Integrative Approach

Integrative Counseling draws on mainstream theoretical perspectives, integrating knowledge and skills from different therapies. Integrative Counselling Psychology In short one size does not fit all Individuals think, feel and react in different ways. By integrating different ways of helping people bring about change in their lives, an integrative counselor can work with each client to produce a uni ue therapy adapted to suit what that client wants and needs. In integrative counseling the counselor works from a cohesive theoretical model. !his model is formed by looking for similarities" resonances, common sense correspondences, between different theoretical approaches. Factor of Awareness

Spirit

Feel

Mind

Body

Think

Act

Factor affecting who we are

Integrative Therapeutic goals #$plore client%s e$pectation and goals

Challenges with Integrative Counselling &. 'i$ing theories with incompatible underlying assumptions Irrational vs (ational ). *ubscribing one central or universal view of human nature we have to remain +P#, -. Inappropriate counselling framework *elect something that fits your personality Quality of Integrative Counselor .ualities of an integrative counselling therapist drive to pull together all of the potential of the therapeutic universe. /e0*he should be prepared to e$plore beyond the establishment. Integrative Psychotherapy 1 refers to the process of integrating the personality, taking disowned, unaware, or unresolved aspects of the self and making them part of a cohesive personality, reducing the use of defense mechanisms that inhibit spontaneity and limit fle$ibility in problem solving and relating to people, and re1engaging the world with full contact. It is the process of making whole. !hrough integration, it becomes possible for people to face each moment openly and freshly without the protection of a preformed opinion, position, attitude, or e$pectation. Person centred counselling 1 offers a non12udgemental relationship between client and counsellor, in which the client can e$plore what they need and want, and how they can achieve their goals. Psychodynamic counselling 1 works by bringing unconscious thoughts and feelings to the surface" there is an emphasis on the influence of the past, and on recurring patterns of relationships. Cognitive Behavioural Therapy 1 works by e$amining the ways that thought, behaviour, and feeling affect each other, and how different aspects of these can be changed to solve specific problems.

3 client who wants to overcome a phobia or an$iety in order to be able to get on with their life may choose to e$amine patterns of thought and feeling, and e$periment with safe ways of getting past their fears 4drawing on cognitive behavioural techni ues5" or they may choose to e$plore their memories to find the source of their fears 4using psychodynamic or person centred techni ues5.

3 client with an alcohol or drug related problem may want to work out ways of controlling their use, find safer ways of feeling better, 4drawing on cognitive behavioural techni ues5 e$plore the past stresses and present triggers that lead to the use, 4using psychodynamic or person centred techni ues5, or work in greater depth and do all these things. 3 client who needs to deal with the influence of past traumas, 4abuse, neglect, bereavement, etc5 may choose to talk about their childhood, e$ploring their memories and dreams 4drawing on psychodynamic techni ues5. 3 client dealing with a trauma that is recent, or still happening, 4domestic violence, divorce, bereavement, etc5 may want to think about ways of coping, and ways of reducing the pain 4drawing on person centred and cognitive behavioural techni ues5. Clients who want to e$plore who they are, or who they want to be, can talk about feelings, plans, and fantasies" identifying patterns and unacknowledged needs. 46rawing on person centred or cognitive behavioural techni ues5. 3 client dealing with any issue may want to work on improving their self esteem, and this can be done by both talking and e$perimenting with ways of behaving 4drawing on person centred, psychodynamic or cognitive behavioural techni ues5.

Background[edit]
Initially, Sigmund Freud developed a talking cure called psychoanalysis; then he wrote about his therapy and popularized psychoanalysis. After Freud, many different disciplines splintered off. Some of the more common therapies include psychoanalytic psychotherapy, counseling, co!counseling, analysis, transactional analysis, cognitive behavioral therapy, gestalt therapy, body psychotherapy, psychodynamic psychotherapy, family systems therapy, person!centered psychotherapy, and e"istential therapy. #undreds of different theories of psychotherapy are practiced. $%& A new therapy is born in several stages. After being trained in an e"isting school of psychotherapy, the therapist begins to practice. 'hen, after follow up training in other schools, the therapist may combine the different theories as a basis of a new practice. 'hen, some practitioners write about their new approach and label this approach with a new name. 'his overall pattern has been observed in numerous new therapies and is certain to form many future therapies. A pragmatic or a theoretical approach can be taken when fusing schools of psychotherapy. (ragmatic practitioners blend a few strands of theory from a few schools as well as various techni)ues; such practitioners are sometimes called eclectic psychotherapists and are primarily concerned with what works. Alternatively, other therapists consider themselves to be more theoretically grounded as they blend their theories; they are called integrated psychotherapists and are not only concerned with what works, but why it works. For e"ample an eclectic therapist might e"perience a change in their client after administering a particular techni)ue and be satisfied with a positive result. In contrast, an integrative

