Integrative Psychotherapy With Physicians In the Trenches: Convergence of Cognitive, Existential, and Psychodynamic Processes

In this article, I present insights gleaned from over a decade of working in therapy with physicians in the trenches who practice at general hospitals located in an area afflicted by the community and political violence, and recently, by the COVID-19 pandemic. Psychotherapy with these physicians requires an integrative psychotherapeutic approach that heeds their changing needs. Espousing cognitive-existential psychodynamics (CEP), a theory-based psychotherapeutic perspective developed for complex cases, I show how cognitive, existential, and psychodynamic processes strongly converge during the treatment of physicians in the trenches. Such convergence is manifested in issues of mental representations (of death, medicine, and the hospital) and choice/meaning.

Psychotherapy Integration as an Ethical Practice

This chapter aims to analyze which ethical challenges clinicians face when practicing different forms of psychotherapy integration. With this purpose, the authors first define psychotherapy integration and differentiate four types of integrative approaches. Drawing on Beauchamp and Childress’s (2013) principles of biomedical ethics, the chapter highlights important common and particular ethical issues in the four types of integrationist psychotherapy practice. Finally, the authors frame questions for future research into integrative-psychotherapy ethics and consider possible clinical responses to ethics issues raised in integrative therapy.