The Relation of Psychotherapy Integration to the Established Systems of Psychotherapy

That individuals (and groups) have vested interests is part of the nature of the human condition and is captured in the cognitive theoretical concept “personal domain” (Beck, 1976, p. 56). Of relevance to psychotherapy integration (and consistent with this concept), there are some apparent philosophical differences between advocates of psychotherapy integration and those of the major systems of psychotherapy. In the same manner that the various schools of integrative and eclectic psychotherapy compete with one another (Lazarus & Messer, 1991, p. 144), so too do they contend with the established systems. In this article, we present several issues about which the systems of psychotherapy and the integration movement may differ, and we respond to criticisms of cognitive therapy that have been the focus of previous articles in this journal. Finally, we give examples of how those who research and apply the contemporary systems of psychotherapy can, within those systems, explore possibilities for psychotherapy integration. We conclude that there is probably much that the integration movement and the established systems of psychotherapy can offer each other.     

共同因素心理治疗整合模式的回顾与评析

共同因素心理治疗整合模式是现代心理治疗整合运动中最早被提出的一种心理治疗整合模式。通过对共同因素整合模式的创建背景、发展历程及基本观点进行了梳理简述,认为其在促进心理治疗各流派融合的同时也人为地造成了“共同因素VS特异因素”新的对立,探讨了唯有建基于人的整合本性的心理治疗整合视野才能促进心理治疗整合运动未来的健康发展。     

Working With the Sacred: Four Approaches to Religious and Spiritual Issues in Counseling

This article examines the advantages and disadvantages of 4 helping orientations of the counselor to religious and spiritual issues in psychotherapy: rejectionism, exclusivism, constructivism, and pluralism. The constructivist and pluralist approaches are advocated as those orientations best suited to work with diverse clients and religious beliefs, and flexible enough to deal respectfully, ethically, and effectively with a variety of religious and spiritual issues in counseling.     

An Overview of Directions in Psychotherapy Integration Research

In general, empirical research in psychotherapy integration has lagged behind the growing theoretical and clinical interest in the field. Even though many of the theoretically integrative treatment models currently available are based on empirical findings and clinical observations, the models themselves remain, for the most part, untested. Rigorous examination of integrative psychological theories and therapeutic programs is a necessary and useful way to increase our understanding of the process of psychotherapy and establish the efficacy and effectiveness of integrative therapies. The present article explores five different research areas in the field of psychotherapy integration, discussing several published studies in each area. The utility of this research for practicing clinicians is also discussed. Additional investigations in these areas and others are encouraged, with the goals of greater understanding of psychotherapy, as well as the further development and acceptance of integrative approaches.     

From cultural to existential diversity: The impossibility of psychotherapy integration within a traditional framework

The authors build upon Castonguay and Goldfried's analysis regarding issues and directions central to advancing psychotherapy integration. They elaborate on two issues addressed only minimally in Castonguay and Goldfried's article. The first involves moving beyond traditional psychotherapy territory to include cultural, self-in-relationship, and interdisciplinary domains. The second concerns using more holistic and synergistic processes to coconstruct integrative theories and approaches. Finally, the authors offer some insights into what they believe should be the goals of the integrative movement and into additional issues they think should be addressed to attain these goals. Psychotherapy has become so complex and changing that we need a new view—one that recognizes the impossibility of any final or superior integrative theory and the need for constant change and evolution in theory and practice.     

Übertragung und Gegenübertragung in Verhaltenstherapie und Psychoanalyse

Most psychotherapists and researchers agree that a good relationship essentially contributes to therapeutic change. The psychoanalytic concepts transference and countertransference which describe fundamental aspects of the psychotherapeutic relationship have now become integrated into behavior therapy. These concepts, however, are used differently in psychoanalysis as well as in behavior therapy. This makes the communication between psychotherapists coming from different orientations difficult. Therefore, a research approach which describes the important verbal and nonverbal elements of a helpful therapeutic interaction independently from therapeutic orientation could help to evaluate their effectiveness in different psychotherapeutic methods. In this way a culture of integration into psychotherapy could be encouraged.     

