In the beginning, the authors tell us about Integrative Psychotherapy, which they refer to as IP: “IP is simply one approach to psychotherapy, informed by Christian theology and spirituality as well as contemporary psychology (16-17; italics in original).”
Imagine yourself driving down a slippery narrow road between two deep ditches. I have modified the authors’ analogy to capture their difficulty in negotiating the territory of counseling and psychotherapy marked on the one hand by those who rely solely on Christian Scripture and on the other hand by those who employ psychological interventions with minimal attention to their Christian faith. The authors are aware of the contributions of other writers, including a special appreciation for Modern Psychotherapies: A Comprehensive Christian Appraisal (Jones & Butman, 1991).
Near the end of the introduction, they state their purpose is “to articulate a Christian Psychotherapy (18).” Christian denotes an evangelical protestant perspective. In addition to including essential theological principles, the authors include findings from the scientific study of psychotherapy. The authors present a humble stance yet, they are well qualified to offer this contribution to the integration literature.
In this review, I will provide a summary of the book by following the logical outline employed by the authors. I will then suggest some considerations related to the theological and psychological foundations of the IP model.
The first four chapters provide an overview of the theoretical foundations for IP, which include both theological perspectives and scientific findings. The next seven chapters explain how IP works. Following a chapter on assessment, the authors elaborate on the three domains of IP (functional, structural, relational) and show how they apply to common clinical conditions (anxiety, depression, personality disorders). They conclude with a summary chapter, which I will use to reflect on their work.
Chapter one contains three basic elements of Christian doctrine: creation, fall and redemption. Based on the creation doctrine, the authors draw upon three historical views of the image of God, which they match to three systems or perspectives of psychology.
A functional view of the image of God correlates with behavioral acts in the world. A structural view considers the reflection of God’s nature in human nature and includes rational and moral attributes, that may parallel the psychology school of structuralism and cognitive science. Finally, the relational view highlights God in relationship to humans, which is reflected in psychological theories and interventions focused on interpersonal relationships.
The authors present the traditional doctrine of the fall in terms of a pervasive state of sin as well as sinful acts. The final doctrinal position is the message of God’s redemptive act in Christ leading to expectations of hope.
The scientific foundation for IP draws primarily upon psychotherapy research rather than more general psychological findings. Central to their perspective is the work of Lambert and others noting a four-factor classification of therapy outcomes and associated percentages that estimate the contribution of each factor: client and extratherapeutic (40%), relationship (30%), hope and expectancy (placebo; 15%), factors associated with a model or technique (15%). (Parenthetically, I note these percentages have since changed.)
The authors conclude with a brief discussion of empirically supported treatments. This would be a good time for readers to reflect on the importance of all models of psychotherapy. That is, if 85% of psychotherapeutic outcomes can be attributed to factors not linked to therapeutic models or techniques, where should we spend our time in education and research? Are there other areas of integration of faith and psychology that are more relevant to human change than are models of psychotherapy?
In chapter three, the authors present and critique cognitive therapy. The presentation of cognitive therapy appears straightforward, but the critique is not. For example, the authors opined that, “Ideally, psychotherapies would emerge from carefully developed personality theories, but the process has been backward for cognitive therapy (92).” From a scientific perspective, it would seem reasonable to collect data related to various effective interventions and formulate a proximal theory to account for the data. One could make a strong case that psychology has suffered from too many large-scale personality theories.
The authors present their IP model in chapter four. The model consists of the three domains described in chapter one (functional, structural, relational). The authors reconnect each domain to its doctrinal base and expand upon the related psychological con- structs along with examples of interventions. Several figures aptly illustrate the model. A final table illustrated the differences between cognitive therapy (CT) and IP with a strong emphasis upon the Christian basis for IP. The CT-IP table and the presentation of CT in chapter three illustrate the weight given to CT in the IP model. The assessment and case conceptualization (chapter five) are useful ways to prepare readers for the following chapters that detail how IP might work.
Consistent with their integration approach, the authors show how Christian beliefs form a basis for the evaluation of self and others. In the next six chapters, the authors present interventions linked to the three domains of IP. Each set of interventions is followed by an application chapter.
