Psychotherapy Integration Research Articles

The Effectiveness of an Integrative Psychotherapy Program in Reducing the Symptoms of Borderline Personality Disorder

The Effectiveness of an Integrative Psychotherapy Program in Reducing the Symptoms of Borderline Personality Disorder

The Many Worlds of Trauma: An Interdisciplinary Perspective

The article presents a multidimensional analysis of trauma. The socio-physiological approach in the first part sets the stage for underlining the role of integrative psychotherapy in addressing traumatic wounds. Drawing from different fields, the study then provides Kazuo Ishiguro's psychoanalytic approach to understanding the relationship between trauma and human existence, with a particular focus on the interplay between memory, identity and chronic emotional disturbances. The study thus explores how fiction can serve as a therapeutic tool, giving voice to characters who either embark on healing journeys or try to conceal their unhealed wounds within self-contained worlds. Through existential parables, therapeutic fiction can delve into the psychological implications of traumas, offering the possibility of acceptance, or even healing, despite the immutable nature of the past. Ultimately, this interdisciplinary analysis aims to deepen one’s understanding of trauma's impact on individuals and society while it highlights the potential for healing and growth in real life through the worlds of fiction.

Promoting Meaning and Recovery for Psychosis: Comparison of Metacognitively-Oriented Psychotherapists and Clinicians in Psychiatric Rehabilitation.

Recovery from psychosis is an expected and desired outcome in psychiatric rehabilitation that may involve subjective outcomes related to personal recovery. While a considerable amount of qualitative research has examined patients' experience of recovery oriented approaches, there are less studies examining clinicians' perspectives. Examining the clinician point of view is important for both supporting clinicians within recovery-oriented practice, as well as for understanding underlying therapeutic processes. The aims of this study were to explore clinician experience of offering different psychiatric rehabilitation treatments for individuals with psychosis, and to understand similarities and differences of clinicians whose work differed in its recovery emphasis. Open-ended interviews were conducted with 10 psychotherapists providing Metacognitive Reflection and Insight Therapy (MERIT), a recovery oriented form of integrative psychotherapy focused on subjective aspects of recovery, and 10 clinicians providing standard psychiatric rehabilitation services. Thematic analysis revealed important similarities and differences between these two groups of providers. There were seven themes found for MERIT therapists: Comfort with uncertainty, Emphasis on collaboration, Being part of therapeutic change, Connecting with clients, Emphasis on patient autonomy, Experiencing growth, and Therapist use of self-awareness. There were four themes found for psychiatric rehabilitation clinicians: Value of a structured approach, Focus on a strengths-based approach, Witnessing behavioral change, and Building rapport to support the work. As expected, both similarities and differences arose between clinician groups. Results indicated that both groups focused on the therapeutic relationship and monitoring progress and outcomes. Unexpectedly, MERIT therapists reported growth as well as comfort with uncertainty. These findings suggest that MERIT is a a psychotherapy that offers unique opportunities for creative and flexible exploration of meaning and agency that is both challenging and rewarding for clinicians. Implications for supporting healthy clinician practice and the development of services are discussed.

EFFICACY OF INTEGRATIVE SELF-REFLECTION INTERVENTIONS ON THE SELF-COMPASSION OF ADULTS WITH SYMPTOMS OF DEPRESSION

Objective: The purpose of the research was to explore the impact of an integrated approach to self-reflections by combining the interventions from Naikan Therapy and Expressive Arts therapy on adults with symptoms of depression. It was hypothesized that after the successful completion of ten bi-weekly psychotherapeutic sessions over a period of 7 weeks (including pre and post assessment), participants would have increased levels of self-compassion compared to the pre-test levels. Research Design: The present research is a quasi-experimental research design. A total of eleven participants within the age range of 18-40 were included in the research using purposive sampling. Place and Duration of the Study: 1 year, at Bahria University, Karachi Campus Participants and Methods: Only participants who were experiencing symptoms of depression, between the age range of 18-40 and at least a 12th grade education level was included in the research. In addition to the Informed Consent Form, Demographic Information Form, Siddiqui Shah Scale of Depression (Siddiqui and Shah, 1997) and Self Compassion Scale (Neff, 2003) were used to assess the level of depressive symptoms and self-compassion of the participants before and after the intervention. Statistical Package for Social Science (SPSS) 22.0 was used for analysis and a paired sample t-test was conducted to see the differences between the pretest and posttest of the participants. Results: Results indicated a significant increase in the levels of self-compassion from pretest (M=57, SD=6.67) to posttest (M=102, SD=10.09) conditions; t (10) = -1.45, P<0.05. Conclusion: Integrative psychotherapies have been found to be effective in increasing awareness, improving self-awareness, improving mindfulness, and reducing self-critical thinking. Overall, these potential implications suggest that it may be an integrative form of therapy for individuals struggling with depression.

