Difficult dialogue between next of kin: A Brazilian perspective on obstacles to integration.

Abstract

Philosophical differences and lack of a common language are acknowledged hindrances for psychotherapy integration. To identify additional obstacles for psychotherapy integration, the authors employed a grounded theory analysis of 22 clinician interviews on psychotherapy integration obtained from Brazilian therapists from 2 closely related schools of psychotherapy (11 Gestalt therapists, 11 psychodrama therapists). A complex conceptual category "obstacles for integration" emerged from the analysis. Further analysis of this category was undertaken for the purpose of more thoroughly investigating how therapists from these 2 related approaches argued their views on "obstacles to psychotherapy integration." Analysis showed that not only did participants lean heavily on theoretical discourse but also they employed an "adversarial attitude" that depreciated their "neighboring" professional community. Arguments of this nature included denying that the other school had something different to offer, displaying concern that integration would weaken or undermine their home school's interests, and believing that the dynamics of the extant professional field in Brazil would make psychotherapy integration fail. Several participants appeared to idealize their own community and debase the "other" or to claim a need for strict fidelity for protecting their "slice of the market." We conclude that future efforts to understand and overcome resistance against psychotherapy integration should look beyond clinical arguments to take the dynamics of in-group-out-group social comparison into account. This should include consideration of political struggles over resources, therapists' need for safety and belonging, and therapists' need to protect their investment in training and status within their disparate professional communities.