Integrative Systemic Supervision: Promoting Supervisees' Theoretical Integration in Systemic Therapy.

Integrative systemic therapy (IST) is a meta-theoretical perspective, grounded in systemic theory and integration, that transcends therapy models in individual, couple, and family therapy. To foster supervisees' theoretical integration and systemic thinking, two of IST's primary tools-the essence diagram and blueprint-are described and applied to inform an integrative, systemic meta-perspective for supervision. Recommendations, specific guiding questions, and examples are provided to operationalize these tools in the multi-level supervision system (i.e., supervisor-supervisee-client system). IST supervisors and other supervisors who are interested in integrative, systemic training can use these tools to guide the process of supervision and strengthen supervisees' ability to hypothesize, plan, converse, and read clients' feedback in relation to the various tasks of therapy. The essence diagram and blueprint are applied to facilitate case consultation and cultivate the development of supervisees' clinical competencies. Particularly, the problem-solving focus of IST has been adapted to include a competency-based and professional growth-oriented dimension for supervision to better promote supervisees' development. Lastly, the advantages and challenges of IST-influenced supervision are discussed.

La terapia sistémica integral (TSI) es una perspectiva metateórica basada en la teoría sistémica y la integración, que trasciende los modelos de terapia en la terapia individual, de pareja y familiar. Para fomentar la integración teórica de los supervisados y el pensamiento sistémico, se describen y se aplican dos de las herramientas principales de la TSI-el diagrama del eje y el diseño- a fin de respaldar una metaperspectiva integradora y sistémica de la supervisión. Se ofrecen recomendaciones, preguntas orientadoras específicas y ejemplos para poner en funcionamiento estas herramientas en el sistema de supervisión multinivel (p. ej.: sistema supervisor-supervisado-paciente). Los supervisores de la TSI y otros supervisores que estén interesados en la capacitación integradora y sistémica pueden usar estas herramientas para guiar el proceso de supervisión y fortalecer la capacidad de los supervisados para plantear hipótesis, planificar, conversar y leer los comentarios de los pacientes en relación con las diferentes tareas de la terapia. El diagrama del eje y el diseño se aplican para facilitar la consulta de casos y cultivar el desarrollo de las competencias clínicas de los supervisados. Particularmente, se ha adaptado el eje de resolución de problemas de la TSI para incluir una dimensión basada en competencias y orientada al crecimiento profesional a fin de que la supervisión promueva mejor el desarrollo de los supervisados. Por último, se comentan las ventajas y las dificultades de la supervisión influida por la TSI.

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.

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.