When integrative therapists debase some of the therapeutic approaches

For therapy to be successful I believe that it is essential that clients feel comfortable and safe with their therapist so that they can start an open and frank dialogue. Various research findings have indicated that the working alliance is as important as any other factor in successful therapeutic outcomes. This is not to say that feeling discomfort is not also part of the process, otherwise the therapist would not be doing their job in naming what needs to be named. John C. Norcross’s approach to integrative psychotherapy involves selecting models and methods from across orientations so that the client’s experience is best met and in context. He shows how meta-analyses demonstrates that tailoring therapy to the individual client enhances treatment effectiveness.

I sometimes wonder, however, whether integrative therapists debase some of the therapeutic approaches. When you look at various profiles on therapist directories, for instance, it is not uncommon to see practitioners describing themselves as analysts, gestaltists and CBT therapists. On closer inspection such profiles state that their psychotherapeutic training took place at generalist training institutes, usually integrative. Some profiles refer to offering ‘Jungian therapy’ as part of their counselling and psychotherapy private practice. In actual fact, what this means is that they had a few lectures on Jungian symbolism, at best. Their training was not in the Jungian approach, at depth, and they did not have analysis a few times weekly as part of their personal therapy (nor did they benefit from specific clinical supervision in the Jungian approach). The same is true of the Gestalt approach when integrative practitioners may have benefitted from a weekend of experiential work using some of the Gestalt tools and techniques in a very general way. However, they won’t have had any real thorough training in the Gestalt approach. As for CBT, it has been my experience that integrative training institutions are biased against the CBT approach and offer such a slimmed down version of it, as part of their core syllabus, that I wonder why they bother in the first place.

Of course, it is fine to say that as an integrative practitioner one can offer components of certain approaches as part of an overall psychotherapeutic offering, as a kind of generalist toolbox.  Indeed, one can use continuing professional development (cpd) to expand one’s knowledge base in particular areas throughout one’s career. However, I find it disingenuous to talk about being an analyst in the absence of specific training in that approach.

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My interview with Paul Magrie, transpersonal psychotherapist

paul margrie CCPEMy interview with Paul Magrie, transpersonal psychotherapist and member of management committee of the CCPE in West London. In the interview Paul discusses his take on integrative psychotherapy and his involvement with CCPE from the 1990s.

CCPE recently celebrated 30 years as a transpersonal training institute and clinical services provider. In the interview Paul refers to Nigel, meaning Nigel Hamilton, director of CCPE. Paul discusses the Planes of Consciousness, the Elements Model and transpersonal transformation as part of a short interview on the meaning of integrative practice.

Listen to the interview by clicking here.

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My interview with Allan Pimentel

My interview with Allan Pimentel, jazz musician and psychotherapist for over 25 years.  Allan is a member of the management committee of CCPE, the largest transpersonal training institute in the UK. In the interview Allan chats about the history of CCPE, which recently celebrated 30 years of being a training institute, how he became a therapist and about his time as an artist-in-residence at the Esalen Institute, California.

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My interview with Windy Dryden about CBT and integrative psychotherapy

Windy Dryden chats about CBT and integrative psychotherapy.

Windy Dryden chats about CBT and integrative psychotherapy.

I recently chatted with Windy Dryden about CBT and integrative psychotherapy. Windy was the first appointed professor of counselling studies at Goldsmiths College, University of London, in 1992.  In the interview we discuss the challenges of editing the Handbook on Individual Therapy, often viewed as essential reading for anyone wanting to know more about counselling and psychotherapy. We also discussed RECBT, IAPT in the NHS, the Albert Ellis Institute and what is uniting about the different approaches in counselling and psychotherapy.

To listen to the interview click here.

For more information on the UK CBT meetup group with live CBT demonstrations visit their website.

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Noel Bell chats to Asher Quinn about integrative psychotherapy

Noel Bell chats to Asher QuinnI had the pleasure of chatting to Asher Quinn the other day about integrative psychotherapy and his passion for music.

