Table 1.

Central Elements of Five Integrative Approaches

Authors	Modality	Key theoretical roots and backgound	Core elements
Gumley and Clark52	Individual psychotherapy	Cognitive	• Metacognitive deficits related to problematic attachment style
		Attachment	• Capacity to mentalize emerges within context of secure attachment
		Interpersonal
		Developmental	• Emphasizes importance of disrupted narrative
Harder and Folke53	Individual psychotherapy	Attachment	• Early attachment central to approach
		Intersubjective	• Attachment style related to affect-regulation processes, stress reactivity, and metacognitive difficulties
		Psychoanalytic
			• Approach is grounded in developmental perspective
Lysaker et al55	Individual psychotherapy	Cognitive	• Metacognitive deficits closely intertwined with inability to form coherent, temporally stable personal narrative
Salvatore et al54		Existential
		Psychodynamic	• Narrative episodes used as means to stimulate metacognitive growth in therapy
		Dialogical
			• Difficulties in metacognition result in intersubjectivity, experienced as threatening
Multicomponent models (eg, Pijnenborg et al57)	Group psychotherapy	Skills training	• Multiple interlocking components in a temporal sequence
		Social cognition	• Self-reflective processes moderate relationship between insight and interrelated prerequisites for insight, including perspective-taking, self-stigma, and neurocognition
		Cognitive
		Narrative
Hasson-Ohayon59	Individual/group psychotherapy	Cognitive–behavioral	• Emphasizes intersubjectivity and interpersonal context as critical for therapy
		Intersubjective
			• Provides assimilative strategies for integrating intersubjectivity into existing cognitive–behavioral approaches