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Logotherapy for clinical practice

  • Carrie Nassif Phd


Logotherapy is based on the meaning-focused existential philosophy of Viktor E. Frankl (1905-1997). Numerous mental health professionals have been inspired by his most popular book, Man's Search for Meaning; however, many are unfamiliar with the depth of Frankl's work. The purpose of this article is to discuss the tenets of logotherapy, including fundamental concepts, applicability and techniques, roles of the therapist, and assessment tools and new research findings. Logotherapy can readily be integrated with techniques that mental health professionals frequently use, and thus it has much to offer mental health professionals regardless of their theoretical orientation. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
University of Mississippi, Oxford
Knoxville, Iowa
Fort Hays State University
Diocese of Nevada
Logotherapy is based on the meaning-
focused existential philosophy of Viktor
E. Frankl (1905–1997). Numerous men-
tal health professionals have been in-
spired by his most popular book, Man’s
Search for Meaning; however, many
are unfamiliar with the depth of
Frankl’s work. The purpose of this arti-
cle is to discuss the tenets of logoth-
erapy, including fundamental concepts,
applicability and techniques, roles of
the therapist, and assessment tools and
new research findings. Logotherapy can
readily be integrated with techniques
that mental health professionals fre-
quently use, and thus it has much to
offer mental health professionals re-
gardless of their theoretical orientation.
Keywords: meaning, purpose in life,
logotherapy, Viktor Frankl, positive
Logotherapy is based on the existential con-
cepts of Viennese psychiatrist and philosopher
Viktor E. Frankl (1905–1997). Frankl chose the
term logotherapy based on the Greek word
“logos” as “meaning”— because his perspective
emphasizes the unique capacity of human beings
to perceive meaning. Many have been inspired by
Frankl’s most popular book, Man’s Search for
Meaning (Frankl, 2006; originally published in
English in 1959 as From Death-Camp to Exis-
tentialism), written over a 9-day period shortly
after his concentration camp liberation during
World War II (Hutzell, 2006; Klingberg, 2001).
The book contains a narrative of concentration
camp experiences and outlines some of the basic
elements of logotherapy. A sense of personal
life-meaning is critical to logotherapy, and Man’s
Search for Meaning is a prime example of how
people may reduce despair in severe circum-
stances by incorporating personal meaning
through attitudes, experiences, and behaviors.
Man’s Search for Meaning was written in 1945,
yet it was still rated as one of the top 10 books to
make a difference in the lives of American readers
as recently as the 1990s (Library of Congress,
1991). Russ Newman, American Psychological As-
sociation Executive Director for Practice, noted it to
be of particular relevance to psychologists after the
terrorist attacks of September 11, 2001 (Newman,
2002). The newest U.S. edition of the book (2006)
indicates that there are more than 12 million copies
in print. Despite its continued relevance, many men-
tal health professionals are not familiar with the
depth of Frankl’s work.
Frankl is credited with writing over 30 books.
Many were published originally in German, but
there have been translations into at least 32 lan-
guages. He published over 700 articles. An abbre-
viated version of Frankl’s vita was published by J. I.
Levinson in 2001 (Levinson, 2001). For more in-
formation about Frankl’s life and how it influenced
the formulation of logotherapy, such as his youth in
Vienna, correspondence with Freud and Adler, ex-
periences in concentration camps during World
War II, and his personal and professional develop-
ment thereafter, the interested reader is referred to
Frankl (1997b), Gould (1993), and Klingberg
(2001). The purpose of the current article is to
present various aspects of logotherapy, including
major tenets, applicability and judicious use of the
Stefan E. Schulenberg, Department of Psychology, Univer-
sity of Mississippi; Robert R. Hutzell, Knoxville, IA; Carrie
Nassif, Fort Hays State University; Julius M. Rogina, Diocese
of Nevada.
