OJD  Vol.10 No.2 , May 2021
A Practical and Contemporary Model of Depression for Our Times—A Timeless Existential Clinician’s Perspective
Abstract: Problem: Depression is spreading rapidly worldwide. It has been forecasted to become the leading cause of disability worldwide by 2030, despite significant efforts and investments made to treat it. This menace has been exacerbated by the current COVID-19 pandemic which has triggered psychological distress and a surge in experiences of emptiness, sadness, and loss of meaning in life. Meaninglessness is one of the biggest threats of our times and is associated with depression and suicide. Gap: Existential psychotherapy has been neglected by researchers and remains misunderstood by the new generation of clinicians as an integrative approach to the prevention and treatment of depression, despite being one of the longest-established forms of psychotherapy. Objective: To address the above gap, recommendations, and emerging risks. Methodology: Review of theoretical and empirical findings, and autoethnography taking a scientist-practitioner stance. Results: A comprehensive, practical, integrated, flexible, and evidence-based model for the prevention and treatment of depression, and other internalizing disorders. Utility: This model will be of interest to researchers, practitioners, students of psychology, and the wider public. Conclusion/Recommendations: The model can be used to promote preventative factors in youth development, develop protective factors in high-risk populations with vulnerability to depression, and treat individuals experiencing depression or other internalizing disorders.
Cite this paper: Salicru, S. (2021) A Practical and Contemporary Model of Depression for Our Times—A Timeless Existential Clinician’s Perspective. Open Journal of Depression, 10, 54-89. doi: 10.4236/ojd.2021.102005.

[1]   American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Association.

[2]   Andolfi, M., Ellenwood, A. E., & Wendt, R. N. (1993). The Creation of the Fourth Planet: Beginning Therapists and Supervisors Inducing Change in Families. The American Journal of Family Therapy, 21, 301-312.

[3]   APA Presidential Task Force on Evidence-Based Practice (2006). Evidence-Based Practice in Psychology. American Psychologist, 61, 271-285.

[4]   Arkowitz, H. (1992). Integrative Theories of Therapy. In D. K. Freedheim, H. J. Freudenberger, J. W. Kessler, S. B. Messer, D. R. Peterson, H. H. Strupp, & P. L. Wachtel (Eds.), The History of Psychotherapy: A Century of Change (pp. 261-303). American Psychiatric Association.

[5]   Arslan, G., Yıldırım, M., Karataş, Z., Kabasakal, Z., & Kılınç, M. (2020). Meaningful Living to Promote Complete Mental Health among University Students in the Context of the COVID-19 Pandemic. International Journal of Mental Health and Addiction, 1-13.

[6]   Baldwin, M. (Ed.). (2013). The Use of Self in Therapy (3rd ed.). Routledge.

[7]   Barnes, H. E. (1959). Humanistic Existentialism: The Literature of Possibility. University of Nebraska Press.

[8]   Basescu, S. (1963). Existential Therapy. In A. Deutsch, & H. Fishman (Eds.), The Encyclopedia of Mental Health (Vol. 2, pp. 583-595). Franklin Watts.

[9]   Basile, B., Tenore, K., & Mancini, F. (2018). Investigating Schema Therapy Constructs in Individuals with Depression. Journal Psychology and Clinical Psychiatry, 9, 214-221.

[10]   Battista, J., & Almond, R. (1973). The Development of Meaning in Life. Psychiatry, 36, 409-427.

[11]   Baumeister, R. F. (1991). Meanings of Life. Guilford.

[12]   Baumeister, R. F., & Newman, L. S. (1994). How Stories Make Sense of Personal Experiences: Motives That Shape Autobiographical Narratives. Personality and Social Psychology Bulletin, 20, 676-690.

[13]   Baumeister, R. F., & Vohs, K. D. (2002). The Pursuit of Meaningfulness in Life. In C. R. Snyder, & S. J. Lopez (Eds.), Handbook of Positive Psychology (pp. 608-618). Oxford University Press.

[14]   Baumeister, R. F., & Wilson, B. (1996). Life Stories and the Four Need for Meaning. Psychological Inquiry, 7, 322-325.

[15]   Beck, A. T., Brown, G., Berchick, R. J., Stewart, B. L., & Steer, R. A. (1990). Relationship between Hopelessness and Ultimate Suicide: A Replication with Psychiatric Outpatients. American Journal of Psychiatry, 147, 190-195.

[16]   Bell, T., Montague, J., Elander, J., & Gilbert, P. (2020). “A Definite Fee-It Moment”: Embodiment, Externalisation and Emotion during Chair-Work in Compassion-Focused Therapy. Counselling and Psychotherapy Research, 20, 143-153.

[17]   Blair, L. (2010). A Critical Review of the Scientist-Practitioner Model for Counselling Psychology. Counselling Psychology Review, 25, 19-30.

[18]   Bloomgarden, A., & Mennuti, R. B. (2009). Therapist Self-Disclosure: Beyond the Taboo. In A. Bloomgarden, & R. B. Mennuti (Eds.), Psychotherapist Revealed: Therapists Speak about Self-Disclosure in Psychotherapy (pp. 3-15). Routledge/Taylor & Francis Group.

[19]   Bohart, A. C. (1999). Intuition and Creativity in Psychotherapy. Journal of Constructivist Psychology, 12, 287-311.

[20]   Bonebright, C. A., Clay, D. L., & Ankenmann, R. D. (2000). The Relationship of Workaholism with Work-Life Conflict, Life Satisfaction, and Purpose in Life. Journal of Counseling Psychology, 47, 469-477.

[21]   Boyraz, G., Waits, J. B., & Felix, V. A. (2014). Authenticity, Life Satisfaction, and Distress: A Longitudinal Analysis. Journal of Counseling Psychology, 61, 498-505.

[22]   Brassai, L., Piko, B. F., & Steger, M. F. (2011). Meaning in Life: Is It a Protective Factor for Adolescents’ Psychological Health? International Journal of Behavioral Medicine, 18, 44-51.

