Integrative Psychotherapy

Applications now open

We are accepting applications for the new academic year, starting on the 8th-9th of November 2025. In order to apply, please send an e-mail to secretariat.accpi@gmail.com or call 0040744333362.

Course Philosophy

Integrative Strategic Psychotherapy is a research-based therapeutic approach centered on the therapeutic relationship. It operates within a model of the Self, which synthesizes key elements from multiple major psychological theories into a coherent framework informed by neurobiological and attachment research.

This approach is structured around ten core principles that incorporate the common factors found across most psychotherapeutic modalities. In essence, these shared therapeutic elements are considered the primary drivers of therapeutic change, with the therapeutic relationship being the most significant among them. At the heart of this relationship are both client and therapist variables, and the interaction between the brain’s left and right hemispheres is regarded as a critical factor in achieving positive therapeutic outcomes.

Integrative Strategic Psychotherapy acknowledges that fundamental principles are shared across various theoretical models and emphasizes that ongoing research should continually inform therapeutic practice. While it presents a structured Self-model and core guiding principles, this approach remains open and adaptable, allowing for the integration of additional theories and intervention models as the field evolves.

The training curricula in integrative psychotherapy

The basic training programme

The basic training in integrative psychotherapy takes place during the first three years of the program and consists of both theoretical and practical components.

Each training module lasts 20 hours, including:

  • 4 hours of theoretical study
  • 11-12 hours of practical application
  • 5 hours of individual work

During this stage, students develop the fundamental skills and knowledge required to apply various therapeutic interventions and techniques in working with clients or patients. The practical component is particularly crucial, as psychotherapy cannot be mastered through theory alone.

The basic psychotherapy training, conducted in English, is available both in a hybrid format. Basic training includes 20 training modules, detailed here: basic training

The advanced training programme

The advanced training in integrative psychotherapy takes place during the 4th and 5th years of the program and focuses on techniques, interventions, and conceptual case models for the main diagnostic categories outlined in the DSM-5.

Each training module lasts 20 hours, comprising:

  • 4 hours of theoretical study
  • 11-12 hours of practical applications
  • 5 hours of individual work

This training stage helps beginner psychotherapists develop diagnostic and treatment plans, with a particular focus on designing effective intervention strategies tailored to the unique needs of each client or patient.

The advanced psychotherapy training, conducted in English, is available in a hybrid format. Advanced training includes 10 training modules, detailed here: advanced training

Group personal development

Personal development is a fundamental component of integrative psychotherapy training. Research indicates that a psychotherapist’s level of personal development is directly correlated with the effectiveness of psychotherapy. Without a deep understanding of ourselves or adequate resolution of our own psychological challenges, we risk projecting our emotions and personal thought patterns onto our clients or patients. One of the greatest challenges for a beginner psychotherapist is to practice active and empathetic listening while clarifying the client’s issues without significant countertransferential interference.

To qualify as an integrative psychotherapist, you must complete at least 25 hours of individual therapy with a psychotherapist of your choice and attend 12 modules of group personal development or therapy.

Supervision

Supervision takes place during the 4th and 5th years of training and is designed to support beginner psychotherapists as they work with clients or patients. Starting a career in psychotherapy comes with many uncertainties and unknowns. Guidance from experienced colleagues is essential when facing challenges, and support is invaluable when dealing with doubts about one’s professional competence.

Group supervision modules are conducted online and last 15 hours per session. If additional individual supervision is required, you may consult any of our supervisors.

During the supervision period, you will work directly with clients or patients in either private practice or institutional settings. To complete and graduate from supervision, you must accumulate a minimum of 300 client contact hours and submit supervision protocols for at least 10 supervised cases covering various pathologies.

You can read more about supervision here: Supervision

Intervision / peer supervision

Intervision is organized monthly, online, and is free of charge for ACCPI members. Intervision sessions are of 3-4 hours. Intervision helps in emergency situations or in situations in which you need some quick advice or a short answer. Intervision cannot replace supervision, but can be an additional resource for our students.

Intervision meetings are announced monthly on our Whatsapp group.

Exams

You will have both theoretical and practical examinations. Theoretical examinations are wither oral (online) or written (live). You will have examinations at the end of the 1st, 3rd and 5th year. You need to write at least 4 essays and book reviews, 10 case protocols and two dissertation papers: at the end of the 3rd and 5th year of training.

The integrative strategic model of psychotherapy

Integrative case formulation models consider a wide range of variables, spanning from biological to transpersonal factors. These typically include biological and medical influences, behavioral and learning models, cognitive frameworks, psychodynamic perspectives, existential and spiritual dimensions, as well as social, cultural, and environmental factors—such as crises, stressful situations, and life transitions (Brooks-Harris, 2011; Eels, 2011; Lichner-Ingram, 2006).