The Many Reasons Why Not to Commit Suicide: The Case of "Maggie"

This case describes the treatment of Maggie, a first-year college student dealing with depression, trauma, and suicidal thoughts and behaviors. It illustrates a conceptualization and practice that takes place within a guiding conception positioned in the "unification pathway" to psychotherapy integration. Specifically, I have developed a foundational, meta-theoretical "big picture," science-based "Unified Theory of Knowledge" (UTOK) that frames the work. It is a model of the evolution of energy, matter, mind, and culture within our universe’s history—that is, from the "big bang" to the multicultural, complex, human societies that dominate the earth today. Within the UTOK metapsychology (Henriques, 2022a), I have described where the discipline of psychology and the theory and practice of psychotherapy are positioned—allowing psychology and psychotherapy to be potentially grounded in a coherent naturalistic ontology that does not reduce to physicalism or overly rely on a natural science empirical epistemology. UTOK shows how we can retranslate the standard biopsychosocial model into a model that defines the layers of existence in terms of life (the realm of living organisms), mind (the realm of minded animals), and culture (the realm of human persons). It uses this new big picture framework to reframe and realign the key insights from the four major approaches to individual psychotherapy—behavioral, experiential/humanistic, psychodynamic, and cognitive—since each school of thought captures crucial aspects of human behavior and experience, both in its flourishing and its entrenchment in maladaptive patterns. Because of the scope and complexity of UTOK, it is not possible to fully summarize it in the pages allotted to it in a PCSP case study. Rather, in the psychotherapy case study of Maggie below, the reader is offered a basic outline of UTOK’s overall structure to provide a sense of what it is all about, together with plentiful references to learn more details about UTOK (e.g., Henriques, 2011, 2022a). This outline is then followed by psychotherapy-specific concepts and a central therapeutic technique—CALM-MO—that logically follow from UTOK and were central in Maggie’s treatment, which is then presented in detail and discussed.

The Practical Value of a Big-Picture, Metatheoretical, Unified Psychotherapy: Henriques' Unified Theory of Knowledge

This commentary begins with a brief overview of Henriques’ ambitious, meta-theoretical Unified Theory of Knowledge (UTOK), Character Adaptation Systems Theory (CAST), and his psychological mindfulness practice "CALM-MO." It also contextualizes these within the Unification Pathway to psychotherapy integration. It then proceeds to highlight key aspects of "The Case of Maggie," with particular attention to how Henriques both "zoomed out" to see the complex multidimensionality of Maggie, as well as "zoomed in" to attend to specific dysfunctional processes with specific interventions consistent with the UTOK. Among the many noteworthy aspects of this case, I highlight (1) the differential roles of cognitive approaches to thinking and reasoning in contrast to the roles of emotional experience and expression in the work of psychotherapy (corrective experiences in contrast to corrective emotional experiences); and (2) the question of the nature of changes in psychotherapy: whether they persist permanently and effortlessly, as some claim, or, in contrast, if they are more complex, non-linear, and dynamic.

Complexity science: A framework for psychotherapy integration

AbstractThe paradigm of complexity science provides a new way to address the problem of psychotherapy integration and allows us to bypass the various shortcomings of the linear‐interventionist perspective. Nine criteria are outlined, which should be satisfied by any integrative approach to psychotherapy: (a) the use of complexity science to provide a meta‐theoretical and generic understanding of change processes (from neuronal to social system levels); (b) a comprehensive and formalised modelling of change processes and personality development; (c) an integrative method of case formulation; (d) the ability to understand a variety of techniques in terms of basic change principles; (e) criteria to guide microdecisions; (f) the application of data‐driven feedback and real‐time monitoring of change dynamics; (g) standardised assessment of outcomes in naturalistic settings; (h) guidelines for training; and (i) strategies that are well‐suited to science–practice integration. Using these criteria as a framework for evaluation, one may grasp the potential of complexity science to drive innovation in the pursuit of psychotherapy integration.