[23]   Buber, M. (1970). I and Thou (trans. W. Kaufmann). Charles Scribner’s Sons

[24]   Bugental, J. F. (1965). The Search for Authenticity: An Existential-Analytic Approach to Psychotherapy. Holt, Rinehart & Winston.

[25]   Bugental, J. F. (1976). The Search for Existential Identity. Jossey-Bass.

[26]   Bugental, J.F. (1987). The Art of the Psychotherapist. Norton.

[27]   Bulut, S. (2019) Socialization Helps the Treatment of Depression in Modern Life. Open Journal of Depression, 8, 41-47.

[28]   Cain, D. J. (2007). What Every Therapist Should Know, Be and Do: Contributions from Humanistic Psychotherapies. Journal of Contemporary Psychotherapy, 37, 3-10.

[29]   Cain, D. J. (2010). Humanistic Psychotherapies. In I. B. Weiner and W. E. Craighead (Eds.), The Corsini Encyclopedia of Psychology (pp. 1-4). John Wiley & Sons, Inc.

[30]   Cain, D. J. (2016). Toward a Research-Based Integration of Optimal Practices of Humanistic Psychotherapies. In D. J. Cain, K. Keenan, & S. Rubin (Eds.), Humanistic Psychotherapies: Handbook of Research and Practice (2nd ed., pp. 485-535). American Psychiatric Association.

[31]   Cain, D. J. (Ed.) (2002). Humanistic Psychotherapies: Handbook of Research and Practice. American Psychiatric Association.

[32]   Carson, D. K., & Becker, K. W. (2004). When Lightning Strikes: Reexamining Creativity in Psychotherapy. Journal of Counseling & Development, 82, 111-115.

[33]   Cashdan, S. (1988). Object Relations Therapy: Using the Relationship. Norton & Co.

[34]   Castiglioni, M., & Gaj, N. (2020). Fostering the Reconstruction of Meaning among the General Population during the COVID-19 Pandemic. Frontiers in Psychology, 11, Article ID: 567419.

[35]   Castonguay, L. G., & Goldfried, M. R. (1994). Psychotherapy Integration: An Idea Whose Time Has Come. Applied and Preventive Psychology, 3, 159-172.

[36]   Castonguay, L. G., Reid Jr., J. J., Halperin, G. S., & Goldfried, M. R. (2003). Psychotherapy Integration. In G. Stricker, T. A. Widiger, & I. B. Weiner (Eds.), Handbook of Psychology: Clinical Psychology (Vol. 8, pp. 327-366). John Wiley & Sons.

[37]   Cooper, M. (2008). Existential Psychotherapy. In J. L. Lebow (Ed.), Twenty-First Century Psychotherapies: Contemporary Approaches to Theory and Practice (pp. 237-276). Wiley & Sons.

[38]   Cooper, M. (2012). The Existential Counselling Primer: A Concise, Accessible and Comprehensive Introduction. PCCS Books.

[39]   Correia, E. A., Cooper, M., Berdondini, L., & Correia, K. (2016). Existential Psychotherapies: Similarities and Differences among the Main Branches. Journal of Humanistic Psychology, 58, 119-143.

[40]   Craig, M., Vos, J., Cooper, M., & Correia, E. A. (2016). Existential Psychotherapies. In D. J. Cain, K. Keenan, & S. Rubin (Eds.), Humanistic Psychotherapies: Handbook of Research and Practice (pp. 283-317). American Psychiatric Association.

[41]   Crumbaugh, J. C. (1968). Cross-Validation of Purpose-in-Life Test Based on Frankl’s Concepts. Journal of Individual Psychology, 24, 74-81.

[42]   Crumbaugh, J. C. (1977). The Seeking of Noetic Goals Test (SONG): A Complementary Scale to the Purpose in Life Test (PIL). Journal of Clinical Psychology, 33, 900-907.;2-8

[43]   Crumbaugh, J. C., & Maholick, L. T. (1964). An Experimental Study in Existentialism: The Psychometric Approach to Frankl’s Concept of Noogenic Neurosis. Journal of Clinical Psychology, 20, 200-207.;2-U

[44]   Damon, W., Menon, J., & Cotton Bronk, K. (2003). The Development of Purpose during Adolescence. Applied Developmental Science, 7, 119-128.

[45]   De Jong, E. M., Ziegler, N., & Schippers, M. C. (2020). From Shattered Goals to Meaning in Life: Life Crafting in Times of the COVID-19 Pandemic. Frontiers in Psychology, 11, Article ID: 577708.

[46]   Debats, D. L., Van der Lubbe, P. M., & Wezeman, F. R. (1993). On the Psychometric Properties of the Life Regard Index (LRI): A Measure of Meaningful Life: An Evaluation in Three Independent Samples Based on the Dutch Version. Personality and Individual Differences, 14, 337-345.

[47]   Deci, E. L., & Ryan, R. M. (1995). Human Agency: The Basis for True Self-Esteem. In M. H. Kernis (Ed.), Efficacy, Agency, and Self-Esteem (pp. 31-49). Springer.

[48]   Deci, E. L., & Ryan, R. M. (2008). Self-Determination Theory: A Macrotheory of Human Motivation, Development, and Health. Canadian Psychology/Psychologie Canadienne, 49, 182-185.

[49]   Dewan, C. J. (2006). Use of Self: A Primer Revisited. Clinical Social Work Journal, 34, 543-558.

[50]   Diener, E., Emmons, R.A., Larsen, R.J., & Griffin, S. (1985). The Satisfaction with Life Scale. Journal of Personality Assessment, 49, 71-75.

[51]   Diener, E., Fujita, F., Tay, L., & Biswas-Diener, R. (2012). Purpose, Mood, and Pleasure in Predicting Satisfaction Judgments. Social Indicators Research, 105, 333-341.

