When a therapist takes an eclectic approach to therapy It means that?

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Gordon Paul, an early proponent of eclectic therapy, captured the essence of this type of therapy when he described it as an approach that seeks to determine, “What treatment, by whom, is the most effective for this individual with that specific problem, under which set of circumstances, and how does it come about?”3

The heart of eclectic therapy involves understanding each client as a unique person with their own particular problems and then selecting research-based techniques from across different types of therapy in order to help that client grow in a personally meaningful way.

How Is an Eclectic Approach Different from a Specialized Approach?

In Eclectic Therapy, skilled therapists tailor their work to what is best for the client and their challenges rather than adhering to a single theory as a one-size-fits-all approach to helping.

Some helping theories, such as cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT) for example, are structured and methodical, and all clients learn the various information, strategies, and techniques that are part of the particular model. In contrast, an eclectic therapist might select some aspects of CBT, DBT, and other theories that make sense for a specific client.

It’s important to know, though, that eclectic therapy is far from a random hodgepodge of ideas applied haphazardly to clients. Indeed, integrational therapists don’t grasp at straws in an attempt to find something, anything, that will help but instead are intentional in the approaches they choose with each client.1

To do this, an eclectic therapist seeks to understand each client in all their complexity in order to be successful in helping clients reach their own goals.1 This involves learning about the multiple facets of each client including their thoughts, feelings, behaviors, relationships, and more.

The therapist then identifies core ingredients that various theories share in order to help clients solve the problems that caused them to seek therapy.1 Goals are determined not by the theory itself (as in changing core beliefs and thought patterns that is the desired outcome of CBT) but by the client and therapist based on the client’s problem, desires, and motivation.4

The therapeutic relationship is the heart of eclectic therapy and what drives the therapist’s choices of techniques to use with each client. The relationship between client and counselor forms the foundation that supports the process.

The process itself is different in eclectic therapy. Therapy evolves over time, and the therapist will use different techniques at different stages. Strategies to facilitate understanding (helping the therapist learn about the clients and the clients to learn about themselves) are commonly used in the early stages of therapy, and then other techniques from different therapeutic approaches are used as therapy progresses depending on what the client is dealing with and what is needed to advance toward goals.3

How Eclectic Therapists Select Their Techniques and Underlying Beliefs

Despite the fact that it is flexible and pulls from multiple therapeutic approaches depending on the needs of the client, eclectic therapy is a very intentional approach to mental health therapy. Therapists purposefully select techniques based on established criteria.

There are three general concepts that define how therapists choose what they do:3

• Theoretical integration
• Technical eclecticism
• Common factors

An eclectic therapist using the theoretical integration method of therapy adheres to two or more established, researched based theoretical approaches and combines them to draw from the best of each according to each client’s needs.1,3 For example, a counselor might combine person-centered therapy with CBT to help clients overcome obstacles. This mental health professional would select strategies and ideas from these two theories when working with all clients, and the specific tools used would vary according to an individual client’s needs.

Technical (think “technique”) eclecticism means that a therapist, rather than adhering to a small number of therapeutic approaches, selects techniques from a wide variety of different therapies depending on what is needed.1 The clinician selects a technique that is shown by research to help a particular issue. Often, therapists use Systematic Treatment Selection (STS), a research-based system developed by Larry Beutler and John Clarkin consisting of 18 principles and guidelines to help determine the very best techniques for a given client and problem.3

Common factors eclectic therapy is based more on core elements essential to healing than on specific tools and techniques. Therapists gravitate toward the underlying belief systems of therapies, such as unconditional positive regard, hope, trust, and empathy as well as driving factors like correcting emotions, changing beliefs, or providing honest feedback to clients to help them see themselves more clearly.

Regardless of how integrational therapists choose their approach, everything they do is customized for an individual client and the difficulties they are dealing with. Some practitioners use a specific type of eclectic therapy in their work with clients.

Types of Eclectic Therapy

Over time, practitioners and researchers have created specific types of eclectic therapy. All have in common the fact that they draw from multiple approaches in order to meet the specific needs of an individual client.