Asher is a transpersonal psychotherapist, shamanic healer and independent music professional, based in Putney, London SW15.   In the interview we chatted about his early involvement with the Counselling Centre for Psychotherapy Education (CCPE), which this year celebrates 30 years in existence, as well as his transpersonal psychotherapy practice.

Click here for the link to the interview.

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My interview with Jocelyn Chaplin

Jocelyn Chaplin

Jocelyn Chaplin chats to Noel Bell

I met the wonderful Jocelyn Chaplin the other day and we had an amazing chat about feminism, psycho-spiritual development and integrative psychotherapy – at her consulting room in North London. We also chatted about seemingly anything, and everything, remotely relevant to counselling and psychotherapy and I thoroughly enjoyed the experience.

Her recent book was Deep Equality: Living In the Flow of Natural Rhythms, which explored the importance of rhythm and dance in personal transformation. You can read a review of the book from Sandra White by clicking here.

There is a Summer Solstice Dionysian Ritual event at Conway Hall in London organised by the Serpent Institute on Thursday June 26, 2014, between 7 and 9pm. The theme is  ‘in the height of the light lies the promise of darkness’. The event will celebrate the mysteries of Rhea/Dionysus and there will be a Minoan theme to the event.

My interview with Jocelyn Chaplin can be listened to on Youtube

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Dr John Rowan chats to Noel Bell about integrative psychotherapy practice

John Rowan transpersonal

On Tuesday I interviewed Dr John Rowan about integrative psychotherapy practice.  In the interview John tells me about his ideas on psycho spiritual development, levels of consciousness and his views on personification. 

Well known in the psychotherapy environment for his work on Subpersonalities, his other books are Ordinary Ecstasy, Healing the Male Psyche (Therapy as initiation) and more recently, Personification: Using The Dialogical Self In Psychotherapy and Counselling.

We chatted in his therapy room at his home in Chingford. Click here for a link to the interview.

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Working from an integrative theoretical approach in psychotherapy

Iintegrationntegrative psychotherapy should include all states of being, that is what it means to work from a holistic perspective, as well as all major theoretical traditions, this is what it means to be integrative.  If human beings exist on at least five levels, namely body, feelings, intellect, soul and spirit, then we have to work on all five of those levels in order to realise human potential. 

In practising as an integrative psychotherapist, one can integrate different theoretical models using different relational maps. One such map is offered by Petruska Clarkson in ‘Systemic Integrative Psychotherapeutic Model’. For Clarkson, there are five ways in which the therapist and client relate:

  • the working alliance;
  • the transferential and countertransferential;
  • the reparative or reparenting;
  • the person to person (Martin Buber’s ‘I/Thou’);
  • the transpersonal.

ChakrasWhilst acknowledging the possible transpersonal aspects of the therapeutic relationship, I would argue that it is important not to be premature to focus on it to the detriment of the other four. Clarkson’s model might be better used as a fluid and flexible way of working, not as a hierarchical map. Added to Clarkson’s five relationships, it is also important to recognise further levels that widen one’s understanding of the context of the client’s existence. These can include the integration of the chakras and the integration of different brain functions.

Kahn (1997) seeks to bring together insights into the therapeutic relationship from Humanist, Psychodynamic (Object Relations), and Self Psychology sources.  Whereas Clarkson sees a multiplicity of relationships, Kahn sees the therapeutic relationship as singular, though having different facets to it. Kahn invites us to draw out the integrative aspects of Freud, Rogers, Gill and Kohut. Both Clarkson and Kahn do not, however, make reference to the kind of relationship likely to be fostered in the technique orientated cognitive behavioural approaches. This element is addressed by Gold (1996) and Power (2002) who offer a more comprehensive integrative model by incorporating cognitive and behavioural theories.

goal settingIt is important that behaviour change techniques, such as anti-procrastination exercises and cognitive change techniques, such as verbal disputing (and using Beck’s ABC Model) have their role to play in effective integrative psychotherapeutic practice. CBT can often be downgraded in the psychotherapeutic brand wars but I believe that the successful engagement of clients in the process of therapy, can be facilitated by goal setting, especially in short term counselling.  Indeed, Bordin (1979), usefully conceptualized the working alliance as consisting of three parts: tasks, goals, and bond. Tasks can be understood  as what the therapist and client agree need to be done to reach the client’s goals. Goals are what the client hopes to gain from the process of therapy, based on the presenting issues. The bond forms from trust and confidence that the tasks will bring the client closer to his or her goals.

