Psychotherapy for the 21st century: An integrative, evolutionary, contextual, biopsychosocial approach

Abstract

Fragmentation of processes and interventions plague the psychotherapies (Gilbert & Kirby, 2019). Part of the problem is that we have not agreed on a framework that could be the basis for integrating knowledge and the scientific enquiry of processes and interventions. This paper outlines an approach that brings together a variety of different disciplines in the service of consilience (Wilson, 1998, Consilience: The unity of knowledge, Vintage, New York, NY; Siegel, 2019). It presents the importance of an evolutionary framework for understanding the proclivities and dispositions for mental suffering and antisocial behaviour, and how they are choreographed in different sociodevelopmental contexts. Building on earlier models (Gilbert, 1989, Human nature and suffering, Routledge, London, UK; Gilbert, 1995, Clin. Psychol. Psychother., 2, 135; Gilbert, 1998, Br. J. Med. Psychol., 71, 353; Gilbert, 2016, Case formulation in cognitive behaviour therapy: The treatment of challenging cases, Wiley, Chichester, UK, pp. 50–89) the call is for an integrative, evolutionary, contextual, biopsychosocial approach to psychology and psychotherapy.