In 1999, Antonio Damasio introduced a theory of the self, proposing the existence of both a proto-self and a core self. Expanding on this, we propose that integrative case formulation should incorporate four key domains:

  1. Proto-Self
  2. Core Set (housed within the Core Self)
  3. Internal Causality & Maintenance Mechanisms (the Plastic Self)
  4. External or Outer Self

These domains correspond to activity patterns in either the left or right hemisphere of the brain, depending on the neural circuits affected. Additionally, the dominant hemisphere impacted by external or internal stimuli determines which dysfunctional mechanisms become most apparent. As a result, clients may exhibit maladaptive cognitions or behaviors, while others may present inappropriate emotional responses or enactments.

Notably, behavior is not treated as a separate domain, as each of these four domains inherently influences behavioral outcomes.

The therapeutic relationship plays a crucial role in how these external self manifestations are addressed. The interaction between the therapist’s internal organization and the client’s internal organization shapes the therapeutic process. This dynamic explains why certain therapeutic approaches may be more effective for specific therapists and clients. As such, the therapeutic relationship emerges as the central element of psychotherapy, serving as the primary factor influencing therapeutic outcomes.

Neurobiological aspects of the Four-Self model

As Siegel (2001, p. 69) states:

“The key issues are these: each neuron connects to an average of 10,000 other neurons. There are about 100 billion neurons, with a combined length of over 2 million miles. Additionally, the range of possible ‘on-off’ firing patterns within this intricate, spider-web-like network of neuronal connections is estimated to be about ten times ten one million times. The fact that our brains can maintain organized functioning is truly remarkable!”

From infancy, a child naturally forms connections with caregivers, and these early experiences play a crucial role in shaping the organization of the child’s internal world. Such experiences trigger neuronal activation, responding to external stimuli from the surrounding environment. As the child develops, neurons begin responding not only to external stimuli but also to internally generated images created by the brain itself.

At the neuronal level, this process involves action potentials traveling along axons to synapses, where neurotransmitters are released. These neurotransmitters cross the synaptic space, either activating or inhibiting the receiving neuron, which in turn sends an electrical signal and releases more neurotransmitters, affecting other neurons. The mind’s processes emerge from the activity of these intricate neural circuits (Mesulam, 1998; Siegel, 2001).

The activation of specific neuron clusters and brain circuits generates various mental processes, creating neural maps that correspond to mental representations such as sensations, images, and linguistic structures. The pattern of neural firing within a circuit produces distinct types of subjective experiences. According to Siegel (1999), the mind can be understood as patterns in the flow of energy and information.

Since the brain is an integral part of the central nervous system, which is interwoven throughout the entire body, the flow of energy and information within the brain must be understood in the context of overall bodily function (Siegel, 2001). This interconnection highlights the importance of considering biological and medical factors when formulating a case in psychotherapy. While therapy primarily focuses on specific mental processes (or, in other words, certain aspects of brain activity), the brain itself is a highly complex, integrated system that functions holistically.

The Role of Emotion in Psychotherapy

Emotional communication lies at the core of both the client’s presenting problem and the therapeutic intervention process. Emotion functions on two levels:

  1. As an intraindividual mental process
  2. As a form of interpersonal communication

From a neurobiological perspective, emotion is not confined to specific brain circuits—a contrast to the long-held belief that emotions were solely a product of the limbic system. Instead, emotions serve both a regulatory function and a response mechanism, incorporating neurobiological, experiential, and expressive components (Izard & Kobak, 1991).

This understanding of brain function, mental processes, and emotional regulation underscores the necessity of integrating neuroscientific knowledge into psychotherapy, ensuring that interventions are comprehensive and aligned with the latest research.

The Four-Self model and its connection to various therapeutic approaches

Although there is very little consensus when it comes to the nature and status of the self, most psychotherapists agree that the sense of Self is a fundamental feature of human experience (Praetorius, 2009). Zahavi (2005) discussed the self as an experiential dimension: a first-person givenness of experiential phenomena. This is a concept borrowed from phenomenology (the ipseity or selfhood as a basic characteristic of consciousness). Experiential properties of experiences are not real objects, but properties of the various types of access or modes of givenness of experiences (Praetorius, 2009). In other words, present experiencing of the world depends on prior experiencing of the world, tracing back to the proto-self and the core self.

Each major psychotherapeutic orientation describes the self as a part of a global hologram: accurately but incompletely (Fall, Holden & Marquis, 2010). The integrative strategic model does not mean to pretend it manages to capture ‘the entire hologram’, but takes a step forward toward the understanding of the complex system, which is the human mind.

