Scientific Validation Criteria

Scientific Validation Criteria for Integrative Psychodynamic Psychotherapy

 

Introduction:

 

Integrative Psychodynamic Psychotherapy is an innovative approach to psychotherapy, with predominantly psychodynamic orientation. Its theory is based upon integration of four psychoanalytic psychologies: Drive psychology (classical psychoanalytic theory), Ego psychology, Object relations psychology and Self psychology.

 

The emotion processing fundamental capabilities theses, extracted from the theories mentioned above, are the theses IPP is based on. The method of working with clients is likewise integrative, as it includes the techniques and skills originally established in variety of other psychotherapy approaches (such as: Psychoanalysis, Gestalt therapy, Transactional analysis, Bioenergetics, NLP, Focusing, Biofeedback and Neurofeedback, REBT etc. ) combined with the techniques and skills emanated from IPP, such as “IPP personality development protocols”, “Basic emotional competencies development protocols”, “Emotional accounting” and the “Mathematics of Psychology”… (Jovanović, 2013).

Integrative Psychodynamic Psychotherapy embraces first and foremost a particular attitude towards the practice of psychotherapy which affirms the importance of a unifying approach to persons. Thus a major focus is on responding appropriately and effectively to the person at the emotional, spiritual, cognitive, behavioural and physiological levels. The aim of this is to facilitate integration such that the quality of the person’s being and functioning in the intrapsychic, interpersonal and socio-political space is maximized with due regard for each individual’s own personal limits and external constraints. (EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

Within this framework it is recognized that integration is a process to which therapists also need to commit themselves. Thus there is a focus on the personal integration of therapists. However, it is recognized that while a focus on personal growth in the therapist is essential there needs also to be a commitment to the pursuit of knowledge in the area of psychotherapy and its related fields. Therefore the EAIPP defines as “Integrative” any methodology and Integrative orientation in psychotherapy which exemplifies, or is developing towards, a conceptually coherent, principled, theoretical combination of two or more specific approaches, and/or represents a model of integration in its own right. In this regard there is a particular ethical obligation on integrative psychotherapists to dialogue with colleagues of diverse orientations and to remain informed of developments in the field (EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

IPP method is not an eclectic, but an integrative approach. The model of basic emotional competencies is the integration foundation for the variety of other psychotherapy approaches, techniques and skills. The core postulate of IPP method is “No tools, no work”, meaning that people cannot change if they do not develop or unblock their basic “life tools”. These tools are emotion processing basic capabilities, i.e. emotion processing psychological software (as emotions are information processing form). The bugs or viruses in these executive programs lead to unhealthy emotions, faulty perception and irrational interpretation of relations with the Self, the others and the world. IPP psychotherapist works with two levels: the level of content and the level of process. By listening the content of clients’ problems, talking to them about this content, their life events, their relations and love and work problems, IPP psychotherapist pays profound attention to the specific patterns and manners in which a client processes his experiences, as well as emotions triggered by these experiences. (Jovanovic, N. 2013a)

 A central tenet of Integrative psychotherapy is that no single form of therapy is best or even adequate in all situations. Integrative psychotherapy therefore promotes flexibility in its approach to problems but also subscribes to the maintenance of a standard of excellence in service to clients, in supervision and in training. Thus when integrative therapists draw on different strategies, techniques and theoretical constructs when dealing with particular situations, this is not done haphazardly but in a manner informed both by clinical intuition and a sound knowledge and understanding of the problems at hand and the interventions to be applied.

 

In the final analysis Integrative psychotherapy, while affirming the importance of foregrounding particular approaches or combinations of approaches in regard to specific problems, nevertheless places the highest priority on those factors which are common to all psychotherapies, especially the therapeutic relationship in all its modalities. In regard to the therapeutic relationship however, particular emphasis is placed on the maintenance of an attitude of respect, kindness, honesty and equality in regard to the personhood of the client in a manner which affirms the integrity and humanity both of the self and the other. Integrative psychotherapy affirms the importance of providing a holding environment in which growth and healing can take place in an intersubjective space which has been co-created by both client and therapist. (EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

In IPP, therapy techniques emanated from different approaches are used inwork with clients if they can contribute to development of a certain emotion processing fundamental capability. This represents the integration foundationof techniques from different approaches, whether they originate from psychodynamic, behaviour  or any other psychotherapeutic approach.

IPP method focuses on two main, composite capabilities: capability to work and capability to love. These two broad compoundlife handling capabilities are, like “Lego-bricks”, built of a certain number of smaller, much simpler bricks – basic emotional competencies (Jovanovic, N. 2013a):

  1. Neutralization and mentalization capabilities (which in IPP are labeled as regulator and articulator of the psyche) (Hartmann, 1939, 1950, Kris, 1951 Fonagy, 2001, 2002, 2003)
  2. Object wholeness (the glue of the psyche) (Klein, 1935, 1940)
  3. Object constancy (the stabilizer of the psyche) (Hartmann, 1952, Akhtar, 1987, 1990, , Burngam, 1969, Mahler, 1963, 1968, 1974)
  4. Ambivalence tolerance (the orientation of the psyche) Hartman &Zimberoff, 2003
  5. Frustration tolerance (the immunity of the psyche), (Freud, 1905, Kohut, 1971.; Wolf,  1980)
  6. Will (the engine of the psyche) (May, R., 1966; Rank, O. 1972; Assagioli, R. 1973)
  7. Initiative (the actuator of the psyche) (Erikson, 1959; Ikonen, 1988.)

Philosophical Aspects of the Approach:

 

1. Does the approach have clearly defined areas of enquiry, application and research?

 

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

“In 1986, the Affective and Anxiety Disorder Research Branch at the National Institute of Mental Health in the U. S, held a 2-day workshop to examine research on psychotherapy integration. The findings of this meeting, which outlined recommended research directions, offered 23 areas of inquiry for psychotherapy integration (Wolfe & Goldfried, 1988). These specific areas of study fell into four general domains: (a) conceptual clarification (eg., the difference between technical eclecticism vs conceptual integration, the need for knowledge-acquistion strategies. the role of integrated theories of psychopathology); (b) psychotherapy process research (e g-.studying the process of change, the role of the therapeutic alliance in different schools of thought, problems associated with school-specific jargon); (c) efficacy studies on integrative therapies (e.g.,, development of empirically based integrative interventions, clinical problems appropriate for an integrated therapy, issues in the assessment of process and outcome); and (d) the training and supervision of integrative therapists (e.g., training in pure form therapies vs an integrative approach).
 
