Journal of Contemporary Psychotherapy

, Volume 45, Issue 1, pp 11–20 | Cite as

Emotion, Relationship, and Meaning as Core Existential Practice: Evidence-Based Foundations

  • Louis Hoffman
  • Lisa Vallejos
  • Heatherlyn P. Cleare-Hoffman
  • Shawn Rubin
Original Paper

Abstract

Existential therapy’s solid evidence-based foundation has not been adequately articulated to date. One challenge to this task is the lack of a singular or unified existential approach. Despite this, there remain shared themes that are common across the approaches to existential therapy. A second challenge is that many existential therapists resist Evidence-Based Practice in Psychology (EBPP), viewing it as excessively restrictive. However, EBPP is more inclusive than previous approaches to evaluating therapeutic effectiveness, such as the empirically supported treatment movement. We maintain that EBPP fits well with existential therapy and supports its practice. This paper identifies three pillars of existential psychology as its (1) relational focus, (2) emphasis on working with emotions and experience, and (3) meaning-centered approach. Each of these pillars have a strong foundation in empirical research, clinical competencies, and ability to be adapted to individual and cultural differences, which have been identified as the core of EBPP (American Psychological Association Presidential Task Force on Evidence-Based Practice in Psychology 2006). While few outcome studies specifically on existential psychotherapy exist, there is extensive research supporting the core practices that comprise existential therapy practice.

Keywords

Existential therapy Evidence-based practice in psychology Therapeutic relationship Meaning Emotions 

