Journal of Psychotherapy Integration

Unification in psychotherapy: An introduction to the special issue.
This introduction to the special issue on “Unification in Psychotherapy” contextualizes unification within psychotherapy integration and psychotherapy in general and describes some of the different dimensions of unification. As a truly international journal, the Journal of Psychotherapy Integration (JPI) is the perfect venue for such a special issue. This issue brings together seven articles that demonstrate both areas of convergence and noteworthy differences: framing common factors within a unified metatheory, issues pertaining to achieving a unifying consensus on mechanisms and processes of change in psychotherapy, process-based therapy, a proposal for memory reconsolidation as a unifier of psychotherapy, unified psychotherapeutics, the role of experiential techniques within the unified protocol, and a unified neurodiversity-affirming approach with autistic clients. This special issue concludes with a commentary by the Journal of Psychotherapy Integration’s incoming Editor-In-Chief, Ueli Kramer. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
The common core of psychotherapy: Bridging common factors with unification to frame the center of the field.
The field of psychotherapy lacks a common framework to explain what it is and how it works. This article lays out a new approach to define the “common core” of the field. First, it frames the common core as consisting of relationship quality, a shared conceptualization, and interventions toward adaptive living. Next, it divides the landscape of psychotherapy integration into three layers, which include the common factors that ground the work, the major schools of thought and the integrative pathways between them, and a zoomed-out, metatheoretical perspective that provides a unified view of the landscape. It then builds a conceptual bridge between the common factors and the unification pathway to integration to construct a common core using the unified framework for psychological science and practice developed by Henriques (2011, 2022a, 2022b). The article summarizes why this framework can be used as a metatheory of the common core. The result is a coherent metatheory for why the therapeutic relationship is central, how therapists can help patients understand maladaptive behavior patterns, and why processes that cultivate a psychologically mindful approach of curiosity, acceptance, loving compassion, and motivation toward valued states of being can reverse maladaptive cycles and result in pathways of wiser, more adaptive living. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Issues in achieving a unifying consensus on mechanisms and processes of change in psychotherapy.
This article considers issues pertinent to achieving a consensus about mechanisms of change as a vital element of both a consensual core and the unification of our field while emphasizing that the process of reaching consensus also raises ineluctable epistemological issues. Our overarching question is this: In the context of its potential contributions to a core body of consensual knowledge about psychotherapy, can there be a unifying consensus about mechanisms of change? We begin by discussing psychotherapy’s preparadigmatic status (stasis), then proceed to overview the field of principles of change, as well as a variety of epistemological issues associated with the pursuit of a consensual core. We then examine the field of mechanisms of change and the significant benefits that ensue from understanding them more deeply. This is followed by a deliberation of hurdles that must be cleared to reach a consensus regarding mechanisms of change; for instance, can we have a consensus even on terminology and definitions of mechanisms of change? This involves distinguishing between mechanisms of change and principles of change; describing the similarities and differences between mechanisms of change and change processes; and distinguishing mediators from mechanisms of change, which, surprisingly, many scholars and researchers in this area conflate. We offer concluding recommendations that we hope can facilitate getting closer to a consensus regarding mechanisms and processes of change that appear to be essential elements of unifying the field of psychotherapy. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Process-based therapy: A common ground for understanding and utilizing therapeutic practices.
This article critiques the “protocol-for-syndrome” model in mental health research, highlighting two primary concerns: the complexity of protocols that include change processes irrelevant to many individuals, and the inadequacy of Diagnostic and Statistical Manual of Mental Disorders syndromes to capture the nuances of individual well-being and suffering. Advocating a shift to a process-based therapy (PBT) approach, the article proposes a coherent integration of diverse change processes and interventions to enrich therapy practices. It introduces a slightly revised extended evolutionary metamodel (EEMM) as a comprehensive framework that provides a consistent language for discussing change processes, focusing on the key drivers of variation, selection, and retention, and categorizing these into dimensions (such as cognition, emotion, self, motivation) and levels (from biology/physiology to psychology and social relationships/culture). The article details the application of EEMM in classifying therapeutic processes, validated through both human and artificial intelligence (AI) ratings. Furthermore, we developed an AI tool built on Distilled Bidirectional Encoder Representations from Transformers (distilBERT) models for categorizing therapeutic content, proving effective and accessible for community engagement and ongoing enhancement. The article also explores network theory and new analytics as tools for therapists to customize therapy to individual client needs. In summary, PBT supports therapeutic diversity while establishing common ground among different methods and approaches. This enhances communication, cooperation, and comparison, fostering the development of tailored and effective therapy strategies. It also opens the door to the potential unification of psychotherapy. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
A proposal for the unification of psychotherapeutic action understood as memory modification processes.
