Eclectic Approach in Psychotherapy

By

Issha

What is Psychotherapy?

Psychotherapy is the informed and intentional application of clinical methods and interpersonal stances derived from established psychological principles for the purpose of assisting people to modify their behaviors, cognitions, emotions and other personal characteristics in directions that the participants deem desirable .

(John Norcross, 1990)

Over the years, a wide range of psycho-therapeutic approaches and theories have developed with an exponential increase occurring in the last 30 years. It is common for experienced therapists to combine several different approaches or techniques some of them are mentioned below: •  Psychodynamic approach •  Behavioral techniques •  Cognitive methods •  Couples therapy

Eclectic Psychology

Eclectic psychology refers to a therapeutic approach in which a variety of methods, principles and philosophies are used to create a treatment program that caters to a patient's unique needs.

Eclectic approaches became increasingly common in the 1970s’. Many therapists have been hesitant to label themselves as eclectic therapists, with only around 10 percent of therapists applying this label to themselves, according to Dr. Drewey of Psych Web.

The Paradigm for Eclectic psychotherapy

Interest in eclectic psychotherapy and in the integration of various systems of psychotherapy has been increasing in recent years. Goldfried and Safran (1986) noted that

"The indication are very clear that the field of psychotherapy in the 1980's is highlighted by rapid developing movements toward integration and eclecticism. "

Major figures in Eclectic Paradigm Beutler (1983, 1986). Garfield (1980,1986) ,

Hart (1983,1986), Lazarus (1981,1986)

Prochaska and DiClementi (1984,1986).

– Goldfried and Newman (1986) provide a historical background and Dryden (1986)

– Goldfried and Safran (1986), Messer (1986) and

Murray (1986) provide critical comments.

Eclectic Psychotherapy The early days of the emerging discipline of psychology were inevitably rigidly dogmatic. Clinicians belonged to well-demarcated schools and practiced in strict accordance with canons of writings by "masters" such as Freud, or Jung, or Adler, or Skinner. Psychology was less a science than an ideology or an art form.

Lazarus proposed that the appraisal of the efficacy and applicability of a treatment modality should be based on six data: BASIC IB • Behavior, • Affect,• Sensation,• Imagery, • Cognition,• Interpersonal Relationships• Biology

• What are the patient's dysfunctional behavior patterns?  • How is her sensorium?  • In what ways does her imagery connect with

her problems, presenting symptoms, and signs?   • Does he suffer from cognitive deficits and

distortions?  • What is the extent and quality of the patient's

interpersonal relationships?

• Does the subject suffer from any medical, genetic, or neurological problems that may affect his or her conduct and functioning?  •     Once the answers to these questions are

collated, the therapist judge which treatment options are likely to yield the fastest and most durable outcomes, based on empirical data

What's the use of theorizing in psychology? Why not simply revert to trial and error and see what works?

Beutler, said:Psychological theories of personality allow us to be more selective. They provide guidelines as to which treatment modalities we should consider in any given situation and for any given patient. Without these intellectual edifices we would be lost in a sea of "everything goes".

Difference in Eclectic and Integrative Approach

– Eclectic Approach

– Therapist chooses interventions because they work.

– Does not need a theoretical basis for, understanding other than efficacy.

– The rationale of efficacy is based on imprecise memories of past experience.

– Integration Approach

– Attends to the relationship between theory and technique.

– They adhere to a set of guiding, theoretical principles and view therapy change.

– Integrationists are concerned not only with what works but why it works.

Eclectic treatment combinations

Three-Stage model of Helping

Process-Experiential Therapy

Three-Stage model of Helping

Introduced by Hill and O'Brien (1999). The three-model views psychotherapist as collaborators and facilitators who guide client in

– Exploring their feelings

– Understanding their problem

– Making choices

– Effecting changes

The Three-Stage model is

Exploration

Insight

Action

Exploration stage in the Hill and O'Brien model

• Establishing rapport and  • Developing a therapeutic relationship,  • Creating a climate in which client can "tell their

stories" • Gaining access to emotion,  • Encouraging emotional arousal and  • Helping clients experience their feelings and •  In general learning about their clients worldviews,

their styles of interaction,  • Their problems, •  Their needs

Insight stage

• The goal in the insight stage is to help clients understand their problems at a deeper level. Insight means seeing things in a new way, gaining a new perspective, or making connections.  • Insight is important because we seem as

human beings to need to make sense out of our world and because insight guides behavior—we choose what to do based on our understanding of the issues.

