The diversity of approaches to psychology and psychotherapy has increased exponentially in the past 20-years. The number of theoretical orientations now exceeds 100 approaches and the specialties within psychology are developing at such a fast rate that it is hard to keep track of them. The idea of a unified psychology appears to be more of a fantasy now than at any time in its history.
The diversity within psychology can draw mixed reactions from both modernism and postmodernism. In many ways, the proliferation of approaches is a product of the specialization inherent in modernism. However, modernism also believed that eventually science would unify psychology. Postmodernism, on the other hand, embraces the psychology’s pluralism while voicing strong concern about attempts to unify psychology. Through its differences, psychology can meet the needs of more people.
A Postmodernism Response to Specialization
Postmodernism, in many ways, favors the continued development of new specializations through its acceptance of multiple approaches to investigation. It is not threatened by the increasing of number of specialties within psychology. Postmodernism does, however, believe that it is important for these different approaches to be in dialogue with each other.
As the different specialties dialogue, it is important that each subject open to being influenced by the other. For example, when experts in quantitative and qualitative research dialogue, it is important for both sides to remain open to recognizing the limitations of their approach and the benefits of the other. Additionally, they should seek to learn how they can improve their own approach through the ideas of the other. Similarly, when psychodynamic therapists dialogue with neuropsychology, it is important for both sides to remain open.
In the modern area, it would be easy to say that the quantitative researchers and the neuropsychologists held the trump cards and were in the position to educate the lesser psychodynamic therapist and qualitative researchers. Postmodernism has pointed out the errors of this approach to dialogue.
A Postmodern Response to the Diversity of Theoretical Orientations
Modernist epistemology is the root of one of psychology’s most embarrassing public debates. Until the last several years, one of the most intense disagreements among psychotherapists was regarding which approach to therapy (i.e., theoretical orientation) was the best. This debate continues in some circles of psychotherapists. In the light of postmodernism, such debates seem irrelevant and futile.
Since different approaches to psychotherapy have different inherent epistemologies, the way to measure their effectiveness will vary in accordance with their epistemological beliefs. Each therapy will likely emerge with more positive outcomes than “the competitors” when measured in accordance with its epistemology and an appropriately-related methodology. Additionally, different approaches to therapy have different ideas of the good life. While some purport happiness or symptom relief represents the good life; others suggest that a self-aware life, a free life, or a virtuous life is a better sought after outcome.
The best example of this problem relates to the empirically supported treatment debate which ravaged so heatedly in the 1990s and early 2000s (Hoffman, 2005). A modernist epistemology still reigned supreme in psychology and a narrowly defined empirical approach (i.e., quantitative research) was seen as the supreme way to evaluate therapy. As this fit with the epistemology of cognitive-behavior, rational-emotive, and behavioral therapy, these approaches tended to fair better than many of the depth psychotherapies.
Postmodern helped level the playing field by pointing out the epistemological errors associated with attempting to prove the superiority of any one approach to therapy through empirical means. New approaches to evaluating the efficacy of psychotherapy incorporate an epistemological pluralism (i.e., evidence based practice) which allows for multiple approaches to evaluating the effectiveness of therapy to be recognized as valid (see Levant, 2005). Additionally, more consideration is given to common factors, such as the therapy relationship, which facilitate positive therapy outcomes regardless of the therapeutic orientation.
The most important change, however, is the consideration given to the client’s values and desired outcome of therapy. It is important for therapists to be aware of the different approaches to therapy and what they can help the client accomplish. For example, various approaches to therapy can help client’s understand how their unresolved childhood issues impact their present relationships; however, the psychodynamic approaches are more effective at accomplishing this. Conversely, cognitive approaches tend to be a better fit for client who desire quick relief from difficult emotional issues, particularly if the client is not interested in increasing self-awareness. In other words, it is more important to match the client with the type of therapy and therapist who best meets their needs. This is a significant improvement from the petty, egocentric battles over which approach to therapy is best.
The Move from Eclectic to Integrative Therapy
The ideas of eclectic and integrative therapy are both distinctly postmodern in many ways. Eclectic therapy acknowledges that different therapies work better for different people. Thus, a pragmatic approach is utilized in which whatever approach works with a client is used. While the eclectic approach was popular for a while, it has more recently fallen into ill repute.
The problem with the eclectic approach was a lack of depth. It takes many years to become an expert at any one approach to therapy; to assume anyone could become an expert at many different approaches to therapy is unreasonable. Eclectic therapy became a “bag of tricks” approach to therapy that often was inconsistent with itself and applied by therapists who had never become skilled or experts in any singular approach to therapy.
