As an integrative therapist with recent experience of working within the health board I sometimes feel frustrated when expected to adhere to the parameters of a rigid model. For me it feels inauthentic expecting the client to 'fit' the model, instead of being available and open to their needs. I have nothing but admiration for Psychologist Birgit Valla, the leader of a large, community mental health centre in Norway who publically announced that neither she nor her staff would employ psychiatric diagnoses or standardized treatment protocols. Instead she chose to put the client's needs first and respond accordingly, whilst still measuring outcomes - with outstanding results. Isn't this what's effective about the therapeutic relationship? After all, who are we to say we know what's best for our clients if we haven't established their needs from the beginning?