[52]   Ebert, D. D., & Cuijpers, P. (2018). It is Time to Invest in the Prevention of Depression. JAMA Network Open, 1, Article ID: e180335.

[53]   Ehlers, A., Maercker, A., & Boos, A. (2000). Posttraumatic Stress Disorder Following Political Imprisonment: The Role of Mental Defeat, Alienation, and Perceived Permanent Change. Journal of Abnormal Psychology, 109, 45-55.

[54]   Elliott, R, Watson, J. C. Timulak, L., Sharbanee, J., Barkham, M., & Lutz, W., Castonguay, L. (Eds.) (2021) Research on Humanistic-Experiential Psychotherapies: Updated Review. In Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change (7th ed.). Wiley. (In Press)

[55]   Elliott, R., Greenberg, L. S., Watson, J., Timulak, L., & Freire, E. (2013). Research on Humanistic-Experiential Psychotherapies. In M. J. Lambert (Ed.), Bergin & Garfield’s Handbook of Psychotherapy and Behavior Change (6th ed., pp. 495-538). Wiley.

[56]   Emmons, R. A. (2003). Personal Goals, Life Meaning, and Virtue: Wellsprings of a Positive Life. In C. L. M. Keyes, & J. Haidt (Eds.), Flourishing: Positive Psychology and the Life Well-Lived (pp. 105-128). American Psychiatric Association.

[57]   Epston, D. & White, M. (1992). Experience, Contradiction, Narrative and Imagination. Dulwich Centre Publications.

[58]   Erikson, E. H. (1968). Identity: Youth and Crisis. Norton & Co.

[59]   Etherington, K. (2001). Writing Qualitative Research—A Gathering of Selves. Counselling and Psychotherapy Research, 1, 119-125.

[60]   Frank, J. D., & Frank, J. B. (1993). Persuasion and Healing: A Comparative Study of Psychotherapy. Johns Hopkins University Press.

[61]   Frankl, V. E. (1955). The Doctor and the Soul: From Psychotherapy to Logotherapy. Vintage Books.

[62]   Frankl, V. E. (1959). Man’s Search for Meaning. Simon & Schuster.

[63]   Frankl, V. E. (1967). Psychotherapy and Existentialism: Selected Papers on Logotherapy. Washington Square Press.

[64]   Frankl, V. E. (1969). The Will to Meaning: Foundations and Applications of Logotherapy. New American Library.

[65]   Frankl, V. E. (1972). The Feeling of Meaninglessness: A Challenge to Psychotherapy. The American Journal of Psychoanalysis, 32, 85-89.

[66]   Friedman, N. (2005). Experiential Listening. Journal of Humanistic Psychology, 45, 217-238.

[67]   Friese, M., Messner, C., & Schaffner, Y. (2012). Mindfulness Meditation Counteracts Self-Control Depletion. Consciousness and Cognition, 21, 1016-1022.

[68]   Geller, J. D. (2003). Self-Disclosure in Psychoanalytic-Existential Therapy. Journal of Clinical Psychology, 59, 541-554.

[69]   Geller, S. M., & Greenberg, L. S. (2002). Therapeutic Presence: Therapists’ Experience of Presence in the Psychotherapy Encounter. Person-Centered & Experiential Psychotherapies, 1, 71-86.

[70]   Gendlin, E. T. (1996). Focusing-Oriented Psychotherapy. Guilford Press.

[71]   Goldfried, M. R., Burckell, L. A., & Eubanks-Carter, C. (2003). Therapist Self-Disclosure in Cognitive-Behavior Therapy. Journal of Clinical Psychology, 59, 555-568.

[72]   Goldman, B. M., & Kernis, M. H. (2002). The Role of Authenticity in Healthy Psychological Functioning and Subjective Well-Being. Annals of the American Psychotherapy Association, 5, 18-20.

[73]   Golomb, J. (1995). In Search of Authenticity: Existentialism from Kierkegaard to Camus. Routledge.

[74]   Greenberg, L. S. (2011). Emotion-Focused Therapy. American Psychiatric Association.

[75]   Greenberg, L. S., & Johnson, S. (1988). Emotionally Focused Therapy for Couples. Guilford Press.

[76]   Greenberg, L. S., & Pascual-Leone, A. (2006). Emotion in Psychotherapy: A Practice-Friendly Research Review. Journal of Clinical Psychology, 62, 611-630.

[77]   Greenberg, L. S., Watson, J. C., & Lietaer, G. (Eds.). (1998). Handbook of Experiential Psychotherapy. Guilford Press.

[78]   Grencavage, L. M., & Norcross, J. C. (1990). Where Are the Commonalities among the Therapeutic Common Factors? Professional Psychology: Research and Practice, 21, 372-378.

[79]   Gunnell, D., Appleby, L., Arensman, E., Hawton, K., John, A., Kapur, N. et al. (2020). Suicide Risk and Prevention during the COVID-19 Pandemic. The Lancet Psychiatry, 7, 468-471.

[80]   Guttman, D. (1996). Logotherapy for the Helping Professional: Meaningful Social Work. Springer.

[81]   Harlow, L. L., Newcomb, M. D., & Bentler, P. M. (1986). Depression, Self-Derogation, Substance Use, and Suicide Ideation: Lack of Purpose in Life as a Mediational Factor. Journal of Clinical Psychology, 42, 5-21.;2-9

[82]   Harter, S., Marold, D. B., Whitesell, N. R., & Cobbs, G. (1996). A Model of the Effects of Perceived Parent and Peer Support on Adolescent False Self-Behavior. Child Development, 67, 360-374.

[83]   Harter, S., Waters, P. L., & Whitesell, N. R. (1997). Lack of Voice as a Manifestation of False Self-Behavior among Adolescents: The School Setting as a Stage upon Which the Drama of Authenticity Is Enacted. Educational Psychologist, 32, 153-173.

[84]   Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and Commitment Therapy: Model, Processes and Outcomes. Behaviour Research and Therapy, 44, 1-25.

