Gestalt therapy research

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The Gestalt therapy research concerns studies (experimental and statistical studies, case studies, etc.) on the effectiveness of Gestalt therapy as psychotherapy. It is part of general psychotherapy research .

Research results on the effectiveness of Gestalt therapy

There are different studies that show the effectiveness of gestalt therapy for improving the symptoms of affective disorders such as depression, anxiety and phobias. A positive effect on personality disorders was also shown , both in inpatient and outpatient settings. Furthermore, a positive effect for patients with psychosomatic and functional disorders could be shown. In the relatively short time of 20 weeks, gestalt therapy intervention was also able to demonstrate an improvement in trauma-related and general symptoms in adults who were abused and abused in childhood . Very good results were shown with gestalt therapeutic intervention in the case of educational difficulties. Results on inpatient treatment of substance abuse are less clear. Although good successes were achieved here with an abstinence rate of 70 percent after nine years, it is unclear to what extent the inpatient, remote setting and social and work therapy contributed to this.

In two extensive catamnestic studies, once on 431 outpatients and once on 800 inpatients who were treated with gestalt therapy for between 10 and 190 weeks and 2/3 suffered from mood disorders , the following result was shown:

  • 63 percent of the patients stated in the follow-up examination that they had achieved their therapy goals.
  • 83 percent of the patients stated that their original symptoms had decreased and
  • 73 percent reported a moderate to strong reduction in symptoms.
  • 4 percent of patients reported no positive change in clinical symptoms,
  • 5 percent said their symptoms were getting worse.

90 percent of all patients reported that gestalt therapy taught them how to deal successfully with recurring symptoms. Half of the patients who were taking psychotropic drugs at the time of therapy had discontinued them at the time of the follow-up. 76 percent of the patients who had taken tranquilizers had stopped taking them at the time of the follow-up. Klaus Grawe , Ruth Donati and Friederike Bernauer (1994, p. 115) assume that gestalt therapy has significantly positive results in a wide range of changes in clinically relevant disorders. The authors also note that it cannot be ruled out that these effects are not due to other than gestalt therapy interventions.

Leslie S. Greenberg has carried out over 20 studies on the effectiveness of Gestalt therapy in over 25 years. "Greenberg was able to demonstrate the importance of the experience-activating power of gestalt therapeutic intervention types for the healing process over longer periods of time, entire therapies and catamenial follow-up surveys."

In a more recent study (2013) of humanistic psychotherapy methods in the USA, the humanistic therapy methods are on the whole tied with cognitive behavioral therapy in terms of effect size. The smaller group of gestalt therapy / emotion-focused therapy according to Leslie S. Greenberg even performed significantly better statistically than cognitive behavioral therapy.

Evidence-based Gestalt Therapy Research

The validity of the data collected in all psychotherapy studies should generally be discussed critically . Some problems arise in every therapy study, regardless of the therapeutic approach examined. Studies with insufficient effectiveness are probably not published in most cases. The picture of individual therapeutic approaches as well as of the therapy landscape itself is distorted without it being possible to discern the quantity and quality in which individual therapeutic approaches are distorted. A similar problem arises with catamnestic studies and those studies that evaluate before and / or during and after therapy. Often not all clients of a treatment group can be reached and it can be assumed that especially those clients who are dissatisfied with the success of the therapy are among those who do not appear in the follow-up data. Another problem is that therapists from a certain school usually prepare studies on their own school and there is therefore a bias in comparisons . This problem is also present in the much-cited analysis by Grawe, Donati and Bernauer from 1994, which is also used here. Although the analysis paints a differentiated, comprehensible picture of all the therapeutic directions examined, the team of authors' preferences for short, specifically target-oriented interventions that are most likely to be realized with behavioral therapy are reflected. On this basis, cognitive-behavioral approaches are most effective. The question of whether it is the only dimension can remain in space.

