Moving towards psychotherapy integration: A student’s perspective
I’m a psychology trainee, taking my first strides on the path towards becoming a clinical psychologist. I am discovering what type of psychologist I want to be, an exploratory process some of you might find familiar.
This journey involves everything I do: my academic studies, my clinical work, and the direction of my research. As a psychotherapy researcher, I study various theoretical approaches, and identify similarities and differences between treatment modalities. In my own research, I explore therapeutic processes and techniques that are used by different therapeutic approaches.
The further I progress in my training, the more I identify with psychodynamic theory, practice, and research. Seemingly paradoxically, however, the more I learn, the more I also see myself as being open to integrating approaches, e.g., cognitive, behavioral, interpersonal, emotion-focused, and common factors techniques.
Studying integrative psychotherapy, I find that other professionals in the field are going through the same process. A growing body of evidence documents the failures of each specific orientation to benefit all clinical populations, and many therapists are transitioning away from rigidly defined treatment models towards integrative approaches to therapy (Norcross, 2005; Castonguay, Reid, Halperin, & Goldfried, 2003). Surveys show that most counselors and psychotherapists who adhere to a specific model nevertheless report that integrative approaches have become a significant source of influence on their therapeutic work (McLeod, 2009).
As a trainee, I am learning that there is value to finding a clinical and theoretical framework in which one feels “at home” – an approach that most often helps one to conceptualize one’s client’s problems and formulate a treatment plan. I am also learning about the importance of going on intellectual journeys and exploring other perspectives, and am constantly seeking ways to enrich my experience. I consult supervisors from different approaches; I am learning to try to think of my clinical cases using multiple points of view, and to experiment with integration of techniques from different approaches. These explorations tend to be exhausting, pushing me to my limits, and challenging me to think flexibly about my work. When I get tired, I return to my secure base – my psychodynamic home. After resting for a while, I encourage myself to go out and explore again.
I hope to see a shift in our field, such that different psychotherapies are not enemies, and do not compete against each other, constantly trying to determine the winners and losers. In my ideal world, these seemingly competing approaches are complementary – a world where cognitive, psychodynamic, interpersonal, and behavioral therapists work together to try to find the best treatment for the client, without allowing personal interests and dogma to get in the way.
We, the trainees, are the ones who are going to determine the future of clinical psychology. We will conduct the most contemporary research, train and supervise the next generation of students, and continue to treat evolving clinical populations. I think that our goals should include an increased collaboration, facilitation of free and open interdisciplinary discussion, and that we should spend every day finding opportunities to learn from each other.
Castonguay, L.G., Reid, J.J., Jr., Halperin, G.S., & Goldfried, M.R. (2003). Psychotherapy integration. In G. Stricker & T.A. Widiger (Eds.), Handbook of psychology: Clinical psychology (Vol. 8, pp. 327–366). New York: John Wiley & Sons Inc.
McLeod, J. (2009). An introduction to counseling (4th ed.). New York, NY: Open University Press.
Norcross, J. C. (2005). A primer on Psychotherapy Integration. In J. C. Norcross, & M. R. Goldfried (Eds.) Handbook of psychotherapy integration (2nd ed.) (pp. 3-23). New York, NY: Oxford University Press.