The integrative viewpoint is a much more sophisticated approach to therapy. It differs from the eclectic approach in that it suggests a foundation or center of practice. For example, Schneider proposed an existential-integrative therapy. In this approach, existential theory forms the foundation of practice; however, it integrates from other theories in order to broaden and strengthen its practice. This creates a flexibility in which existential therapy can be adapted to meet the needs of more clients while expanding its theoretical basis.
Integrative therapy does create some limitations as compared to the eclectic approach. Whereas eclectic pulls from theories very liberally and quickly adapts to new ideas, the integrative approach incorporate new ideas or techniques more thoughtfully. For example, in the existential-integrative theory, all that is integrated is tested against the foundation of existential theory. If what is being integrated does not fit, then one of two things must happen: adjustments must be made to existential theory or the proposed idea needs to be discarded.
As is illustrated in this discussion, the key differences between an eclectic and an integrative approach is the foundation and the concern for internal consistency. Therapists will provide better services if their theory is consistent with their beliefs or values and if it remains internally consistent. From a postmodern perspective, two red flags can be noted in this discussion of the integrative approach.
First, postmodernism is opposed to the foundational approaches to knowledge that dominated in modern and premodern times. Although this is a valid concern, it is more a limitation in language. The idea of having a foundation in the integrative approach is not to say that there is an base of Ultimate Truth which everything should be tested against; rather, it is used to indicate that a theory should be internally consistent.
Second, by indicating an approach to therapy should be consistent with the therapist’s values, this could be interpreted as suggesting these values are then imposed on clients. To a degree this is true; however, it is no more true than of any other approach to therapy. Therapists always will inadvertently impose their values on their clients at times. This occurs more often if therapists are unaware of their values or the values implicit in their approach to therapy. In other words, the integrative psychotherapies seek to decrease the imposition of values by encouraging therapists to critically think through the values associated with their therapeutic orientation. By being aware of their values, they can better avoid imposing them on clients.
A final concern with the integrative psychotherapies pertains to what clients are appropriate for a therapist to work with. Through developing a niche, therapists are focusing on a more narrowly defined clientele, or at least it seems that way. To a degree, this is true, particularly early on in a therapist’s career. However, this is also not completely true.
The integrative psychotherapies encourage clients to become well-grounded in a particular theory in order to develop expertise in that approach to therapy. Initially, this may limit their clientele. However, as they begin to learn how to adapt this theory and integrate aspects of other orientations, they are better able to meet the needs of a wide range of clients where they are at in a manner consistent with their values.
Eclectic to Integrative: An Illustration of the Development of Postmodernism
A valid early critique of postmodernism is that it focused primarily, if not exclusively, on deconstructing modernism and essentially promoting a rather an over-simplistic relativism. However, over time, postmodernism began to develop a more sophisticated and constructive perspectives such as epistemological pluralism (Hoffman, Hoffman, Robison, & Lawrence, 2005; Hoffman, Stewart, Warren, & Meek, 2006) and ontological holism (Murphy, 1996).
The move from eclectic to integrative psychotherapies mimics this progression. Eclecticism, as an initial attempt to utilize postmodern sensitivities in the inter-theory dialogue, took a more relativistic and over-simplistic approach. However, the integrative approach demonstrates postmodern ideas with increasing depth and sophistication of thought. Integrative approaches draw from multiple approaches while recognizing the need for internal consistency.
The postmodern push for interdisciplinary dialogue can also be applied to intrapersonal disciplinary dialogue. Differences should not be feared, but embraced. However, it is imperative to be in dialogue about the disparities. In the modern period, such dialogues would take the tone of which approach is better while in the postmodern period the focus is on mutual understanding and growth. Dialogue offers the promise of growth instead of division.
Hoffman, L. (2005). Depth psychotherapy and the empirically supported movement: Critica lissues. Retrieved from the Depth Psychotherapy Network web site: http://www.depth-psychotherapy-network.com/Professional _Section/Empirically/Hoffman_EST_1.htm
Hoffman, L., Hoffman, J., Robison, B., & Lawrence, K. (2005, April). Modern and postmodern ways of knowing: Implications for therapy and integration. Paper presented at the Christian Association for Psychological Studies International Conferences, Dallas, TX.
Hoffman, L., Stewart, S., Warren, D., & Meek, L. (2006, August). Multiple selves in postmodern therapy: An existential integrative critique. Paper presented at the American Psycholoigcal Associations Annual Convention, New Orleans, LA.
Levant, R. (2005, Feb). Evidence-based practice in psychotherapy. Monitor on Psychology, 36, 5.
Murphy, N. (1996). Beyond liberalism and fundamentalism: How the modern and postmodern philosophy set the theological agenda. Harrisburg, PA: Trinity Press International.
Schneider, K. (in press). Existential-integrative psychotherapy: Guideposts to the core of practice.
Schneider, K. J. & May, R. (1995). The psychology of existence: An integrative, clinical perspective. New York: McGraw-Hill.