Clinical pluralism

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Clinical pluralism is a term used by some psychotherapists to denote an approach to clinical treatment that would seek to remain respectful towards divergences in meaning-making. It can signify both an undertaking to negotiate theoretical difference between clinicians,[1] and an undertaking to negotiate differences of belief occurring within the therapeutic relationship itself.[2][3][4] While the notion of clinical pluralism is associated with the practice of psychotherapy, similar issues have been raised within the field of medical ethics (see Medical ethics § Cultural concerns).[5][6]

Clinical pluralism can be applied within a particular approach to psychotherapy, such as psychoanalytic psychotherapy.[7] Modern psychoanalytic training involves not only hours of training sessions but the use of diverse clinical practices.[8] An example of psychoanalytic treatment following clinical pluralism is coparticipant psychoanalysis, which features an individualized treatment but is diverse in the practices employed. This technique holds that all analyses represent unique sets of practices, which depend on the varying characteristics of the personalities that make up the analytic dyad.[9]

Clinical pluralism is also associated with eclectic and integrative psychotherapy, which are distinguished from clinical practice that follows a specific theoretical school with its own therapeutic techniques.[10] These approaches to therapy all maintain that there is no single theory or therapeutic modality that can offer optimum efficacy.[10]

See also[edit]


  1. ^ Borden, W. (2009). Reshaping Theory in Contemporary Social Work: Toward a Critical Pluralism. New York: Columbia University Press.
  2. ^ Basseches, M. (1997). A Developmental Perspective on Psychotherapy Process, Psychotherapists' Expertise, and 'Meaning-Making Conflict' Within Therapeutic Relationships: Part I. Journal of Adult Development, 4(1), 17–33.
  3. ^ Fiscalini, J. (2004). Coparticipant Psychoanalysis: Toward a New Theory of Clinical Inquiry. Columbia University Press.
  4. ^ Brown, R.S. (2016). Spirituality and the Challenge of Clinical Pluralism: Participatory Thinking in Psychotherapeutic Context. Spirituality in Clinical Practice, 3.3, 187–195.
  5. ^ Masi, R. (1988). Multiculturalism, Medicine and Health Part 1: Multicultural Health Care. Canadian Family Physician, 34, 2173–2177.
  6. ^ Tilburt, J.C., & Miller, F.G. (2007). Responding to Medical Pluralism in Practice: A Principled Ethical Approach. Journal of the American Board of Family and Medicine, 20.5, 489–494.
  7. ^ Bokanowski, Thierry; Fiorini, Leticia Glocer; Lewkowicz, Sergio (2009). On Freud's "Mourning and Melancholia". London: Karnac Books. pp. viii. ISBN 9781855757448.
  8. ^ Sandler, Paulo Cesar; Costa, Gley Pacheco (2019-02-18). On Freud's "The Question of Lay Analysis": Contemporary Freudian Turning Points and Critical Issues. Routledge. ISBN 9780429664922.
  9. ^ Fiscalini, John (2007). Coparticipant Psychoanalysis: Toward a New Theory of Clinical Inquiry. New York: Columbia University Press. pp. 201. ISBN 978-0231132626.
  10. ^ a b Gurman, Alan S. (2008). Clinical Handbook of Couple Therapy, Fourth Edition. New York: The Guilford Press. p. 354. ISBN 9781593858216.