Assimilative Integration Research Articles

SPECIAL ISSUE: The ACT of Biofeedback—Training for Psychological Flexibility

This paper examines the innovative integration of acceptance and commitment therapy (ACT) principles with biofeedback methodologies, presenting a novel approach to psychophysiological therapy. This paper uses Kevin Polk’s structured ACT matrix approach to elucidate how biofeedback can augment ACT processes, including acceptance, cognitive defusion, and present-moment awareness. The paper explicates practical techniques such as the “Hook Words Exercise” and “Verbal Aikido,” demonstrating their application within a biofeedback-enhanced therapeutic context. This integrative approach represents a significant advancement in psychophysiological interventions, offering a comprehensive framework for deepening interoceptive awareness and fostering psychological flexibility and value-aligned living while bridging the gap between cognitive processes and physiological responses. By exemplifying assimilative integration in psychotherapy, this approach offers a promising avenue for advancing both clinical practice and research in psychophysiological interventions, potentially improving therapeutic outcomes and client engagement.

Bolstering family therapy: Assimilating EMDR into ABFT in youth residential treatment.

The psychotherapy field has a long history of integration to improve treatment effectiveness. One type, assimilative integration, offers innovative opportunities to family therapy to incorporate the clinical and research contributions of different approaches. This paper contributes to the literature on integration by exploring how Eye Movement Desensitization and Reprocessing (EMDR) can be assimilated into Attachment-Based Family Therapy (ABFT) for youth in residential psychiatric treatment. ABFT seeks to improve attachment security to parental figures by asking adolescents and young adults to discuss attachment ruptures. This process, specially designed for patients with internalizing disorders, can provoke anxiety, particularly for a patient population that commonly has a history of trauma and adverse life experiences. EMDR is a first-line therapy for post-traumatic stress disorder and has the potential to be effective in treating various other mental health conditions. When patient emotional withdrawal or dysregulation due to breaches in trust between child and parent emerges in ABFT, EMDR may help desensitize associated memories and bolster the family therapy process. The authors provide an overview of both models, and a detailed case study as an example. The paper concludes with a discussion on implications, integration efforts, and limitations.

Needs, Modes, and Stances: Three Cardinal Questions for Psychotherapy Practice and Training.

Advances in motivational science (Dweck, 2017), personality dynamics (Lazarus & Rafaeli, 2023), and process-based psychotherapy (Hofmann & Hayes, 2019) converge into a pragmatic, integrative, and transtheoretical model of practice and training. The model comprises three elements: a formulation centered on clients' psychological needs which provides guidance regarding the goals and processes most profitable to pursue; a recognition that such pursuit frequently requires contending with a multiplicity of clients' internal self-states (i.e., modes); and an enumeration of pragmatic therapeutic stances likely to help address clients' need-related goals in light of their modes. We distill these elements into three cardinal questions: What needs does this client have that are not currently met, and what are the most profitable ways of remedying that frustration? What mode or modes does this client manifest - both generally and at this very moment? and What stance should I adopt in response to the client's current mode? We suggest that clinicians should be trained to continually pose these questions and seek to answer them collaboratively with their clients. This model - illustrated here using schema therapy terms - offers a process-based approach which serves as a theoretically integrative starting point but is general enough to provide an assimilative integration roadmap for therapists anchored in most primary orientations. Integrative or assimilative therapists trained to attend to needs, modes, and stances are likely to be (and be perceived as) particularly responsive, and thus, to enact "common factor" practices known to be conducive to therapeutic alliance and gains.

Refining the Experiential Component of Schema Therapy for Traumatised Populations: a New Continuum of Experiential Techniques

The schema therapy model is a potential new viable alternative for trauma-focused psychotherapy. This is because it employed a series of integrative and experiential techniques to resolve the unconscious impacts of past traumatic experiences. Additionally, its unique concepts of Early Maladaptive Schemas (EMS) and Schema Modes provided a new explanation for understanding trauma impacts. However, as schema therapy was not designed for trauma work, it does have certain limitations in its techniques, especially in its experiential component. In this theoretical paper, the identified limitations of the experiential techniques in schema therapy were addressed through assimilative integrating art therapy, dream-work and psychodynamic techniques. A new continuum of experiential techniques was created and integrated into schema therapy. This newly integrated schema therapy was named ‘trauma-focused schema therapy’ (Tf-ST). The six steps of assimilative integration were illustrated.