References

  1. Addad, M., & Himi, H. (2009). Logotherapy—theoretical aspects and field studies in Israel. In A. Batthyany & J. Levinson (Eds.), Existential therapy of meaning: Handbook of logotherapy and existential analysis (pp. 445–461). Phoenix, AZ: Zeig, Tucker & Thesen.Google Scholar
  2. Alsup, R. (2008). Existentialism of personalism: A Native American perspective. In K. J. Schneider (Ed.), Existential-integrative psychotherapy: Guidepost to the core of practice (pp. 121–127). New York: Routledge.Google Scholar
  3. American Psychological Association Presidential Task. (2006). Evidence-based practice in psychology. American Psychologist, 61, 271–285.CrossRefGoogle Scholar
  4. Bao, Z. (2009). Zhungzi’s view of freedom. In L. Hoffman, M. Yang, F. J. Kaklauskas, & A. Chan (Eds.), Existential psychology east-west (pp. 221–231). Colorado Springs, CO: University of the Rockies Press.Google Scholar
  5. Breitbart, W., Rosenfeld, B., Gibson, C., Pessin, H., Poppito, S., Nelson, C., et al. (2010). Meaning-centered group psychotherapy for patients with advanced cancer: A pilot randomized controlled trial. Psycho-Oncology, 19, 21–28.CrossRefPubMedCentralPubMedGoogle Scholar
  6. Brown, L. S. (2008). Feminist therapy as a meaning-making practice: Where there is no power, where is the meaning? In K. J. Schneider (Ed.), Existential-integrative psychotherapy: Guidepost to the core of practice (pp. 130–140). New York: Routledge.Google Scholar
  7. Bugental, J. F. T. (1978). Psychotherapy and process: The fundamentals of an existential-humanistic approach. New York: McGraw-Hill.Google Scholar
  8. Bugental, J. F. T. (1987). The art of the psychotherapist: How to develop the skills that take psychotherapy beyond science. New York: Norton & Company.Google Scholar
  9. Bugental, J. F. T. (1990). Intimate journeys. San Francisco, CA: Jossey Bass.Google Scholar
  10. Bugental, J. F. T. (1999). Psychotherapy isn’t what you think: Bringing the psychotherapeutic engagement into the living moment. Phoenix, AZ: Zeig, Tucker, & Co.Google Scholar
  11. Bunting, K., & Hayes, S. C. (2008). Language and meaning: Acceptance and commitment therapy and the EI model. In K. J. Schneider (Ed.), Existential-integrative psychotherapy: Guidepost to the core of practice (pp. 217–234). New York: Routledge.Google Scholar
  12. Cleare-Hoffman, H. P., Hoffman, L., & Wilson, S. S. (2013, August). Existential therapy, culture, and therapist factors in evidence-based practice. In K. Keenan (Chair), Evidence in support of existential-humanistic psychotherapy: Revitalizing the third force. Symposium presented at the 121st Annual Convention of the American Psychological Association, Honolulu, HI.Google Scholar
  13. Comas-Diaz, L. (2008). Latino psychospirituality. In K. J. Schneider (Ed.), Existential-integrative psychotherapy: Guidepost to the core of practice (pp. 100–109). New York: Routledge.Google Scholar
  14. Cooper, M. (2003). Existential therapies. Thousand Oaks, CA: Sage.Google Scholar
  15. Cozolino, L. (2002). The neuroscience of psychotherapy. New York: W.W. Norton & Company.Google Scholar
  16. Dallas, E., Georganda, E. T., Harisiadis, A., & Zymnis-Georgaios, K. (2013). Zhi mian and “oistios” of life. Journal of Humanistic Psychology, 53, 252–260.CrossRefGoogle Scholar
  17. Dezutter, J., Casalin, S., Wachholtz, A., Luyckx, K., Hekking, J., & Vandewiele, W. (2013). Meaning in life: An important factor for the psychological well-being of chronically ill patients? Rehabilitation Psychology, 58, 334–341.CrossRefPubMedCentralPubMedGoogle Scholar
  18. Dorman, D. (2008). Dante’s cure: Schizophrenia and the two-person journey. In K. J. Schneider (Ed.), Existential-integrative psychotherapy: Guidepost to the core of practice (pp. 236–245). New York: Routledge.Google Scholar
  19. Duncan, B. L., Miller, S. D., Wampold, B. E., & Hubble, M. A. (Eds.). (2009). The heart and soul of change: Delivering what works in therapy (2nd ed.). Washington, DC: American Psychological Association.Google Scholar
  20. Elkins, D. N. (2009). Humanistic psychology: A clinical manifesto. A critique of clinical psychology and the need for progressive alternatives. Colorado Springs, CO: University of the Rockies Press.Google Scholar
  21. Fillion, L., Duval, S., Dumont, S., Gagnon, P., Tremblay, I., Bairati, I., et al. (2009). Impact of meaning-centered intervention on job satisfaction and on quality of life among palliative care nurses. Psycho-Oncology, 18, 1300–1310.CrossRefPubMedGoogle Scholar
  22. Frankl, V. E. (1984). Man’s search for meaning: An introduction to logotherapy(3rd ed.). New York, NY: Simon & Schuster. (Original work published in 1959).Google Scholar
  23. Greenberg, L. S., Korman, L. M., & Paivio, S. C. (2001). Emotion in humanistic psychotherapy. In D. J. Cain & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice (pp. 499–530). Washington, DC: American Psychological Association.Google Scholar
