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Comparative Analysis of Psychotherapy Integrative Theories

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Comparative Analysis of Psychotherapy Integrative Theories Comparative Analysis of Psychotherapy Integrative Theories Irena Tojcic A Thesis submitted in parlial fulfilment of the requirements for the Degree of Master of Science in Psychology University of Canterbury Christchurch New Zealand August 2000 I b:lr; 1000 In memory ofmy father Z 4 r~ov 2000 Acknowledgements It would be impossible to admowledge all the people who have helped me reach this very important stage of my life and, therefore, I am going to mention the most significant ones. First, I would like to thank my supervisor Ken Strongman for giving me all the necessary emotional and practical support that I have needed in pursuing my academic comeback. I would also like to thank my fonner supervisor Tony Ward who helped me lay the foundations for my thesis, as well as Brian Haig who first drew my attention to theoretical research. Last but not least, I regard myself as being very lucky to have shared my life's journey with my beloved husband Goran and our terrific son Sven who have made everything seem worthwhile. Abstract Psychotherapy represents a diverse and controversial field. It is characterised by an excessive proliferation of various psychotherapeutic approaches accompanied by the sectarian attitudes of a majority of psychotherapists. In response to these, the psychotherapy integration movement was established. Within this movement three ways of psychotherapy integration have emerged, namely, theoretical integration, common factors approach and technical eclecticism. Methodological issues of theoretical integration are the focus of interest in this thesis. The current methodological recommendations in this area seem to be very limited. A specific method of assimilative integration has been proposed and the necessity of the existence of metatheoretical congruence between theories to be integrated has been emphasised. Both of these recommendations are in need of further elaboration and extension. In order to clarifY some of these methodological issues, the current "state of the art" of theoretical integration is explored by comparatively analysing existing integrative theories. In this way, their similarities and differences are revealed with the unveiling of some aspects of the integrative assimilation that was used in their creation. On the basis of these findings some guidelines for future theoretical integration are proposed that might prompt fimher theoretical and empirical research in this area. CONTENTS A C K NOWL EDG EMEN TS ---------------------------------------------------------------------- I ABSTRACT ------------------------------------------------------------------------------------11 LIST OF= TABLES ------------------------------------------------------------------------------"11 IN TRO DU CTI 0 N ----------------------------------------------------------------------------------1 CHAPTER 1 PSYCHOTHERAPY INTEGRA TION-----------------------------------5 1.1. In trod u ction ------------------------------------------------------------------------------------------------------5 1.2. Technical eclecticism --------------------------------------------------------------------------------------------8 1.3. Common factors appl'oach -----------------------------------------------------------------------------------12 1.4. Thcol'ctical integl'ation ----------------------------------------------------------------------------------------15 1.4 .1. Cyclical psychodynamics (CP) ---------------------------------------------------------------------19 1.4.2. Cognitive-analytic theory (CAT) -------------------------------------------------------------------20 1.4.3. Behavioural psychotherapy--------------------------------------------------------------------------20 1.4.4. System-process cognitive therapy -----------------------------------.------------------------------21 1.4.5. The active self model---------------------------------------------------------------------------------22 1.4.6. Process-experiential psych otherapy ----------------------------------------------------------------22 1.4.7. Interpersonal-cognitive-experiential psychotherapy --------------------------------------------23 1.4. 8 . Self-In ana gem ent therap y ----------------------------------------------------------------------------23 1.4.9. Constructivist approaches ---------------------------------------------------------------------------24 CHAPTER 2 RATIONALE ---------------------------------------------------------------- 26 CHAPTER 3 COMPARATI"E F=RAMEWORK -------------------------------------- 39 3.1. In trod u cti 0 n ----------------------------------------------------------------------------------------------------- 39 3.2. Organisation of Comparative Framework (CF) --------------------------------------------------------- 42 3.2.1. The baclcground ---------------------------------------------------------------------------------------4 2 3.2.2. Guiding asslllnptions --------------------------------------------------------------------------------48 3.2.3. Families of psychotherapies and their guiding assumptions-----------------------------------55 BEHAVIOUR THERAPIES •........