“Will there be a willingness to actually engage with it?”: Exploring attitudes toward culturally integrative psychotherapy among Canada’s African community.

“Will there be a willingness to actually engage with it?”: Exploring attitudes toward culturally integrative psychotherapy among Canada’s African community.

The Conceptual Framework of Interpersonal Conflict as Integration of 7C Playfulness and Positive Psychotherapy.

This article presents the conceptual framework of interpersonal conflict as an integration of the concept of 7C playfulness and positive psychotherapy. The conflict is based on M. Smith’s three-component attitude structure. The interpersonal conflict as a dynamic process occurring between at least two interrelated parties (individuals and / or groups), is described by cognitions, which make up the sphere of controversy (cognitive component); emotions covered by three possible ways of processing the key conflict (emotional component); behavioral patterns of ludic positions in balance or in their polar manifestations (behavioral component).

Patient perspectives on working with preferences in psychotherapy: A consensual qualitative research study

Objective Assessing and accommodating patient preferences is integral to evidence-based practice. This qualitative study sought to explore patient perspectives and experiences of preference work in psychotherapy. Methods Participants were 13 UK-based patients who had completed up to 24 sessions of a collaborative–integrative psychotherapy. Ten participants identified as female and three as male. Interviews were conducted at endpoint and analyzed using a team-based, consensual qualitative research approach. Results Three superordinate domains were developed: Preferences Themselves, Process of Working with Preferences in Psychotherapy, and Effect of Preference Work (or its Absence). Patients typically wanted leadership, challenge, and input from their psychotherapist, and an affirming style. Patients attributed the origin of their preferences to personal history, characteristics, or circumstances; the present psychotherapy; or past episodes of psychotherapy. Some preferences changed over time. Preference work was described as having positive effects on the therapeutic relationship and patients’ intrapersonal worlds; however, variantly, non-accommodation of preferences was also experienced as beneficial. Conclusion Our findings provide in-depth answers to a range of novel questions on preference work—potential mechanisms by which preference work impacts outcomes, factors that may facilitate preference work, and origins of preferences—as well as nuancing previously-established quantitative findings. Implications for clinical training and practice are discussed.

The Healthy Adult in Schema Therapy: Using the Octopus Metaphor

This conceptual paper presents the Healthy Adult mode in Schema Therapy using the octopus metaphor. As a relatively new form of integrative psychotherapy, Schema Therapy has in recent times become increasingly popular among psychotherapists, as a preferred transdiagnostic treatment approach. Schema Therapy, however, is not free from theoretical criticisms and practical challenges. The aim of this article is twofold. First, to offer clients a simple, pictorial, creative, powerful, and memorable metaphor that they can use to develop and strengthen their Healthy Adult mode as a positive psychological intervention to achieve their goals. Second, to present a parsimonious, creative, and flexible model, aligned with the integrative psychotherapy tradition, for psychotherapists to blend into their own style and practice. Drawing on relevant theoretical and empirical findings, and taking a scientist-practitioner stance, this article unpacks the therapeutic factors and mechanisms of change embedded in the use of metaphor, and how they can be integrated into Schema Therapy. The article elucidates the psychological linkages between theory and practice, and highlights the corresponding outcomes and benefits for clients. Thereby, it contributes to the multiple nuances and versions of Schema Therapy and integrative psychotherapy.

Dialectical behavior therapy for justice-involved veterans: Changes in treatment targets in a small, pre-post design clinical trial.