[85]   Heidegger, M. (1962). Being and Time (trans. J. Maquarrie and E.H. Freund). Harper & Row.

[86]   Held, B. S. (2002). The Tyranny of the Positive Attitude in America: Observation and Speculation. Journal of Clinical Psychology, 58, 965-991.

[87]   Henretty, J. R., & Levitt, H. M. (2010). The Role of Therapist Self-Disclosure in Psychotherapy: A Qualitative Review. Clinical Psychology Review, 30, 63-77.

[88]   Hetrick, S. E., Parker, A. G., Hickie, I. B., Purcell, R., Yung, A. R., & McGorry, P. D. (2008). Early Identification and Intervention in Depressive Disorders: Towards a Clinical Staging Model. Psychotherapy and Psychosomatics, 77, 263-270.

[89]   Higgins, E. T. (1987). Self-Discrepancy: A Theory Relating Self and Affect. Psychological Review, 94, 319-340.

[90]   Higgins, E. T., Klein, R., & Strauman, T. (1985). Self-Concept Discrepancy Theory: A Psychological Model for Distinguishing among Different Aspects of Depression and Anxiety. Social Cognition, 3, 51-76.

[91]   Hill, C. E., & Knox, S. (2001). Self-Disclosure. Psychotherapy: Theory, Research, Practice, Training, 38, 413-417.

[92]   Hill, P. L., & Turiano, N. A. (2014). Purpose in Life as a Predictor of Mortality across Adulthood. Psychological Science, 25, 1482-1486.

[93]   Hoffman, L., Vallejos, L., Cleare-Hoffman, H. P., & Rubin, S. (2015). Emotion, Relationship, and Meaning as Core Existential Practice: Evidence-Based Foundations. Journal of Contemporary Psychotherapy, 45, 11-20.

[94]   Horney, K. (1951). Neurosis and Human Growth: The Struggle toward Self-Realization. Routledge.

[95]   House, R. (2007). The Be-Coming of a Therapist: Experiential Learning, Self-Education and the Personal/Professional Nexus. British Journal of Guidance & Counselling, 35, 427-440.

[96]   Husserl, E. (1965). Phenomenology and the Crisis of Philosophy. Harper & Row.

[97]   James W. (1890). The Principles of Psychology (Vol. 1). Henry Holt and Company.

[98]   Johnson, J. T., Robinson, M. D., & Mitchell, E. B. (2004). Inferences about the Authentic Self: When Do Actions Say More than Mental States? Journal of Personality and Social Psychology, 87, 615-630.

[99]   Joseph, S. J., Gonçalves, A. P., Paul, A., & Bhandari, S. S. (2020). Theoretical Orientation of a Range of Psychological Approaches to Address Mental Health Concerns during the COVID-19 Pandemic. Asian Journal of Psychiatry, 53, Article ID: 102221.

[100]   Joshi, C., Marszalek, J. M., Berkel, L. A., & Hinshaw, A. B. (2014). An Empirical Investigation of Viktor Frankl’s Logotherapeutic Model. Journal of Humanistic Psychology, 54, 227-253.

[101]   Kabat-Zinn, J. (1990). Full Catastrophe Living: Using the Wisdom of Your Mind and Body to Face Stress, Pain, and Illness. Delacorte.

[102]   Kasper, L. B., Hill, C. E., & Kivlighan Jr., D. M. (2008). Therapist Immediacy in Brief Psychotherapy: Case Study I. Psychotherapy: Theory, Research, Practice, Training, 45, 281-297.

[103]   Kernis, M. H. & Goldman, B. M. (2006). A Multicomponent Conceptualization of Authenticity: Theory and Research. Advances in Experimental Social Psychology, 38, 283-357.

[104]   Kiesler, D. J. (1988). Therapeutic Metacommunication: Therapist Impact Disclosure as Feedback in Psychotherapy. Consulting Psychologists Press.

[105]   King, L. A., Hicks, J. A., Krull, J. L., & Del Gaiso, A. K. (2006). Positive Affect and the Experience of Meaning in Life. Journal of Personality and Social Psychology, 90, 179-196.

[106]   Kinnier, R. T., Metha, A. T., Keim, J. S., Okey, J. L., Adler-Tabia, R., Berry, M., & Mulvenon, S. (1994). Depression, Meaninglessness, and Substance Abuse in “Normal” and Hospitalized Adolescents. Journal of Alcohol and Drug Education, 39, 101-111.

[107]   Kirkman, M. (1999). I Didn’t Interview Myself: The Researcher as Participant in Narrative Research. Annual Review of Health Social Science, 9, 32-41.

[108]   Kleftaras, G., & Psarra, E. (2012). Meaning in Life, Psychological Well-Being and Depressive Symptomatology: A Comparative Study. Psychology, 3, 337-345.

[109]   Klinger, E. (1977). Meaning & Void: Inner Experience and the Incentives in People’s Lives. University of Minnesota Press.

[110]   Kracen, A. C., & Bairdb, K. (2017). Exploring Influence and Autoethnography: A Dialogue between Two Counselling Psychologists. The European Journal of Counselling Psychology, 6, 162-173.

[111]   Krug, O. T. (2009). James Bugental and Irvin Yalom: Two Masters of Existential Therapy Cultivate Presence in the Therapeutic Encounter. Journal of Humanistic Psychology, 49, 329-354.

[112]   Kwon, P. (2000). Hope and Dysphoria: The Moderating Role of Defense Mechanisms. Journal of Personality, 68, 199-223.

[113]   Laing, R. D. (1967). The Politics of Experience and the Bird of Paradise. Penguin.

[114]   Lakey, C. E., Kernis, M. H., Heppner, W. L., & Lance, C. E. (2008). Individual Differences in Authenticity and Mindfulness as Predictors of Verbal Defensiveness. Journal of Research in Personality, 42, 230-238.

[115]   Längle, A., Orgler, C., & Kundi, M. (2003). The Existence Scale: A New Approach to Assess the Ability to Find Personal Meaning in Life and to Reach Existential Fulfillment. European Psychotherapy, 4, 135-151.