Correspondence regarding this article should be addressed to
Stefan E. Schulenberg, PhD, Department of Psychology, Uni-
versity of Mississipi, Oxford, MS 38677. E-mail: sschulen@
Psychotherapy Theory, Research, Practice, Training Copyright 2008 by the American Psychological Association
2008, Vol. 45, No. 4, 447–463 0033-3204/08/$12.00 DOI: 10.1037/a0014331
approach, therapist strategies, assessment-related is-
sues, and new research support and remaining
needs. Our intent is to provide an in-depth, yet
concise, orientation to logotherapy compiled from
often difficult-to-find publications (e.g., out-of-print
sources), incorporating recently translated texts and
current and forthcoming empirical findings. This
article represents an update as to logotherapy’s cur-
rent status in the United States, with emphasis on
logotherapy’s utility and accessibility to a broad
Meaning and Well-Being
A major reason that logotherapy has something
to offer mental health professionals across various
theoretical orientations has to do with the influence
of the meaning construct on human health and be-
havior. There is a growing basis for the relationship
between a sense of meaning and psychological and
physical well-being (Melton & Schulenberg, 2008;
Reker, 1994; Ryff, 2000; Ryff & Singer, 1998a,
1998b; Savolaine & Granello, 2002; Spiegel &
Fawzy, 2002; Zika & Chamberlain, 1992). For ex-
ample, meaning may contribute to an array of areas
related to wellness, including awareness of social
support, sense of identity and values, health-
promoting behaviors (motivation to follow
through), and stress inoculation (Ryff & Singer,
1998b; Savolaine & Granello, 2002). Moreover, in
a recent review of the literature, Melton and Schu-
lenberg (2008) noted that meaning is associated
with a range of outcomes, such as stable mood and
less psychological distress, more proactive and so-
ciable behavior, and favorable attitudes toward life
and the self. Meaning has clear significance to the
human condition. The concepts emphasized in
logotherapy are of interest to mental health profes-
sionals striving to find ways to help their clients
help themselves and are compatible with a variety
of existing theoretical orientations and the contem-
porary positive psychology movement.
Relationship to Other Therapies and
Positive Psychology
Several sources indicate that spirituality (in the
general sense of meaning, values, and purpose, as is
emphasized in logotherapy) is becoming increas-
ingly relevant in modern psychotherapy and medi-
cine (see DuBois, 2007, Mahoney, 2000, and
Savolaine & Granello, 2002), and there is increas-
ing evidence that spirituality is associated with pos-
itive health outcomes (Seeman, Dubin, & Seeman,
2003). The field of psychology has shown increased
interest of late not only in spirituality but also in
resilience and positive mental health (e.g., Emmons
& McCullough, 2004; Keyes & Haidt, 2003; Lopez
& Snyder, 2003; Snyder & Lopez, 2002). Logoth-
erapy has long emphasized the importance of mean-
ing, faith, hope, humor, and many other adaptive
constructs that have become a part of positive psy-
chology; thus there is increasing support for the
utility of logotherapy concepts to researchers and
clinicians. Frankl and other logotherapists have
done much clinical work in these areas, and this
existing work can readily be incorporated into positive
psychology, as well as other, specific paradigms.
Logotherapy is often regarded as a humanistic–
existential school of thought, but it has much in
common with other paradigms. Indeed, McMul-
lin (2000) noted that “logotherapy is one of the
precursors to cognitive therapy” (p. 31), and in
describing innovative techniques used in cogni-
tive restructuring therapy (specifically perceptual
shifting), he outlined many techniques that are
consistent with those practiced by logotherapists.
Particularly relevant examples of perceptual
shifting described by McMullin include bridging
techniques, with the “Hierarchy of Values
Bridges” exercise being a prime illustration of
how clients’ personally meaningful values hier-
archy may be used to shift from old, maladaptive
beliefs into new, more adaptive beliefs.
larly, the creative, active, and strengths-focused
aspects of logotherapy have parallels with con-
structive therapies, such as solution-focused or
narrative-focused therapies (Combs & Freedman,
1994; Furman & Ahola, 1994), in the encourage-
ment of a more positive outlook in relation to life
Frankl saw logotherapy, with its emphasis on
the meaning-dimension of human beings (often
termed the spiritual dimension in the broad sense
of the word) as an addition to other therapies
(Frankl, 1985, 1986, 1988, 2006), with the goal
of enhancing techniques as opposed to replacing
them. Simply put, logotherapy is intended to be
collaborative (Fabry, 1981; Kovacs, 1999), and it
has been explored in relation to a number of
Logotherapy techniques are described in a subsequent
section of this article. For additional information regarding
perceptual shifting and relevant examples, the reader is re-
ferred to McMullin (2000).