The basic principles of the integrative strategic model

Common Therapeutic Factors and Psychotherapeutic Diagnosis in Integrative Psychotherapy

Common therapeutic factors are the primary drivers of therapeutic change, with the therapeutic relationship being one of the most significant among them. This relationship is co-created by both the therapist and the client, shaped by their individual characteristics and interactions (Gilbert & Evans, 2003). At the core of this relationship are client variables and therapist variables, both of which influence the therapeutic process and its effectiveness.

A crucial component of integrative psychotherapy is the therapeutic myth or rationale presented to the client, which should be flexible and tailored to the client’s specific needs.

Stages of Psychotherapeutic Treatment and Strategy

The integrative psychotherapeutic process follows a structured approach, focusing on:

  1. Building the therapeutic alliance
  2. Developing and maintaining the therapeutic relationship
  3. Categorical and dimensional diagnosis (particularly psychotherapeutic and relational diagnosis)
  4. Case formulation
  5. Presenting a therapeutic myth or rationale
  6. Creating a treatment plan
  7. Selecting appropriate interventions
  8. Mastering verbal and non-verbal communication within psychotherapy
  9. Facilitating re-learning
  10. Supporting the transfer of acquired skills from therapy to the client’s everyday life

Research indicates that the psychotherapist’s level of self-development is directly linked to therapeutic outcomes (Gilbert & Orlans, 2011; Connor, 1994). Therefore, integrative psychotherapists must continuously work on their self-awareness and professional growth to enhance their effectiveness.

The Integrative Approach: Flexibility and Adaptation

An integrative psychotherapist must be adaptive, selecting interventions that best align with the client’s specific needs. This requires a broad theoretical framework that encompasses:

  1. Cognitive processes
  2. Behavioral patterns
  3. Psychodynamic influences
  4. Systemic factors
  5. Personality structures
  6. Motivational aspects
  7. Developmental considerations, including sexual development
  8. Cultural and multicultural influences

Flexibility is crucial in integrative psychotherapy. The therapeutic approach must be tailored to the client’s presenting concerns and relational needs—whether for depression, anxiety disorders, personality disorders, or other psychological conditions. This ensures that the therapeutic strategy remains dynamic and responsive to the client’s evolving experiences.

Facilitating Therapeutic Change

Therapeutic change occurs across multiple dimensions, including:

  1. Emotional processing and regulation
  2. Cognitive restructuring and insight
  3. Behavioral adaptation
  4. Biopsychosocial influences
  5. Psychodynamic shifts
  6. Systemic and relational transformation
  7. Cultural awareness and integration
  8. Self-reflection and self-observation
  9. Testing and experimenting with new approaches and solutions

Importantly, integrative psychotherapy must be research-driven, ensuring that interventions are scientifically validated and continuously refined based on new findings.

Psychotherapeutic Diagnosis: Challenges and Considerations

One of the key dilemmas in psychotherapy is determining the most effective approach to clinical assessment. Given the need for flexibility, reliability, and validity, should psychotherapists rely on a highly structured, categorical diagnostic system?

This debate has led to varying opinions. Some psychotherapists openly reject strict DSM-based diagnoses, arguing that many therapy clients do not neatly fit into predefined diagnostic categories. For example, in a discussion on psychotherapeutic diagnosis, one clinician dramatically discarded the DSM, symbolizing his belief that it had little relevance to private practice. However, a structured diagnostic language is necessary for effective communication between mental health professionals, particularly in multidisciplinary settings.

Even case formulation—an essential part of psychotherapy—poses challenges, as different therapeutic schools often lack a shared language, making interdisciplinary collaboration more complex. Additionally, psychotherapeutic diagnosis is not a one-time event but an ongoing process that unfolds throughout therapy, adapting to the client’s progress and evolving needs.

The Integrative Perspective on Diagnosis

From an integrative psychotherapy standpoint, truth and reality are not merely discovered but co-created by the therapist and client (Evans & Gilbert, 2005). As such, diagnosis is best understood as “an ongoing reference to truth in the service of the client’s healing and/or improved coping” (Wehowsky, 2000, p. 247).

Regardless of the diagnostic framework used, the initial evaluation of a client should provide a secure therapeutic foundation. This involves:

  • Emotional attunement between therapist and client
  • Collaborative communication to foster trust
  • Repairing relational disruptions when they arise (Finn, 2012)

Much of this interaction occurs at a non-verbal level, making the therapist’s attitude, openness, and curiosity critical in facilitating an effective and non-judgmental assessment.