Within the past decade or so, work has proceeded along each of these lines. For example, Wiser, Goldfried, Raue and Vakoch (1996) have outlined a program of comparative process research, whereby the mechanisms of change were studied in psychodynamic and cognitive-behavioural interventions. Other research has studied the relationship between process and outcome, uncovering such unexpected findings that even in the treatment of cognitive therapy for depression, contributions from other orientations (e.g.,, focusing on developmental and interpersonal issues and enhancing client emotional experiencing) helped to facilitate successful outcome (Castonguay et al., 1996; Hayes. Castonguay & Goldfried, 1996). As will be seen in the responses to the questions that follow, many of the issues raised in the 1986 workshop (e.g., the role of the therapeutic alliance) have been the subject of inquiry over the years.”
 

(For IPP-specific)

Integrative Psychodynamic Psychotherapy has a clearly defined research area:

a) it examines development of the basic emotional (and cognitive-conative) competencies which are discussed in four psychoanalytic psychologies: Drive psychology, Object relations psychology, Ego psychology and Self Psychology. The following basic emotional competencies are studied: neutralization and metallization capability, object wholeness, object constancy, frustration tolerance, ambivalence tolerance, will and initiative. Apart from the basic emotional competencies, the research area includes more complex capabilities which stem from the combination of the basic ones such as: ability to empathize, to sustain solitude, delaying gratification capability, patience, reality testing capabilities…as well as the two most complex capabilities – capabilityto love and capability to work. These capabilities also stem from functional interaction of the basic emotional competencies mentioned above. The research area includes development of the basic emotional competencies, stages of their normal development and deviations in development, sustaining normal or deviant development of the capabilities at emotional, cognitive, conative and behavioral level.

b)interdependence between basic emotional competencies–how developmental stagnations in a particular competence reflecton developmental stagnations in another competence, the possible combinations of capabilities deviations, how these combinations correlate with the structure of personality and personality disorders…

c)“counter-skills” research– counter-skills is an IPP methodology term introduced to represent complex behavior patterns (defense mechanisms, emotions, thoughts, beliefs, actions…) that are developed as forms of adaptation when basic emotional competencies are not functional enough. The term “counter-skills” is similar to the term defense mechanism, but it has a broader meaning because it includes specific patterns of behavior, habits, skills of manipulation of Self and others, and other coping strategies that a person has developed in order to make up for deficiencies in the basic emotional competencies.

d)“emotional accounting “ research– examines typical methods of calculating with emotions -“mathematics of psychology”, systems of estimation of “profitability” estimation within emotional life and creating the complex estimation system of emotional profitability, so-called emotional accounting. (Jovanović, N. 2013)

e) it examines the correlation between deficient development of certain emotional competencies and specific types of anxiety:

 

Basic emotional competencies  are our life handling tools. Each of them is a  tool which can be used for healthy management of a certain type of anxiety. If underdeveloped or defective, each of fundamental emotion processing competences may be followed by a specific type of anxiety, which then is difficult to overcome. (Senić & Jovanović, 2011). Hence, the psychotherapy approach is defined by the anxiety type connected to the specific problem occurred in an emotional competence that should be mended, unblocked and/or developed ( undiveloped neurtralisation and mentalisation with overwhelming  anxiety, object wholeness with persecutory anxieties, object constancy with separation anxiety, frustration tolerance with specific frustration untolerance anxiety, ambivalence tolerance with anxieties connected to decision making and fear of making mistakes, will capability with anxieties related to self-support, endurance, stamina, Initiative with anxieties related to rivalry, showing off “castration anxiety” )  (Jovanović, N. 2013a)

Area of application :  IPP method is a theoretical and research framework which is applied in counseling psychology, psychotherapy, coaching, preventive work, educational process, management, improvement of business efficiency. The most important area of application is psychotherapy. Regarding psychotherapy, IPP method has developed numerous techniques and procedures aimed at development of basic emotional competencies. Apart from that, the IPP methodology also contributes to classification of therapeutic techniques from other orientations (such as: Psychoanalysis, Gestalt therapy, Transactional analysis, NLP, REBT, KBT, Bioenergetics, Radix, Focusing, Psychodrama Biofeedback and Neurofeedback…) that can  also be efficient for the development of certain basic emotional competencies. It specifies which technique is the most suitable for the development of a certain competence and at which stage of development it should be applied. IPP method can be used to treat all sorts of psychological problems.

Research area: Research area includes:

a) measuring instruments – instruments for measuring the level of development of the basic emotional competencies that could be useful in psychotherapy and counseling, particularly in evaluation of the psychotherapeutic process. (Petrović, J., Jovanović, N., & Trbojević, J. 2015)

b) Evaluation of the psychotherapeutic process carried out by the principles of Integrative Psychodynamic Psychotherapy. The research is directed toward the evaluation of the process itself, as well as the research of the effects of the psychotherapy.

c) research of the efficiency of the IPP self-help protocol – the IPP method has been developing specific “activation protocols” – systems of questionnaires and instructions that can be used by clients to work on their development independently, seeking a therapist’s advice occasionally.

d) research of the possibilities and effects of the application of IPP method in various areas (in educational process – “Student’s emotional competence training”, in business – “ Manager’s emotional competence training”, in coaching –“Psychodynamic Integrative Coaching” – a specially developed educational program accredited by the EMMC- European Mentoring & Coaching Council)

Practice: Integrative Psychodynamic Psychotherapy has been used as a psychotherapeutic method both in individual and group work with clients for more than two decades. Many programs that can be used in areas other than psychopathology have been developed within the IPP method: in teacher training (seminars based on “Student’s emotional competence training” accredited by the Ministry of Education, Science and Technological Development, the Government of The Republic of Serbia and Montenegro), workshops, trainings held in numerous companies (Emotional competence training for executives and managers), in sport (Peak achievement and Peak Performance Training through development of emotional competencies of sportsmen – held in the Serbian Institute of Sport and Sports Medicine and Olympic Committee of Serbia…)

2. Does the approach demonstrate its claim of knowledge and competence within its field’s tradition regarding assessment/diagnosis and treatment/intervention?

 

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

 

“During the 1986 conference on psychotherapy integration, the existence of different language systems was considered as being an obstacle to psychotherapy integration. Although theoretical jargon may be seen as being useful in communicating with like-minded colleagues, it prevents those from another theoretical system from benefiting from a school’s clinical insights and research findings. Recognizing the need for a common language in a theoretically integrated approach to assessment and therapy, integrative therapists have chosen to translate various theoretical constructs into the vernacular. This provides not only a common ground for communicating across theoretical orientations, but allows for a clearer integration of contributions from different schools of thought.

