Eclectic/ Integrative approaches

Examples of eclectic therapy

- Multimodal therapy by Lazarus - Eclectic therapy by Beutler - Eclectic therapy by Garfielda

Two groups of theoretical integration models

1. Connecting two models of psychotherapy (psychodynamic-behavioral therapy of paul wachtel) 2. Meta theories - Trying to explain/ describe the process of change in psychotherapy of all kinds - generic model of psychotherapy of Orlinsky and Howard

Eclecticism

is a conceptual approach that does not hold rigidly to a single paradigm or set of assumptions, but instead draws upon multiple theories, styles, or ideas to gain complementary insights into a subject, or applies different theories in particular cases.

Transtheoretical model of psychotherapy of Prochaska and DiClemente

is an integrative theory of therapy that assesses an individual's readiness to act on a new healthier behavior, and provides strategies, or processes of change to guide the individual.[1] The model is composed of constructs such as: stages of change, processes of change, levels of change, self-efficacy, and decisional balance.

Syncretism

uncritical and unsystematic combinations of techniques

Lambert improvement percents:

- 40% - improvements are connected with the factors outside the therapy, spontaneous improvement - 30% - psychotherapeutic relationship - empathy, encouraging to take the risk - 15% - placebo effect - 15% - specific techniques of psychotherapy

Eclecticism VS Integration - Eclecticism is

- Technical - Divergent (differences) - choosing from many - applying what is - collection - applying the parts - atheoretical but empirical - sum of parts - realisitc

Assimilative Psychotherapy

- Using techniques from different schools of psychotherapy while preserving one way of thinking (one theory)

Examples of assimilative psychotherapy

- assimilative, psychodynamic approach of Stricker and Gold - Assimilative cognitive-behavioral psychotherapy of Castonguay's and colleagues - Assimilative interpersonal and cognitive psychotherapy of Safran

Cyclical Psychodynamics

- by Wachtel - integrates psychodynamic and behavioral therapy - The past, stages of the development shape your current experiences - psychoanalysis - the past and the stages of development has a minor impact how you behave currently - Watchel - the past is important but it can be changed though current experiences - links psychoanalysis to behaviorism - Interaction of internal conflict with current experiences

Eclecticism in psychotherapy

- choosing appropriate techniques used in different approaches to psychotherapy - decision based on the research and clinical experience what technique worked for a similar patient with a similar problem -

MT - Treatment

- choosing the most effective techniques for each specific problem - list of 39 basic techniques - therapy takes about a year, once a week session - different forms of therapy at the same time - individual, marital, family, group, pharmacotherapy

Aim of Wachtel's therapy

- main aim is to break the vicious circle - focus on the mechanisms how the circle self-reinforces - Change through the insight gained thanks to interpretation of the unconscious motives. - Change through the change of the behavior thanks to the behavioral techniques e.g. assertiveness training

Common factors

- searching for those elements of the therapy, that are responsible for the effectiveness of the psychotherapy independently from the used methods common factors = unspecific factors Specific factors - techniques specific for a given school of psychotherapy - it does not create a new method of psychotherapy - you can not work using only the common factors approach

Theoretical integration

- synthesis of two or more models of psychotherapy

Eclecticism vs Integration - Integration

- theoretical - convergent (commonalities) - combining many - creating something new - Blend - Unifying parts - More theoretical than empirical - More than sum of parts - Idealistic

Common factors - Lampropoulus/ Jorgensen

- therapeutic alliance - empathy and support - positive expectations about therapy - emotional catharsis - problem exploration and insight - exposure and confrontation of the problem - learning of new behaviors - new narrative about the self

Rosenzweig - Common Curing Factors

1) Therapeutic alliance 2) Integration of patient's personality subsystems 3) Coherent way of thinking about self and others 4) Characteristics of the therapist

Jerome Frank lists four general factors that are essential to every form of psychotherapy:

1. A particular kind of emotionally charged relationship between the patient and the therapist that supports the patient's confidence in the therapist's competence and in his desire to help; 2. the fact that psychotherapy and its institutional context are socially sanctioned and legitimized, which in itself enhances the patient's expectations of help; 3. the immanent rationale or myth behind any given therapy, which offers an explanation of the patient's problems and methods for eliciting change; 4. specific tasks and procedures that demonstrate the therapist's competence and give the patient an alibi for change.

There are four routes to integration:

1. Technical eclecticism 2. Theoretical integration 3. Assimilative integration 4. Common factors

Integrative psychotherapy

All forms of psychotherapy that adapt, connect or modify into a new entity two or more already existing schools of psychotherapy

MT - BASIC-ID

B- Behavior A - Affect S - Sensation I - Imagery C - Cognition I - Interpersonal relationships D - Drugs/ biology

Multimodal Therapy by Lazarus

It is based on the idea that humans are biological beings that think, feel, act, sense, imagine, and interact—and that psychological treatment should address each of these modalities. - there are many sources of disorders - no single cause, no single treatment method - we use multi-modal approach - treatment should affect many elements of human life

MT - Therapeutic relationship

Therapist choose an optimal relationship with the client. The dimensions: - directive-nondirective - formal-informal - supportive-avoiding support - disclosing-secretive Authentic chameleon