The 4 great integrative models in psychological therapy
Although traditionally psychologists, including clinicians, have been attached to particular theoretical models (such as the behavioural, psychodynamic, phenomenological or humanist), there is a growing trend towards the integration of different approaches. However, this kind of movement dates back to at least the middle of the 20th century.
In this article we will describe the characteristics of the main integrative models in psychological therapy , as well as the types of integration that exist. Among the developments we will talk about we can highlight the interpersonal therapy of Klerman and Weissman or the trans-theoretical model of change of Prochaska and Diclemente.
Integrative models in psychotherapy
In 1950 John Dollard and Neal Miller, two researchers from Yale University, published “Personality and Psychotherapy: An Analysis in Terms of Learning, Thinking and Culture”. In it they reformulated key concepts of psychoanalysis in behavioral terms ; this was one of the first milestones in the history of integration in psychotherapy.
At this time there were multiple psychological models in vogue; psychoanalysis and learning theory were the most influential, but other orientations also carried weight and new ones, such as cognitivism, were beginning to flourish. This context favoured the mixture of very varied proposals, sometimes opposed to each other.
Another relevant aspect in the development of integrative models was the research on the effectiveness of psychotherapy and its components and approaches. The results suggested that different forms of intervention could be useful depending on the specific case, and that much of the success of psychotherapy should be attributed to common factors.
During the following decades the integration movement continued to develop along very different paths. In this sense we must distinguish three main types of integration in psychotherapy, which reveal different approaches towards a common goal: the increase of the explanatory capacity of the models and the effectiveness of the treatments.
What types of integration are there?
There are three main types of psychotherapeutic integration : the theoretical, the technical and the common factors approach , which focuses on the aspects underlying the effectiveness of therapy regardless of its orientation. This division is very general and does not represent the complexity of the integrative movement, but gives an idea of its basic tendencies.
1. Theoretical integration
Theoretical integration consists of combining the approaches of different psychological orientations. In some cases, the same weight is given to complementary approaches, such as behaviourism and cognitivism, while in others a theory is used as a basis and the concepts of others are introduced into it; constructivism is particularly useful in this regard.
2. Technical eclecticism
Technical integration is commonly known as “technical eclecticism”. This approach focuses on increasing the effectiveness of psychotherapy by combining the most useful inputs from different orientations for specific problems. Thus, it is easier to apply than theoretical integration, although it runs the risk of lacking systematicity.
3. Common factor approach
This approach to integration is probably the oldest of the three; its origin dates back to the 1930s-1960s, when the contributions of Rosenzweig, Alexander and French or Carl Rogers appeared. It is now known that 30% of the effectiveness of therapies is due to common factors and only 15% to the chosen techniques.
Integrative Psychological Therapies and Theories
Although there are many psychotherapeutic approaches that can be encompassed within the integrative paradigm, we will focus only on some of the most significant examples. Other relevant models include Wachtel’s dynamic cyclical psychotherapy, the theoretical integrationism of Neimeyer and Feixas or the proposal of Mardi Horowitz.
1. Rogers’ Person-Centered Therapy
Carl Rogers, a pioneer in humanistic psychotherapy, developed his person-centered model from his research on the therapeutic process. From this he concluded that effectiveness depends mainly on the authentic attitude of the therapist , as well as on his unconditional acceptance of the client and his ability to empathise with him.
2. Klerman and Weissman Interpersonal Therapy
Gerald Klerman and Myrna Weissman developed their interpersonal therapy in the 1970s as a method of treatment for major depression; it is now also applied in cases of bulimia or in family therapy. This type of intervention is based on psychodynamic theory and cognitive-behavioral therapy and includes techniques from different models.
3. Lazarus Multimodal Therapy
Richard Lazarus is best known for his contributions to coping with stress. His multimodal therapy proposes the use of very diverse techniques depending on the specific problems and the client’s personality; this includes interventions such as behaviour modification, cognitive restructuring, biofeedback and pharmacological therapy.
4. Trans-theoretical model of the Prochaska and Diclemente gearbox
This theoretical and practical model is applied in the treatment of addictions . It defines change at six stages (pre-contemplation, contemplation, preparation, action, maintenance and completion), two types of process (cognitive-experiential and behavioural) and five levels (symptomatic, cognitive, interpersonal, systemic and intrapersonal).