The integrative attitude–a personal journey

The origins of clinical psychotherapy date from the beginning of last century and the development of broadly four foundational schools–psychoanalytic, cognitive-behavioural, humanistic and transpersonal psychologies. The imperative to integrate these schools, however, is relatively recent and in the last 25 years a professional integration movement has developed, exemplified by the formation of SEPI and the UKAPI, and ‘integrative psychotherapist’ is now the most popular nomenclature used in the profession. This article gives a brief history of the integration movement, reviews some issues raised by developments so far, and discusses the personal dilemma that integration evokes in the would-be integrative practitioner. Using my own journey I espouse an integrative attitude that is based on the nature of integration as an evolving personal process rather than an ideal, fixed, profession-wide position. I describe three interweaving modalities of integration I call constructive, complicit and contiguous integration, which form a developmental framework that aims to encourage the individual activity of questioning, inventing, researching and interrogating the discipline within its philosophical, professional and social context. In concluding, this article exhorts the profession to see integration as a personal journey, as a way of being that is constantly becoming and unfolding in relation with the therapist's training, experience and interaction with peers and clients. The result is indefinable and unnameable, and perhaps represents the soul of integrative psychotherapy.     

Toward an integration of child and family therapy

Current forms of treatment for the symptomatic child are reviewed and analyzed. There are four general approaches to treatment: individual child psychotherapy, conjoint parent-child psychotherapy and counseling, parent therapy and counseling, and conjoint family therapy. Each approach has certain strengths, but in-and-of itself is an incomplete treatment mode. An integration of child and family therapy is recommended, and recent attempts at this integration are described. These include approaches which work within the framework of conjoint family therapy and those which provide concurrent child and family therapy.     

Integration of Cognitive-Behavioral and Interpersonal Therapies for Latinos: An Argument for Technical Eclecticism

The integration of psychotherapeutic techniques is a common practice among today's clinicians. However, most discussions on psychotherapy integration have focused on general theoretical issues without attention to special populations. Latinos now represent the largest ethnic minority population in the United States and the mental health needs of this population are increasing. Although there are few controlled outcome studies that focus on Latinos, basic research suggests that integrating components of interpersonal therapy (IPT) into cognitive-behavioral therapy (CBT) may be particularly effective with this population. Specific suggestions for integrating CBT and IPT techniques are presented, and ways in which this integration can be adapted in a culturally sensitive manner are reviewed. An ethical and culturally sensitive CBT-IPT integration for Latinos requires empirical verification. Future studies on CBT-IPT synthesis should demonstrate the effectiveness of such integration relative to CBT or IPT alone.     

Effective Psychotherapy With Low-income Clients: The Importance of Attending to Social Class

The purpose of this article is to explore some of the issues associated with conducting psychotherapy with low-income clients. Throughout the article, we draw from our specific clinical experiences working with low-income Latina mothers in a depression prevention program. The themes that we address regarding class and psychotherapy are in the areas of assessment of social class, integration of class issues into the therapy process, and managing differences in social class between therapists and clients. As we discuss these themes, we provide concrete recommendations in order to advance awareness and effectiveness in working with economically disadvantaged populations.     

Entwicklungstendenzen psychotherapeutischer Praxis und Forschung

This review presents an analysis of articles in the journal “Psychotherapeut” during the years 2000 and 2001 with the focus on new efforts in the field of psychotherapeutic practice and research. The main topics of the journal are the presentation of new therapeutic approaches, some of them integrating different theoretical orientations, and the emphasis on the therapeutic relationship as a specific contribution to the process and the results of psychotherapy. In addition, this article presents a survey of the various subjects in psychotherapeutic research including a) the application and testing of new questionnaires to measure the effectiveness and the process of psychotherapy and b) research in the epidemiology of selected forms of stress, their consequences and lasting effects.     

Body language and metaphors revealed through applications of Movement Psychotherapy in a hospice: A clinical case of refractory pruritis

Movement psychotherapy (MP), and dance/movement therapy (DMT), are body-orientated psychotherapy approaches that use movement for the integration of emotional, cognitive, physical, social and spiritual aspects of self (European Association Dance Movement Therapy, 2010). It is distinctively a combination of moving and sensing the body with verbal self-reflection (Bloom, 2006). Several papers have presented DMT as a treatment in general medical care and cancer care, but there is still a paucity of evidence-based studies. The authors describe a clinical case illustrative of many of the situations in which facing death was particularly tormenting. The emotional pressure can produce a barrier of communication with the risk of rupturing the therapeutic relationship. The movement therapist’s function is to clarify the elements of body language and this has important implications for clinical practice because the end-of-life decisions are difficult, like palliative sedation therapy (PST). Even if procedural guidelines for PST help physicians and care teams through the decision-making process and make them more comfortable when responding to physical suffering, physicians more frequently report an emotional pressure when their patients experience psychological symptoms, with the risk that PST could become a potential “counterphobic defence to treat”.     