For example, Benjamin’s Structural Analysis of Social Behavior (SASB) provides a transtheoretical approach for classifying interpersonal behavior, classifying an action according to its level of affiliation and control. Using a circumplex coding scheme, a message a person sends to another, and the way this other person reacts to it, can be assessed along these dimensions. The assessment procedure can also be used to evaluate how individuals deal with themselves intrapersonally, as when they are excessively self-critical and demanding of themselves (i.e., low in affiliation and high in control). This system has applicability to a variety of theoretical orientions, and consequently lends itself particualry well to psychotherapy integration.”

(For IPP-specific)

Regarding diagnostics and assessment, Integrative Psychodynamic Psychotherapy relies on a traditional body of knowledge and competencies within psychodynamic approach. The knowledge of the basic emotional competencies that are being assessed (their development, pathology, deficiency or blockage) leads to diagnostics which is the basis for further psychotherapeutic treatment/ intervention and monitoring client’s progress in psychotherapy. Apart from that, the IPP method deals with development of the new diagnostic tools which rely on existing theoretical and diagnostic knowledge, but that are specifically directed toward assessment of the basic emotional competencies development (Petrović, J., Jovanović, N., & Trbojević, J. 2015).  In the area of treatment and intervention, the IPP methodology uses transference and resistance as cornerstones of psychodynamic psychotherapeutic intervention, complemented by techniques and procedures borrowed from other orientations (Gestalt therapy, Transactional analysis, REBT, etc.) as well as by its own techniques and procedures in accordance with theoretical knowledge on emotional competencies, code of ethics and professional conduct within psychodynamic tradition (respect for client’s autonomy) (Jovanović, N.2013).

3. Does the approach have a theory of the human being, the therapeutic relationship and health and illness, which is clear and self consistent?

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

 

“A consistent research finding has been that the therapeutic relationship contributes significantly to successful outcome (Horvath & Greenberg. 1994). This has been found to be the case in various forms of therapy, be it psychodynamic, experiential or cognitive-behavioural in orientation- Consequently, it is believed to represent a common change factor, reflecting the fact that people are more likely to change when in the context of an interpersonally safe haven Based on this finding, Safran and his colleagues (Safran et al., 1990) have specified how to recognize points within the therapeutic interaction where there may be a threat to the therapeutic alliance, and what might be done to alleviate this rupture. On the basis of the finding that alliance strains in cognitive therapy are associated with poorer outcome in cognitive therapy for depression (Castonguay et al., 1996), Castonguay and Safran are currently collaborating on a research project to test the enhanced effectiveness of cognitive therapy when it includes guidelines for dealing with strains in the alliance.
 
Other research findings on the process of change in different orientations have yielded results with important implications for developing more effective interventions- For example, Beutler and Consoli (1992) have found that cognitive interventions were more effective than insight-oriented treatment with externalizing patients, and that defensive individuals responded better to nondirective than directive treatments,, Also relevant is the work of Prochaska and DiClemente (1992), which suggests that an intervention that takes into account where a patient exists within the general phase of the change process can be more effective than treatment procedures that do not.
 

(For IPP-specific)

 

In its theoretical approach of understanding the human nature, Integrative Psychodynamic Psychotherapy is based upon psychodynamic body of knowledge and theories of four psychoanalytic psychologies: Drive psychology, Object relations psychology, Ego psychology and Self psychology. However, what makes IPP unique is integration of the body of knowledge of the above mentioned theories and  a few other theories ( such as informacionist, behavioral, R. Assagioli’s Psychosynthesis (Assagioli, R. (1973) etc.), which explains the origin of the term “integrative”. The Distinct trait of IPP theoretical approach is not only the integration, but also in theoretical contribution regarding human functioning in the field of “emotional accounting” – the way a person calculates with their emotions (consciously or unconsciously) and makes conclusions about benefits or disadvantages of emotions, thoughts and behavior. In its theoretical approach regarding human nature, IPP method focuses on the tradeoffs of a person’s “dealing with the world”, comparing them with business operations of a company, developing principles that result in “business policy” regarding a personal way of trading with both the world and oneself and assessing risk, profit and loss (focusing on psychoanalytic concept of secondary gain more precisely). The development of the basic emotional competencies and its influence on different strategies for” trading with the world” are particularly investigated (Jovanović, N.2013).
According to the IPP methodology, therapeutic relationship is seen as an educational process. It is a process of “re-education”, as Freud specifically called it; education for being true to oneself. The goal of psychotherapeutic process itself defines the therapist-client relationship, the relationship based upon respect of a client’s autonomy and creating atmosphere which enables a client to move toward discovering truth about oneself – a neutral, non-judgemental atmosphere. Relationship with a client is based on ananalytic contract, the way it was defined by Thomas Szasz in The Ethics of Psychoanalysis (Szaz,T. 1988).

 

However, there are certain differences between the psychoanalytic and the IPP method regarding the degree of a therapist’s non-directiveness and participation. In the IPP method, the degree of a therapist’s non-directiveness and participation depends on the basic emotional competence that is being singled out and on how developed it is; just as degree of a parent’s directiveness and involvement depends on a child’s age and changes in their developmental needs. IPP method places considerable importance on the phenomenon of transference and countertransference in a client-therapist relationship, with greater emphasis on process than content in transference analysis. According to our understanding of the origins of transference, its principal cause is in the structure and interrelation of the basic emotional competencies. Actually, certain deficits in development of the basic emotional competencies lead to the situation in which a person builds such a “tool kit” that prevents them from building relationships other than transferential. The more intensive a person’s relationships are, the more their “tools” for building emotional relationships (basic emotional competencies) are tested, and their deficits are clear to see. Development of transference neurosis is not about the transference of relationship, but about an increase of emotional investment and intensity of relationship, which puts the basic competencies under greater pressure and makes the defects more conspicuous in their structure.

This disclosure of the basic emotional competencies defects can be interpreted as transference from important persons from childhood, but also as exhibiting defectsin structure of the capability to handle high-intensity situations. Therefore, the IPP methodology also incorporates the psychoanalytic concept of transference, but it treats it somewhat differently. IPP methodology is designed as a cognition process that usually lasts shorter than psychoanalysis and one cannot necessarily expect development of transference neurosis or full intensity of the transfer in the relationship with the therapist, the resolution of which is what constitutes healing. However, if transference neurosis occurs in IPP therapies it is analyzed and resolved in similar fashion as in psychoanalyses. Basic, but not the only tool to deal with transference phenomena is interpretation. However, the interpretation is more focused on interpreting the manner of communication (a client’s way of doing things and emotional capability not fully functioning), than on interpreting the contents of transference, although the contents of transference is not neglected.