Schulenberg, Hutzell, Nassif, and Rogina
specific forms of therapy over the years, with
rational emotive behavior therapy (Hutchinson &
Chapman, 2005) and acceptance and commit-
ment therapy (Sharp, Schulenberg, Wilson, &
Murrell, 2004; Sharp, Wilson, & Schulenberg,
2004) being recent examples. Training in logoth-
erapy may benefit clinicians from a variety of
perspectives, given its congruence with many dif-
ferent methods.
Fundamental Tenets
The fundamental tenets of logotherapy have
been documented by Frankl in a number of
English-language texts. Available books include
the most recent edition of Man’s Search for
Meaning (Frankl, 2006) and the recent translation
of On the Theory and Therapy of Mental Disor-
ders: An Introduction to Logotherapy and Exis-
tential Analysis (Frankl, 2004). Additional
English-language texts include The Doctor and
the Soul: From Psychotherapy to Logotherapy
(Frankl, 1986), The Will to Meaning: Founda-
tions and Applications of Logotherapy (Frankl,
1988), The Unheard Cry for Meaning (Frankl,
1985), and Man’s Search for Ultimate Meaning
(Frankl, 1997a).
Described in the aforementioned texts, one
construct central to logotherapy is referred to as
the tri-dimensional ontology—the conceptualiza-
tion of human beings along three overlapping
dimensions: physical, psychological, and spiri-
tual (i.e., noological, meaning oriented). It is
commonly understood that human beings often
respond with conditioned or automatic reactions
(such as self-statements, behaviors, and emo-
tions) in the first two dimensions and that other
animals also function in the first two dimensions.
The third dimension is emphasized in logoth-
erapy as distinguishing human beings from other
animals. However, human beings do not have to
function in the third dimension (i.e., can behave
in conditioned and automatic ways). Functioning
in the third dimension often demands a percep-
tual shift away from the typical conditioned ad-
herence to peer group expectancies or mass ad-
vertising, for instance.
In addition to the tri-dimensional ontology,
logotherapy’s basic tenets assert that (a) human
life has meaning, (b) human beings long to ex-
perience their own sense of personal life mean-
ing, and (c) human beings have the potential to
experience life meaning under all circumstances.
Frankl held the position that opportunities to
respond—in action, experience, or attitude—
exist throughout an individual’s life, and when
the chosen response is consistent with the indi-
vidual’s personal values hierarchy, the individual
experiences the longed-for sense of life meaning.
Frankl held that each individual’s personal life
meaning incorporates reaching out to an overall
order to the universe, to other human beings, and
to other animals. Responses inconsistent with
one’s personal life meaning do still have objec-
tive impact; however, they do not provide the
individual a sense of life meaning. Oftentimes,
individuals are objectively successful according
to what others (e.g., peer groups, marketing com-
panies, and cultural ideals) might find important,
but they lack a sense of life meaning, leaving a
feeling of emptiness labeled existential vacuum.
Applicability to Mental Health Problems
In practice, logotherapy has application at each
of the dimensions of the human being (the tri-
dimensional ontology). Physiologically, logoth-
erapy is recognized for its efficacy in the reduc-
tion of despair in unavoidable suffering.
Psychologically, Frankl developed useful tech-
niques, notably paradoxical intention and dere-
flection, especially for problems originating in
anticipatory anxiety. From the spiritual sphere,
many people experience meaninglessness at
some point that is characterized by existential
vacuum (Frankl, 2006; Hutzell, 1990; Sahakian
& Sahakian, 1972). As such, individuals may feel
bored or apathetic, as if they are “just going
through the motions” of their lives (Frankl, 2006;
Hutzell, 1990). It is this feeling of emptiness that
can motivate people to respond to their circum-
stances, and it is their awareness of their personal
life meaning that can guide them in an objective
direction that they experience as full or satisfy-
ing. However, left unchecked, the feeling of emp-
tiness may lead to disturbances from a lack of
actualization of personal life meaning or from
conflicts of personally meaningful values (Frankl,
2006; Hutzell, 1990; Sahakian & Sahakian,
When the existential vacuum leads to distur-
bances, the most common problems that are pre-
dicted to fill the existential vacuum are violations
of social norms, distress symptoms, and
physiological/psychological addictions. Frankl
labeled these the mass neurotic triad and spoke
Logotherapy for Clinical Practice
of them as aggression, depression, and addiction
(Frankl, 2006; Hutzell, 1990). Although each of
these problems can originate also from the phys-
iological and psychological dimensions, when the
symptoms originate from a sense of meaningless-
ness, they can then be treated with therapy de-
signed to work particularly with discovering
personal life meaning. The idea that meaningless-
ness is associated with alcohol (and other drug
use) is well supported in the literature (Marsh,
Smith, Piek, & Saunders, 2003). The parallels
between logotherapy and the spiritual elements of
Alcoholics Anonymous have been discussed
(Holmes, 1991; Koster, 1991), and logotherapy
has been applied in the treatment of alcohol prob-
lems (Crumbaugh, 1980, 1981; Crumbaugh,
Wood, & Wood, 1980; Henrion, 2002; Hutzell,
In addition to drug and alcohol problems, logo-
therapy has been useful with depression, anxiety,
and psychoses, as well as despair associated with
incurable illnesses (see Fabry, 1994; Frankl,
2004; Lukas, 2000; Lukas & Hirsch, 2002).