••••.••••••••••••.......•.....•.....-.- ..-- ..••••••••• -........•••- ••••.•.- •.•.- ..- 55 COGNITIVE THERAPIES ••••...•.. -...- ......••••.- ...•..- ....-----.---.---------- ...••••- ..-- ..-----.--- ......-.--.- 56 COGNITIVE-BEHAVIOUR AND SKILL TRAINING THERAPIES----------·---·-----·-------------·---·-··- 56 BEHAVIOURAL MEDICINE/HEALTH THERAPIES-························---···-····---··---·--·--.--.•--.- 56 HUMANIST THERAPIES ...........................................- ......--- ••. -.•-.-- ..· ..··--·····----···-····57 TRADITIONAL PSYCHOANALYSIS ...............................--- .................- ..-- ..............------ .. 57 INTERPERSONAL AND SOCIOCULTURAL THERAPIES .........................- ...--- ............-.- ... 57 ECLECTIC AND INTEGRATIVE THERAPIES -.-..:---- ......---- .............-- ...- ....- ......- ..--.-- .....- .. 58 3.2.4. Levels of analysis --------------------"------------------------""------------------"-------------------59 3.2.5. Units of ana1ysis---------------------------------------------------------------------------------------61 3 .2.6. Conceptuallnodel----------------------------------------------------""-------------------------------62 3.2.7. Propositional model ----------------------------------------------------------------------------------66 3 .2. 8. Procedural In ode1-------------------------------------------------------------------------------------- 67 3.3. The integrative theories analysed within the comparative framework -.-------.------.--._-------- 68 CHAPTER 4 CYCLICAL PSYCHODYNAIVIICS (CP) ---------~---':'--------------- 71 4.1. Introduction --------------------------------------------.-------------------------------------------------------- 71 4.2. Guid ing ass u m pti0 ns ------------------------------------------------------------------------------------------ 73 4.2.1. Ontology------------------------------------------------------------------------------------------------73 4.2.2. Cosmology ---------------------------------------------------------------------------------------------73 4.2.3. Epistemology ------------------------------------------------------------------------------------------74 4.3. Conceptual model--------------------------------------------------------------------------------------------·74 4.3.1. Levels and units of analysis ----------------------------------------------------.--------------------74 4.3 .2. I(ey concepts -------------------------------------------------------------------------------------------74 4.4. Propositional model--------------------------------------------------------------------------------------------76 4.5. Procedural model ---------------------------------------------------------------------------------------------- 79 CHAPTERS PROCESS-EXPERIENTIAL PSYCHOTHERAPY (PEP)-------81 5.1. Introd uctio n ----------------------------------------------------------------------------------------------------- 81 5.2. Guiding assumptions ------------------------------------------------------------------------------------------ 82 5 .2.1. Onto logy ------------------------------------------------------------------------------------------------82 5.2.2. Cosmology ---------------------------------------------------------------------------------------------83 5.2.3. Epistemology ------------------------------------------------------------------------------------------83 5.3. Conceptual model---------------------------------------------------------------------------------------------- 84 5.3.1. Levels and units of analysis -------------------------------------------------------------------------84 5.3.2. I(ey con cepts -------------------------------------------------------------------------------------------84 5.4. Propositional model-------------------------------------------------------------------------------------------- 88 5.S. Procedural model ---------------------------------------------------------------------------------------------- 92 CHAPTER 6 INTERPERSONAL-COGNITIVE-EXPERIENTIAL PSY CH OTH ERAPY (I CEP) --------------------------------------------95 6.1. In trod u cti 0 n ----------------------------------------------------------------------------------------------------- 95 6.2. Guiding assunIptions ----------------------------------------------------------------------------------------- 96 6.2. 1. Onto logy ------------------------------------------------._----------------------------------------------96
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