5x7 Integrative Therapeutic Matrix – Tania G. Blom, Artemis S. Antoniou, Samuel Ochieng


This article comprises a brief description of the 5x7 Integrative Therapeutic Matrix as a Theoretical and Clinical Model for Psychotherapy Integration, Rooted in research evidence Clarkson (1995, 2003) declared that it is not any particular psychological counselling paradigm itself that is the essence of therapeutic effectiveness, but the actual therapeutic relationship between therapist and client (Antoniou & Blom, 2006). Clarkson (1995, 2003) stated that there are five types of relationships, (a) the working alliance, (b) the transference/countertransference relationship, (c) the developmentally needed relationship, (d) the person-to-person relationship, (e) the transpersonal relationship. In addition, she suggested that there are seven domains, these are: (1) the physiological, (2) the emotional, (3) the nominative, (4) the normative, (5) the rational, (6) the theoretical, (7) the transpersonal (or the currently inexplicable).

1. THEORETICAL AND RESEARCH BASIS

The therapeutic approach is based on the Clarkson’s 5x7 Matrix. This matrix is composed by the Five Relationships framework for psychotherapy integration (Clarkson 2003; Antoniou & Blom 2006) and the Clarkson’s Seven Level model. O’Leary, E. (2006) describes integration as being theoretical, convergent, idealistic and unifying, constructing something new, by blending the parts creating therapy which is greater than the sum of the parts integrated. More research findings indicate that more than any other factor, it is the actual relationship between the therapist and the client that establishes the value of the therapy (Bergin & Lambert 1978; O’Malley, Suh & Strupp 1983; Hill 1989; Roth & Parry 1997). For Goldfried (1980) relationship is the foundation of all psychotherapy. Frank (1979), Hynan (1981), Norcross & Goldfield (1992), (Kahn 1996:13), Hubble, Duncan, & Miller (1999), Padeskey (2000), Paley & Shapiro (2001)

The Five Relationship Model

We are born of relationship, nurtured in relationship, and educated in relationship. We represent every biological and social relationship of our forebears, as we interact and exist in a consensual domain called ‘society’. (Cottone 1988:363)

The Five Relationship model provides flexibility and scope to all therapists, irrespective of their training or ‘school’. The five relationships as referred in Antoniou & Blom (2006) are:

(a) The working alliance:

This is the constituent of the client–therapist relationship that enables both the client and the therapist to work together even when one or both experience strong desires to the contrary. 

(b) The transferential/ countertransferential relationship:

This is the anticipated relationship, in which the experience of unconscious wishes and fears onto or into the therapeutic partnership take place.

(c) The reparative/ developmentally needed relationship:

“The developmentally needed or reparative relationship is an intentional provision by the psychotherapist of a corrective, reparative, or replenishing relationship or action where the original parenting was deficient, abusive or overprotective” (Clarkson 2003:113).

(d) The person-to-person relationship:

“The person-to-person relationship is the core or real – as opposed to object relationship” (Clarkson 2003:152). Garfield and Affleck (1961); Sloane, Staples, Cristol, Yorkston and Whipple (1975); Ford (1978); Adelstein, Gelso, Haws, Reed and Spiegel (1983); Gelso, Mills and Spiegel, (1983) have all shown that it is significant to the client that there be a real relationship from within which environment the psychotherapist can use whatever theory or technique he or she advocates.

(e) The transpersonal relationship:

Clarkson (1995) stated that the transpersonal relationship involves, '...the spiritual or inexplicable dimensions of relationship in psychotherapy' (p.18). Eight years later, Clarkson expresses this relationship as follows: “The transpersonal relationship is the timeless facet of the psychotherapeutic relationship, which is impossible to describe, but refers to the spiritual dimension of the healing relationship” (Clarkson, P 2003:187). Grof defined it as “Experiences involving an expansion or extension of consciousness beyond the usual ego boundaries and beyond the limitations of time and/or space” (1979:155).(Antoniou & Blom, 2006). For Whitehouse (2006), “the experiences of transpersonal connection between therapist and client are difficult to describe adequately”.

The Seven Level Model

The Seven Level Model comprises a phenomenological thinking tool. It does not function as a territory rather than a map of a territory—in this case, the territory of the therapeutic relationship presented. For ease of explanation, this tool brackets (groups) each level yet it is not hierarchical in any way. No level is more or less important than any other is. This model is a pattern or state of discourse and experience.

The Seven Levels are:

The physiological level 1:

The sphere of sensory encounter, the component of our sensory world that functions in time prior to the manifestation of language. This level pertains to the body and encompasses all bodily functions and processes.

The emotional/effective level 2:

Encompasses the feelings that we experience in common with human babies and animals – anger, fear, joy etc.

The nominative level 3:

Comprises the utilisation of images and naming through words, a course of action that rests on classification into classes and categories and precedes complex abstract thinking.

The normative level 4:

Consists of the various aspects of the individual encountering the norms and values of the group, culture, family, society, professional association etc. This deals with people as ‘cultural beings’, with collective belief systems, stereotypes of gender, values, norms and also the expectations of society.

The rational/logical level 5:

The level of facts, i.e. of what takes place in a specific time and place, and it is undeniable by the people who attend it, e.g. the natural phenomenon of gravity. It is here that clear principles of certification and measurement can be applied as well as proofs for that particular time and culture. For instance in this level belong science, statistical probabilities and logic.


