Integration Flashcards
Give a brief overview of integration
Attempts to look beyond and across the confines of single-school approaches
to see what can be learned from other perspectives and how clients can benefit
from a variety of ways of conducting therapy
Characterized by openness to various ways of integrating diverse theories and techniques
What is the ultimate goal of integration?
The ultimate goal of integration is to enhance the efficiency
and applicability of psychotherapy
What are the methods, techniques, and procedures of integration?
Four of the most common pathways toward the integration of psychotherapies are technical
integration, theoretical integration, assimilative integration, and the common factors approach
Technical integration aims at selecting the best treatment techniques for the individual and the problem.
It tends to focus on differences, chooses from many approaches, and is a collection of techniques (basis of multimodal therapy)
Theoretical integration refers to a conceptual or theoretical creation beyond a mere blending of techniques. This route has the goal of producing a conceptual framework that synthesizes the best aspects of two or more theoretical approaches under the assumption that the outcome will be richer than either theory alone (used in DBT, ACT, and EFT)
Assimilative integration approach is grounded in a particular school of psychotherapy, along with an openness to selectively incorporating practices from other therapeutic approaches. Assimilative integration combines the advantages of a single coherent theoretical system with the flexibility of a variety of interventions from multiple systems (used in MBCT)
The common factors approach searches for common elements across different theoretical systems.
describe integration and eclecticism
This course has provided you with an overview of the most important contemporary approaches to counselling and psychotherapy. You will have noticed by now that the various schools of psychotherapy are characterized by different underlying philosophical beliefs, a significant variability in the range and meanings attached to core theoretical constructs, and often conflicting preferences for specific treatment interventions or techniques. During the last two or three decades, the field of counselling and psychotherapy has seen an increasing interest towards a more unified view of the process of therapeutic change. Researchers and theorists have employed various terms (oftentimes interchangeably and/or loosely) to refer to this unifying tendency: integration, eclecticism, rapprochement, synthesis, or described an approach as comprehensive, multimodal, pluralistic, or transtheoretical.
The diversity among contemporary approaches to counselling makes it difficult to identify one single ingredient, let alone a set of ingredients, that may be responsible for achieving positive outcomes in psychotherapy. However, there is considerable agreement among theorists and clinicians regarding the intrinsically human capacity for change and growth.
Upon completion of this lesson you should be able to:
describe the similarities and differences among various approaches;
describe the main concepts regarding integration and eclecticism in psychotherapy;
reflect on your own views on human nature and the therapeutic process of change in relation to the integration movement.
Readings
The textbook reading for this lesson is Chapter 15 of Corey’s Theory and Practice of Counseling and Psychotherapy. Read the chapter before you begin to work on the lesson in order to get an overview of the topic. Supplement the material in your textbook by reading the excellent articles by Hollanders (1999) and Marquis and Wilber (2008). Remember that you can always look up technical terms in the online Glossary.
What is the brief history of psychotherapy integration?
Most of the history of psychotherapy seems to have been characterized by an ideological “cold war” among the different schools. However, the existence of a variety of paradigms may have been a necessary developmental stage toward sophisticated attempts at rapprochement.
As early as 1932, at a meeting of the American Psychological Association, Thomas French drew parallels between Freud and Pavlov by noticing the underlying similarities between the concepts of repression and extinction. In 1936, Sol Rosenzweig published an article in which he proposed three commonalities among various systems of psychotherapy. The factors he identified at the time were: (a) the therapist’s personality, (b) the helpfulness of providing interpretations, and (c) the synergistic effect of one area of functioning on another. Freud constantly struggled with the selection and integration of diverse methods.
Prior to the 1960’s, most of the conflicting approaches to psychotherapy were psychodynamic and behavioural. In the 1960’s and 1970’s psychodynamic and behaviour therapy polarized and triggered comparative research. The integration movement gained a strong impetus in the 1980’s and 1990’s. The formation of the Society for the Exploration of Psychotherapy (SEPI) in 1983 helped spark the integration movement. Mid- to late 1980’s, the International Journal of Eclectic Psychotherapy was founded, and later renamed Journal of Integrative and Eclectic Psychotherapy in 1987. In 1991, the Journal of Psychotherapy Integration became the official publication of SEPI, including the SEPI Newsletter.
