Existential Analysis 29.

1: January 2018

Exploring Learning Outcomes In

Existential Therapy
Anders Dræby Sørensen, Rosemary Lodge
& Emmy van Deurzen

Abstract
This study explores the lived experience of clients in existential therapy.
The research points to the value of the learning perspective for understanding
the outcomes of existential therapy. It facilitates a model of learning in
existential therapy to help us understand learning outcomes based on
learning processes and design.
Key Words
Existential, psychotherapy, therapy, learning, outcome, process, qualitative

Introduction and Research Context

Outcome research from the medical model
Following Wampold (2009), the medical meta-model has become dominant
to outcome research and evaluation on psychotherapy. According to this
model, psychotherapy is a clinical technology of treatment, and the objective
of psychotherapeutic intervention is to relieve or remove the symptoms
of psychological distress and inadequate reactions according to diagnostic
criteria or other clinical measurements. Thus, the medical model conceives
the results of psychotherapy in terms of a unique clinical outcome, measuring
healing and reductions in patients’ diagnosable symptoms.
According to Cooper (2008: p 16), most outcome research focuses on the
assessment of the general efficacy of psychotherapy in terms of clinical
outcome. These clinical guidelines are part of a growing trend to argue that
some approaches are more efficacious for certain forms of psychological
distress than other approaches (Cooper, 2008: p 37). The national health
authorities in Western countries use evidence-based assessments of the efficacy
of various kinds of psychotherapy for the development of clinical guidelines
for determining which therapies to recommend for the treatment of particular
forms of psychological distress (e.g. NICE 2004; Sundhedsstyrelsen, 2012).
The instrumental focus on clinical outcomes hinders a more nuanced
conception and evaluation of the outcome of psychotherapy by not taking
into account how clients experience the impact of different types of in a
broader sense. Furthermore, the medical model does not take into account
that different psychotherapeutic approaches include different forms of
practice and orientate themselves around different concerns, aims and

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types of objectives that may result in different ways in which clients

experience the outcome of psychotherapy. This therefore requires different
methods of investigation and research as well.
Even though existential therapies do not conceptualize themselves as
clinical technologies aiming for clinical outcomes, they tend to be evaluated
from within the medical model. Consequently, existential therapies are likely
to be considered as being less efficient than clinical psychotherapies such
as cognitive behavioural therapy as their full and unique impact is not being
considered. Furthermore, it leaves existential therapies with a problem in
terms of explaining and demonstrating what their actual outcomes are, as
they are having to speak in a language that is alien to their specific paradigm.

Outcome research from a learning model

It is possible to shed new light on the problem concerning the understanding
and evaluation of existential therapy by incorporating our understanding
of the continuity of the modality with educational and learning processes.
While clinical health technologies typically define their aim and objective
as a unique and measurable clinical outcome, in education it is common
to work with different types of learning outcomes relating to different
types of objectives. Learning outcomes are concerned with the achievements
of the learner rather than the intentions of the educator, as expressed in
the objectives of an educational effort (Moon, 2002; Adam, 2004).
We will use this insight into learning outcomes and educational objectives
in relation to existential therapy, because since the 1950s it has also been
customary to conceptualize the developmental changes that take place in a
client during psychotherapy as forms of learning. This is in spite of the fact
that almost no one has accepted the full implications of this perspective and
that most outcome research has not been conceptualized within this framework.
However, recently there have been a few efforts towards developing
methods for assessing outcomes in terms of learning that reflect changes
specific to individual clients. Thus, McLeod (2011) explains how current
qualitative research suggests that clients experience learning as part of the
process or outcome of psychotherapy. According to a study by Burnett and
Dorrsen (2000), it was possible to categorize participants’ experience of
counselling in terms of three learning areas: self; relationships with others;
and the process of learning and change. According to a study by Carey
and others (2007), it was possible to categorize participants’ experience
of psychotherapy in terms of three areas of change: feelings, thoughts and
actions. This change occurred by means of motivation, self-perception,
learning, therapeutic relationship and the relief of talking, as well as tools
and strategies. Yet this research did not study the experienced learning
outcomes of psychotherapy as it related to particular educational approaches
and objectives.

