当代心理治疗整合的反思与展望

心理治疗整合是指试图超越某单一心理治疗流派的局限,借鉴其他流派的优势,对各种不同的治疗理论和方法持包容和开放的态度的一种当代心理治疗取向.心理治疗整合主要有四种模式:技术折衷、共同因素、理论整合、同化整合.整合取向仍是目前心理治疗的大势所趋,越来越多的治疗师开始接受整合理念,不仅不同的治疗理论和方法之间需要整合,而且理论研究与临床实践也需要整合.     

催眠疗法的整合:认知催眠疗法

认知催眠疗法是心理治疗的整合模式下,催眠疗法与认知疗法有机结合而发展成的一种治疗方法.催眠疗法虽然有临床疗效,但因为缺乏现代心理治疗和行为矫治的理论,所以难以进入主流学院派的心理疗法范畴.促进催眠疗法发展的一个途径是在心理疗法整合模式的思想指导下,就像心理疗法中的认知疗法和行为疗法整合一样,催眠疗法作为一种有效的疗法整合融入公认的认知疗法中,从而让催眠疗法有现代理论依托.认知催眠疗法的提出,为催眠术临床实践提供了标准统一的理论平台,也代表着心理疗法整合模式的发展,有利于临床实践和理论相结合.     

整合相关职业资源推动医学模式转变

当代知识的高度分化使得我们的知识结构趋于专一化,因此,我们难以通过改革医学教育使医务卫生工作者以及医学生获得与生物-心理-社会医学模式要求相适应的综合性知识结构,这是导致我国医学模式转变困难的根本原因.但是,我们可以选择通过整合社会工作师、心理治疗师等相关职业,组建由医师、护士、药师、心理治疗师、社会工作师共同组成的医疗卫生服务团队,借助不同专业人员的相互配合,克服个人知识结构专一化制约的路径来实现医疗卫生服务模式的转变.     

心理治疗中的共同要素理论与特殊成分说:争议与整合

共同要素理论与特殊成分说是探讨心理治疗改变因素的两大对立理论。文章综述了共同要素理论的内涵及两条发展途径,并以实证支持治疗为例,探讨了特殊成分说的内涵及研究进展,分别探讨了两者存在的问题及争议。"共同要素vs特殊成分"更多体现的是研究者的视角,是探索导致心理治疗改变的因素时所进行的临时划分,两者相互依赖、相互转化,但未能囊括治疗改变的所有因素。未来,需要深入了解心理治疗的改变过程与机制,培养同时掌握特殊成分与共同要素技能的新一代治疗师,在推进循证心理治疗的过程逐渐进行整合。     

心理治疗中共同要素理论的历史发展

从共同要素的角度,分理论模式化与研究实证化两条线索,追溯了心理治疗中共同要素理论的思想渊源,并自Saul Rosenzweig开始,综述了Carl Rogers、Jerome Frank、Marvin Goldfried、Michael Lambert、Bruce Wampold等学者的观点,探讨了共同要素理论的历史演进、内涵结构、理论模式及当代研究进展。认为它在不久的未来,将与特殊技术说逐步走向整合,加深对心理治疗过程与改变机制的认识,共同提升心理治疗的效果。     

具身心理治疗:原理与技术

具身心理治疗是以身体心理治疗、舞动治疗为代表的,理论上契合具身认知观点、实践中注重身体作用的一种当代心理治疗取向。它将“身体”与“躯体”区分开来,赋予身体解剖学的、感觉运动的、认知的与嵌入环境等不同层面的意义。当前,已有不少研究证实身体有助于改善治疗关系,促进来访者认知、情绪的改变,并发展出一系列注重身体内外感知、姿势或运动的非言语治疗技术。具身心理治疗重构了身体在治疗过程中的概念与角色,发展了新的技术,是传统心理治疗的有益补充; 但也存在实证证据不足、理论框架尚未完全整合、容易过分强调身体作用等问题。今后需自觉整合其他治疗流派、开发独特的核心技术,推进循证的具身心理治疗的发展。     

积极心理治疗模式与发展趋势

积极心理治疗是在跨文化的基础上以冲突为中心的治疗模式,治疗中关注个人实际的和潜在的能力,并借助东方寓言故事哲理,用跨文化的认知观点解释冲突。这种符合人性特点的心理治疗模式,为心理治疗开辟了新的途径,促进了心理治疗的发展。     

阿德勒心理治疗方法与当代心理治疗整合精神的契合

阿德勒为心理治疗提供了一个经得起时间考验的综合理论。他对人类行为做了务实的概念化处理,并改变了程序使其可能整合当代心理治疗理论中众多有价值的见解。阿德勒心理治疗与当代实践之间存在很多相似之处,因为阿德勒治疗是一种现在与未来定向的、限时性的（即短程的）、整合性和折衷性的方法。     

积极心理治疗模式与发展趋势

积极心理治疗是在跨文化的基础上以冲突为中心的治疗模式,治疗中关注个人实际的和潜在的能力,并借助东方寓言故事哲理,用跨文化的认知观点解释冲突.这种符合人性特点的心理治疗模式,为心理治疗开辟了新的途径,促进了心理治疗的发展.     