Logotherapy has applicability in a growing num-
ber of areas, such as rehabilitation (Ososkie &
Holzbauer, 2004; Starck, 1982, 2003), mental
retardation/developmental disabilities work
(Hingsburger, 1989, 1990; Schulenberg, 2003a,
2003c), pastoral psychology (Graber, 2003;
Leslie, 1965; Welter, 1987), aging (Kimble,
2000), family therapy and relationship counseling
(Crumbaugh & Henrion, 2004; Lantz, 1993;
Winters, 2002), and daily life/work-related issues
(Crumbaugh, 1973; Pattakos, 2004).
Recent World Congresses on Logotherapy
have included colloquiums on incorporating
logotherapy into the treatment of specific diag-
noses of the Diagnostic and Statistical Manual of
Mental Disorders (4th ed., text rev.; DSM–IV–
TR; American Psychiatric Association, 2000).
These protocols are subsequently published in
The International Forum for Logotherapy. Exam-
ples of recent papers have included applications
with mood disorders (Henrion, 2004; Ungar,
2002), anxiety disorders (Rogina, 2002), and per-
sonality disorders (Rodrigues, 2004; Rogina,
2004; Rogina & Quilitch, 2006).
Judicious Use of the Approach
When applications of a particular theory or
technique are discussed, the question of when the
theory or technique is contraindicated often
arises. In other words, are there situations in
which logotherapy should not be used? There is
little in the logotherapy literature on this subject
because logotherapists do not tend to think in
these terms. Logotherapists consider that each
human being has internal resources, or strengths,
that may be applied in any given situation. Logo-
therapists work with clients on helping them to
identify and access these internal resources.
However, there are situations that arise that sig-
nificantly inhibit the ability of clients to identify
and access their internal resources. For example,
while the potential utility of logotherapy with
psychoses was noted previously, in extreme cases
in which individuals are experiencing severe psy-
chotic states and reality testing is poor because of
active hallucinations, delusional systems, or both,
symptoms must be managed via other methods
(e.g., medication) prior to application of logoth-
erapeutic principles. However, even in such
cases, logotherapy may be useful with friends and
family who are struggling in terms of how they
can assist their loved one. Moreover, in the above
instance, once symptoms are brought under con-
trol via other treatment, logotherapy is applicable
with regard to helping clients understand and
accept their diagnoses, work with mental health
professionals, and adhere to their treatment pro-
grams in spite of the fact that the logotherapy is
not expected to “cure” the psychosis. Thus, rather
than thinking in terms of contraindications, logo-
therapists typically think in terms of judicious use
of the approach, working in collaboration with
other strategies as necessary, to maximize the
chances of a positive treatment outcome on
the one hand and, on the other hand, to minimize
the despair that can be associated with situations in
which a positive outcome (cure) is not possible.
Logotherapeutic Strategies
The roles of the therapist. The roles of the
therapist in logotherapy include regarding clients
as fellow human beings, emphasizing their
uniqueness, teaching that they have some free-
dom to respond to their situations or problems,
and demonstrating to clients various techniques
and how they may be applied to their situations or
problems. When clients assert that they have no
freedom to respond, the therapist helps them to
search for their remaining freedom, plus encour-
ages them to take responsibility to respond to that
freedom through behaviors, experiences, or atti-
Schulenberg, Hutzell, Nassif, and Rogina
tude changes in ways that they find meaningful
and adaptive.