Maximizing Exposure's Benefit: Making it Possible, Bearable and Fruitful

Exposure is hypothesized to be a key active ingredient in several approaches to psychotherapy. Dr. Irada Yunusova (2023) explores this as a common element in both Accelerated Experiential Dynamic Psychotherapy (AEDP) and behavioral exposure therapy. The current commentary elaborates on other important factors that contribute to maximizing the effectiveness of interventions in both these models. These include titrating the level of challenge, memory consolidation, common factors, and neuroplasticity. Dr. Yunusova’s detailed case review is an example of assimilative integration, where one can see her incorporation of a model new to her (AEDP) into her home base of Behavior Therapy, as well as the factors noted above that enhance its effectiveness.

Perceived Assimilative Integration Approach in Assessment Indicator Practices of Enhancing the Soft Skills of Students in a New Normal

In every educational intent, a student's soft skills and the teacher's approach are equally crucial. This is particularly relevant in a school context. Soft skills are crucial and will be necessary for success in the information systems industry. The purpose of this study was to ascertain whether the Assimilative Integration Approach?self-regulation, self-validation, and self-enhancement?have any bearing on improving the soft skills of LSPU-SPCC students including interpersonal, collaborative, communication, and critical-thinking abilities. The study used the descriptive-correlational research methodology. 228 undergraduates from the university's colleges, ranging from the first year to the fourth year, participated in this survey as respondents. The survey's items were adapted and modified from research and writings by Martin, S. (2022); Half, R. (2022); and Worksheets on Self-Regulation in the Classroom. The independent and dependent variable questionnaire was provided via Google Forms and sent through email. Tests of significance and descriptive statistics were employed by the researchers. The statistical tools employed in this study were frequency, percentage, weighted mean, and Pearson's r correlation coefficient. Cronbach alpha was utilized to establish the instrument's validity. The results showed that the assimilative integration strategy is well regarded by the respondents in terms of self-validation, self-regulation, and self-enhancement. The respondents have an affirmative impression of Self-validation, Self-Regulation, and Self-Enhancement on the Assessment indicator practices in Interpersonal Skills, Collaborative Skills, Communication Skills, and Critical Thinking Skills. This study identified the strengths and weaknesses of both the teachers and the students.

How do novice therapists manage the process of assimilative integration? A qualitative interview study about the application of implicit heuristics.

How do novice therapists manage the process of assimilative integration? A qualitative interview study about the application of implicit heuristics.

Supplemental Material for How Do Novice Therapists Manage the Process of Assimilative Integration? A Qualitative Interview Study About the Application of Implicit Heuristics

Supplemental Material for How Do Novice Therapists Manage the Process of Assimilative Integration? A Qualitative Interview Study About the Application of Implicit Heuristics

Psikolojik Danışma ve Psikoterapide Bütünleşmeye Doğru

İnsanlık tarihinde her toplumda ruhsal sıkıntıları hafifletme görevi üstlenen kişiler olmuştur ancak bu eylemin resmen psikoterapistlere ait olması yaklaşık olarak yüz yıl öncesine dayanır. Zaman içerisinde pek çok psikolojik danışma ve psikoterapi kuramı ortaya çıkmıştır. Günümüzde ise 400’ün üzerinde psikoterapi sistemi olduğu bilinmekte ve her geçen gün bu sayı artmaktadır. Psikoterapilerin sayısının artışı, bütün danışan ve sorunlara tek bir kuramla yaklaşmanın yetersiz kalması ve terapötik ortak etkenlerin terapi sonucuna önemli katkıları olduğunun fark edilmesi gibi nedenlerle son dönemde psikoterapi kuramları arasındaki benzerlikleri bulma ve bütünleşmeye gitme anlayışı hız kazanmıştır. Psikoterapilerin bütünleşmesi ile ilgili pek çok yol bulunmaktadır. Bütünleşmede en popüler dört yol teknik eklektisizm, kuramsal bütünleşme, ortak faktörler ve özümseyici bütünleşmedir. Teknik eklektisizm, belli bir kurama bağlı kalmaksızın farklı yaklaşımların tekniklerini kullanmayı içerir. Kuramsal bütünleşme, iki veya daha fazla psikoterapi kuram ve tekniklerini yeni bir kavramsallaştırma veya terapi yaklaşımına dönüştürmek üzere bütünleştirmektir. Ortak faktörler yaklaşımı, farklı terapilerin paylaştığı temel bileşenleri belirlemeyi ve ortaklıklarına dayanarak daha etkili terapiler yaratmayı hedeflemektedir. Özümseyici bütünleşme ise, diğer yönelimlerin teknik ve ilkelerini bütünleştirirken temel bir kuramsal oryantasyona bağlı kalmayı tercih eder. Bütünleşme çabaları psikoterapide ortak bir dil oluşturma, bölünme ve parçalanmanın önüne geçme, yeni marka isimleri yaratmaktansa psikoterapide etkililiği ön plana alma açısından önem arz etmektedir. Bu arada, bütünleşme çabalarının yeni psikoterapi formları üretmesi istenmeyen bir sonuçtur. Bütünleşme çabalarının esas amacının farklılıklar içindeki benzerliği bulmak olduğu unutulmamalıdır.

