The rise of integrative psychotherapy
By John Söderlund
Integrative psychotherapy Is that like eclectic psychotherapy?
Isn't everyone essentially integrative or eclectic, anyway? So, why the fuss about integration?
Because, says George Stricker, Distinguished Research Professor of Psychology in the Derner Institute, Adelphi University, eclecticism is simply not enough and the growth of integration is good for both practitioners and clients. Stricker is unequivocal that the integrative psychotherapy movement has gained pace in the past few decades. Quite simply, that's "because the movement conforms to what goes on in treatment and what is helpful to patients," he explains.
As an example of an integrated approach, he cites cognitive behavioural therapy (CBT), the approach which he believes has been involved in more integrative movements than any other.
Because of the complexity of integration of various approaches, the most common form it takes for the average practitioner is the assimilation of some ideas from one school into another, Stricker continues.
So, what differentiates integrative therapists from eclectic therapists? Commented one member of an e-mail based community for therapists and counsellors: "Integration is like choosing raw ingredients to make a balanced and nutritious meal, from a recipe to be used again, whilst eclecticism is like visiting the salad bar to select prepared food for just that meal, equally nutritious, and a different selection can be made next time."
It's this considered, methodical attempt to bring theories and practices together that sets the integrationists apart from the eclectics.
Paul Wachtel, a central figure in the integrative movement since the seventies, says that eclecticism tends to focus on "what works," and relies heavily on empiricism and statistical analysis to discover what seems to work. For Wachtel, it's this lack of theory that distinguishes the eclectics from the more theoretically grounded integrationists, who should be able to say not only what works, but why it works.
Tullio Carere, a committed integrationist, sketches the history of psychotherapy integration in several phases (www.cyberpsych.org/sepidocs.htm). The first, the "latency" phase, began in the early 1930's but was not a well defined area of interest, he says. The 1970's saw the more clear delineation of integration as a concern, with more concerted efforts being made at rapprochement across the boundaries. An interim phase, he says, was marked by the launch of the Society for the Exploration of Psychotherapy Integration (Sepi) in 1983 and the growing concern with a range of themes in integration and common theoretical and clinical languages.
The third phase, he suggests, is beginning with the new century, and, if successful, will see integrative psychotherapy moving from an area of interest to a scientific discipline.
The area of interest is clear. Carere reckons half of psychotherapists around the world call themselves either eclectic or integrative by orientation. But the evolution of integrative psychotherapy into a scientific discipline still needs to be seen, he believes.
Hilde Rapp, chair of the British chapter of Sepi, sees the drive towards greater awareness of integration as something of a political one.
"Strictly speaking, Sepi is an information sharing organisation - talking across the fence," she says. "We're forever putting people in touch with one another."
Psychotherapy integration is not a new school, she says, but adds that there are new schools which, while integrative, are discrete new schools which draw on and systematically integrate the most useful ideas they can find from other schools.
A typical integrative brand of therapy is Eye Movement Desensitisation and Reprocessing, (EMDR), about which its originator, Francine Shapiro, speaks to New Therapist in an exclusive interview.
But the history of EMDR is illustrative of the very problem to which Rapp is alluding in her comments about the advance of integrationism: That of the emergence of discrete new schools which then have to define their allegiances in the modality wars, much in the same way Jung broke from Freud in the early history of psychoanalysis.
The history of EMDR has been dogged by controversy which makes other, more traditional modality wars look tame by comparison. Those opposed to the method have slated the lack of evidence and theoretical grounds for its claimed efficacy (see page 16 of this edition). In response, its proponents have scrambled for more research-based evidence of its value and recruited thousands of practitioners as trainees and advocates of the method.
To be truly integrative then, means to largely abandon one's religious fervour about any particular method, including any discrete approaches or philosophies which are themselves integrative of other approaches. Sound like a difficult balancing act? Well, why do you think it has taken integrationism 70 years to get integrated into our psychotherapeutic repertoires?
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