There are so many theoretical orientations that comprise today’s integrated therapist. This used to be called eclecticism, meaning that the therapist’s therapeutic style derived from a diverse selection of theoretical approaches. It appears that the field has moved away from the idea of eclecticism because it sounds esoteric and lacks the depth that an integrative approach encourages. Instead of pulling from a counseling bag of tricks, we have moved to a more sophisticated system of applying empirically supported approaches and established interventions, with a stronger emphasis on training.
If you are integrated therapist, how have you selected what goes into your therapeutic repertoire? Ethical guidelines dictate appropriate therapeutic orientations, which must avoid harm and have a scientific basis (see ACA Ethical codes A.4.a., C.6.e, E.5.c., E.5.d., F.6.f). Your site will also determine which therapeutic orientations you may prescribe to, especially when billing with insurance companies or following guidelines under managed care. A third factor that influences theoretical style is the population that you work with, both culturally and according to their presenting problem. All of these elements must align with your training and competency, in forming your integrated approach.
In looking at this, there appears to be an increasing number of therapist who identify with an integrated approach, rather than singular theoretical schools. My concern relates to what “integrated” entails, and how its composition varies from therapist to therapist. For example, I am big on CBT, but I also apply principles of Adlerian therapy, motivational-interviewing, and solution-focused therapy, among others. Then you have certain “theories” like multi-cultural counseling and logotherapy that are more of a standard practice, in my view, rather than a school of thought. Another therapist’s application of an integrated therapy may look completely different. Some integrated approaches may even cross-pollinate with other fields of healthcare, fitness, and wellness activities.
Beyond the factors listed above, there appears to be more to the process of defining the integrated approach in counseling. You may consider the influence of therapist personality: are you adept at executing a directive style, or can you manage a non-directive approach? This is where we begin to get vague. The world of science likes operationally defined procedures and practices. What does it mean for our profession, in having various definitions and compositions of integrated therapy? I wonder about this, especially as the profession continues to operate and grow within the psychological and behavioral sciences.
Margo Velez is a counselor and doctoral candidate, proudly serving the mental health and wellness needs of clients in her private practice, located in Atlanta, GA. For more information, visit her website here.