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Exploring Learning Outcomes In Existential Therapy

Existential therapy and learning

Therefore, this study will specifically explore the lived experience of the
outcome of existential therapy that does show the empirical and conceptual
basis for practice in terms of learning. According to Cooper (2009), existential
therapy includes various approaches to psychotherapy, and this study focuses
on the British School of Existential Analysis, now often referred to as the
existential-phenomenological school, which involves a special model for
what needs to be learned in therapy (e.g. Deurzen & Adams, 2016).
We will relate existential therapy to Colaizzi’s (1973, 1978) existential
phenomenological understanding of learning. As a supplement to programmed
learning as a measurable and quantifiable acquisition of knowledge and
techniques, Colaizzi posits the concept of genuine learning as an activity
in which the learner extracts the contents of material that gives him or her
a new meaning of reality. Thus, Colaizzi’s theory of genuine learning deals
with existential learning as a personally and bodily experienced restructuring
of the learner’s Being-in-the-World, through which their existence is changed.
Hence, the core of genuine learning content is meaning in relation to our
lives, and learning is a reflective and painful process that challenges our
current thinking and behaviour patterns, requiring us to make an existential
choice. Colaizzi also describes the genuine learning process as a movement
towards the authentic self that requires us to put something at stake to
restructure our world by existentially transforming our self and life, taking
responsibility for our own existence.
According to Cooper (2009), the British school has a diverse approach,
here represented by Deurzen, Cohn and Spinelli who tend to reject the
medical model of mental health and avoid viewing clients through clinical
categories and diagnoses. The existential approach stresses that life problems
are not manifestations of specific dysfunctions but expressions of diverse
difficulties in coming to terms with life’s challenges (Deurzen, 2008;
Spinelli, 2007; Cohn, 2009). We will argue that in various ways these
representatives of the Existential-Phenomenological school share the general
idea that the educational objective of existential therapy is that clients
learn skills for becoming more authentic, being aware of themselves and
reflecting on their actual existence. This involves learning skills for handling
difficulties, making choices and taking responsibility, living bodily and
resourcefully with engagement, courage and freedom in accordance with
their true values, beliefs and experiences. This educational objective is
consistent with Colaizzi’s understanding of genuine learning as an experiential
process, taking place at the level of an existential transformation of the
client’s self and life.
Learning in existential therapy is based on the establishment of a strong
relationship between therapist and client in a meeting that provides the
framework for creating a dialogue from which the client can learn to live

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more resourcefully and authentically (Deurzen & Adams, 2011: p 137;

Spinelli, 2007: p 59; Cohn, 2005: p 33, ch 5).
Facilitation of learning in existential therapy is based on an exploration
of the client’s world design or world views. According to Deurzen and
part of the Existential-Phenomenological school, there are four simultaneous
ways of Being-in-the-world in which the client experiences his or her
existence in relation to his- or herself, others, nature and the spiritual world
(Deurzen, 2008; Cohn, 2005). Spinelli identifies three substructures: the
self-construct, the other-construct and the world-construct (Spinelli, 2007:
p 33), thus leaving out the spiritual dimension.
The therapist assists the client in exploring the client’s existential
dimensions using questioning and a phenomenological method of exploration
for staying with the client’s experiences. Deurzen articulates the role of
the therapist as that of a mentor or an experienced teacher who is not
directive but rather assists the client in the process of living with
greater expertise, thereby encouraging the client in finding his or her own
direction in life (Deurzen, 2008: pp 10, 19-21). Cohn articulates the function
of the therapist in terms of helping, assisting, enabling, listening and
providing from an informed, personal and real role (Cohn, 2005: pp 24,
27, 37, 134). Spinelli highlights that the therapist must work through
presence, acceptance and immediacy from a position of un-knowing in
order to be non-judgemental, being with and for the client (Spinelli, 2007:
pp 59-64, 108-113).
Materials and Methods
Six Danish clients, having experienced existential therapy participated
in the study. They ranged in age between twenty-six to forty-six. The
study addressed the learning outcomes of a short-term experience of
existential therapy, of between twelve and fifteen sessions. In order to
clarify the importance of the choice of approach, the researcher only
recruited participants who had sought therapy voluntarily.
The researcher used a semi-structured interview with open-ended questions
as the method of research, designed to enable the participants to articulate
detailed individual experiences. The researcher developed an interview
guide which was inspired by the literature review, based on a phenomenological
understanding of learning in the therapeutic process, so as to be able to
elicit all the changes experienced by participants as result of the existential
therapy in which they had participated. This involved a focus upon
the participants’ own understanding of their learning, as they believed it
occurred to them (Broberg, 2000: ch 4; Colaizzi 1973: pp 45-46; Giorgi,
1989: p 100). Thus, the phenomenological perspective involved a learner-
centred focus on the participants lived experience of the outcome of the
therapeutic learning process.

