The patient is the main subject in therapy, and often, the emphasis is on their unique individual characteristics. As much as the counselling professional tries to bring together all elements of therapy to achieve the combined approach, they must consider creating a therapeutic relationship. Renger (2023, pp. 245-247) emphasises that to achieve client-centred therapy, the therapist seeks an understanding of the client’s experience and establishes themselves as empathetic and ethical. Renger (2023, p. 246) goes on to explain that questioning the client to learn about the individual experiences helps in deepening the relationship between them, which is described as the relational nature of therapy. Considering the need to evaluate the unconscious mind, early experiences, and the influence of unconscious conflicts and defence mechanisms, combining the psychodynamic and humanistic approaches would promote holistic understanding as well as emphasise the creation of a therapeutic relationship.
This essay will discuss the integrative relationship approach, further explain the rationale for combining the psychodynamic and humanistic approaches, and finally link the integrative relationship approach to personal growth and counselling. First, the integrative relationship approach will be defined and explained as it relates to counselling, then the humanistic and psychodynamic approaches will be laid out individually for understanding and subsequently discussed on why they should be integrated and used together. The last section will explore the integrative relationship approach as it relates to personal growth and the counselling process. The conclusion will sum up the essay, with the thesis statement restated and important parts highlighted.
Psychodynamic and Humanistic Approaches (Integrative Relationship Approach) To Counselling
What is the Integrative Relationship Approach?
The integrative relationship approach is part of the relational strategies used in therapy because of the need to establish a professional yet therapeutic relationship with the client. It can be defined as an approach to psychotherapy that combines elements from various therapeutic modalities with a primary focus on the therapeutic relationship (Okamoto et al., 2019, p. 112). In this approach, the process of integrating client growth revolves around addressing clients’ needs in a holistic manner, motivating and facilitating them to embrace opposing aspects and establish new connections with parts of themselves they had previously neglected (Gilbert, 2019, pp. 164-189).
Most studies have suggested that the integrative relationship approach is recommended in counselling because it is grounded in the belief that the therapeutic relationship is a primary catalyst for positive change and healing. For instance, Finlay (2015, p.3) explains that the healing process is facilitated by the connection; in a case where it is the connection that promotes healing also fosters healing, otherwise directly quoted as; “it’s the relationship that heals, the relationship that heals, the relationship that heals” from Yalom’s rosary. An integrative relationship approach significantly allows therapists to draw from various therapeutic modalities to create a more comprehensive and holistic understanding of the client.
Rationale for Combining the Psychodynamic and Humanistic Approaches
Psychodynamic Approach
The psychodynamic approach is like a dysfunctional yet actual family with members who barely speak to one another, and sometimes they speak different languages. This likening is from a meta-analysis reported by Fonagy (2015, p. 140), in which this approach is looked at from a human subjectivity point of view. In other words, psychodynamic therapy will assess the interplay between a person’s relationship with their environment, whether it is external or internal. Fonagy (2015, pp.137-150) helps define the approach as the human potential, which is considered extraordinary, specifically in dynamic self-alteration and self-correction. From this definition, it can be derived that the developmental perspective is carefully incorporated, and all limitations to the conscious influence, conflict ubiquity and the representation of relationships internally, complex meanings and mental defences notwithstanding, have the potential to be attached to experience (Fonagy and Target, 2008, pp. 1079-1091).
In essence, the psychodynamic approach emphasises gaining insight into unconscious processes and exploring how past experiences shape current behaviours and emotions (Yeomans, Clarkin, and Levy, 2021, pp. 338-339). Although critics argue that insight might not always lead to practical and measurable change in behaviour despite being valuable, it can lead to enduring and long-term benefits, addressing underlying issues rather than just alleviating symptoms. For instance, Finlay (2015, pp. 3-5) discusses the challenges integrative therapists face, especially in how to blend perspectives, which can be answered by seeking theoretical knowledge and then integrating it into relational approaches for long-term sustainability. Therefore, psychodynamic therapy may be effective, but its efficiency is increased with the introduction or integration of the relational approach to counselling.
