Integrative Psychotherapy - AbsoluteAstronomy.com

Integrative psychotherapy may involve the fusion of different schools of psychotherapy

Psychotherapy

Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...

. The word 'integrative' in Integrative psychotherapy may also refer to integrating the personality and making it cohesive, and to the bringing together of the "affective, cognitive, behavioral, and physiological systems within a person".

In Integrative and eclectic counselling and psychotherapy, (Palmer and Woolfe, 1999), the authors make clear the distinction between integrative and eclectic

Eclecticism

Eclecticism is a conceptual approach that does not hold rigidly to a single paradigm or set of assumptions, but instead draws upon multiple theories, styles, or ideas to gain complementary insights into a subject, or applies different theories in particular cases.It can sometimes seem inelegant or...

approaches: "Integration suggests that the elements are part of one combined approach to theory and practice, as opposed to eclecticism which draws ad hoc from several approaches in the approach to a particular case."

Psychotherapy's eclectic practitioners are not bound by the theories, dogma, conventions or methodology of any one particular school. Instead, they may use what they believe or feel or experience tells them will work best, either in general or suiting the often immediate needs of individual clients; and working within their own preferences and capabilities as practitioners.

Background

Initially, Sigmund Freud

Sigmund Freud

Sigmund Freud , born Sigismund Schlomo Freud , was an Austrian neurologist who founded the discipline of psychoanalysis...

developed a talking cure called psychoanalysis

Psychoanalysis

Psychoanalysis is a psychological theory developed in the late 19th and early 20th centuries by Austrian neurologist Sigmund Freud. Psychoanalysis has expanded, been criticized and developed in different directions, mostly by some of Freud's former students, such as Alfred Adler and Carl Gustav...

; then he wrote about his therapy and popularized psychoanalysis. After Freud, many different disciplines splintered off. Some of the more common therapies include: psychoanalytic psychotherapy

Psychoanalysis

, counseling, co-counseling, analysis, transactional analysis

Transactional analysis

Transactional analysis, commonly known as TA to its adherents, is an integrative approach to the theory of psychology and psychotherapy. It is described as integrative because it has elements of psychoanalytic, humanist and cognitive approaches...

, cognitive behavioral therapy, gestalt therapy

Gestalt therapy

Gestalt therapy is an existential/experiential form of psychotherapy that emphasizes personal responsibility, and that focuses upon the individual's experience in the present moment, the therapist-client relationship, the environmental and social contexts of a person's life, and the self-regulating...

, body psychotherapy

Body Psychotherapy

Body psychotherapy, also referred to as body-oriented psychotherapy and somatic psychology, is a significant branch of psychotherapy, with origins in the work of Pierre Janet, Sigmund Freud and particularly Wilhelm Reich....

, psychodynamic psychotherapy

Psychodynamic psychotherapy

Psychodynamic psychotherapy is a form of depth psychology, the primary focus of which is to reveal the unconscious content of a client's psyche in an effort to alleviate psychic tension. In this way, it is similar to psychoanalysis. It also relies on the interpersonal relationship between client...

, family systems therapy, person-centered psychotherapy

Person-centered psychotherapy

Person-centered therapy is also known as person-centered psychotherapy, person-centered counseling, client-centered therapy and Rogerian psychotherapy. PCT is a form of talk-psychotherapy developed by psychologist Carl Rogers in the 1940s and 1950s...

, and existential therapy

Existential therapy

Existential psychotherapy is a philosophical method of therapy that operates on the belief that inner conflict within a person is due to that individual's confrontation with the givens of existence. These givens, as noted by Irvin D...

. Hundreds of different theories of psychotherapy are practiced.

A new therapy is born in several stages. After being trained in an existing school of psychotherapy, the therapist begins to practice. Then, after follow up training in other schools, the therapist may combine the different theories as a basis of a new practice. Then, some practitioners write about their new approach and label this approach with a new name. This overall pattern has been observed in numerous new therapies and is certain to form many future therapies.

A pragmatic or a theoretical approach can be taken when fusing schools of psychotherapy. Pragmatic

Pragmatism

Pragmatism is a philosophical tradition centered on the linking of practice and theory. It describes a process where theory is extracted from practice, and applied back to practice to form what is called intelligent practice...

practitioners blend a few strands of theory from a few schools as well as various techniques; such practitioners are sometimes called eclectic psychotherapists and are primarily concerned with what works. Alternatively, other therapists consider themselves to be more theoretically grounded as they blend their theories; they are called integrated psychotherapists and are not only concerned with what works, but why it works.

For example an eclectic therapist might experience a change in their client after administering a particular technique and be satisfied with a positive result. In contrast, an integrative therapist is curious about the "why and how" of the change as well. A theoretical emphasis is important; for example, the client may only have been trying to please the therapist and was adapting to the therapist rather than becoming more fully empowered in themselves.

Different routes to integrative psychotherapy

The most recent edition of the Handbook of Psychotherapy Integration (Norcross & Goldfried, 2005) recognized four general routes to integration: Common Factors, Technical Eclecticism, Theoretical Integration, and Assimilative Integration (Norcross, 2005).

