PRACTICA PSIHOTERAPIEI INTEGRATIVE ÎN ROMÂNIA

Psihoterapia integrativă este o abordare aplicată de un număr tot mai mare de specialiști în
domeniu la nivel european și internațional. Abordarea integrativă promovată de Institutul Român
de Psihoterapie Integrativă (IRPI) are la bază teoriile psihanalitice, umaniste și cognitiv-
comportamentale.

In cadrul IRPI este prezentă Comunitatea Psihoterapeuţilor Integrativi Practicieni ce are peste
200 de membrii cu activităţi profesionale de succes in filialele: Bucureşti, Constanţa, Baia Mare,
Satu Mare, Timişoara, Piteşti, Craiova.Specialistii sunt autorizati de Colegiul Psihologilor din
Romania si certificati de Federatia Romana de Psihoterapie si indeplinesc standardele de formare
si de practica profesionala internationale conform Asoiciatiei Europene de Psihoterapie.

Psihoterapia integrativă este utilizată ca formă de intervenție individuală, de grup (familie sau
cuplu) și în grup. Formarea în psihoterapie integrativă include module de dezvoltare personală și
formare teoretică cu multiple aplicații practice. Numeroşi psihoterapeuţi în practică aplica
elemente din diferite teorii psihoterapeutice şi contruiesc strategia de intervenţie în funcţie de
nevoile specifice ale fiecărui client. O idee fundamentală a psihoterapiei integrative constă în
faptul că toate formele de terapie sunt eficiente si au adus domeniului resurse bune prin cercetari
stiintifice, teorii, metode, tehnici si proceduri de lucru ce vin in sprijinul dezvoltarii umane si
tratamentului spre insanatosire. Psihoterapia integrativa promoveaza flexibilitatea si integrarea în
modul de abordare al problemelor. De asemenea se bazeaza pe principii ce conduc la construirea
si menţinerea unui standard de excelenţă în serviciile oferite clientilor şi în pregatire
profesională.

PSIHOTERAPIA INTEGRATIVĂ – VALIDARE ŞTIINŢIFICĂ

Material elaborat in cadrul Asociatiei Europene de Psihoterapie Integrativa

(EAIP) www.europeanintegrativepsychotherapy.com Psihoterapia integrativa imbratiseaza in
primul rand o atitudine particulara in ceea ce priveste practica psihoterpiei, afirmand importanta
unei abordari unificate a metodelor in tratamentul persoanelor. Pune accentul pe raspunsul
adecvat si eficient la necesitatile spirituale, emotionale, cognitiva comportamentale si
psihologice ale persoanei. Scopul este acela de a facilita integrarea astfel incat calitatile
persoanei, care exista si functioneaza in spatiul intrapsihic, interpersonal si socio-politic este
maximizat, tinand cont de limitele fiecarui individ si conditiile exterioare.

DEFINIȚIE EAIP defineste „integrativa” orice metoda care exemplifica sau dezvolta o
combinatie conceputala, principiala, teoretica intre doua sau mai multe abordari specifice sau
care reprezinta un model de integrare ca atare. Legat de aceasta, exista o obligatie etica a
psihoterpeutilor integrativi de a dialoga cu colegii de diverse orientari profesionale si de a
ramane informati cu privire la descoperirile in domeniu. O doctrina centrala a psihoterpiei
integrative este aceea ca nici o terpie individuala nu este perfect adecvata pentru orice situatie –
Psihoterpia integrativa promoveaza asadar flexibilitatea abordarii si subscrie la mentinerea
standardelor de excelenta in serviciile pentru clienti, in training si supervizare. Asfel cand
psihoterpeutii integrativi creeaza diferite strategii, tehnici si constructii pentru rezolvarea
diverselor situatii, acest proces nu se face hazardat, ci intr-o maniera bazata pe intuitia clinica si
o cunoastere solida si clara a problemelor existente si a solutiilor necesare.
PSIHOTERAPIA INTEGRATIVA

 pune in prim plan abordarile particulare si combinate in tratarea diverselor probleme,

 acorda prioritate factorilor comuni tuturor genurilor de psihoterpie.
 pune un accent deosebit pe o atitudine de respect, bunatate, onestitate si egalitate cu
privire la personalitatea clientului,
 psihoterapeutul afirma integritatea si umanitatea celuilalt dar si a siesi.