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Exploring Learning Outcomes In Existential Therapy

All interviews were voice recorded using a digital recorder placed between
the researcher and participant. The research was based on a successful
research ethics application in line with the British Psychological Society’s
code of ethics and conduct. This involved obtaining written consent from
the participants and taking responsibility to protect the participants
from physical and mental harm. The researcher specifically considered
confidentiality, making all the interviews anonymous.
The study adopted the perspective of Interpretative Phenomenological
Analysis (IPA) in order to explore both the participants’ lived experience
from their perspective and a further investigation of what this experience
meant to them. The data analysis adopted the model for six-stage thematic
analysis, developed by Smith, Flowers & Larkin (2010), with the double
aim of identifying whether:
• there were any specific characteristics in the participants lived
experience of existential therapy
• there was compliance of the learning outcomes with the educational
objectives of existential therapy
Results
The results of the analysis were the finding of six master themes.

Master Theme 1
Motivation for therapy
The first master theme illustrated that all participants had varied yet real
motivations for going into therapy and based their decision on an experience
of mental discomfort or a wish for self-knowledge. The findings also
showed that choice of therapeutic approach or therapist did not play a
significant role in the decision to go into therapy.
The participants articulated initial hopes and wishes for a therapeutic
outcome of authenticity, in-depth self-exploration or improvement of their
mental state, closely related to their reasons for going into therapy. Most
participants expressed an initial or gradual expectation of a positive outcome
of therapy as insight and skills for self and life.

Master Theme 2
Learning outcome to do with self and life
The second master theme illustrated a major learning outcome from existential
therapy regarding self and life. The findings showed that, previous to
therapy, participants experienced a problematic self-relation or self-image,
a problem in following their own values or having a direction in life.
The most prominent learning outcome of existential therapy was a more
authentic, caring and valuing relation to oneself, closely related to a changed
self-image. Another major learning outcome was that of developing a

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better sense of personal life values, related to an experienced learning

outcome of greater engagement and satisfaction in life. These aspects were
followed by learning a more open and courageous approach to life, living
with freedom and uncertainty, learning a sense of direction in life with a
more engaged participation in the world. These findings matched the
participants’ initial wishes, hopes and expectation for a learning outcome
for life and self.

Master Theme 3
Learning outcome to do with thinking, acting and feeling
The third master theme illustrated a major learning outcome regarding
thinking, acting and feeling. The findings showed that participants articulated
a lived experience of previously lacking skills for coping with difficulties
and feelings of anxiety, taking responsibility and making choices.
The participants articulated a lived experience of learning skills for
coping with difficulties and making authentic choices. Furthermore, most
participants articulated the learning of skills to take responsibility, to react
calmly, to act from their own position in life and to think openly. These
findings are important, since the participants experienced previous difficulties
within these areas.