The Humanistic Approach
The humanistic approach in therapy, also known as humanistic psychology, emerged as a reaction against the deterministic and behaviouristic views predominant in the mid-20th century (Stangor and Walinga, 2019). Stangor and Walinga (2019) describe the approach as holding onto a hopeful yet constructive view of humans and their immaculate capacity to be self-determining. Its use in psychology reflects attempts to restore the significance of consciousness and provide a more holistic view of human life. In that regard, the forces in society and the unconscious strongly influence the human mind, highlighting the individual’s conscious capacity to develop competence and self-respect (Stangor and Walinga, 2019). It was during the establishment of this approach to counselling that client-centred therapy was introduced, which relies on the capacity of clients to self-direct, be empathetic, and accepting of development.
The humanistic approach is relational, where the therapist and client meet halfway to focus on the ‘between.’ The situation in this approach revolves around what happens, how it happens, and who is present in therapy and its processes. In this approach, a counsellor provides a microscopical view of the social world with a major interest in where the professional touches and clients are touched as a part of the ‘between’ (Finlay, 205, pp 3-5). On the other hand, the presence of the therapist is also a way of creating a relationship where there is safety and steadiness (Cataldo et al., 2021, p.e19004). Most importantly, the client is seen as a human being in the interaction with the counsellor, and it is this relationship that creates a collaborative partnership for effective therapy. Therefore, as Finlay (2015, pp. 3-5) explains, the integrative relationship approach places a strong emphasis on the needs and preferences of the client where therapists can adapt their style and interventions based on the client’s personality, communication style, and therapeutic goals, fostering a client-centred therapeutic experience. At the end of the day, the humanistic approach creates a therapeutic alliance by integrating elements from different therapeutic modalities, creating a collaborative and trusting space for exploration in the process.
The rationale for Integrating the Two Approaches
After discussing the humanistic and psychodynamic approaches separately, there are very slim similarities, making them seem almost completely opposite. Although they are effective approaches, they need each other to function even more effectively. Both approaches have individual pitfalls, which can be minimised when they are used at the same time. Therefore, the wider rationales for integrating the two approaches are based on complementary perspectives, addressing diverse needs, and building and enhancing a therapeutic relationship between the client and the professional.
According to Hawkins (2019, p. 41), the psychodynamic approach is effective for clients struggling with past traumas, unconscious conflicts, and repetitive patterns, while Pramanik and Khuntia (2023, pp. 932–949) state that the humanistic approach helps clients facing existential anxieties, lack of purpose, and difficulties in self-acceptance. Together, the two approaches can allow therapists to tailor their interventions to meet each client’s specific needs, addressing both unconscious processes and conscious existential struggles. Additionally, the psychodynamic approach usually helps clients integrate unconscious material into conscious awareness, reducing its influence on behaviour, i.e., it is the ability to encounter positive and negative transference collaboratively that allows clients to re-work their past to find new freedom, as explained by Ross (2019, p. 19); whereas the humanistic approach encourages clients to embrace their full potential and live their lives authentically. The greatness of the latter argument is that the approaches are different from one another yet complementary to the extent that their use together through integration promotes wholeness. Counselling benefits from this integration through clients bridging the gap between the past and present while integrating fragmented aspects of their personalities for a more fulfilling life (Ross, 2019, pp. 19-21).
Lastly, the integration can repair alliance raptures, i.e., at the same time, the psychodynamic approach emphasises transference and countertransference to offer opportunities for exploring relational dynamics and addressing attachment issues. In contrast, the humanistic approach cultivates empathy and genuineness that foster a therapeutic alliance that would otherwise be as chaotic as it would be in the robotic-like administration of therapy (Cameron, 2019, p.0022167819880653.) As it is known, alliance raptures occur when there is a deterioration in the therapeutic alliance quality resulting from a lack of collaboration in coming up with the therapy goals or even a strained affective bond (Schenk et al., 2019). Suppose the humanistic approach focuses on how the affective bonds can be worked out. In that case, the psychodynamic approach will balance out the remaining part by looking at the external factors that contribute to this incompatibility. Therefore, the balancing out of each other works perfectly when the two are combined.
