Integration av olika skolbildningar i psykoterapi: möjligheter och hinder

Sammanfattning: The aim of the present thesis is to constitute a first step in the process of clarifying similarities and dissimilarities between Swedish psychotherapeutic orientations. Special emphasis is placed on the possibly facilitating or impeding nature of any differences that are revealed for the integration of orientations. The first study constitutes a survey of the literature, setting the theme of similarities and differences in its historical context. One finding in this study was that the founders of the dominant schools (i.e. Freud for the psychodynamic tradition, Skinner and Wolpe for behaviourism, Rogers for humanistic psychology and Beck for cognitive psychotherapy), all considered there to be effective ingredients in forms of therapy other than their own. The founders, with the exception of Rogers, did not, however, emphasize similarities to any great degree, but rather noted these in passing. Instead, the founders focussed heavily on clarifying those characteristics that typify and delineate their own schools of thought. Another finding in the first study, as regards the clinical development of theory and practice, was the increasing similarities between orientations. The same tendency was also in evidence in psychotherapy research, leading to the conclusion that this tendency towards greater integration can be expected to continue. This will probably entail a development in the direction of a common science of psychotherapy and a lesser role for the individual orientations. The second study comprised a questionnaire based survey of attitudes among a representative sample of Swedish psychotherapists, and an additional number of cognitive and cognitive behavioural therapists. There were four groups in the comparison: 161 psychodynamic therapists, 93 cognitive therapists, 95 cognitive behavioural therapists and 67 integrative/eclectic therapists. Important questions were views on the characteristics and execution of good therapy. There were many similarities, but more differences in attitude. Cognitive behavioural therapists formed the most distinct group, being in greatest contrast to the psychodynamic therapists. The cognitive and psychodynamic therapists had a good deal of common ground in their views on what constitutes a good therapist, whereas cognitive and cognitive behavioural therapists were closer in their views on treatment. The integrative/eclectic therapists were close to the psychodynamic therapists in their views in general. The conclusion of this study was that the differences between psychodynamic therapy on the one hand, and cognitive/cognitive behavioural on the other, in their views of psychotherapeutic technique, and to some degree science, are still of such a magnitude as to constitute an obstacle to integrating the orientations in such an enterprise as a common therapy training. It is, however, difficult to find any patent obstacles to an integration of the cognitive and cognitive behavioural orientations.