Integrative Multitheoretical Psychotherapy

by Brooks-Harris, Jeff E.

• ISBN13: 9780618253227
• ISBN10: 061825322X
• Edition: 1st
• Format: Paperback
• Copyright: 2007-03-30
• Publisher: Wadsworth Publishing

Summary

When psychotherapists survey the complex theoretical landscape before them, they face a puzzling dilemma: should they choose a single theory as a guide or try to learn concepts and strategies from multiple theories and combine them in practice? Whereas most counseling theory texts assume that psychotherapists in training will choose a single theory, this text is offered as a guidebook for those who decide to explore diverse theoretical terrain rather than follow a narrow path through the wilderness. This book introduces a new integrative approach called Multitheoretical Psychotherapy (MTP). Over the last five years, MTP has been used in the training of practicum counselors and psychology interns at a university counseling center. My colleagues and I have articulated MTP as a user-friendly approach to combining ideas and skills from seven psychotherapy theories, based on the needs of individual clients. I hope this approach will prove useful for a broad audience of graduate students and professionals from diverse academic fields including psychology, counseling, social work, psychiatry, nursing, and marriage and family therapy.

Table of Contents

Preface	p. xv
A New Approach to Psychotherapy Integration	p. 1
Introduction to Psychotherapy and Integration	p. 2
Chapter Overview	p. 2
What Is Psychotherapy?	p. 3
A Brief History of Psychotherapy	p. 4
Three Contrasting Theories	p. 5
Evolution Away from Extremes	p. 8
Complexity Arising from Diverse Theories	p. 13
A Multitheoretical Framework for Psychotherapy	p. 18
What Is Psychotherapy Integration?	p. 18
A Brief History of Psychotherapy Integration	p. 20
Diverse Routes to Integration	p. 23
Common Factors	p. 24
Technical Eclecticism	p. 26
Theoretical Synthesis	p. 28
Multitheoretical Frameworks	p. 30
Assimilative Integration	p. 32
Thematic Models	p. 34
Helping Skills	p. 35
Personal Integration	p. 36
Where Does MTP Fit?	p. 37
Chapter Summary	p. 38
Five Principles for Psychotherapy integration	p. 40
Chapter Overview	p. 40
Philosophical Foundations of Multitheoretical Psychotherapy	p. 40
Intentional Integration	p. 42
What Is Intentionality?	p. 43
What Is Intentional Integration?	p. 43
Intuitive, Intentional, and Technical Integration	p. 44
Other Integrative Approaches	p. 46
Future Research	p. 46
Multidimensional Integration	p. 47
Multidimensional Model of Human Functioning	p. 48
Multidimensional Intentionality	p. 49
Other Integrative Approaches	p. 50
Future Research	p. 50
Multitheoretical Integration	p. 51
Multitheoretical Framework for Psychotherapy	p. 51
Combining Theories	p. 53
Multitheoretical Intentionality	p. 54
Other Integrative Approaches	p. 55
Future Research	p. 56
Strategy-Based Integration	p. 57
Catalog of Key Strategies	p. 57
Levels of Complexity	p. 58
Combining Strategies	p. 59
Strategy-Based Intentionality	p. 60
Other Integrative Approaches	p. 61
Future Research	p. 61
Relational Integration	p. 62
Collaborative Empiricism	p. 63
Social Reinforcement	p. 64
Empathic Attunement	p. 64
Health Promotion	p. 64
Participant-Observation	p. 65
Social Choreography	p. 65
Cultural Consultation	p. 65
Relational Intentionality	p. 66
Other Integrative Approaches	p. 66
Future Research	p. 67
Chapter Summary	p. 67
Multidimensional Adaptation and Integrative Treatment Planning	p. 70
Chapter Overview	p. 70