Psihoterapia integrtiva afirma importanta asigurarii unui mediu portivit, in care crestera si
vindecarea pot avea loc intr-un spatiu intersubiectiv creat impreuna de catre client si terapeut.

Aspecte filosofice ale abordarii:

1. Are abordarea definite clar ariile de cercetare, aplicare si documentare? In 1986, Grupul de
Cercetare a tulburarilor de anxietate si afectivitate de la Institutul National de Sanatate Mintala
din SUA a tinut un work – shop de 2 zile pentru a examina crecetarile in integrarea
psihotepeutica. Rezultatele intalnirii, care au evidentiat directii noi de cercetare, au oferit 23 de
arii recomandate de studiu pentru intergrarea psihoterapiei.(Wolfe & Goldfield 1988). Aceste arii
specifice au putut fi incluse in 4 domenii generale:

A. clarificari conceptuale (diferenta intre eclectismul tehnic si inegrare conceptuala, necesitatea

unor strategii de colectare a cunostintelor in domeniu, rolul teoriilor integrate ale
psihopatologiei)

B. cercetarea proceselor psihoterapeutice (studiul prceselor schimbarii, rolul alaiantei terapeutice

a diferitelor gandiri, problemele asociate cu jargonul specific diveselor scoli)

C. eficacitatea studiilor de psihoterapie integrativa (dezvoltarea unor metode de interventie de

factura empirica, probleme legate de evaluarea proceselor si rezultatelor)

D. trainingul si supervizarea terapeutilor integrativi (training in forma terapiei pure vs. abordare
integrativa).

In ultimii 10 ani, munca s-a concentrat in aceste 4 directii. De exemplu, Wiser, Goldfield, Raue
si Vakoch (1996) au realizat un program de cercetare comparativa, in care mecanismele
schimbarii erau analizate prin interventii psiho-dinamice si cognitiv-comportamentale. O alta
cercetare a studiat relatia intre procese si rezultate, descoperind atatea aspecte neasteptata incat
pana si in terapai cognitiva pentru depresie, contributiile din alte arii (concentrarea asupra
problemelor de dezvoltare si si interpersonale si intensificare experientelor emotionale ale
clientului) au facilitata un rezultata de succes. Asa cum se va vedea in raspunsurile la intrebarile
urmatoare, multe dintre problemele ridicate in 1986 (eg. rolul aliantei terapeutice) au constituit
subiectul altor cercetari peste ani.

2. Abordarea demonstreaza necesitatea de cunostinte si competente in traditia domeiului sau,

in ceea ce priveste diagnosticarea si tratamentul? In timpul conferintei din 1986 existenta mai
multor limbi a fost considerata un obstacol in psihoterpia integrativa. Recunostarea necesitatii
unei limbi comune in aceasta teorie integrata, multi dintre tarapeuti au ales sa traduca in propria
limba (vernacular – limba materna) diverse continuturi teoretice. Aceasta a oferit nu numai un
camp comun pentru comunicarea in scopul orientarii teoretice, dar a permis si o integrare mai
clara a contributiilor diferitelor scoli de gandire. De exemplu, analiza Structurala a
Comportamenutlui Social a lui Benjamin (SASB) ofera o abordare transteoretica pentru
clasificarea comportamentului interpersonal, clasificand o actiune in functie de nivelul sau de
afiliere si control. Utilizand o schema circumplexa de codificare, un mesaj pe care o persoana il
trimite alteia, si feedbackul acesteia din urma, pot fi realizate aceste clasificari. Impunerea
acestei proceduri poate fi utilizata pentru a evalua felul in care indivizii se comporta vizavi de
sine si ceilalti, ca de exemplu atunci cand sunt excesiv de auto-critici sau auto-distructivi (adica
afiliere scazuta sau exces de control). Acest sistem are aplicabilitate intr-o varietate de orientari
teoretice, si este imprumutat consecvent in domeniul psihoterapiei integrative.

