Psychotherapy has developed from four foundational schools of psychoanalytic, cognitive behavioural, humanistic, and transpersonal psychology, and it has been estimated (Karasu 1986; Corsini 1995) that over 400 systems of psychotherapy have evolved. However, empirical studies (Asay & Lambert 1999) suggest that the quality of the therapeutic relationship, regardless of system, is the major influence on therapeutic outcome. These professional factors, and other economic and social influences (Norcross & Newman 1992), engendered a psychotherapy integration movement and a burgeoning of integrative approaches and publications. This movement, formalised by SEPI in 1982, is described currently by three main routes to integration (Safran and Messer 1997), which offer little guidance and leave several issues unresolved (Hollanders 2000b). This PhD thesis presents a new organising framework by which psychotherapy integration can be understood, described and developed. It consists of three dimensions I call constructive, complicit and contiguous integration, and it forms the connecting principle for the published works. The works cover over six years of qualitative inquiry into psychotherapy integration using a heuristic research strategy (Moustakas 1990), which incorporated interpretative phenomenology, case studies, reflexive action and writing as component methods. The new organising framework redefines the current topography of psychotherapy integration and provides an innovative tool for aspiring integrationists. Constructive integration repositions the existing routes to integration and is illustrated by articles on games and projective identification, relationship in organisations, Jung and object relations, and countertransference. Complicit integration emphasises how higher-order integrative approaches simplify the current complexity of psychotherapy. This is exemplified by articles on Clarkson's relational framework in Kleinian psychotherapy and brief dynamic therapy. Contiguous integration reflects how psychotherapy relates to the world at large. Freud's anthropology, Bion's group theories and Jung's collective unconscious are examples of this dimension. I present four articles on organisational and social artefact to further illustrate this dimension. Finally, I present an article on psychotherapy integration itself, which describes these dimensions and the innovative framework they form. I then highlight why this PhD thesis represents a significant and original contribution to knowledge.

The integrated psychotherapy model (IPM) is an insight-oriented, integrative therapeutic approach that weaves psychoanalytic, cognitive-behavioral, and humanistic approaches into a treatment methodology. This model is new and untested; therefore, its therapeutic effectiveness is unknown. The purpose of this study was to measure the treatment effectiveness of IPM using Bell's Object Relations and Reality Testing Inventory, the Constructive Thinking Inventory, and the Working Alliance Inventory. Participants in the study included 19 undergraduate psychology students volunteering for extra credit and 11 clients of counseling psychology graduate students. This quasi-experimental, pretest-posttest, nonequivalent group study involved 9 sessions of IPM for the treatment group and 9 classes in a general psychology course for the comparison group. An analysis of covariance using the pre-post testing of object relations and reality testing, productive and unproductive thinking, and working alliance measured changes in these constructs and determined the therapeutic effectiveness of IPM. Results revealed that there were no differences between the experimental and comparison groups. Although no significant differences were demonstrated when comparing pre and post testing, this study demonstrated that 9 sessions of IPM did not harm those who underwent the treatment; this finding is positive given the need for further research to potentially validate the IPM as a new and effective integrative model for psychotherapy. It is recommended that a similar study be repeated with more seasoned IPM therapists, a longer treatment period, and the focus of change on client symptoms.

The purpose of this study was to analyze the extent to which a sample of Swedish psychotherapists used techniques and interventions that are not part of the methods that they have been trained in. i.e. to what extent do they have an integrated approach in their professional activities. The hypothesis is that most psychotherapists in Sweden do not work strictly with just one psychotherapeutic orientation, but that they use techniques and methods from other orientations, which would be consistent with international research results in this field. Participants were recruited by mailed letters to a sample of authorized Swedish psychotherapists of all potential orientations. The letters contained an information paper and a questionnaire.

No description available.

This research builds upon and explores an enigmatic set of experiences which theorists in the Object Relations tradition have characterised as regression to dependence, a return to a primitive, pre-verbal relational process presenting in some clients in psychotherapy. This research is a study of the concept of regression to dependence, its manifestation within the psychotherapy process, and facilitation within the therapeutic relationship. The Psychoanalytic theoretical positions on regression to dependence are explored, together with the Relational/Developmental perspective which recognises regression and its importance within psychotherapy. This exploration seeks to understand the experience of regression to dependence, how regression to dependence can be effectively worked within Integrative Psychotherapy, and makes recommendations for Integrative practitioners and theorists related to effective facilitation of clients, showing how the Relational/Developmental approach can effect repair. The study employs a qualitative methodology. A heuristic study was undertaken in which eleven practicing psychotherapists were interviewed and data was collected via semi-structured interviews. Most participants were interviewed twice, with a view to collecting data on both their personal experience as a client in psychotherapy and also their experiences as practitioners when working with clients who were experiencing regression to dependence. The transcripts from these interviews were analysed for emergent themes. The themes are discussed in the context of and with reference to the Psychoanalytic theoretical position and the Relational/Developmental perspective. An account is offered of how these experiences have come to be understood as recollecting difficulties in early infantile relationships. Reflections are made on the essence and qualities of a therapy that can facilitate regression to dependence in order to promote healing. Recommendations are made for the practice of Integrative Psychotherapy and the training of Integrative Psychotherapists in order to prepare them for this work. These recommendations for therapists include; having sufficient preparation, knowledge and understanding to be able to recognise and work with a regressive process emerging in the client; having an understanding of the need to facilitate this process for some clients; and to be aware of the need for particular adaptations in the therapeutic stance in some circumstances, and the difficulties which may arise. Recommendations are also offered regarding the support needed for the therapist whilst working with this process, which include the need for ongoing personal therapy, and supervision. The researcher’s personal story is an intrinsic part of the research, and as an integral part of this study is in accordance with the heuristic and autoethnographic styles, and with the practice of Integrative Psychotherapy, where the use of self is seen as a crucial clinical tool in the therapeutic process. Throughout this study reflexivity has been used regarding the personal experiences of the researcher as client, therapist and researcher.

