Problem-Oriented Integrative Therapy: Maximizing Clinical Flexibility in Treating Complex Psychiatric Conditions

Although integrative therapies are increasingly popular in clinical psychology, their dissemination in the psychiatric literature has been limited. To care for patients living with complex psychiatric problems, the authors formulated a flexible, pragmatic, problem-oriented integrative therapy (PIT). The aims of this article are to increase psychiatric attention to the value of integrative therapies, authorize their use, and present the authors’ PIT approach. PIT combines common factors, theoretical synthesis, and technical eclecticism. After delineating patients’ problems and goals, clinicians apply discrete therapeutic elements derived by unbundling numerous theories and practices. Clinicians improvise and pivot their practice in response to patients’ shifting problems and goals, as well as to advances in the field. Practicing PIT requires familiarity with numerous therapeutic theories and models and a willingness to continually expand skill sets. PIT’s effectiveness may be assessed by comparing results obtained with PIT with those obtained via conventional psychotherapeutic modalities.