Running head: REFLECTION ONE
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Reflection I
Psychotherapy Integration
Doctorate of Professional Counseling
Javier D. Ley
Mississippi College, Clinton, Mississippi
September 28th, 2014
REFLECTION ONE
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Reflection I
The present reflection paper centers on chapter one of the text Psychotherapy Integration
(Sticker, 2010) and on the prologue and chapter one of The Heart and Soul of Change (Duncan,
B.L., Miller, S.D., Wampold, B.E., & Hubble, M.A., 2010). The reflection starts with a summary
of the pertinent readings of both texts. The summary is followed by the relevance of these
readings on my personal Project Demonstrating Excellence (PDE). Finally, the paper ends with a
personal reflection on the topics presented.
To begin, chapter one of Sticker’s text provides an introduction to the concept of
psychotherapy integration. In its definition, the author emphasizes the importance of becoming
open to different theoretical and technical perspectives. There are also definitions of different
approaches to which the term of psychotherapy integration has been applied. These approaches
include common factors (aspects present in different models), technical integration (using
techniques from different models without regard to theory), theoretical integration (theory that
applies theoretical frameworks from different models), and assimilative integration (using
techniques from different approaches but delivered through one specific theory). The author also
explicitly states a value to theory in integration, above and beyond technical eclecticism (Sticker,
2010).
The other text (Duncan et al, 2010) starts with a prologue that sets that credit straight in
regards to the common factors approach and the influence of Saul Rosenzweig, who is credited
for setting the stage for common factors and for the concept of the dodo verdict. The common
factors approach explains the similar success of diverse therapeutic perspectives by suggesting
implicit aspects of these different psychotherapies that are more relevant than specific
techniques. Related to this fact, is the concept of the dodo verdict taken from Alice in
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Wonderland. The dodo verdict basically states that diverse therapies are the same in regards to
possible outcomes and that all deserve praise for that.
Chapter one of Duncan and colleagues (2010) presents an introduction to that which
works in therapy and on its delivery. The authors mention that which is currently good in therapy
and it includes the decline of an emphasis of proving specific models are better than others, the
reduction in stigma related to mental health, the growing number of mental health professionals,
the proven effectiveness of psychotherapy, the emerging relevance of common factors and of
evidence based practice. On the other side, the authors also mention that which is not currently
good in the field and it includes the fact of larger supply of professionals as compared to demand
of services, the underutilization of psychotherapy, and doubtful competence of many
professionals in the field. There is also an enriching section of that which works in therapy and it
encompasses the information through research on common factors which include the following
four aspects: client factors and extratherapeutic factors, specific models and techniques, the
therapists, and the therapeutic alliance (Duncan et al, 2010).
In regards to the relevance of these topics to my PDE, the concept of psychotherapy
integration deals directly with my area of specialization which is “Positive Psychology
interventions for adults in Treatment for Substance Use Disorders in Nicaragua.” In this area, I
seek to integrate Positive Psychology (PP) tenants with those of treatment for SUD’s. I am
particularly interested in the possible areas for integration between PP and Motivational
Interviewing and PP and Twelve Step concepts. In relation to what works in therapy and the
common factors approach, Project Match is a good example of how similar outcomes were
achieved by different modalities (Project Match Research Group, 1997). Taking these into
consideration for my PDE, I would add consideration of how to apply common factors to my
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project in order to achieve outcome improvements. For example, how can placebo, hope, and
expectancy help me improve my therapeutic proposal.
Finally, what I found the most interesting aspect of the readings were those related to the
common factors: client and extratherapeutic factors, models and techniques, the therapists, and
the therapeutic alliance (Duncan et al, 2010). Out of these, the topic included in models and
techniques, of placebo, hope, and expectancy are my favorites. I was taken by reading about by
mixing practitioner’s allegiance with client’s expectations for positive outcomes. I was reminded
of how I was told about this over and over by a mentor in the addictions field. He would go on
and on about how it did not matter if it was this approach or that approach. That what really
mattered was whether the counselor believed in what he or she was doing and whether the client
also believed it and in the counselor. I had to grow myself into this thought as it was not
something I believed fully. Now I find myself totally agreeing with this and other common factor
premises. I also find that therapist training needs some revamping to reflect this research. There
are trainings galore on specific modalities, but why are they not main stream trainings on how to
improve therapeutic allegiance, improve hope and expectancy, and the self of the therapist, all
independent of specific therapeutic perspective?
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References
Duncan, B.L., Miller, S.D., Wampold, B.E., & Hubble, M.A. (Eds). (2010). The heart & soul of
change: Delivering what works in therapy (2nd ed.). Washington, DC: American
Psychological Association.
Project MATCH Research Group. (1997). Matching alcoholism treatments to client
heterogeneity: Project MATCH posttreatment drinking outcomes. Journal of Studies
on Alcohol. Vol. 58: 7-29.
Stricker, G. (2010). Psychotherapy integration. Washington, DC: American Psychological
Association.