by Dr. Becky Spelman on 18/07/2018
Everyone who comes to therapy is a unique human being, with a unique history and set of experiences, and issues and problems that are particular to them. They often initially present in considerable distress, and frequently with number of comorbid problems. For instance, someone can have an eating disorder, problems with emotional regulation, and anxiety, all at the same time. Because people and their mental and emotional health issues are multi-faceted, flexibility and versatility are essential—particularly in complex cases, when the aetiology of the patient’s problems may not be immediately obvious, or when they have had less than satisfying results from previous experiences with psychotherapy.
The term ‘integrative therapy’ is used to describe a psychotherapeutic approach that involves integrating elements from different styles of therapy, depending on the patient’s needs and their current situation. This flexible approach allows therapists to tailor-make a treatment for each client. Techniques that can be usefully integrated, for example, include practical approaches such as cognitive behavioural therapy, which looks at ways in which people can more effectively manage their symptoms on a daily basis, and psychodynamic therapy, which aims to uncover and understand what is going on in the patient’s unconscious that might be leading them to feel or behave in a particular way.
There are many distinct forms of psychotherapy, and the variety of ways in which they can be integrated is therefore considerable. Two, three, or even more theoretical approaches can all be usefully combined—and the combination is likely to change as the patient and therapist travel on their psychotherapeutic journey together.
An integrative approach to therapy calls for open-mindedness on the parts of both the therapist and the patient. Rather than simply following a rigid plan, they work together to figure out what is most effective, which elements the patient finds easier to respond to, and what is more productive in terms of outcome. This process enables the therapist to understand, to a great extent, not just what is working for their patient, but why. As the process of therapy continues, they will be able to incrementally fine-tune their approach in reaction to their patient’s evolving needs. For example, a patient could present with a number of issues, which change and shift with the passage of time. They might need help in managing emotions and practicalities associated with a chronic physical ailment, be dealing with depression or anger, and have problems with an intimate relationship—all at the same time. When one or more of these issues comes under control, their needs with respect to the others are likely to change. Something that was once felt as an emergency may become less urgent, allowing other things to come to the fore.
Any therapist planning to use integrative therapy needs to have a solid grounding in a wide range of theoretical approaches. In other words, they need to be highly trained in an academic sense; to understand the background, theory, vocabulary and practise of a wide range of psychotherapies. They also need considerable experience of working with patients. An empathic approach to the issues that have brought them to therapy is also essential. As their experience grows, they will become incrementally more adept at learning quickly which combined approaches can help their current patient.
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