Integrative therapy in psychology: an approach that cares for you as a whole

What is integrative therapy in psychology

Integrative therapy in psychology is a clinical approach that combines and adjusts, in a personalized way, different therapeutic methods that already have scientific evidence — rather than applying a single fixed protocol to everyone.

The starting point is simple: psychological complaints do not come in isolation. Anxiety usually comes with insomnia. Trauma usually comes with body pain. Burnout usually comes with irritability and routine disorganization. Treating only the main symptom with a single method often leaves the person better — but not whole.

When we talk about integrative therapy, we mean: caring for four dimensions together — emotions, thoughts, body, and routine — using the techniques that best fit what you are experiencing at that moment.

How it differs from "holistic" and "integrative therapies (SUS)"

It is important to make two distinctions:

• "Integrative therapies" in the SUS sense (the National Policy for Integrative and Complementary Practices, PNPIC/2006) refers to practices such as acupuncture, phytotherapy, homeopathy, and thermalism. That is not what we practice in clinical psychology.
• "Holistic" in common sense sometimes encompasses practices without evidence, spirituality, or esoteric methods. In clinical psychology, that is not it either. Everything I apply is grounded in peer-reviewed literature.

When you read "integrative therapy in psychology", read it as: a personalized combination of evidence-based methods, tailored to your complaint and your moment.

Why an integrative approach makes sense

In clinical practice, it is rare for someone to arrive with "just one complaint." More common is to arrive with a tangle:

• Anxiety that keeps you awake → insomnia → daytime fatigue → more anxiety → irritability → conflicts at work → more anxiety. A cycle.
• An old trauma that appears in startle responses, in the body (tension, pain), and in difficulty concentrating. Three symptoms, one root.
• Burnout that mixes with hopelessness, with poor sleep, with eating too much or too little, with difficulty feeling pleasure.

The integrative logic is: not to treat the isolated symptom, but to identify the whole system. To look at your life as a puzzle where each piece (emotions, thoughts, body, routine) influences the others — and to work on more than one piece at a time, with the right methods for each.

This type of care is especially useful for cases where the complaint is already in the body or has already become a compromised routine, and where a single method seems too short for what you are going through.

How Mariana applies it in practice

The choice of method comes from the initial evaluation, not from a fixed menu. There are three main methods I work with, and they enter into different combinations according to your complaint:

EMDR — Eye Movement Desensitization and Reprocessing

EMDR is especially useful for processing traumas and intrusive memories — situations that continue to activate the body even when the rational mind already knows "it is over." During the session, while you safely access the memory, bilateral stimuli (usually eye movements) help the brain reprocess what got stuck.

It has Level A evidence for PTSD (Post-Traumatic Stress Disorder) according to the APA and WHO, and growing studies for anxiety, complicated grief, and phobias. Learn more about EMDR.

Brainspotting

Brainspotting is a technique that works with the visual field location that directly connects to parts of the brain where the memory is stored. It is especially useful for somatic traumas — when the pain is more in the body than in words — and for emotional blocks where the person "knows what they feel, but cannot access it any other way."

Developed by David Grand starting in 2003, it has grown in clinical evidence and in integration with trauma neuroscience. Learn more about Brainspotting.

CBT — Cognitive Behavioral Therapy

CBT is the most studied approach in psychology — it has Level A evidence for generalized anxiety, mild to moderate depression, eating disorders, OCD, phobias, and many other conditions. It works with the identification and restructuring of thought and behavior patterns that maintain suffering.

In the integrative approach, CBT serves as the organizational backbone of the work: what we are doing, why, at what pace. Learn more about Cognitive Behavioral Therapy.

The combination varies from case to case. Generally, EMDR and Brainspotting come in when there is a strong emotional or somatic charge; CBT serves as the organizational backbone. But none of this is fixed — what governs is your real need.

What to expect from an integrative session

The first session (about 90 minutes)

It is the longest and most conversational session. Here we:

• Do a detailed clinical listening — your history, the main complaint, what you have already tried, what helped and what did not.
• Map the four dimensions: emotions, thoughts, body, and routine (sleep, diet, activity, work, relationships).
• Build, together with you, an initial plan: therapeutic goals, methods that make sense, pace of sessions.

The following sessions (50 to 60 minutes)

They are more focused. Generally, the session starts with a short check-in (how you are arriving, how the week was, sleep, body), and we follow the thread of what is most urgent at that moment. I may bring EMDR, Brainspotting, or CBT — or all three combined, as needed.

In some cases, I assign light homework — a breathing exercise, a brief journal entry, a routine guideline. Nothing that takes more than a few minutes a day.

Frequency and duration of the process

Generally:

• Frequency: weekly in the first weeks, then biweekly, then monthly (maintenance), if applicable.
• Total duration: varies greatly. Mild anxiety cases may be completed in 8 to 12 sessions. Deeper traumas require 20 to 40 sessions. There is no single timeframe.
• Format: online (I serve all of Brazil) or in-person in Brasilia. Most people start online for convenience.

When I may need other health professionals

There are situations where psychological care benefits from supplementation from other areas. When this happens, the recommendation is made with your consent, and you have full freedom of choice regarding the professional.

Common situations where this may occur:

• When there is suspicion of hormonal or metabolic issues affecting mood — a general medical evaluation may be useful.
• When insomnia shows signs of apnea or another sleep disorder — evaluation with a sleep specialist makes a difference.
• When eating is very dysregulated and this maintains the emotional condition — a nutritionist can add to the care.
• When the body needs to start moving again — a physical educator or physiotherapist may be part of the plan.
• When there is a clear indication for pharmacological evaluation or follow-up — coordination with a psychiatrist is essential.

Important: Mariana remains your psychologist and maintains the care of what is psychological. Recommendations are made carefully, always preserving your confidentiality and respecting your choice.

Scientific evidence behind the approach

Each method used in integrative therapy has its own research base:

• EMDR: Level A evidence for PTSD, according to the American Psychological Association and the World Health Organization. Recent systematic reviews consolidate its effectiveness for trauma and related symptoms.
• Brainspotting: technique developed by David Grand starting in 2003, based on trauma neuroscience and bilateral processing. Emerging evidence and growing clinical acceptance.
• CBT: the most studied approach in psychology, with Level A evidence for dozens of conditions (anxiety, depression, OCD, phobias, post-traumatic stress, etc.).

Studies on the integrative approach itself show that, in complex cases, combining methods tends to be more effective than applying a single method in a standardized way. The key is personalization: what governs is not the technique, but how well it adapts to your complaint, your pace, and your context.

In other words: it is not because two methods are effective in isolation that they work together. But there is growing evidence that, when combined with clinical judgment, the results are consistent and lasting.

Perguntas frequentes