Bayesian Approach to Psychotherapy Integration: Strategic Modification of Priors.

Integrative psychotherapies have become the mainstay in mental health care. The most researched therapy, CBT, being integrative itself, continues to integrate such new elements as mindfulness, spirituality, and experiential techniques. There is no commonly accepted strategy for psychotherapy integration. New elements are sometimes added on a trial and error basis with a following post-hoc theoretical and empirical justification. Other times, they are incorporated based on an ad-hoc theoretical premise, and empirical studies follow to support or invalidate it. Nevertheless, four main integrative strategies have been identified as technical eclecticism, common factors integration, principle-based assimilative integration, and theoretical integration (Norcross, 2005). Strategies outside of these four have also been suggested. Recently, a principle of nested hierarchy has been proposed as a way of integrating different strategies into a general roadmap for building an integrative therapy (Krupnik, 2018). The nested hierarchy principle does not, however, offer a strategy for theoretical integration at the top of its hierarchy. In this report, I suggest using the Bayesian theory of psychopathology for such strategy. I propose to apply Bayesian framework to psychotherapy integration and discuss a possibility of using it as a universal strategy called Strategic Modification of Priors (SMOP). I illustrate SMOP's application with a synopsis of a clinical case.

A randomized-controlled trial of cognitive–behavioral therapy for depression with integrated techniques from emotion-focused and exposure therapies

ABSTRACTBackground: Emotional processing (EP) is hypothesized to be a key mechanism of change in psychotherapy that may enhance its long-term efficacy. To study the effects of fostering EP in psychotherapy for depression, this randomized-controlled clinical trial compares the efficacy and pattern of change of a cognitive–behavioral therapy that integrates emotion-focused techniques within an exposure framework (Exposure-Based Cognitive Therapy for depression; EBCT-R) to a standard cognitive–behavioral therapy (CBT). Methods: One hundred and forty-nine depressed outpatients were randomized to a maximum of 22 sessions of manualized EBCT-R (N = 77) or CBT (N = 72). Primary outcomes were self-reported and clinician-rated depressive symptoms at posttreatment and 12-month follow-up. Secondary outcomes were self-esteem, interpersonal problems, and avoidance thoughts and behaviors. Results: Depressive symptoms improved significantly over therapy in both treatments, with large within-group effect sizes for CBT (d = −1.95) and EBCT-R (d = −1.77). The pattern of depression change during treatment did not differ between treatments. Symptom relief lasted over 12 months and did not differ between EBCT-R and CBT. Conclusions: Results suggest that both treatments produced significant short- and long-term improvement in depression symptoms, but the integration of emotion-focused techniques within an exposure framework did not have added benefit.Trial registration: ClinicalTrials.gov Identifier: NCT01012856Clinical or methodological significance of this article: This trial compares cognitive–behavioral therapy (CBT) with a similarly structured CBT that was designed to foster emotional processing by integrating emotion-focused techniques within an exposure framework. Results indicate that this form of assimilative integration did not improve outcomes at 12-month follow-up.

