Process and Outcome Research in Existential Psychotherapy

Abstract

This study aims to be a contribution to both process and outcome research regarding existential psychotherapy having used, respectively, Psychotherapy Process Q-Set and Clinical Outcomes in Routine Evaluation – Outcome Measurements. Four dyads in a total of 48 sessions were analysed. Results reflect upon the primacy of the therapeutic relationship. Key words Existential psychotherapy, process, outcome, research, dyads, PQS, CORE-OM. Research in existential psychotherapy Existential psychotherapy is considered an approach focused in relational and intersubjective processes (Spinelli, 2007). It is centred on the analysis of the personal existential meaning, and on one’s choice and responsibility for ones own life path (Cooper, 2003). Therefore, it provides a deeper understanding of human existence as emerging in contradictory tensions (Van Deurzen, 2002). A range of existential philosophers have influenced and defined an existential approach to therapy from different schools of thought. They include Martin Heidegger and Medard Boss (Daseinsanalysis), Viktor Frankl (logotherapy), Kirk Schneider and Rollo May (existential-humanistic approach), Emmy van Deurzen-Smith and Ernesto Spinelli (British school of existential therapy) and other influences from brief existential therapies (Cooper, 2003, 2010). It is believed that deeply humanising engagement within the therapeutic encounter is one of the common drivers for all existential schools (Cooper, 2015). Several authors have presented different theories and practical approaches for the existential practice, but none of these contributions were the subject of empirical validation and characterization (Cooper, 2003; Schneider & May, 1995; Spinelli, 2007; Sousa, 2014; Van Deurzen & Adams, 2011). Due to this diversity, and lack of empirical research in existential psychotherapy (Cooper, 2010; Holanda, 2006; Sousa, 2006), it is still not 79 clear how these multiple schools work from a practical point of view. Additionally, literature expresses the modus operandi for existential psychotherapy but there is no scientific evidence of what existential therapists do in their practice, contrasting with the general international therapy panorama (Lambert, Bergin & Garfield, 2004). Process and outcome research It has become accepted that psychotherapy is indeed beneficial and effective for the client (Lambert & Ogles, 2004; Lambert et. al., 2004; Wampold, 2001). More recently, research has started to focus on the elements that contribute to the success of therapy, however it remains an uncommon research topic. The main point is no longer validating the effectiveness of psychotherapy, but is rather understanding how the therapeutic change occurs. Research is then more centred on the outcome and the process itself (Orlinsky, Ronnestad & Willutzki, 2004, in Lambert et. al., 2004). Considering the existing gap in existential psychotherapy research (Cooper 2010, 2015; Holanda, 2006; Sousa, 2006; Van Deurzen, 2002), the current paper presents a study of the therapeutic process and its outcome in therapy. This research aims to qualitatively investigate and characterize the therapeutic processes of existential therapy dyads and connect these to outcome measures. Data may help us clarify which therapy processes occur in real existential psychotherapy interactions, and also the implications of those interactions in terms of the outcome.