What is Integrative Counselling? Combining Approaches for Better Therapy

Beyond the Single-Method Approach

Imagine walking into a hardware shop to fix a leaky tap. The assistant hands you a hammer.

"But I need a spanner," you say.

"Sorry," they reply. "We only use hammers here. Our entire shop is hammer-based. If you have a problem, the hammer will solve it."

This sounds absurd—obviously you choose tools based on the job, not limit yourself to one tool for everything.

Yet traditional single-modality therapy works exactly like this. A CBT therapist approaches every problem through a CBT lens. A psychodynamic therapist uses psychodynamic techniques. A person-centred therapist maintains person-centred principles.

Each approach is powerful and effective—for certain people, at certain times, with certain difficulties.

But what if you could access multiple therapeutic tools, selected based on what you specifically need rather than your therapist's singular training?

That's integrative counselling.

What "Integrative" Actually Means

Integrative counselling (also called integrative psychotherapy or integrative therapy) means drawing from multiple therapeutic approaches within a coherent framework.

An integrative therapist doesn't randomly grab techniques from different methods like a magpie collecting shiny objects. They've trained in multiple modalities and deliberately combine them based on:

• Your needs and presentation
• What works for your specific difficulties
• What resonates with you personally
• What the therapeutic relationship needs at this moment

Think of it as therapeutic fluency—speaking multiple therapeutic "languages" and choosing which to use based on the conversation needed.

Integrative vs Eclectic: A Crucial Distinction

Two similar-sounding terms with an important difference:

Eclectic Therapy

Approach: "I'll use whatever technique seems useful from wherever I've learned it."

Risk: Can feel haphazard, lacking coherent theoretical foundation. Might apply techniques without fully understanding their underlying principles.

Strength: Flexible, responsive, pragmatic.

Integrative Therapy

Approach: "I've deeply trained in multiple approaches and thoughtfully combine them within a coherent philosophical framework."

Strength: Theoretically sound, deliberately chosen interventions, maintains consistency whilst offering flexibility.

Standard: Most professionally trained integrative therapists have a primary orientation (often humanistic/person-centred) and integrate additional modalities into this foundation.

Common Integrative Combinations

Humanistic Base with Added Techniques

Core: Person-Centred or existential foundation (unconditional positive regard, client-led, holistic)

Integrated additions:

• Gestalt experiments for blocked awareness
• TA concepts for understanding patterns
• CBT techniques for specific symptom management
• Mindfulness for present-moment attention
• Psychodynamic exploration of unconscious patterns

Rationale: Humanistic values (respect, collaboration, trust in client's wisdom) provide the container; other methods offer specific tools when needed.

Relational-Integrative

Core: Focus on the therapeutic relationship as primary healing agent

Integrated additions:

• Attachment theory
• Psychodynamic concepts (transference, projection)
• Emotion-focused techniques
• Somatic/body awareness
• Contemporary relational neuroscience

Rationale: The relationship is central; techniques support relational healing.

Cognitive-Integrative

Core: CBT structure and techniques

Integrated additions:

• Person-centred empathy and acceptance
• Mindfulness/ACT approaches
• Psychodynamic understanding of patterns
• Schema therapy for deeper belief work

Rationale: CBT's structure and evidence base enhanced by relational depth and flexibility.

Psychodynamic-Integrative

Core: Psychodynamic understanding of unconscious processes

Integrated additions:

• Attachment theory (often primary)
• Mentalization-based techniques
• Person-centred presence
• Somatic awareness
• Contemporary neuroscience

Rationale: Psychodynamic depth with modern relational and embodied approaches.

How Integrative Counselling Works in Practice

Assessment and Formulation

Your integrative therapist considers:

• Your presenting difficulties: Anxiety? Relationship patterns? Trauma?
• Your personality and preferences: Structured vs exploratory? Thinking vs feeling-focused?
• What you've tried before: What helped? What didn't?
• Your goals: Symptom relief? Deep self-understanding? Specific behavior change?
• Cultural and contextual factors: What approaches align with your values and background?

From this, they formulate a therapeutic approach drawing on whichever models best fit.

