in The Need For Gestalt Therapy Research. chapter two.
Eva K. Gold And Stephen G. Zahm in Handbook for Theory, Research, and Practice in Gestalt Therapy, Edited by Philip Brownell. First published 2008
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The Need for Gestalt Therapy Research
The Need For Gestalt Therapy Research. chapter two.
Eva K. Gold And Stephen G. Zahm in Handbook for Theory, Research, and Practice in Gestalt Therapy, Edited by Philip Brownell. This book first published 2008 by Cambridge Scholars Publishing
The gestalt approach to psychotherapy has not been well researched; (Page 39)
During gestalt therapy’s early years, there was an anti-intellectual bias among many gestalt therapy practitioners, partly in reaction to the perceived over intellectualization of the theory out of which it developed - psychoanalysis. (Page 39)
the developers of gestalt therapy, and many of its early adherents, tended toward creative unconventionality, non-conformity, and even anarchism in thought and political persuasion. (Page 39)
gestalt therapy is taught experientially, trainees experience the effectiveness of the approach first-hand, as they learn by observing and participating in workshop and training demonstrations, not primarily by reading about or discussing the theory in academic settings. (Page 39)
gestalt therapy reflects artful application of method informed by theory; it is more an improvisation than a scripted method that can be easily quantified and replicated. (Page 40)
over the past several decades there has been more writing on gestalt therapy theory and practice, (Page 40)
The research has often been narrowly focused and limited, (Page 40)
looking at a particular technique or method, (Page 40)
While these types of studies have proven the methods as effective as or more effective than the methods used for comparison, it is not possible to apply these results to the effectiveness of the gestalt approach generally, since no single technique represents gestalt therapy, or captures its essence. (Page 40)
these techniques are assessed out of context, (Page 40)
their meaning is limited. (Page 40)
existing research rarely includes a sound research design (Page 40)
Research protocols have also not always been sufficiently rigorous to meet today’s research standards (Page 40)
Over the last twenty years there has been a sea change in the entire field of psychology resulting in increasing emphasis on empirical validation of approaches to psychotherapy. (Page 40)
when health insurance companies (Page 40)
pay for psychotherapy provided by psychologists (Page 40)
move away from psychotherapy as an art and a relationship, to a medical-model focused on symptoms (Page 40)
the standard of "medical necessity" holds sway (Page 40)
what has generally been demonstrated, with rare exceptions, is that the different psychotherapy treatments produce about the same level of modest results. Of the treatments that have been studied, meaningful differences between the approaches are practically non-existent (Wampold 2001). (Page 41)
meta-analysis, it has been concluded that the list of empirically supported treatment approaches primarily reflects simply that these methods have been researched and others haven’t. (Page 41)
the limited research that has been done on gestalt therapy also shows that it is as effective as, or more effective than, other approaches it has been compared to, even using the limited criteria of symptom reduction—which is not gestalt therapy’s primary focus. (Page 41)
while there is no evidence that these approaches are more effective than others, adherents of the approaches are nevertheless quick to claim their status as empirically validated and to imply that other approaches are less valid. (Page 41)
As the field has shifted toward a medical model focused on symptom reduction, with requirements for empirical validation, there has been a lack of serious critique and questioning of what this means for the practice of psychotherapy. (Page 42)
leaving out the values of holistic approaches such as relationship, the person’s total well-being, and ability to function in the world (Page 42)
While gestalt therapy has survived and even thrived in some areas of Europe and South America (Page 42)
this shift threatens it, (Page 42)
This threat (Page 42)
is exacerbated by a parallel process. (Page 42)
Other contemporary approaches have adopted or incorporated aspects of gestalt therapy into their theory and practice, but have not recognized or given gestalt therapy credit for the original ideas they assimilated. (Page 42)
the self psychology/intersubjective approach, in its move away from traditional psychoanalysis, embraces a philosophical and theoretical viewpoint which had previously been developed in gestalt therapy (Page 42)
Intersubjective psychodynamic theory has conceptualized and articulated important aspects of psychotherapeutic treatment and human functioning in ways very similar to those previously described by gestalt theorists. (Page 42)
The therapeutic stance which is phenomenological and relational is also contained in gestalt therapy theory and method. (Page 42)
the importance many approaches now place on acceptance of what is, awareness, and (Page 42)
present moment (Page 43)
are, in fact, cornerstones of gestalt therapy theory and method. (Page 43)
also recently recognized what gestalt therapy has always understood, (Page 43)
trying to get rid of thoughts or feelings often only makes symptoms worse, adding another layer of "shoulds" and self criticism, and leaving the authentic energy of these disowned feelings and experiences unexplored and therefore poorly understood. (Page 43)
Steven Hayes, developer of acceptance and commitment therapy, or ACT (Hayes 2007) (Page 43)
writes that in the last ten years, a number of approaches to therapy have entered the mainstream based on the core idea that the more we struggle to change or get away from what our experience is, the more stuck we can become. (Page 43)
