A concept shared by both existential and person-centered therapy is that of

In essence, the Existential view places a major importance on the development of the relationship as central to the therapy. The relationship is famed in terms such as “real” or “authentic,” with the realness of the therapist serving as both a model and guide for the client to emulate.

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Expressive Therapies: Music, Art, and Sandplay

S. Loue, in Encyclopedia of Mental Health (Second Edition), 2016

Humanistic Approaches

Humanistic approaches to art therapy include existential therapy (Frankl, 1963; May, 1976), person-centered therapy (Rogers, 1951, 1961), and Gestalt therapy (Perls, 1969). The existential basis for art therapy, delineated by Moon (1995), derives from the ideas of Frankl and May. Frankl (1963) believed that individuals should be challenged to discover the meaning and purpose in life. May (1976) viewed creativity as a struggle against disintegration; creativity was thought to be not only key to mental health but also could announce the appearance of a new being. The existential approach emphasizes the liberation of the individual from his or her fears and anxieties, the development of self-awareness, the creation of one’s own identity, and the provision of an opportunity to make sense of what otherwise seems meaningless.

Person-centered therapy involves the reflection back to the client of his or her feelings and thoughts; the therapist will also clarify and summarize what the client has said to indicate to the client that he or she has been heard. The therapist does not interpret what the client has done, but rather tries to understand through skilled questioning what the client is trying to communicate through his or her art. It is critical to this approach that the therapist provides unconditional acceptance and support to the individual.

The Gestalt approach to art therapy suggests that the whole – the gestalt – is greater than the sum of its individual components. The Gestalt approach to art therapy views the client’s art as the gestalt of the client at that moment in time. Art therapists using this approach focus on active movement in the art expression and challenge clients to understand how the forms they use in their art convey meaning (Rhyne, 1995).

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Clinical Geropsychology

Jacob Lomranz, Liora Bar-Tur, in Comprehensive Clinical Psychology, 1998

7.21.6.3 Methods

The eclectic approach is tailored to the specific needs of the client. These approaches include dynamic, cognitive, and behavior modification, group methods, family and milieu systems, existential therapy, organizational, educational, and community approaches. Specific techniques found useful with the elderly are employed, including life review therapy, reminisence groups (Haight & Webster, 1995), family counseling (Brink, 1979), and educational programs and training (Garrison, 1978). These are applied to individuals, families, groups, community, staff, and interdisciplinary networks. Group work (e.g., psychotherapy, family, task groups, life review) is a major methodological component (MacLennan, Shura, & Weiner, 1988). Intervention are geared to eliminate psychopathology as well as preventive work to increase clients' sense of control and hopefulness about change. Reserve capacities are utilized, based on selection, optimization, and compensation (Baltes & Baltes, 1993; Ryff, 1989). Considerable attention is paid to assessment and diagnostics (Storandt, Siegler, & Elias, 1978). Existing diagnostic tools are adapted or modified, and specialized tools are developed in cooperation with the University Herczeg Institute on Aging. Thus, traditional and nontraditional approaches for intervention and assessment are employed. The psychologists work in cooperation with social workers, occupational, art- and physiotherapists. Special attention is given to psychosoma interaction, and ongoing communication is maintained with the medical and paramedical staff. Regular contact is held with the “Home mother,” the caregivers, and technical departments (e.g., maintenance, cleaning, kitchen). Informal contact and interaction (discussions in the elevator, garden, etc.) are part of the approach and highly valued. All these activities also contribute to the integration of the clinic as an integral part of the nursing home.

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Clinical counseling and applied psychotherapy in supportive oncology

David W. Kissane, Matthew Doolittle, in Supportive Oncology, 2011

Supportive counseling

Similar to psychoeducational approaches, the set of techniques that fall under the rubric “supportive” is utilized in nearly every therapeutic interaction. Supportive work focuses on active listening, clarification, and reflection with the purpose of emphasizing any evidence of strong coping and adaptive interactions to encourage and reinforce them, and thus increase the patient's sense of self-efficacy.12 Such support can become meaningful only if it is plausible, that is, the reactions and suggestions of the therapist should occur in a setting of trust, established and maintained by the therapist's compassionate and reliable regard for suffering. The physical and psychological environment should invite the articulation of emotions and descriptions of behaviors and relationships. After a therapeutic alliance is established, the patient can be encouraged to realize and to mobilize supports through articulation of appropriate goals and improved coping with illness. In cases of grave illness, another role of supportive treatment is to “detoxify” death, that is, to help the patient observe the process of death as part of life—a part that can be managed admirably by the patient as it has been managed admirably by others.