Brief Eclectic Therapy

Brief eclectic therapy (BET) is a specific approach to helping clients deal with and overcome a traumatic event.5 It combines elements of CBT and psychodynamic therapy (a focus on interpreting and processing emotions and thoughts). A focus of brief eclectic therapy is on the emotions of guilt and shame that often occur in the aftermath of a traumatic experience.

Multimodal Therapy

Developed by Aaron Lazarus, multimodal therapy is based on social and cognitive learning theory, and it draws on techniques from numerous different mental health therapies.6 Eclectic therapists using a multimodal approach determine their client’s needs by assessing a number of criteria in seven modalities of being, which can be remembered by the acronym BASIC ID: behavior, affect (emotions), sensations (senses), imagery (visualization and imagination), cognition (language-based thinking), interpersonal relationships, and drugs/biology (including physical bodies and health).7 This way, they can help each client in specific and personal ways.

Cognitive-Interpersonal Therapy

This helping approach combines cognitive therapies like CBT with interpersonal therapy. It’s a methodical approach to helping people become aware of and understand their distorted thoughts about themselves and their relationships that cause problems in their lives.3

Transtheoretical Therapy

James Prochaska and Carlos DiClemente developed this approach that pulls concepts across theories to explain how people change.1 It combines theories about stages of change, levels of change, and the process of change.3 Working from their understanding of how people create positive, effective change in their lives to accomplish their goals, therapists select techniques from a variety of therapies to help clients grow.

Three-Stage Model

This form of eclectic therapy is newer than the others, developed by Clara Hill around 2014. The three-stage model provides therapists a framework of three stages of the therapeutic process.1 Knowing what happens during each stage helps professionals select techniques that will work for an individual client during each stage of therapy. The first stage is the exploration stage and is based on Carl Rogers’ Person-Centered Therapy. The second stage is the insight phase, based on psychoanalytic therapy, and the third stage is the action phase, based on cognitive-behavioral therapy.

Cyclical Psychodynamics

Another newer type of eclectic therapy, Paul Wachtel’s cyclical psychodynamics is a therapeutic approach driven by a strong therapeutic relationship. This therapy combines psychodynamic therapy, CBT, systemic therapy, and experiential therapy to improve a client’s emotional experiences and help them develop new interpersonal relationship skills.8

Most therapist’s won’t bog their clients down with technical names for their specific approaches. What’s important to know is that integrational therapy in general is a purposeful healing approach that is based on sound methods and research-based techniques. Knowing that there are different types of eclectic therapy can help you have peace of mind and confidence that your therapist isn’t simply using a trial-and-error approach consisting of techniques drawn randomly from one theory or another.

What Can Eclectic Therapy Help With?

Because it is so flexible and meets each client’s needs and personality, eclectic therapy can help with a wide range of challenges. It can be used in individual as well as group therapy.4 Further, this approach is useful for overcoming stressors and difficulties like relationship problems or general life stressors as well as mental health disorders.

Eclectic therapy has been shown to be helpful for people with the following mental health concerns:3

• Major depression
• Dysthymic disorder
• Postpartum depression
• Bipolar disorder
• Eating disorders
• Personality disorders
• Marriage, family, or other relationship struggles
• Developmental challenges and issues related to specific stages of life
• Complicated pregnancy
• School-related problems in kids and teens
• Coping skills for medical problems or health issues

Eclectic Therapy Examples

The following examples of eclectic therapy illustrate how therapists might approach treatment for clients living with anxiety, depression, or PTSD. Because this type of therapy is highly individualized, your own work with an eclectic therapist will likely look a bit different.

As noted, eclectic therapy is quite versatile. Because a therapist creates a unique process and selects individualized treatments for each client, no two people seeing the same therapist will have identical therapy. This is because each challenge is different for every person who experiences it. For example, anxiety disorders are extremely common, but because people have different personalities, backgrounds, and current life experiences, anxiety is different for everyone. To an integrational therapist, a single method of helping every client with anxiety would be inadequate.

With this caveat in mind, here’s a look at how an integrational therapist might approach therapy.

Eclectic Therapy for Anxiety

After learning more about the client and their experience with anxiety, an eclectic therapist would create a plan that draws from acceptance and commitment therapy (ACT), cognitive behavioral therapy, and positive psychology.

