Nested Hierarchy for Therapy Integration: Integrating the Integrative

Abstract

Several well-established psychotherapies have seen a proliferation of their derivatives. Among notable examples are truncated forms of psychoanalysis, such as psychoanalytic psychotherapy and brief psychodynamic therapy; a variety of cognitive behavioral therapies (CBT) including CBT-I (CBT for insomnia), CBT-D (CBT for depression), and CPT (a trauma-focused CBT). Despite its relatively young age EMDR has also produced multiple modifications like ego states EMDR, EMDR for addiction, and EMDR for somatic conditions. The majority of modifications are developed by integrating new interventions with the original protocols. However, there is no commonly accepted ad hoc methodology or standard for such integration. This article suggests a “nested hierarchy” as a methodology for psychotherapy integration, exploring its ramifications for practice and research.