The invitation to contribute to this issue on integrative and eclectic psychotherapies gives me an opportunity to reflect on a topic that has hovered unexamined over my clinical practice for a long time. I realize now that I have not attempted to formulate these answers before because they create some anxiety, the reasons for which will become apparent as I continue. At the same time, as I think about the questions this topic raises, I am coming to understand more about my relationship to theory and its use in my clinical work. Surely the ability to tolerate anxiety and explore its sources is the premise of good clinical work? In this last sentence, I am clearly identifying myself as a psychodynamic clinician. The anxiety creeps in when I ask myself to what extent I also practice in an integrative or eclectic fashion. I am uncomfortable with the label eclectic; the word suggests post facto explanations for clinical work that has not been fully thought through. Indeed, I am embarrassed by the memory of a much younger me being asked by a senior clinician, I had met socially, what kind of psychotherapist I was. Even as the words came out of my mouth, I realized that saying ‘‘eclectic’’ was a cop out because I could not articulate my approach at that time in my career. Integrative, on the other hand, suggests knowledge of several different modalities and different theories of mind, recognition of the overlap between them, and an attempt to include those aspects of one that might move clinical work forward; an integrative approach amounts to informed flexibility. Rational as this explanation sounds, the notion of flexibility challenges the different orthodoxies to which I have been exposed at different times in my training, the orthodoxies to which most of us are inevitably exposed during our training. Graduate schools and training institutes rarely teach integrated approaches, faculty members are selected because they represent a particular theory, supervisors because they can oversee clinical work that defines a particular way of practicing, marking them and, consequently their supervisees, as insiders. Orthodoxy is a function of the need to establish an identity. It is not only the need for a unifying theory that can render integrative approaches suspect. Clinicians who combine different psychotherapeutic approaches frequently come under attack. In November 2009, the Washington Post accused therapists of being ‘‘behind the times’’ because, unlike well trained physicians, they do not use the latest scientific findings to guide their technique. Psychologists are singled out for behaving like kids in a candy store: ‘‘They look around, maybe sample a bit, and choose what they like, whatever feels good to them.’’ (Mischel 2009) Although Mischel is targeting psychologists because their graduate training is supposed to follow the Boulder scientist-practitioner model, his comments apply to all mental health professionals who do not adhere strictly to evidence based treatment. Questions about integrative and eclectic choices are anathema to this kind of thinking: Mischel would argue that they encourage the candy store approach. As an undergraduate I would have endorsed Mischel’s criticism enthusiastically. A philosophy major, I felt as if the scales had fallen from my eyes when I was introduced to the British Empiricists. Here were straightforward ways to make sense of human experience that seamlessly transferred to the behavioral psychology to which I was also exposed. In the early nineteen seventies, Social Learning Theory was in its heyday and I was hooked by its simplicity and universality. But when it came to accepting G. Boulanger (&) 242 West 101 Street, New York, NY 10025, USA e-mail: ghislaine242@gmail.com

/pdf/arguing-with-myself-thoughts-on-taking-an-integrative-akpl28thok.pdf

The effectiveness of psychotherapy.

Arguing with Myself: Thoughts on Taking an Integrative Approach

................................................................................................74 AUTOBIOGRAPHICAL STATEMENT...............................................................76

/pdf/the-effects-of-meta-communication-training-on-therapeutic-asx78nhn8i.pdf

The effects of meta-communication training on therapeutic process and outcome at a university counseling center

?Como han surgido y evolucionado los principales formatos de investigacion de la psicoterapia? ?Cuales son las principales lineas de investigacion actuales? ?Cuales son sus ventajas y sus limites? Delante de las incontables lineas de investigacion de la psicoterapia, este articulo proporciona un panorama historico que ayuda a comprender lo que se estudia y como se estudia actualmente en el dominio de la psicoterapia. Se contextualiza la investigacion de la psicoterapia en los ultimos 50 anos bajo las exigencias del medio cientifico, social e economico. Se definen los principales conceptos basicos y se termina con el balance actual y una reflexion sobre las tendencias futuras de la investigacion en este dominio.

/pdf/aspectos-metodologicos-de-la-investigacion-de-la-56nkvfb0i3.pdf

Aspectos metodológicos de la investigación de la psicoterapia. Panorama histórico.

De bijdrage van specifieke hulpvormen aan de effectiviteit van de jeugdzorg is nihil. Dat is een boodschap die bezoekers aan de serie conferenties Jeugdzorg in onderzoek nu twee keer hebben meegekregen. Tijdens de tweede editie van de conferentie, januari 2006, zette Barry Duncan krachtig neer dat de kwaliteit van de therapeutische relatie vele malen meer het effect van de hulp bepaalt dan de specifiek-therapeutische methode (Duncan, 2006). Eind januari 2007, bij de derde editie van de conferentie, was het weer raak. Michael Barkham gaf daarin aan – refererend aan the great psychotherapy debate – dat de algemene effectgrootte van therapie (in termen van de ‘effectsize’ d) 0,80 bedraagt, die van te onderscheiden therapieen 0,00-0,20 en die van specifieke ingredienten 0,00 (Barkham, 2007).

Effectiviteit: het grote debat

In het begin van de jaren negentig kwam ik aan de Katholieke Universiteit Nijmegen (nu de Radboud Universiteit) in contact met Ger Keijsers, een slim, jong en enthousiast psycholoog, druk bezig met zijn proefschrift. Hij onderzocht onder andere wat de essentiele en noodzakelijke elementen zijn voor de behandeling van verschillende angststoornissen en hoe die in protocollen konden worden gevangen. Hij had vertrouwen in de goede afloop van dat onderzoek; dat bleek uit het feit dat hij de behandelingen voor zijn onderzoek liet uitvoeren door derde- en vierdejaars studenten zonder enige ervaring, maar die wel graag therapeut wilden worden. Het geven van therapieen werkt motiverend voor een therapeut in wording; en de motivatie en het enthousiasme die Keijsers bij zijn studenten wist te bewerkstelligen waren groot.

The effectiveness of psychotherapy.

Citations

Arguing with Myself: Thoughts on Taking an Integrative Approach

The effects of meta-communication training on therapeutic process and outcome at a university counseling center

Aspectos metodológicos de la investigación de la psicoterapia. Panorama histórico.

Effectiviteit: het grote debat

Hart en ziel van effectieve psychotherapie

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