Another problem arises for Gestalt therapy. In contrast to psychoanalysis and behavioral therapy, Gestalt therapy was not originally founded and defined on its own, but rather in contrast to the other two main directions, especially psychoanalysis . Likewise, the methodological diversity could become a stumbling block with regard to validity. In the studies on Gestalt therapy compared by Uwe Strümpfel in 2006, this is shown by the fact that different studies examined different therapy concepts that are probably not easily comparable with one another, as various factors that can distort the result, such as Strümpfel 2006, p. 261 himself writes, were highly variable. The duration of therapy varied from 2 hours to 2 years; the setting was outpatient, inpatient, multimodal, individual or group therapy, therapy program, weekend marathon, weekly sessions or less frequent, depending on the study. The problem to be treated ranged from specific decision-making problems to serious psychiatric illnesses. The designation of what had been investigated and ultimately booked under gestalt therapy varied accordingly, without any further explanation of the procedure. In addition to therapies that came under the heading of gestalt therapy, programs with gestalt elements, experience-oriented and experiential therapy, and, in some cases, procedures that were vaguely described as humanistic, were examined. The conceptual, definitional and clinical fuzziness is likely to make the determination and operationalization of the individual variables, as well as the comparability of the studies, more difficult and thus affect the validity.

Because effectiveness in this context means "the multiple replicated, statistically significant improvement of entire treatment groups." However, difficulties with validity and operationalizability limit statistical significance and replicability.

From the perspective of 2014 it can be stated that the number of examinations and data on the effectiveness of gestalt therapy and humanistic psychotherapy procedures has increased significantly overall; so that Hartmann-Kottek assumes that gestalt therapy is now "internationally recognized as an evidence-based psychotherapy method".

Gestalt therapy in the study by Grawe, Donati and Bernauer from 1994

In 1994 Grawe, Donati and Bernauer (p. 116) assessed the situation of clinical research on gestalt therapy as inadequate to be able to make a reliable statement about its effectiveness. It should be noted, however, that this study from 1994 is now far back in time and no longer corresponds to the current status. For comparison, u. a. the studies by Strümpfel and the work of Greenberg mentioned above can also be used.

The scientific connection and clinical research show, according to Grawe et al. In 1994 there was still a long way off from cognitive-behavioral therapies, psychoanalytic therapy and talk therapy (p. 118, ibid.). However, the authors state that gestalt therapy could prove to be broadly effective in further research.

Compared to two other humanistic methods examined in the authors' meta-analysis, transaction analysis and psychodrama , Gestalt therapy achieved a broader spectrum of effects and a more reliable effect (p. 116, ibid.). The authors certify that both gestalt therapy and conversation psychotherapy have a broad spectrum of effects beyond the primary symptoms (p. 719, ibid.). In this area, according to Grawe's analysis, Gestalt therapy is superior to analytical therapy.

The authors Grawe, Donati and Bernauer, 1994, p. 714 ff. Have subjected cognitive-behavioral therapy, psychoanalytic therapy and conversation psychotherapy to a direct statistical comparison with regard to the size of the effect. Dialogue psychotherapy was included in the comparison as the only humanistic method, since only forms of therapy for which there was sufficient data were to be compared, which was not the case for Gestalt therapy at the time. They came to the conclusion that cognitive-behavioral therapy was superior to analytical therapy and talk psychotherapy in terms of its effects.

The superiority of cognitive-behavioral procedures over counseling psychotherapy could be justified by the fact that this procedure, due to its non-directive philosophy, is more indicated for clients and has the ability and motivation to deal with their difficulties in a relatively self-determined manner. In their opinion, there is also the less disorder-specific approach of counseling psychotherapy, in contrast to the differentiated disorder-specific approaches of behavioral therapy. However, due to the nature of mental disorders, this is likely to be only a small group of clients.

Furthermore, the authors claimed that empirically well-founded statements about the patient groups for whom this form of therapy is suitable and for whom it is less suitable are not possible for gestalt therapy (p. 115, ibid.). Based on the orientation of Gestalt therapy towards growth and self-realization of the client, it could be assumed that something similar to that of counseling psychotherapy also applies to Gestalt therapy. Namely, that they are indicated for clients who are motivated to therapy less negatively by specific suffering from symptoms, but rather by the desire to mature and grow in their personality. Or that gestalt therapy as part of a multimodal therapy together with other therapies contributes to the (post) maturation of severely disturbed clients.

