Integrative psychotherapy

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Richard G. Erskine · New York

What it is

Not a manualised protocol but an integrative relational framework. "Integrative" has two meanings here: (a) integrating the personality, i.e. making disowned, unaware or unresolved ego states part of a cohesive self, and (b) selectively combining affective, cognitive, behavioural, physiological and…

Format

• No formal stage model is given in the primary sources. O'Reilly-Knapp & Erskine (TAJ 33(2)) explicitly describe no formal stages but a typical pattern; the course below follows that pattern, with the assessment dimensions the authors use to choose interventions.
• Format. Individual, face-to-face, open-ended and often long-term (the published schizoid case ran about 4 years). Parent ego state work may take one or several sessions; Erskine is reported to suggest about 90 minutes for it. Erskine also works in workshops and groups, but no group protocol was…

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 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?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• 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

• drift into intellectualisation.
• naming too much too fast; check fit.
• premature intellectual interpretation.
• supplying words the client does not own.
• reading it as resistance and confronting it.

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.