The theoretical/narrative level 6:

At this level, people function as ‘story tellers’ as meaning making creatures. At this level belong the explanations given about what happen and the creation of meaningful stories out of or about a fact. At the theoretical level, everyone tells his or her own stories and it is very difficult to find one story/theory that is true for everybody. The transpersonal (or currently inexplicable) level 7:

A level where people are convinced by direct experience, which often feels impossible to articulate or communicate to those who have never experienced at least a similar experience. Jung called it ‘synchronicity’. It encompasses those experiences that we cannot prove on the rational level or explain on the theoretical level. It is beyond duality and causality; it is the container for all those phenomena and experiences that cannot be confined to any other level and/or for all those phenomena that are currently inexplicable. The 5x7 Matrix

Utilized together, the five relationships and the seven levels model work as a matrix enabling the therapist to integrate appropriate therapeutic interventions to suit the client’s unique needs. Integration within psychotherapy by its very nature, includes more than a single approach and enables the therapist to draw on all schools and types of training in psychotherapy should this seem appropriate for the client. Recommendations

The 5x7 relational Matrix as a Theoretical and Clinical Framework for Psychotherapy and Integration offers flexibility to integrate several methods and techniques (e.g. TA, CBT), yet under the umbrella of the whole therapeutic relationship with the client. Instead of fitting the client into a pre-decided theoretical framework, the 5x7 model is a self-evolving tool, which enables the therapist to use and navigate all the information that s/he receives from his/her relationship with the client and using/integrating a variety of theoretical frameworks- to act accordingly in order to meet the unique needs/issues of a unique client.

The 5x7 Matrix can be applied not only into the psychotherapeutic context, but also to any scale of relational context and to all relationships. It is a useful tool for understanding yourself, a situation or a subject and it can provide the most complete description of human experience. It can facilitate any professional, practitioner, student, person or group to decide what to do with the vast amount of information they have and choose inclusively and consciously a cost-effective and beneficial action.

References

Antoniou A.S., & Blom, T.G. (2006). The Five Therapeutic Relationships. Clinical Case Studies, Vol.5 No.5, pp. 437-451 . CA: Sage Publications. Bergin, A.E., & Lambert, M.J (1978). The evaluation of therapeutic outcomes. In S.L. Garfield and A.E. Bergin (Eds) Handbook of Psychotherapy and Behavior Change, pp. 139-89.New York: Wiley, 2nd edition. Clarkson, P. (1992b). The seven level model. In W. Dryden (Ed.) Integrative and Eclectic Therapy: A Handbook, pp.41-83. Milton Keynes: Open University Press. Clarkson,P. (1995). The Therapeutic Relationship. London: Whurr Publishers Ltd. Clarkson, P. (2002). On Psychotherapy2: Including the 7-Level Model. London: Whurr Clarkson, P. (2003). The Therapeutic Relationship pp.35 – 232 London: Whurr Publishers Ltd, 2nd edition. Clarkson, P. (2003). Gestalt Counselling in Action 2nd edition. London: Sage Clarkson, P. & Lapworth, P. (1992). Systemic Integrative Psychotherapy. In W. Dryden (Ed.) Integrative and Eclectic Therapy: A Handbook, pp.41-83. Milton Keynes: Open University Press. Cottone, R.R. (1988). Epistemological and ontological issues in counselling: Implications of social systems theory. Counselling Psychology Quarterly, 1(4), 363 Dryden, W. (Ed.) (1984). Individual Therapy in Britain. London: Harper&Row. Fairbairn, W.R.D. (1958). On the nature and aims of psychoanalytic treatment. International Journal of Psychoanalysis. 39, 374-86 Frank, J.D. (1979). The present status of outcome studies. Journal of Consulting and Clinical Psychology, 47, 31016. Goldfried, M.R. (1980). Toward the delineation of the therapeutic change principle. American Psychologist, 35, 991-9 Hill, C.E. (1989).Therapist Techniques and Client Outcomes. Newbury Park, CA: Sage. Hubble, M.A., Duncan, B.L., and Miller, S.D. (1999).The Heart and Soul of Change – What Works in Therapy. Washington, DC: American Psychological Association Hynan, M.T. (1981). On the advantages of assuming that the techniques of psychotherapy are ineffective. Psychotherapy: Theory, Research and Practice. 18,11-13. Kahn, M.D. (1991). Between the Therapist and Client: The New Relationship. New York: W.H. Freeman & Co Norcross, J.C. and Goldfield, M.R. (1992). Handbook of Psychotherapy Integration. New York: Basic Books O’Leary, E. (2006). The need for integration. In O’Leary,E. & Murphy, M. (Eds) New Approaches to Integration in Psychotherapy. New York: Routledge pp.4 O’Leary,E. & Murphy, M. (Eds) (2006). New Approaches to Integration in Psychotherapy. New York: Routledge. O’Malley, S. S., Suh, C. S. and Strupp, H. H. (1983). The Vanderbilt psychotherapy process scale: A report on the scale of development and a process outcome study. Journal of Consulting and Clinical Psychology, 51:581-6 Padesky, C. (1995).A Clinician’s Guide to Mind over Mood. New York: Guilford Padesky, C. (2000). Cognitive Therapy Workshop. Imperial College, London Paley, G. & Shapiro, D.A. (2002). Lessons from psychotherapy research for psychological interventions for people with schizophrenia. Psychology and Psychotherapy: Theory, Research and Practice,75, 5-17 Roth, A.D. & Parry, G. (1997). The implications of psychotherapy research for clinical practice and service development: Lessons and limitations. Journal of Mental Health, 6, 367-380 Whitehouse, T. (2006). Transpersonal connection within psychotherapy. Counselling Psychology Review Vol 21 No 4