[116]   Leahy, R. L. (2002). A Model of Emotional Schemas. Cognitive and Behavioral Practice, 9, 177-190.

[117]   Leary, M. R. (2003). Interpersonal Aspects of Optimal Self-Esteem and the Authentic Self. Psychological Inquiry, 14, 52-54.

[118]   Lewinsohn, P. M., Rohde, P., Seeley, J. R., Klein, D. N., & Gotlib, I. H. (2000). Natural Course of Adolescent Major Depressive Disorder in a Community Sample: Predictors of Recurrence in Young Adults. American Journal of Psychiatry, 157, 1584-1591.

[119]   Liggins, J., Kearns, R. A., & Adams, P. J. (2013). Using Autoethnography to Reclaim the ‘Place of Healing’ in Mental Health Care. Social Science & Medicine, 91, 105-109.

[120]   Loevinger, J. (1993). Ego Development: Questions of Method and Theory. Psychological Inquiry, 4, 56-63.

[121]   Lopez, F. G., & Rice, K. G. (2006). Preliminary Development and Validation of a Measure of Relationship Authenticity. Journal of Counseling Psychology, 53, 362-371.

[122]   Lovibond, P. F., & Lovibond, S. H. (1995). The Structure of Negative Emotional States: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33, 335-343.

[123]   Lum, W. (2002). The Use of Self of the Therapist. Contemporary Family Therapy, 24, 181-197.

[124]   Luo, M., Guo, L., Yu, M., Jiang, W., & Wang, H. (2020). The Psychological and Mental Impact of Coronavirus Disease 2019 (COVID-19) on Medical Staff and General Public—A Systematic Review and Meta-Analysis. Psychiatry Research, 291, Article ID: 113190.

[125]   Madill, A., & Doherty, K. (1994). ‘So You Did What You Wanted Then’: Discourse Analysis, Personal Agency, and Psychotherapy. Journal of Community & Applied Social Psychology, 4, 261-273.

[126]   Mahrer, A. R. (1996). The Complete Guide to Experiential Psychotherapy. John Wiley & Sons.

[127]   Mahrer, A. R. (2011). Transformation: A Glimpse into the Future of How Change Will Come about. Howard Gontovnick Publications.

[128]   Marco, J. H., Alonso, S., & Baños, R. (2020). Meaning-Making as a Mediator of Anxiety and Depression Reduction during Cognitive Behavioral Therapy Intervention in Participants with Adjustment Disorders. Clinical Psychology & Psychotherapy, 28, 325-333.

[129]   Marsh, A., Smith, L., Piek, J., & Saunders, B. (2003). The Purpose in Life Scale: Psychometric Properties for Social Drinkers and Drinkers in Alcohol Treatment. Educational and Psychological Measurement, 63, 859-871.

[130]   Mascaro, N., & Rosen, D. H. (2005). Existential Meaning’s Role in the Enhancement of Hope and Prevention of Depressive Symptoms. Journal of Personality, 73, 985-1014.

[131]   Mascaro, N., & Rosen, D. H. (2006). The Role of Existential Meaning as a Buffer against Stress. Journal of Humanistic Psychology, 46, 168-190.

[132]   Maslow, A. H. (1968). Toward a Psychology of Being (2nd ed.). Van Nostrand Reinhold.

[133]   May, R. (1958). Contributions of Existential Psychotherapy. In R. May, E. Angel, & H. F. Ellenberger (Eds.), Existence: A New Dimension in Psychiatry and Psychology (pp. 37-91). Basic Books/Hachette Book Group.

[134]   May, R. (1969). Love and Will. Norton & Company.

[135]   May, R. (1981). Freedom and Destiny. Norton & Company.

[136]   May, R. (1983). The Discovery of Being. Norton & Company.

[137]   McAdams, D. P. (1996). Personality, Modernity, and the Storied Self: A Contemporary Framework for Studying Persons. Psychological Inquiry, 7, 295-321.

[138]   McGregor, I., & Little, B. R. (1998). Personal Projects, Happiness, and Meaning: On Doing Well and Being Yourself. Journal of Personality and Social Psychology, 74, 494-512.

[139]   McKnight, P. E., & Kashdan, T. B. (2009). Purpose in Life as a System That Creates and Sustains Health and Well-Being: An Integrative, Testable Theory. Review of General Psychology, 13, 242-251.

[140]   McLaughlin, K. A. (2011). The Public Health Impact of Major Depression: A Call for Interdisciplinary Prevention Efforts. Prevention Science, 12, 361-371.

[141]   Medlock, G. (2012). The Evolving Ethic of Authenticity: From Humanistic to Positive Psychology. The Humanistic Psychologist, 40, 38-57.

[142]   Mennin, D. S. (2006). Emotion Regulation Therapy: An Integrative Approach to Treatment-Resistant Anxiety Disorders. Journal of Contemporary Psychotherapy, 36, 95-105.

[143]   Moreno, J. L. (1977). Psychodrama (Vol. 1). Beacon House.

[144]   Morgan, J., & Farsides, T. (2009). Psychometric Evaluation of the Meaningful Life Measure. Journal of Happiness Studies, 10, 351-366.

[145]   Mørken, D. (2019). The Authenticity Scale as an Outcome Measure for Psychological Therapies. Doctoral Dissertation, University of Roehampton.

[146]   Ormel, J., Cuijpers, P., Jorm, A., & Schoevers, R. A. (2020). What Is Needed to Eradicate the Depression Epidemic, and Why. Mental Health & Prevention, 17, Article ID: 200177.

[147]   Pennebaker, J. W., Kiecolt-Glaser, J. K., & Glaser, R. (1988). Disclosure of Traumas and Immune Function: Health Implications for Psychotherapy. Journal of Consulting and Clinical Psychology, 56, 239-245.

