in general because clinical practice, especially if you’re in the private practice world can be very isolating.

And so having more network of individuals that you can refer to or that you can seek collaboration or consultation with is always a good idea to help break down that isolation that’s so important and quite frankly, dangerous in our profession.

I couldn’t agree with you more. Krista, you offered clinical supervision. Can you tell us a little bit about your approach, and who might be a good fit to work with you?

I find a few things, right? Like I am not a specialist in any particular modality. So anyone who’s looking for clinical supervision about a particular modality I may not be their cup of tea.

Who I think works really well with me is individuals who are creative that don’t necessarily ascribe to the medical model of clinical work all the time. ’cause that is certainly not where I stand. I believe in much more what Katrina Brown refers to as critical clinical social work like, so this idea of decolonized, anti-racist practice modalities, which I think are definitely where I come from.

And so I have a diverse bunch of clinicians then that tend to gravitate towards me because of that particular stance and because of my other work at the university in those areas. So that helps.

I really like taking on clinical supervisees that come from that more critical lens. Partly because I think. There needs to be more of us, right? So when we think about, for instance, black social workers working in the field, I want more of them because we’re getting more and more diverse practitioners. What we’re not getting is diverse clinical supervisors. And so my goal really is to help support those individuals so that they don’t need to come to someone like me because I come from a white middle class background and I really want to help create change within clinical work and that means supporting individuals.

So anyway, who else is good with me? I certainly tend to more narrative work because of my trauma background and because of my grief and loss background. So people who are interested in that kind of piece would be helpful. And really, I’m a hugely relational worker because I think relationship is the most important part of both therapy, but also of supervision.

So to connect with Krista, head to her website at kristaosborne.ca, or you can simply scroll down to the show notes and click on the link.

Krista, thank you so much for joining us on the podcast today to define eclectic practice and explain how it can provide practical solutions to therapeutic problems.

Thanks for having me.

Thank you everyone for tuning into today’s episode, and I hope you join me again soon on Your Clinical Supervisor’s Couch podcast.

Until next time, bye for now.