Master Theme 4
Learning outcome to do with relationships
The third master theme illustrated a final learning outcome to do with
relationships with others.
Most participants articulated the experience of a previous problematic
way of relating or a tendency to other-focus in relationships, closely related
to a previous lack of ability to be oneself and engage in mutual relationships.
All participants articulated the lived experience of learning skills for
engaging in mutual relationships and for being oneself in relationships.
Furthermore, most participants articulated learning to set limits while respecting
others in relationships. This learning outcome is important, because most
participants articulated a previous experience of lacking capabilities within
these fields, even though a learning outcome to do with relationships was
not a recurrent wish, hope or expectation amongst the participants.

Master Theme 5
Perception of therapy and therapist
The fifth master theme illustrated how the participants perceived the
educational role of the therapist, as well as the learning processes in
existential therapy and how they were brought about. The findings show
that participants experienced existential therapy as an in-depth and caring
learning space for transforming the client’s self through a learning process,

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teaching insight, courage and the valuing of life alongside acceptance of

the uncertainty of freedom in life.
This learning works as an exploration of the clients’ selves and lives,
through a dynamic of questioning, testing and reflecting, which followed
the clients’ agenda. Furthermore, this client-following learning process
worked as a meeting between therapist and client through a relational
dynamic, which had the quality of being caring, close and non-judging.
The learning process required that the client engaged in it to take ownership
of it. The therapist must take up the role of a companion for the client by
being with and for the client in his or her learning, while at the same time
taking the role of assisting the revealing of this learning through recognition
of the client.

Master Theme 6
Evaluation of learning outcome and learning process
The final master theme concerned an experience of existential therapy as
involving a positive and fulfilling learning outcome, through an intense
and demanding learning process, relating to the initial experiences of a
lack of well-being to do with the self and life and wishes for self-knowledge.
Moreover, the participants’ evaluation of the therapeutic relationship as
having a significant importance for the experience of learning in existential
therapy supported the findings of the relationship to the therapist as a crucial
dynamic in the process of learning. The participants’ evaluation of the
therapeutic approach as having significant importance also supported the
findings of existential therapy as a specific design for an in-depth learning
space for transformation of the self by acquiring skills and insights for life.
Discussion
The researcher summarized the discussion as a draft research model of
learning process and outcome in existential therapy, as well as a draft
research model of the learning framework. In this way, this study involves
both an emphasis on the learning outcomes and a corresponding attention
to the learning process and framework in existential therapy, generating
these outcomes.

1. Learning Process and Outcome in Existential Therapy

The first model regards three levels of learning process and learning
outcomes in existential therapy, following the discussion of master themes
one to four.

1.1 Motivational learning

According to Deurzen, clients can only benefit from existential therapy
if they go along with its basic assumptions (Deurzen, 2008: p 1). However,

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both Deurzen and Spinelli state that it is not helpful if the client adopts
the therapist’s implicit assumptions through blind imitation or the therapist
explains or helps reformulate the client’s experiences in theoretical terms
(Deurzen, 2008: p 2; Spinelli, 2006: p 122).
The participants tend to evaluate the existential approach as
important for their experience of learning in therapy, even though
active choice of therapeutic approach was not an aspect of their decision
to go into therapy. This suggests that motivation for choice of direction is
not part of the previous decision making but that motivation for direction
may be learned in therapy and may be part of the client’s decision
to remain.
Similar to most literature on psychotherapy, Deurzen, Cohn and Spinelli
more or less explicitly assume that clients’ motivation for beginning
existential therapy is based on experience of problems, distress, anxiety
or discomfort in life, underpinning the distinction between existential
therapy and existential coaching (Deurzen & Adams, 2011: p 11; Deurzen
& Hanaway, 2012; Spinelli, 2006: p 185 and 2010; Cohn, 2009: p 69).
However, the findings that half the participants from existential
therapy based their decision on a wish for self-knowledge may suggest
a challenge to the theoretical assumptions about the main motivators
for going into existential therapy. As the participants’ articulation of
motivators correspond with their experience of learning outcomes, the
findings may also suggest that participants tend to articulate their
initial decision of therapy in light of their experience of learning in
existential therapy.
Both Deurzen and Spinelli tend to articulate the importance of
letting the client tell the therapist about his or her concerns and
expectations regarding the process and outcome of therapy, and letting the
therapist tell the client about what to expect from therapy (Deurzen &
Adams, 2011: p 128; Spinelli, 2008: pp 99-101). Even though the choice
of the existential approach was not a recurrent theme, the findings show
how clients seem to have articulated and explored their initial wishes and
expectations for therapy in terms of its educational objectives and theoretical
assumptions.
In general, this study provides support for the assertions by Schweickhardt
and others (2009), as well as Carey and others (2007), that psychological
motivation is important for the client’s previous decision for going into
psychotherapy and matters for the process and outcome of psychotherapy.
Not fully accounted for in the literature, the research indicates that motivational
learning is an important dynamic in existential therapy. Thus, existential
therapy involves some kind of training of the clients to not only learn an
existential attitude for self and living but also to explore themselves with
an existential therapist.