Multidimensional Model of Human Functioning	p. 70
Concurrent Dimensions	p. 71
Contextual Dimensions	p. 73
What Dimensions Have Been Left Out?	p. 77
Multidimensional Thinking	p. 80
Multidimensional Adaptation	p. 80
Concurrent Adaptation	p. 83
Working Interactively with Thoughts, Actions, and Feelings in Psychotherapy	p. 84
Biopsychosocial Adaptation	p. 86
Psychodynamic-Interpersonal Adaptation	p. 87
Systemic-Constructivist Adaptation	p. 88
Multicultural Adaptation	p. 90
Working Interactively with Contextual and Concurrent Dimensions in Psychotherapy	p. 91
Summary of Multidimensional Adaptation	p. 93
Integrative Treatment Planning	p. 94
Watching for Multidimensional Focus Markers	p. 94
Conducting a Multidimensional Survey	p. 95
Establishing an Interactive Focus on Two or Three Dimensions	p. 98
Formulating a Multitheoretical Conceptualization	p. 100
Choosing Intervention Strategies Corresponding to Focal Dimensions	p. 102
Ongoing Psychotherapy	p. 103
Chapter Summary	p. 103
Key Strategies: Translating Psychotherapy Theories Into Practical Skills	p. 105
Cognitive Psychotherapy: Encouraging Functional Thoughts	p. 106
Introduction to Cognitive Psychotherapy	p. 106
Historical Context	p. 106
Cognitive Adaptation	p. 107
Cognitive Conceptualization	p. 107
Case Examples of Cognitive Conceptualization	p. 109
Cognitive Strategies	p. 111
Identifying Thoughts	p. 112
Clarifying the Impact of correction Thoughts	p. 114
Challenging Irrational Thoughts	p. 116
Illuminating Core Beliefs	p. 119
Evaluating Evidence	p. 122
Testing Hypotheses	p. 124
Modifying Beliefs	p. 127
Reinforcing Adaptive Cognitions	p. 129
Encouraging Accurate Perceptions	p. 132
Supporting Dialectical Thinking	p. 134
Fostering Mindful Awareness	p. 137
Working with Imagery	p. 140
Brainstorming Solutions	p. 142
Providing Psychoeducation	p. 144
Supporting Bibliotherapy	p. 147
Chapter Summary	p. 149
Behavioral Psychotherapy: Choosing Effective Actions	p. 151
Introduction to Behavioral Psychotherapy	p. 151
Historical Context	p. 151
Behavioral Adaptation	p. 152
Behavioral Conceptualization	p. 153
Case Examples of Behavioral Conceptualization	p. 155
Behavioral Strategies	p. 157
Clarifying the Impact of Actions	p. 158
Illuminating Reinforcement and Conditioning	p. 160
Identifying Target Actions	p. 163
Determining Baselines	p. 165
Encouraging Active Choices	p. 168
Assessing Stages of Change	p. 170
Establishing Schedules of Reinforcement	p. 173
Prescribing Actions	p. 175
Constructing a Hierarchy	p. 177
Exposing Clients to Images or Experiences	p. 179
Fostering Acceptance	p. 182
Encouraging Commitments	p. 185
Providing Training and Rehearsal	p. 188
Coaching and Shaping	p. 190
Chapter Summary	p. 193
Experiential-Humanistic Psychotherapy: Exploring Feelings and Personal Experiences	p. 195
Introduction to Experiential-Humanistic Psychotherapy	p. 195
Historical Context	p. 195
Experiential Adaptation	p. 196
Experiential Conceptualization	p. 196
Case Examples of Experiential Conceptualization	p. 200
Experiential Strategies	p. 201
Identifying Feelings	p. 201
Clarifying the Impact of Feelings	p. 204
Encouraging Expression of Feelings	p. 206
Fostering Self-Actualization	p. 208
Communicating Empathy and Positive Regard	p. 210
Supporting Authenticity	p. 212
Integrating Parts of Self	p. 215
Focusing Attention	p. 218
Fostering Here-and-Now Awareness	p. 220
Creating Experiments	p. 223
Accepting Freedom and Responsibility	p. 226
Recognizing Existential Limitations	p. 228
Chapter Summary	p. 230
Biopsychosocial Psychotherapy: Connecting Body and Brain	p. 232
