Integrated Treatments and Eclecticism
The marriage of behavioral and cognitive therapies that yields the cognitive-behavioral approach is not the only blending of therapy types that has been going on. Indeed, the last few decades have seen a strong trend toward psychotherapists endorsing what is sometimes called multimodal therapy or eclecticism—a deliberate weaving together of the various traditions (Beitman, Goldfried, & Norcross, 1989; Lazarus, 2006; Norcross & Freedheim, 1992). This broad tendency is evident in the work of many clinicians; in fact, when U.S. psychologists are asked to describe their work, the thera-peutic approach that most identify with is eclectic/integrative (Prochaska & Norcross, 2007; see Figure 17.10). As one example of this tendency, consider Marsha Linehan’s dialectical behavior therapy (DBT) for borderline personality disorder. DBT grew out of the cognitive approach, but includes elements from cognitive, behavioral, humanistic, and psychodynamic therapies to address the profound emotion dysregulation associ-ated with borderline personality disorder (Linehan, Bohus, & Lynch, 2007).
This eclecticism obviously allows the therapist flexibility to tailor his approach to the specific needs and symptoms of each patient. And over the course of treatment, it allows the therapist to pursue lines of discussion or specific interventions that are working and to back off from interventions that are ineffective. In addition, multimodal therapy makes sense theoretically. We saw that mental disorders rarely have a single cause; instead, they emerge from a complex set of factors creating the diathesis as well as factors creating the more immediate stressors. It seems sensible, therefore, that treatment might need to work on multiple fronts, which is precisely what multimodal therapy is designed to do.