In the IPP method, other “techniques” that could be called “corrective emotional experiences” are used in work with transference phenomena. These techniques are: holding, containing, “education” – teaching client some basic facts on human functioning and relationships, as well as various techniques that could be defined as “training”– for example, techniques for training of the will. In a therapist-client relationship within the IPP method, a therapist moves from non-directiveness toward directiveness, from a role as a mirror toward a role of a teacher and coach, depending on the competence that is being developed with a client. How, when and why a therapist changes their relationship with a client is precisely defined in the IPP theory of therapeutic relationship (Jovanović, N.2013).

The theory of health and illness is focused on the basic Ego strenghts – basic emotional competences. When the impact of trauma, relationships with important persons in a client’ life, the influence of various past and present experiences on development of a client’s personality and character are observed within the therapy, the focus of the observation is on the impact of these factors on the development of the basic emotional competencies. The IPP theory explains repetition compulsion similarly as transference – not as a transference from the past to the present ( due to unresolved relationships, unfullfilled wishes and unfinished business), but as a present manifestation of these competences created in the past. With such a level of development of ’’life tools“ one cannot expect different behavior, the improvement has to come from development and unblocking of these tools. Health is defined as development and proper use of the basic ego strenghts – emotional competencies, while  illness is understood as a defect in their development or the obstruction in their use. In order to compensate for the underdevelopment or the blockage of the basic emotional competencies, clients develop various ’’counter-skills“ and substitute adaptive behavior (defence mechanisms, ’’games“, manipulation of Self and others, distorting reality…).

Essentially, the IPP theory is based upon the concept of health and illness established by psychoanalytic theory ( four psychoanalytic psychologies: Drive psychology, Object relations psychology, Ego psychology and Self Psychology), with the point of reference that health is based on the truth ( realistic self-perception and perception of others), while illness is based on the lie (consious or unconsious distorting reality about the Self, the others and the world). The IPP theory sets the basic laws of psychodynamics that mirrors ’’The law of bouyancy“: ’’Any lie, immersed in psyche or mind, pushes out the amount of mental health equal to the volume of the lie immersed. “This could be translated into Freud’s words : ’’ Where ID was, let EGO be“, or “What was unconscious, let it be conscious“. However, the point is that acknowledging the truth itself is only a part of the healing process. Above all, health is the proper use of the truth. The use of the truth requires the “tools” – basic emotional competencies, and the tools have to be developed by various forms of practice. Health is a skill, not just the knowledge of the skill. Health is the use of knowledge and skills in a clever way. Besides, the IPP theory defines the goal of psychotherapeutic process as “becoming a good person. The term “good person “is seldom used in psychology and psychotherapy. A therapist strives to be value-neutral, to value neither the content a client presents, nor a client themselves; in that sense the therapist is neutral. On the other hand during the therapy, the therapist clearly states the core values of the IPP theory and associates them with health. The therapy goal in the IPP method is that a client becomes a better person and it is clearly defined what it means – a realization of the core values of human nature – capability to love and capability to work. The fulfilment of these skills is not an “optional subject” in the “school of life”. Failure to actualize the basic emotional competencies is directly connected to pathology and a client’s suffering, and it needs to be clearly presented and demonstrated to the client. People have the freedom to choose not to grow but they do not have the freedom to choose not to bear the consequences and pain of their choice. Not to develop their own basic emotional competencies has its price, and a client needs to be aware of it. In a technique called “the pricelist of life decisions”, we are teaching a client how to calculate the payoff of their decisions (choices) with the greatest possible accuracy and precision, especially of those decisions regarding avoiding growth and using counter-skills (Jovanović, N, 2013).

Methodological aspects :

 

4. Do the methods specific to this approach generate developments in the theory of psychotherapy, demonstrate new aspects in the understanding of human nature and lead to ways of intervention/treatment?

 

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

 

“As indicated in response to the previous question, the comparative study of the change process across orientations, and the investigation of the relationship between process and outcome, can have important implications for developing more effective methods of therapy, inasmuch as these studies make use of transtheoretical constructs (i.e., described in the vernacular), the findings can be readily used to develop improved, integrative treatments – The example given above in the collaborative efforts of Castonguay and Safran offer a case in point, whereby findings on strains in the therapeutic alliance were used to expand the scope of cognitive interventions for depression.
 
Another important example of how an integrative approach to therapy has led to more effective treatments is Linehan’s (1993) Dialectical Behavior Therapy (DBT) in the treatment of borderline personality disorder. A treatment approach that is receiving widespread recognition on an international basis, DBT is specifically designed for patients who paradoxically need to be validated and accepted for who they are and at the same time need to change. In a clinical tour de force, Linehan has integrated a person-centered approach (for validation) with a cognitive-behavioral coping skills model (for facilitating change), finding that it is more effective with this patient population than other currently available, theoretically pure treatments.

For IPP Speciffic

-The signature of IPP methodology, lies mainly in developed methods for detecting “bugs” in the basic emotional competencies “software”, identifying them in the content a client presents and in clearly demonstrating it to the client. When computer programmers want to fix a “bug”, or to change an algorithm, they know they have to “edit” the database, to enter the source code, the invisible matrix which is beyond what we see on the screen. The source code mostly contains “if-then” instructions, if X occurs, then execute Y. This mirrors processes in our heads. If these formulas are in tune with reality and well-adjusted to the terms of “dealing” with life, then we live well and enjoy our lives. If not, it can be precisely predicted, as in an accounting department, how and when a personwill “crack” and bankrupt emotionally as a consequence of poor “dealing” with life. Once we manage to bring to light their own “emotional accounting” to the client, then, as a good accountant, we can present them the “business mistakes”, the risks of that kind of “business policy” for their emotional life.

The innovation introduced by the IPP method lies in methods for detecting erroneous formulas for calculating the cost effectiveness of certain life decisions, away of life, counter-skills and emotion processing.  Theoretically speaking, the novelty is in the thorough development of the basic Ego strengths – emotional competencies, their interaction and stages of development. This systematic approach to capabilities and selection of techniques including both IPP and the techniques from other therapeutic orientations,  gives a therapist a clear insight into the method of detecting defects of certain capability, the stage of development of the capability, as well as into the track record which methodology approaches are most appropriate for a particular client. The systematization also allows for more efficient education and training for future psychotherapists. (Jovanović, N.2013)

 

IPP method conjointly offers an explanatory taxonomy of psychotherapy goals (Jovanović, N. 2013). This taxonomy defines the particular type of learning which takes place in the psychotherapy process and the distinct capabilities that are activated through a certain form of learning.

 

Taxonomy of  psychotherapeutic goals

The “arsenal“ of capability developing techniques is quite vast, but the psychotherapy techniques are scattered over the different psychotherapy approaches and without a „proper tutorial“ on how to use them, meaning that there isn’t a satisfactory explanation of which technique is meant to be used for what specific problem and when and how it should be applied. In IPP method, we have created a list of techniques originated from various psychotherapy methods (as well as of techniques that we have developed). This list encompasses all the basic emotion processing capabilities associated with the growth assignements, and connects them to the „manual“ on how the techniques can be used to develop certain capabilities.