Supportive-expressive group therapy

One notable form of structured supportive therapy, supportive-expressive group therapy (SEGT), has been used in the field of oncology to aid management of medical symptoms through a group process that creates a “medicalized” culture. Based on Yalom's work13 in existential therapy and elaborated by David Spiegel and colleagues,14 SEGT was devised with the goal of improving quality of life by establishing unique social supports to sustain advanced cancer patients through illness and death. Groups are larger than usual at 10 to 12 members to allow for absence due to illness, with new members joining 2 or 3 at a time to replace deceased members. As a way of emphasizing social support and group cohesion, therapists allow and even encourage contact among members outside of the group, with the understanding that members will discuss these out-of-session interactions and bring up relevant concerns during group time. Sessions generally take place weekly at a clinical location, but when a member becomes gravely ill, groups may meet at the hospital or at the home of the dying member to sustain their connectedness. Therapists and group members also routinely attend funerals. The effective group helps members move from a mindset of ambivalence about illness to one better focused on creative living, evidenced by humor, celebration, assertiveness, altruism, worthwhile pursuits, and eventually courageous acceptance of dying.15 Co-therapy is essential for groups, allowing one therapist to have greater expertise about cancer and the other about psychotherapy, if this balance works. The primary task of the therapists is to ensure that feelings are shared alongside medical information, and that attitudes to treatment emerge in group discussions, allowing an appreciation of the diversity of views in the group and the modeling of alternative behavior and coping approaches. Although the long-term nature of the group allows members to observe a range of experiences and to recognize demoralization or “burnout,” one danger of the long-term nature of the treatment is that group members will become complacent.

Rather than let the group function as just a social gathering, therapists are responsible for keeping the focus on cancer and on connectedness, both within and between members of the group and their families. Mature groups may be able to achieve these goals through genuine humor (not an expression of an awkward defensiveness), celebration of life's milestones, rehearsal of assertive and effective medical interactions, development of creativity in group members, altruism representing kindness to others to whom the members feel connected, and finally acceptance of dying with courage when that time finally comes.

Clinicians face the possibility of negative transference reactions that may be masked in the criticism of other doctors, as well as the risk of an idealized transference in which the therapist is given too much authority, with the possibility that the work of the group as well as the treatment of cancer may be impeded. These challenges can be further magnified by the relatively loose boundaries of the group work and the emotional intensity of death. Regular supervision and frequent coordination between co-therapists are therefore critical to this work. Early findings that similar forms of therapy were associated with increased survival have long been disconfirmed,16,17 but the medicalizing approach in SEGT may promote treatment adherence.18 Multiple studies have shown that SEGT improves quality of life in cancer patients and may reduce anxiety and depression.19,20 Indeed, the Melbourne-based SEGT study prevented new onset of depression compared with patients in the control arm.18

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Foundations

D. David, ... S. Ştefan, in Comprehensive Clinical Psychology (Second Edition), 2022

1.01.3.1.3 The Existential Models

Stemming from existential philosophy, the existential approach in psychotherapy is seen more as a philosophy of conducting therapy than as a distinctive therapeutic method (Prochaska and Norcross, 2014). Representative figures include Rollo May, James Bugental, and Irvin Yalom. Viktor Frankl, the founder of logotherapy, can also be considered a pioneer in this approach (Beutler et al., 1998). Existential therapists blend client/person-centered and Gestalt techniques, as well as some psychoanalytic-psychodynamic principles in helping clients overcome their lack of authenticity in the face of existential fears (Prochaska and Norcross, 2014). Existential therapy invites deep self-exploration to find the authentic answers within the person that address a fundamental question: how can we find our meaning in life given that we are finite creatures (mortal), ultimately alone, and overwhelmingly free and responsible for our path? In these regards, the therapist does not provide answers, but helps the client find the right questions. Also, it's not just about intellectual exploration; in order to find our meaning, we need to fully embrace our existence and emotions, experiencing “whole-bodied” reawakening (Schneider and Krug, 2017).