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1.2 L earning in existential therapy about initial and previous experiences

in three domains
This study shows that participants commonly experienced the learning
outcomes of existential therapy in the three domains of self and life;
thinking, acting and feeling; and relationships with others, suggesting a
combination of the findings by Carey and others (2007), and Burnett and
Dorrsen (2000).
Research findings indicate that participants mainly articulate their previous
and initial experiences in terms of their lacks and difficulties in the three
domains, matching their experiences of their learning outcomes in the
same domains. Thus, this study does provide support for the assertion from
literature that existential therapy involves an educational focus on an
exploration of clients’ initial and previous experiences to do with difficulties
in living (Cohn, 2005; Deurzen, 2008; Deurzen & Adams, 2011; Spinelli,
2007). Consequently, existential therapy seems to be an educational design
for changing a client’s experience of living through a learning process that
involves recognition of these difficulties within the three domains of learning
as targets of change.

1.3 Learning outcomes in existential therapy in three domains

The finding of the experienced learning outcomes in the first domain to do
with self and life confirms the initial assumption that the educational focus
of existential therapy mainly concerns self and life. It also confirms that
existential therapy is not based on programmed learning of techniques and
knowledge, but relates to Colaizzi’s understanding of genuine learning,
involving an existential transformation of self and life (Colaizzi, 1973 and
1978). Moreover, the findings do suggest a match with the educational
objective of developing a more authentic self-relation with a higher self-
awareness, a better sense of personal values and skills for living with
courage, freedom and engagement. The findings especially support Deurzen’s
idea that existential therapy helps the clients set and follow their own
direction in life from a sense of autonomy (Deurzen & Adams, 2011: p 69).
They also suggest the significance of changing the self-image with more
valuing and caring relation to oneself. However, what is also striking about
the findings is that learning skills for being able to live in a bodily way is
an educational objective of existential therapy (e.g. Groth, 2001; Madison
& Gendlin, 2012), but not an experienced learning outcome. This could be
because no participants experienced any bodily challenges, that they are
implicit in other experiential dimensions, or that the actual practice of
existential therapy in this particular study ignored bodily experiences.
The finding of the experienced learning outcome in the second domain
of thinking, acting and feeling does match with the educational objective
of learning skills for making authentic choices and taking responsibility,

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as well as learning a more reflective way of thinking and relating to

difficulties. Furthermore, the finding of how participants experienced
becoming more capable of thinking and acting from their own limits, values
and position in life also demonstrates how existential therapy does relate
to genuine learning, involving an existential restructuring of one’s Being-
in-the-World and thereby of one’s way of thinking, acting and feeling
(Colaizzi, 1973, 1978).
The finding of the experienced learning outcome in the third domain of
relationships with others matches the educational objective of learning to
engage in mutual relationships with others and being oneself in relationships.
According to Deurzen, an important aspect of our relatedness to others is
that we want to engage with them while simultaneously needing to ‘establish
our separateness and our individuality’ (Deurzen & Adams, 2011: p 108).
Interestingly, participants did not explicitly articulate an experience of
learning to separate, which could be because learning to become authentic
does imply this experience or that existential practice ought to focus stronger
on separating.

