what is integrative counselling?
The terms "integrative psychotherapy" and "integrative counselling" describe any multi-modal approach combining therapies. There are two distinct ways that therapists incorporate different therapies into their work: by integrating the elements of the therapies into a single, combined approach to theory and practice, or by eclectically drawing on several approaches in their work with individual clients. Eclectic practitioners are not bound by the theories or methodology of a particular psychological approach. They use their experience to determine what will work best in order to meet the needs of individual clients.
Recent reviews of research findings about what works in therapy have led to some recommendations for good practice. These are that therapists should:
- Tailor psychotherapy to specific client characteristics
- Aim to cultivate a respectful, empathic and collaborative therapeutic relationship that encourages honest feedback and has agreed goals
- Monitor their clients' responses to the therapy relationship and the treatment that they are receiving
- Use evidence-based treatments with evidence-based therapy relationships to obtain the best outcomes
I do not subscribe to the view of emotional distress that attaches medicalised labels to individuals. I believe in the inherent value of each individual. I focus on people's personal strengths and resources, as well as on their concerns, needs and goals, in a manner characterised by warmth and empathy. I seek regular feedback because studies have shown that when clients give their honest opinion regarding the progress of treatment and the therapeutic relationship - and the treatment is guided by this - the likelihood of improvement increases and that of deterioration decreases.
I tailor all treatment according to my clients' needs and take their preferences into account, drawing on my knowledge and experience of:
- Cognitive behavioural therapy (CBT)
Behaviour therapy is based on learning theory and on the belief that behaviour can be changed or reconditioned to alleviate distress. Cognitive therapy theorises that early experiences affect beliefs about oneself, others and the world, making it difficult to cope in certain situations; it helps clients identify, challenge and change unhelpful thoughts and images to reach more a more realistic and optimistic viewpoint. CBT combines these two theories and uses techniques from both to change both thoughts and behaviours.
- Humanistic therapy
This approach encourages clients to explore their feelings and take responsibility for their thoughts and actions. Past and present events may be considered and resolved. Client creativity may be explored to improve creative expression or performance, or as an aid to well-being.
- Solution-focused brief therapy (SFBT)
SFBT is based on the concept that individuals know their own minds best and also have the necessary resources to change and achieve their desired outcome. It focuses on what the client is already doing that works. It sets clear goals and helps the client decide how to achieve them.
Mindfulness is a specific way of paying attention, non-judgementally, to stay "in the moment". This has a calming effect on the mind and also breaks the chain in such negative processes as worry and rumination or strong emotion. It can be incorporated into many therapeutic approaches.
- Dialectical behavioural therapy (DBT)
DBT developed from, and is part of, CBT. It adds mindfulness and acceptance strategies to CBT to enable clients to manage intense emotions and damaging behaviours with less frustration. It helps to develop skills in distress tolerance, emotional regulation and interpersonal relationships, all of which are particularly relevant for people suffering from some personality disorders or who have been abused as small children.
In addition, clinical hypnosis may be used as an adjunct to this integrative way of working, if deemed beneficial by both therapist and client.