Investigating Integrative Approaches to Therapy
Investigating Integrative Approaches to Therapy
By Micah Saviet, LCSW-C, CEAP, BCC, NBC-HWC
We humans are so varied with numerous differences - in fact, that’s what makes the world so fascinating! For example, we are each unique in the way our brain processes information and makes connections; the way we learn and communicate; what makes our nervous system feel good and how it responds to stimuli; our preferences, interests, and passions; our desires for interpersonal connections; and so much more.
The more experience I have gained as a therapist, the more I have discovered that each client is unique. While there are a range of typical challenges or concerns that clients often seek out therapy to address, the routes to achieving individual goals vary widely.
Research tells us that the most significant factor impacting the positive success of therapeutic outcomes is the quality of the relationship between the client and therapist. Apart from that, much of the research concludes that different interventions or approaches demonstrate largely similar outcomes (e.g., Del Re et al., 2021; Martin, Garske, & Davis, 2000). This illustrates that there is no ‘one size fits all’ approach when it comes to therapy.
My preferred approach when working with clients is what can be categorized as a holistic “integrative approach”. I have developed a particular interest in using holistic integrative approaches since I found this useful in my own mental health journey. I find that the more integrative approaches I can draw from when working with clients, the better equipped I am to meet each person’s unique needs.
What is Integrative Therapy?
According to the Institute for Integrative Psychotherapy (n.d.):
“Integrative Psychotherapy embraces an attitude towards the practice of psychotherapy that affirms the inherent value of each individual. It is a unifying psychotherapy that responds appropriately and effectively to [each] person at their affective, behavioral, cognitive, and physiological levels of functioning, and addresses as well the spiritual dimension of life” (para. 1).
Instead of having a singular approach or procedure to treat each client’s concerns, integrative therapy draws from varied theories, approaches, and techniques to meet each client’s needs and concerns. This results in a client-centered approach that supports the client as a ‘whole being’ above any of the therapist's own needs, comfort, or desire to follow a specific protocol or approach. Integrative therapy can incorporate what the therapist thinks might work, but it also involves a dynamic interplay of “research evidence, clinical judgment, and client factors” (Zarbo et al., 2021, p. 1). It is really about what is best for you as the client.
What are Some Examples of Integrative Therapies?
Below are a few examples of research-backed holistic, integrative modalities that I enjoy using to support clients in my therapy practice.
Somatic Experiencing®
Developed by Dr. Peter Levine in the 1970’s, Somatic Experiencing® (SE) can be defined as “a naturalistic, and neurobiological, body-oriented approach to healing trauma and other stress-related disorders; restoring the authentic self with self-regulation, relaxation, wholeness, and aliveness” (Ergos Institute, 2022, para. 1). SE is increasingly recognized as a helpful bottom-up approach for addressing trauma and other symptoms by cultivating a sense of safety and security (e.g., Kuhfuß et al., 2021).
I enjoy using SE as a way to help clients develop the ability to self-regulate and, as needed, calm their nervous system. This could be as simple as noticing where you feel a particular emotion (e.g., sadness) in your body. Then considering the following: What color is it? What is the texture? What image does it remind you of?
Over time, with kindness and patience, SE can help bring greater awareness to our lived experiences and the ability to be more present to ones’ self and others.
Mindfulness
Pioneer and founder of Mindfulness-Based Stress Reduction (MBSR), John Kabit-Zinn (Mindful, 2017) defines mindfulness as the “awareness that arises through paying attention, on purpose, in the present moment, non-judgementally” (p. 2). Numerous studies have demonstrated that mindfulness can be a powerful approach to addressing many psychological challenges, including stress, anxiety, and depression (e.g., Khoury et al., 2013).
Mindfulness can take many forms–formal meditation practice, body scan, increasing attunement to the present moment, noticing thoughts, mindfully eating, self-compassion, and more. I believe that mindfulness is a useful and important component of therapy that helps to cultivate a lens of curious compassion about our lived experiences.
Clients have often shared with me that they are either hesitant or unsure what mindfulness is about or have tried mindfulness before and it was either “too difficult” or it “didn’t work”. A key part of my therapy approach is exploring and educating my clients about the numerous ways we can be “mindful” in our daily activities and how mindfulness can help us navigate the judgemental, negative, self-critical messages in our heads. I am continuously pleasantly surprised by the power found in a seemingly simplistic mindful moment, as are clients who choose to develop their own mindfulness “muscles”.
Energy Psychology
According to the Association for Comprehensive Energy Psychology (ACEP) (2023), “Energy psychology (cognitive somatic practices) is a family of mind-body methods that rapidly reduce stress and trauma while increasing calm. Calming the body (where stress is stored) is a missing key to unlocking rapid change” (para. 1).