  24. Greening, T. (1992). Existential challenges and responses. The Humanistic Psychologist, 20(1), 111–115.CrossRefGoogle Scholar
  25. Halama, P. (2009). Research instruments for investigating meaning of life and other logotherapeutic constructs. In A. Batthyany & J. Levinson (Eds.), Existential therapy of meaning: Handbook of logotherapy and existential analysis (pp. 415–444). Phoenix, AZ: Zeig, Tucker & Thesen.Google Scholar
  26. Hirsch, B. Z. (2009). Logotherapy—the theory—the logotherapist—The client. In A. Batthyany & J. Levinson (Eds.), Existential therapy of meaning: Handbook of logotherapy and existential analysis (pp. 39–52). Phoenix, AZ: Zeig, Tucker & Thesen.Google Scholar
  27. Hoffman, L. (2008). An existential approach to working with religious and spiritual clients. In K. Schneider (Ed.), Existential-integrative psychotherapy: Guideposts to the core of practice (pp. 187–202). New York: Routledge Press.Google Scholar
  28. Hoffman, L. (2009a). Introduction to existential psychotherapy in a cross-cultural context: An East-West dialogue. In L. Hoffman, M. Yang, F. J. Kaklauskas, & A. Chan (Eds.), Existential psychology east-west (pp. 1–67). Colorado Springs, CO: University of the Rockies Press.Google Scholar
  29. Hoffman, L. (2009b). Gordo’s ghost: An introduction to existential perspectives on myths. In L. Hoffman, M. Yang, F. J. Kaklauskas, & A. Chan (Eds.), Existential psychology east-west (pp. 259–274). Colorado Springs, CO: University of the Rockies Press.Google Scholar
  30. Hoffman, L. (2009c). Knowing and the unknown: An existential epistemology in a postmodern context. Humana. Mente, 11, 97–110.Google Scholar
  31. Hoffman, L., & Cleare-Hoffman, H. P. (2011). Existential therapy and emotions: Lessons from cross-cultural exchange. The Humanistic Psychologist, 39, 261–267.CrossRefGoogle Scholar
  32. Hoffman, L., Cleare-Hoffman, H. P., & Jackson, T. (2014). Humanistic psychology and multiculturalism: History, current status, and advancements. In K. J. Schneider, J. F. Pierson, & J. F. T. Bugental (Eds.), The handbook of humanistic psychology: Theory, research, and practice (2nd ed.). Thousand Oaks, CA: Sage.Google Scholar
  33. Hoffman, L. Dias, J., & Soholm, H. C. (2012, August). Existential-humanistic therapy as a model for evidence-based practice. In S. Rubin (Chair), Evidence in support of existential-humanistic psychology: Revitalizing the ‘third force.’ Symposium presented at the 120th Annual Convention of the American Psychological Association, Orlando, FL.Google Scholar
  34. Hoffman, L., Stewart, S., Warren, D., & Meek, L. (2009a). Toward a sustainable myth of self: An existential response to the postmodern condition. Journal of Humanistic Psychology, 49, 135–173.CrossRefGoogle Scholar
  35. Hoffman, L., Yang, M., Kaklauskas, F. J., & Chan, A. (Eds.). (2009b). Existential psychology east-west. Colorado Springs, CO: University of the Rockies Press.Google Scholar
  36. Holland, J. M., Neimeyer, R. A., Currier, J. M., & Berman, J. S. (2007). The efficacy of personal construct therapy: A comprehensive review. Journal of Clinical Psychology, 63, 93–107.CrossRefPubMedGoogle Scholar
  37. Jafary, F., Farahbakhsh, K., Shafiadabi, A., & Delavar, A. (2011). Quality of life and menopause: Developing a theoretical model based on meaning in life, self-efficacy beliefs, and body image. Aging and Mental Health, 15, 630–637.CrossRefPubMedGoogle Scholar
  38. Kang, S. M., Shaver, P. R., Sue, S., Min, K. H., & Jing, H. (2003). Culture-specific patterns in the prediction of life satisfaction: Roles of emotion, relationship quality, and self-esteem. Personality and Society Psychology Bulletin, 29, 1596–1608.CrossRefGoogle Scholar
  39. King, L. A., & Hicks, J. A. (2012). Positive affect and meaning in life (Chapter 6; Kindle version). In P. T. P. Wong (Ed.), Meaning: Theories, research, and applications. New York: Taylor & Francis.Google Scholar
  40. Krause, N. (2012). Healthy aging. In P. T. P. Wong (Ed.), Meaning: Theories, research, and applications (2nd ed.; Chapter 19; Kindle version). New York, NY: Taylor & Francis.Google Scholar
  41. Krug, O. (2009). James Bugental and Irvin Yalom: Two masters of existential therapy cultivate presence in the therapeutic encounter. Journal of Humanistic Psychology, 49(3), 329–354. doi:10.1177/0022167809334001.CrossRefGoogle Scholar
  42. Leitner, L. M., Faidley, A. J., & Celentana, M. A. (2000). Diagnosing human meaning making: An experiential constructivist approach. In R. A. Neimeyer & J. D. Raskin (Eds.), Constructions of disorder: Meaning-making frameworks for psychotherapy (pp. 175–203). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  43. Maddi, S. R., Khoshaba, D. M., Harvey, R. H., Faxel, M., & Resurreccion, N. (2011). The personality construct of hardiness, V: Relationships with the construction of existential meaning in life. Journal of Humanistic Psychology, 51, 369–388.CrossRefGoogle Scholar