El Modelo de Asimilación como un Modelo Integrador sobre el Cambio Terapéutico


 
 
 Este trabajo se centra en el modelo de asimilación de experiencias problemáticas. Dicho modelo es un modelo de corte integrador que nos permite estudiar el proceso de cambio en cualquier enfoque terapéutico y con diversos tipos de pacientes y sujetos. Por ello, expondremos, en primer lugar, los principales conceptos y características del modelo, como por ejemplo, qué significa asimilar, el concepto de voz y de voz no dominante y voz dominante, junto con la descripción de la Escala de Asimilación de Experiencias Problemáticas. A continuación, se describirán los resultados más destacados alcanzados en tres áreas principales: el estudio del proceso de cambio en pacientes; el proceso irregular y dentado de asimilación y el papel que tiene el terapeuta en dicho proceso. Esta última cuestión se relaciona con el concepto de responsividad y con el concepto de integración asimilativa.
 
 

How to Work With Middle-Aged Siblings: Integration of Narrative-Behavioral Approaches in Family Therapy

ABSTRACTMiddle-aged siblings’ concerns are rarely addressed in psychotherapy literature. Siblings without their own families of procreation are quite common in many Asian cultures. Therapists’ challenges for such shrinking systems can be approached with assimilative integration. A dominant narrative therapy foundation that absorbs behavioral strategies can be a relevant style of addressing problems faced by siblings. The narrative frame helps with individual as well as family related incongruent stories, whereas the behavioral frame creates a sense of mastery over the current interactions that can in-turn consolidate new meaning about family life. Using a case illustration, we propose the use of a narrative-behavioral approach in family therapy with 2 siblings who have to create a meaningful family life together.

The systematic use of homework in psychodynamic-interpersonal psychotherapy for depression: An assimilative integration approach.

The systematic use of homework in psychodynamic-interpersonal psychotherapy for depression: An assimilative integration approach.

Psychotherapy integration under scrutiny: investigating the impact of integrating emotion-focused components into a CBT-based approach: a study protocol of a randomized controlled trial.

BackgroundThis currently recruiting randomized controlled trial investigates the effects of integrating components of Emotion-Focused Therapy (EFT) into Psychological Therapy (PT), an integrative form of cognitive-behavioral therapy in a manner that is directly mirroring common integrative practice in the sense of assimilative integration. Aims of the study are to understand how both, an existing therapy approach as well as the elements to be integrated, are affected by the integration and to clarify the role of emotional processing as a mediator of therapy outcome.MethodsA total of 130 adults with a diagnosed unipolar depressive, anxiety or adjustment disorder (seeking treatment at a psychotherapy outpatient clinic) are randomized to either treatment as usual (PT) with integrated emotion-focused components (TAU + EFT) or PT (TAU). Primary outcome variables are psychopathology and symptom severity at the end of therapy and at follow up; secondary outcome variables are interpersonal problems, psychological wellbeing, quality of life, attainment of individual therapy goals, and emotional competency. Furthermore, process variables such as the quality of the therapeutic relationship are studied as well as aptitude-treatment interactions. Variables are assessed at baseline, after 8 and 16 sessions, at the end of therapy, after 25 ± 3 sessions, and at 6, 12 and 36 month follow-up. Underlying mechanisms of change are investigated. Statistical analyses will be conducted using the appropriate multilevel approaches, mainly two-level regression and growth analysis.DiscussionThe results of this study will indicate whether the integration of emotion-focused elements into treatment as usual increases the effectiveness of Psychological Therapy. If advantages are found, which may be limited to particular variables or subgroups of patients, recommendations for a systematic integration, and caveats if also disadvantages are detected, can be formulated. On a more abstract level, a cognitive behavioral (represented by PT) and humanistic/experiential (represented by EFT) approach will be integrated. It must be emphasized that mimicking common practice in the development and continued education of psychotherapists, EFT is not integrated as a whole, but only elements of EFT that are considered particularly important, and can be trained in an 8-day training plus supervision of therapies.Trial registrationClinicalTrials.gov, NCT02822443, 22 June 2016, retrospectively registered

How I Have Changed Over Time as a Psychotherapist.

