A Relational Psychodynamic Perspective on Assimilative Integration

In this paper we discuss recent advances in relational psychoanalytic thinking, and demonstrate how an assimilative approach to integration can be based on this theoretical and clinical model. We describe 3 instances in which active interventions may be used to enhance relationally oriented, psychoanalytic work: by impacting on relationships outside of therapy that maintain pathological patterns, by filling in intrapsychic deficits, and by supporting the patient's active efforts at change. We provide clinical examples to illustrate each of these points.     

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.     

Introduction to the Special Issue on Assimilative Integration

This issue of Journal of Psychotherapy Integration includes a set of articles that explore and apply the concept of assimilative integration. They do so from different theoretical perspectives, including psychodynamic, cognitive–behavioral, family systems, and Yogic/Buddhist, as well as from broad conceptual standpoints. The articles are followed by 3 commentaries that offer an appreciation and critique of assimilative integration and recommendations for its further development.     

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.     

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.     

Psyche and System: On Progress in the Integration of Individual Psychotherapy and Family Psychotherapy

This article addresses the frequency with which the same group of patients utilizes individual and family therapies, and at the same time do not constitute actual integration. The conditions under which such serial or concurrent utilization of the two forms of psychotherapy may be considered to be integrative are discussed.     

What is the End Point of Psychotherapy Integration? A Commentary

This commentary on six papers about assimilative integration considers the place assimilative integration, as defined by Messer, ought to have in the discussion on psychotherapy integration. After briefly summarizing the contribution of each paper, with particular attention to whether the paper takes a position on the end point of psychotherapy integration, the author compares the relative benefits of assimilative integration to those of a unified grand theory. He argues that assimilative integration, as an end point, is preferable to a unified grand theory because it has a more generative influence on both theory evolution and clinical practice.     

My Perspective on Psychotherapy Integration: An Outsider Who's Out of It

My rejoinder is a response to two commentaries on my SEPI keynote in 1997: commentaries written by Goldfried and Cullari. Instead of grappling with the ideas I presented, both respondents were distracted by my satirical beginning. In my talk I proposed a method for studying psychotherapy integration. I am not pessimistic about the potential for integration, nor am I pessimistic about psychotherapy. But I am a skeptic, and science is driven—and indeed advance—by skepticism. In fact, psychotherapy integration requires that its advocates be skeptics. I still do not know what psychotherapy integration is, and remain confused. I can only conclude that I am not only an outsider, but out of it.     

Eclecticism and Integration: A Personal Retrospective View

As indicated in the title, this article presents a personal retrospective account of the development of the author's eclectic and integrative views of psychotherapy. Although this period covers more than 50 years, I have tried my best to recall events as accurately as possible.     

Group-Based Psychotherapy Integration in Theory and Practice: Therapeutic Community Revisited

A group-based theoretical integration model presented in this journal (F. Knobloch, 1996) is elaborated in practice. The core aspects of the group-based system are described and illustrated with clinical examples as they apply to a modified therapeutic community: (a) the creation of the therapeutic world to represent real life and its multiple realities; (b) the group schema model as a context for problem identification and exploration; (c) the collaboration between therapists and group members; (d) the exploration and experimentation of problems through individual and group tasks; and (e) the transfer of new behaviors to real life situations and (f) the systematic application of major psychotherapy theories and techniques.     

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.     

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.     

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.     

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.     

Logotherapy-Enhanced REBT: An Integration of Discovery and Reason

Viktor Frankls Logotherapy and Albert Elliss Rational Emotive Behavior Therapy (REBT) are at seemingly opposite ends of the psychotherapeutic spectrum. However, a close review of the assumptions and philosophy of each school of therapy reveals that these two systems are compatible. We propose that a Logotherapy-enhanced REBT can increase human achievement and happiness by balancing the individual discovery of meaning with the pursuit of reason. This integrated and enhanced therapy will help human beings participate in positive life experiences and take greater responsibility for change. Fruitful and beneficial aspects of a Logotherapy enhanced-REBT are explored with respect to cognitions, emotions, and the reduction of rumination. Conclusions are drawn, limitations are discussed, and future recommendations are outlined.     

Definitional and Research Issues in the Common Factors Approach to Psychotherapy Integration: Misconceptions, Clarifications, and Proposals

This paper focuses on two common misconceptions of common factors in therapy. The first misconception entails the confusion between common factors and therapeutic factors, and thus the inappropriate and misleading use of the term therapeutic common factors in various situations. The second misconception is the mixing of commonalities of different kinds and levels in proposed lists and studies of common factors. These areas are discussed and clarified, and recommendations designed to facilitate conceptual and methodological improvements relative to each misconception are offered. The selection of best levels and kinds of common factors to be studied are further explored (i.e., the study of client change events and antecedent therapist behaviors across different therapies), and specific proposals for their research are outlined.     

Teaching Family Therapy-Centered Integration: Assimilation and Beyond

This article addresses key themes in the teaching of family therapy-centered integration and describes the critical role of assimilative integration. The tenets of assimilative integration provide a framework for introducing students to multiple systemic theories and techniques while allowing them to maintain a secure base in one main theory. This form of integration is compared and contrasted to theoretical eclecticism, which guides students to become securely based in multiple theories through providing a framework for selecting which systemic approach to use when and with whom. Other issues that shape the form, content, and process of integrative training are discussed including the role of institutional culture and clinical needs, the importance of fully incorporating issues of diversity and social oppression, and the relational context within which teaching and learning take place.