Twenty years after the study by Grawe et al. These assumptions about Gestalt therapy and the procedures of humanistic psychotherapy can no longer be maintained, since a wealth of studies and data are now available for these forms of psychotherapy.

further reading

  • Stefan Blankertz, Erhard Doubrawa: Lexicon of Gestalt therapy. Hammer, Wuppertal 2005, ISBN 3-7795-0018-3
  • Reinhard Fuhr u. a. (Ed.): Handbuch der Gestalttherapie . Hogrefe, Göttingen 1999, ISBN 3-8017-1286-9
  • Hans Peter Dreitzel (and colleague by Brigitte Stelzer): Shape and process. A psychotherapeutic diagnosis or: the healthy person has little character. EHP, Bergisch Gladbach 2004, ISBN 3-89797-031-7
  • Lotte Hartmann-Kottek: Gestalt therapy . Springer, 2nd expanded edition, Berlin 2008, ISBN 3-540-75743-0
  • Lotte Hartmann-Kottek: Scientific supplementary data on Gestalt therapy , in: Hartmann-Kottek, L. (Ed.): Gestalt therapy - fascination and effectiveness , Gießen 2014, Psychosozial-Verlag, pp. 349–351.
  • Markus Hochgerner (ed.): Gestalt therapy . Facultas, Vienna 2004, ISBN 3-85076-643-8
  • Erving and Miriam Polster: Gestalt Therapy. Theory and practice of integrative gestalt therapy . Hammer, Wuppertal 2001, ISBN 3-87294-872-5
  • Uwe Strümpfel: Therapy of the feelings. Research findings on Gestalt therapy . EHP, Cologne 2006, ISBN 3-89797-015-5 . see also the book HP .: http://www.therapie-der-gefuehle.de
  • Grawe, Klaus; Donati Ruth; Bernauer, Friederike: Psychotherapy in Transition. From confession to profession. 3rd edition. Hogrefe. Göttingen 1994, ISBN 3-8017-0481-5
  • N. Gegenfurtner, R. Fresser-Kuby (Ed.): Emotions in focus. Gestalt therapists in dialogue with Leslie Greenberg. Edition Humanistic Psychology EHP 2006.
  • Validating shape. An Interview with Researcher, Writer, and Psychotherapist Leslie Greenberg by Leslie Greenberg and Philip Brownell; in: Gestalt !, 1/1997.
  • U. Grillmeier-Rehder, HE Jedliczka & G. Stemberger: Are Gestalt Theoretical Psychotherapy and Integrative Gestalt Therapy Effective? In: Phenomenal 1 (1) 2009, pp. 30–32, [1]

Individual evidence

  1. ↑ (cf. Strümpfel 2006, pp. 164–181.)
  2. ↑ (cf. Strümpfel 2006, pp. 182–202.)
  3. ↑ (Gegenfurtner / Fresser-Kuby 2006, p. 92)
  4. ↑ (Gegenfurtner / Fresser-Kuby 2006, p. 98)
  5. ↑ a b Hartmann-Kottek, L .: Scientific supplementary data on Gestalt therapy , in: Hartmann-Kottek, L. (Ed.): Gestalt therapy - fascination and effectiveness , Gießen 2014, Psychosozial-Verlag, p. 350.
  6. ↑ (cf. Perls, F. 1999, pp. 20-21, Polster, Polster 2003, pp. 19–20)
  7. ↑ (cf. Grawe, Donati and Bernauer 1994, p. 674)
  8. ↑ Hartmann-Kottek, L .: Scientific supplementary data on Gestalt therapy , in: Hartmann-Kottek, L. (Ed.): Gestalt therapy - fascination and effectiveness , Gießen 2014, Psychosozial-Verlag, p. 351.
  9. ↑ (cf. Grawe, Donati and Bernauer 1994, p. 137 ff.)
  10. ↑ Bergmann, J .: On the effectiveness of humanistic psychotherapy , in: Hartmann-Kottek, L. (Ed.): Gestalt therapy - fascination and effectiveness , Gießen 2014, Psychosozial-Verlag, pp. 325–348.