From Cognitive Behavior Therapy to Psychotherapy Integration: An Evolving View

Abstract

Mapping the Journey: Evolution of a Story From Cognitive Behavior Therapy to Psychotherapy Integration: An Evolving View Marvin R. Goldfried. New York: Springer Publishing Company, 1995, 304 pp., $42.95 (hardcover). With the ever increasing proliferation of schools of psychotherapy, the lack of significant differences in outcome among diverse models of therapy, and the increasing need for accountability from a more informed consumer base, the move toward psychotherapy integration has gained momentum in recent years. One of the leaders of this movement has been Marvin Goldfried, a distinguished behavior therapist and long-time proponent of psychotherapy integration. In this volume, using a broad sampling of his previous writings, Goldfried takes us on a fascinating journey, documenting in a vivid way his own sense of theoretical evolution. Following a new introduction, Goldfried begins this book with his first article on behavior therapy and then lays out for the reader the trajectory of his professional development, using articles he generated over the years as the road map by which we may understand his professional journey. Though not strictly chronological, the flow of the book moves from his earlier to later writings. Traditionally, there have been three avenues toward psychotherapy integration: technical eclecticism, theoretical integration, and a common factors approach (Norcross & Newman, 1992). The common factors approach represents the core of Goldfried's efforts toward collaboration and integration: the understanding that there are common principles of change which may be delineated across theoretical orientations. These common therapeutic principles include: (1) an expectation that therapy will be helpful, (2) the availability of an optimal therapeutic relationship, (3) the use of feedback to increase patients' awareness, (4) the facilitation of corrective experiences, and (5) the opportunity to engage in ongoing reality testing. From Cognitive Behavior Therapy to Psychotherapy Integration is divided into five sections: an introduction; sections on cognitive-behavioral assessment, facilitating coping skills, expanding the scope of cognitive-behavior therapy, and a final section detailing the challenges and opportunities of psychotherapy integration. In Part I, Goldfried presents an overview of his thinking as concerns the essentials of psychotherapy, and argues for the study of psychotherapy integration for two primary reasons. First, it is clear that professionals from all orientations are moving toward more eclectic/integrated models of practice. Goldfried cites a number of studies that document this phenomenon, and maintains that as scientist-practitioners, our clinical practice must be supported by empirical research. Second, he rejects the uniformity myth that all models of therapy are basically equivalent, and argues that different models of therapy may have differential effects depending on presenting concern and client characteristics. Although he does not accept the uniformity myth, Goldfried's focus is not on differences among therapies, but on commonalities, or "therapeutic strategies or principles" (p. 8). By doing so, integrationists hope to arrive at clinically robust phenomena which will lead to a better understanding of the change process itself. Part II (Assessment) represents some of Goldfried's earliest work, and the behavioral emphases are most evident in this section. In it, he documents procedures for behavioral assessment, delineates between traditional and behavioral modes of assessment, and discusses the emergence of cognitive variables in cognitive-behavioral models. In Part III Goldfried develops the theme of facilitating client coping skills. In this chapter he uses language that is vaguely constructivist, as he reframes the teaching of coping skills as an active process by which clients are able to gain a new sense of perspective over stressful or problematic life situations. …