Energy psychology incorporates a variety of approaches that integrate somatic and cognitive elements with thousands of years old bio-energy points sometimes known as such as meridians or chakras. One well-known form of energy psychology that many have heard of is “tapping” (also known as Emotional Freedom Techniques).
Energy psychology is research-backed, with over 155 research studies documenting its efficacy for situations such as anxiety, depression, sports performance, post-traumatic stress, overeating, and more (for more information about the research see: https://www.energypsych.org/researchdb8c71b7).
As one of my favorite and frequently used clinical approaches, I find energy psychology a practical, effective, client-centered method for relieving distress and anxiety, getting unstuck, and restoring balance.
Coaching
As a therapist who is trained and credentialed also as a coach, I often blend therapy and coaching for a unique approach to assisting clients in moving toward their desired goals.
The International Coaching Federation (ICF) broadly defines coaching as “...partnering with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential. The process of coaching, often unlocks previously untapped sources of imagination, productivity and leadership” (para. 7).
Backed by increasing research evidence, coaching incorporates various theories, frameworks, and approaches, all sharing the common understanding that the client is inherently “creative, resourceful, and whole” (Kimsey-House et al., 2010). I enjoy integrating a coaching approach in therapy, as desired and appropriate, because it puts the client in the “driver's seat of their own car” helping to formulate goals and steps to get there.
Are There Any Downsides to Integrative Therapy?
Because each person is unique, it’s important to find a therapeutic approach that works well for you. Integrative therapy offers options. At the same time, some people might prefer a more structured or traditional approach such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavioral Therapy (DBT).
Would I Benefit from Integrative Therapy?
Each person is unique in their needs and what approach will work best for them. I find that an important part of the initial engagement with new clients is to discuss what approaches have worked well in the past as well as what approaches and/or styles haven’t seemed to be a good fit for each client’s unique personality and needs.
Have you tried CBT, DBT, or other traditional approaches previously, and haven’t found them beneficial or suitable to your preferences? Then an integrative approach may be a good option to explore to expand the ways you increase calm, find balance, restore peace, and work toward your goal.
If you have previously found benefit from traditional or structured therapy approaches such as CBT, DBT, psychodynamic approaches, or others, you may not desire to try a new approach, such as integrative therapy. Why reinvent what you know already helps? At the same time, if you are still searching for help, there may be something to gain from adding other modalities in order to explore additional benefits that are possible.
If you have interest or curiosity in any of the integrative approaches I’ve discussed in this post, please don’t hesitate to ask me about them. I am very passionate about working with clients from a holistic integrative approach in order to best meet each person’s individual needs! See my provide here
References
Association for Comprehensive Energy Psychology (ACEP). (2023). Definition for therapists, other practitioners and organizational leaders. https://www.energypsych.org/energy-psychology#:~:text=Energy%20psychology%20(EP)%20comprises%20a,energy%20healing%2C%20and%20health%20optimization.
Del Re, A. C., Flückiger, C., Horvath, A. O., & Wampold, B. E. (2021). Examining therapist effects in the alliance–outcome relationship: A multilevel meta-analysis. Journal of Consulting and Clinical Psychology, 89(5), 371–378. https://doi.org/10.1037/ccp0000637
Ergos Instiutute. Somatic Experiencing® (SE™). (2022). https://www.somaticexperiencing.com/somatic-experiencing
Institute for Integrative Psychotherapy (e.d.). What is integrative psychotherapy? https://www.integrativetherapy.com/en/integrative-psychotherapy.php
International Coaching Federation (ICF). (2023). All things coaching. https://coachingfederation.org/about
Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V., ... & Hofmann, S. G. (2013). Mindfulness-based therapy: a comprehensive meta-analysis. Clinical Psychology Review, 33(6), 763-771. https://doi.org/10.1016/j.cpr.2013.05.005
Kimsey-House, H., Kimsey-House, K., Sandahl, P., & Whitworth, L. (2010). Co-active coaching: Changing business, transforming lives. Hachette UK.
Kuhfuß, M., Maldei, T., Hetmanek, A., & Baumann, N. (2021). Somatic experiencing–effectiveness and key factors of a body-oriented trauma therapy: a scoping literature review. European Journal of Psychotraumatology, 12(1). https://doi.org/10.1080/20008198.2021.1929023
Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68(3), 438–450. https://doi.org/10.1037/0022-006X.68.3.438
Mindful Staff. (2017). Jon Kabat-Zinn: Defining mindfulness. https://www.mindful.org/jon-kabat-zinn-defining-mindfulness/
Zarbo, C., Tasca, G. A., Cattafi, F., & Compare, A. (2021). Integrative psychotherapy works. Frontiers in Psychology, 6. doi: 10.3389/fpsyg.2015.02021