A person’s “memory” is the stored form of all types of acquired personal knowledge, including both knowledge of personal experiences (episodic memory) and knowledge of patterns perceived in the world (semantic memory), such as the knowledge that staying safe around one’s rage-prone, alcoholic parent urgently requires never expressing any views or feelings of one’s own. This article explores the possibility of (a) understanding most, if not all, psychotherapeutic action as a reconfiguration of knowledge held in memory and (b) identifying each of the distinct, fundamentally different endogenous mechanisms, or types of processes, that can modify memory therapeutically. In this way, a potential means of unifying psychotherapy emerges, enabling us to identify how any particular therapeutic process influences symptom production through its memory modification effects. Memory neuroscience has identified mechanisms of memory modification sufficiently for the proposed explorations to be pursued fruitfully at this point. The resulting unification scheme consists of two qualitatively different, main modes of memory modification, each with submodes. This scheme can account for the full range of therapeutic outcomes, from partial, unstable, relapse-prone symptom reduction to transformational change, defined here as the enduring cessation of a symptom and its underlying theme of emotional distress. Case vignettes illustrate the fundamental modes and some submodes of therapeutic memory modification. Viewed through this unification framework, diverse therapy systems no longer seem to belong to different worlds. Rather, their distinctive techniques and methodologies become a rich array of options for tailoring memory modification and therapeutic change uniquely for each person. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Unified psychotherapeutics: Are we any closer to our aspirations and what are the dangers?
In this article, we briefly review the evolution of unified psychotherapy and the developments that have occurred since its more formal inception in the early part of the 20th century. While there are various paths to psychotherapy integration, unification seems to be the final one, drawing from the rich empirical and clinical knowledge accumulated over a century and fueled by rapid advances in technology. An online learning platform based on the developments in psychotherapeutics—the theory and practice of psychotherapy—is presented, organizing the domains of psychotherapeutics in a unifying framework for psychotherapy education, training, and to optimize clinical efficacy. This learning system offers essential domains of knowledge, a compendium of psychotherapeutic techniques, and approaches to psychotherapy. It is evident that artificial intelligence (AI), which can harness the unseen patterns from massive data sets, will enable us to create treatment algorithms drawing from all established approaches, techniques, and modalities. It is important that the data derived from large data sets be based on high-quality information and credible research. This type of accessible learning system will be a useful resource for clinicians and psychotherapy trainers by distilling and delivering high-quality knowledge online. It is suggested that continued technological advances, and especially AI, will further fuel the process of unification. It is imperative that psychotherapists and behavioral scientists take the initiative to build systems that are guided by ethics; otherwise, the dark side of technology might lead psychotherapy down a harmful path. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Experiential techniques and therapeutic relationship in metacognitive interpersonal therapy: A contribution to the unified protocol.
Experiential techniques are essential tools for therapists adhering to the principles of the Unified Protocol. We investigate their central role in psychotherapy, irrespective of the therapist’s orientation, and how they act as fundamental catalysts for the change of patients with diverse diagnoses. In this context, we present a rationale for the use of experiential methods in various therapeutic approaches, substantiating their effectiveness and safety with empirical evidence. Furthermore, we illustrate a clinical case in which experiential techniques were employed through metacognitive interpersonal therapy to assist the patient in accessing the inner world and accelerating personal transformation. We emphasize how these techniques enable swifter and more manageable change, without harmful effects on the therapeutic relationship. Drawing from research and clinical examples, we discuss how the application of experiential techniques in metacognitive interpersonal therapy aligns with certain aspects of the Unified Protocol and can be considered an essential component of therapy, regardless of the therapist’s preferred approach and the patient’s diagnosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Moving toward neurodiversity-affirming integrated psychotherapy with autistic clients.
As mental health providers often do not know how to work with autistic clients in a way that respects autistic experience, many autistic adults are left with unmet mental health needs. Developing neurocultural competence and humility involves questioning antiautistic bias and innovating affirming methods. This article explores how therapy sessions may look when informed by Henriques’ character adaptation systems theory. The suggested approach can inform treatment stages and provide mental health professionals with ways to improve their practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Unifying psychotherapy: Are we there, yet?
The present discussion considers unification in psychotherapy in a differentiated critical light. It underscores its contribution to the understanding of how psychotherapy works—its mechanisms of change. Theoretical, methodological, clinical, and ethical considerations are highlighted. It delineates how psychotherapy research can take up the concepts from the unification pathway to psychotherapy integration, thus contributing to understanding how psychotherapy works in coherent ways. Challenges, possible solutions, and perspectives are outlined. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Journal of Psychotherapy Integration - Vol 34, Iss 3