3. Abordarea are o teorie a umanului, a relatiei terapeutice, a bolii si sanatatii, care sa fie
clara si consistenta? O crecetare consistenta a aratat ca relatia terapeutica contribuie
semnificativ la obtinerea unor rezultate de succes (Horvath & Greenberg 1994). Aceasta a fost
observata in mai multe forme de terapie fie ea psiho-dimanica, experimentala sau cognitiv –
comportamentala). Reprezinta de asemenea un factor comun de schimbare, demonstrand ca
oamenii se schimba mai degraba intr-un mediu interpersonal sigur. Bazat pe acesta teorie, Safran
si colegii sai (1990) au specificat modul de recunoastere a punctelor in care relatia terapeutica
poate deveni o amenintare, precum si modul in care trebuie actionat pentru a inlatura aceasta
ruptura. pe baza descoperirii faptului ca alianta terapeutica incordata interpia cognitiva este
asociata cu un rezultat slab in tratarea depresiilor (Castonguay et al. , 1996) Castonguay si Safran
colaboreaza in prezent la un proces de cercetare pentru a testa eficienta terapiei cognitive atunci
cand include linii directionale pentru a ocoli tensiunile in relatia terapeutica. Alte carcetari au
oferit solutii pentru dezvoltarea unor metode mai eficiente de de intervenite – de exemplu,
Beutler si Consoli (1992) au descoperit ca interventia cognitiva este mai eficienta decat
tratamentul orientat pe interior, in cazul pacientilor exteriorizati, si ca indivizii defensivi raspund
mai bine la tratamente indirecte decat la cele directe.

Aspecte metodologice
4. Metodele specifice acestei abordari genereaza dezvoltarea teoriei psihoterapiei, demostreaza
noi aspecte in intelegerea naturii umane si conduce catre cai de interventei/ tratament? Asa
cum a fost indicat mai sus, studiul comparativ al metodelor si investigarea relatiilor dintre proces
si rezultat, duce la dezvoltarea unor metode mai eficiente de terapie, iar aceste studii care
utilizeaza constructii trans-teoretice pot fi utilizate intradevar pentru a dezvolta tratamente
imbunatatite, integrative. Exemplul oferit mai sus de colaborare intre Castonguay si Safran ofera
un model in care descoperirile in domeniul tensiunilor din relatia terapeutica au fost utilizate
pentru a extinde scopul interventiilor cognitive pentru depresie. Un alt exemplu important despre
cum o abordare integrativa a condus la un tratament mai eficient este Terapia Comportamentului
Dailectic (1993) a lui Linehan, legat de tratamentul tulburarilor de personalitate. Devenit un
tratament raspandit la nivel international DBT este creat special pentru pacienti care in mod
paradoxal au nevoie de validare si acceptare a ceea ce sunt dar in acelasi timp au nevoie si de
schimbare. Intr-un tur de forta clinic, Linehan a integrat o abordare centrata pe persoana (pentru
validare) si un model de capturare cognitiv – comportamental (pentru facilitarea schimbarii),
descoperind ca este mult mai eficient astfel decat prin utilizarea altor metode pure de
tratament. 5. Abordarea include procese de schimb verbal, alaturi de constientizarea surselor
de comunicare si informare non-verbala? Din necesitate, pentru o abordare comprehensiva si
integrativa, trebuie acordata atentie interctiunii umane. De exemplu, sistemul de codificare
SASB, o procedura care a oferit informatii utile in domeniu in ceea ce priveste interactiunea
terapeutica dintr-o perspectiva transteoretica, ia in considerare nu numai verbalul, dar si non-
verbalul (tonul vocii, expresiile facial, etc). Astfel, in functie de sursele nonverbale de
comunicare , propozitia „Esti liber safaci asa cum simti” poate fi clasificata ca intensa ca afiliere
si scazuta in control, sau invers. Clinicieni experimentati, indiferent de orientare, pot face aceasta
distincite, si pot face apel cu certitudine la acesta sistem de codificare. pe langa faptul ca este un
instrument pentru studierea procesului terapiei, non-verbalul este si unpentru training si
comunicare. De asemenea relevant este si proiectul lui Greenberg, Rice si Elliot (1993) care a
studiat „marcatori” ai interctiunii terapeutice. Acesti marcatori reprezinta puncte in discutia
terapeutica in care modul de reactie al clientului are deosebite implicatii pentru derularea
ulterioara a tratamentului. Acesti marcatori pot fi transmisi printr-o varietate de orientari
teoretice, si pot fi folositi ca linii directoare in terapie. O alta analiza a comunicarii interpersonale
este Sistemul de Codificare Terapeutica Focus (CSTF) care subliniza aspecte ale functionarii
clientului pe care terapeutul trebuie sa puna accent in comunicarea terpeutica, putand fi folosite
pentru o formulare integrativa a cazului. (Goldfield 1995). 6. Abordarea ofera posiblitati clare
de interventie si diagnostic, facilitand schimbarea constructiva a factorilor care provoca sau
mentin boala si suferinta? Procedurile diferite de evaluare utilizate in procesele de cercetare
orientate pe integrare si in practicile clinice au fost utilizate pentru a raspunde la intrebarea „Ce a
foct eficient din ceea ce a facut psihoterapeutul?” Si intrucat rezultatele acestor practici nu sunt
incluse intr-o scoala de gandire anume, pot fi utilizate egal de profesionisti pentru a integra
diverse orientari. Mai mult, aceste descoperiri au aplicabilitate in practica clinica, adresand si
intrebarea ridicata adesea de terapeut: „Ce pot sa fac intr-o sesiune, ca sa fie eficient?” Diversele
sisteme de evaluare servesc ca mape de lucru pentru terapeuti. Astefel, diferite mape de lucru au
diferite utilizari clinice, in functie de natura terenului pe care se actioneaza. In egala masura,
cunostintele aprofundate pot imbunatatii eficienta terapiei integrative aplicate. 7. Abordarea
include strategii clar definite de a permite clientilor sa isi dezvolte noi modalitati de organizare
a evenimentelor si a comportamentului? Pe baza analizei mai multor abordari teoretice legate
de schimbare, Goldfield si Padawer (1982) au subliniat anumite strategii clinice comune care se
regasesc in mai multe scoli de gandire, capturand astfel aspectul integrativ al tratamentului.
Aceste strategii comune au fost descoperite delimitand caracterul teoretic de practica, si constau
in facilitarea aliantei terapeutice, utilizarea incurajarii si a inducerii sperantei, intarirea
constientizarii ai a experientelor semnificative si prezentarea unei sistem de testare continuu.
Utilizarea cestor factori comuni il ghideaza pe terapeutul integrativ catre un nivel strategic, unde
este capabil sa intervina fara a fi limitat de curentele unei anumite scoli de gandire, intrucat
cerintele particulare ale cazului tratat il determina sa utilizeze anumite metode. De exemplu,
incurajarea clientului spre constientizare poate include orientarea catre ganduri, sentimente,
dorinte, actiuni sau impactul asupra celorlalti, dese sau alte metode teoretice asociate diverselor
abordari terapeutice. (psihodinamic, interventia interpersonala, proceduri comportamentale).

