Integrative formulation

Combine the levels of explanation coherently, and state the reasoning for each borrowed element.

Complex presentations; any case where a single-school formulation leaves too much unexplained.14 fieldsIntegrative Therapies transtheoretical

How this document is used well

Integration done well is principled; done badly it is a magpie collecting techniques. The discipline is to state, for each element you import, what it explains that your primary model does not, and what would count as evidence that you were wrong to import it.

Route to integration	What it combines	Risk
Technical eclecticism	Techniques selected by evidence and fit, without theoretical merger	Incoherence; a bag of tricks
Theoretical integration	Two or more theories merged into a new one	A theory nobody can test
Common factors	The ingredients shared across approaches	Nonspecificity; loses what particular methods add
Assimilative integration	One home theory that absorbs outside methods	Assimilating so much the home theory disappears

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Levels of explanation

Biological / medicalBehavioural — contingencies and avoidanceCognitive — appraisals, beliefs, processing styleEmotional — regulation, avoidance, unprocessed affectInterpersonal / dynamic — patterns and their originsSystemic — family, couple, workplace, institutionCultural, structural and material*Existential — meaning, mortality, freedom, isolation

Putting it together

Primary organising model*What is imported from elsewhere, and what each import explains that the home model does not*Stage of change for the primary target

Matching intervention to stage is the transtheoretical model’s central practical claim: action-oriented technique with a precontemplative patient produces resistance, not change.

Sequencing — what first, what later, and on what trigger we switch*Coherence check: do these elements contradict each other, and does the patient experience one treatment or several?*What would tell me this formulation is wrong*

A formulation with no disconfirming condition is not a formulation; it is a belief.

6 required fields outstanding: Cultural, structural and material; Primary organising model; What is imported from elsewhere, and what each import explains that the home model does not …

How this document is used well

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What Praxical.Psych is, and is not