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Levels of Meaning and the Need for Psychotherapy Integration
Clinical Social Work Journal ( IF 2.591 ) Pub Date : 2020-07-10 , DOI: 10.1007/s10615-020-00769-6
Jerome C. Wakefield , Judith C. Baer , Jordan A. Conrad

We argue for the importance of multitheoretical integrative clinical intervention and training. Mental health professionals, including clinical social workers, are frequently primarily committed to a single dominant therapeutic theory, perhaps one that was favored by a school, fieldwork agency, inspiring teacher, or influential supervisor. However, each such theory tends to target just one aspect of the extraordinarily complex human meaning system that scientific research has shown to operate at biological, neuroscientific, behavioral, cognitive, unconscious, family-systems, and cultural levels in complexly interacting ways. We know that any monotheoretic intervention approach likely fails to help a substantial number of clients, implying an ethical imperative not to equate failure to respond to monotheoretical treatment with clinical failure. Thus, there are persuasive scientific and ethical arguments supporting the move toward psychotherapy integration in which multiple theories and their associated techniques are seen as part of a larger theoretical and interventive metasystem. Such integration is especially urgent in clinical social work with its diverse and often multi-problem clients. In this article, we consider the reasons for integration, review the levels of the human meaning system that interact in normal and abnormal functioning and thus justify a multitheoretical approach, examine recent research in support of integrationist practices, and offer the example of the natural conceptual convergence occurring between cognitive and psychodynamic approaches to illustrate how, as theories mature, they tend to converge and recognize the same reality of the human meaning system.

中文翻译:

意义的层次和心理治疗整合的需要

我们主张多理论综合临床干预和培训的重要性。精神卫生专业人员,包括临床社会工作者,通常主要致力于单一的主导治疗理论,也许是学校、实地调查机构、鼓舞人心的教师或有影响力的主管所青睐的理论。然而,每一个这样的理论往往只针对极其复杂的人类意义系统的一个方面,科学研究表明,该系统在生物、神经科学、行为、认知、无意识、家庭系统和文化层面以复杂的相互作用方式运作。我们知道,任何单一理论干预方法都可能无法帮助大量客户,这意味着道德上的必要性不能将未能对单一理论治疗做出反应等同于临床失败。因此,有说服力的科学和伦理论据支持向心理治疗整合的转变,其中多种理论及其相关技术被视为更大的理论和干预元系统的一部分。这种整合在临床社会工作中尤其紧迫,因为它的客户多种多样,而且往往是多问题的客户。在这篇文章中,我们考虑了整合的原因,回顾了在正常和异常功能中相互作用的人类意义系统的层次,从而证明了多理论方法的合理性,审查了支持整合主义实践的最新研究,并提供了自然概念的例子认知方法和心理动力学方法之间发生的趋同,以说明随着理论的成熟,它们如何趋于趋同并认识到人类意义系统的相同现实。有说服力的科学和伦理论据支持向心理治疗整合的转变,其中多种理论及其相关技术被视为更大的理论和干预元系统的一部分。这种整合在临床社会工作中尤其紧迫,因为它的客户多种多样,而且往往是多问题的客户。在这篇文章中,我们考虑了整合的原因,回顾了在正常和异常功能中相互作用的人类意义系统的层次,从而证明了多理论方法的合理性,审查了支持整合主义实践的最新研究,并提供了自然概念的例子认知方法和心理动力学方法之间发生的趋同,以说明随着理论的成熟,它们如何趋于趋同并认识到人类意义系统的相同现实。有说服力的科学和伦理论据支持向心理治疗整合的转变,其中多种理论及其相关技术被视为更大的理论和干预元系统的一部分。这种整合在临床社会工作中尤其紧迫,因为它的客户多种多样,而且往往是多问题的客户。在这篇文章中,我们考虑了整合的原因,回顾了在正常和异常功能中相互作用的人类意义系统的层次,从而证明了多理论方法的合理性,审查了支持整合主义实践的最新研究,并提供了自然概念的例子认知方法和心理动力学方法之间发生的趋同,以说明随着理论的成熟,它们如何趋于趋同并认识到人类意义系统的相同现实。
更新日期:2020-07-10
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