2. Learning Framework of Existential Therapy

The second model regards two levels of the learning framework of existential
therapy, following the discussion of master themes fix and six. This
framework enables the modelling of learning processes that support the
learning outcomes.

2.1 Learning principles

From the research, we can show that existential therapy is an educational
framework for learning that involves four basic learning principles.

I. Demanding transformation of client’s self and life

Following Colaizzi, existential therapy does seem to consist of a facilitation
of genuine learning that involves an existential transformation of the
client’s self and life through a challenging and possibly painful process
(Colaizzi, 1973, 1978). The client cannot be part of this learning as a
passive processer of information, knowledge and techniques but must
engage actively and take ownership of a restructuring of his or her Being-
in-the-World, which might include experiences of uncertainty and anxiety.
By investing in this learning process, the client gains insight into self
and life and develops personal skills for living with a sense of freedom
and authenticity.

II. In-depth, client following and directional exploration

onsistent with theory, learning in existential therapy is based on an
C
in-depth exploration of self and life that is not directive but rather by

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following the client’s agenda. Learning requires that therapy does not
become a form of controlling or directing the client and does not attempt
to fix, categorize or advise the client. Research supports Deurzen’s
position, because even though therapy is not directive, it is directional
by assisting the clients in finding their own direction in life (Deurzen,
2008: pp 10, 19-21). Furthermore, learning is based on the client’s
perception of this space as caring and non-judgemental, which facilitates
the client’s openness and expands the depth of learning.

III. Exploring for changing client’s subjective understanding and Being-

in-the-world
As predicted with theory, from a phenomenological perspective, existential
therapy works through a process of exploration by which the client’s
subjective Being-in-the-world is transformed, reorganizing his or her
understanding of self, life and others, way of thinking, acting and feeling.
Following Gadamer’s (1989) hermeneutics, this discovering, developing
or revising of perspectives in the therapeutic conversation, enables a
renewed understanding of the whole that changes the client’s self-
understanding and Being.

IV. Questioning of client’s experiences

In agreement with a hermeneutic perspective, the dialogue is the most
central factor for learning, making existential therapy a kind of inquiry
between therapist and client that is based on an interplay of questioning
and answering (e.g. Gadamer, 1989: ch 4). Through dialogue, the therapist’s
and the client’s horizons are fused, enabling the co-creation of mutual
understanding that is specific to the dissolution of the client’s problems
in living.

2.2 The educational role of the therapist and the learning relationship
The four principles involve that learning in existential therapy requires
a conversation between two persons and that clients could not, on their
own, enable the creation of new understanding and restructuring of their
Being-in-the-world.
Research findings support the theoretical assumption that the learning
framework of existential therapy is based on the establishment of a strong
learning relationship between therapist and client. Even more than in theory,
the findings emphasize the importance of the client’s responsibility and
capacity for taking ownership as an essential part of the learning relationship.
They also support the assertion that learning in existential therapy does
not work by using specific therapeutic techniques and accentuates the
therapeutic learning relationship as a meeting. Thus, therapy involves the
creation of a community characterized as caring, close and non-judgemental.

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This coming together of client and therapist enables a secure space to be