• Techniques from ACT, such as acceptance and mindfulness, would help a client stop struggling against anxiety and begin living fully in their present moment rather than stuck in worries about the past or future.
• The therapist would select specific CBT techniques like learning about automatic negative thoughts and thought stopping, to help clients change unhealthy thinking that is contributing to anxiety.
• As treatment progresses, the therapist would eventually add techniques from positive psychology such as identifying and using character strengths to help the client increase self-confidence.

Eclectic Therapy For Depression

Depression has roots in long-term problems, and it frequently involves struggles with interpersonal relationships.(F3) Therefore, an eclectic therapist might use psychodynamic therapy and interpersonal therapy to help a client overcome depression.

Techniques from psychodynamic therapy would help clients explore emotional difficulties and come to terms with problematic experiences from the past. Once a client was ready, the therapist would then select specific treatments from interpersonal therapy to help them develop insights and interpersonal skills to improve relationships and interactions with others.

Brief Eclectic Therapy For PTSD

To help people face, address, and overcome painful thoughts and feelings in the aftermath of a traumatic event, a brief eclectic therapist combines CBT and psychodynamic therapy.2,5 Select CBT techniques help clients recognize their particular negative thoughts about the trauma and change their thought patterns, while specific psychodynamic techniques allow people to process difficult emotions.

Brief eclectic therapy involves 16 weekly sessions that typically last 45 minutes to one hour. Each session has a specific objective in helping clients deal with the trauma.9

Eclectic Therapy for a Range of Difficulties

Regardless of the problem that leads an individual to seek therapy, CBT is the most common therapeutic approach that therapists draw from.5

Other common techniques that are selected from multiple approaches and used in eclectic therapy to help a variety of problems include:1

• Skill-building exercises
• Problem-solving tools
• Relaxation techniques
• Exploration to increase insight and awareness
• Identifying personal themes that may be interfering in life
• Homework assignments to solidify learning and changes

How to Find a Therapist Who Uses an Eclectic Approach

The process of finding an eclectic therapist is similar to the general process of finding a therapist. Asking your doctor for a referral can be useful, as can talking to friends and family members. You can also find information about therapists by visiting local community centers, libraries, hospitals, and mental health organizations. You can also search online directories, specifically for eclectic therapists.

Who Is Able to Practice Eclectic Therapy?

Any licensed therapist can provide eclectic therapy.4 You don’t have to seek therapists with training unique to this approach as you would for other therapies such as mindfulness-based cognitive therapy. That said, it’s important to find a qualified mental health professional.4 This means finding a therapist who has an advanced degree in counseling, psychology, or a closely related field and is licensed by the state in which they practice.

A therapist who has completed graduate school and has met licensure requirements has the knowledge and experience to properly select the appropriate techniques from across different types of therapy. Further, they’re able to explain what they are using with you and why they have chosen the particular approaches they are using.

Cost of Eclectic Therapy and Does Insurance Typically Cover It?

The cost of eclectic therapy is similar to that of other types of therapy. Therapists charge different rates depending on their education, credentials, experience, arrangements with insurance companies, and location. Mental health therapy can range from about $50 to $250 per session.10

Insurance companies require therapists to prove that the techniques they use for a specific problem (like depression, anxiety, PTSD, etc.) are supported by research, which means that eclectic therapy techniques are often covered by insurance.2 As explained above, therapists use research-supported techniques to help clients.

Key Questions to Ask a Therapist When Considering an Eclectic Approach to Therapy

Some questions to ask your therapist before beginning an eclectic approach to therapy include:

• Have you worked with people with my problem before?
• Do you have standard approaches that you draw from, like CBT?
• How will you decide what will be most helpful to me?
• Approximately how many sessions do you think we will have?
• How will you know if I’m making progress?
• How will I know if I’m making progress?
• What will happen if I don’t get better?

What to Expect at Your First Appointment

Your first appointment with an eclectic therapist will be largely centered on the two of you getting to know each other and beginning to form a strong, trusting therapeutic relationship. Rather than diving directly into the problem or challenge that led you to therapy, the first session lays the foundation for the work to come.

