Is integrative use of techniques in psychotherapy the exception or the rule? Results of a national survey of doctoral-level practitioners.

Abstract

This study sought to investigate the extent to which therapists endorse techniques outside of their self-identified orientation and which techniques are endorsed across orientations. A survey consisting of 127 techniques from 8 major theories of psychotherapy was administered via U.S. mail to a national random sample of doctoral-level psychotherapy practitioners. The 201 participants endorsed substantial numbers of techniques from outside their respective orientations. Many of these techniques were quite different from those of the core theories of the respective orientations. Further examining when and why experienced practitioners switch to techniques outside their primary orientation may help reveal where certain techniques fall short and where others excel, indicating a need for further research that taps the collective experience of practitioners. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Wisdom in professional knowledge: Why it can be valuable to listen to the voices of senior psychotherapists

“…Instead, they were implying that it was possible to do both at the same time. This finding is consistent with both the idea that experienced therapists "metabolize" theory in terms of integrating it into their way of being in the world (Betan & Binder, 2000), the notion that they implement a "postmodern epistemology of practice" that is skeptical of the value of singular theoretical positions (Polkinghorne, 1992), and the extensive evidence that experienced clinicians integrate techniques and ideas from a plurality of therapy approaches (see, for example, Lampropoulos & Dixon, 2007;Thoma & Cecero, 2009). .…”

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“…An example of this could be when a client seems anxious (thus receives a diagnosis about anxiety), where in fact, this client has no job or support system and this is the source of the worry. Real-world clients have multiple challenges and counseling usually aims to improve holistic well-being based on numerous theories with diverse interventions designed to fit clients' needs (Thoma & Cecero, 2009). Often, challenges are complex and there are underlying issues that need to be addressed.…”

“…Understanding clients emerges organically from a counselor's experience with clients (Cheston, 2000;Thoma & Cecero, 2009). The counseling experience integrates empathy, values, boundaries, and relationship into a counseling session.…”

“…Counselors in the real world typically do not stick to one process of change (Thoma & Cecero, 2009), and after graduation, the theories chosen for application in real-life practice may not match those used during formal theories courses (Guiffrida, 2005;Thoma & Cecero, 2009). The challenge for educators is to simulate real-world experiences sufficiently enough to enable students to feel comfortable and authentic.…”

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“…There are glimpses of this type of theoretical fluidity in qualitative studies such as Polkinghorne (1992) and Oddli and Halvorsen (2014), where therapists have been interviewed about the way in which they use theory to inform practice. The fact is that, no matter how they describe their theoretical allegiance, most therapists draw on a diversity of concepts (see, for example, Thoma and Cecero, 2009). …”