created for the client’s openness and expression, facilitating in-depth learning
and transformation of the client’s self and life.
In this respect, research findings support the theoretical assumption
that the therapist must take on two active and explicit educational roles in
order to enable this mutual learning relationship by being with and for
the client. Furthermore, by suggesting the term ‘companion’ for one
educational role, the findings support the assertion that the therapist’s
educational role is not one of an advisor or directive teacher. Thus, the
therapist accompanies the client and invites the client to cooperate by
being a knowing, aware and engaged companion, supporting Deurzen’s
ideal of the wise therapist and calling for a certain modification of Spinelli’s
ideal of the unknowing therapist (Deurzen & Adams, 2011: p 34; Spinelli,
2007: pp 63-64).
The findings suggest the term ‘assistant revelator’ for the second educational
role, corresponding to previous research findings that it is important that
the therapist is able to validate the client’s experiences and has a non-
judgemental attitude (Oliviera, Sousa & Pires, 2012: pp 296-297). Honneth
(1996) describes how recognition in relationship gives the individual
confidence to develop identity and self-confidence, and the therapist’s
recognition of the client seems to be significant for the revelation that
opens and unfolds new possibilities for the client.
Conclusion
The study demonstrates an overall correspondence between the theoretical
design and educational objectives and the participants’ lived experience
of the learning process, outcome and framework. This may indicate that
existential therapy works according to its intentions. On the other hand,
the correspondence may also indicate that existential therapy involves
some kind of conceptual education of the client according to its theoretical
design. This indication does not only seem to support Deurzen’s claim
that clients can only benefit from existential therapy if they are able to
go along with its basic assumption (Deurzen, 2008: p 1). It also suggests
that existential therapy may be more directive than it intends to be and
that theory does not fully articulate this dimension of conceptual education.
The overall conclusion of the study is a strong argument for understanding
and evaluating the learning process and outcome of existential therapy
from a learning perspective:
Firstly, the study involves a suggestion for incorporating the idea of
motivational learning of the educational philosophy of existential therapy.
Hence, theory ought to include commitment of clients to the educational
framework and objectives of existential therapy in the initial phase
of therapy.

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Secondly, the educational design of existential therapy should involve

a thorough exploration of clients’ initial end previous experiences of
difficulties within the three domains of learning as a means to forming the
clients’ experiences of these difficulties as targets of change.
Thirdly, the specification of learning outcomes in three domains might
usefully correlate to theory for practitioners and trainees. These learning
outcomes help show a far more varied outcome of existential therapy on
behalf of the client and give a more comprehensive and nuanced understanding
of the results of existential therapy than the idea of clinical efficacy.
Moreover, Smail (1980) has pointed out that healing processes that occur
in psychotherapy might simultaneously be understood in terms of learning
processes. Thus, a learning perspective does not rule out a medical approach
to existential therapy but has the ability to include it in a broader frame
of reference and meaning.
Fourth, for Lave and Wenger (1991), to be able to participate in the
practice of existential therapy, one must be able to learn a certain repertoire
of skills and principles, and often these are not fully articulated. Thus,
the specification of the learning principles of existential therapy may
guide existential therapists to facilitate learning for clients as well as
guide the training of existential therapists. Furthermore, the specification
of the educational role of the therapist and the learning relationship in
existential therapy may serve to improve the therapists’ abilities to
facilitate learning for clients as well as improve the training of
existential therapists.

Dr. Anders Dræby Sørensen is a philosopher and a private practice existential

therapist and clinical supervisor. He teaches at the New School of Psychotherapy
and Counselling in London and is a lecturer at the University Extension at
the University of Copenhagen as well as at the University Extension at the
University of Aarhus. Sørensen is a research supervisor at the Danish School
of Education in Copenhagen and has published one hundred and sixty nine
books, articles, papers and book reviews.
E-mail: [email protected]
Dr. Rosemary Lodge is a senior lecturer at Regent’s University and has
experience in teaching and supervision (research and clinical) in addition
to course leadership and development. She is a BPS chartered and HCPC
registered existential counselling psychologist who has worked in a variety
of settings including charitable organisations, drug and alcohol services
and schools. Lodge has a private practice where she sees individuals,
couples and groups for therapy, and psychologists and therapists for both
clinical and research supervision. She also works in a secondary school
providing one-to-one counselling for adolescents aged eleven to eighteen.
E-mail: [email protected]

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Anders Dræby Sørensen, Rosemary Lodge & Emmy van Deurzen