As human beings, we have to confront four ultimate concerns of our existence: death, freedom, aloneness/existential isolation, and meaninglessness (Yalom, 1980). We cannot escape these ultimate concerns, we all share them, whether we are aware of them or not. Actually, the awareness of these concerns naturally causes anxiety, and we shield ourselves from it by employing defense mechanisms (Yalom, 1980). The source of psychopathology in existential therapy lies in hiding away behind these defenses, living inauthentic lives, yet with these uncomfortable truths eating us from within. Having discovered the power of lying early in life, we learn to shield ourselves from anxiety, but in time, we learn to believe our lies, and get stuck in roles we play for ourselves and for others. With respect to death, for instance, we lie that if we are careful enough, if we avoid danger, if we stay healthy, we can trick the inescapable (Prochaska and Norcross, 2014). However, we can only lie to ourselves if we shut down to experiences which tell us otherwise, and thus we miss on life. Moreover, in psychopathology, lying gets us stuck into objectified (rigid) versions of ourselves—we lie to protect us from existential anxiety, and we learn that, in order to do this, we must do a fixed set of actions: check on our family, check our health, avoid certain places, certain people etc. We thus become the object of our defenses (i.e., symptoms), and feel powerless against them. When we lie, we lose contact with our intentionality—our personal direction, our creation of meaning; we can choose what we want our life to mean, we can choose what we want to stand for, but, if we lie, we entrap ourselves into believing that we cannot (believing, for example, that we are “at the mercy” of our depression, anxiety, addiction, etc.).

If the source of psychopathology is lying, the antidote is the truth. The goal of existential therapy is authenticity; in therapy, we have to become aware of the aspects we turned our back on by lying and take the responsibility of choosing (freely) our own direction (Prochaska and Norcross, 2014). To facilitate awareness, therapists encourage free experiencing—honestly expressing whatever patients are experiencing in the here-and-now. In existential therapy, the therapist does not have to remain neutral or display unconditional positive regard, but has to stay authentic, modeling authenticity in the client.

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Psychotherapy Effectiveness

G. Andersson, P. Cuijpers, in Encyclopedia of Mental Health (Second Edition), 2016

Psychotherapy – A Broad Term

Psychotherapy is a broad and popular treatment for a range of mental health problems. Definitions of psychotherapy usually include that there is an interaction (typically verbal) between a professional (the therapist) and a client (or patient), that there is psychological theory behind the treatment, a structure for the contact between the therapist and the client, and a relation between the therapist and the client (in group treatments this can be in the form of group cohesion). Psychotherapy is usually described along two different dimensions, one being the therapy orientation or school and the other being the format of the psychotherapy (e.g., individual, group-based etc.). When it comes to the first dimension there are numerous therapy brands and there is a substantial overlap between different therapies. However, the major psychotherapy orientations are the psychodynamic therapies, the cognitive-behavioral therapies, the behavioral therapies, and the humanistic-existential therapies. Added to this we have therapies that are focused on mindfulness and acceptance, supportive therapies, art therapy and systems-oriented therapies, just to give a few examples. There are many more therapies and integrative forms of psychotherapy, for example, psychoanalysis is vastly different from more recent forms of psychodynamic psychotherapy (Lambert, 2013). The format question is the second dimension to consider and psychotherapy can range from one-session exposure treatment for specific phobia to long-term treatments spanning over years for personality disorders. The way the psychotherapy is delivered also varies from the traditional face-to-face setting with one therapist and one client to group treatments, couple therapy, family treatment, guided self-help, telephone-based psychotherapy, and more recently treatments that blend modern information technology and face-to-face meetings. Further, the target for psychotherapy varies as well, but it is now clear that psychotherapy counts as a regular treatment in medical settings. In particular, when it comes to the cognitive-behavioral treatments there are numerous applications for a wide range of clinically relevant problems (e.g., health problems such as chronic pain), and there are several hundreds of controlled studies (only for depression and anxiety disorders). In this article we will focus on the effects of psychotherapy for common mental disorders. We will cover if psychotherapy is better than doing nothing, if there are differences between therapy schools and formats, if psychotherapy is as effective as medication, and finally if psychotherapy works in regular clinical settings.

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Adults: Clinical Formulation & Treatment

Larry E. Beutler, ... Stacey Peerson, in Comprehensive Clinical Psychology, 1998

6.07.3.1.1 Existential theories

Experiential theories have continued to expand, but probably at a lower rate than in their heyday of the 1970s. Theories have become more integrative of phenomonological, humanistic, and existential perspectives, and have been applied to an increasing array of problems, formats, and environments.

Because they did not arise from a single strand of philosophy, it is difficult to find a coherent direction of development that has characterized the evolution of existential therapy. Several major authors, both European and American (e.g., Boss, Binswanger, Bugental, May, Maslow, Yalom), have offered contrasting directions. The works of May, Bugental, and Maslow have been particularly forward-looking and serve as a representative view of the field.

