The Eclectic Slide

Eclectic and integrative orientations continue to rise nationally as one of the most popular therapeutic approaches, despite the San Francisco Bay Area’s overwhelming preference for psychodynamic therapy.

By Josie Valderrama, Winter 2010

As therapists-in-training, those of us in Alliant’s clinical psychology programs are typically just beginning to explore the landscape of theoretical approaches, discovering what works best with our natural inclinations as well as taking in the theoretical influence of supervisors and course instructors. For many therapists, no single theoretical orientation can fully describe their personal style. Rather than publicly align themselves with psychodynamics, cognitive behaviorism, or other popular theories, these psychologists bill themselves as eclectic or integrative therapists.

In surveys of clinical psychologists in the American Psychological Association conducted between 1960 and 2003, eclectic or integrative therapy has consistently been the most commonly endorsed orientation, according to a 2005 study by Norcross, Karpiak, and Santoro. In the most recent survey, eclectic or integrative therapy was endorsed as much as cognitive behavioral therapy, with each orientation being favored by 29% of respondents. In comparison, 15% endorsed psychodynamics or psychoanalysis, 10% endorsed behaviorism, and 2% endorsed humanism or existentialism.

Interestingly, there are signs that the breakdown of orientations may be different in the Bay Area. An informal survey of the Psychology Today website’s directory of San Francisco therapists revealed 127 listings under eclectic. In contrast, there were 190 listings for cognitive behavioral, 111 for humanistic, and a whopping 349 for psychodynamically oriented therapists.

“Although I chose the term ‘eclectic’ as the one that best describes my orientation from the choices available on the Psychology Today website, I prefer the term ‘integrative,’” said Lesley Parke, PhD, whose name was the first to come up in a Google search of the phrase, “San Francisco eclectic psychologist.” “My theoretical and technical orientation is an integration of psychodynamic, cognitive-behavioral, control-mastery, attachment-oriented, and schema therapy,” she said. Parke recommends students check out The Society for the Exploration of Psychotherapy Integration (www.sepi.org) to learn more about integrative approaches.

In talking to students at CSPP, some expressed reservations about the eclectic label, with connotations ranging from “super hippy” and “weird” to “indecisive.” Students I spoke with expressed a more positive opinion of the integrative label.

“I like integrative better,” said Ann Wilson, a G2 PsyD student. “Eclectic sounds too new age,” she said. “But I do think it is beneficial to not be so rigid in theoretical orientation because that can shut out a lot of potential solutions.”

Although they are lumped together, some psychologists attempt to delineate between integrative and eclectic approaches. Integrative is seen as a new, hybrid form of therapy, whereas eclectic is a more ad hoc and case-specific approach. So while an integrative therapist may spend years creating a unique and uniform vision of therapy based upon an amalgamation of theoretical approaches, an eclectic therapist may adapt vastly different modalities based upon what is most empirically expedient for a particular client and disorder.

Whether integrative or eclectic, it seems likely that approaches which combine multiple theoretical perspectives will remain popular among therapists. In a survey of psychotherapy experts about future trends in therapy, it was predicted that the practice of eclectic and integrative therapies would continue to increase, as well as cognitive behavioral therapy and culturally sensitive therapy, and that classical psychoanalysis would continue to decline, according to a 2002 article by Norcross, Hedges & Prochaska. Of course, we can never be sure what’s around the corner in terms of research findings or newfound approaches: Only time will tell the accuracy of these forecasts.