In regarding clients as equal human beings,
therapists set a high standard by including not
only their clients’ physiological and psychologi-
cal dimensions but also their spiritual dimen-
sions, in which responsibility, morality, and per-
sonal life meaning are possible. Modernizing a
quote of the German poet Goethe, Frankl (1967)
said, “If we take man as he is, we make him
worse; if we take him as he ought to be, we help
him become it” (p. 12; see also Fabry, 1981). The
logotherapist, Joseph Fabry, paraphrased it this
way: “As long as we treat human beings as ani-
mals that can be trained, and machines that can
be manipulated, we make them into animals and
machines. If we make them aware of the re-
sources of their human spirit we help them lift
themselves into their true humanness” (Fabry,
1981, p. 11). In other words, logotherapists afford
clients the dignity of expecting them to be capa-
ble as human beings in spite of the limitations of
their current situation or problem.
In logotherapy, the client is active and partic-
ipatory, retaining responsibility to alter maladap-
tive patterns and to actualize personal life mean-
ings (Lukas, 1979/1995). The therapist assists the
client in facilitating this process. The client is
encouraged to recognize the freedom he or she
has and to implement that freedom in order to
take the energy away from the problem or symp-
tom and, instead, to move in a less problematic,
and more personally meaningful, direction. The
therapeutic relationship is one of equality and
offering opportunities to clients rather than one of
superiority and “fixing” clients. As such, the ther-
apist helps clients to clarify and work toward
actions, experiences, and attitudes in which cli-
ents experience personal life meaning. The ther-
apist insists that choices are always available,
even if they are limited to choices among atti-
tudes (Lukas, 1979/1995).
Phases of logotherapy. When logotherapy is
conducted, oftentimes a series of four phases, or
steps, are followed (see Fabry, 1994, and Lukas,
1979/1995). The first step involves differentiation
of clients from their symptoms. Clients are more
than clusters of symptoms, and in logotherapy it
is imperative that they not overidentify with a
given diagnosis. They remain human beings with
the ability to overcome obstacles and experience
personal life meaning. The second step involves
attitude modification about the symptoms. Atti-
tudes are shifted away from overfocus on the
symptoms and shifted toward awareness of re-
maining options that are in keeping with what the
individual perceives as his or her personal life
meaning, in spite of the symptoms. Attitudes are
not forced upon clients (unless in severe cases
such as suicide); rather, in the process of working
with clients, a logotherapist facilitates the devel-
opment of adaptive attitudes that are derived
from each client’s perceived personal life mean-
ing (or personally meaningful values hierarchy).
What choices are available in response to a par-
ticular situation or problem? What directions are
most meaningful to a client? The third step in-
volves symptom reduction, which often occurs
automatically following successful completion of
modification of attitudes. At other times, specific
techniques for symptom reduction are incorpo-
rated (e.g., coping skills, self-efficacy tech-
niques). Once symptom separation has been
achieved, and more adaptive attitudes have been
discovered, clients sense that options are avail-
able, and symptoms become more manageable.
The final step involves maintenance of mental
health through future orientation and facilitation
of continued awareness of personal life meaning
and the resultant purpose or goals in life.
Well-known therapeutic techniques. Logoth-
erapy has yielded several specific, well-known
therapeutic techniques. They focus on heighten-
ing peoples’ awareness of their personal life
meaning (i.e., their personally meaningful values
hierarchy), facilitating goal development, living
responsibly, and making adaptive choices consis-
tent with personal life meaning (Hutzell, 1990).
Attitude modification, particularly facilitated
through Socratic dialogue (Fabry, 1994; Gutt-
mann, 1996; Hutzell, 1990; Lukas, 1979/1995;
Lukas & Hirsch, 2002), is the most often used
logotherapy technique. Socratic dialogue is a
technique whereby a therapist asks questions of
clients to facilitate internal exploration to dis-
cover personal life meanings, to explore how
these may be actualized, and to foster recognition
that choices toward these ends are always avail-
able. In the case of working with a client who
feels faced with an insurmountable problem for
which there is no solution, a logotherapist may
ask about responses to similar problems in the
past, seeking clues from the client as to person-
ally meaningful attitude modifications that may
have been used successfully to reduce the despair
of the unchangeable problem. For the client, such
Logotherapy for Clinical Practice
discussion prompts the rediscovery of a person-
ally meaningful hierarchy of values, thought pro-
cesses, and motivations that may be brought to
bear on the current situation. In addition to atti-
tude modification, well-known logotherapeutic
techniques that have been developed include par-
adoxical intention, dereflection, and logoanalysis.