He lists mindfulness based cognitive therapy (MBCT), dialectical behavior therapy (DBT) and ACT, as all agreeing that a first step toward fundamental change is to embrace the present moment, even if the experience is difficult or painful. (Page 43)
these may be novel concepts to those steeped in the behavioral traditions, they sound like textbook descriptions of gestalt therapy! (Page 43)
Gestalt therapy is based less on abstract theory than on empirical observation of functioning and on self regulation, (Page 43)
there is no acknowledgement that other psychotherapy systems espouse these ideas and employ these same methods. (Page 43)
newly-minted. Some of these other approaches are among those that have been extensively researched and, as a result, sanctioned and supported while using principles and methods originally developed by gestalt therapy. (Page 43)
there are currently three processes that combined threaten its continued survival. (Page 44)
(1) The focus on empirical validation in the field as a whole, along with the fact that gestalt therapy has not been extensively or rigorously researched; (Page 44)
(2) the fact that other approaches are either borrowing from or discovering for themselves gestalt therapy’s concepts and methods; (Page 44)
(3) the fact that these other approaches do not acknowledge and credit gestalt therapy as the groundbreaking psychotherapy system it is in its implementation of these ideas and methods over the past sixty years. (Page 44)
gestalt therapy offers what these other approaches cannot. It provides a comprehensive theory and method based on understanding and observation of healthy human functioning—organismic self regulation. (Page 44)
Gestalt therapy is broad based, encompassing all aspects of human functioning: Cognitive, affective, behavioral, physical, and spiritual. (Page 44)
Gestalt therapy offers a methodology based on theory that is not a cookie cutter collection of techniques, but an experiential and experimental approach broadly encompassing many types of interventions, and a theoretical understanding of when and why these interventions are employed. (Page 44)
our understanding of the paradoxical theory of change and knowledge of what is required for closure of a unit of experience, lends depth to what some contemporary approaches describe with the slogan "change follows acceptance." (Page 44)
our understanding of the concept of so-called resistance and the yes-no of ego functioning, which clarifies why trying to forcefully change or eliminate feelings without a full phenomenological exploration is doomed to failure, (Page 44)
the essential issue here is not simply credit for gestalt therapy, but ensuring that the field and its practitioners continue to gain from the depth, creativity, strengths and benefits of the gestalt approach. (Page 45)
gestalt therapy researchers can contribute to the field by doing research that is actually meaningful and clinically relevant. (Page 45)
From our perspective, the craft of psychotherapy must be researched without reducing it to a set of specific procedures that can be mechanically taught, learned and applied as the current research paradigm dictates. (Page 45)
Orlinsky and Ronnestad (2005) (Page 45)
conclude that as a result the kinds of symptoms and methods academicians study have little relevance to the practitioner’s world. (Page 45)
Researchers have paid disproportionate attention to efficacy trials (where treatments are studied under controlled conditions and it is possible to have randomized control groups) (Page 45)
and not enough attention to effectiveness studies where treatments are looked at in "real world" conditions. (Page 46)
We must marry the rigor of scientific technology and empirical study to the wealth of methods and practices that gestalt therapy has developed. (Page 46)
how might we assess for such personal characteristics as authenticity, and how it relates to relationship satisfaction? (Page 46)
We might look at increased self awareness, its relationship to self criticalness and self compassion/self support. (Page 46)
Many of the newer therapies have returned to a focus on the individual, leaving out interpersonal elements. (Page 46)
Gestalt therapy maintains a focus on the centrality of the relationship, which lines up with research findings on the importance of the patient’s experience of the therapist and the relationship (Lambert and Barley 2001). (Page 46)
the next refinement for gestalt therapy could be a more detailed understanding of elements of the process involved in organismic self regulation; for example the figure formation/destruction process, awareness, assimilation and closure. (Page 46)
in every approach there is the person of the patient, the person of the therapist, the relationship that develops, and the level of empathy and rapport experienced by the patient. (Page 46)
While some theories may lack a focus on how to cultivate a healing relationship, gestalt therapy offers the dialogic relationship model as well as the skills for phenomenological investigation of the patient’s moment to moment experience of the therapist and the relationship, (Page 47)
and has much to offer in researching psychotherapeutic relationship dynamics. (Page 47)
Just as gestalt therapy once revolutionized the field of psychotherapy, it can also have an important and much needed impact on the current state of the field of psychotherapy research. (Page 47)
Resources (Page 47)
Hayes, S. (2007) Hello, Darkness. Psychotherapy Networker, September/ October, 2007. (Page 47)
Lambert, M. and D. Barley. 2001. Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy, 38 (4). (Page 47)
Orlinsky, D. and M. Ronnestad. 2005 How psychotherapist develop: A study of therapeutic work and professional growth. Washington: American Psychological Association. (Page 48)
Wampold, B. 2001. The great psychotherapy debate: Models, methods and findings. Mahwah: .Lawrence Erlbaum Associates (Page 48)