Transcending Therapy Models and Managing Complexity: Suggestions from Integrative Systemic Therapy.

Integrative Systemic Therapy (IST) is a metatheoretical perspective for the conduct of individual, couple, and family therapy. Following a brief description of IST, this article presents developments in IST and their implication for psychotherapy integration. The nature of problem solving in IST is clarified, and the relationship between IST's essential problem-solving tasks and its core decision-making process is defined. Particular attention is paid to two dimensions of IST that have given it its name: integration and systems theory. The advantages of a therapy that is client system-centered and not model-driven are discussed, and a justification for "good enough" execution of interventions abstracted from specific models is provided. A procedure for balancing pragmatic demands of therapy with a commitment to account, as needed, for broader or deeper systemic issues is presented.

La terapia sistémica integrativa (TSI) es una perspectiva metateórica para llevar a cabo la terapia individual, de pareja y familiar. Después de una breve descripción de la TSI, este artículo presenta avances en dicha terapia y su implicancia para la integración en la psicoterapia. Se aclara la índole de la resolución de problemas en la TSI y se define la relación entre las tareas esenciales de resolución de problemas de la TSI y su proceso fundamental de toma de decisiones. Se presta atención particularmente a dos dimensiones de la TSI que le han dado su nombre: la integración y la teoría de sistemas. Se explican las ventajas de una terapia que está centrada en el sistema del paciente y no dirigida por un modelo, y se justifica la ejecución "suficientemente buena" de intervenciones abstraída de modelos específicos. Finalmente, se presenta un procedimiento para equilibrar las exigencias pragmáticas de la terapia con un compromiso de tener en cuenta, cuando fuera necesario, cuestiones sistémicas más amplias o profundas.

Putting the "family" back into family therapy.

In this article, we examine the field of family therapy by drawing a distinction between two forms of practice: Whole Family Therapy (WFT), defined as treating the whole family, and Relational Family Therapy (RFT), defined as working with a subsystem of the family or an individual while retaining a systemic lens. Our thesis is that the practice of WFT has been in decline for some time and steps must be taken to keep it from becoming a defunct practice. We consider the trajectory of WFT and RFT throughout the development of family therapy through reference to the people, the literature, training, and practice patterns associated with family therapy. We remind the reader of the many benefits of WFT and suggest that today WFT is likely to be practiced in conjunction with RFT and individual therapy. Since training of family therapists today is largely located in degree-granting programs, we identify constraints to including WFT in such programs. We conclude by offering suggestions that can enhance a program's ability to train students in WFT.

Integrative problem-centered metaframeworks therapy I: core concepts and hypothesizing.

Over the last 20 years psychotherapy and family therapy have been inundated with a plethora of empirically validated treatments for particular disorders. That trend will increase. Psychotherapists will increasingly be exhorted and ultimately required to integrate empirical data and multicultural competence into their practice. Additionally, individual psychotherapy's default dominance of psychotherapeutic discourse needs to integrate and come to theoretical and clinical terms with the implications of the growing body of research demonstrating the validity and value of a multisystemic perspective. This article (and its companion article) presents a comprehensive, integrative, multisystemic, and empirically informed psychotherapeutic perspective to help therapists and psychotherapy trainers successfully address these challenges-Integrative Problem Centered Metaframeworks (IPCM) Therapy. This first article presents and illustrates IPCM's theoretical foundation, core concepts, and "case formulating" components. It delineates a Blueprint for the practice and teaching of 21st century psychotherapists who can meld science and art into best practice.

Integrative problem-centered metaframeworks therapy II: planning, conversing, and reading feedback.

This is the second of 2 articles presenting Integrative Problem Centered Metaframeworks (IPCM) Therapy, a multisystemic, integrative, empirically informed, and common factor perspective for family, couple, and individual psychotherapy. The first article presented IPCM's foundation concepts and Blueprint for therapy, focusing on the first Blueprint component-Hypothesizing or assessment. This article, focusing on intervention, presents the other 3 Blueprint components-Planning, Conversing, and Feedback. Articulated through the Blueprint, intervention is a clinical experimental process in which therapists formulate hypotheses about the set of constraints (the Web) within a client system that prevents problem resolution, develop a therapeutic Plan based on those hypotheses, implement the Plan through a coconstructed dialogue with the clients, and then evaluate the results. If the intervention is not successful, the results become feedback to modify the Web, revise the Plan, and intervene again. Guided by the therapeutic alliance, this process repeats until the presenting problems resolve. IPCM Planning sequentially integrates the major empirically and yet-to-be empirically validated therapies and organizes their key strategies and techniques as common factors. Conversing and Feedback employ empirical STIC(®) (Systemic Therapy Inventory of Change) data collaboratively with clients to formulate hypotheses and evaluate interventions. This article emphasizes the art and science of IPCM practice.