  44. Mascaro, N., & Rosen, D. H. (2006). The role of existential meaning as a buffer against stress. Journal of Humanistic Psychology, 46, 168–190.CrossRefGoogle Scholar
  45. May, R. (1991). The cry for myth. New York: Delta.Google Scholar
  46. Monheit, J. (2008). A lesbian and gay perspective: The case of Marcia. In K. J. Schneider (Ed.), Existential-integrative psychotherapy: Guidepost to the core of practice (pp. 140–146). New York: Routledge.Google Scholar
  47. Neimeyer, R. A., Baldwin, S. A., & Gillies, J. (2006). Continuing bond and reconstructing meaning: Mitigating complications in bereavement. Death Studies, 20, 715–738.CrossRefGoogle Scholar
  48. Norcross, J. C. (1987). A rational and empirical analysis of existential psychotherapy. Journal of Humanistic Psychology, 27(1), 41–68.CrossRefGoogle Scholar
  49. Norcross, J. C. (Ed.). (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patients. New York: Oxford University Press.Google Scholar
  50. Norcross, J. C. (2009). The therapeutic relationship. In B. L. Duncan, S. D. Miller, B. E. Wampold, & M. A. Hubble (Eds.), The heart and soul of change: Delivering what works in therapy (2nd ed., pp. 113–141). Washington, DC: American Psychological Association.Google Scholar
  51. Norcross, J. C., Beutler, L. E., & Levant, R. F. (Eds.). (2006). Evidence-based practices in mental health: Debate and dialogue on the fundamental questions. Washington, DC: American Psychological Association.Google Scholar
  52. Norcross, J. C., & Lambert, M. J. (2010). Evidence-based therapy relationships. In J. C. Norcross (Ed.), Evidence-based therapy relationships. Retrieved from http://www.nrepp.samhsa.gov/Norcross.aspx.
  53. Pan, J. Y., Wong, D. F. K., Joubert, L., & Chan, C. L. W. (2008). The protective function of meaning of life and life satisfaction among Chinese students in Australia and Hong Kong: A cross-cultural comparative study. Journal of American College Health, 57, 221–231.CrossRefPubMedGoogle Scholar
  54. Raskin, J. D. (2008). The evolution of constructivism. Journal of Constructivist Psychology, 21(1), 1–24.CrossRefGoogle Scholar
  55. Rice, D. L. (2008). An African American perspective: The case of Darrin. In K. J. Schneider (Ed.), Existential-integrative psychotherapy: Guidepost to the core of practice (pp. 110–121). New York: Routledge.Google Scholar
  56. Richert, A. J. (2010). Integrating existential and narrative therapy: A theoretical base for eclectic practice. Pittsburgh, PA: Duquesne University Press.Google Scholar
  57. Roepke, A. M., Jayawickreme, E., & Riffle, O. M. (2013). Meaning and health: A systematic review. Applied Research in Quality of Life: Advance online publication. doi:10.1007/s11482-013-9288-9.Google Scholar
  58. Rogers, C. (1961). On becoming a person: a therapist’s view of psychotherapy. Boston, MA: Houghton-Mifflin Company.Google Scholar
  59. Salvatore, S., Gelo, S., Gennaro, A., Manzo, S., & Radaideh, A. A. (2010). Looking at the psychotherapy process as an intersubjective dynamic of meaning-making: A case study with discourse flow analysis. Journal of Constructivist Psychology, 23, 195–230.CrossRefGoogle Scholar
  60. Schneider, K. J. (Ed.). (2008). Existential integrative psychotherapy: Guideposts to the core of practice. New York: Routledge.Google Scholar
  61. Schneider, K. J. (2012). The case of Allison: An existential-integrative inquiry into death anxiety, groundlessness, and the quest for meaning and awe. In P. R. Shaver & M. Mikulincer (Eds.), Meaning, mortality, and choice: The social psychology of existential concerns (pp. 339–352). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  62. Schneider, K. J., & Krug, O. T. (2010). Existential humanistic therapy. Washington, DC: American Psychological Association.Google Scholar
  63. Serlin, I. (2008). Women and the midlife crisis: The Anne Sexton complex. In K. J. Schneider (Ed.), Existential-integrative psychotherapy: Guidepost to the core of practice (pp. 146–163). New York: Routledge.Google Scholar
  64. Solomon, S. (2012). The social psychology of meaning, mortality, and choice: An integrative perspective on existential concerns. In P. R. Shaver & M. Mikulincer (Eds.), Meaning, mortality, and choice: The social psychology of existential concerns (pp. 401–417). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  65. Spinelli, E. (1997). Tales of un-knowing: Eight stories of existential therapy. Washington Square, NY: New York University Press.Google Scholar
  66. Stark, P. L., Ulrich, B., & Duffy, M. E. (2009). The meaning of suffering experiences. In A. Batthyany & J. Levinson (Eds.), Existential therapy of meaning: Handbook of logotherapy and existential analysis (pp. 487–502). Phoenix, AZ: Zeig, Tucker & Theisen.Google Scholar