[148]   Perls, F. (1969). Gestalt Therapy Verbatim. Real People Press.

[149]   Perls, F., Hefferline, G., & Goodman, P. (1951). Gestalt Therapy. Julian Press.

[150]   Phillips, A. G., & Silvia, P. J. (2010). Individual Differences in Self-Discrepancies and Emotional Experience: Do Distinct Discrepancies Predict Distinct Emotions? Personality and Individual Differences, 49, 148-151.

[151]   Pinto, S., Soares, J., Silva, A., Curral, R., & Coelho, R. (2020). COVID-19 Suicide Survivors—A Hidden Grieving Population. Frontiers in Psychiatry, 11, Article ID: 626807.

[152]   Pos, A. E., & Greenberg, L. S. (2012). Organizing Awareness and Increasing Emotion Regulation: Revising Chair Work in Emotion-Focused Therapy for Borderline Personality Disorder. Journal of Personality Disorders, 26, 84-107.

[153]   Rafaeli, E., Maurer, O., & Thoma, N. C. (2014). Working with Modes in Schema Therapy. In N. C. Thoma & D. McKay (Eds.), Working with Emotion in Cognitive-Behavioral Therapy: Techniques for Clinical Practice (pp. 263-287). Guilford Publications.

[154]   Reger, M. A., Stanley, I. H., & Joiner, T. E. (2020). Suicide Mortality and Coronavirus Disease 2019—A Perfect Storm? JAMA Psychiatry, 77, 1093-1094.

[155]   Reker, G. T. (2005). Meaning in Life of Young, Middle-Aged, and Older Adults: Factorial Validity, Age, and Gender Invariance of the Personal Meaning Index (PMI). Personality and Individual Differences, 38, 71-85.

[156]   Reker, G. T., & Wong, P. T. P. (1988). Aging as an Individual Process: Toward a Theory of Personal Meaning. In J. E. Birren, & V. L. Bengtson (Eds.), Emergent Theories of Aging (pp. 214-246). Springer.

[157]   Reker, G. T., Peacock, E. J., & Wong, P. T. (1987). Meaning and Purpose in Life and Well-Being: A Life-Span Perspective. Journal of Gerontology, 42, 44-49.

[158]   Rogers, C. R. (1942). Counseling and Psychotherapy: Newer Concepts in Practice. Houghton Mifflin.

[159]   Rogers, C. R. (1951). Client-Centered Therapy: Its Current Practice, Implications, and Theory. Houghton Mifflin.

[160]   Rogers, C. R. (1961). On Becoming a Person: A Therapist’s Point of View of Psychotherapy. Constable.

[161]   Rogers, C. R. (1980). A Way of Being. Houghton Mifflin.

[162]   Rogers, J. R. (2001). Theoretical Grounding: The “Missing Link” in Suicide Research. Journal of Counseling & Development, 79, 16-25.

[163]   Rosen, H. (1996). Meaning-Making Narratives: Foundations for Constructivist and Social Constructionist Psychotherapies. In H. Rosen & K. Kuehlwein (Eds.), Constructing Realities (pp. 3-54). Jossey-Bass.

[164]   Rosenberg, M. (1965). Society and the Adolescent Self-Image. Princeton University Press.

[165]   Rowlands, J. (1995). Empowerment Examined. Development in Practice, 5, 101-107.

[166]   Ruffin, J. E. (1984). The Anxiety of Meaninglessness. Journal of Counseling & Development, 63, 40-42.

[167]   Ryff, C. D., & Singer, B. H. (1998). The Role of Purpose in Life and Personal Growth in Positive Human Health. In P. Wong & P. Fry (Eds.), The Human Quest for Meaning (pp. 213-236). Erlbaum.

[168]   Ryff, C. D., & Singer, B. H. (2008). Know Thyself and Become What You Are: A Eudaimonic Approach to Psychological Well-Being. Journal of Happiness Studies, 9, 13-39.

[169]   Samman, E., & Santos, M. E. (2009). Agency and Empowerment: A Review of Concepts, Indicators and Empirical Evidence. Oxford Poverty & Human Development Initiative (OPHI).

[170]   Sartre, J. P. (1973). Existentialism and Humanism (trans. P. Mairet). Methuen.

[171]   Satir, V., Banmen, J., Gerber, J., & Gomori, M. (1991). The Satir Model. Science and Behavior Books.

[172]   Scales, P. C., & Leffert, N. (2004). Developmental Assets: A Synthesis of the Scientific Research on Adolescent Development (2nd ed.). Search Institute Press.

[173]   Scheier, M. F., Wrosch, C., Baum, A., Cohen, S., Martire, L. M., Matthews, K. A. et al. (2006). The Life Engagement Test: Assessing Purpose in Life. Journal of Behavioral Medicine, 29, Article No. 291.

[174]   Scheiner, J., & Sleater, A. M. (2020). Impact of the Therapist’s “Use of Self”. The European Journal of Counselling Psychology, 8, 118-143.

[175]   Schippers, M. C., & Ziegler, N. (2019). Life Crafting as a Way to Find Purpose and Meaning in Life. Frontiers in Psychology, 10, Article No. 2778.

[176]   Schlegel, R. J., Hicks, J. A., Arndt, J., & King, L. A. (2009). Thine Own Self: True Self-Concept Accessibility and Meaning in Life. Journal of Personality and Social Psychology, 96, 473-490.

[177]   Schlegel, R. J., Vess, M., & Arndt, J. (2012). To Discover or to Create: Metaphors and the True Self. Journal of Personality, 80, 969-993.

[178]   Schneider, K. J. (2016). Existential-Integrative Therapy: Foundational Implications for Integrative Practice. Journal of Psychotherapy Integration, 26, 49-55.

[179]   Schneider, K. J., & Krug, O. T. (2010). Theories of Psychotherapy. Existential-Humanistic Therapy. American Psychiatric Association.