Adapting Through the Work

Integrative therapy isn't static. Your therapist might:

Week 1-4 (Building alliance): Primarily person-centred—offering empathy, acceptance, following your lead

Week 5-8 (Pattern recognition): Introducing TA concepts to help you understand relationship games you play

Week 9 (Stuck point): Suggesting a Gestalt experiment to access emotions you're avoiding

Week 10-15: Returning to person-centred exploration now that something's shifted

Week 16 (Practical challenge): Teaching specific CBT techniques for managing a panic attack

This responsive flexibility is integrative therapy's hallmark—the method serves you, not vice versa.

Example: Working with Anxiety

A single-modality therapist might:

• CBT only: Identify anxious thoughts, challenge them, practice exposure
• Person-Centred only: Explore your experience of anxiety, trust your process
• Psychodynamic only: Explore childhood origins, unconscious conflicts

An integrative therapist might do all of this across different phases:

1. Person-centred acceptance to build safety and reduce shame
2. Psychodynamic exploration of where this anxiety originated
3. Gestalt work to notice how anxiety lives in your body
4. CBT techniques for managing acute symptoms
5. TA to understand the "script" driving anxious responses

Each element addresses a different dimension of the anxiety.

The Underlying Philosophy

Despite diversity of techniques, most integrative counselling rests on shared philosophical foundations:

1. You Are a Whole Person

Not just a collection of symptoms to eliminate or thoughts to restructure. You're a complex being with:

• Thoughts AND feelings AND sensations
• History AND present AND future
• Individual psychology AND relationships AND social context

Integrative approaches honor this complexity.

2. Multiple Paths to Healing

There isn't one "correct" way to heal. Sometimes you need:

• Practical skills (CBT)
• Emotional processing (person-centred, Gestalt)
• Pattern understanding (TA, psychodynamic)
• Body-based work (somatic approaches)
• Relationship repair (relational therapy)

Different paths work for different people and different issues.

3. The Relationship Matters Most

Regardless of techniques used, research consistently shows therapeutic relationship quality predicts outcomes better than specific approach.

Integrative therapists prioritize this relationship foundation whilst adding techniques when helpful.

4. Tailored is Better Than Standardized

Standardized protocols work for research. Real humans need personalization.

Integrative therapy individualizes treatment based on you as a unique person, not you as a diagnostic category.

Advantages of Integrative Counselling

Flexibility and Responsiveness

If one approach isn't working, your therapist can try something else without referring you elsewhere or feeling constrained by their single modality.

Stuck in endless person-centred exploration without progress? Try some structure.

CBT feeling too rigid and disconnected from emotions? Bring in humanistic depth.

Addresses Multiple Dimensions

Complex problems rarely have simple solutions. Integrative work can simultaneously address:

• Symptoms (CBT techniques)
• Underlying patterns (psychodynamic, TA)
• Present-moment experience (Gestalt, mindfulness)
• The therapeutic relationship (relational approaches)
• Bodily manifestations (somatic awareness)

Suits Diverse Clients

Different people respond to different approaches:

• Some need structure and homework (CBT elements)
• Others need exploratory space (person-centred)
• Many need both at different times

Integrative therapists can match your style and needs.

Supported by Research

Studies increasingly show integrative approaches are as effective (often more effective) than single-modality treatment, particularly for complex presentations.

The flexibility to adapt seems to enhance outcomes.

Potential Drawbacks

Requires Highly Trained Therapists

Integrative work is only as good as the therapist's training. Someone with superficial knowledge of multiple approaches may do worse than someone deeply skilled in one method.

Mitigation: Choose therapists with substantial training in each modality they integrate, not just weekend courses.

Can Feel Inconsistent

If your therapist shifts approaches without explanation, it might feel confusing or lacking direction.

Mitigation: Good integrative therapists explain their thinking: "I'm suggesting we try X because I've noticed Y pattern."

Less Prescriptive for Some

If you want a clear, manualized protocol ("do these 12 CBT sessions exactly like this"), integrative therapy's flexibility might feel unsatisfying.

Alternative: Stick with single-modality, protocol-driven approaches if that suits you better.

Research is Harder

Because integrative therapy is individualized, it's difficult to study with randomized controlled trials (which require standardization).

Reality: Effectiveness research shows positive outcomes, but there's less RCT evidence than for manualized CBT.

What to Expect in Integrative Counselling

Initial Sessions

Your therapist will:

• Listen to your story
• Understand your goals
• Ask about previous therapy experiences (what helped, what didn't)
• Explain their integrative approach
• Begin building the therapeutic relationship

Early sessions might be primarily person-centred (building trust and understanding) regardless of techniques used later.