[Correction Notice: An Erratum for this article was reported online in Psychological Services on Jul 13 2023 (see record 2023-89801-001). In the article, the title was incorrect and should have been "Dialectical Behavior Therapy for Justice-Involved Veterans: Changes in Treatment Targets in a Small, Pre-Post Design Clinical Trial." This error did not impact the results or conclusions. All versions of this article have been corrected.] Dialectical Behavior Therapy for Justice-Involved Veterans (DBT-J; Edwards, Dichiara, Epshteyn, et al., 2022) was recently developed as an integrative psychotherapy + case management intervention to address the range of complex criminogenic, mental health, substance use, and case management needs commonly faced by justice-involved veterans. Research to date suggests delivery of DBT-J to be both acceptable and feasible (Edwards, Dichiara, Epshteyn, et al., 2022). However, data on therapeutic change experienced by DBT-J participants has been limited. The present study represents an initial investigation into longitudinal changes in criminogenic risk, psychological distress, substance use, case management needs, and quality of life experienced by 20 justice-involved veterans across their course of DBT-J participation. Results reflected notable improvements across treatment targets from pre- to posttreatment; these gains were largely maintained at 1-month follow-up. Such findings attest to the potential utility of DBT-J and to the need for continued research into the efficacy of this intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Supplemental Material for “Will There Be a Willingness to Actually Engage With It?”: Exploring Attitudes Toward Culturally Integrative Psychotherapy Among Canada’s African Community

Supplemental Material for “Will There Be a Willingness to Actually Engage With It?”: Exploring Attitudes Toward Culturally Integrative Psychotherapy Among Canada’s African Community

Integrative Psychotherapy - An Important Resource for the Psychophysical Wellbeing of the Person in the 21st Century Society

The psychotherapist is an important specialist who makes a major contribution to ensuring the mental health of people in today’s society. Unfortunately, however, the psychotherapist is not correctly perceived, or he/she is even unknown to the collective mind, despite the fact that psychotherapy is a valuable resource in today’s social context loaded with a multitude of stressful and traumatic factors. Integrative psychotherapy, one of the newest forms of psychotherapy, responds effectively to the challenges of today’s society in an integrated way, focusing on the relationship between the therapist and the patient. The integrative psychotherapist is the specialist who, through prevention, diagnosis and intervention, guides the person towards the balance that ensures mental health. The research carried out on a panel of students confirms that the image of the psychotherapist is not known or is perceived in a distorted way, even by a public with a certain level of intellectual background. The integrative psychotherapists involved in the research also highlight that psychotherapy is an important resource in enhancing quality of life, but it is little known and not valued. Therefore, there is a need to promote the image of the psychotherapist at the level of the collective mind, the need for an education to promote mental health, an education that focuses not only on physical health but also on mental health, an education that leads to the psycho-physical well-being of the person.

Wybrane zagadnienia związane z zaburzeniami zdrowia psychicznego i seksualnego w medycynie rodzinnej na przykładzie zespołu Gansera

In the family doctor's practice, there are patients with mood disorders (depressive episodes), neurotic disorders (hypochondriac disorders, generalized and mixed anxiety disorders) and insomnia as well as with comorbidities (e.g. asthma, diabetes, heart disease, Alzheimer's disease). Each case in the diagnostic and treatment process requires the cooperation of a family doctor with a psychiatrist. The aspects of psychotherapy are also important; used in patients with mood and neurotic disorders: cognitive-behavioral and integrative psychotherapy. A difficult example of such a problem is Ganser's syndrome, which is also known as pseudo-dementia. It is considered a manifestation of dissociative disorders. Affected patients may show complete amnesia. These patients may also be unable to perform the simplest tasks. There are suggestions that the Ganser syndrome may be an attempt at simulation in a particularly difficult life situation. Symptoms of Ganser syndrome include sudden problems with carrying out everyday activities or answering the simplest questions.

“Am I Going to Die?”: Delivering Serious News to Patients With Liver Disease

“Am I Going to Die?”: Delivering Serious News to Patients With Liver Disease

Physiological indicators of emotional arousal related to ANS activity in response to associative cards for psychotherapeutic PTSD treatment.