 

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Can CBM and therapist-free therapy form part of an integrative approach to counselling and psychotherapy?

Content writing LondonThe term integrative psychotherapist can be loosely banded around these days and can often engender confusion for potential clients when seeking counselling and psychotherapy. Each school of counselling and psychotherapy can be quite precious about their particular approach. Psychoanalysis can be seen as purist as can Rogerian therapy in that they both offer a comprehensive approach to dealing with psychological disturbance that is exclusive and unique.

Integrative therapists can, however, use a multiple range of tools and techniques to meet the needs of their clients, in whatever state or stage they might be. They do not adhere in a rigid manner to one particular philosophical or theoretical approach but often use tools and techniques in a flexible and inclusive way given that clients present with varying needs. Integrative therapists can, for instance, work with the transference but could also employ a range of techniques from the Gestalt school, Transactional Analysis, Person Centred approach, Existential approach or even creative interventions from the Transpersonal school. The underlying theoretical approach of the integrative schools is that clients present in different levels and stages of consciousness and, therefore, therapists need a multi disciplinary range of skills and theory in order to be most effective.

French (1933) was perhaps the first integrative scholar when he proposed an integration between Freudian analysis and Pavlovian conditioning commalities. There have been many scholars since then who have proposed further ideas on integration including Paul Wachtel, Gerard Egan, Kuhn and Rorty. For pluralists such as Cooper and McCleod (2010) therapy should be based on what the client needs, rather than getting them to comply with standardised treatments. Research on the therapeutic alliance indicates that the therapeutic alliance may be a better predictor of outcome than technique or approach.

However, what if the client does not need a one to one and face to face therapist?  What if you could relieve symptoms of emotional ill health by conducting “therapy” on your own with a computer screen?  Does this sound daft?  Read on.

There has been some research, such as that conducted by Norman Schmidt of Florida State University and his colleagues, that suggests that Cognitive-bias modification (CBM) can be effective after a few 15-minute sessions.  The approach involves neither drugs nor the discussion of feelings. You don’t need to even leave your house.  No, this is not online therapy.  The only requirement is to sit in front of a computer screen and use a programme that subtly alters harmful thought patterns.

The theoretical basis of CBM is based on the idea that many psychological problems are caused by automatic, unconscious biases in thinking. The goal of CBM is to alter such biases, and doing so has apparently proved surprisingly easy.

So does it work?  In an era of evidence based psychological interventions research has become even more important. More recent research by Reinout Wiers of the University of Amsterdam suggests that CBM can help alcoholics deal with their addiction. However, one of the pioneers of the approach Professor Colin MacLeod, from UWA’s Elizabeth Rutherford Memorial Centre for the Advancement of Research on Emotion (CARE), and his team suggests that more research is needed to demonstrate its wider effectiveness. His team has already published studies that show how CBM works for anxiety and addictions.

Can CBM form part of an integrative psychotherapeutic approach? There are many purists in counselling and psychotherapy that do not view an integrative approach as forming a coherent theory and skills set in the therapy room. The argument from analysts and Rogerian therapists is that an integrative approach lacks an in-depth insight to any particular theory and the integration approach can be clumsy and hap hazard in its application.  Integrative therapists are, therefore, a kind of jack of all trades and master of none.

Even integrative psychotherapists themselves can fail to properly comprehend the benefits of a cognitive approach and pay only lip service to approaches such as CBT. In the brand wars of counselling and psychotherapy approaches, any cognitive based approach can be viewed at one end of a pendulum with limited use. So, CBM, in the absence of the therapist in the room, would perhaps appal the integrative schools even further. Indeed all face to face “talking therapists” would effectively be put out of business if CBM was to gain more credibility.  But perhaps a truly integrative approach must be liberally holistic and see the potential role of an approach such as CBM as having a part to play for some clients to overcome certain conditions at particular points in their lives.

 

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