Integrative therapy, counseling, or psychotherapy, is a talking therapy that incorporates a range of different therapeutic approaches to treat various issues. Therapists who use an integrative approach do not feel that there is one type of therapy that can help someone in every situation. They believe that clients benefit the most by mixing different methods and techniques tailored to the individual.

What is the goal of integrative therapy?

The goal of integrative therapy, similarly to other types of talking therapy, is to help people reach a level of fulfilment where they feel they are the most authentic version of themselves that they can be, and that they can manage struggles in life. Integrative therapists should try to support you as a whole person, including your mental, emotional and physical health, and understand how they are interlinked.

A key principle from humanistic therapy that is crucial to integrative therapy is that your therapist should hold you in ‘unconditional positive regard’, which means they lead with empathy and, regardless of what you bring into the therapy room, in whichever way you bring it, they will continue to hold you in high esteem. This helps to focus on your potential for growth and your positive qualities that will help you to reach the goals you identify.

As with other types of talking therapy, most integrative therapy is client-led rather than therapist-led. Try to avoid expecting the therapist to tell you what to do; instead, think about what you want to talk about ahead of time.

What is integrative therapy used to treat?

Integrative therapy can be used to treat a range of mental health problems and can be beneficial for people just wanting to achieve greater fulfilment in their lives or deal with ongoing difficult life situations.

Examples of reasons people might go into integrative therapy include:

  • Depression
  • Anxiety
  • Relationship struggles and divorce
  • Drug or alcohol addiction
  • Bereavement
  • Experiences of trauma
  • Low self esteem
  • Problems at work
  • Health issues and chronic illness

Integrative therapy might be a good option if you have looked into different types of talking therapy and aren’t sure which one will be right for you, or if you have tried the type of therapy usually prescribed for your mental health problem and it hasn’t helped you.

Integrative therapy can be particularly useful if you are wanting to understand and overcome patterns of negative thinking, for example, worries, fears or doubts about yourself.

What are common integrative therapy techniques?

Approaches

The different techniques used in integrative therapy vary depending on the therapist’s approach to integration. One method, the ‘eclectic’ way, means that the therapist uses different techniques from different types of therapy according to what works best for the person and is primarily concerned with the outcome. They might be guided by which combination has worked best for people with experiences similar to yours.

A fully integrative approach means the therapist wants to understand why a particular blend of techniques worked well and whether it would work the same for others. They might also question the extent to which the therapy was unique or shows universally accurate results. For example, the relationship between the therapist and client may have influenced the outcome because the power dynamic made the person want to please the therapist and show progress. [4]

Many integrative therapists believe that, by default, combining more than one approach to therapy is better than just using one, which is often supported by research. [5]

Techniques

Common factors

In this technique, the therapist will use the factors that are most commonly used and effective across different types of therapy to work with someone. For example, mindfulness techniques are used across various types of talking therapies even though they might be called different things. [6] [7] [8]

Assimilative

In this technique, a therapist will choose one type of talking therapy as the basis of their work with you, but as they get to know you and other people they work with, they will gradually incorporate different techniques from other talking therapies. Many therapists start out applying an integrative approach this way. It’s important to know which approach your therapist is using as the foundation of their work with you, so that if you have therapy with a different therapist in the future, you can tell them. [9]

Multi-stage

Some therapists will integrate different types of talking therapy in a structured and formulaic way, using different approaches for different stages of your work together. For example, focussing on person-centered as you explore the issues that you will tackle together first, moving on to psychodynamic as you seek to gain greater understanding of those issues and then to behavioral as you try to achieve change. This can also be done in a different order, depending on what the person wants to tackle first. [10]


Is integrative therapy effective?

Integrative therapy can involve any combination of approaches, for example, psychodynamic therapy and hypnotherapy, to help someone with a mental health problem with physical symptoms. This combination has been proved to be effective with some people. [11] 

Because there are so many possible combinations of approaches, there is no definitive research on all integrative approaches. However, many therapists will integrate techniques that have proved most effective, drawn from different approaches.

It is also generally accepted that a humanistic approach to the relationship between the person in treatment and the therapist is more important than the modality of therapy used.

According to some research, applying particular techniques from different approaches to talking therapy contributes to around seven percent of the variation in what people achieve through talking therapy. [12]

Some studies also show that integrative therapy is effective with children with learning disabilities, including autism. This is because it tackles all of the elements of the way we function as people - our behaviors, thinking patterns, physical body and feelings.

What should you expect in an integrative therapy session?

First session

Before you begin treatment, your first integrative therapy session should be for you and your therapist to work out if it’s the right kind of talking therapy for you, or whether you would benefit from one specific approach. You might talk about any other type of talking therapy you know about or have experience of and which parts do or don’t appeal to you, or have or haven’t been effective.

Following sessions

A common element of lots of types of talking therapy is a person-centered approach, in which therapy is led by the person rather than the therapist. As you begin to have regular sessions, you should be ready to take a lead because your therapist sees you as the expert on your own life rather than themselves. 

This approach also means your therapist believes you hold the keys to achieving greater fulfilment and becoming the most authentic version of yourself. They will help you to do this by validating your feelings, reflecting back honestly and holding you in high esteem, regardless of what you bring into the therapy room and how you bring it. They may even challenge you in areas where they feel you need to be challenged, but will always do this with empathy and with your goals in mind,

Common techniques your therapist might use in your sessions from popular approaches include accessing your subconscious mind together, to understand your preoccupations. This psychodynamic technique might include talking through any running themes in your dreams or any connections you can see between things happening in your present life and things that have happened or feelings you have had in the past.