  67. Steger, M. F. (2012). Experiencing meaning in life: Optimal functioning at the nexus of well-being, psychopathology, and spirituality. In P. T. P. Wong (Ed.), Meaning: Theories, research, and applications (2nd ed.; Chapter 8; Kindle version). New York, NY: Taylor & Francis.Google Scholar
  68. Tavernier, R., & Willoughby, T. (2012). Adolescent turning points: The association between meaning-making and psychological well-being. Developmental Psychology, 48, 1058–1068.CrossRefPubMedGoogle Scholar
  69. Thompson, N. J., Coker, J., Krause, J. S., & Henry, E. (2003). Purpose in life as a mediator of adjustment after spinal cord injury. Rehabilitation Psychology, 48, 100–108.CrossRefGoogle Scholar
  70. van Hees, M. M., Rotter, T., Ellermann, T., & Evers, S. A. (2013). The effectiveness of individual interpersonal psychotherapy as a treatment for major depressive disorder in adult outpatients: a systematic review. BMC Psychiatry, 1, 1–10. doi:10.1186/1471-244X-13-22.CrossRefGoogle Scholar
  71. Vasquez, M. T. (2007). Cultural difference and the therapeutic alliance: An evidence-based analysis. American Psychologist, 62, 878–885. doi:10.1037/0003-066X.62.8.878.CrossRefGoogle Scholar
  72. Vontress, C. E. (1979). Cross-cultural counseling: An existential approach. Personnel & Guidance Journal, 58(2), 117–122.CrossRefGoogle Scholar
  73. Walsh, R. A., & McElwain, B. (2001). Existential psychotherapies. In D. J. Cain & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice (pp. 253–278). Washington, DC: American Psychological Association.Google Scholar
  74. Wampold, B. E. (2001). The great psychotherapy debate: Models, methods, and findings. Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
  75. Wampold, B. E. (2008). Existential-integrative psychotherapy: Coming of age. Psyccritiques, 53(6), doi:10.1037/a0011070.
  76. Wampold, B. E. (2009a). Research evidence for the common factors models: A historically situated perspective. In B. L. Duncan, S. D. Miller, B. E. Wampold, & M. A. Hubble (Eds.), The heart and soul of change: Delivering what works in therapy (2nd ed., pp. 49–81). Washington, DC: American Psychological Association.Google Scholar
  77. Wampold, B. (2009b). How psychotherapy works. http://www.apa.org/news/press/releases/2009/12/wampold.aspx.
  78. Wampold, B. E., Goodheart, C. D., & Levant, R. F. (2007). Clarification and elaboration on Evidence-Based practice in psychology. American Psychologist, 62, 616–618.CrossRefPubMedGoogle Scholar
  79. Wang, X. (2011). Zhi mian and existential psychology. The Humanistic Psychologist, 39, 240–246.CrossRefGoogle Scholar
  80. Watson, J. C., Greenberg, L. S., & Lietaer, G. (2010). Relating process to outcome in person-centered and experiential psychotherapies: The role of the relationship conditions and clients’ experiencing. In M. Cooper, J. C. Watson, & D. Holldampf (Eds.), Person-centered and experiential therapies work: A review of the research on counseling, psychotherapy and related practices (pp. 132–163). Ross-on-Wye, UK: PCCS Books.Google Scholar
  81. Whelton, W. J. (2004). Emotional processes in psychotherapy: Evidence across therapeutic modalities. Clinical Psychology and Psychotherapy, 11, 58–71.CrossRefGoogle Scholar
  82. Wolfe, B. E. (2008). Existential issues in anxiety disorders and their treatment. In K. J. Schneider (Ed.), Existential-integrative psychotherapy: Guidepost to the core of practice (pp. 204–216). New York: Routledge.Google Scholar
  83. Wong, P. T. P. (2012a). Toward a dual-systems model of what makes life worth living. In P. T. P. Wong (Ed.), Meaning: Theories, research, and applications (2nd ed.; Chapter 1; Kindle version). New York, NY: Taylor & Francis.Google Scholar
  84. Wong, P. T. P. (2012b). From logotherapy to meaning-centered counseling and therapy. In P. T. P. Wong (Ed.), Meaning: Theories, research, and applications (2nd ed.; Chapter 28; Kindle version). New York, NY: Taylor & Francis.Google Scholar
  85. Yalom, I. D. (1980). Existential psychotherapy. New York: Basic Books.Google Scholar
  86. Yalom, I. D. (1989). Love’s executioner and other tales of psychotherapy. New York NY: Harper Perennial.Google Scholar
  87. Yalom, I. D. (1999). Momma and the meaning of life: Tales of psychotherapy. New York: Perennial.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Louis Hoffman
    • 1
  • Lisa Vallejos
    • 1
  • Heatherlyn P. Cleare-Hoffman
    • 2
  • Shawn Rubin
    • 3
  1. 1.School of Psychology and Interdisciplinary InquirySaybrook UniversityOaklandUSA
  2. 2.American School of Professional Psychology at Argosy UniversitySan Francisco Bay AreaUSA
  3. 3.School of Clinical PsychologySaybrook UniversityOaklandUSA

Personalised recommendations