我国心理治疗发展研究概况及影响因素分析

我国心理治疗发展研究概况及影响因素分析河南省医学科学院（郑州４５０００３）赵山明河南省医学情报研究所（郑州４５０００３）能昌华随着生物医学模式向生物—心理—社会医学模式的转变，８０年代以来心理疗法被迅速引进和应用。本文采用文献计量学方法，对《中国生物...     

A Common Factors Approach to Psychotherapy Training

This article addresses training in psychotherapy integration from the perspective of common factors. Problems related to this training perspective are first reviewed. As an attempt to deal with such problems, current teaching and supervision efforts by the author are briefly described. Based on a developmental model of clinical learning, a sketch of a more comprehensive program of integrative psychotherapy training is advanced.     

Psychotherapy Integration: Contributions from Lifestyle Theory

The lifestyle theory of intervention is evaluated with respect to its status as an integrated psychotherapy using theoretical integration, technical eclecticism, and the common factors approach as criteria. Because lifestyle theory integrates concepts from evolutionary biology, existential philosophy, cognitive psychology, social learning theory, and various therapeutic models it satisfies preliminary criteria for theoretical integration. To the extent that it provides an internally consistent model and makes use of techniques from disparate schools of psychotherapy, it adopts a technical eclectic approach to intervention. The lifestyle model also appears to qualify as an integrated psychotherapy by virtue of its attention to several common factors in psychotherapy.     

Assimilative and Accommodative Integration: The Basic Dialectics

Two basic styles in psychotherapy integration can be described, in which respectively the assimilative or the accommodative mode of proceeding preponderate. The first is chosen by those who wish to keep a firm grounding in any one theoretical system, into which they incorporate perspectives or practices from other schools, reinterpreted and reformulated in their own terms. The second is favored by those who prefer to practice eclectically, without worrying too much about the contradictions and incompatibilities among the different approaches. The latter therapists can remain at this purely eclectic level, or move on towards a proper integration. In this case the integration does not usually happen on the base of a preferred system, as in theoretical integration, but rather follows the line of the common factors approach. This integration mode has a prevalent accommodative character. It points to a basic structure that is common to the different methods, and becomes clearer the more the relation is freed of the constriction of theoretical models. An attempt is made to show the substantial complementarity and the dialectical relation that links the two fundamental modes of psychotherapy integration.     

Psychotherapy integration: An idea whose time has come

Growing numbers of clinicians and researchers from the major therapeutic orientations have begun to demonstrate an open attitude toward potential contributions of other approaches. Efforts at rapprochement and integration sharply contrast with the acrimonious debates that prevailed in the field a few decades ago. These efforts represent much needed attempts to better understand psychotherapy and to improve its effectiveness. In this article, the factors that have contributed to the emergence and development of psychotherapy integration are described, including the inadequacies of predominant models, limited effectiveness of existing treatments, and external pressures for the accountability of psychotherapy. Also reviewed are core issues within the integration movement itself, such as the search for theoretical integration, elaboration of eclectic therapies, identification of conceptual convergence and common factors, development of integrative approaches for particular clinical problems, and improvement in major orientations as a result of transtheoretical dialogue. Finally, several unresolved issues and unanswered questions facing psychotherapy integration are described, as they suggest future directions for the development of this movement.     

西方心理疗法的整合趋势及其前瞻

由于认识到各种心理疗法皆有不足,故从20世纪70年代以后,人们开始探讨心理疗法的整合问题。可从总体上把它划分为三个彼此关联的层面：技术上的折衷;寻求对疗效起作用的共同因素;以及理论上的整合。心理疗法整合的目的并不是要到一个能囊括一切的完美的体系,而是让人们以更为开放的态度和更为开阔的眼光,多维度、多视角地探索各疗法间相得益彰的方式。     

An Outsider's Perspective on Psychotherapy Integration

This article offers those who are identified with progress in psychotherapy integration an outsider's perspective on progress in the field. The author argues for a contextual study of psychotherapy and psychotherapy integration, noting that the social psychology of psychotherapy may be an overlooked dimension in the study of psychotherapy integration. He suggests that perceptions of progress in psychotherapy integration may be exaggerated due to the lack of such a perspective.     

意义疗法的理论、方法与技术:基于存在积极心理学的视角

意义疗法是以存在积极心理学为理论基础,以构建个体生命意义为目的,实现生活正负两极性的动态平衡,从而解决其心理困扰获得心理治愈与成长的一种整合性心理咨询与治疗方法。起源于Frankl意义学说的意义疗法是通往人类美好生活的路径,它源于对苦难生活所隐含意义的本质认识。在理论上,意义疗法以意义定向看世界为中心,以意义管理理论和双系统模型为支架; 在方法上,为保障意义获得,应遵循8个基本问题和12条原则,充分发挥意义源的作用,实现意义获得的双路径统一; 在技术上,灵活采用趋向性(PURE)策略、回避性(ABCDE)策略、以及双视角双通道策略或其它策略的整合。意义疗法因包含了精神成分而超越了心理动力学和个体心理学等传统心理治疗方式。未来研究还需明确意义疗法整合了哪些流派的具体方法和技术,细化意义疗法主要的技术与策略的操作步骤,考察成熟幸福感量表在中国文化下的适用性,以及充分整合质性与量化研究方法检验意义疗法在中国的适用性