Your therapist might also draw on techniques from Cognitive Behavioral Therapy, such as encouraging you to observe and note down your feelings, thoughts and behaviors outside of sessions and then bring them to a session to discuss them. They will use this to help you identify the patterns which may be keeping you stuck.

Depending on what you feel comfortable with and what you think might be effective, they might also use other approaches like hypnotherapy or creative arts.

How do I know if integrative therapy is right for me?

As with many types of talking therapy, to get the most out of it you need to be open to exploring elements of your present and your past life and feel resilient enough to face this when you enter integrative therapy.

Most integrative therapy requires a level of commitment from the person entering it and is generally used for medium to long-term work. This kind of therapy might not be right for you if you have a specific issue you want to work on to find solutions quickly, without understanding why you struggle with it.

If you enter this type of therapy, it’s a good idea to think carefully about what kind of therapist you want to work with, because of the importance of the relationship for making progress. For example, whether you feel more or less comfortable opening up to someone from a similar background to your own, or whether you prefer a therapist that identifies with a specific gender or sexuality.

Whoever your therapist is, you should feel like they are not judging you, consistently hold you in high regard, listen carefully to you and want to work with you to help you find greater fulfilment. You should not feel like your therapist holds all the power or knowledge, or like they are not fully committed to helping you. In an early session, you should work with your therapist to agree on your goals and the way that you will work together.

If your therapist is not sure you can make the progress you want to with integrative therapy or with them, they should recommend that you work with somebody else or try a different approach.

One element of integrative therapy that many people benefit from is the degree to which you can work with your therapist to tailor an approach that is most effective for you. Most integrative therapists take a flexible approach and adapt the techniques they are using depending on the person’s situation and how they are responding. Sometimes, this can vary from session to session, or simply from one issue to another.

Integrative therapists also take into account the interconnection between your thoughts, feelings, behaviors, physical body or symptoms, and even your spirituality. This can enable you to tackle an issue from different perspectives as you try to understand it with your therapist.

As integrative therapy has been shown to be very effective, it is a very popular approach used globally. According to one study, around 85 percent of therapists use multiple approaches, with an average of four different types of talking therapy employed by integrative therapists. [13]

History of integrative psychotherapy

Integrative psychotherapy has been adapted over many years, following the development of talking therapy by Sigmund Freud, whose approach was called psychoanalysis. Psychoanalysis has occupied a prominent position in the development of talking therapy, though many of Freud's ideas are now discredited and seen as controversial. It is, however, still widely used and understood to be an effective type of therapy for some conditions, especially if combined with other approaches and delivered over a longer period of time. [2]

In response to this, many other types of talking therapy grew, including psychodynamic therapy, which is rooted in some of Freud's ideas. Around the same time, behaviorist approaches to psychology began to gain popularity. In the 1960s, cognitive behavioral therapy became popular for treating specific mental health issues. In response to these two approaches, humanistic therapy was developed, which moved away from seeing the client as a diagnosis, and instead as a complex human being. Hundreds of different types of talking therapy in various combinations are used to treat people around the world. [3] Many integrative therapists' practice is underpinned by psychodynamic approaches to therapy.

Resources:

  1. Integrative Psychotherapy Association. The Association. (2016).  Retrieved from: https://web.archive.org/web/20161011012738/http://integrativeassociation.com/english/association/
  2. Leichsenring, F. (2005), Are psychodynamic and psychoanalytic therapies effective. International Journal of Psychoanalysis.
  3. Norcross, J. C. (2005). The Psychotherapist's Own Psychotherapy: Educating and Developing Psychologists. American Psychologist. https://doi.org/10.1037/0003-066X.60.8.840
  4. Palmer, S., Woolfe, R. (1999). Integrative and Eclectic Counselling and Psychotherapy. Thousand Oaks, CA: SAGE Publications Ltd.
  5. Norcross, J. C. (2005). The Psychotherapist's Own Psychotherapy: Educating and Developing Psychologists. American Psychologist. https://doi.org/10.1037/0003-066X.60.8.840
  6. Frank, J. D., and Frank, J. B. (1991). Persuasion and healing: A comparative study of psychotherapy. Baltimore, MD: Johns Hopkins University Press.
  7. Wampold, B. E., Imel, Z. E. (2015). The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work. Oxfordshire, UK: Routledge.
  8. Miller, S. D., Duncan, B. L., & Hubble, M. A. (2005). Outcome-informed clinical work. In J. C. Norcross & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 84–102). Oxford, UK: Oxford University Press. https://doi.org/10.1093/med:psych/9780195165791.003.0004
  9. Messer, S. B. (1992). A critical examination of belief structures in integrative and eclectic psychotherapy. In J. C. Norcross & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 130–165). Basic Books.
  10.  Hill, C. E. (2014). Helping Skills: Facilitating Exploration, Insight, and Action. American Psychological Association.
  11. Kraft, T., and Kraft, D. (2007). Irritable bowel syndrome: symptomatic treatment versus integrative psychotherapy. Retrieved from: https://onlinelibrary.wiley.com/doi/abs/10.1002/ch.339
  12.  Zarbo, C., Tasca, G. A., Cattafi, F., Compare, A. (2016). Integrative psychotherapy works. Frontiers in Psychology, 6, Article 2021. https://doi.org/10.3389/fpsyg.2015.02021
  13. Tasca, G. A., Sylvestre, J., Balfour, L., et al. (2014) What clinicians want: Findings from a psychotherapy practice research network survey. Retrieved from: https://www.researchgate.net/publication/269931545_What_Clinicians_Want_Findings_From_a_Psychotherapy_Practice_Research_Network_Survey