Anxiety Disorders

Integrated Psychotherapy Approaches

Judy Z. Koenigsberg

• Publisher: Routledge
• Year: 2020
• Print ISBN: 9780367086640
• eBook ISBN: 9780429657290
• Topic: Psychology
• Subtopic: Abnormal Psychology
• Index: Psychology

This text provides integrated and unified treatment frameworks for anxiety disorders and examines how contemporary integrated psychotherapy treatment models from different therapeutic interventions can be used to help patients.

Dr. Koenigsberg provides a research-based overview of major themes that underlie these treatment models, then analyzes the symptoms and causes of specific anxiety disorders such as panic disorder, social anxiety disorder, and phobias, as well as obsessive-compulsive disorder, and posttraumatic stress disorder. Case studies of integrated or unified treatment approaches are provided for each disorder, along with the theoretical and technical factors that are involved in applying these approaches in clinical practice. Supplementary online materials include PowerPoint slides and test questions to help readers further expand their understanding of integrated and unified approaches for the anxiety disorders and assess their newfound knowledge.

Graduate and undergraduate students, novice and seasoned therapists, and researchers will learn the rationale for and the history of past and contemporary integrated and unified models of treatment to gain better insight into anxiety disorders.

Part I

Integrated and Unified Psychotherapy

Part I presents chapters that describe integrated and unified psychotherapy treatments, the rationale for integration, and offers a history of past and contemporary integrated and unified models of psychotherapy. The first chapter, “Integrated and Unified Psychotherapy Approaches,” defines integrated psychotherapy and distinguishes between single-school, eclectic, integrated, integrative, and unified psychotherapy approaches. It aims to stimulate thoughts about how the reader may feel comfortable considering ways to integrate ideas and methods from various theoretical orientations. Chapter 2, “The Need for Integrated and Unified Psychotherapy Approaches,” presents the rationale for integrated and unified frameworks and delineates various types of models of psychotherapy integration and unification. Part I, which ends with Chapter 3, “A Brief History of Integrated and Unified Psychotherapy Approaches,” offers a brief history of integrated and unified psychotherapy perspectives.

1 Integrated and Unified Psychotherapy Approaches

Introduction

Chapter 1 describes the various types of psychotherapy models, e.g., single system or monotherapy, eclectic, integrated, integrative, and unified or integral. The chapter distinguishes one framework from another and offers examples of single-system, integrated, and unified psychotherapy models or frameworks.

Models of Psychotherapy and Supervision: Single-School, Eclectic, Integrated, Integrative, Integral, Unified

A goal of this chapter is to describe different types of therapy models and to explain how they influence the way in which practitioners practice and supervisors train. Models of psychotherapy include single-school or monotherapy, eclectic, integrated, integrative, and integral or unified. Although the chapter begins with single-school models, the primary focus is on psychotherapy integration and unified models of psychotherapy.

Single-School or Monotherapy Models of Psychotherapy

What is a single-school perspective? A single-system approach relies on one theoretical framework. Although there are several monotherapy perspectives, the following four are representative: Psychodynamic, existential/humanistic, cognitive-behavioral, and systemic (Fernández-Álvarez, 2001; Längle & Kriz, 2012; Wachtel, 2014). Whereas the aforementioned monotherapy orientations have contributed to psychotherapy integration, they, often, have been dismissive of each other (Fernández-Álvarez, Consoli, & Gómez, 2016; Wachtel, 2010). It is the integrated and unified perspectives that have contributed to the unity of psychotherapy while focusing on the particular needs of patients.

Distinctions Among Eclectic, Integrated, and Integrative Psychotherapy Models

What is the difference between eclectic psychotherapy, psychotherapy integration, and integrative psychotherapy? Terms such as eclectic, integrated, and integrative have been used interchangeably; however, there are differences among them. This section points out the distinctions among the aforementioned terms.

What is the difference between eclectic and integrated psychotherapy? The difference between the two involves the notion of theory. Eclectic psychotherapy draws ideas together without working to reconcile them, and appears to be a middle step towards integration (Forman, 2010). Whereas eclectic psychotherapy involves employing treatment techniques because of their effectiveness and without concern for a theoretical rationale, psychotherapy integration underscores the correlation between method and theory (Stricker, 1993). An eclectic psychotherapist applies divergent techniques; however, an integrated psychotherapist plans a synthesis of distinct theoretical orientations (Beitman, Goldfried, & Norcross, 1989). Both integrated therapy theories that are well-organized and systematic and eclectic psychotherapy perspectives that are less ordered aim towards a unified psychotherapy framework (Walder, 1993). According to Cutts (2011), although eclectic psychotherapy employs theoretical components, without referring to theory, the purpose of therapy integration is to achieve a unified approach. Macarthur (2013) argues that assimilative integration takes theory into account; however, its goal is not a unified model.

What is integrative psychotherapy, and how does it differ from psychotherapy integration? Integrative psychotherapy is represented as a bona fide treatment approach, as a psychotherapy school, rather than as a psychotherapy process that characterizes psychotherapy integration (Stricker, 1993). Stricker (1993) distinguishes between psychotherapy integration and integrative psychotherapy by describing psychotherapy integration as a process whose outcome is a myriad of integrations, both theoretical and technical, and defines integrative psychotherapy, on the other hand, as no more than an advanced single-school or monotherapy approach. Consistent with the aforementioned view, Wachtel (2010) distinguishes between psychotherapy integration and integrative psychotherapy by explaining that whereas therapy integration connotes an ongoing process, integrative therapy connotes a product or a method. The bottom line is that an integrative psychotherapy perspective challenges the idea that different treatment models cannot work together (Fernández-Álvarez et al., 2016).

