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Psihoterapii Integrative

Curs: Prof. Dr. Ctlin


Nedelcea &
Conf. Dr. Iulia Ciorbea
Seminar: Dr. Claudiu Papasteri
Argument
La nceputul anilor 2000: peste 400 forme diferite de
psihoterapie raportate:
Care este eficiena (difereniat) a acestora?
Ce form de psihoterapie putem alege?
Toate formele de psihoterapie existente prezint limitri:
Teoretice &
Metodologice.
Practica real a psihoterapeuilor este n mare parte
integrativ.
Meta-analizele existente arat c nu exist diferene reale
ntre formele de psihoterapie sub raportul eficienei
(Cuijpers, 2017).
n Romnia exist reglementri deficitare i o nelegere
deficitar a domeniului.
Calitatea practicii psihoterapeuilor din Romnia.
Despre ce vom discuta
Scientist-Practitioner model in psychotherapy
Evidence based practice,
Evidence based interventions.

Outcome research in psychotherapy


Eficiena psihoterapiei,
Modelul factorilor comuni n psihoterapie.

Integrarea n psihoterapie.

Current psychotherapies.
Prelegeri
1. Introducere (definiie, rute de integrare, delimitri)
2. Outcome research in psychotherapy / eficiena
psihoterapiei
3. Evidence based psychotherapies
4. Common factors conceptualizarea larg
5. Common factors relaia terapeutic
6. Common factors conceptualizarea restrns
7. Common factors conceptualizarea restns
8. Integrarea asimilativ exemplificri (inclusiv
MPS)
9. Current approaches in psychodynamic & C-B
orientation
10. Current approaches in H-E orientation
Ce este psihoterapia
integrativ
Generic = orice abordare multi-modal n
psihoterapie; combinarea psihoterapiilor n scopul
atingerii eficienei.

Psihoterapia integrativ:
Nu este o form / metod de psihoterapie,
Este o abordare care implic selectarea i integrarea de
modele teoretice i metode din orientri terapeutice
diferite, cu scopul de a dezvolta cea mai bun abordare
pentru un client particular, aflat ntr-un context paticular,
Implic o formare diversificat a psihoteraputului.

Meta-analizele existente au demonstrat c terapia


personalizat crete eficiena tratamentului.
Modele (rute) de integrare n psihoterapie
Factorii comuni
the core ingredients that different therapies share in common,
emphasising on therapeutic actions that have been demonstrated to
be effective,
Frank & Frank (1991), Wampold (2001), and Miller, Duncan & Hubble
(2005).

Eclectismul tehnic
... selecting the best treatment for the person and the problem
guided primarily by data on what has worked best for others in the
past (Norcross, 2005),
encourages the use of diverse strategies without being hindered by
theoretical differences,
may not be a clear conceptual framework describing how techniques
drawn from divergent theories might fit together,
Exemple: Lazarus (2005) terapia multi-modal & Beutler, Consoli, &
Lane (2005), selecia sistematic a tratamentului (systematic
treatment selection).
Modele (rute) de integrare n psihoterapie
Integrarea teoretic
Dou sau mai multe terapii sunt integrate n sperana c rezultatul va fi mai bun
dect cl obinut din utilizarea singular a fiecreia (Norcross, 2005).
Unele modele:
se focalizeaz pe combinarea i sintetizarea unui numr mic de teorii la un nivel profund,
Ex. Cyclical psychodynamics, integreaz teorii psihodinamice, comportamentale i ale
sistemelor familiale (Wachtel, Kruk, & McKinney, 2005); Cognitive analytic therapy,
integreaz psihoterapia cognitiv i teoria psihanalitic a relaiilor obiectuale (Ryle,
2005); integral psychotherapy (Forman, 2010; Ingersoll & Zeitler, 2010),
n timp ce alte modele descriu relaiile existente ntre cteva forme de psihoterapie,
Ex. The transtheoreticcal model (Prochaska & DiClemente, 2005).

Integrarea asimilativ
Pornete de la premisa c majoritatea psihoterapeuilor i aleg o orientare teoretic
de baz i pe msura acumulrii de experin ncorporeaz idei i strategii din ate
orientri n practica lor.
Acest model favorizeaz ancorarea ferm ntr-un model de psioterapie, acompaniat
de preocuparea de a asimila perspective teoretice sau metode dinalte coli (Messer,
1992).
Ex. Frank (1999), Stricker & Gold (2005) propun un model de integrare asimilativ cu
baz psihodinamic; Castonguay, Newman, Borkovec, Holtforth, & Maramba (2005)
un model de integrarea cu baz cognitiv-comportamental; Nedelcea & Ciorbea
(2014) modelul de lucru orientat procesual-sistemic, cu baz umanist experienial.
Other models combining the routes
Hill, C.E. (2014) - The three-stage model of helping
skills:
a combination of theoretical integration and technical
eclecticism,
Stages:
Exploration, based on client-centered psychotherapy,
Insight, based on psychodynamic psychotherapy, &
Action, based on yhe behavioral approach.

Good and Beitman (2006)


an integration of common factors and technical eclecticism,
highlighting both:
a. core components of effective therapy, &
b. specific techniques designed to target clients' particular areas of
concern.
Other models combining the routes
Brooks-Harris (2008) - Multitheoretical psychotherapy
combines elements of technical eclecticism and theoretical integration,
therapists are encouraged to make intentional choices about combining
theories and intervention strategies.

Forman (2010); Ingersoll & Zeitler (2010) Integral psychotherapy


a meta-theory that recognizes that reality can be organized from four major
perspectives: subjective, inter-subjective, objective, and inter-objective,
psychotherapeutic integration would include:
subjective approaches (cognitive, existential),
inter-subjective approaches (interpersonal, object relations, multicultural),
objective approaches (behavioral, pharmacological),
and inter-objective approaches (systems science).
each can be seen as essential to a comprehensive view of the life of the
client,
includes a stage model suggesting that various psychotherapies seek to
address issues arising from different stages of psychological development.
Integrare vs Eclectism
Woolfe & Palmer (2000)
Integration suggests that the elements are part of one
combined approach to theory and practice, as opposed
to eclecticism which drawsad hocfrom several
approaches in the approach to a particular case.

Norcross & Goldfried (2005)


Psychotherapy'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 experience tells them will work best,
either in general or suiting the often immediate needs of
individual clients; and working within their own
preferences and capabilities as practitioners.