Interventions that improve functioning by reducing symptoms are applied to anxiety disorders. Interventions that address cognitive schemas are applied to depression. Finally, the authors discuss strategies for understanding disorders that have their origin in early relationships. They draw upon theorists such as Sullivan, Horney, and Bowlby as well as object-relations and family systems theories to explore perspectives that account for markedly dysfunctional patterns of interacting with others. As with the previous chapters, the authors demonstrate relationship-based interventions to a common problem, the treatment of personality disorders.
The final chapter presents concluding thoughts. The subsection titled, Toward a Com- prehensive Christian Approach, contains six points that provide a useful basis to comment upon IP.
First, they note that IP is comprehensive when viewing a person from the perspective of Christianity and psychology. The reader should keep in mind the restrictive sense of the terms Christian (evangelical protestant) and psychology (primarily modern theories of psychotherapy and effective interventions).
It certainly would be useful to explore related issues that are beyond the scope of the present text such as how other aspects of theology relate to perspectives on science in general and psychological science in particular. In addition, although the authors addressed medication along with a theological basis for pharmacotherapy, a broader treatment of biopsychology and neuroscience will likely become more important to treatment as scientists make new discoveries.
Second, the authors have provided a reasonable basis for considering three domains or lenses for viewing client needs. They appropriately note the artificiality of isolating these domains for the purposes of presenting a model. Clearly, IP is both a multimodal model and one that integrates Christianity with multiple domains. It would be helpful to con- sider other literature on multimodal intervention strategies, including the contribution of Multimodal Therapy (Lazarus, 1989).
Third, the authors note how IP provides a basis for consideration of multiple dimensions found in different psychotherapies. For example, IP includes different emphases on the past versus the present or differential emphases upon emotions, cognitions, or behaviors. This broad umbrella is indeed a useful function of their eclectic approach.
Fourth, the authors have shown a respect for the role of science as a basis for psychotherapeutic interventions. Although the authors have shown their familiarity with empirical studies of psychotherapy as well as a diversity of psychotherapies, they are decidedly antireductionistic. I do not perceive the need to avoid analytic laboratory studies of the elements of behavior change purported to exist in psychotherapy models if such research is balanced by field studies with more holistic perspectives.
The authors appear particularly concerned that current outcome measures for domain three (relational) interventions may not be adequate. This is a wise move as any model must be tested for those who wish to use evidence-based approaches.
Fifth, the authors have clearly presented a Christocentric perspective on psychotherapy. They often return to the teachings of Christ when articulating a basis for taking a particular perspective on sin or a caring attitude. A glance at the scripture list in the end material affirms this focus. Others may wonder whether additional value can be gleaned from other scriptures that could provide a broader base for one tenet or another. In fairness, the authors do suggest that readers study theology and there will always be some disagreement on what constitutes a reasonable scriptural basis for any doctrinal position.
Sixth, the authors assert that IP is applicable to both Christian and non-Christian clients. The key question is how could a Christian therapist using an IP model treat non-Christian clients? Although the authors assert that the IP therapist should respect faith differences, it is difficult to see how therapists, convinced that they possess a true worldview would demonstrate genuine respect for someone who possesses a de facto false worldview.
In conclusion, IP is a well written work that makes a contribution to the integrative literature. It is truly a comprehensive model that offers a firm basis for viewing clients from an evangelical Christian perspective as well as organizing a variety of counselling interventions.
The authors introduced their work by explaining that they have listened to various sources when preparing this volume. Given this commendable attitude toward feedback, it seems as if readers will have an opportunity to shape future editions of IP.
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Key Words: Christian Counseling, Christian Counseling and Psychotherapy, Christian counseling and depression, Christian counseling and personality disorders, Christian counseling and relationships
Jones, S. L., & Butman, R. E. (1991). Modem psychotherapies: A comprehensive Christian appraisal. Downers Grove, IL: InterVarsity Press.
Lazarus, A. A. (1989). The practice of multimodal therapy. Baltimore: The Johns Hopkins Press.McMinn, M.R. & Campbell, C.D. (2017). Integrative Psychotherapy: Toward a Comprehensive