Eclectic Therapy
Overview
There are more than 400 recognized therapeutic modalities, many of which are evidence-based and effective in treating mental health conditions. However, the approach best suited to any client can differ based on diagnoses, goals, challenges, therapeutic alliance, and personality type. Eclectic therapy, sometimes called multi-modal therapy or person-centered therapy, eclectic therapy is an approach that draws upon multiple evidence-based modalities and techniques. It is the most used therapeutic approach in modern psychotherapy.1
Gordon Paul, a psychologist and early founder of eclectic therapy, described the approach as follows: “What treatment, by whom, is most effective for this individual with that specific problem, and under which set of circumstances.” By practicing eclectic therapy, therapists can approach each client as an individual and tailor the therapy sessions to meet their unique needs.
How it works
Eclectic therapy draws upon multiple therapeutic approaches with different strategies and therapeutic frameworks. Several common approaches incorporated into eclectic therapy treatment plans include the following.
Cognitive-behavioral therapy (CBT)
CBT2 is one of the most practiced and highly studied forms of therapy and can be incorporated into eclectic therapy alongside any other therapeutic approach. The practice of cognitive behavioral therapy is grounded in the relationship between cognition (thoughts), emotions (feelings), and behaviors. It’s a highly structured form of therapy that may incorporate practices such as gradual exposure and desensitization, cognitive restructuring, and psychoeducation. In some cases, CBT is practiced alongside exposure therapy, which is a form of desensitization to help clients face fears in a safe environment.
Acceptance and commitment therapy (ACT)
Acceptance and commitment therapy3 is a type of person-centered therapy based on accepting emotions and thoughts as they are and learning to approach life from a mindful lens. An eclectic therapist might use this approach alongside others to help clients take a less judgmental and stigmatized view of their mental health challenges.
Dialectical behavior therapy (DBT)
Dialectical behavioral therapy is a modality based on CBT. It’s commonly used for people who experience intense emotions. While it was developed specifically for those with borderline personality disorder (BPD), it has been expanded to additional therapeutic populations and diagnoses.
Psychodynamic therapy
Popularized by Sigmund Freud, psychodynamic therapy4 emphasizes exploring and revealing the unconscious psyche that drives maladaptive behavior. The goal of psychodynamic therapy is to increase self-awareness and understanding to relieve distress. Psychodynamic therapy is often a longer-term treatment than CBT or DBT, and its effectiveness relies on a significant therapeutic relationship.
Brief eclectic psychotherapy (BEP)
A common approach to eclectic therapy incorporates cognitive-behavioral therapy into a psychodynamic approach. While CBT is a short-term therapy focused on solving immediate challenges, psychodynamic therapy emphasizes the therapeutic alliance and exploration of past experiences. When combined, this eclectic therapy approach can effectively address shame and guilt. BEP may be beneficial for clients with post-traumatic stress disorder (PTSD).
Multi-modal therapy
This therapeutic approach emphasizes using multiple treatments and therapeutic approaches, such as medications, talk therapy, eclectic therapy, and other techniques that may be more effective than any one approach alone. For example, eclectic therapists might combine exposure therapy, mindfulness-based therapy, integrative therapy, cognitive behavioral therapy, and other person-centered therapy approaches like family therapy as part of their multimodal therapy treatment plan. Each therapeutic approach used this eclectic therapy approach pulls from evidence-based methods.
Cognitive-interpersonal therapy (CIT)
CIT integrates cognitive, experiential, and interpersonal therapeutic approaches that may aid in addressing maladaptive thoughts and their impact on interpersonal relationships through using role-playing, acting, or props.
What to expect
Unlike approaches grounded in a single therapeutic theory, eclectic therapy enables therapists to draw upon multiple modalities to help their clients most effectively. Initially, sessions may emphasize trust-building and therapeutic alliance. To determine the best person-centered approach, eclectic therapists may ask questions about clients’ challenges, childhood, relationships, and therapeutic goals.
Eclectic therapy sessions
Sessions may include a wide variety of approaches and techniques, including but not limited to the following:
- Cognitive restructuring
- Acceptance and mindfulness training
- Other relaxation techniques
- Positive psychology
- Problem-solving
- Exposure therapy
- Psychoeducation, including worksheets and other homework
- Eye movement desensitization and reprocessing (EMDR)
- Communication skills building
As your sessions progress, the eclectic approach your therapist takes may change. For example, early sessions may emphasize structured interviews, psychodynamic approaches, and education, whereas later sessions may focus more on cognitive-behavioral and intersectional approaches.