therapist is curious about the *why and how* of the change as well. A theoretical emphasis is important; for e"ample, the client may only have been trying to please the therapist and was adapting to the therapist rather than becoming more fully empowered in themselves.

Different routes to integrative psychotherapy[edit]

'he most recent edition of the #andbook of (sychotherapy Integration +,orcross - .oldfried, %//01 recognized four general routes to integration 2ommon Factors, 'echnical 3clecticism, 'heoretical Integration, and Assimilative Integration +,orcross, %//01.

Common factors[edit]
'he first route to integration is called common factors and *seeks to determine the core ingredients that different therapies share in common* +,orcross, %//0, p. 41 'he advantage of a common factors approach is the emphasis on therapeutic actions that have been demonstrated to be effective. 'he disadvantage is that common factors may overlook specific techni)ues that have been developed within particular theories. 2ommon factors have been described by 5erome Frank +Frank - Frank, 64461, 7ruce 8ampold +%//61, and 9iller, :uncan and #ubble +%//01. 2ommon factors theory asserts it is precisely the factors common to the most psychotherapies that make any psychotherapy successful.

Technical eclecticism[edit]
'he second route to integration is technical eclecticism which is designed *to improve our ability to select the best treatment for the person and the problem;guided primarily by data on what has worked best for others in the past* +,orcross, %//0, p. <1. 'he advantage of technical eclecticism is that it encourages the use of diverse strategies without being hindered by theoretical differences. A disadvantage is that there may not be a clear conceptual framework describing how techni)ues drawn from divergent theories might fit together. 'he most well known model of technical eclectic psychotherapy is Arnold =azarus> +%//01 9ultimodal 'herapy. =arry 3. 7eutler>s model of Systematic 'reatment Selection +7eutler, 2onsoli, - =ane, %//01 represents another model of technical eclecticism.

Theoretical integration[edit]
'he third route to integration commonly recognized in the literature is theoretical integration in which *two or more therapies are integrated in the hope that the result will be better than the constituent therapies alone* +,orcross, %//0, p. <1. Some models of theoretical integration focus on combining and synthesizing a small number of theories at a deep level, whereas others describe the relationship between several systems of psychotherapy. ?ne prominent e"ample of theoretical synthesis is (aul 8achtel@s +8achtel, Aruk, - 9cAinney, %//01 model of 2yclical (sychodynamics that integrates psychodynamic, behavioral, and family systems theories. Another e"ample of synthesis is Anthony Byle>s +%//01 model of 2ognitive Analytic 'herapy, integrating ideas from psychoanalytic obCect!relations theory and cognitive psychotherapy. A third, emerging model of theoretical integration is specifically called *Integral (sychotherapy* +Forman, %/6/;$D& Ingersoll - Eeitler, %/6/;$F&9ar)uis, %//< $0&1. 'he most notable model describing the relationship between several different theories is (rochaska and :i2lemente>s +%//01 'ranstheoretical 9odel.

Assimilative integration[edit]
*'his mode of integration favors a firm grounding in any one system of psychotherapy, but with a willingness to incorporate or assimilate, in a considered fashion, perspectives or practices from other schools* +9esser, 644%, p. 6061. :ifferent integration is the fourth route

and acknowledges that most psychotherapists select a theoretical orientation that serves as their foundation but, with e"perience, incorporate ideas and strategies from other sources into their practice. Increasingly, integrationists are acknowledging that most counselors will prefer the security of one foundational theory as they begin the process of integrative e"ploration. Formal models of assimilative integration have been described based on a psychodynamic foundation +Frank, 6444; Stricker - .old, %//01 and based on cognitive!behavioral therapy +2astonguay, ,ewman, 7orkovec, #oltforth, - 9aramba, %//01.

