Integrative Psychotherapy

"Applying identical psychosocial treatments to all patients is now recognized as inappropriate and, in selected cases, perhaps even unethical. Different folks require different strokes. The efficacy and applicability of psychotherapy will be enhanced by tailoring it to the unique needs of the client, not by imposing Procrustean methods on unwitting consumers of psychological services."  

(Norcross, 2005)

The integrative mandate is embodied in Gordon Paul’s (1967) famous question: 

What treatment, by whom, is most effective for this individual with that specific problem, and under which set of circumstances? 

Although it is likely that individual schools of psychotherapy will be maintained and taught in their pure forms, it is clear that most therapists will increasingly use concepts and methods from other sources to supplement their work and to meet the needs of clients who are not responding optimally to the core model for the simple reason that they suffer from a multitude of specific problems that should be remedied with a similar multitude of methods. Clinical reality demands a flexible, if not integrative, perspective. Psychotherapy should be flexibly tailored to the unique needs and contexts of the individual client, not universally applied as one-size-fits-all.  

Rivalry among theoretical orientations has a long and undistinguished history in psychotherapy, dating back to Freud. In the infancy of the field, therapy systems, like battling siblings, competed for attention, affection, and adherents. Clinicians traditionally operated from within their own theoretical frameworks, often to the point of being blind to alternative conceptualizations and potentially superior interventions. 

An ideological “cold war” reigned as clinicians were separated into rival schools of psychotherapy. 

As the field of psychotherapy has matured, integration or eclecticism has emerged as a mainstay. Clinicians now acknowledge the inadequacies of any one theoretical system and the potential value of others.  Psychotherapy integration is characterized by dissatisfaction with single-school approaches and a concomitant desire to look across school boundaries to see how clients can benefit from other ways of conducting psychotherapy. Although various labels are applied to this movement—eclecticism, integration, differential therapeutics, prescriptive matching—the goals are similar. The ultimate goal is to enhance the efficacy and applicability of psychotherapy. 

No theory is uniformly valid and no mechanism of therapeutic action is applicable to all individuals. Thus, the purpose of integrative psychotherapy is not to create a single or unitary treatment, but to select different treatments according to the responses of the patient and the goals of the treatment, following an established set of integrative principles. The result is a more efficient and efficacious therapy than a single-theory approach—and one that fits both the client and the clinician.