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.     

Mindfulness: A Proposed Common Factor

Mindfulness is proposed as a core psychotherapy process. It is defined as a state of psychological freedom that occurs when attention remains quiet and limber, without attachment to any particular point of view. It can be shown that this process is collaborativefy employed by psychotherapist and patient within all psychotherapy orientations, and also by the integrative psychotherapist when making optimal choices among orientations. This article addresses (1) the defining attributes of mindfulness, (2) relevant conceptual approaches that lend theoretical support for a mindfulness factor, (3) two attentional forms of mindfulness that seem to have particular correspondence with either psychodynamic or cognitive-behavioral therapy, (4) clinical applications, and (5) the role of mindfulness for the integrative decision-making process.     

Developing a research tradition consistent with the practices and values of counselling and psychotherapy: Why Counselling and Psychotherapy Research is necessary

Despite the general acknowledgement that it is important for counselling and psychotherapy practice to be informed by research, it is clear that in recent years a widening gap has emerged between research and practice. This paper briefly reviews some of the factors responsible for the current crisis in therapy research and offers a number of reasons why a healthy relationship between research and practice is necessary. It is suggested that, at present, there exists within psychology and social science a level of acceptance of pluralistic and innovative approaches to research, which may facilitate the emergence of a new genre of practitioner‐oriented inquiry in the field of counselling and psychotherapy. Some of the ways in which Counselling and Psychotherapy Research intends to contribute to this movement are described, for example the promotion of new forms of writing, use of information technology, and the creation of knowledge communities. Readers are invited to participate in this endeavour.     

The Integrative Revolution in Couple and Family Therapy

A quiet revolution has resulted in significant movement toward integrative practice in couple and family therapy. This article examines the present status of integrative methods, highlighting the factors that have led to their broad acceptance, issues surrounding the definition of integration and the nomenclature used, the content of recent approaches, and specific conceptual developments and directions.     

Psychological movement patterns in psychotherapy

The following article represents a first step in the formulation of a method of experiential psychotherapy which integrates content and process areas of clinical practice. The integration is based on Eugene Gendlin's experiential understanding of psychotherapy (1973), and on an adaption of Rudolf von Laban's movement system (Dell 1970). The article focuses on the methodological issues of this integrative approach. For a fuller discussion of this new approach and of its clinical application, see Saner (1981).     

A Participant-Observer's Perspective on Psychotherapy Integration

Jacobson has raised a number of issues about the usefulness of psychotherapy integration. Some of his concerns stem from his doubt that people are capable of change, and some that appear to be the result of a misinterpretation of what constitutes psychotherapy integration. This article attempts to clarify some of these misunderstandings, which seem to be the result of equating psychotherapy integration with the integration of theories. Comments are also made about the research underpinings related to work in this area.     

Psychotherapy for the treatment of depression: a comprehensive review of controlled outcome research

Previous quantitative reviews of research on the efficacy of psychotherapy for depression have included only a subset of the available research or limited their focus to a single outcome measure. The present review offers a more comprehensive quantitative integration of this literature. Using studies that compared psychotherapy with either no treatment or another form of treatment, this article assesses (a) the overall effectiveness of psychotherapy for depressed clients, (b) its effectiveness relative to pharmacotherapy, and (c) the clinical significance of treatment outcomes. Findings from the review confirm that depressed clients benefit substantially from psychotherapy, and these gains appear comparable to those observed with pharmacotherapy. Initial analysis suggested some differences in the efficacy of various types of treatment; however, once the influence of investigator allegiance was removed, there remained no evidence for the relative superiority of any 1 approach. In view of these results, the focus of future research should be less on differentiating among psychotherapies for depression than on identifying the factors responsible for improvement.