Paradoxical intention is a technique that be-
havior therapists have empirically validated, that
Frankl developed independently in the 1920s
(Ascher, 1989; Fabry, 1982; Frankl, 1975; Lukas,
1986), and that was first published in 1939
(Frankl, 1939, 1975, 1978/1979). It has been use-
ful in cases involving recursive anxiety, such as
agoraphobia and public speaking anxiety (Ascher
& Schotte, 1999; Schotte, Ascher, & Cools,
1989; see also Schulenberg, 2003a). Components
of classical paradoxical intention, when con-
ducted by logotherapists, have been described
(Fabry, 1982; Frankl, 1975, 1985; Hutzell, 1990;
Lukas, 1982, 1986; Yoder, 1994) and include (a)
a nonmanipulative therapist– client partnership,
(b) ruling out of biological etiology, (c) educating
clients about paradoxical intention with regard to
what it is and how it works, (d) tailoring the
technique to the individual’s presenting com-
plaints, (e) participating in the fear state, while (f)
simultaneously incorporating humor to counter-
act anxiety. (In logotherapy, the spiritual
dimension—in this case through the use of
humor—is utilized to facilitate self-distancing to
allow attitude change and then behavior change.)
Dereflection (Frankl, 1975, 1985, 1988, 2004;
Hutzell, 1990; Lukas, 1986, 2000), as reported by
Frankl, appeared in the 1940s (in German), with
the first English-language appearance in 1952
(Frankl, 1952, 1975). It is known that, in some
cases, people focus on the possibility of a prob-
lem or a symptom with such intensity that they
create anticipatory anxiety that actually makes
the problem or symptom worse (Frankl, 2006;
Hutzell, 1990; Sahakian & Sahakian, 1972). The
point of dereflection is to reorient a client’s at-
tention away from the preoccupying problem or
symptom and refocus the attention instead onto
related, highly motivating areas of personal life
meaning (Frankl, 2006; Hutzell, 1990). The re-
sulting effect is typically a reduction of the an-
ticipatory anxiety associated with the symptom or
problem in question and thus a reduction in the
symptom or problem itself (Frankl, 2006; Hut-
zell, 1990; Sahakian & Sahakian, 1972). Dere-
flection is often a technique of choice when
working with sexual dysfunction (reorienting the
focus of an individual toward the pleasure of
one’s partner instead of one’s own physiological
success), and it has been argued that the influen-
tial work of W. H. Masters and V. E. Johnson in
relation to sexual problems validates Frankl’s
approach in this area (Frankl, 1952, 1975; Saha-
kian & Sahakian, 1972). Use of dereflection has
grown over the years such that it is used to help
clients respond to a variety of mental health dif-
ficulties when too much focus is placed on symp-
toms to the detriment of client strengths.
Another logotherapeutic technique, logoanaly-
sis (developed by Crumbaugh, 1973), is applied
to persons experiencing a lack of sense of per-
sonal life meaning (initially experienced as bore-
dom or apathy but with the potential to evolve
into violations of social norms, distress symp-
toms, and physiological and psychological addic-
tions). Logoanalysis offers a systematic process
of mental and written exercises to help individu-
als set a life direction and subsequent achievable
goals based on their personal life meaning. The
process lends itself well to self-help (Crumbaugh,
1973; Hutzell & Eggert, 1989; Hutzell & Jerkins,
1995) and small-group formats (Hutzell, 1983,
2002) and has yielded a variety of therapeutic
exercises. For example, the Meaning in Life
Evaluation scale (MILE; Crumbaugh & Hen-
rion, 2004; Henrion, 2001) was designed to
heighten an individual’s sense of personal life
meaning through awareness of their hierarchy
of personally meaningful values, by prompting
individuals to select from among 20 different
values via a paired-comparisons approach. Ex-
amples of values incorporated in the MILE
include friendship, acceptance, health, and so
forth. Of the 20 different values, the 5 highest
ranked by the paired-comparisons process are
then emphasized to foster meaningful goal set-
ting. The MILE facilitates active thinking and
prioritizing of values, as well as recognition as
to whether energy is being focused on the pur-
suits that are most meaningful in relation to the
participant’s values hierarchy.