Years of psychotherapy practice at university, state, and military hospitals developed the author's interest in the presentation of love relationship problems. Mood and anxiety disorders, as the most prevalent pathologies, were often co-morbid with or secondary to partner relationship issues. Most vexing for clients was a situation of repeated dysfunctional partner selections in which similar problems arose each time. This incubated the idea of a process, probably outside of awareness, that functioned to perpetuate self-defeating partner selection patterns. The author was introduced to Money's `lovemap' concept during studies and identified readily with its principles and mechanisms. The lovemap is defined as a highly individualised, developed, mental template or cognitive blueprint of the ideal lover. It is assumed that every person has a lovemap, and would be able to describe it if asked the right questions. The concept promised to be a useful vehicle for studying self-defeating partner selection patterns, as `errors' might be coded into the lovemap that are expressed in such a presentation. The author identified the need to ground the lovemap concept in recognised psychological theory in order to motivate for its relevance. Kelly's theory of cognitive constructs provided robust links for lovemap as a sophisticated construction system, and the developmental theories of Freud and Erikson situated lovemap genesis within recognised periods of emerging human capacities to love and relate sexually; the stages of puberty to young adulthood. Lovemaps are assumed to function optimally when love and lust co-operate in pairbonding, or the capacity to couple. Extensive literature reviews cover the research fields of romantic love, human sexuality, and pairbonding, affording hypotheses as to lovemap pathology. A qualitative, Phenomenological research design of case studies with six adult persons, who had experienced radical contradictions of original lovemaps, identified when and how lovemap change took place. Thematic analysis of the attributions for change distilled a number of implications for therapy that would encourage certain indicated change processes. An integrative psychotherapy model recognises the cognitively- and socially constructed nature of lovemaps and proposes intervention components that blend cognitive-behavioural and narrative approaches. This model will be tested extensively with a suitable client population. / Psychology / D. Litt. ET Phil. (Psychology)

Years of psychotherapy practice at university, state, and military hospitals developed the author's interest in the presentation of love relationship problems. Mood and anxiety disorders, as the most prevalent pathologies, were often co-morbid with or secondary to partner relationship issues. Most vexing for clients was a situation of repeated dysfunctional partner selections in which similar problems arose each time. This incubated the idea of a process, probably outside of awareness, that functioned to perpetuate self-defeating partner selection patterns. The author was introduced to Money's `lovemap' concept during studies and identified readily with its principles and mechanisms. The lovemap is defined as a highly individualised, developed, mental template or cognitive blueprint of the ideal lover. It is assumed that every person has a lovemap, and would be able to describe it if asked the right questions. The concept promised to be a useful vehicle for studying self-defeating partner selection patterns, as `errors' might be coded into the lovemap that are expressed in such a presentation. The author identified the need to ground the lovemap concept in recognised psychological theory in order to motivate for its relevance. Kelly's theory of cognitive constructs provided robust links for lovemap as a sophisticated construction system, and the developmental theories of Freud and Erikson situated lovemap genesis within recognised periods of emerging human capacities to love and relate sexually; the stages of puberty to young adulthood. Lovemaps are assumed to function optimally when love and lust co-operate in pairbonding, or the capacity to couple. Extensive literature reviews cover the research fields of romantic love, human sexuality, and pairbonding, affording hypotheses as to lovemap pathology. A qualitative, Phenomenological research design of case studies with six adult persons, who had experienced radical contradictions of original lovemaps, identified when and how lovemap change took place. Thematic analysis of the attributions for change distilled a number of implications for therapy that would encourage certain indicated change processes. An integrative psychotherapy model recognises the cognitively- and socially constructed nature of lovemaps and proposes intervention components that blend cognitive-behavioural and narrative approaches. This model will be tested extensively with a suitable client population. / Psychology / D. Litt. ET Phil. (Psychology)