Rollo May, a psychoanalyst by training and practice, probably is most responsible for introducing existential therapy to the United States (Rice & Greenberg, 1992). Along with Irvin Yalom, one of his major contributions (May & Yalom, 1984) was the blending of existential and phenomenological viewpoints. Adopting the phenomenological view, he believed that the personal experience of an individual person was the most important vehicle to knowledge and understanding, and emphasized that a person could be understood through their own experiences more adequately than through a therapist's theory about people (May, 1961; May & Yalom, 1984). Likewise, May thought that access to a patient's motivation for change was best obtained through an exploration of the meanings, ideals, and goals that directed their life.

May's perspective began with a fascination with anxiety and its meaning. This topic served as the basis for his doctoral dissertation in 1950 as well as for a major book, The meaning of anxiety (May, 1977) that was revised and reprinted several times. He saw anxiety, defense, and abortion of developmental progress as the inevitable products of conflict between goals and aspirations and the demands and constraints of reality. However, in a viewpoint that was reminiscent of Rogers and others, he maintained that anxiety was growth enhancing.

Pushing this point further, May launched an insightful and provocative attack against psychotherapy theory. He noted that psychotherapists, in the interest of effecting good therapy, observe and attribute meanings to patterns or mechanisms of behavior, using language and concepts that are constructed by their theoretical orientation. He pointed out that both the experience of and resolution of anxiety was often aborted by therapists and other observers when they construed the patient's experience in ways that forced it into line with their own conceptual frameworks.

The tendency of therapists to filter perceptions of the patient through a rigid lens of theoretical views clouded their ability to accurately perceive and relate to the patient. More importantly, it frustrated the objective of bringing the patient into contact with the anxiety, preventing self-knowledge and resolution. He pointed out that a rigid or dogmatic theory prevented the therapist from adopting a phenomonological perspective. The therapists' task is to separate themselves sufficiently from their own histories and dispositions to accurately perceive the meanings offered by a patient's own developmental history.

Perhaps May's major contribution was his piercing questions of fellow therapists. He provocatively asserted the possibility that what therapists view as an understanding of the patient is, in reality, a projection of their own self-reinforcing theory.

The foregoing is not to diminish May's contributions to experiential theory. May's vision was to understand how people become aware of their own growth and potential, that is one's “beingness” (May, Angel, & Ellenberger, 1958). It is this phenomenon of becoming aware of one's beingness that characterizes May's most frequently noted contribution to theory, the “I-Am” experience.

The definition of the “I-Am” includes the perception of what is real, but adds an awareness of some emerging or existent potential. Thus, a person exists in the present but with the potential to become (May, 1961). This dynamic aspect of self experience is central to the capacity to change; it is a precondition for their solution (May et al., 1958). The success of this solution, however, depends upon a therapist being able to help clients recognize and experience their own existence.

May's “I-Am” experience was so ontologically sound that it resonated through much of the existential movement. The value of his teachings seemed to help organize and guide the search for what Bugental (1976) calls the “lost sense of being.” May's “I-Am” experience was incorporated by Bugental into what he called the “existential sense.” Like May, Bugental identified existing or being alive as the fundamental concern of each human being.

Bugental, however, emphasizes that the striving for existence supersedes the mere act of being alive. It is a motivator that drives a person to become more vibrant and sensitive to life. This quest for more life was inextricably related to what he called the tragedy of the human condition, the inability both to recognize and seize opportunities for fuller living.

Bugental's concept of the “lost being” is a person who was invisibly crippled, blind, and deaf to their own state of needing (Bugental, 1976, 1987). This blindness to one's own state of emotional impairment represented a loss of the inward vision that made it possible to assess how well outer and inner experiences match.

Abraham Maslow was another major figure in blending existential and humanistic theory. His most noted contribution was his assertion of a jurisdiction for psychology which dealt explicitly with issues of growth, motivation, and creativeness (Maslow, 1968). His hierarchy of needs expressed his motivational theory and replaced the unimotivational concept of self-actualization, embodied in experiential theory, with a conception that arranged this drive within an array of more basic motives. The ultimate questions of, “Who am I?” and “What am I?” according to Maslow could only be answered by the individual asking the questions and proceeding through the hierarchically arranged answers.

Another contribution of Maslow's was his conceptualization of inner awareness as a process of “listening to the impulse voices” (Maslow, 1971). He proposed that failures in personal growth, such as neuroses, were conditions in which these “impulse voices” or “inner signal” became weak or disappeared altogether. With the inability to hear these signals, the person was incapacitated and became detached from their own essence.

