Systemic Integrative Practice: A Meta-Framework

Integrative psychotherapeutic practice is the process of creating a broad, overarching framework as a guide to selecting and combining concepts and interventions. Attracting attention over the past 20 years, it has been identified as the dominant trend in family therapy moving into the 21st century. It is no surprise that clinicians necessarily combine several theories, techniques, and factors in their work given the multidimensional nature of work with clients and families. Integrative practice has evolved over time with different models and frameworks proposed, and yet in the field, there are concerns that it is not widely taught despite many identifying as eclectic or integrative. The purpose of this paper is twofold. Firstly, it reviews the topic of integrative practice, its history, evolution, strengths and pitfalls, and models. Secondly, a systemic meta-framework is proposed as a guide to clinical practice and teaching. The review found a move from eclecticism to integrative practice, with the evolution of integration leading to five primary methods. The proposed QIFT Systemic Meta-Framework for Integrative Practice both fits within and extends these methods, with the following key elements: way of being, therapeutic alliance with a focus on neurobiology, systemic assessment and formulation, and decision-making highlighting theory of change.