Many therapists describe themselves as integrative, but what does this mean in practice? Is it simply about drawing on different therapeutic techniques, or does integration require something deeper within the therapist themselves?
In today’s therapeutic landscape, the term integrative therapist is widely used. Yet true integration is not simply about combining approaches or selecting tools from different models.
The origins of integrative thinking can be traced back to early philosophical and psychological discussions, where thinkers sought to look beyond what was immediately understood and explore the unknown. Prochaska and Norcross (2010) suggest that psychotherapy integration is rooted in a spirit of curiosity and openness to dialogue across different therapeutic perspectives. This means that rather than being confined to a single theoretical framework, therapists remain willing to explore, question, and learn from multiple approaches.
Traditionally, play therapists often remained closely aligned with the theoretical orientation in which they were trained. While this provided a strong foundation, it sometimes limited flexibility when working with complex or challenging cases. The emergence of new conceptual frameworks and evidence-informed interventions has significantly broadened the possibilities for therapeutic practice, offering therapists more tools and perspectives to meet the unique needs of each child.
‘Mixing and Matching’
A common misconception is that being an integrative therapist means simply ‘picking techniques’ from different therapies. “Depending on which theoretical frameworks are utilized within the integrative approach” (Drewes, 2009, p. 1) therapists often work in an integrative way, drawing on ideas and approaches to support the child’s therapeutic process, including:
| Approach | Explanation |
| Attachment Theory | Used to understand relational patterns and the impact of early relationships on the child’s development. |
| Psychodynamic Thinking | Explores unconscious processes, helping to uncover underlying motivations and emotional conflicts. |
| Somatic Awareness | Supports clients in recognising how emotions are held and expressed physically, fostering body–mind connection. |
| The Polyvagal Theory | Guides understanding of the nervous system, helping therapists support regulation, safety, and co-regulation in the therapeutic relationship. |
| Creative and Expressive Methods | Incorporates art, play, and other expressive modalities when words alone are insufficient to communicate experience. |
| Parent/Caregiver Engagement | Integrates work with parents/caregivers to support the child’s environment, relationships, and attachment patterns. |
| The Needs Paradox® | A structured approach for play and creative therapists to facilitate parental engagement and contain and support clients with relational trauma. |
By moving beyond strict adherence to a single model, integrative child therapists can respond more effectively to the complexities of human experience, creating a therapeutic space that is more personalised in which they adapt interventions to the individual child’s developmental needs, emotional state, and relational context.
The Importance of Reflection
Being an integrative therapist requires more than knowledge of different theories and frameworks as there is necessity for the therapist to have a high level of reflective capacity as they move between perspectives whilst remaining grounded in the therapeutic relationship. This reflective stance allows therapists to consider:
Integration is driven by a desire to understand clients more fully, to consider their experiences from different angles, and to apply the methods that are most helpful in each unique situation. It is less about combining techniques at random and more about engaging in thoughtful, reflective practice, where each perspective informs the therapist’s understanding and enhances their capacity to respond flexibly and effectively. Ultimately, this curiosity and openness foster richer therapeutic work, encouraging therapists to remain both humble and creative in their approach.
Conclusion:
Across both child and adult psychotherapy, there is growing recognition that integrative approaches provide a more flexible and responsive way to support clients.
Over time, many therapists regardless of their original training have found that complex and challenging cases rarely fit ‘neatly’ within a single model. Therapists must be able to hold multiple ideas at once and remain curious about what is happening within the therapeutic relationship. As a result, they have moved beyond a ‘one-size-fits-all approach’, drawing instead on multiple theories and techniques to meet each client’s unique needs.
As clinicians, we are reminded of Ivey’s predictions in psychotherapy that “the final gasp of ‘my theory is better and more perfect than your theory’ will be heard’’ (1980, p. 14). Put simply, Ivey was advocating for a flexible, integrative approach rather than strict adherence to one model, establishing the philosophical basis for the development of integrative psychotherapy.
Authors: Karen O’Neill & Tara McDonald
Published: 27th March 2026
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Reference List:
Drewes, A. A. (2009). Rationale for integrating play therapy and CBT. In A. A. Drewes (Ed.), Blending play therapy with cognitive behavioral therapy: Evidence-based and other effective treatments and techniques (pp. 1-2) Hoboken.
Ivey, A. E. (1980). Counseling 2000: Time to take charge. Counseling Psychologist, 8, 12–16.
Prochaska, J. O., & Norcross, J. C. (2010). Systems of psychotherapy: A transtheoretical analysis (7th ed.). Belmont.