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.
You Might Be Interested in the Christian Counseling Book List
About the authors
Mark R. McMinn has a Ph.D. in clinical psychology from Vanderbilt University. He is a scholar in residence at George Fox University following his retirement in 2020. He has written numerous books and scholarly publications. See Google Search
Clark D. Campbell has a PhD in clinical psychology. He has held professorships and administrative positions at American universities. See Google Search.
Key Words: Christian Counseling, Christian Counseling and Psychotherapy, Christian counseling and depression, Christian counseling and personality disorders, Christian counseling and relationships
References
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.
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