Integrative Relationship Approach Vs Personal Growth and the Counselling Process
Based on the discussion in the preceding sections, the integrative relationship approach integrates various therapeutic modalities that ultimately address the unique needs of individuals. When applying this approach to individual growth and the counselling process, it is responsible for positive change and development. For instance, a therapist will integrate elements from different therapeutic modalities based on the specific needs of the client because they have been given that freedom by the inclusion of the “integrated” concept. On the other hand, the personalised approaches that occur through the application of the humanistic approach ensure a more personal relationship with the therapy process and the relation of the counselling point to individual life (Myles, 2023, pp. 1-5). Counselling is capable of providing emotional support because the existence of the therapist assures a positive and trusting relationship, which in turn provides a moment for self-reflection and exploration, which have been important to personal growth (Myles, 2023, p. 1). Significantly, that space provided during the counselling process is responsible for a therapeutic relationship that ultimately creates this secure base where clients undergoing counselling explore their thoughts, feelings and behaviours that necessitate therapy.
Significantly, reflecting on the integrative relationship approach enables confirmation that holistic assessment is possible because different dimensions of experiences are explored at the same time. Therefore, a comprehensive exploration through holistic assessment helps in understanding oneself, which fosters personal growth (Myles, 2023, p. 1- 5). As discussed earlier, there is a significant consideration for integrating psychodynamic approaches with humanistic approaches, which, in simple understanding, create the need for comprehending unconscious processes and humanistic principles for self-awareness and personal meaning. It is the same reason professionals in counselling seek to provide space for clients to understand themselves and then allow them to relate to the real world, something that is capable of preventing alliance raptures, which then predict outcomes of counselling as found by Zilcha-Mano et al. (2015, p.568).
The must-go-to process in counselling is setting goals collaboratively with the client, which caters to client-centred therapy. First, a professional and personal relationship must exist but with boundaries with the client. This means the therapeutic relationship will be the vehicle for optimal therapeutic results (Salsbury and NOMC, 2015). Subsequently, after the relationship is established, we are required to take an active role in defining our personal growth objectives and determine whether these goals align with our growth. These goals also contribute to personal growth because they amplify individual values and highlight how the journey is meaningful and congruent to personal aspirations. Salsbury and NOMC (2015) explain the goal-setting process in an easily comprehensible manner that clients in client-centred therapy will lead the way to what they consider to be true desires. Therefore, the counselling process comes in to provide informed choices to clients in selecting the type of services they want to consume. It is likened to the adjustment-to-blindness training that allows and encourages the client to choose their personal goals, i.e., what they intend to achieve at the end of the session. Therefore, the integrated relationship approach, as it relates to my personal growth and the counselling process, is about personal empowerment to take charge of my persona.
Lastly, although it is not commonly discussed, the integrated approach caters to cultural factors because of the contextual and inclusive factors. In the wake of the technological age, where inclusivity matters more than ever, the integrated relationship approach is likely to contribute to cultural sensitivity in the counselling process. In countries like Canada, where the indigenous communities value their culture, there is an emphasis on the counselling process being culturally sensitive to contribute to the cultural safety required to achieve rehabilitation. As Kirmayer and Jarvis (2019, pp.11-23) report, culturally responsive services are significant to achieving equity in mental healthcare. It is the same reason Koç and Kafa (2019, pp. 100-115) recommend cross-cultural research on psychotherapy because one finding might influence how counselling is practised in another. Therefore, the integrative approach opens windows to accommodate concepts like cultural competence.
Conclusion
A supportive and adaptive framework is necessary in counselling because it recognises the significance of the therapeutic relationship in fostering personal development. Taking into account the necessity of assessing the unconscious mind, early life experiences, and the impact of unconscious conflicts and defence mechanisms, integrating the psychodynamic and humanistic approaches would facilitate a holistic understanding of clients while emphasising the creation of a therapeutic relationship. The integrative relationship approach itself explores therapeutic concepts from multiple viewpoints while focusing on the client. Its advancement to have the humanistic and psychodynamic approaches integrated will achieve even better results, especially in personal growth. Again, the integration of these approaches gives the therapist an upper hand in understanding how they can collaborate with the client to create goals and objectives for the subsequent sessions. In general, the approach has great potential, especially in evaluating the effectiveness of interventions and making adjustments to support sustained personal growth.
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