SEE FAR CBT is an integrative treatment protocol for PTSD and anxiety disorders which combines CBT, body-mind (somatic experience) and imagery-based (fantastic reality; FR) methods. FR is introduced using associative therapeutic cards (COPE cards) to represent both "a pleasant/safe place" and the re-narrating process of the traumatic story. Although some preliminary evidence exists regarding the impact of COPE cards integration in psychotherapy, further validation is needed as to whether these cards can induce distinct arousal-affective states in the observer. The aim of this study was to examine whether exposure to COPE cards evoke different emotional-psychophysiological states using objective physiological measures reflecting autonomic nervous system responses; hence, to further validate its use as a potentially effective tool within the context of SEE FAR CBT therapeutic process. Ninety-five healthy under-graduate participants were first exposed to high-arousal, negatively-valenced cards and asked to put themselves in a state of emotional/physical arousal. Afterwards, they were exposed to low-arousal, positively-valenced cards and were asked to try to calm and relax to the best of their ability. Heart rate, blood pressure and heart rate variability (HRV) were measured at baseline, at the arousal phase and finally at the relaxation phase. It was found that exposure to arousing negative cards resulted in significant increase in blood pressure and a decrease in HRV, while exposure to relaxing positive cards resulted in significant decrease in blood pressure and an increase in HRV. These findings support the efficacy and utility of associative COPE cards in affecting psychophysiological arousal.

Religious Psychotherapy for Depressive and Anxiety Disorder: A Systematic Review

This study aims to determine the effect of religious accommodation on psychotherapy in anxiety and depression disorders. This review systematically examines clinical trials of the integration of religion and psychotherapy for treating patients with depression or anxiety. The results of the studies review shown that psychotherapy using religious alternatives effective for treating depression and anxiety as other types of psychotherapy. Integrating religion into psychotherapy has shown a variety of results. But some studies shown that religious can support mental illness, and prayer can be alternative to meditation in psychotherapy. Religion and psychotherapy can affect anxiety, depression, suicide, and bipolar in the psychotherapy practice. Religion and psychotherapy can build self-control in people, and religion and psychotherapy can drive people to their well-being. But in the studies shown that in the practice of psychotherapy, the use of religion and spirituality as alternatives to meditation is still separated. This results in many variations of results in studies of religion and spirituality in psychotherapy practice.

Incommensurability: an obstacle to the integration of psychotherapy and spirituality. the desert fathers as an overcoming epistemological paradigm

In recent years, the body of literature that deals with trying different ways of integrating spirituality into psychotherapeutic practice has grown exponentially. Probably the interest in this topic has arisen with regard to the inclusion in the DSM-IV of the new category "Religious or Spiritual Problem" (Code V62.89). Until then, religious or spiritual issues had been viewed in the clinical practice as symptoms of some mental illnesses like, for example, the delusions with religious content typical of schizophrenics. But with the fourth edition of the aforementioned manual, there began to be an interest in the study of spirituality as it expresses a fundamental aspect of personality. In this vein, various models of integration of spirituality and psychotherapy have been formulated. Our intention is to study the problem of incommensurability as one of the epistemological and methodological problems that supposes a project of this type. We present the writings of the Desert Fathers as an explanatory model that guarantees an epistemologically legitimate integration of spiritual traditions with psychotherapeutic practice. And for that reason, we argue that their writings could constitute a way to overcome the relationship of mutual incommensurability that apparently exists between scientific rationality and spirituality.

Client preference accommodation for religious/spiritual integration and psychotherapy outcomes in naturalistic practice settings.

The purpose of this practice-research network study was to examine client preferences for religious/spiritual (R/S) integration and test whether preference accommodation in this area is linked to positive treatment outcomes (i.e., less dropout and greater client change). Thirteen independent practice psychotherapists and their 175 clients completed measures of R/S integration preferences and use of R/S techniques and approaches throughout treatment. Psychotherapists also completed an assessment of treatment dropout and change for each participating client. Overall, participating clients expressed moderate preferences for R/S integration, time spent on R/S topics, and an R/S match with their psychotherapists. Preferences in each of these 3 areas were stronger for R/S identifying clients (compared with non-R/S clients) and when clients believed that R/S integration was more essential to produce positive treatment outcomes. Both client R/S identification and client R/S integration preferences predicted psychotherapist's use of R/S techniques in treatment sessions. Importantly, clients' ratings of R/S preference accommodation significantly predicted psychotherapists' ratings of client treatment completion and client change. Specifically, with each unit increase on a 5-point measure of client perceptions of R/S preference accommodation, clients were 1.63 times more likely to be rated as treatment completers and 1.83 times more likely to be identified as having improved while in treatment. Implications for R/S integration in psychotherapy and future research directions are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).