Maslow envisioned the result of detachment to resemble a zombie, the experientially empty person, rather than an anxious person as proposed by others. Anxiety represented a level of being aware of disconnection, but complete disconnection included a lack of awareness of this disconnection. Maslow viewed the disconnected person as one who was empty, and believed that recovering the self must include the recovery of the ability to have and recognize these inner signals (Bugental, 1987).

One major implication of this theory was in the nature of obsessive and compulsive behaviors. The experientially empty person, lacking direction from within, turned to outer cues for guidance and reassurance of existence. This person relied on external cues, such as clocks, rules, calendars, schedules, agenda, and other people as a substitute for personal resources (Maslow, 1971).

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Vedic Principles of Therapy

R.W. Boyer PhD, in EXPLORE, 2012

Humanistic/Existential Approaches

Developed by Rogers, the client-centered aspect of humanistic therapy is nondirective. It holds that under appropriate therapeutic support with genuine concern, unconditional positive regard, and empathy the client can improve self-esteem, strengthen self-control, and become more open to new ways to solve problems and apply positive attitudes, without explicit direction. There is less focus on past history, diagnoses, or problems, and more emphasis on healthy acceptance of the individual as a whole, unique person. As with analytic approaches, it is considered less effective with individuals who are severely disturbed or have lower intelligence. In this context it is due to not providing substantive guidance, which is generally considered imposing limitations on the client. Its principles have been incorporated into other therapies, rather than being applied as a formal approach in itself.

Existential Therapy was influenced by philosophies in the aftermath of World Wars I and II. It emphasizes individual uniqueness, personal meaning, and coping with the depressing state of human civilization and loss of a grounded sense of right and wrong. It encourages confronting life challenges of existential isolation, lack of inherent meaning, coping with freedom, and individual extinction. It shares the analytic model of conscious and unconscious processes, but focuses more on the present rather than childhood traumas, toward acceptance of the transience of life and inevitable annihilation at death.

Gestalt Therapy emphasizes the whole person in the context of his or her environment including family, friends, past and present. Viewing conventional morality as constrictive, it focuses on what is going on inside and outside oneself in the here and now. It is highly interactive, relying on trust between client and therapist to apply engaging techniques such as role playing, letter writing, visualizations, and body awareness. Techniques are used to facilitate emotional expression and work through blocked past experiences and develop meaning in the face of freedom, existential isolation, and death.

Broadly within the humanistic approach, Interpersonal Therapy (IPT) focuses on social relationships as a major source of distress. It emphasizes the exploration of social roles and expectations in romantic partners, family, friends, and coworkers, and on building new skills such as assertiveness. Family Therapy focuses on the client's family of origin as a system of relationships resistant to change. It examines different roles taken by family members, and intervenes to change entrenched dysfunctional enmeshment and disengagement. Strategies frequently involve role playing, confrontation, and in some cases building a generational map—genogram—of family patterns. Narrative family therapy somewhat similarly involves reflecting on and devising stories of family histories to gain insights into family roles and dynamics toward developing more self-sufficiency and balance in relationships.

Generally these humanistic approaches view the individual as an integrated whole who is striving for acceptance, meaning, and balance individually and socially. They emphasize insight and general coping skills within ordinary daily experience, and also sometimes emotional release. They generally have not incorporated specific means to expand conscious mind, and traditionally have not recognized and included such means to develop human potential. However, importantly, they do accept the basic principle of the natural ability to grow psychologically as inherent to human life.

How are person

Furthermore he suggests that the existential idea works along similar to the person centred approach in that the” two of us, you and me”, are responsible for the coming to grips with the vagaries of life, meaning, and even death” this is where the therapist should concentrate on the client and not themselves.

How are existential and person

In existential theory, psychological challenge or disturbance takes place when an individual is not true to him or herself, whereas Roger's person-centered theory believed defensiveness, disorganization, and incongruent circumstances led people from their natural path to fulfillment.

Is person

Humanistic psychologists, on the other hand, are more person-focused (hence, person-centred therapy) and seek to help individuals become more fully-functioning and self-actualizing. The primary question that existential psychology concerns itself with is, What does it mean to exist? (Frankl, 1964).

What theory is similar to person

Similar to Person-Centered therapy, Gestalt therapy also emphasize on the authentic self; the more authentic an individual is to his- or herself, the less stress or anxiety the individual would experience.