Aspecte profesionale
8. Este abordarea deschisa catre dialog cu alte modaliatai de psihoterapie, in ceea ce priveste
atat practica dar si teoria sa? Integrarea psihoterpiei este caracterizata de insuficienta in fata
unei abordari solitare si de o dorinta concomitenta de a privi catre alaturari teoretice pentru a
vedea ce se poate invata din alte metode de desfasurare a terapiei. Prin natura sa, aceasta
abordare necesita dialog deschis si continuu inre metodele terapeutice. Terapia integrativa are
obiectivul de a ajunge la o abordare comprehensiva, integrata a tratamentului, dupa un dialog
deschis absolut necesar. Radacinile psihoterpiei integrtive ajung pana in 1930, cand aceasta
devine tema latenta. Din 1980, ajunge o miscare importanta, in mare parte datorita constituirii
SEPI (Societatii de Explorare a Psihoterapiei Integrative). Formata in 1983 SEPI isi propune sa
reuneasca profesionisti in domeniul psihoterpiei si sa intareasca viziunea acestei abordari. Este o
organizatie interdisciplinara cu un scop international, care tine anual conferinte in care se
actualizeaza munca in domeniu si se ofera noi oportunitati de discutie si schimb de idei.

9. Sunt domeniile si metodele de tratament alese descrise metodologic intr-un mod care sa
permita utilizarea lor si de catre alti colegi?

