Multimodal therapy and eclectic psychotherapy

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Arnold A. Lazarus, Sol L. Garfield · 1989

What it is

These two approaches are not single therapies with their own set of techniques. They are frameworks for choosing techniques from many schools and combining them. Lazarus called his position technical eclecticism, defined in a later account as "using empirically supported methods without adherence…

Format

• Lazarus's 1989 book moves "from the initial interview through relapse-prevention follow-up" (publisher's description, paraphrased). Its chapters run: basic rationale and method; basic concepts; the Initial Review; the multimodal assessment–therapy connection; determining BASIC I.D. interactions;…
• Comprehensive assessment. The client completes the Multimodal Life History Inventory (MLHI) at home after the first session.

Who practises it, and how they are trained or regulated

• The therapist turns vague complaints into specific, separate, interacting problems placed across all seven modalities, and works out how the modalities interact ("Determining BASIC I.D. Interactions" is a chapter title).

Evidence status, as the guide reports it

• Middle and later phases. Apply the common factors, plus specific procedures that have evidence for the presenting problem. Monitor progress.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Plateaus. Re-check goals and the alliance.
• Do not improvise a version and present it as Lazarus's method.
• One member being cast as "the problem". Keep every member's profile visible.
• The client nods without agreeing. Ask them to put the explanation in their own words.
• Anxiety or a return of symptoms as the end approaches. Normalise it and refer back to the plan.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.