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The Clinical Challenges of Assimilative Integration

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Journal of Psychotherapy Integration

Abstract

S. B. Messer (1992) introduced the notion of assimilative integration in psychotherapy, theorizing that integrative practitioners adhere to their preferred theoretical paradigms while judiciously blending aspects from other models. His assimilative approach offers a conceptual and clinical middle ground between technical eclecticism and a grand, unified theory of psychotherapy. However, the practice of competent assimilative integration is fraught with many challenges, both theoretical and clinical. The goal of the present paper is to explore the challenges of implementing assimilative integration. First, the theoretical and clinical barriers to assimilative approaches are considered. Second, the use of assimilative integration to avoid therapeutic failures is discussed. Finally, a case example is presented to illustrate the author's attempt to assimilate narrative, interpretive interventions within his preferred cognitive–behavioral treatment paradigm.

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REFERENCES

  • Arkowitz, H. (1996). Toward an integrative perspective on resistance to change. In Session: Psychotherapy in Practice, 2(1), 87–98.

    Google Scholar 

  • Basch, M. F. (1980). Doing psychotherapy. New York: Basic Books.

    Google Scholar 

  • Basseches, M. (1997a). A developmental perspective on psychotherapy process, psychotherapists' expertise, and "meaning-making conflict" within therapeutic relationships: A twopart series. Journal of Adult Development, 4(1), 17–33.

    Google Scholar 

  • Basseches, M. (1997b). A developmental perspective on psychotherapy process, psychotherapists' expertise, and "meaning-making conflict" within therapeutic relationships: Part II. Journal of Adult Development, 4(2), 85–106.

    Google Scholar 

  • Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: Meridian.

    Google Scholar 

  • Beck, A. T., Emery, G., & Greenberg, R. L. (1985). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.

    Google Scholar 

  • Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford.

    Google Scholar 

  • Bohart, A. (1995). Reflections on failure cases. Journal of Psychotherapy Integration, 5(2), 155–158.

    Google Scholar 

  • Bohart, A., & Tallman, K. (1996). The active client: Therapy as self-help. Journal of Humanistic Psychology, 36(3), 7–30.

    Google Scholar 

  • Brehm, J.W. (1966). A theory of psychological reactance. New York: Academic Press.

    Google Scholar 

  • Bricker, D., Young, J. E., & Flanagan, C. M. (1993). Schema-focused cognitive therapy: A comprehensive framework for characterological problems. In K. T. Kuehlwein & H. Rosen (Eds.), Cognitive therapies in action: Evolving innovative practice (pp. 88–125). San Francisco: Jossey-Bass.

    Google Scholar 

  • Duncan, B. L., Hubble, M. A., & Miller, S. D. (1997). Psychotherapy with "impossible" cases: Time efficient treatment of therapy veterans. New York: Norton.

    Google Scholar 

  • Gold, J. R. (1994). When the patient does the integrating: Lessons for theory and practice. Journal of Psychotherapy Integration, 4(2), 133–158.

    Google Scholar 

  • Gold, J. R. (1995). Knowing and not knowing: Commentary on the roots of psychotherapeutic failure. Journal of Psychotherapy Integration, 5(2), 167–170.

    Google Scholar 

  • Gon¸calves, O. F. (1994). Cognitive narrative psychotherapy: The hermeneutic construction of alternative meanings. Journal of Cognitive Psychotherapy:AnInternational Quarterly, 8(2), 105–125.

    Google Scholar 

  • Greenberg, L., & Pascual-Leone, J. (1995).Adialectical constructivist approach to experiential change. In R. A. Neimeyer & M. J. Mahoney (Eds.), Construcitivism in psychotherapy (pp. 169–191).Washington, DC: American Psychological Association.

    Google Scholar 

  • Greenberg, L., Rice, L. N., & Elliott, R. (1993). Facilitating emotional change: The moment-bymoment process. New York: Guilford.

    Google Scholar 

  • Hanna, F. J. (1996). Precursors of change: Pivotal points of involvement and resistance in psychotherapy. Journal of Psychotherapy Integration, 6(3), 227–264.

