Compatibility of Components in Cognitive Behavioral Therapies: A Call for Combinatory Congruency

A large minority of psychotherapists endorse practicing integrative therapy, drawing from different schools of therapy, and an increasing number of contemporary therapies are designed by combining elements or components from different treatment models (e.g., modular treatments, process-based therapy). As a result, clients are likely to be the recipients of a number of different techniques or strategies, based on different theoretical models, emphasizing different change principles. This paper sets out to explore the potential challenges introduced by integrative treatments, exemplified with the diverse therapies found under the umbrella of cognitive behavioral therapies (CBTs). Although several scholars have proposed a unifying agenda for CBTs by underscoring commonalities and shared change principles, which is an important perspective, the extent to which compatibility exists between CBTs remains an underexplored scientific question. In this paper, we argue that integrative therapy can risk detracting from a positive outcome when the compatibility between distinct strategies or components is not ensured. We call for practitioners and researchers to ensure combinatory congruency, that is, compatibility between components manifested as their efficient and effective delivery together. We conclude by suggesting ways in which combinatory congruency can be established in the design phase of an integrative treatment or as an important step in additive and dismantling studies of existing integrative treatment packages.