Emerging models that combine routes[edit]

In addition to well!established approaches that fit into one of four routes, there are newer models that combine aspects of the traditional routes. For e"ample, #ill>s +%//F1 three!stage model of helping skills encourages counselors to emphasize skills from different theories during different stages of helping. #ill>s model might be considered a combination of theoretical integration and technical eclecticism. #ill@s model is called the 'hree Stage 9odel. 'he first stage is the e"ploration stage. 'his is based on client!centered therapy. 'he second stage is entitled insight. Interventions used in this stage are based on psychoanalytic therapy. 'he last stage, the action stage, is based on behavioral therapy. .ood and 7eitman +%//G1 described an integrative approach highlighting both core components of effective therapy and specific techni)ues designed to target clients> particular areas of concern. 'his approach can be described as an integration of common factors and technical eclecticism. 9ultitheoretical (sychotherapy +7rooks!#arris, %//<1 is a new integrative model that combines elements of technical eclecticism and theoretical integration. 'herapists are encouraged to make intentional choices about combining theories and intervention strategies. 'he generic term, integrative psychotherapy, can be used to describe any multi!modal approach which combines therapies. An effective form of treatment is psychodynamic psychotherapy combined with hypnotherapy. In %//H, for e"ample, Araft - Araft +%//H1 $6& gave a detailed account of a 0F year old female patient with refractory I7S in a setting of a phobic an"iety state. 'he patient made a full recovery and this was maintained at the follow! up a year later. An additional, emerging approach to psychotherapeutic integration is specifically called *Integral (sychotherapy* +Forman, %/6/;$D& Ingersoll - Eeitler, %/6/;$F& 9ar)uis, %//< $0&1. Integral (sychotherapy is grounded in the work of theoretical psychologist and philosopher Aen 8ilber +6440,$G& %/// $H&1. Integral 'heory is a meta!theory that recognizes that humans organize reality from four maCor perspectives subCective, intersubCective, obCective, and interobCective. Iarious psychotherapies ground themselves in one or more of these four foundational perspectives, often reducing other perspectives to their own. (sychotherapeutic integration using this model might include, for e"ample, subCective approaches +cognitive, e"istential1, intersubCective approaches +interpersonal, obCect relations1, obCective approaches +behavioral, pharmacological1, and interobCective approaches +systems theory1. 7y understanding that each of these four basic perspectives is irreducible to one another, each can be seen as essential to a comprehensive view of the life of the client. Integral 'heory also owns a comple", incorporative stage model that suggests that different psychotherapies seek to redress issues arising from different stages of psychological development. For e"ample, different problems arise in pre!egoic +early childhood1, egoic +adolescent and conventional adult1, or trans!egoic +transpersonal, late adulthood1 stages of development. Also, psychotherapies conflict in that their interventions and e"pectations for client growth presuppose different sets of stage!related psychological achievements +Forman,

%/6/;$D& 8ilber, %/// $H&1. 8hen the nature of psychological development over time is understood, what appear to be competing psychotherapies can be brought further together into a useful integration. ,otably, Integral (sychotherapy ! unlike many other approaches to psychotherapeutic integration ! also incorporates the perspectives and insights from contemplative and meditative traditions, both 3ast and 8est.

Comparison with full eclecticism[edit]

In Integrative and eclectic counselling and psychotherapy, +(almer and 8oolfe, 64441, the authors make clear the distinction between integrative and eclectic approaches *Integration suggests that the elements are part of one combined approach to theory and practice, as opposed to eclecticism which draws ad hoc from several approaches in the approach to a particular case.*$<& (sychotherapy@s eclectic practitioners are not bound by the theories, dogma, conventions or methodology of any one particular school. Instead, they may use what they believe or feel or e"perience tells them will work best, either in general or suiting the often immediate needs of individual clients;$<&$4& and working within their own preferences and capabilities as practitioners.