Psychotherapy Integration Unit 2: Common Factors

1. Psychotherapy Integration Unit 2: Common Factors Information From Stricker, G. (2011). Psychotherapy integration. Washington, DC: American Psychological Association.

2. Outline History of Psychotherapy Integration Contemporary Integration

3. History of Psychotherapy & Theoretical Integration • Freud • Stated “there are many ways and means of practicing psychotherapy. All that lead to recovery are good” (Freud, 1905/1953) • Identified common factors of client expectation and the central role of the therapist’s personality • French (1933) • Identified similarities between psychoanalysis and Pavlovian conditioning • His ideas were not well received at the time

4. History of Psychotherapy & Theoretical Integration • Rosenzweig (1936) • Pointed out commonalities in all psychotherapies • Dodo bird effect – “Everyone has won” • Alexander & French (1946) • Corrective emotional experience –the client re-experiences previously difficult relationships in the relationship with the counselor, and can experience those difficulties in new ways. This happens in all psychotherapies • Cyclical nature of insight leading to change and change leading to insight • These ideas were also not well received at the time

5. History of Psychotherapy & Theoretical Integration • Donnard & Miller (1950) • Wrote about psychoanalytic concepts in learning terms • Bridged a gap between two previously very different theories • Considered somewhat controversial, and not well received by current community

6. First Comprehensive Common Factors Work • Frank & Frank (1961) • Identified many commonalities across a vast arrange of change processes • Culturally comprehensive work • Initial list of common factors: • Expectancy for change • Arousal of hope • Emotional arousal • Encouragement of change outside of therapy • Encouragement of self-understanding through interpretations • Corrective emotional experiences

7. Two Approaches to Psychotherapy • London (1964) suggested that all kinds of psychotherapies could be grouped into one of two approaches • Action-Oriented • Encourage the client to take action to change behavior • Example: Behavior Therapy • Insight-Oriented • Seek to discuss matters of concern to promote understanding • Example: Psychoanalytic Approaches • Integration of these two approaches provides the most effective and longest lasting psychotherapeutic change

8. Historical Types of Integration • Understanding two theories by merging or translating the language of one into the language of the other (Dollard & Miller, 1950) • Lazarus (1976) – Multimodal Therapy • An example of technical eclecticism • BASIC-ID • Behavior • Affect • Sensation • Imagery • Cognition • Interpersonal Functioning • Drugs/Biology

9. Historical Types of Integration • Beck (1979) – Cognitive Behavioral Therapy • Combined aspects of cognitive therapy and behavioral therapy • Contemporary Era of Psychotherapy Integrationwas marked by the publication of Wachtel’s (1977) Psychoanalysis and Behavior Therapy

10. Contemporary Era of Psychotherapy Integration • Wachtel - All change in every therapy was a cyclical process • Groups & Resources for Psychotherapy Integration were created • Society for the Exploration of Psychotherapy Integration • Journal of Psychotherapy Integration • Handbook of Psychotherapy Integration • Comprehensive Handbook of Psychotherapy Integration

11. Contemporary Era of Psychotherapy Integration • Clinicians and Researches started creating different approaches to integrating aspects of many psychotherapies • Various types of integrated treatments have been developed • Transtheoretical approach – Levels of Change that apply to all psychotherapies • Dialectical Behavior Therapy – Integrates Eastern and Western approaches to therapy • Client Directed therapy

12. Contemporary Approaches to Integration Four Approaches: Common Factors Technical Integration Theoretical Integration Assimilative Integration

13. Common Factors Aspects of Psychotherapy that are present in all approaches to treatment Students -- (Refer to ongoing slides for The Heart and Soul of Change, which focuses on common factors)

14. Technical Integration • Most simple form of integration • Use of techniques drawn from several different approaches • Also known as technical eclecticism • Sometimes seen as a “hodgepodge” of various techniques thrown together • Better when techniques are pulled together through a systematic basis for the combination of techniques • Techniques should compliment each other and be flexible to match different client needs

15. Theoretical Integration • Most difficult type of integration • Blending of different approaches to psychotherapy • Should produce a “grand unified theory” • All contradictions between theories must be addressed • Examples: • Cyclical Psychodynamics • Cognitive-analytic therapy • Behavioral Psychotherapy

16. Assimilative Integration Most recently developed approach to integration A solid theoretical approach is already established and different techniques are integrated in from other theories Requires a theoretical meaning for each integrated technique An example will be further explained next chapter