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Abstract
The past 10 years has seen little activity in the attempt to integrate psychodynamic and behavioral therapies. While these therapies are generally seen as incompatible, recent developments have resulted in forms of each (Control/Mastery theory and Functional Analytic Psychotherapy) that are strikingly similar in their conceptualization of psychopathology, their interventions and their outcome measures. This paper revisits the possibility of integrating these therapies from a common factors perspective. While these therapies possess many commonalties, theoretical differences still result in incompatibility. This incompatibility between two very similar treatments poses serious questions for the psychotherapy integration movement. Implications for theory and treatment are explored.
The promise and problem of integration
The past 20 years have seen an increase in calls for psychotherapy integration by members of the academy and professional psychotherapists. Integrationists have recommended that the field of psychology move toward a more unified theory of psychotherapy in the face of a proliferation of 'brand name' therapies that total over 400 (Beitman et aL, 1989). The majority of these therapies have not developed as a result of scientific inquiry, but from the intuition and experience of clinicians (Adams, 1995). While the work of innovative clinicians has an important role in the development of psychological theory (Davison & Lazar-us, 1995), it is not hard to see how the varied experiences of thousands of clinicians can lead to the development of hundreds of theories and methods of practice. Integrationists have suggested several other rationales for moving toward psychotherapy integration including; inadequacy of single theories to treat all psychopathology, external socioeconomic contingencies, ascendancy of short-term problem-focused treatments, opportunities to observe and experiment with various treatments, the paucity of differential effectiveness demonstrated between therapies, recognition that therapeutic commonalties heavily contribute to outcome variance, and development of a professional network for integration (Norcross & Newman, 1992).
Integrationists have drawn attention to a serious issue in the field of psychotherapy. According to Arnkoff et aL (1993), the field has moved into a state of chaos with new therapies continually created and abandoned (usually with little or no regard to empirical research or validation), little communication possible between professionals who adhere to different schools, and a competition between brands that has produced extended, dogmatic debate, but little clarity. Additionally, integrationists have...