Whereas an eclectic psychotherapist may employ a particular method, observe a positive change in a patient, and not analyze the reason that the positive change took place, an integrative psychotherapist would analyze the reason why, and the way in which, a patient changes (Jones-Smith, 2012). Therapists who adhere to an eclectic approach seem to not have much in common and do not adhere to a prior set of principles; however, therapists who opt for an integrated point of view consider both what works and the reason that something works (Jones-Smith, 2012).

The Meaning and Purpose of Psychotherapy Integration and Integrative Psychotherapy Models

Whereas the previous section explained the distinctions between eclecticism and integration, the next section discusses the meaning of integration. What does psychotherapy integration mean for patients and therapists? Psychotherapy integration refers to an investigation of the ways that different psychotherapy approaches can combine (Stricker & Gold, 2006). An integrated psychotherapy approach strives to improve psychotherapy by incorporating different perspectives and techniques (Castonguay & Goldfried, 1994). The essence of psychotherapy integration reflects alignment. Although the ideas and methods of models of psychotherapy vary, frequently, they are compatible (Comer, 2015). For example, it has been demonstrated that the positive effects for individuals who have engaged in psychodynamic treatments that are long-term are equal to the effects for interventions that are evidence-based, and clinicians who identify as other than psychodynamic tend to integrate psychodynamic concepts into their therapy sessions (Boulanger, 2011; Shedler, 2010).

Psychotherapy integration needs to include both an integration of a therapist’s explicit theories or formal learning of orientations and implicit theories or conceptualizations about psychotherapy (Jones-Smith, 2012; Shoben, 1962). Whereas explicit theories involve the adoption of a formal orientation such as humanistic or cognitive, implicit theories involve notions on how to develop a therapeutic relationship with a client regardless of didactic or formal theoretical orientation (Jones-Smith, 2012).

Does psychotherapy integration occur within the treatment or within the therapist? Whereas some researchers propose that clinicians need to apply integration within the treatment in the way that a therapist employs several methods, others suggest that integration occurs within the therapist as each patient calls for a different perspective (Stricker, 1993). Psychotherapy integration is not a simple endeavor, and it seeks to recognize the complexity necessary to service a diversity of patient requirements (Fernández-Álvarez et al., 2016). For Stricker (2010), psychotherapy needs to include continuous integration.

How does integrated psychotherapy encompass a wider or broader view of human beings? How does integrated psychotherapy work to develop a complete view of a human being, a perspective that encompasses the physiological, psychological, and sociocultural elements of an individual’s challenges? Biopsychosocial theories assert that deficits result from a broad range of communications among social, physiological, emotional, cognitive, developmental, genetic, cultural, and other domains (Calkins & Dollar, 2014; Comer, 2015; Pincus, 2012). Today, integration therapists blend treatment methods from distinct approaches, some of which are empirically supported (Comer, 2015; Norcross & Beutler, 2014). Prochaska and DiClemente’s (2005) transtheoretical model is an example of a psychotherapy integration approach that has been empirically supported (Fernández-Álvarez et al., 2016).

What is the purpose of integrative psychotherapy? A goal of an integrative psychotherapy approach is to promote learning from a variety of standpoints in order to facilitate usefulness and productivity in a clinical context (Aafjes-van Doorn, Klinar Alfaro, Fialová, & Kamsteeg, 2018; Greben, 2004). A psychotherapist who is integrative is informed and flexible (Boulanger, 2011). For example, one type of integrative therapy involves pragmatic blending, which refers to the emergence of an emotional problem from a blend of learned, unconscious, and interpersonal sources that usually include interpersonal, Rogerian, psychodynamic, and behavioral intervention approaches (Halgin, 1985–1986; Halgin & McEntee, 1993). Integrative psychotherapists examine how patients benefit from treatments that are not restricted to one school of thought by drawing on methods across different orientations within an evidenced-based context (Norcross & Goldfried, 2005; Norcross & Popple, 2017).

Is there a connection between integrative psychotherapy and a common class of emotional disorders, the anxiety disorders? Evidence-based research has shown that integrative psychotherapy interventions (e.g., interpersonal, schema) can benefit patients with different anxiety disorders, e.g., generalized anxiety and social anxiety (Hamidpour, Dolatshai, Shahbaz, & Dadkhah, 2011; Stangier, Schramm, Heidenreich, Berger, & Clark, 2011; Zarbo, Tasca, Cattafi, & Compare, 2016).

What is the essence of patient integration? Critical to psychotherapy integration is the need for...

Table of contents

• Cover
• Endorsements
• Half-Title
• Title
• Copyright
• Dedication
• Contents
• Foreword
• Preface
• Acknowledgments
• PART I Integrated and Unified Psychotherapy
• PART II Integrated and Unified Psychotherapy Approaches for the Anxiety Disorders
• PART III Integrated and Unified Psychotherapy Approaches for Obsessive-Compulsive Disorder (OCD) and Posttraumatic Stress Disorder (PTSD)
• Index