Nevertheless, in order to make these techniques helpful in developingemotion processing capabilities, it is necessary to apply them through a solid, deep emotional contact with the therapist.

5. Does the approach include processes of verbal exchange, alongside an awareness of non-verbal sources of information and communication?

 

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)
“Of necessity, a comprehensive, integrative approach to therapy requires attention to the complexities of human interaction. For example, the SASB coding system, a procedure that has successfully informed the field about therapeutic interaction from a transtheoretical perspective, takes into account not only what is said, but also how it is said (e.g.,voice quality, facial expression). Thus, depending upon nonverbal sources of communication, the statement “You are free to do it any way you’d like” can be categorized as high in affiliation and low in control, or low in affiliation and high in control Experienced clinicians, regardless of orientation, can readily make this distinction, and can reliably make use of this coding system. In addition to being a research tool for studying the process of therapy, it clearly is also useful for purposes of clinical training, and has been used to train beginning therapists in the subtleties of communication-
 
Also of relevance is the work of Greenberg, Rice and Elliot (1993), which has studied “markers” in the therapeutic interaction. These markers represent points in the therapeutic discourse where a client reacts in a way that has important implications for how the therapist should proceed clinically. Such markers can be informed by a variety of theoretical orientations, and may be used to develop integrative clinical guidelines,, Still another integrative approach to the analysis of interpersonal communication is the Coding System of Therapeutic Focus (CSTF), which highlights aspects of the client’s functioning (e.g., thinking, emotions, actions) on which the therapist places a focus within the therapeutic interaction, and can be used to provide an integrative case formulation (Goldfried, 1995),

For IPP Speciffic

The IPP method is a mainly verbal psychodynamic psychotherapy, which integrates methods used in other orientations, including those with behavioral orientation. However, significant attention is given to both non-verbal communication and work with physical manifestations of resistance, body language, muscle tensions caused by emotions… Apart from the verbal techniques, reflecting, free association, dream analysis and others, various techniques from other orientations are used in the IPP method, such as thetechnique of body awareness from Gestalt Psychotherapy, focusing (Eugen Gendlin, technique directed toward the “felt shift”), and techniques from body-oriented psychotherapies (bioenergetics, radix…)

6. Does the approach offer a clear rationale for intervention/treatment and assessment/diagnosis, faciliatating constructive change over factors provoking or maintaining illness or suffering?

 

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

 

“The various transtheoretical assessment procedures used in integration-oriented process research and clinical practice (e.g., the Structural Analysis of Social Behavior, Coding System of Therapeutic Focus) have been used to address the question: “What did the therapist do in a session that was effective?” Inasmuch as these procedures are not linked to a particular theoretical school, the research findings coming from such process research can readily be used by professionals who integrate several different orientations. Moreover, these findings have direct applicability to clinical practice, as they readily address the question raised by practicing therapists, namely: “What can I do in a session that can be effective?”
These various assessment systems essentially serve as maps to deal with different aspects of the therapeutic territory. Different maps have different clinical uses. depending on the nature of the terrain it details the most (i.e., intrapersonal issues or interpersonal relations). They are used to formulate clinical cases in such a way as to point to treatment directions, and can be used to monitor progress during ongoing therapy- And while the map is not the territory, knowledge of both can greatly enhance the clinical effectiveness of the integrative therapist.”

 

The IPP methodology offers a very precise scheme of basic emotional competencies, their normal development and stagnation (Jovanović, N. 2013). Manifestations of deficiencies in capabilities development are clearly defined in cognitive, emotional, conative and behavioral spheres. For each type of stagnation and its manifestation, there are specific therapeutic techniques that can be used to unblock or develop certain capability. Basic assumption of the IPP methodology is that the development of the “life tools”, basic Ego strengths – emotional competencies is crucial for a client’s ability to grow. Insight alone is not sufficient. Without a change in the way of functioning of the basic emotional competencies there is no true change in a client. “You cannot make bricks without straw”. Defects of capabilities reflect mental “illness”, just as counter-skills are a client’s attempt to make up for the lack of basic capabilities with various kinds of manipulation of self and others. Detecting the counter-skills, developing the capabilities, and substituting counter-skills with capabilities, make the basis of both therapeutic change and its stability in a client’s future functioning.  (Jovanović, N.2013)

 

If any of these “bricks” are omitted, the psyche remains defective (i.e. a person misses a part of the Self). Love and work capabilities are damaged.

If the neutralization capability is in an inchoate form, a person is guided by their urges and drives (“they lose their minds”). A person gets impulsive, irrational and unarticulated.

If a “glue of psyche” – object wholeness is damaged or not fully formed, maintaining the broader picture of reality, Self and object is impossible. The inner world of a person is split off and divided into a black and white clusters, the world of evil and good (a person is untogether, their perspective is either all positive or all negative, they either idealize or hate…).

Without the object constancy, i.e. the capability which ensures our emotional stability, people get unstable, codependent, needy and tend to cling onto others.

If frustration tolerance is underdeveloped, a person is not psychologically immune to inevitable life frustrations, love and work capabilities are, logically, undeveloped and immature, and such person can easily get extremely stressed out, crashed when under pressure.

If ambivalence tolerance is underdeveloped, a person is unable to make decisions and stick to them, is incapable to face antagonistic emotions towards someone of something (or their own Self) and equally incapable of resolution reaching, choosing one between two alternatives, is unable to make up their mind and be determined.

If will capability is underdeveloped, a person is lacking energy necessary to continuously support their desires and goals.

If initiative is not fully developed, a person is reactive, without the key for their psychological engine. A person with underdeveloped initiative needs someone else to get her move forward.

All the mentioned emotion processing capabilities are intertwined, mutually connected and in a reciprocal relationship. The following diagram depicts their mutual and reciprocal connection:

7. Does the approach include clearly defined strategies to enable clients to develop new organization of experience and behaviour?

 

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

 

“On the basis of an analysis of different theoretical approaches to change, Goldfried and Padawer (1982) have outlined certain clinical strategies that are common to the different schools of thought and therefore capture the integrative approach to treatment. These common strategies may be conceptualized as reflecting a level of abstraction between theory and technique, and consist of the encouragement of hope, the facilitation of a good therapeutic alliance, the enhancement of client awareness, the encouragement of corrective experiences, and the presentation of ongoing reality testing.
 