Prof. Emmy van Deurzen is a philosopher, psychologist and existential

therapist. She directs her private practice Dilemma Consultancy in London
and is also Principal of the New School of Psychotherapy and Counselling
at the Existential Academy in London, both of which she founded with
Professor Digby Tantam in 1996. She is a Visiting Professor with Middlesex
University, for whom she directs several doctoral and masters programmes.
She developed a philosophical therapy based on existential-phenomenology,
which has provided a new departure for therapists who are interested in
the therapeutic search for value, meaning and purpose. Van Deurzen has
published fifteen books on existential therapy and the human condition.
E-mail: [email protected]
References
Broberg, A. (2000). Tools for Learners as Knowledge Workers. Umeå:
Umeå University
Burnett, P. & Dorssen, L. (2000). What do clients learn from
counselling? International Journal for the Advancement of Counselling.
22, 241-254
Carey, T. et al (2007). Psychological change from the inside out. Counselling
and Psychotherapy Research. 7, 178-87
Colaizzi, P. (1973). Reflection and Research in Psychology: A phenomenological
study of learning. Iowa: Kendall
Colaizzi, P. (1978). Psychological research as the phenomenologist views
it. In R. D. Valle & M. King (ed.) Existential-Phenomenological Alternatives
for Psychology. New York: Oxford University Press
Cooper, M. (2008). Essential Research Findings in Counselling and
Psychotherapy. London: Sage
Cooper, M. (2009). Existential Therapies. London: Sage
Deurzen, E. van (2008). Existential Counselling and Psychotherapy in
Practice. London: Sage
Deurzen, E. & Adams, M. (2011). Skills in Existential Counselling and
Psychotherapy. London: Sage
Deurzen, E. van & Hanaway, M. (eds.) (2012). Existential Perspectives
on Coaching. Hampshire & New York: Palgrave Macmillan
Gadamer, H-G. (1989). Truth and Method. London: Continuum
Giorgi, A. (1989). Learning and memory from the perspective of
phenomenological psychology. In R. Valle & S. Halling (eds.) Existential-
Phenomenological Perspectives in Psychology. NY: Plenum
Groth, M. (2001). The body I am: Lived body and existential change. In
E. Spinelli (ed). Embodied Theories. London: Continuum
Honneth, A. (1996). The Struggle for Recognition. UK: Polity Press
Lave, J. & Wenger, E. (1991). Situated Learning. Cambridge: Cambridge
University Press

62 Existential Analysis: Journal of The Society for Existential Analysis

6 Sorenson 049-063.indd 14 17/01/2018 00:11

Exploring Learning Outcomes In Existential Therapy

Madison, G. & Gendlin, E. (2012). Palpable existentialism. In L. Barnett

& G. Madison (eds.) Journal of the Society for Existential Therapy.
London: Routledge
McLeod, J. (2003). Qualitative Research in Counselling and Psychotherapy.
London: Sage
Moon, J. (2002). The Module and Programme Development Handbook:
A practical guide to linking levels, outcomes and assessment criteria.
London: Kogan
National Institute for Clinical Excellence (NICE) (2004). Clinical Guideline
for the Management of Anxiety. London: NICE
Oliviera, A., Sousa, D. & Pires, A. (2012). Significant events in existential
psychotherapy. The client’s perspective. Journal of the Society for
Existential Analysis. 23:2, 288-234
Schweickhardt, A. et al (2009). Psychotherapy motivation – factor analysis
and validity of a modified version of the Psychotherapy Motivation
Questionannire (FTPM). Psychotherapie, Psychosomatik, Medizinische
Psychologie. 59 (11), 401-408
Smail, D. (1980). Learning in psychotherapy. In P. Salmon (Ed.), Coming
to Know. London: Routledge
Smith, J. & Flowers, P. & Larkin, M. (2010). Interpretative Phenomenological
Analysis. London: Sage
Spinelli, E. (2007). Practicing Existential Psychotherapy. London: Sage
Spinelli, E. & Horner, C. (2010). An existential approach to coaching
psychology. In S. Palmer (ed.) Handbook of Coaching Psychology.
London: Routledge
Sundhedsstyrelsen (2012). Faglige Retningslinjer for Henvisning til
Psykolog. For patienter med let til moderat depression eller let til
moderat angst. Copenhagen: Sundhedsstyrelsen
Wampold, B. (2009). The Great Psychotherapy Debate. Abingdon: Routledge

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