Who it benefits
Those who would benefit from therapy (talk therapy) can often benefit from an eclectic approach. When multiple therapeutic techniques are appropriately selected and combined, they can address a wide range of mental and physical health challenges, including:
- Anxiety disorders, such as social anxiety disorder, panic disorder, and generalized anxiety disorder
- Depressive disorders, like major depressive disorder
- Bipolar disorder
- Personality disorders
- Eating disorders
- Post-traumatic stress disorder (PTSD)
- Chronic pain, including low back pain and migraines
- The emotional impacts of physical conditions, such as fibromyalgia, irritable bowel syndrome, and cancer
- Relationship challenges
- Conflict resolution challenges
- Substance use disorders
- Trauma
- Family dynamics
- General stress
Eclectic therapy support
Eclectic therapy often enables therapists to individualize their therapy treatment plans and address co-occurring challenges that require unique therapeutic approaches. For example, someone with post-traumatic stress disorder may also experience alcohol use disorder. These conditions may be best addressed with a combination of brief eclectic therapy, therapy support groups, and medication.
Though eclectic therapy can be helpful for many people, there are certain conditions, such as phobias, that may respond best to singular treatment modalities. Therefore, a therapist can evaluate whether eclectic therapy is appropriate on a case-by-case basis.
For those struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.
Goals for therapy
Eclectic therapy objectives
- Customization of treatment: Tailor therapy techniques from various modalities such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and psychodynamic therapy to address the different needs of each client.
- Holistic improvement: Focus on improving overall psychological health by addressing a spectrum of emotional, cognitive, and behavioral challenges.
- Enhanced self-awareness: Increase self-awareness by exploring underlying motivations and unresolved conflicts.
- Development of coping strategies: Empower clients to develop different coping strategies that are informed by a mix of evidence-based practices, aiding their ability to manage stress, resolve conflicts, and make healthier decisions.
- Goal specificity: Encourage clients to set Specific, Measurable, Achievable, Relevant, and Time-bound (SMART) goals that are aligned with their personal growth and therapeutic progress. For example:
- "I aim to use mindfulness techniques to manage anxiety triggers in social situations within the next month."
- "I will apply cognitive restructuring methods to challenge and alter negative thought patterns by our next session."
- "In the coming weeks, I plan to explore and discuss past traumas using psychodynamic approaches to understand their impact on my current behavior."
- Empowerment through education: Educate clients about the diverse tools and approaches at their disposal, helping them to become active participants in their healing process.
Research
A 2022 qualitative study by Douglas Behan, Ph.D., published in BMC Psychology, interviewed six therapists about how their clinical practices evolved over time. Behan found that, though many therapists begin their career practicing from one theoretical orientation, most evolve into a form of informal eclecticism guided by client interactions. Other studies support this outcome, with some finding that 85% of therapists utilize eclectic or integrative approaches, with an average of four therapeutic orientations.
Eclectic therapy studies
Other studies have evaluated the effectiveness of various eclectic therapy approaches. For example, a 2017 study among rural children in Brazil found that a combination of cognitive-behavioral therapy, art therapy, and group guidance for mothers effectively reduced anxiety and improved thought patterns. In a 2021 case study on moral trauma, researchers found that brief eclectic psychotherapy reduced symptoms of PTSD, such as remorse, guilt, shame, and negative self-image.
A 2016 theoretical study published in the International Journal of Clinical and Health Psychology highlighted the complexity of non-diagnostic client factors, relationships, and contextual factors in determining effective treatment approaches. The authors emphasized that, though eclecticism has benefits, there is not a systematized approach for therapists to follow when deciding how to choose an appropriate strategy. The authors argue for creating a systematic treatment selection system, which would provide guidelines based on client needs and overall characteristics to guide the approach.
Finding therapy
Several resources may help you connect with a licensed therapist, including the following:
- Therapist locators: The Anxiety and Depression Association of America (ADAA) provides a searchable directory of licensed mental health professionals in the United States. A network of psychiatrists can also be found through the American Psychiatric Association or the American Psychological Association.
- Online therapy: Platforms like BetterHelp have extensive networks of licensed therapists who use various evidence-based therapeutic approaches. Online therapy often costs similarly to an insurance co-pay, so it may be a valuable option if you do not have health insurance or if in-person therapists nearby do not accept your insurance.
When you find a therapist, consider doing the following:
- Read their bio: Learn more about each potential therapist’s background, educational attainment, specializations, years of experience, and therapeutic modalities. Though many therapists practice eclecticism, it may be informal. Instead of explicitly listing eclectic therapy, they may list multiple therapeutic modalities, such as cognitive-behavioral therapy, psychodynamic therapy, and grief counseling.
- Learn about their general approach: Some therapists may practice more short-term, goal-oriented therapies, whereas others may take a less directive approach.
- Assess your therapeutic alliance: Therapy is often most effective when clients and therapists have a strong therapeutic relationship. Ask yourself the following questions when meeting a therapist:
- Do I trust and respect my therapist?
- Do they listen to my concerns and validate my feelings?
- Are there appropriate boundaries?