Asa cum este sugerat mai sus, nucleul psihoterpiei integrtive este acela de a trece dincolo de
granitele si golurile traditionale dintre orientari. In decursul timpului, psihoterpia s-a impartit in
mai multe curente de lucru, fiecar emergand in directia sa. Esenta integrarii este accea de a
apropia si intari aceste metode, pentru dezvoltarea in final a domeniului in sine. De asemena
mentionat mai sus, utlizarea limbii natale (vernacular) in locul jargonul teoretic ca un mod de a
descrie activitatea clininca si de cercetare este marcajul abordarii integrative in psihoterapie.
SEPI are un rol educational si prin workshopurile clinice si intalnirile anuale (Madrid 1998). In
urma acestuia, a publicat un jurnal si o revista, sustinand si existenta unor retele regionale prin
astfel de materiale : Jurnalul Integrarii Psihoterapiei, o publicatie ce apar de 4 ori pe an, include
descrieri clinice, cercetari, si articole teoretice legate de psihoterpia integrtiva. Revista serveste la
publicarea celor mai recente realizari in domeniu, fiind un fel de buletin informativ, ce a fost
recent dezvoltat si in format electronic (web).

10. Este informatia asociata cu aceasta abordare rezultatul auto-reflectiei si reflectiei critice a
unor profesionisti? Istoria integrarii psihoterapiei a inclus considerabile auto-reflecii de-a lungul
anilor. A trecut peste granite teoretice si a inclus numeroase grupuri profesionale (psihologi,
psihiatri, sociologi) devenind un scop international. In UK Dryden (1980) s-a ocupat de
depasirea acestor obstacole intre domenii. in Germania , Bastine (1980) a fost cel care a deschis
subiectul beneficiilor intrepatrunderii metodelor terapeutice. In Canada Greenberg si Safran
(1987) au publicat „Emotiile in psihoterapie” si Lecomte si Castounguay au publicat „Apropiere
si integrare in psihoterapie”. In Italia Guidano (1987) a contribuit cu „Complexitatea sinelui” iar
in SUA Norcross si Goldfield (1992) si Stricker si Gold (1993) au publicat ghiduri despre
psihoterpia integrativa. La Serviciul Executiv National al Departamentului Englez de Sanatate,
Roth si Fonagy (1996) au incurajat ideea „incercarii de integrare a metodelor de terapie”, oferind
in lucrarile lor o baza de lucru teoretica pentru apliarea principiului integrarii psihterapiei, pe
care l-au considerat ca fiind viitorul psihoterpiei.

Integrative psychotherapy
A range of psychotherapy approaches have been recognized as effective and even the treatment
of choice across the range of psychiatric diagnostic categories (e.g.,
see https://www.nice.org.uk/guidance/cg123 or https://www.nice.org.uk/guidance/conditions-
and-diseases/mental-health-and-behavioural-conditions). However, in clinical practice, the
choice of the most effective psychotherapy for each mental disorder is complicated by the
existence of over 400 varieties of psychotherapy approaches that can be defined and classified in
several ways according to their theoretical model (i.e., behavioral, systemic, cognitive,
psychodynamic, etc.), format (i.e., individual, family, group), temporal length and frequency of
the sessions, as well as any possible combination of these elements (Garfield and Bergin, 1994).
Due to their different epistemologies and attempts to create rigid boundaries around the theories,
dialog among these models has been limited.
In part to bridge this historical division, a number of leaders in the field have proposed an
integrative approach to psychotherapy, which since the 1990s has been gaining wider acceptance
(Norcross and Goldfried, 2005). For example, the Society for the Exploration of Psychotherapy
Integration (SEPI; http://www.sepiweb.org/) is an international organization with a growing
membership that includes some of the world's leaders in psychotherapy practice and research.
More commonly, psychotherapists choose one theoretical model and apply it in a flexible and
integrative way in their therapy practice. In recent decades, an increasing number of
psychotherapists do not prefer to identify themselves completely within a single approach, but
prefer to define themselves as integrative or eclectic (Feixas and Botella, 2004). In a recent large
survey of over 1000 psychotherapists, only 15% indicated that they used only one theoretical
orientation in their practice, and the median number of theoretical orientations used in practice
was four (Tasca et al., 2015). According to the integrative psychotherapy movement, a new
research field is evolving toward the search for common goals, aiming at selecting theories and
techniques among psychotherapy models and developing a new field in a collaborative and
integrative manner. The integrative psychotherapy movement does not aim at combining all the
psychotherapeutic models into one, but its purpose is to develop a new framework for dialog
among different approaches (Feixas and Botella, 2004).
The term “integration” may denote different meanings. The so-called “integrative perspective”
indicates a general flexible and inclusive attitude toward the different psychotherapeutic models
(Greben, 2004). It aims to see what can be learned and introduced from various perspectives in
practice. Integration in psychotherapy involves four possible approaches: theoretical integration
(i.e., transcending diverse models by creating single but different approach), technical
eclecticism (i.e., using effective ingredients from different approaches), assimilative integration
(i.e., working primarily from within one model but integrating aspects of others when needed),
and common factors approach (i.e., focusing on effective therapeutic practices that are common
to all approaches; Kozarić-Kovacić, 2008; Castonguay et al., 2015).
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Why integrative psychotherapy works

