Integrative Theory Paper
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Integrative Theory Paper
Janelle D. Osborn
Fort Hays State University
Abstract
Psychotherapy integration attempts to look beyond and across the confines of single-school approaches to see what can be learned from other perspectives and how clients can benefit from a variety of ways of conducting therapy. (pg. 466) “The majority of psychotherapist do not claim allegiance to a particular therapeutic school but prefer, instead, some form of integration.”(Narcross 2005; 2007) (pg. 466)
This paper will inform the reader of this writers personal theoretical orientation, its key concepts, and the writers view of the role as a counselor, the therapeutic goals, its relationship issues and central techniques and methods. This writers personal theoretical orientation includes the integration of several theories and techniques from several counseling models. This writer sees the utilization of several approaches as the best resolution of problems based on the individual clients needs.
This paper will work from the perspective that the writer is working within a clinical setting with clients who are largely average to low average functioning, are culturally diverse and generally have a low social economical status. These clients usually have little resources and often little time to spend in treatment.
The theoretical orientation that is a foundation for this writer is the Cognitive-Behavioral Therapy. This writer will discuss Cognitive-Behavioral Therapy as her primary approach in terms of techniques, goals, therapist/client relationships and concepts. Other concepts, such as Carl Rogers Person Centered Therapy will be blended into this writers orientation. This writer recognizes clients are more likely to cooperate with therapy interventions if they feel they are in control of their direction of treatment and the therapist is genuinely interesting in their well being.
Carl Rogers Person-Centered approach is founded in Rogers basic approach that people are trustworthy and have a vast potential for understanding themselves and resolving their own problems without direct intervention from the therapist. Roger states that humans are capable of self-directed growth if they are involved in a specific kind of therapeutic relationship. (pg. 174)
Person-Centered approach is aimed at the client achieving greater independence and integration. Its focus is directed away from the presenting problem and is placed on the person. The therapeutic goal is to assist the clients in growth so they can cope with problems as they are able to identify them. (pg.179)
The role of the therapist in person-centered approach is in their way of being and attitudes. This is based on research which has shown that the attitude of the therapist rather than the knowledge, theories and techniques that facility change in the client. (Rogers, 1961) (pg. 180) The therapist is to be present and accessible to the clients and to focus on their immediate experience. The therapist engages in a real relationship with the client. The therapist does this through acceptance, congruency, and empathetic listening to be a catalyst for change. The therapist does not view the client through diagnostic labels but rather through their own world. The therapist works with clients with a genuine caring, supportive, and empathetic attitude in order to allow the clients defenses to fall and allow for allows for a change in perceptions. (pg. 180)
Roger developed a hypothesis of the conditions needed for therapeutic personality change. (Rogers (1957) (pg. 181) Rogers hypothesized that “significant positive personality change does not occur except in a relationship.” (pg. 181) The therapeutic relationship in using the person-centered approach must include congruence/genuineness, unconditional positive regard and acceptance, and accurate empathic understanding. The therapist must be real and authentic during the therapy. The therapist keeps personal issues within and does not express them on the outside. The therapist can openly express feelings, thoughts, reactions and attitudes that are present in the relationship with the client. Careful reflection and judgment are given by the therapist to the client. (pg.183)
Unconditional positive regard through genuine caring for the client as a person is done through empathic identification with the client. According to Rogers the greater the degree of caring and valuing on the part of the therapist to the client the greater the change the therapy will be successful. (pg.183)
Understanding the clients experience and feelings during a moment to moment interaction during the therapy session is essential to having accurate empathic understanding. The therapist sees the clients experiences in the here and now. The aim is to encourage the client to get closer to their selves and feel things more intensely in an aim to recognize and resolve incongruence from within them. (pg. 183)
Rogers reflective style and client-centered therapy are seen as the primary and central techniques of the person-centered approach. Contemporary person-centered therapy has evolved over the past 70 years. It is open to change and refinement and no techniques are basic to the therapy. Suggestions are taken by therapist as long as it fosters the client and therapists relationship is being together in an empathic way. (pg. 185)
Short comings of this approach have been identified as lacking structure for those working within central mental health facilities that require more structure. Cultural expectations of wanting a direct counselor to help deal with problems may not work well with this approach. Clients who are not comfortable with direct expressions of empathy or self disclosure may not be comfortable with this style of therapy. This approach is not best used solely or alone but is best when used in combination with other therapies such as behavioral or cognitive-behavioral approaches. (pg. 196)
Cognitive-Behavioral Approach is stemmed from traditional behavioral therapies. They share a lot of the same characteristics such as a collaborative relationship between client and therapist, the premise that psychological distress is largely a function of disturbances in cognitive processes, focus on changing cognitions to produce desired changes and affect behavior, being present-centered, time-limit focused, taking an active and directive stance as a therapist, and providing educational treatment focused on specific problems. (pg. 290,291)