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。     

A Message to Assimilative Integrationists: It's Time to Become Accommodative Integrationists: A Commentary

This commentary considers the six papers on assimilative integration in the larger context of the significance of this specific form of integration for psychotherapy integration in general. The author begins by revealing his bias that theoretical integration is the most mature form of psychotherapy integration. In this context, he views assimilative integration as an advanced form of eclecticism that absorbs technical eclecticism into the practitioner/theorist's home orientation. Several of the papers present useful examples of assimilative integration, but they tend not to explore the implications of the successful application of foreign techniques for their home theories. The author concludes by suggesting that assimilative integrationists need to become accommodative integrationists by thinking through the implications for, and the implied modifications to, their home theoretical orientations. Accommodative integration would bring us a step closer to the author's ultimate goal—an emergent, unifying, and integrative theory of psychotherapy.     

Does Every Good Behaviorist Deserve Favor? A Reply to Neil Jacobson

This is a response to Dr. NeilJacobson's article, An Outsider's Perspective on Psychotherapy Integration, which appears in this issue. It addresses the issue of the differences between eclecticism and psychotherapy integration as well as the possible advantages integration holds over a one-model therapy system. This article suggests that virtually all psychotherapy systems operate under an integrated three paradigm model, and offers some concrete examples of this explanation. It also suggests that the use of psychotherapy integration may lead to a better paradigm match between client and therapist, and ultimately to better outcome. This article concludes that psychotherapy integration possibly offers the best alternative in terms of reducing the biases of one's underlying treatment oaradiem.     

The Clinical Challenges of Assimilative Integration

S. B. Messer (1992) introduced the notion of assimilative integration in psychotherapy, theorizing that integrative practitioners adhere to their preferred theoretical paradigms while judiciously blending aspects from other models. His assimilative approach offers a conceptual and clinical middle ground between technical eclecticism and a grand, unified theory of psychotherapy. However, the practice of competent assimilative integration is fraught with many challenges, both theoretical and clinical. The goal of the present paper is to explore the challenges of implementing assimilative integration. First, the theoretical and clinical barriers to assimilative approaches are considered. Second, the use of assimilative integration to avoid therapeutic failures is discussed. Finally, a case example is presented to illustrate the author's attempt to assimilate narrative, interpretive interventions within his preferred cognitive–behavioral treatment paradigm.     

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.     

Eclecticism, integration and comprehensiveness in counselling theory and practice

A trend toward eclecticism and integration amongst counsellors and others is described. This is mainly prompted by the demands of practice. Eclecticism emphasises 'borrowing freely from various sources' while integration emphasises 'combining parts into a whole'. Integration can be either horizontal, within a theoretical position, or vertical, between theoretical positions. Four models of eclecticism and integration are presented: single theoretical position; supermarket eclectic; eclectic theory-integrative practice; and integrative theory and practice. Neither eclecticism nor integration guarantees comprehensiveness. Some dimensions of a comprehensive theoretical position are described. The lack of a sound, comprehensive and integrative theoretical position, focused on the developmental needs and problems of living of the vast majority of people, has negative implications for both counselling and counsellor training.     

Bridging Technical Eclecticism and Theoretical Integration: Assimilative Integration

Assimilative integration is a new type of psychotherapy integration introduced by Messer in 1992. This paper explains the where, what, when, and how of this integrative route, outlines its advantages and weaknesses, and discusses areas for potential assimilative practice in various models of therapy. Following a brief review of the current status of psychotherapy integration and its practices, assimilative integration is conceptualized as a mini theoretical integration and as theoretical eclecticism it is offered as a bridge between theoretical integration and technical eclecticism. Assimilative integration is proposed as the best theoretically and empirically based integrative approach available at this time, particularly for therapists who have been trained in a single mode of therapy before they became integrationists.     

Processes and Stages of Change: Counseling With the Transtheoretical Model of Change

Technical eclecticism and theoretical integration literature has typically examined how multiple approaches to counseling practice may lead to more comprehensive and functional outcomes. Few have proposed an integration of approaches from a scientist‐practitioner perspective; many others have neglected the richness found in the body of existing theory. The purpose of this synthesis is to highlight the contributions that the Transtheoretical Model of Change (J. O. Prochaska & C. C. DiClemente, 1984; J. O. Prochaska & J. C. Norcross, 1994) has for technical eclecticism and theoretical integration. The intervention implications of processes and stages of change are discussed.     