Lesser-known logotherapy techniques. Many
other applications and techniques of logotherapy
have been developed that are not as widely known
as those described above. These techniques include
the Mountain Range Exercise (Ernzen, 1990; Schu-
lenberg, 2003c, 2004b), the Movies Exercise (Schu-
lenberg, 2003b; Welter, 1995), the Family Shoebox
Game (Lantz, 1993), use of stories and metaphors
Schulenberg, Hutzell, Nassif, and Rogina
(Moore, 1998; Schulenberg, 2003b; Welter, 1995),
and a variety of additional, assorted exercises de-
signed to clarify values and enhance meaning.
The initial idea for the Mountain Range Exer-
cise was noted by Frankl (see The Doctor and the
Soul, Frankl, 1986), and developed as an activity
by Ernzen (1990). A mountain range is drawn,
and the person completing the exercise places
people of importance to him or her (such as
friends or family members, authors, musicians,
and the like) on the various peaks. Participants
are asked what they share in common with the
individuals on their peaks, as well as whose
mountains they would like to be a part of. The
activity assists individuals in identifying posi-
tives in their lives, as well as in values clarifica-
tion. The activity is useful in either individual or
group therapeutic settings and has been used with
a variety of populations and treatment contexts,
such as people with alcohol-related problems,
psychiatric inpatients, and meaningful living
groups (Ernzen, 1990). It has also been used with
adolescent male sex offenders with mental retar-
dation (or developmental disabilities) and sexual
behavior problems as a means of building rapport
and discussing important treatment issues, such
as values and sexual offense histories (Schulen-
berg, 2003c, 2004b). Variations on the traditional
Mountain Range Exercise have also been pro-
posed. Pattakos (2004) suggested adapting the
Mountain Range Exercise to the work environ-
ment to clarify values and find meaning in em-
ployment via those people who have influenced a
particular individual’s professional development.
There are two components to the Movies Ex-
ercise (Schulenberg, 2003b; Welter, 1995), both
of which focus on facilitating awareness of per-
sonal life meaning. The first component prompts
an individual to develop a movie of his or her life,
focusing on the past up to the present time. The
second component is a movie from the present
into the future. These creative activities afford
opportunities to develop various movie aspects.
(Who will be in them? What actor or actors will
play the lead roles? What are the movies’ titles?
What kind of budgets will be available? What
will the movies be about, and what genre will
typify each film?) These various aspects are dis-
cussed in terms of the participant’s personally
meaningful values hierarchy, identity formation,
interpersonal relationships, and key experiences
in order to help clarify the participant’s sense of
personal life meaning.
In the Family Shoebox Game (Lantz, 1993),
the therapist presents a family with a shoebox,
tape, scissors, and magazines; the task is to ad-
here magazine pictures to the shoebox to repre-
sent family values and meanings. The outside of
the box is used for values and meanings that are
presented to people outside of the immediate
family, while the inside of the box is used for
values and meanings of particular importance to
the members of the immediate family. Lantz
(1993) argued that such tasks help families in two
primary ways: first, it gives family members a
clear task that requires communication about val-
ues and meanings that are important to the family
experience, and second, it provides the family
therapist with a means of observing family inter-
action patterns that may help or hinder a family’s
search for meaning and direction. An underlying
premise of Lantz’s (1993) applications of logo-
therapy to family therapy is that increased knowl-
edge of family values and meaning can serve to
stimulate healthy family interaction patterns,
which can, in cyclical fashion, further guide fam-
ily members toward an increased sense of values
and meaning and direction for the family as a
Logotherapists often use stories and metaphors
as one means of facilitating attitudinal change
(Moore, 1998; Schulenberg, 2003b; Welter,
1995). Frankl’s own life experiences in the con-
centration camps and his attitudinal stance to-
ward adversity (Frankl, 2006; Klingberg, 2001)
serve as one remarkable example. However, the
logotherapeutic literature is replete with stories
and metaphors that function as illustrations for
how one may adaptively deal with adversity.