[180]   Schneider, K. J., & Leitner, L. M. (2002). Humanistic Psychotherapy. In M. Hersen, & W. Sledge (Eds.), Encyclopedia of Psychotherapy (pp. 949-957). Academic Press

[181]   Schneider, K. J., & May, R. (1995). The Psychology of Existence: An Integrative, Clinical Perspective. McGraw-Hill.

[182]   Schoeller, D. (2020). Authenticity as Emerging Meaning—Dialectics, Pragmatism, and Psychotherapy. In G. Brüntrup, M. Reder, & L. Gierstl (Eds.), Authenticity (pp. 73-91). Springer VS.

[183]   Schulenberg, S. E., Schnetzer, L. W., & Buchanan, E. M. (2011a). The Purpose in Life Test-Short Form: Development and Psychometric Support. Journal of Happiness Studies, 12, 861-876.

[184]   Schulenberg, S. E., Strack, K. M., & Buchanan, E. M. (2011b). The Meaning in Life Questionnaire: Psychometric Properties with Individuals with Serious Mental Illness in AN Inpatient Setting. Journal of Clinical Psychology, 67, 1210-1219.

[185]   Sedikides, C., & Skowronski, J. J. (1997). The Symbolic Self in Evolutionary Context. Personality and Social Psychology Review, 1, 80-102.

[186]   Sheldon, K. M. (2004). Integrity (Honesty/Authenticity). In C. Peterson, & M. E. P. Seligman (Eds.), Character Strengths and Virtues (pp. 249-272). Oxford University Press.

[187]   Sher, L. (2020). The Impact of the COVID-19 Pandemic on Suicide Rates. QJM: An International Journal of Medicine, 113, 707-712.

[188]   Shumaker, D. (2012). An Existential-Integrative Treatment of Anxious and Depressed Adolescents. Journal of Humanistic Psychology, 52, 375-400.

[189]   Siddique, S. (2011). Being In-Between: The Relevance of Ethnography and Auto-Ethno-aphy for Psychotherapy Research. Counselling and Psychotherapy Research, 11, 310-316.

[190]   Smith, J. L. (2004). Food, Health and Psychology: Competing Recipes for Research and Understanding. Journal of Health Psychology, 9, 483-496.

[191]   Snyder, C. R., Sympson, S. C., Ybasco, F. C., Borders, T. F., Babyak, M. A., & Higgins, R. L. (1996). Development and Validation of the State Hope Scale. Journal of Personality and Social Psychology, 70, 321-335.

[192]   Spinelli, E. (2006). The Value of Relatedness in Existential Psychotherapy and Phenomenological Enquiry. Indo-Pacific Journal of Phenomenology, 6, 1-8.

[193]   Spinelli, E. (2007). Practising Existential Psychotherapy: The Relational World. SAGE.

[194]   Stansfeld, S., & Rasul, F. (2007). Psychosocial Factors, Depression and Illness. In A. Steptoe (Ed.), Depression and Physical Illness (p. 19-49). Cambridge University Press.

[195]   Steger, M. F. (2010). The MLQ Description, Scoring, and Feedback Packet.

[196]   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.), The Human Quest for Meaning (pp. 165-184).

[197]   Steger, M. F., Frazier, P., Oishi, S., & Kaler, M. (2006). The Meaning in Life Questionnaire: Assessing the Presence of and Search for Meaning in Life. Journal of Counseling Psychology, 53, 80-93.

[198]   Steger, M. F., Mann, J. R., Michels, P., & Cooper, T. C. (2009a). Meaning in Life, Anxiety, Depression, and General Health among Smoking cessation patients. Journal of Psychosomatic Research, 67, 353-358.

[199]   Steger, M. F., Oishi, S., & Kashdan, T. B. (2009b). Meaning in Life across the Life Span: Levels and Correlates of Meaning in Life from Emerging Adulthood to Older Adulthood. Journal of Positive Psychology, 4, 43-52.

[200]   Stillman J. R. (2016). How Narrative Therapy Principles Inform Practice for Therapists and Helping Professionals: Illustrated with Vignettes. In V. Dickerson (Eds.), Poststructural and Narrative Thinking in Family Therapy (pp. 83-97). AFTA Springer Briefs in Family Therapy. Springer.

[201]   Stricker, G. (2003). The Many Faces of Self-Disclosure. Journal of Clinical Psychology, 59, 623-630.

[202]   Szasz, T. (2005). What Is Existential Therapy Not? Existential Analysis, 16, 127-130.

[203]   Tagini, A., & Raffone, A. (2010). The ‘I’ and the ‘Me’ in Self-Referential Awareness: A Neurocognitive Hypothesis. Cognitive Processing, 11, 9-20.

[204]   Taylor, S. E. (1983). Adjustment to Threatening Events: A Theory of Cognitive Adaptation. American Psychologist, 38, 1161-1173.

[205]   Thapar, A., Collishaw, S., Potter, R., & Thapar, A. K. (2010). Managing and Preventing Depression in Adolescents. BMJ, 340, Article No. c209.

[206]   Thompson, S. C., & Janigian, A. S. (1988). Life Schemes: A Framework for Understanding the Search for Meaning. Journal of Social and Clinical Psychology, 7, 260-280.

[207]   Tillich, P. (1952). The Courage to Be. Yale University Press.

[208]   Tsang, S. K., Hui, E. K., & Law, B. (2012). Positive Identity as a Positive Youth Development Construct: A Conceptual Review. The Scientific World Journal, 2012, Article ID: 529691.

[209]   Twenge, J. M., Catanese, K. R., and Baumeister, R. F. (2003). Social Exclusion and the Deconstructed State: Time Perception, Meaninglessness, Lethargy, Lack of Emotion, and Self-Awareness. Journal of Personality and Social Psychology, 85, 409-423.

[210]   Twenge, J. M., Cooper, A. B., Joiner, T. E., Duffy, M. E., & Binau, S. G. (2019). Age, Period, and Cohort Trends in Mood Disorder Indicators and Suicide-Related Outcomes in a Nationally Representative Dataset, 2005-2017. Journal of Abnormal Psychology, 128, 185-199.