Reconstructing An Erection and Elaborating Ejaculation: Personal Construct Theory Perspectives on Sex Therapy

Abstract

Personal construct psychotherapy has rarely been applied to sexual disorders. In this paper a constructivist approach is contrasted with alternative methods of treating such problems on three related dimensions concerning whether it (1) is introspective or extraspective, (2) views the complaint as representing a personal construction or faulty mechanism, or (3) aims toward personal or normative goals. It will be illustrated by reports of the treatment of two men presenting with sexual complaints, and its technical eclecticism will be compared with integrative trends in sex therapy.     

Must most psychotherapists remain as incompetent as they now are?

Although psychotherapy often is effective or helpful for groups of people, it is frequently inefficient and therefore is wasteful for many clients and actually contributes to harming a sizable minority of them. Some of the main aspects of therapeutic inefficiency are discussed in this paper, including: overemphasis on past experience; encouraging dependency and the dire need for love; overemphasis on modeling; the stressing of insight; the use of catharsis and abreaction; the use of cognitive distraction; self-efficacy suggestions; operant conditioning; gradual desensitization; and unselective eclecticism. Specific suggestions for increasing the efficiency of psychotherapy are given.     

Integrating Religion and Psychology in Therapy: Issues and Recommendations

This article explores the history of the relationship between religion and psychology, integration difficulties within psychotherapy, and recommendations for problem resolution. Two religious frameworks psychologists can use to reduce conflicts and enhance psychotherapy with regard to religious concerns are provided2.     

Pragmatism, Pluralism, and Psychotherapy Relationships: An Interview with John C. Norcross, Ph.D.

John C. Norcross has made significant contributions in the areas of the transtheoretical model of change, psychotherapy integration, and empirically supported psychotherapy relationships. This interview explores the contributions of pragmatic philosophy and his personal upbringing to his work as a psychotherapy researcher and practitioner. Dr. Norcross discusses the status of the psychotherapy integration movement, the work of the Task Force on Empirically Supported Psychotherapy Relationships, and future trends in psychotherapy over the next 25 years. He emphasizes the importance of a methodological rigor that recognizes the unique characteristics of the psychotherapy relationship. He describes his current interest in the psychotherapy of psychotherapists, illustrating it with his personal challenges in balancing work and home.     

Theorietreue und Variationen

Interventional techniques can be integrated into inpatient group psychotherapy. Our approach is not meant to be a wild eclecticism but an empirically founded interventional repertoire that contains psychoanalytical, depth psychological, behavioral and hypnotic therapeutic interventions. A “uniform solution” for an integrative therapy is not possible. A tension between theory conformity and variations remains inherent to psychotherapy for a multitude of reasons. An interventional repertoire is illustrated by case examples which use operationalized psychodynamic diagnostics (OPD). The results must be appraised within the time frame of inpatient treatment. The conception in guideline psychotherapy that the individual approaches cannot be mixed because they would lose their effectiveness, does not correspond to our experiences. The chances and risks of switching interventions must be considered.     

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.     

Eclecticism and integration in counselling: Implications for training

The multiplicity of approaches in the field of counselling, together with a growing interest in eclecticism and integration amongst practitioners, present a challenge for counsellor trainers. One way in which this challenge is being met is by the development of training programmes that purport to be integrative. The development of such programmes, however, presents a further challenge to trainers, since sophisticated integration is rare. Some of the issues needing careful consideration by trainers involved in integrative programmes are explored under the headings of 11 key statements.     

The inadvisability of admixing psychoanalysis with other forms of psychotherapy

Current opinion overwhelmingly favors eclectic and/or integrative mergers of the various schools of psychotherapy, including psychoanalysis. A review of the empirical literature concerning therapeutic techniques, however, reveals that the quest for eclectic and/or integrative technique definitions seriously impairs the relevance of research for theory and practice, especially as concerns the technique of interpretation in psychotherapy. In addition, recent work in the history and philosophy of science provides an additional warning against the one-sided pursuit of eclecticism and/or integrationism, for it is the clash between, and not the merger of, distinct theories and practices that serves to advance science and objectivity. In concluding, a critical pluralist perspective is recommended as the preferred orientation in the scientific study of psychoanalysis and other forms of psychotherapy.The author thanks Lisa Rohleder for her assistance in collecting the literature concerning interpretation in psychoanalysis.     

Use of Religious Resources in Psychotherapy from a Tradition-Sensitive Approach: Cases from Chinese in Malaysia

Pastoral Psychology - This paper highlights the integration of spiritual and religious approaches in psychotherapy using the three major religions (Taoism, Buddhism, and Christianity) of the...