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Integrative therapy involves combining elements from various psychotherapy practices to create a bespoke approach to fit your individual needs.
But there’s a disagreement between clinical psychologists on the efficacy of integrative therapy. Some professionals actively practice integrative therapy, harnessing the benefits from various other treatments. In contrast, others believe they should only deliver therapies such as CBT, EFT and EMDR in their proven model.
If you’re interested in learning more about integrative therapy, including whether it works, how it differs from other approaches and which conditions it can prove effective for, keep reading this comprehensive guide.
As we have already touched upon, integrative therapy is an approach that involves the combination of elements of other therapies to produce a bespoke and personalised treatment plan built around you. There is no singular defined approach to integrative therapy as it can include practices from two or more proven treatments such as CBT (Cognitive-behaviour therapy) and EFT (emotion-focused therapy).
However, that’s not to say integrative therapy lacks structure. An experienced clinical psychologist may opt for integrative therapy after a comprehensive assessment of your needs. For example, if you’re a client with a series of concerns or conditions who may benefit from elements from a variety of proven practices.
In any therapeutic approach, we aim to give people tools they need to navigate their struggles better and overcome obstacles. Unlike counselling, a defined therapeutic practice is typically delivered in an intense treatment plan over a short period, and it’s often beneficial to go with an integrative approach to help equip people with various tools that can help them navigate challenges without relying too much on one approach.
Integrative therapy isn’t as simple as taking one session from CBT and another from EMDR, for example. Instead, a clinical psychologist will form the treatment upon your needs and behaviours, taking into account factors such as living circumstances and even consider things like your own motivation towards getting better.
Sadly, there’s no simple answer here.
While there is much anecdotal evidence proving the efficacy of integrative therapy, it’s difficult to assess whether the approach “works” - and who it works for. As mentioned earlier, we know that integrative therapy can benefit clients with multiple mental health concerns or conditions. For example, an individual may be experiencing social anxiety as a symptom of past trauma. The practical application of CBT may help the client to navigate the daily challenges brought on by anxiety, while EMDR is often an effective treatment for those dealing with trauma. A combination of both approaches may prove effective for this client, but may be less effective for you personally if you have different needs.
Clinical psychologist Dr Duncan Precious, notes that integrative therapy is often a highly beneficial approach for those experiencing complex, longer-term issues. He says: “An integrative approach is best suited to a client with long-standing, enduring and complex needs.
So, in cases where the diagnosis is unclear, a diagnosis-led therapeutic approach such as CBT, without any other treatments, would likely prove ineffective.
Dr Nicky Hartigan points out that ‘proving’ the efficacy of integrative therapy is difficult by its very nature, but it is shown to work when the treatment plan is provided by an experienced professional. She says: “Therapies can only be tested and become ‘evidence based’ if they are run on a protocol .
“This is how we develop insights into what kinds of things work for most people, most of the time and understand whether these approaches are safe and ethical.
“However, all this evidence is based on population data and averages within a group of people (this is true of all medicine) and, so when you are working with an individual with a unique set of life experiences and personal beliefs/ideas/qualities they will not always respond to a strict protocol treatment (even though that treatment is ‘evidence based’).
“This is the time when the skill of the therapist is to draw on a range of evidence-based and safe/ethical models to find what is workable for that individual.”
Since no two patients are the same, integrative therapy allows specialists to create bespoke treatment plans that equip clients with the skills and knowledge they need to overcome their own personal challenges.
However, since all integrative therapy is different, results may vary between clients. So, it’s really up to the clinician in question whether it’s right for a specific client. Transparency is key to creating and nurturing a successful client/therapist relationship. Therefore, the psychologist should not take an integrative approach simply because it is their own preferred method. Instead, the assessment and psychological formulation indicate this is the best approach, and both the psychologist and the client agree.
What we mean by this, of course, is that you as a client should feel comfortable with an integrative approach and agree with the direction once you’ve discussed it with your therapist.
While often used interchangeably, eclectic and integrative therapy are not exactly the same. As the name suggests, integrative therapy integrates two or more techniques within the same treatment. For example, a client undergoing CBT to help ease panic attacks but may also benefit from mindfulness techniques to regain a sense of calm.
Eclectic therapy is also a personalised approach, taking from multiple other practices, but it typically leans towards a purer form of each treatment. So, going back to our example client undergoing CBT, the clinical psychologist has recognised a need for mindfulness training. Rather than integrating elements of this into the existing CBT treatment, an eclectic practitioner would see the client recommended a full mindfulness programme. Where integrative finds success in its flexibility, combining multiple theories, eclectic therapists aim to retain the purity of each proven treatment approach.
We’ve already touched upon some of the good and bad aspects of integrative therapy. Since the integrative approach is inherently different depending on the client, its strengths in one scenario could be a weakness in another.
A clinical psychologist may recommend integrative therapy for conditions such as depression, anxiety, OCD, stress, low self-esteem, trauma, bereavement, psychosis, relationships, personality disorders, and addictions.
Experienced clinical psychologists often lean towards integrative therapy because, over the years and often decades practising psychology, they will develop a much broader understanding of how we can apply each facet of treatment to certain presentations.
Think of it like going on a journey. A clinical psychologist is your guide. They help you map out the route, identify any obstacles along the way and even consider vital contextual factors. Throughout the journey, which is often structured and intensive (unlike counselling, which takes place over a longer period of time and is guided by the client), the clinical psychologist will give you the tools you need to navigate your journey and, ultimately, reach the end - but your journey may not be the same as the person who ventured down that path before.
Dr Precious continues this analogy: “Here, the psychologist can not be wedded too much to one particular route, as they need to allow the client to express themselves and learn through trial and error. Sometimes both client and therapist may feel lost, having had to change course or navigate around an unexpected obstacle that appears.
“However an experienced clinical psychologist will know when they are lost and get their map out, re-orientate themselves and set a new bearing with the client.”
Dr Precious shares an example of when a client may not benefit from integrative therapy. He cites “a clear diagnosis, specific time constraints and considerable evidence for a specific and proven therapy” as some of the many reasons why he may not recommend the integrative approach to a patient.
He explains: “For example, if a patient has PTSD with a single episode (Type 1 Trauma), we’d likely take a specific proven therapy such as trauma-focused CBT or EMDR approach.”
“However, even in this example, we may integrate other elements of CBT into the treatment plan, such as CBT for generalised anxiety.”
Dr Lucy Stirling reiterates this, she adds: “The reason to use an integrative approach versus a single mode approach would always be clinically guided: what are these individuals’ experiences in life? Have they had therapy before? What helped, what didn’t help? What does the research say? etc.”
So, while integrative therapy might not be the primary approach for everyone, clinical psychologists will often borrow from other therapies to treat symptoms. For example, when a client has been without treatment for a long time and has since developed other symptoms as a result - like the patient with PTSD developing anxiety, as in Dr Precious’s example above.
Integrative therapy can be a hugely effective approach, with many clinical psychologists opting for it in order to deliver a personalised service tailored around your needs. As with any therapy, success relies on a strong collaborative and trusting approach between the therapist and the client. As Dr Precious explains above, there is no fixed path with the integrative approach, making it less straightforward than traditional therapy. However, that flexibility is what makes it so powerful for many people.
Looking to find the right online therapy for you? As you can tell from our article, we take the process of deciding on approaches and finding the right treatments for you very seriously. At HelloSelf, we’ve got a network of clinical psychologists with specialisms in every area of psychology, so we can match you with the right therapist to accompany you on your journey to becoming a better self. Get in touch today to take your first step.