The use of such common factors guides the integrative therapist at a strategic level. With these common strategies in mind, the therapist is then able to select more specific interventions without being limited by the dictates of a specific school of thought,, instead, the requirements of the case at hand determine which intervention method would be used as a means of implementing a given strategy. Thus, the “encouragement of client awareness” might involve an increased awareness of thoughts, feelings, desires, actions, or interpersonal impact on others, drawing on methods traditionally associated with different theoretical orientations- In their comprehensive perspective, integrative therapists focus on the eigenvelt (using psychodynamic methods), the mitvelt (using interpersonal and systems interventions) and the umvelt (using behavioural procedures).”

For IPP-speciffic

 

Why does IPP method pay a particular attention to emotional processing? In order to clarify this procedure, computer-human comparison will again be offered as a model (people are, of course, much more complex systems than computers are). Nevertheless, when a computer has a bug, a user can notice it on its screen. The screen shows unexpected dots, forms or squares… a user is unable to reada text or see a picture at the computer screen. A user who has some basic IT knowledge does not think that the computer screen is broken. Such user knows that something went wrong with the software (which processes the data and creates what is seen at the screen). Such user may also wonder if there is something wrong with the computer hardware (mechanical part of the computer). When people have problems with the “hardware”, they visit their GP’s, neurologists, surgeons, or other specialist for human hardware (i.e. organs). On the other hand, when people experience problems with their software (the data processing program), they seek psychological help.

The states that people seek help for, are actually – the screen – or “clinical picture” as psychologists, psychiatrists and psychotherapists usually call it. Psychotherapists do not deal with hardware, but with the clients’ capabilities and skills that are underdeveloped. Therefore, we cannot fix someone’s self-esteem or depression or impatience or any other unhealthy or dysfunctional state, nor could we create any of pleasurable states if we first do not fix basic emotion and cognitive processing capabilities, capabilities which are meant to process the psychological data, which then will lead to a positive change of a previously unhealthy state.

People create their states by processing what happens to them. The job of a psychotherapist is to help people to develop or unblock the interfering bugs which have created problems in human software. The human software can be seen as an executive emotion processing program. If a software is broken, the psychological problems, previously called “Clinical picture” become evident and manifest. (Jovanovic, N. 2013)

Basic Ego capabilities for processing emotions are “glasses” a person uses to observe and interpret both their inner world and outward reality. These glasses arrange a person’s experience. They see themselves and the world through their inner “lenses” and resists to see the information and experiences that do not match the picture they created by looking through these “lenses”. In the IPP method, the content a client presents is used mainly to detect these distortions, the typical way in which they perceive, arrange and interpret their personal experiences. The therapist is constantly facing the client exactly with the way they do it – the way they perceive, the way they arrange and the way they interpret their experiences. The therapist is focused on these processes, the unconscious algorithms for processing reality. In addition to verbal communication, written records for organizing experiences, so-called protocols the clients work on during and between the sessions throughout the entire therapy, are very important in the IPP methodology. The protocols are used in different ways: to arrange experiences chronologically for creating the impression of self-continuity in time and space for different segments: “important people” – their influence on development of a client’s personality, “important events in life – Me before and after them”, “important decisions – why did I make them, how did they influence developmentof my personality”…. Working on arrangement of important experiences and information about their own personality and life serves as an “external organizer of the psyche”, order that is subsequently introjected giving a client an impression that they have “glued” different parts of themselves, and that they have become an integrated person… New arrangement of the experiences leads to new structure of behavior, but not always directly. When they rearrange their experiences, some people spontaneously change their behavior, while some clients have to be “pushed” to apply the internal changes at behavioral level. In these situations, a therapist and a client design “homework” – agreed and specified changes in behavior that are challenging enough, yet not too overwhelming for a client to execute within the scheduled time. To motivate clients to change and accept the risk the changes carry, the IPP method often uses structured protocols – “pricelist of life decisions” and “emotional accounting” which help them to calculate the benefits from abandoning the old and embracing the new forms of behavior with great precision. (Jovanović, N. 2013)

 Professional aspects:

 

8. Is the approach open to dialogue with other psychotherapy modalities about its fields of theory and practice?

 

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

 

“Psychotherapy integration is characterized by a dissatisfaction with single-school approaches and by a concomitant desire to look across theoretical boundaries to see what can be learned from other ways of conducting therapy. By its very nature, this approach to therapy requires open, ongoing and collegial dialogue across the therapy modalities. Integrative therapy maintains that the awareness-enhancing process of psychodynamic therapy and the action-producing processes of behavior therapy-plus many others-are the curative factors in psychotherapy,, In order to arrive at such a comprehensive, integrative approach to treatment, collaborative dialogue is essential.
 
The roots of psychotherapy integration go back to the 1930s, at which point it was only a latent theme – Since the 1980s, however, this theme emerged into a salient movement, due in large part to the formation of the Society for the Exploration of Psychotherapy Integration (SEPI). Formed in 1983, SEPI was established as a way of bringing together the growing number of professionals interested in this approach to treatment. An interdisciplinary organization that is now international in scope, SEPI holds yearly conferences at which many of the most active clinicians and researchers present their current work, and where the attendees are provided with the opportunity to discuss and exchange ideas. It is this spirit of open dialogue, where professionals go to listen and learn, that is the strength of this approach.

For IPP-speciffic

IPP is an integrative psychotherapeutic approach completely open to dialogue with other therapeutic modalities, regarding both theory and practice .The IPP methodology offers a solid ground on which techniques from other psychotherapeutic modalities can be built, a structural scheme of basic emotional competencies and approaches which can help their development in therapeutic process. As an integrative approach with a clear bases for integration, IPP is open to all approaches that observe certain ethical standards regardless of whether orientation is psychodynamic or not (since behavioral techniques can be integrated in psychodynamic therapy) if they offer techniques that can useful for development of basic emotional competencies.  Although psychotherapists of other modalities are familiar with psychodynamic terminology, during the IPP training psychotherapists are being taught basic concepts, techniques and “jargon” of other psychotherapeutic orientations and build a vocabulary of the same or similar terms named differently in other psychotherapeutic orientations.

9. Are the chosen fields of study and methods of treatment/intervention of this approach methodologically described in a way that can be used by other colleagues?

 

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

 

“As suggested above, the strength of psychotherapy integration is the desire to reach across boundaries and bridge the traditional gap between orientations. The field of psychotherapy has been characterized over the years by competing factions, each of which tends to go its own way. With its own unique jargon, any contributions that might be made are all too often available only to members of the particular school,. The very essence of the integrative approach is to enhance the development of the field. which can only be done so by facilitating communication among professionals,, As mentioned earlier, the use of the vernacular-instead of theoretical jargon” as a way of describing clinical and research findings is the hallmark of an integrative approach to therapy.”

