Does It Matter What Your Client Thinks? The Role of Theory in Intervention

Abstract

Kamhi (2000) presents a case study of a child with a phonological impairment whose view of the intervention process led her to refuse to work on her goals with anyone other than her clinician. In this response, the potential clinical impact of discrepant views among the participants in a clinical intervention is discussed. In particular, it is argued that subjectivity is inherent in all interactions, but that different theories place differing emphasis on the importance of the subjective states of interactional participants. Three prominent theories of intervention are discussed: social interactionist, behaviorist, and information processing. It is argued that discrepancies between a clinician's and a client's view of what is happening during clinical interactions may complicate intervention. It is further argued that theoretical eclecticism may have a particularly negative impact, as it will increase the likelihood of misunderstandings. A conclusion is that, when clashes in perspectives arise, they force the clinician to make explicit what he or she believes—what causes disorders, what processes work to remediate them, and why.