Integrative Psychotherapy as an Effective Form of Counselling
Integrative counselling and psychotherapy can be seen as one of the most effective approaches of counselling. The philosophical stance of this form of therapy is that there is no single approach to psychological intervention that is suitable for every client; each person is unique and distinctive, which means that 'one size fits all' approaches to therapy will not be effective.
As an individual, psychological distress varies from one person to another; hence relying on one approach of therapy alone will be difficult when treating many health conditions.
Integrative counselling can be classified into four segments, including:
- common factors
- technical eclecticism
- theoretical integration
- assimilative integration
Which integration therapy are you using as a contemporary counsellor/psychotherapist?
Theoretical integration is the combination of two approaches with a common philosophy, which suggests that joining two theories would work more effectively than a single premise. The classic examples are cognitive analytic therapy (CAT) which was derived from psychodynamic therapy and cognitive therapy and conceived by Anthony Ryle (1990); and Conversational Therapy developed by Hobson (1985).
Cognitive behavioural therapy (CBT) is part of the theoretical integration and Trans-theoretical approach developed by Prochaska & DiClemente (1994). One problem identified in theoretical integration is that it is difficult to integrate some theories; for instance, it is difficult to integrate psychodynamic theory and behavioural theory because of their distinctions in philosophies, ideas, concepts and assumptions.
As an example, psychodynamic approach suggests that our early experiences from birth onwards and their impacts lead to our psychological problems. In contrast, behaviour theory sees problems as much more agreeable to change. The distinction between them would result in incompatibilities between the two theories.
The aim of common factors approach is to look at the common tools available in each approach that can be useful in the therapy. There is no benchmark list of common factors; however, if a list were to be constructed, it absolutely would encompass the common factors.
Irrespective of the approach a therapist will use in therapy it would include common factors.
Common factors are unavoidable; they are:
- The therapist/client rapport
- The emotional release or catharsis
- Therapist qualities such as attention, positive regards, empathy, congruence,
- Confronting difficulties
- Social skills training
- Time as a precious element in counselling
In the assimilative approach, the therapist sticks to one system of approach, for example, Humanistic or psychodynamic, but the therapist will use strategies from other therapeutic approaches as well. A classic example is that a therapist may understand the client in terms of cognitive theory because they find this approach helpful in understanding what is going on in the process of the treatment. Nonetheless, the therapist may recall that there are strategies in some approaches that are not proposed by cognitive theory, but rather can work very effectively and contribute to the treatment or treatment plan.
The cognitive therapist can use Gestalt therapy techniques like ‘‘increase awareness’’ to inhibit automatic thoughts. Gestalt theory says this is enough and you do not have to ‘‘do’’ anything to change; change will happen by itself once a client increases awareness. One of the functions of cognitive therapy is to try to bring automatic thoughts into awareness. Awareness is the first step towards change and better problem-solving. Another classical example is behavioural therapist can deploy the Gestalt two-chairs dialogue.
In technical eclectics, the therapist looks at and selects the best interventions. The therapist habitually relies on experience and knowledge of what has worked in the past for others, through theories and research literature to choose therapy suitable for the clients.
Technical eclecticism shares similarities and differences with assimilative integration, but it has no theoretical underpinning to the approach. The similarities shared among assimilative integration and technical eclecticism are that both of them rely on a repertoire of therapeutic techniques, focusing on the wellbeing of clients rather than committing themselves to a particular school of thought of psychotherapy.