For IPP speciffic

As previously mentioned, although psychotherapists of other modalities are quite familiar with psychodynamic terminology, during the IPP training, the therapists are being taught basic concepts, techniques and “jargon” of other psychotherapeutic orientations and build vocabulary of the same or similar terms named differently in other psychotherapeutic orientations. In theoretical considerations of IPP it is common to connect basic emotional competencies and other key concepts of IPP with theoretical and methodological concepts of other psychotherapeutic approaches, which makes IPP theory and methodology comprehensible and of use to colleagues from other orientations.

10. Is the information associated with this approach the result of conscious self-reflection and critical reflection by other professionals within the approach?

 

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

 

“The long history of psychotherapy integration has involved considerable self-reflection over the years,, It has crossed theoretical boundaries, has encompassed various professional groups (psychology, psychiatry, social work), and has been international in scope. In the UK. Dryden (1980) has dealt with with differences in therapeutic style across theoretical orientations. In Germany, Bastine (1980) has discussed the methods for accomplishing an integration of the therapies, as well as its theoretical and practical benefits. In English-speaking Canada, Greenberg and Safran (1987) published Emotion in Psychotherapy; from French-speaking Canada, Lecomte and Castonguay (1987) edited Rapprochement et Integration en Psychotherapie. From Italy, Guidano (1987) contributed Complexities of the Self,, Among the numerous books appearing in the United States, Norcross and Goidfried (1992) and Stricker and Gold (1993) edited extensive handbooks on psychotherapy integration.
 
In their thoughtful and extensive review of research in psychotherapy, commissioned by the National Health Service Executive of the English Department of Health, Roth and Fonagy (1996) have concluded that one of the more promising directions for future investigation is with those approaches that “attempt to integrate models of therapy. These provide a more formal theoretical framework for the ‘eclecticism’ that often characterizes everyday clinical practice, with clear implications for efficacy” (p. 375). It is our distinct impression that there is a growing consensus that integrative approaches to treatment represent the future of psychotherapy.”

For IPP speciffic

During the two decades of its use, IPP has evolved from the process of self-reflection of the author and critical reflection of other professionals within this approach, which greatly contributed to improvement of methods, techniques and development of new areas of application.  There are numerous papers by IPP psychotherapists which include critical reflections, changes and revisions. (Petrović, J. (2007), Senic. R., Jovanović, N., (2011), Jovanović, N. (2013), Petrović, J., Jovanović, N., & Trbojević, J.(2015) Jovanović-Đorđević, S. (2016) Jovanović-Đorđević, S., Đorđević, P. (2016b), Petrović, J. (2016), Vučković M. (2016), Solujić A. (2016), Paunović I. (2016), Deh D. (2016)

11. Does the approach offer new knowledge, which is differentiated and distinctive, in the domain of psychotherapy?

 

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

 

“What is new and distinctive about psychotherapy integration is that it approaches the question of how people change from a vantage point that has not been taken before, namely the common factors that cut across different schools of thought. To the extent that commonalities may be found across therapeutic orientations, it is likely that these will represent robust phenomena, as they have emerged despite the different theoretical starting points. In addition to looking at commonalities, however, psychotherapy integration also acknowledges the importance of technical eclecticism, whereby different intervention procedures coming from different orientations may be used, depending upon what is needed in any given case at hand. A third theme within psychotherapy integration is work being done to achieve an integration at the theoretical level.
 
It should be pointed out that these three approaches to the study of psychotherapy integration are not mutually exclusive, but rather are closely interrelated. For example, common factors inform us about what different theoretical models have in common and, as a result, highlight the areas in which more detailed empirical and clinical examination is required. In looking for greater specificity in our clinical and research efforts, we thus move into a clarification of the parameters of these general principles. This represents the technical eclecticism thread of the orientation, in which we examine the specific techniques that are effective in certain clinical situations. Once we have obtained information of the effectiveness of several techniques, it is possible to engage in a bottom-up approach to theory construction. Thus. while theoretical constructs associated with a given school of thought may have generated specific interventions, the existence of a technically eclectic array of effective methods may require us to regroup what we have found to be effective into a new conceptual model involving a form of theoretical integration.”

 

Innovations introduced by IPP:

 

  1. Scheme of basic EGO capabilities (emotional competencies) and their interdependence (above) These capabilities have been mentioned by numerous authors in the field of psychoanalytical theory and practice, but not in the way they are structured and interrelated in the IPP method. What is new and distinctive is integration of knowledge on development of basic emotional competencies into a clear model offering explicit criteria for the use of therapy techniques that come from different approaches in the process of developing specific capabilities.
  2. Operational defining of the manifestation of fully developed capabilities and defects in development of capabilities at cognitive, emotional, conative and behavioral level. (Jovanović, N. 2013) More precise definitions of the manifestations allow for the construction of measure instruments and conducting methodologically more appropriate research of psychotherapeutic process.
  3. Clear criteria for the use of psychotherapeutic techniques from different orientations in work with basic Ego capabilities. (Jovanović, N. 2013)
  4. Emotional accounting and mathematics of psychology. Pricelist of life decisions. The law of psychodynamics
  5. The concept of “counter-skills” and methods for their detection. “psychological antivirus program”. The concept of counter-skills is similar to defense mechanisms and the concept of “games” in Transactional Analysis, but includes a complex set of psychological mechanisms and behaviors people develop to compensate for underdeveloped basic emotional competencies.
  6. IPP Protocols – self-knowledge protocols with semi-structured questionnaires which enable a client to do most of the work on their development independently. The protocols lead the client toward self-knowledge and structuring of the insight about themselves into an integrated “representation of their own personality)”. This makes the client more active and speeds up the therapeutic process. (Jovanović, N. 2006, 2013)
  1. Applied IPP programs: knowledge of basic emotional competencies and techniques for their development has been implemented into numerous training programs that move from the scope of psychotherapy toward prevention, developmental psychology and education. Many life skills trainings based on promoting and developing emotional competencies have been designed in various areas: education, corporate business, sport, optimum performance achievement training and in work with clients without serious psychological problems who want to improve their potentials.
  2. Numerous new therapeutic techniques for the development of the basic emotional competencies have been designed

12. Is the approach capable of being integrated with other approaches considered to be part of scientific psychotherapy so they can be seen to share with them areas of common ground?

 

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

 

 

“By looking at common principles (e.g., the therapeutic alliance, increasing awareness, encouraging corrective experiences), we are in the position of having the contributions of different theoretical orientations converge, thereby increasing the likelihood of advancing the field. Moreover, by translating theory-based jargon into the vernacular, we have at our disposal a common language for dialoguing across the orientations. In using this approach to bridge the gap across theoretical orientations, our hope is that”,.. some members of each community may also begin vicariously to understand how a statement previously opaque could seem an explanation to members of the opposing group” (Kuhn, 1970, p. 203).
 
