Eclectic and Integrative Therapy

Question 1

4 main directions/modes/forms in psychotherapy integration

Answer 1

1. technical eclecticism
2. common factors approach
3. theoretical integration
4. assimilative integration

Question 2

Technical Eclecticism

Answer 2

• 2 or more therapies are applied sequentially
• examples: 1. multimodal therapy 2. transtheoretical therapy 3. Prescriptive psychotherapy and systematic treatment selection

Question 3

Prescriptive Psychotherapy

Answer 3

• best match of therapist, strategies, and techniques to patients problems and characteristics based on 4 dimensions:
  1. Necessary intensity of therapy
  2. Focus on insight or skill & bx change
  3. Degree of therapist directive was
  4. Changes in the ways patients emotions are managed within sessions

Question 4

Transtheoretical Psychotherapy

Answer 4

*patients are assessed for readiness for change and what processes will work best for them
*10 change processes:
consciousness raising
Dramatic relief
Self-reevaluation
Environmental reevaluation
Self-liberation
Social liberation
Counter conditioning
Stimulus control
Reinforcement management
Helping relationship
*6 stages of readiness to change:
Precontemplation
Contemplation
Preparation
Action
Maintenance
Termination
*levels of change:
Areas of symptoms & situational problems
Maladaptive cognitions
Current interpersonal conflicts
Family and system conflicts
Intrapersonal conflicts

Question 5

History of Theoretical Integration

Answer 5

• attempt to integrate concepts about conflict and anxiety from two perspectives – psychoanalysis and behaviorism.
• Suggested methods of treatment – modeling, homework.
• greater emphasis on goal-setting and treatment focus, more attention to actual events on people’s lives

Question 6

Common Factors Approach

Answer 6

• Review various therapies to identify elements they may share in common
• Belief that common factors are at least as important as the unique factors

Question 7

Theoretical Integration

Answer 7

• synthesizing aspects of varied personality theories, combining models of psychopathology, integrating 2 or more traditional systems
• Wachtel’s cyclical psychodynamic theory

Question 8

Assimilative Integration

Answer 8

• derivative of both theoretical integration and technical eclecticism
• A primary system of therapy is supplemented with specific techniques from other approaches
• Mindfulness based cog therapy
• Emotionally focused couples therapy

Question 9

History of Technical Eclecticism

Answer 9

• Choice of techniques based on what should work best for this particular person and problem
• clinician can use techniques from different therapy systems without adopting the theoretical base associated with that system

Question 10

Multimodal Therapy

Answer 10

• assess 7 areas of patient’s bio psychosocial functioning: BASIC ID (Behavior, Affect, Sensation, Imagery, Cognition, Interpersonal relations, Drugs/biology
• Matched treatments to problems and persons
• Uses some theory to guide choices in technique. Social learning theory.
• Techniques are behavioral and cognitive, little from other therapies.

Question 11

History of Common Factors

Answer 11

Search for basic ingredients that different therapies share. Identify similarities
Underlying belief: all therapies are equally effective.
Alexander and French: “corrective emotional experience”. To re-expose the client, under more favorable circumstances, to emotional situation which he/she could not handle in the past.
“The patient, in order to be helped, must undergo a corrective emotional experience suitable to repair the traumatic influence of previous experiences.”
Jerome Frank – restoration of morale as a common factor. Therapies address a common problem – demoralization – loss, self-esteem, feelings of inadequacy, alienation, hopelessness
Summary: strong emphasis on therapy relationship as a common factor
70’s – common factors became more significant
Minor impact on practice
What common factors should be examined?
Therapist characteristics, client characteristics, change processes, relationship processes?
Difficult to identify specific common factors. What specific aspects of the relationship are important in effecting change?

Question 12

Problems with Eclectic Approach

Answer 12

multiple possible variables that may correlate with multiple outcome measures. May need more theory to help select and order variables worthy of study.

Question 13

Systematic Eclectic Therapy

Answer 13

draws on entire range of therapy approaches. Considers variables such as client characteristics, resistance to influence, coping style, as well as presenting problem.

Question 14

Sequential and Parallel-Concurrent Integration Approach

Answer 14

Separate forms of therapy are given in sequence or during the same phase of treatment in separate sessions or separate sections of the same session
Cognitive-behavioral therapy and interpersonal-emotional processing therapy for GAD

Question 15

4 types of psychotherapy integration

Answer 15

1. assimilative integration
2. sequential and parallel-concurrent integration approach
3. theoretical integration
4. technical eclecticism