Therapist • "actively work with clients in the insight

stage to construct meanings and reframe experiences. "

( Hill & O'Brien, 1999)    While people cannot change their personality fundamentally, they can learn to accept who they are and make the most of their potential.

Action Stage

Rather than telling clients what to do though, the action stage focuses on helping clients decide if they want to make changes in their lives. If, after considering the pros and cons about changing, clients decide that indeed they want to change, helpers work with clients to decide what changes to make, how to go about making those changes, and how to modify action plans when the inevitable obstacles come up. It is important here that helpers not be invested in trying to make clients change, but instead work with clients to figure out what they want to do.

Essential Components & Implications for Practice

– Clinicians following the three-stage model of helping show similarities with

– Cognitive therapists in emphasizing empathic collaboration and changing dysfunctional cognitive schemas.

– Psychoanalytic clinicians in focusing on covert processes, operating in both client and therapist that profoundly influence the therapeutic relationship (Hill & O'Brien, 1999, 2001).

– Application of Hills' Helping Skills Model may be beneficial for patients whose diagnosis has significantly affected their ability to perform self-care, work, and leisure activities.

Process-Experiential Therapy or Emotionally focused therapy

– Leslie Greenberg, Robert Elliott and colleagues have combined client-centered therapy with components of existential, Gestalt and experiential therapies to form process experiential therapies.

– Clients are helped to integrate information from their emotional and cognitive systems so as to make a more satisfactory adjustment (Cain, 2002).

• Clients are the experts on their experience, the therapist do not interpret or advice. Instead they encourage clients to identify their inner experiences and to engage in processes of discovery and choice.  • The therapists help the client in the process of

creating new meaning. 

Theory of Pathology

– Distress and impairment arise when a person is unable to find words or image to symbolize his or her experiences and when the key emotion schemes through which experiences are interpreted are dysfunctional. Emotion Schemes are "implicit idiosyncratic organizational structure that serve as the basis for human experience and self organization"(Elliott and Greenberg, 2001).

Guiding Principles

The therapist aims at mutual collaboration and co-exploration and offers intervention in a non imposing, non authoritative manner. A central issue in treatment is the balance between

* Relationship

* Responsiveness

* Task Directiveness

Six Principles of relationship

– Empathic attunement

– The therapeutic bond

– Task collaboration

– Task facilitation

– Experiential processing

– The task completion

(Elliott & Greenberg, 1995, 2002).

Practical Application

It is chiefly applied in individual therapy, but is also applicable in groups and couple formats. It is most helpful for outpatients with less severe pathology and relatively mild distress. A virtual component of training is experiential learning in which the trainee may practice the roles of therapist and client (Elliott and Greenberg, 1995).

Conclusion

HMOs (Health Management Organizations).

– They want proof that the treatment is the right one for the patient's problem.

– Defend their choice of treatment as the most appropriate treatment for the problem.

– Therapists will have to achieve expertise in a variety of techniques.

References–Garland, J. L., & Chesbro, S. B. (2012). Culturally Competent Interviewing: Applying Hill's Three-Stage Model of Helping Skills to Healthcare Practice. Journal of the National Society of Allied Health, 66, 1034-1048. Retrieved from http://98.139.21.31/search/srpcachep=hiils+three+stage+model+of+helping+application&fr=cbmax&ei=UTF-&u=http://cc.bingj.com/cache.aspxq=hiils+three+stage+model+of+helping+applicationd=4629946137120808&mkt=enUS&setlang=enUS&w=H_sHTNE71s85dOTN6iRfE7AOUyb760n&icp=&.int=us&sig=nwfXKF8bNV711zOgLMsELg--

–Hecker, E. J., & Thrope, L. G. (2007). Introduction to clinical psychology science, practice and ethics. Maine: Pearson Education, Incorporation.

–Patterson, H. C. (1989). Eclecticism in psychotherapy: Is integration possible? Psychotherapy, 26, 157-161. Retrieved from www.sageofasheville.com/pub...ECLECTIC_PSYCHOTHERAPY.pdf

–Vaknin, S. (2006, November 7). Eclectic Psychotherapy. Retrieved from http://www.articlesfactory.com/articles/psychology/eclectic-psychotherapy.html

– Dewey, R. (2007). Eclecticism in therapy. Retrieved from http://www.intropsych.com/ch13_therapies/eclecticism_in_therapy.html