Integrative psychotherapy fits different patients, problems and contexts

There is a growing agreement among psychotherapists and researchers that no single
psychotherapeutic approach can be effective and appropriate for all patients, problems, and
contexts. Each existing psychotherapeutic model and approach is inadequate for some
individuals (Norcross and Goldfried, 2005). Evidence-based research has demonstrated that
psychotherapeutic treatments that are integrative in their nature (e.g., Interpersonal
Psychotherapy, Schema Therapy, Cognitive analytic therapy) are effective for several psychiatric
disorders (e.g., Depression, Post-partum depression, Social Anxiety disorders, Generalized
Anxiety Disorders, Personality Disorders, Dissociative Identity) (Reay et al., 2003; Kellett, 2005;
Hamidpour et al., 2011; Stangier et al., 2011; Masley et al., 2012; Roediger and
Dieckmann, 2012; Clarke et al., 2013; Miniati et al., 2014).

Integrative psychotherapy includes effective common factors

At the heart of psychotherapy integration is the important research findings that despite the
varying theoretical rationales and approaches of different schools of psychotherapy, they produce
similar outcomes (Barth et al., 2013). What has lead psychotherapists to integrate psychotherapy
models is the evidence that common factors across psychotherapy approaches (e.g., therapeutic
alliance, client expectations, therapist empathy, etc.) likely account for more outcome variance
than the specific effects attributed to each psychotherapeutic approach (e.g., interpretations in
dynamic therapies or cognitive restructuring in cognitive behavioral therapies) (Wampold and
Imel, 2015). Specific therapeutic techniques contribute about 7% on the outcome variance in
psychotherapy, while the common factors account for almost 20% of the outcome variance
(Lambert and Bergin, 1992). In recent decades, clinicians and researchers have been coming to a
growing consensus about the existence of common factors that are shared among several
psychotherapeutic approaches (Norcross and Goldfried, 1992; Wampold and Imel, 2015).
Common factors among psychotherapy approaches that have been associated with positive
outcomes and therapeutic changes include: the ability of the therapist to inspire hope and to
provide an alternative and more plausible view of the self and the world; the ability to give
patients a corrective emotional experience that helps them to remedy the traumatic influence of
his previous life experiences; the therapeutic alliance; positive change expectations; and
beneficial therapist qualities, such as attention, empathy and positive regard (Stricker and
Gold, 2001; Feixas and Botella, 2004; Norcross and Goldfried, 2005; Constantino et al., 2011;
Horvath et al., 2011). Among the cited common factors, therapeutic alliance has the most
evidence as a predictor of patient change (Feixas and Botella, 2004).

Integrative psychotherapy is flexible to patients' needs and sensitive to therapeutic alliance

One key value of integrative psychotherapy is its individualized approach (Norcross and
Goldfried, 2005). The integrative psychotherapy model aims to respond to the person, with
particular attention to affective, behavioral, cognitive, and physiological levels of functioning,
and to spiritual beliefs. Integrative psychotherapy allows for a better adaptation of the therapy to
the distinctive characteristics and needs of each client, by allowing the therapist to tailor their
knowledge of evidence-based treatments and approaches. The main emphasis of integrative
psychotherapy is on the individual characteristics of the patient and on the therapeutic
relationship, both considered as key elements of therapeutic change (Feixas and Botella, 2004),
as well as on client motivation. This approach is in line with the recent guidelines by the
American Psychological Association on what constitutes Evidence-Based Practice (American
Psychological Association, 2006). In those guidelines, EBP are defined by research evidence,
clinical judgment, and client factors. Consistent with this definition, integrative psychotherapy is
not a technique applied to a passive patient, but the client is seen as an active participant in the
therapy, and the therapist adjusts his or her approach depending on client characteristics and
preferences. It is within the context of the therapeutic relationship that changes can be promoted
and clients can most benefit from a caring and empathic therapist (Feixas and Botella, 2004).
 Go to:

