Distinguishing integrative from eclectic practice in cognitive behavioral therapies

In psychotherapy research, practice, and training, there remains marked controversy about the merits of theoretical purism (i.e., model specific), versus integration, as well as how such principles may be represented in practice. Adding to the confusion is that many attributes of the therapeutic relationship, processes in therapy, and techniques have been popularized in the context of one or two theoretical approaches, but are incorporated into the practice of many approaches. This article demonstrates the various ways in which three core interventions (i.e., activity scheduling, self-monitoring, and identification, evaluation, and modification of thoughts) can be applied within the context of different cognitive and behavioral therapeutic models. It also demonstrates the role of in-session therapist language in describing the theoretical basis and processes underpinning therapeutic interventions. Case examples are presented to illustrate therapy provided by two hypothetical clinicians, Therapist A and Therapist B. Whether or not a practitioner elects to practice integrative psychotherapy, we advocate for consistency in the theoretical approach through the course of a service for a particular patient. Implications are outlined and discussed within the context of the current state of cognitive and behaviorally focused psychotherapies and integrative psychotherapy.