Your therapist will ask you questions to begin to understand you. They might ask about your background, current problems and exactly how they are affecting your personal life, your family, social life,and support system, level of satisfaction with your career or job, and your goals. In doing so, the therapist is learning what approaches will be most helpful to you.

You’ll likely also be given the chance to ask questions about the process and the therapist. Because of the nature of eclectic therapy, your therapist probably won’t be able to provide a detailed treatment plan with predetermined goals and strategies for every session. They will, however, be able to give you an idea of what to expect in general.

Is Eclectic Therapy Effective?

Eclectic therapy is an established and proven approach to therapy that uses purposefully selected techniques which research has shown to be helpful for a specific problem.4 When helping clients, therapists choose research-supported strategies for a specific problem.

Eclectic therapy is indeed science-based and proven effective as indicated by the existence of two dedicated peer-reviewed, scholarly journals: the American Psychological Association’s Journal of Psychotherapy Integration and the International Integrative Therapy Association’s International Journal of Integrative Psychotherapy.

Eclectic therapy has been found to be effective even in difficult cases (such as clients who are resistant to treatment or for complex and challenging problems). Therapists at the Daytona Institute for Family Therapy engaged in a five-year project called The Impossible Cases Project (results reported in 2002) to study which factors were most helpful in difficult therapy cases.3

They discovered that the two most important factors for success in these cases were:

1. the therapeutic relationship between counselor and client
2. the ability of the therapist to adapt treatment techniques to the client’s perspective of the problem and finding solutions workable to the client. These two factors are the heart of eclectic therapy.

Risks of Eclectic Therapy

Systemic eclectic therapy (the intentional, thoughtful selection of treatments that has been the subject of this article) conducted by qualified therapists (those that have advanced degrees in their field and are licensed), poses little risk. However, poorly executed therapy that wantoly pulls techniques from various theories in an attempt to find something that might work—known as unsystematic eclectic therapy—can be ineffective or even harmful to the client.3

As with any other type of therapy, it’s crucial to ensure that your therapist is properly qualified. You can discover a therapist’s credentials in online bios or by calling or visiting their office. It is okay to ask a potential therapist about their credentials and background, and a good therapist will gladly answer your questions. Most openly display their certificates and other credentials to be open and transparent.

Criticisms of Eclectic Therapy

No therapeutic approach is for everyone, eclectic therapy included. Some criticisms of this type of therapy include:3,4

• The lack of a set structure or procedure means that clients won’t always know what to expect at each session or how many sessions they can expect to have
• Some people find the use of techniques from multiple disciplines to be confusing or disorienting
• It can be difficult for a therapist to clearly explain what the process will be like from start to finish
• If the therapist doesn’t clearly explain what they are doing and why, it can seem syncretic, like a random grab-bag of strategies with no united purpose

The Pros & Cons of Eclectic Therapy

Like all types of mental health therapy, eclectic therapy has advantages and disadvantages. Considering both the pros and cons can help you decide if this integrative approach to healing is right for you.

Pros of an Eclectic Approach

Some advantages of eclectic therapy include:1,4,11

• It’s flexible to accommodate different clients’ needs rather than a one-size-fits all approach to therapy
• It is useful for multiple and complex problems (usually, people see a therapist for more than one issue or a single issue that is multifaceted)
• The techniques used are research-based and shown to be effective
• The therapy is adapted to the client rather than the client having to fit into a set model

Cons of an Eclectic Approach

Disadvantages may include such issues as:1,11

• It can feel unpredictable or confusing
• It might seem like the therapist is using a trial-and-error approach
• There isn’t a clear, obvious, or predictable structure

History of Eclectic Therapy

Until the 1970s, therapeutic theories were separate from each other, and therapists adhered to a specific approach.2 Very little overlap occurred, and professionals were loyal to their chosen method. As time passed, research continued, and as more therapeutic approaches were developed, people began to see that more than one type of therapy was effective, and by the 1970s, therapists began to use multiple approaches in their work with clients.

One of the earliest proponents of an integrated approach to therapy was Arnold Lazarus with his multimodal therapy.4 Through the 70s and 80s, different types of eclectic therapy were developed, and they continued to evolve.3 Still today, new eclectic therapies are emerging as research continues into what makes psychotherapy effective for different people with unique challenges.