Introduction to Biopsychosocial Psychotherapy	p. 232
Historical Context	p. 232
Biopsychosocial Adaptation	p. 234
Biopsychosocial Conceptualization	p. 234
Case Examples of Biopsychosocial Conceptualization	p. 238
Biopsychosocial Strategies	p. 239
Exploring the Effect of Biology on Psychological Functioning	p. 240
Recognizing the Influence of Psychological Functioning on Health	p. 243
Considering the Interaction between Health and Relationships	p. 245
Understanding Health within a Sociocultural Context	p. 248
Encouraging Physical Wellness	p. 251
Reducing Substance Use	p. 253
Teaching Relaxation	p. 256
Fostering Physiological Awareness	p. 258
Working Interactively with Body and Brain	p. 261
Facilitating Acceptance of Illness	p. 264
Encouraging an Active Role in Health Care	p. 267
Considering Psychotropic Medication	p. 269
Considering Alternative Interventions	p. 272
Chapter Summary	p. 275
Psychodynamic-Interpersonal Psychotherapy: Modifying Interpersonal Patterns	p. 277
Introduction to Psychodynamic-Interpersonal Psychotherapy	p. 277
Historical Context	p. 277
Psychodynamic-Interpersonal Adaptation	p. 278
Psychodynamic Conceptualization	p. 279
Case Examples of Psychodynamic Conceptualization	p. 281
Psychodynamic Strategies	p. 283
Listening to Narratives	p. 283
Encouraging Free Association	p. 286
Identifying Relationships Themes	p. 288
Making Interpersonal Interpretations	p. 291
Honoring Resistance	p. 293
Exploring Childhood Experiences	p. 295
Working Through Past Conflicts	p. 298
Identifying Attachment Styles	p. 301
Observing the Therapeutic Relationship	p. 303
Attending to Subjective Responses	p. 306
Resolving Conflicts in the Therapeutic Relationship	p. 308
Modifying Relational Interactions	p. 311
Interpreting Dreams	p. 313
Adapting to Interpersonal Losses or Disputes	p. 316
Encouraging New Relationships	p. 318
Learning from Termination	p. 320
Chapter Summary	p. 323
Systemic-Constructivist Psychotherapy: Living within Social Systems	p. 325
Introduction to Systemic-Constructivist Psychotherapy	p. 325
Historical Context	p. 325
Systemic-Constructivist Adaptation	p. 326
Systemic-Constructivist Conceptualization	p. 327
Case Examples of Systemic-Constructivist Conceptualization	p. 330
Systemic-Constructivist Strategies	p. 333
Understanding Problems within Their Social Context	p. 333
Viewing Families as Systems	p. 336
Detecting Repetitive Interaction Patterns	p. 339
Describing the Structure of the Family	p. 341
Identifying Family Roles	p. 344
Searching for Multigenerational Patterns	p. 346
Clarifying Family Belief Systems	p. 349
Giving Directives for Strategic Change	p. 351
Exploring the Social Construction of Meaning	p. 354
Externalizing Problems	p. 357
Encouraging Adaptive Narratives	p. 359
Utilizing Clients' Resources	p. 361
Constructing Solutions	p. 363
Orienting Toward the Future	p. 365
Chapter Summary	p. 368
Multicultural-Feminist Psychotherapy: Adapting to Cultural Contexts	p. 370
Introduction to Multicultural-Feminist Psychotherapy	p. 370
Historical Context	p. 370
Multicultural Adaptation	p. 371
Multicultural Conceptualization	p. 373
Case Examples of Multicultural Conceptualization	p. 377
Multicultural-Feminist Strategies	p. 378
Viewing Clients Culturally	p. 379
Clarifying the Impact of Culture	p. 381
Creating Culturally Appropriate Relationships	p. 384
Celebrating Diversity	p. 386
Illuminating Similarities and Differences	p. 388
Recognizing the Impact of Identity	p. 391
Facilitating Identity Development	p. 393
Appreciating Multiple Identities	p. 396
Highlighting Oppression and Privilege	p. 398
