A key hope underpinning mainstream psychiatry and clinical psychology has long been the medically informed idea that ‘mental disorders’ could be identified by biological and genetic markers permitting diagnoses and standardised treatment regimes. Amongst others, David Kupfer, Chair of the DSM 5 Taskforce has noted that this hope has yet to be realised. Kupfer’s observation raises the broader question of whether this approach can ever represent an adequate response to most presentations involving debilitating emotional distress.

Much contemporary training of psychologists is devoted to assessment, diagnosis and skills training in standardised responses. But research strongly suggests that effective responses are not related to the treatment-specific competence of the therapist or adherence to established protocols. The evidence points instead to the positive impact of therapists’ interpersonal skills in supporting interventions compatible with clients’ values and clients’ own framing of their distress.

In this presentation, I review the evidence for a ‘working with’ rather than ‘doing to’ approach – the former being a long-held values-based skill set of counselling psychologists that has at its heart a common-factors approach to therapy. I then consider a) key training and supervision implications of this approach and b) barriers inhibiting its explicit incorporation into the training of all psychologists working in the field of ‘mental health’.