Take, for example, the common principle of the corrective experience (or new learning), which involves clients taking a risk in their lives by saying or doing something they have previously feared or avoided. Therapists from different orientations recognize the importance of this phenomenon, but may implement it in different ways. Thus, within a psychodynamic orientation, this risk-taking may be more likely to occur in the way the client interacts with the therapist, whereas the corrective experience in a behavioural therapy may be more likely to take place between sessions, as when the therapist encourages clients to assert themselves to a significant other. The overall principle is the same, but the method of implementing it may vary according to orientation (hence the technical eclectism).”

For IPP speciffic

 

Since IPP is theoretically based upon four psychoanalytic psychologies: Drive psychology, Object relations psychology, Ego psychology and Self Psychology, it can be integrated with all approaches with psychodynamic orientation. IPP is called “integrative” because it is based upon integration of different psychodynamic approaches according to the clear criteria based on discoveries of the basic emotional competencies extracted from them. Since understanding of development and functioning of each basic emotional competence is used as a guideline for the choice a specific technique, regardless of the orientation the technique developed in, the criteria also enable integration with methods developed in behavioral therapy.

Research aspects:

 

13. Does the approach describe and display a coherent strategy to understand human problems and a coherent relation between methods of intervention/treatment and results?

 

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

“The overriding research strategy for developing and confirming effective integrative interventions involves the comparative study of the therapeutic process and its relationship to outcome. In conducting such research, therapy sessions are evaluated using a transtheoretical coding procedure (e.g., SASB, CSTF, measures of the therapeutic alliance), which are then related to outcome. The process analysis may involve one or more different theoretical orientations, depending upon the outcome study that is the focus of the investigation. For example, in a study of cognitive therapy for depression, a process-outcome analysis has revealed that the therapeutic alliance and client emotional experience level were both positively related to symptom reduction (Castonguay, et al, 1996). in another study with the same data set, it was found that therapists who focused on clients’ developmental issues were more likely to be successful (Hayes et al,,, 1996). It should be noted that the treatment manuals did not focus on these factors, even though they proved to be clinically important. This research strategy therefore is able to uncover effective aspects of a therapeutic intervention, regardless of whether or not it is derived from the theoretical underpinnings of the intervention procedure.”

For IPP speciffic

As previously explained, the strategy of understanding human problems is based upon understanding the level of development of the basic Ego capabilities necessary  for good quality of life without pathology. Understanding developmental stages of the capabilities, as well as the manifestation of defects in their functioning, enables  a therapist to detect which capability or more of them, are not functioning  according to a client’s age, as well as to choose the techniques that can help to unblock or develop the capabilities.

14. Are the theories of normal and problematic human behaviour adopted by the approach explicitly related to effective methods of diagnosis/assessment and intervention/treatment and research?

 

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

 

 

“An excellent illustration of the relationship between the theory of human behavior and the success of the intervention within psychotherapy integration is the dialectical behavior therapy approach that Linehan (1993) has taken in the treatment of borderline personality disorder. On the basis of clinical experience and research evidence, it has been found that borderline patients are particularly sensitive to criticism. It has been hypothesized that there may be some constitutional/biochemical factors that contribute to their unstable emotional state, which has been exacerbated by early experiences of non acceptance and abuse. In addition to their sensitivity to criticism, they also manifest unstable and conflictual interpersonal relationships. As most practicing clinicians well know, this makes them a most difficult patient population with which to work,.
 
In originally attempting to use a behavioral orientation with this patient population, Linehan found that encouraging borderline patients to learn better ways of coping with their emotions and interpersonal problems proved to be unsuccessful given their sensitive to criticism, the patients reacted to the therapist’s suggestion that they needed to change as invalidating who they were. Upon this realization, Linehan developed an integrated intervention, whereby the therapy begins with a person-focused approach, accepting patients just as they are-This empathic. validating approach continues until patients reach the point where they ask to learn new ways of coping, at which point the therapist can suggest the option of implementing behaviorally oriented coping skills. This dialectic stance continues throughout the therapy, where the therapist maintains the delicate balance between acceptance and change. The available research findings are very promising, indicating that this integrated therapy is more effective than other available approaches in dealing with this patient population.”

For IPP spceffic

IPP offers tables of development of the basic emotional competencies and their manifestations in both normal and defective development, as well as their ways of expressing at cognitive, emotional, conative and behavioral levels. Apart from that, it gives a clear and thorough overview of developmental tasks in a person’s lifelong cycle in normal development, as well as development of counter-skills (pathology that results from unfulfilling developmental tasks). The development of the basic emotional competencies is connected with capabilities, to perform developmental tasks (Jovanović, N.2013). Within the IPP, effective methods of assessment/diagnosis, treatment/intervention and research of specific deviations in development of the basic emotional competencies have been designed.

15. Are the investigative procedures of this approach defined well enough to indicate possibilities of research?

 

(For integrative psychoteraphy in general-from EAIP-Scientific Validation Criteria for Integrative Psychoterapy)

 

 

“As illustrated in the response to several of the earlier questions, an integrative approach to therapy lends itself most readily to research. Given the premise that psychotherapy integration is committed to using therapy procedures that are effective clinically-regardless of their theoretical origin-psychotherapy research is essential to the system. Indeed, the development of integrative interventions may be readily derived from process analyses of clinically effective interventions, such as the finding that patient level of emotional experience is positively related to successful cognitive therapy for depression. What this suggests is that cognitive therapy procedures should be modified so that they include affect-arousal interventions, which might be integrated from experiential approaches to therapy. Once having done this, the “enhanced” cognitive therapy can be directly compared to standard cognitive therapy within the context of a controlled clinical trial, In short, there is an intrinsic interface between research and practice in psychotherapy integration, where each feeds into the other.

 

For IPP speciffic

 

IPP method offers tables with precisely defined manifestations of both developed capabilities and defects in capabilities at cognitive, emotional, conative and behavioral levels. These definitions enable us to start designing instruments to measure development of the basic emotional capabilities that can also be used to diagnose and monitor progress of psychotherapeutic treatment, as well as conducting further research. The instruments are currently being designed evaluated and standardized.  IPP protocols have also proved successful in monitoring effects of change, due to their quantification. They offer possibilities of both quantitative and qualitative analyses. Emotional accounting is a highly quantified procedure which also allows for the application of quantitative research methods in the field of psychotherapeutic changes. IPP method has developed a significant number of structured questionnaires for both self-evaluation and evaluation by the therapist which allows for evaluation of change and therapeutic progress.

 

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