    Google Scholar 

  • Kopp, R. R., & Craw, M. J. (1998). Metaphoric language, metaphoric cognition, and cognitive therapy. Psychotherapy, 35(3), 306–311.

    Google Scholar 

  • Lazarus, A. A., & Messer, S.B. (1991). Does chaos prevail? Anexchange on technical eclecticism and assimilative integration. Journal of Psychotherapy Integration, 1(2), 143–158.

    Google Scholar 

  • Lewis, M. (1997). Altering fate: Why the past does not predict the future. New York: Guilford.

    Google Scholar 

  • Mahoney, M. J. (1991). Human change processes: The scientific foundations of psychotherapy. New York: Basic Books.

    Google Scholar 

  • Meichenbaum, D. (1993). Changing conceptions of cognitive behavior modification: Retrospect and prospect. Journal of Consulting and Clinical Psychology, 61(2), 202–204.

    Google Scholar 

  • Messer, S. B. (1992). A critical examination of belief structures in integrative and eclectic psychotherapy. In J. C. Norcross & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 130–165). New York: Basic Books.

    Google Scholar 

  • Messer, S. B. (1996). A psychodynamic perspective on resistance in psychotherapy: Vive la r´esistance. In Session: Psychotherapy In Practice, 2(1), 25–32.

    Google Scholar 

  • Neimeyer, R. A. (1993). An appraisal of constructivist psychotherapies. Journal of Consulting and Clinical Psychology, 61(2), 221–234.

    Google Scholar 

  • Neimeyer, R. A. (1996). Process interventions for the constructivist psychotherapist. In H. Rosen & K. T. Kuehlwein (Eds.), Constructing realities: Meaning-making perspectives for psychotherapists (pp. 371–411). San Francisco: Jossey-Bass.

    Google Scholar 

  • Neimeyer, R. A., & Mahoney, M. J. (Eds.). (1995). Constructivism and psychotherapy. Washington, DC: American Psychological Association.

    Google Scholar 

  • Newman, C. F. (1991). Cognitive therapy and the facilitation of affect: Two case illustrations. Journal of Cognitive Psychotherapy: An International Quarterly, 5(4), 305–316.

    Google Scholar 

  • Newman, C. F. (1994). Understanding client resistance: Methods for enhancing motivation to change. Cognitive and Behavioral Practice, 1(1), 47–69.

    Google Scholar 

  • Newman, C. F. (1997). Maintaining professionalism in the face of emotional abuse from clients. Cognitive and Behavioral Practice, 4(1), 1–29.

    Google Scholar 

  • O'Hanlon, W. H. (1990). A grand unified theory for brief therapy: Putting problems in context. In J. K. Zeig & S. G. Gilligan (Eds.), Brief therapy: Myths, methods, and metaphors (pp. 78–89). New York: Brunner/Mazel.

    Google Scholar 

  • O'Hanlon, W. H. (1994). The third wave. The Family Therapy Networker, 18(6), 18–29.

    Google Scholar 

  • Orlinsky, D. E., & Howard, K. I. (1986). Process and outcome in psychotherapy. In S. L. Garfield & A. E. Bergin (Eds.), Handbook of psychotherapy integration (3rd ed.), (pp. 311–381). New York: Wiley.

    Google Scholar 

  • Persons, J. B., & Tompkins, M. A. (1997). Cognitive-behavioral case formulation. In T. D. Eells (Ed.), Handbook of psychotherapy case formulation (pp. 314–339). New York: Guilford.

    Google Scholar 

  • Prochaska, J. O., & DiClemente, C. C. (1992). The transtheoretical approach. In J. C. Norcross, & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 300–334). New York: Basic Books.

    Google Scholar 

  • Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47(9), 1102–1114.

    Google Scholar 

  • Ramsay, J. R. (1998). Postmodern cognitive therapy: Cognitions, narratives, and personal meaning-making. Journal of Cognitive Psychotherapy: An International Quarterly, 12(1), 39–55.

    Google Scholar 

  • Russell, R. L., & van den Broek, P. (1992). Changing narrative schemas in psychotherapy. Psychotherapy, 29(3), 344–354.