Reflecting on my career as a psychotherapist has led me to consider 3 major areas that have affected the way I practice, namely, assimilative integration, the visions of reality, and brief psychodynamic therapy. Although starting out as a traditional psychoanalytic therapist, I became more integrative as I was exposed to other approaches and to patients with a variety of needs. As a result I developed a mode of integration, which I call assimilative. After applying the literary genres of tragedy, comedy, romance, and irony to psychoanalytic, behavioral, and humanistic psychotherapies, I found that they also could be used to describe any patient's multiple facets and psychological challenges. I demonstrate here how such visions helped in the treatment of a case of bipolar disorder. Upon recognizing the need for briefer forms of treatment, I developed an interest in conducting, conceptualizing, and researching brief psychodynamic therapy. I conclude the article by answering questions posed by the editors regarding how I have changed over time in conducting psychotherapy.

Integrating Motivational Interviewing and Brief Behavioral Activation Therapy: Theoretical and Practical Considerations

Behavioral Activation and specifically the Brief Behavioral Activation Therapy for Depression (BATD) has a strong record of empirical support but its focus on practical out-of-session activation-based assignments can lead to poor levels of adherence if efforts to enhance motivation are not prioritized. Towards this end, this paper describes the assimilative integration of Motivational Interviewing (MI) and BATD to improve clinical outcomes by integrating MI’s focus on building and maintaining motivation to change into BATD. The paper provides an overview of MI and BATD, theoretical issue raised in integrating the two approaches, and examples of how this integration results in a nondirective and motivation-focused approach to conducting BATD.

Research on psychotherapy integration: Building on the past, looking to the future

Integration has become an important and influential movement within psychotherapy practice, reflected by the fact that many treatment providers now identify as integrative. However, integration has not had as great an influence on psychotherapy research. The goal of this paper is to highlight the growing body of research on psychotherapy integration, and to identify future directions for research that may strengthen the integration movement as well as the field of psychotherapy as a whole. We first summarize the past 25 years of research on integration, with a focus on four approaches to integration: theoretical integration, technical eclectic, common factors, and assimilative integration. Next, we identify directions of research within these four areas that could strengthen and support integrative practice. We then propose ways in which the perspective of integrationists could contribute to psychotherapy research in the critical areas of harmful effects, therapist effects, practice-oriented research, and training. We end this paper by suggesting that a greater collaboration between integrationists and psychotherapy researchers will help to create a unified landscape of knowledge and action that will benefit all participants and advance the field.

From No Name Woman to Birth of Integrated Identity: Trauma-Based Cultural Dissociation in Immigrant Women and Creative Integration

This paper explores the challenges in integration of ethnic identity among a certain segment of immigrant women who have experienced sexism related traumas in their culture of origin. Unlike other immigrant women who may come from a nontraumatic, average expectable environment of their culture of origin into American culture, these women’s assimilative experiences and integration of identity are more complicated by the fact that their ethnic identity is tied to trauma. These women may find a refuge in the American culture, while defensively dissociating from their culture of origin, disavowing ethnic ties, severing contact with family, or avoiding contact with people from the same ethnic group. Their avoidance of their culture of origin amounts to cultural dissociation. Cultural dissociation is hard to detect and work with because cultural phenomenon in general is a blind spot for most American psychoanalysts. I contend that in order to successfully engage dissociated cultural states, a therapist’s ability to self reflect on her cultural situatedness is crucial. The creative challenge of the analyst-patient dyad is to disentangle the patient’s particular traumatic experiences from nontraumatizing normative aspects of the culture of origin in order to promote a viable ethnic identity.

Soft skills assessment: theory development and the research agenda

Soft skills have become a subject of increasing interest in lifelong learning. Soft skills development is intended to enable and enhance personal development, participation in learning and success in employment. The assessment of soft skill is therefore widely practised, but there is little in the way of research or evidence on how well this assessment is done. Critically reviewing soft skills assessment requires both theory development and establishing a research agenda. Theory development can draw on a number of established theories which help to explain how the cognitive, emotional and social dimensions interact to shape learner behaviour around getting feedback. These include control theory, goal theory and attribution theory. Theory development following an assimilative integration approach based on attribution theory, which combines both ‘self-regulation’ and ‘socially situated’ aspects, is suggested as the most fruitful. Three areas of research can be associated with this; researching the context, the content and the consequences of soft skill assessment. The challenges of this research agenda are outlined and explored. Dealing with these challenges will enable a more robust and critical review of the assessment of soft skill, and the impact of that on both life chances and employment opportunities.