What are the directions in psychotherapy?
According to Norcross and Newman (1992), there are three main directions in the psychotherapy integration movement:
Theoretical Integration. The goal of theoretical integration is to create a conceptual framework that synthesizes the best elements of two or more approaches to therapy. Integration aspires to more than a simple combination; it seeks an emergent theory that is more than the sum of its component parts and that leads to new directions for practice and research. Examples of such conceptual efforts may be Wachtel’s integration of psychoanalytic and behavioural theories, or the Transtheoretical approach developed by Prochaska and DiClemente.
Technical Eclecticism. The least theoretical of the three, technical eclecticism should not be construed as anti-theoretical. It selects the best treatment for the client and the presenting concern. The selection is guided by data on what has worked best for others in the past with similar problems or similar characteristics. Proponents of technical eclecticism use procedures from diverse systems that may be epistemologically and ontologically incompatible. For technical eclectics, no necessary connection exists between metabeliefs and techniques. A supporter of technical eclecticism and the founder of Multimodal Therapy, Lazarus (1967) stated that “to attempt a theoretical rapprochement is as futile as trying to picture the edge of the universe. But to read through the vast amount of literature on psychotherapy, in search of techniques, can be clinically enriching and therapeutically rewarding” (p. 416). Others have criticized technical eclecticism for its lack of theoretical grounding.
Table 1: Eclecticism vs. Integration
Eclecticism
Integration
technical
divergent (differences)
choosing from many
applying what is
collection
applying the parts
atheoretical but empirical
sum of parts
realistic
conceptual
convergent (commonalities)
combining many
creating something new
blend
unifying the parts
more theoretical than empirical
more than the sum of parts
idealistic
Adapted from: Norcross, J. C., & Goldfried, M. R. (Eds.). (1992). Handbook of psychotherapy integration. New York, NY: Basic Books (p. 12).
What is the common factors approach?
This approach seeks to determine the core ingredients that different therapies share in common, with the eventual goal of creating more parsimonious and efficacious treatments based on those commonalities. The basic rationale is that commonalities are more important in accounting for therapy outcomes than the unique factors that differentiate among the various approaches. One way of determining common therapeutic principles is to focus on a level of abstraction somewhere between theory and technique, known as clinical strategy or change process. At the same time, researchers have pointed out the necessity of capitalizing on the contributions of specific techniques and their differential effectiveness with specific disorders. As Norcross and Newman (1992) put it, “treasure our sameness, but respect our differences” (p. 14).
What are the obstacles to psychotherapy integration?
In your textbook, Norcross and Newman (1992) are cited with regard to the factors fostering the development of the integration movement over the past two decades. Here I would like to cite the same original source in reference to the possible obstacles to psychotherapy integration. Those authors argue that some clinicians and theorists may not be eager to embrace an integrative or eclectic view due to the following reasons:
intrinsic investment of individuals in their private perceptions and theories;
inadequate commitment to training in more than one therapy system;
approaches have divergent assumptions about psychology and health;
inadequate empirical research on the integration of psychotherapies;
absence of a “common” language for psychotherapists (Norcross & Newman, 1992, p. 23).
Seven years later, Hollanders (1999) identified more possible reasons for the clinicians’ reluctance towards integration and eclecticism. Review that author’s comments in the supplementary article and compare them to the material in your textbook.
What is the profs concluding remark for integration and eclecticism?
The habits and boundaries associated with the various schools are hard to eclipse, and, for most of us, integration remains more of a goal than a constant daily reality. Eclecticism in practice and integration in aspiration is an accurate description of what most of us in the integrative movement do much of the time. Wachtel, 1991, p. 44
Activities
Review the eleven “key statements” about integration and eclecticism made by Hollanders (1999) in the assigned supplementary article.
List as many arguments as you can in support of the eclectic position in counselling.
List as many arguments as you can against the eclectic position in counselling.
Self Reflections
What criteria could you develop in order to create your own eclectic type of therapy?
What basis do you have for including or excluding certain major concepts from the various approaches into or from your style of counselling?
What are the implications of the trend towards integration identified by Hollanders (1999) in the area of training and supervision?
