Working with Meaning in Life in Mental Health Care: A Systematic Literature Review of the Practices and Effectiveness of
In the past, when individuals had questions about meaning in life, they turned to their tribe, religion or philosophy, but nowadays many see therapists. This chapter systematically reviews the evidence base for meaning-centred therapy (MCT). Thirty differ
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ction In all times and cultures, individuals have most likely asked questions about what makes their life meaningful, for example: ‘What is important to focus my limited time and energy in life on?’ ‘How can I live a fulfilling life?’ ‘What do I really want?’ Although sceptical scholars criticise meaning in life as a tenuous construct, research shows that many individuals perceive there to be a larger direction and orientation in their daily lives, and when they lack this experience, they seem more prone to developing depression, anxiety and other psychological problems (cf. Shin & Steger, 2014). Although the answers to these questions differ between individuals, many people construct meaning socially in the context of their wider group, such as the traditional context of a tribe or religion (cf. Chao & Kesebir, 2013; Mikulincer & Shaver, 2013; Neimeyer, 2001; Stillman & Lambert, 2013). However, in our individualistic and secular age, individuals also search for answers inside themselves, focusing on what they see as their authentic true self (cf. Berman, 2009; Schulze, 1992/2005). Consequently, many have turned to therapists for their individual quest for meaning. Little is known about this new approach, that is, meaning-centred therapy (MCT). It can be asked how psychologically trained meaning-centred therapists support clients to construct a sense of meaning and how effective is their support. This chapter systematically reviews the practices of such therapists and examines their empirical evidence base. As will be described, meaning-centred therapists have traditionally steered away from standardisation and systematic research, as this would not do justice to the totality of the individual’s subjective experience; instead, MCT practitioners often base their practices on individual therapy experiences and
J. Vos, Ph.D. (*) Department of Psychology, University of Roehampton, Holybourne Avenue, London SW15 4JD, UK e-mail: [email protected] © Springer International Publishing Switzerland 2016 P. Russo-Netzer et al. (eds.), Clinical Perspectives on Meaning, DOI 10.1007/978-3-319-41397-6_4
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philosophy. However, it has recently been argued that systematic empirical research is important for pragmatic reasons such as receiving professional recognition and financial support; with this in mind, empirical MCT studies have been published in recent years (Vos, Cooper, Correia, & Craig, 2015). Therefore, this chapter is based on a systematic literature review of quantitative and qualitative studies on MCT, covering 52,220 citations and 60 trials in 3713 participants, as described elsewhere (Vos & Vitali, 2016). As this review revealed that some MCT therapists differ in their philosophies and practices, the current chapter starts with an overview of different types of MCT and how these differences have emerged. Subsequently, six fundamental clinical and aetiological assumptions that these schools have in common are described alongside their empirical evidence. This is followed by a review of evidence f
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