Be integrative, not eclectic

Psychotherapists commonly practice different types of psychotherapy integration, applying the
common factors approach as well as assimilative integration or theoretical integration. The
common factors approach tends to downplay the importance of specific effects or techniques of
psychotherapies (i.e., two-chair technique, exposure, Socratic questioning, etc.), in favor of
working with common factors known to be related to positive outcomes (e.g., therapeutic
alliance, therapist empathy, client expectations, etc.; Norcross and Goldfried, 2005). On the other
hand, assimilative integration involves working primarily from one theoretical approach (e.g.,
cognitive behavioral therapy) but also incorporating techniques from other psychotherapeutic
approaches as needed for any given client or context (e.g., interpreting transference; Stricker and
Gold, 2001). Finally, theoretical integration aims to bring together theoretical concepts from
several different psychotherapeutic approaches and to develop a “Grand Unified Theory” of
psychotherapy (Stricker and Gold, 2001).
The psychotherapy integration movement highlights that psychotherapy integration is not only
the process of taking some techniques from various models and applying them as needed (i.e.,
technical eclecticism), but it involves also the focus on the link between theory, evidence, and
technique (Norcross and Goldfried, 2005). In other words, integrative psychotherapy is different
from technical eclecticism. An eclectic therapist chooses a technique because it may work or
may be efficient, without concern for its theoretical basis or research evidence. If an eclectic
psychotherapist's client experiences positive outcomes after receiving a specific technique, the
therapist does not necessarily investigate why the positive change occurred in order to develop a
generalizable model of treatment. In contrast, psychotherapy integration focuses on the
relationship between an effective practice and its theoretical and empirical basis (Norcross and
Goldfried, 2005). For example, evidence-based psychotherapy relationship practices (i.e.,
alliance, therapist empathy, congruence, positive regard, etc.), which are integrative in nature and
based on common factors, have been the focus of a recent APA task force report
(Norcross, 2011).
In conclusion, the evidence indicates that integration in general psychotherapeutic practice is
desirable, even if clarification needs to emerge at the level of theory. In order to overcome this
limitation of psychotherapy integration, psychotherapy orientations should cultivate integration
and work closely together while maintaining their separate identities. International organizations
like SEPI or the Society of Psychotherapy Research (http://www.psychotherapyresearch.org/)
represent a good example of the possibilities of collaboration and integration among
psychotherapists of different orientations. Moreover, a strong collaboration between
integrationists and psychotherapy researchers could lead to the development of a unified
background of knowledge and action that, in turn, will advance the promising integrative
psychotherapy field (Castonguay et al., 2015).

What is Integrative Therapy?

Last reviewed by Sheri Jacobson April 21, 2016 Counselling, Theory & training, Types of
Therapy
 By: Steven-L-Johnson
What is integrative therapy? Just what it sounds like – a form of therapy that integrates
different things. In this case what is being combined are different forms of psychotherapy, and
the various tools that each one can offer to you as the client.
The main idea behind integrative therapy is that you are unique, and what would work
perfectly for you is not necessarily what would work for other people. A integrative therapist
therefore works to make a program of therapy that suits your personal needs and issues.
Integrative therapy is increasingly the most common type of therapy. Given the wide array
of therapies on offer nowadays, most therapists have undertaken several forms of training and
found a way to blend them together that produces results for their clients. Or, they have studied
at a school that has a program of integrative therapy that unifies different schools of
psychotherapeutic thought.
What is the aim of integrative therapy?
The aim of integrative therapy is to help you explore what is causing you problems in life and
to create a bespoke program to help you begin to approach life in a more open and productive
way.
But it is also about helping you function at your best levels in all areas of your life – mental,
emotional, and physical.
Integrative therapy is about integrating yourself, and all of the various parts of your
personality and being, into a balanced and effective whole.
The Main Theories of Integrative Therapy
1. There is no one theory that is the magic answer.
Integrative psychotherapy believes that the human psyche can be accessed and understood in
different ways.