Exploring Societal Expectations	p. 400
Supporting Social Action	p. 402
Integrating Spiritual Awareness	p. 405
Becoming Aware of the Therapist's Worldview	p. 407
Reducing Cultural Biases	p. 409
Chapter Summary	p. 411
Applications to Treatment and Training	p. 413
Multitheoretical Psychotherapy in Action: Case Examples with Four Different Diagnoses	p. 414
Chapter Overview	p. 414
Multitheoretical Psychotherapy for Depression	p. 416
Client's Presenting Concern	p. 416
Watching for Focus Markers	p. 417
Conducting a Multidimensional Survey	p. 417
Establishing an Interactive Focus	p. 418
Formulating a Multitheoretical Conceptualization	p. 420
Choosing Interventions from a Catalog of Key Strategies	p. 422
Outcome	p. 424
Future Development of MTP for Depression	p. 424
Multitheoretical Psychotherapy for Anxiety	p. 425
Client's Presenting Concern	p. 425
Watching for Focus Markers	p. 426
Conducting a Multidimensional Survey	p. 427
Establishing an Interactive Focus	p. 427
Formulating a Multitheoretical Conceptualization	p. 428
Choosing Interventions from a Catalog of Key Strategies	p. 431
Outcome	p. 433
Future Development of MTP for Anxiety	p. 433
Multitheoretical Psychotherapy for Substance Abuse	p. 434
Client's Presenting Concern	p. 434
Watching for Focus Markers	p. 434
Conducting a Multidimensional Survey	p. 435
Establishing an Interactive Focus	p. 436
Formulating a Multitheoretical Conceptualization	p. 438
Choosing Interventions from a Catalog of Key Strategies	p. 441
Outcome	p. 443
Future Development of MTP for Substance Abuse	p. 443
Multitheoretical Psychotherapy for Health Behaviors	p. 444
Client's Presenting Concern	p. 444
Watching for Focus Markers	p. 444
Conducting a Multidimensional Survey	p. 445
Establishing an Interactive Focus	p. 446
Formulating a Multitheoretical Conceptualization	p. 447
Choosing Interventions from a Catalog of Key Strategies	p. 450
Outcome	p. 451
Future Development of MTP for Health Behaviors	p. 451
Chapter Summary	p. 452
Training and Supervision in Multitheoretical Psychotherapy	p. 454
Chapter Overview	p. 454
Introduction to Multitheoretical Training	p. 454
Process and Content	p. 454
When Should Integrative Training Occur?	p. 455
Five Principles for Training Multitheoretical Psychotherapists	p. 457
Training for Intentional Integration	p. 457
Training for Multidimensional Integration	p. 459
Training for Multitheoretical Integration	p. 459
Training for Strategy-Based Integration	p. 461
Training in Relational Integration	p. 462
Two Distinct Features of Multitheoretical Training	p. 463
Key Strategies Training	p. 463
Integration in Action	p. 464
Future Research	p. 465
Introduction to Multitheoretical Supervision	p. 468
Five Principles for Integrative Supervision	p. 468
Using MTP to Enact Existing Models from the Supervision Literature	p. 471
Bernard's Discrimination Model of Supervision	p. 471
Neufeldt's Supervision Strategies	p. 471
Stoltenberg's Developmental Model of Supervision	p. 473
Single-Session MTP Supervision Sequence	p. 476
Identifying the Current Focus	p. 476
Conducting a Multidimensional Survey	p. 477
Identifying Focal Dimensions	p. 478
Formulating a Focused Conceptualization	p. 479
Identifying Key Strategies	p. 479
Customizing Key Strategies	p. 479
Future Research	p. 480
Ongoing Professional Development	p. 480
Chapter Summary	p. 481
Appendixes
Multitheoretical Conceptualization	p. 483
Catalog of Key Strategies	p. 485
References	p. 493
Name Index	p. 511
Subject Index	p. 515
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