    Google Scholar 

  • Safran, J.D., & Messer, S.B. (1997). Psychotherapy integration: Apostmodern critique. Clinical Psychology: Science and Practice, 4, 140–152.

    Google Scholar 

  • Shapiro, D. A., Barkham, M., Reynolds, S., Hardy, G., & Stiles, W. B. (1992). Prescriptive and exploratory psychotherapies: Toward an integration based on the assimilation model. Journal of Psychotherapy Integration, 2(4), 253–272.

    Google Scholar 

  • Stiles, W. B., Barkham, M., Shapiro, D. A., & Firth-Cozens, J. (1992). Treatment order and thematic continuity between contrasting psychotherapies: Exploring an implication of the assimilation model. Psychotherapy Research, 2(2), 112–124.

    Google Scholar 

  • Stiles, W. B., Shapiro, D. A., & Elliott, R. (1986). Are all psychotherapies equivalent? American Psychologist, 41(2), 165–180.

    Google Scholar 

  • Stricker, G. (1995). Failures in psychotherapy. Journal of Psychotherapy Integration, 5(2), 91–93.

    Google Scholar 

  • Strupp, H. H. (1973). On the basic ingredients of psychotherapy. Journal of Consulting and Clinical Psychology, 41(1), 1–8.

    Google Scholar 

  • Strupp, H. H. (1993). The Vanderbilt psychotherapy studies: Synopsis. Journal of Consulting and Clinical Psychology, 61(3), 431–433.

    Google Scholar 

  • Strupp, H. H. (1996). Some salient lessons from research and practice. Psychotherapy, 33(1), 135–138.

    Google Scholar 

  • Strupp, H. H., & Binder, J. L. (1984). Psychotherapy in a new key: A guide to time-limited dynamic psychotherapy. New York: Plenum.

    Google Scholar 

  • Strupp, H. H., Schacht, T. E., Henry, W. P., & Binder, J. L. (1992). Jack M.: A case of premature termination. Psychotherapy, 29(2), 191–205.

    Google Scholar 

  • Tannen, D. (1998). The argument culture: Moving from debate to dialogue. New York: Random House.

    Google Scholar 

  • Vincent, N., & LeBow, M. (1995). Treatment preference and acceptability: Epistemology and locus of control. Journal of Constructivist Psychology, 8, 81–96.

    Google Scholar 

  • Wachtel, P. L. (Ed.). (1982). Resistance: Psychodynamic and behavioral approaches. New York: Plenum Press.

    Google Scholar 

  • Wachtel, P. L. (1997). Psychoanalysis, behavior therapy, and the relational world. Washington, DC: American Psychological Association.

    Google Scholar 

  • Wallach, M. S., & Strupp, H. H. (1960). Psychotherapists' clinical judgments and attitudes towards patients. Journal of Consulting Psychology, 24(4), 316–323.

    Google Scholar 

  • White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: Norton.

    Google Scholar 

  • Winter, D. A., & Watson, S. (1999). Personal construct psychotherapy and the cognitive therapies: Different in theory but can they be differentiated in practice? Journal of Constructivist Psychology, 12(1), 1–22.

    Google Scholar 

  • Wright, J. H., & Davis, D. (1994). The therapeutic relationship in cognitive-behavioral therapy: Patient perceptions and therapist responses. Cognitive and Behavioral Practice, 1(1), 25–45.

    Google Scholar 

  • Young, J. E. (1994). Cognitive therapy for personality disorders: A schema-focused approach (Rev. ed.). Sarasota, FL: Professional Resource Press.

    Google Scholar 

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  1. Center for Cognitive Therapy/Bucks County Office, University of Pennsylvania Health System, 817 Lawn Avenue, Sellersville, Pennsylvania, 18960

    J. Russell Ramsay

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  1. J. Russell Ramsay
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Ramsay, J.R. The Clinical Challenges of Assimilative Integration. Journal of Psychotherapy Integration 11, 21–42 (2001). https://doi.org/10.1023/A:1026624923957

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