2. Contradicting theories can work together.

Even if psychological theories appear to contradict each other, they might be helpful to you if
they are combined. So an integrative therapist, if they feel two seemingly different approaches
could help you, will find a way to use both with you.

3. The client-therapist relationship is itself an important part of therapy.

Your integrative therapist commits to being part of your inner exploration and growth. They
work to be supportive and non judgemental, listening with an open and present mind, and seeing
you as their equal.
 By: aka Tman
4. People, too, need be integrated.
Integrative therapy is not interested in just pulling together approaches to helping you, but also in
pulling together the different components that make up your psychological wellbeing. They look
at ways to access and unite not just your behaviour, thoughts, and emotions, but perhaps also
your physical wellbeing, social skills, and your sense of spirituality.

5. You are a whole being.

Integrative counselling is fairly holistic, taking into account your mental and emotional
wellbeing as well as your physical wellbeing.

How integrative therapy works

Integrative therapy draws its theories and tools from the three main schools of
psychotherapeutic thought – psychoanalytical (which includes psychodynamic), humanistic,
and cognitive behavioural. While there is some crossover between these schools (one grew out of
the other, with psychoanalytic being first) one could define them each other by something along
the lines of:
Psychoanalytical therapy explores your unconscious to discover how your past experience has
informed your future and can involve free association and dream analysis.
Humanistic therapy is interested in your capacity to achieve your potential and believes you
know best what works for you. It might look to the past for patterns but also focuses on helping
you address present day behavioural patterns.
Cognitive behavioural therapy mostly focuses on changing your present day behaviour to
improve your moods and ability to cope. It focuses on the connection between thought,
emotions, and actions.
Mindfulness is also increasingly used. It is a set of tools that help you be more present to what
you are thinking, feeling, and experiencing right now, instead of always being caught up in
worries about the past and future.
Which approaches your therapist uses, and in what order, depend on you and what your
issues and challenges are. For example, if you have come to see your integrative therapist as
you are troubled by a childhood trauma they might use psychodynamic tactics, helping you
remember what happened and examining the way you interpret your past. If this trauma has led
you to behave in ways you don’t like, perhaps your therapist would then use cognitive
behavioural techniques to help you gain more of an ability to monitor and choose your reactions
on a day to day basis.

By: andessurvivor
How is integrative therapy different than other forms of therapy?
Ways integrative therapy can be different to other forms of therapy are:

 there is no exact model of working (although therapists might have some of their own
models)
 the therapy is fitted to you, instead of vice versa
 it is flexible, it can be changed mid-process
 it is less structured or rigid
Does integrative therapy have no structure at all, then?
Integrative therapy does not mean your therapist just randomly picks what they think
would work from you from all the training they have.
While integrative therapists do use different schools of therapeutic thought, they will have
learned or developed over time a structured way to combine their knowledge base, or, again, will
be trained in the best ways to use different techniques together. There is still room for making
your program of therapy bespoke and flexible, but it is not so loose as to feel experimental.

What are the benefits of integrative therapy?

You might find integrative therapy beneficial in the following ways:

 you will understand more clearly what causes you to feel challenged in life
 you will learn to recognise what triggers you into unhelpful behaviours and be supported in
trying new, more productive ones
 you can recognise limitations you’ve set on yourself and find ways to move beyond them
 you can integrate all the different aspects of yourself (mind, body, emotions, social skills,
spirituality)
 you can set goals that lead you toward the life you feel happy about
 you can begin to face your life in a more open, available, and less judgemental way
What issues is integrative therapy recommended for?
Integrative therapy is beneficial for the following issues:

 anxiety
 depression
 low self-esteem
 phobias
 addictions
 bereavement
 trauma
 learning difficulties
 autism
CONCLUSION
Like all forms of therapy, integrative therapy requires that you are open to exploring your
fears, your hopes, your life, what is causing you challenges, and what you hope for your future.
But if you like the idea of a therapy which is a bit more bespoke and less rigid than other
forms, then integrative therapy might indeed be for you.
Would you like to try this type of therapy? Harley Therapy offers highly experienced
integrative psychotherapists and counselling psychologists in three London locations. You
can now book a first appointment online. Not in the UK? We now also offer online
therapy worldwide.
*Do you have an experience about integrative therapy you’d like to share? Or a question
you’d like to ask? Do so below, we love hearing from you.