[211]   Vallerand, R. J. (2008). On the Psychology of Passion: In Search of What Makes People’s Lives Most Worth Living. Canadian Psychology, 49, 1-13.

[212]   van Deurzen, E. (2012). Existential Counselling & Psychotherapy in Practice. SAGE.

[213]   van Inwagen, P. (1983). An Essay on Free Will. Oxford University Press.

[214]   Vanhooren, S. (2019). Struggling with Meaninglessness: A Case Study from an Experiential-Existential Perspective. Person-Centered & Experiential Psychotherapies, 18, 1-21.

[215]   Volkert, J., Schulz, H., Brütt, A. L., & Andreas, S. (2014). Meaning in life: Relationship to Clinical Diagnosis and Psychotherapy Outcome. Journal of Clinical Psychology, 70, 528-535.

[216]   Wampold, B. E. (2012). Humanism as a Common Factor in Psychotherapy. Psychotherapy, 49, 445-449.

[217]   Wampold, B. E. (2015). How Important Are the Common Factors in Psychotherapy? An Update. World Psychiatry, 14, 270-277.

[218]   Wampold, B. E. (2008). Existential-Integrative Psychotherapy: Coming of Age [Review of the Book Existential-Integrative Psychotherapy: Guideposts to the Core of Practice, by K. J. Schneider, Eds.]. PsycCRITIQUES, 53.

[219]   Wang, Y., Kala, M. P., & Jafar, T. H. (2020). Factors Associated with Psychological Distress during the Coronavirus Disease 2019 (COVID-19) Pandemic on the Predominantly General Population: A Systematic Review and Meta-Analysis. PLoS ONE, 15, e0244630.

[220]   Ward, A. (2019). Character and Discomfort. Character and …, 5, 2-8. Wendt Center for Character Education, University of Dubuque.

[221]   Waterman, A. S. (1990). The Relevance of Aristotle’s Conception of Eudaimonia for the Psychological Study of Happiness. Theoretical & Philosophical Psychology, 10, 39-44.

[222]   Welling, H. (2005). The Intuitive Process: The Case of Psychotherapy. Journal of Psychotherapy Integration, 15, 19-47.

[223]   Whisman, M. A., & Kwon, P. (1993). Life Stress and Dysphoria: The Role of Self-Esteem and Hopelessness. Journal of Personality and Social Psychology, 65, 1054-1060.

[224]   White, M. & Epston, D. (1990). Narrative Means to Therapeutic Ends. W.W. Norton.

[225]   White, M. (1995). Re-Authoring Lives. Dulwich Centre Publications.

[226]   Williams, D. C., & Levitt, H. M. (2007). Principles for Facilitating Agency in Psychotherapy. Psychotherapy Research, 17, 66-82.

[227]   Winnicott, D. W. (1960). Ego Distortion in Terms of True and False Self. In The Maturational Process and the Facilitating Environment: Studies in the Theory of Emotional Development (pp. 140-152). International Universities Press.

[228]   Winnicott, D. W. (1965). The Maturational Processes and the Facilitating Environment: Studies in the Theory of Emotional Development. International Universities Press.

[229]   Winston, C. N. (2015). Points of Convergence and Divergence between Existential and Humanistic Psychology: A Few Observations. The Humanistic Psychologist, 43, 40-53.

[230]   Wong, P. T. (1998). Implicit Theories of Meaningful Life and the Development of the Personal Meaning Profile. In P. T. P. Wong & P. S. Fry (Eds.), The Human Quest for Meaning: A Handbook of Psychological Research and Clinical Applications (pp. 111-140). Lawrence Erlbaum.

[231]   Wong, P. T. (2010). Meaning Therapy: An Integrative and Positive Existential Psychotherapy. Journal of Contemporary Psychotherapy, 40, 85-93.

[232]   Wong, P. T. (2011). Meaning-centered counseling and therapy: An integrative and comprehensive approach to motivational counseling and addiction treatment. In W. M. Cox, & E. Klinger (Eds.), Handbook of motivational counseling: Goal-based approaches to assessment and intervention with addiction and other problems (pp. 461-487). John Wiley & Sons.

[233]   Wood, A. M., Linley, P. A., Maltby, J., Baliousis, M., & Joseph, S. (2008). The Authentic Personality: A Theoretical and Empirical Conceptualization and the Development of the Authenticity Scale. Journal of Counseling Psychology, 55, 385-399.

[234]   Woźniak, M. (2018). “I” and “Me”: The Self in the Context of Consciousness. Frontiers in Psychology, 9, Article No. 1656.

[235]   Yalom, I. D. (1980). Existential Psychotherapy. Harper Collins.

[236]   Yalom, I. D. (1991). Love’s Executioner and Other Tales of Psychotherapy. Penguin.

[237]   Yalom, I. D. (2002). The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients. HarperCollins.

[238]   Yapko, M. (2009). Depression Is Contagious: How the Most Common Mood Disorder Is Spreading around the World and How to Stop It. Simon & Schuster.

[239]   Zghoul, T., Cowen, P. J., & Harmer, C. J. (2019). A Perspective: From the Serotonin Hypothesis to Cognitive Neuropsychological Approaches. In M. D. Tricklebank, & E. Daly (Eds.), The Serotonin System (pp. 95-104). Academic Press.

[240]   Zika, S., & Chamberlain, K. (1987). Relation of Hassles and Personality to Subjective Well-Being. Journal of Personality and Social Psychology, 53, 155-162.

[241]   Ziv-Beiman, S. (2013). Therapist Self-Disclosure as an Integrative Intervention. Journal of Psychotherapy Integration, 23, 59-74.

[242]   Ziv-Beiman, S., & Shahar, G. (2016). Therapeutic Self-Disclosure in Integrative Psychotherapy: When Is This a Clinical Error? Psychotherapy, 53, 273-277.