Psychotherapy integration is not a specific model of therapy, but rather an approach that incorporates the use of several different therapy models. It is based on the idea that optimal therapy can occur when the therapist uses a multi-model approach, carefully combining the theories and techniques of various approaches. At Healthy Synergy, we take an integrative approach to therapy. This approach means we carefully consider what your needs are and combine approaches that have been proven effective to treat the specific concerns that you present.
The integrative approach to therapy can be applied in multiple ways. One example of therapy with an anxious client may incorporate the use of Cognitive-Behavioral Therapy (CBT), Dialetical-Behavioral Therapy (DBT), and Psychodyamic Therapy (PT). In this example, CBT may be utilized to challenge negative patterns of thinking (e.g., “I am not good at anything and no one likes me”) and to develop more realistic perceptions of self and others (e.g., “I am good at some things and some people to like me”). DBT may be used to help the client gain ways of coping with intense emotions associated with their anxiety and for helping them gain mindfulness in their daily life (a method of relaxation and focusing). Finally, psychodynamic therapy may be utilized to help the client become more aware of how they interact in relationships and how prior ways of coping or defending against feeling anxious are not working for them. For instance, they may learn how avoiding anxiety provoking situations may increase anxiety. Together, an integration of these therapeutic approaches is more effective than any of them on their own.
Dielectical Behavioral Therapy (DBT)
Dialectical Behavior Therapy (DBT) is a type of treatment that focuses on helping people become more in control of their emotions. Life stresses, combined with prior traumas and/or feelings of depression or anxiety, may make your emotions feel too intense and sometimes “out-of-control.” DBT is a therapy approach that helps to decrease the intensity of your feelings and encourages the development of coping strategies to deal with difficult feelings and stressful situations.
DBT starts with the therapist taking an accepting and non-judgmental stance. The therapist hopes to convey an acceptance of your current way of thinking and feeling without the use of negative self-judgment. Often, people harshly criticize the way they think, feel, or act. While change is desired, such self-admonishment can be very debilitating and often leads to distorted views and/or avoidance of one’s problems. In therapy the DBT therapist will work with you to acknowledge and accept your current state of being. Gaining acceptance of your present state allows the therapist to facilitate change in your feelings, thoughts, and behaviors.
Another important concept of DBT is helping you understand the dialectics. Dialectics means examining opposing ways of viewing a situation and understanding the elements of truth in each view. Often individuals believe that only one way of thought, feeling or action is correct. The DBT therapist will help you consider alternative ways of viewing a situation. This involves reasoning through extreme ideas or feelings and learning to see the middle ground in nearly every situation.
DBT therapy also involves learning new skills that help you tolerate stress and regulate intense feelings. These skills focus on helping you become more mindful in your daily life. Research has shown that daily mindfulness can significantly reduce the effects of stress. Additional skills taught include relationship skills, skills to help regulate intense emotions, and skills to increase your ability to cope with stress.
DBT has been applied effectively in the treatment of borderline personality disorder, depression, eating disorders, and anxiety disorders.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is a type of treatment that focuses on understanding how your thoughts impact the way you feel and what you do. The core idea is that feelings can change when you change how you think and act. When you experience negative thoughts this can lead to faulty beliefs about yourself, others, and the world around you. For instance, if you hold the negative thought that “people do not like you,” you will probably feel negatively about yourself. You may also feel negative about other people for judging you negatively and you may see the world as an unfriendly and judgmental. The CBT therapist helps by challenging these negative thoughts and supporting the client in seeing themselves, others, and the world more realistically.
CBT begins through the development of a strong working relationship between you and the therapist. The therapist then works with you to identify your negative thoughts and how they are influencing the way you currently feel and behave. The therapist then challenges these thoughts in a supportive way, and helps you realize alternative ways of viewing yourself, others, and the world. With an alternative point of view the therapist encourages you to become behaviorally active, with the idea that action can further increase the acquisition of a new way of thinking and feeling. The therapist may also support you by teaching you new skills to support improvements in mood and thought. These skills frequently include identification of problematic thoughts, structured problem solving, and relaxation techniques.
CBT has received strong treatment support for many mental health issues. Specifically, CBT has been proven effective in the treatment of mood disorders including depression and bipolar disorder, and also in the treatment of many anxiety disorders including generalized anxiety disorder, post-traumatic disorder, and panic disorder. CBT has also demonstrated effectiveness in the treatment of eating disorders, substance abuse, and personality disorder. The research indicates that CBT alone can alter brain activity in those receiving treatment, indicating that overall brain function improves with engagement in this type of therapy.
Psychodynamic Therapy (PT) is a treatment that focuses on understanding how you see yourself, how you view others, how you have functioned in current and past relationships, and on the internal conflicts in feelings and thoughts you experience. The goal is to increase awareness about how your experiences influence you in your current situation and how beliefs, feelings, and thoughts about these experiences perpetuate unhealthy patterns of relating to self and others.
Your psychodynamic therapist will want to learn about your background including past relationships with key figures, past successes and problems, and how you have functioned and coped throughout the various stages of your life. The therapist pays attention to how defenses and negative coping mechanisms have been used and continue to be used. Often during earlier parts of life, we adopt coping strategies that work well in certain situations, and as we get older we tend to continue to use the same coping strategies. While sometimes they are effective, often they are not because the situations and circumstances of our life have changed and rendered those old methods ineffective. The psychodynamic therapist helps you identify what defenses and coping strategies you are using and how they are impacting your current situation.
PT is particularly effective in helping an individual gain a better understanding of themselves and to produce long-term changes in how they view themselves and are able to function in relationships. It has also been proven effective for the treatment of depression, anxiety, substance use disorders, and personality disorders.
Eye Movement Desensitization and Reprocessing (EMDR)
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