How do integrative psychotherapists integrate? A qualitative exploration of tales from the trenches

This is a phenomenological study exploring the first-person lived experiences of 14 clinicians in their daily practices of integrative psychotherapy, in an Irish context. The data were gathered through semi-structured interviews lasting 50 minutes and investigated using Interpretative Phenomenological Analysis (IPA). Three master themes emerged: (1) Being an Integrative Practitioner (2) The Therapeutic Relationship – A Dynamic Process and (3) Identity – Personal and Individual. The findings confirm that integrative psychotherapy is a complex and idiosyncratic process. The therapy practices as described by participants differ to those as outlined in the literature. Participants use their prior, tacit knowledge of what worked previously, built up through a cycle of praxis, as a reference point for their practice. Integration is seen as combining different interventions and techniques. All consider listening as the mainstay of building the therapeutic relationship and the driver towards integration. There is an appreciation of multiple aspects of client problems and multiple ways these can be understood in theory and worked through using a variety of interventions and techniques. Tailoring their approaches to the needs of each client was seen as a key responsibility of the therapist. A pluralistic perspective is proposed as a structure for containing the myriad of theories and therapies that practitioners are struggling to incorporate into their practices. This also aims to address the lack of clarity and agreed definition within the field in general. Since integrative/eclectic approaches are increasingly popular internationally, it is difficult to isolate issues relating to integration without reference to the wider field of psychotherapy. The study produced some novel and surprising discoveries: the lack of a cohesive identity shared by integrative psychotherapists, and a view of self as not being a researcher, despite the fact that descriptions of their practices often suggested the opposite. Developing a practitioner-researcher outlook is considered of great significance to the profession. A spirit of open, collaborative inquiry and a therapeutic pluralism have been advanced as an apposite stance for the profession to adopt in proactively meeting the challenges within what is a dynamic and ever-evolving field of endeavour.