Common factors

The first route to integration is called common factors and "seeks to determine the core ingredients that different therapies share in common" (Norcross, 2005, p. 9)
The advantage of a common factors approach is the emphasis on therapeutic actions that have been demonstrated to be effective. The disadvantage is that common factors may overlook specific techniques that have been developed within particular theories. Common factors have been described by Jerome Frank (Frank & Frank, 1991), Bruce Wampold (2001), and Miller, Duncan and Hubble (2005). Common factors theory

Common factors theory

- Common factors theory in psychotherapy :Within psychotherapy research, common factors theory proposes that different theoretical and evidence-based approaches to psychotherapy and counseling have common components and that those components account for outcome more than components that are unique...

asserts it is precisely the factors common to the most psychotherapies that make any psychotherapy successful.

Technical eclecticism

The second route to integration is technical eclecticism which is designed "to improve our ability to select the best treatment for the person and the problem…guided primarily by data on what has worked best for others in the past" (Norcross, 2005, p. 8). The advantage of technical eclecticism is that it encourages the use of diverse strategies without being hindered by theoretical differences. A disadvantage is that there may not be a clear conceptual framework describing how techniques drawn from divergent theories might fit together. The most well known model of technical eclectic psychotherapy is Arnold Lazarus’ (2005) Multimodal Therapy

Multimodal Therapy

Multimodal therapy is approach to psychotherapy founded by Arnold Lazarus. It is based on the idea that humans are biological beings that think, feel, act, sense, imagine, and interact; and that each of these "modalities" should be addressed in psychological treatment...

. Larry E. Beutler

Larry E. Beutler

Dr. Larry E. Beutler, PhD, ABPP is a clinical psychologist.-Biography:Dr. Beutler received his PhD from the University of Nebraska and subsequently served on the faculties of Duke University Medical Center, Stephen F. Austin State University, Baylor College of Medicine, the University of Arizona...

’s model of Systematic Treatment Selection (Beutler, Consoli, & Lane, 2005) represents another model of technical eclecticism.

Theoretical integration

The third route to integration commonly recognized in the literature is theoretical integration in which "two or more therapies are integrated in the hope that the result will be better than the constituent therapies alone" (Norcross, 2005, p. 8). Some models of theoretical integration focus on combining and synthesizing a small number of theories at a deep level, whereas others describe the relationship between several systems of psychotherapy. One prominent example of theoretical synthesis is Paul Wachtel's (Wachtel, Kruk, & McKinney, 2005) model of Cyclical Psychodynamics that integrates psychodynamic, behavioral, and family systems theories. Another example of synthesis is Anthony Ryle’s (2005) model of Cognitive Analytic Therapy

Cognitive analytic therapy

Cognitive Analytic Therapy is a form of psychological therapy initially developed in the United Kingdom by Anthony Ryle. This time-limited therapy was developed in the context of the UK's National Health Service with the aim of providing effective and affordable psychological treatment which could...

, integrating ideas from psychoanalytic object-relations theory and cognitive psychotherapy. The most notable model describing the relationship between several different theories is Prochaska and DiClemente’s (2005) Transtheoretical Model

Transtheoretical Model

The Transtheoretical Model of Behavior Change assesses an individual's readiness to act on a new healthier behavior, and provides strategies, or processes of change to guide the individual through the stages of change to action and maintenance....

Assimilative integration

"This mode of integration favors a firm grounding in any one system of psychotherapy, but with a willingness to incorporate or assimilate, in a considered fashion, perspectives or practices from other schools" (Messer, 1992, p. 151). Different integration is the fourth route and acknowledges that most psychotherapists select a theoretical orientation that serves as their foundation but, with experience, incorporate ideas and strategies from other sources into their practice. Increasingly, integrationists are acknowledging that most counselors will prefer the security of one foundational theory as they begin the process of integrative exploration. Formal models of assimilative integration have been described based on a psychodynamic foundation (Frank, 1999; Stricker & Gold, 2005) and based on cognitive-behavioral therapy (Castonguay, Newman, Borkovec, Holtforth, & Maramba, 2005).

Emerging models that combine routes

In addition to well-established approaches that fit into one of four routes, there are newer models that combine aspects of the traditional routes. For example, Hill’s (2004) three-stage model of helping skills encourages counselors to emphasize skills from different theories during different stages of helping. Hill’s model might be considered a combination of theoretical integration and technical eclecticism. Hill's model is called the Three Stage Model. The first stage is the exploration stage. This is based on client-centered therapy. The second stage is entitled insight. Interventions used in this stage are based on psychoanalytic therapy. The last stage, the action stage, is based on behavioral therapy. Good and Beitman (2006) described an integrative approach highlighting both core components of effective therapy and specific techniques designed to target clients’ particular areas of concern. This approach can be described as an integration of common factors and technical eclecticism. Multitheoretical Psychotherapy

Multitheoretical Psychotherapy

Multitheoretical psychotherapy is a new approach to integrative psychotherapy developed by Jeff E. Brooks-Harris and his colleagues at the University of Hawaii at Manoa...

(Brooks-Harris, 2008) is a new integrative model that combines elements of technical eclecticism and theoretical integration. Therapists are encouraged to make intentional choices about combining theories and intervention strategies.
The generic term, integrative psychotherapy, can be used to describe any multi-modal approach which combines therapies. An effective form of treatment is psychodynamic psychotherapy combined with hypnotherapy. In 2007, for example, Kraft & Kraft (2007)http://www.londonpsychotherapy.co.uk gave a detailed account of a 54 year old female patient with refractory IBS in a setting of a phobic anxiety state. The patient made a full recovery and this was maintained at the follow-up a year later.

External links

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