Ongoing Work

Sessions might vary significantly:

• Some weeks feel free-flowing and exploratory
• Others are structured with specific techniques
• You might do experiments, homework, or simply talk

Your therapist will (ideally) explain why they're suggesting particular approaches: "I'm noticing you intellectualize your emotions—let's try focusing on body sensations to access feelings more directly."

Ending

Integrative therapy doesn't have predetermined length. Like single-modality work, you and your therapist decide together when you've achieved your goals.

Finding an Integrative Therapist

Questions to Ask

"What approaches do you integrate?" Listen for: Specific named modalities, clear explanation of how they combine them

"What's your primary/core orientation?" Most integrate FROM somewhere—person-centred base, psychodynamic foundation, etc.

"How do you decide which approach to use when?" Look for thoughtful, client-focused answers, not "I just do what feels right."

"What training do you have in each approach you use?" Proper training matters. "I've read about Gestalt" is different from "I did a 2-year Gestalt diploma."

What to Look For

• Registration with BACP, UKCP, or HCPC
• Substantial training (not just introductory courses) in integrated modalities
• Ability to clearly explain their approach
• Willingness to adapt based on your needs
• Transparency about techniques they're using and why

Red Flags

• Can't articulate their theoretical framework
• Claims to integrate "everything" without specific training
• Randomly shifts approaches without explanation
• Defensive when asked about qualifications

Common Integrative Combinations (What Therapists Might List)

"Person-Centred and Gestalt": Humanistic foundation with experiential work

"Person-Centred and TA": Humanistic presence with structured pattern understanding

"Person-Centred and Psychodynamic": Acceptance with exploration of unconscious patterns

"CBT and Mindfulness (or ACT)": Cognitive work with present-moment awareness

"Psychodynamic and Attachment-Based": Unconscious exploration with relational focus

"Humanistic, TA, and Gestalt": All three humanistic approaches (this is my combination)

Is Integrative Counselling Right for You?

Consider integrative if you:

• Want flexibility rather than a rigid protocol
• Have complex, multi-layered difficulties
• Appreciate having different tools for different situations
• Previous single-approach therapy felt too limiting
• Value the relationship but also want practical techniques

Stick with single-modality if you:

• Prefer clear, structured protocols
• Want an approach with extensive research specifically on that method
• Have found a single modality that works beautifully for you
• Feel confused by mixing approaches

My Integrative Approach

As a BACP-registered integrative therapist, I draw primarily from:

Person-Centred Therapy (foundation):

• Unconditional positive regard
• Empathic understanding
• Genuineness and authenticity
• Trust in your capacity for growth

Transactional Analysis:

• Understanding ego states (Parent, Adult, Child)
• Recognizing games and scripts
• Exploring relationship patterns

Gestalt:

• Present-moment awareness
• Body-focused techniques
• Experiments when helpful
• Completion of unfinished business

The person-centred foundation provides the relational container. TA offers clear conceptual frameworks when understanding patterns helps. Gestalt brings experiential depth when talking alone isn't enough.

I choose based on:

• What you need right now
• What you respond to
• Where we're stuck
• What your goals require

Some clients primarily experience person-centred acceptance with occasional TA concepts. Others engage deeply with Gestalt experiments. Most experience all three over time, woven together based on what serves the work.

Final Thoughts

Integrative counselling isn't about diluting different approaches into a weak therapeutic soup. Done well, it's about drawing on the richest aspects of multiple traditions to create something more comprehensive and responsive than any single approach alone.

You don't have to fit yourself into a therapeutic method. The method can adapt to fit you.

Not every therapist needs to be integrative—there's genuine value in deep expertise in one approach. But for many people, particularly those with complex difficulties or who've found single approaches limiting, integrative work offers the breadth and flexibility needed for genuine healing.

The question isn't "Is integrative therapy better?" It's "Does this way of working match how I heal and what I need?"

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About the Author: The Kicks Therapy content team provides honest information about different therapeutic approaches. Our practice offers integrative counselling combining Person-Centred, Transactional Analysis, and Gestalt methods.

Curious whether integrative counselling might suit you? Book a consultation to discuss your needs and how we might work together. We tailor the approach to you, not the other way around. £80 per session in Fulham or online, with block discounts available.