Some of these stories are real-life examples of the
experiences of logotherapists. For instance, in a
case of irreversible physical loss, as was re-
counted by Long (1995), Klingberg (2001), and
Levinson (2002), a well-known logotherapist,
Jerry Long, was a teenaged baseball player whose
pitching had the attention of the professional
leagues. Then he broke his neck and became
physically dependent on others for his most basic
activities of daily living. While he recognized
that his potential for an athletic career had van-
ished, he also came to realize that much freedom
remained in other areas in which he could actu-
alize personal life meaning. He took responsibil-
ity for implementing that freedom: graduated
from high school, went on to college, and even-
tually earned his doctorate in clinical psychology
Logotherapy for Clinical Practice
and became a practicing logotherapist. He was
able to lead a fulfilling life in spite of quadriple-
gia. He often summed up succinctly his inspiring
credo for life: “I broke my neck; it didn’t break
me.” He took responsibility to do what he could,
within the freedom that he had, to establish and
maintain an attitude to pursue a personal life
meaning, in spite of his physical condition. Cli-
ents learn from such stories that regardless of
one’s circumstances, a proactive attitudinal
stance toward adversity may be chosen.
A number of additional exercises to increase
awareness of personal life meaning and to moti-
vate people toward the actualization of their po-
tentials have been described by Fabry (1988),
Mendez (2004), Pattakos (2004), and Crumbaugh
and Henrion (2004). One example contained in
Fabry’s text is the Value Auction, in which indi-
viduals are invited to consider various values that
are auctioned off and how much they wish to
“bid” on them from their limited pool of “funds.”
Another example is the Self-Appraisal Exercise,
in which people are encouraged to participate in
answering questions such as those relating to
descriptions of themselves, whom they and others
wish themselves to be, and their views as to their
potentials. Such exercises prompt reflection on
the consistencies between the individual’s inter-
nal and external behaviors and their sense of
personal life meaning. Mendez (2004) addition-
ally outlined a number of less well-known tech-
niques applied by logotherapists (e.g., Logo-
drama, Life Review and Life Preview, Guided
Discovery of Meaning Potentials, the Logoan-
chor, and Appealing Techniques). Finally, Pat-
takos’ (2004) exercises are geared toward per-
sonal life meaning in the workplace, while
Crumbaugh and Henrion’s (2004) activities re-
late to enhancing personal life meaning in in-
terpersonal relationships.
Psychometric Assessment of the
Meaning Construct
A variety of logotherapy tools have been intro-
duced over the years to quantify and study the
meaning construct. The best known of these are the
Purpose in Life test, the Life Purpose Question-
naire, and the Seeking of Noetic Goals test. There is
ample evidence for the internal consistency of the
global scores generated by these measures, with
coefficient alphas often reported in the .80s, and
in some instances exceeding .90 (Melton & Schu-
lenberg, 2008).
The Purpose in Life (PIL) test is the earliest
and most widely studied of the well-known logo-
therapy psychometric instruments (Crumbaugh &
Maholick, 1964, 1969) and is the primary logo-
therapy measure of the degree to which an indi-
vidual experiences a sense of personal life mean-
ing. The PIL has been psychometrically reviewed
in a number of sources (e.g., Crumbaugh & Hen-
rion, 1988; Hutzell, 1987a, 1988; Melton &
Schulenberg, 2008; Reker, 2000; Schulenberg,
2004a). With regard to validity, the PIL, as is
expected, correlates positively with constructs
such as happiness, emotional stability, and extro-
version, and negatively with constructs such as
boredom proneness, anxiety, and depression
(Hutzell, 1988, 1989; Melton & Schulenberg,
2007, 2008; Robak & Griffin, 2000; Schulenberg,
2004a). Such correlations are consistent with
logotherapy conceptualizations and research
studies that demonstrate the relationship between
meaning and well-being (Melton & Schulenberg,
2008; Schulenberg, 2004a).
The Life Purpose Questionnaire (LPQ; Hablas
& Hutzell, 1982; Hutzell, 1989) is another mea-
sure of the degree to which an individual expe-
riences a sense of personal life meaning, but it
was designed for use with specialized popula-
tions, such as geriatric neuropsychiatric inpa-
tients, for whom the PIL proves impractical
(Hablas & Hutzell, 1982), and the LPQ is some-
times the measure of choice over the PIL because
it uses a simple dichotomous-choice format, in
contrast to the PIL’s more complex Likert-type
response format (Hablas & Hutzell, 1982; Hut-
zell, 1989). The LPQ is the second most fre-
quently studied of the logotherapy measures. Va-
lidity support is evident via moderate-to-high
correlations with the PIL and scores that demon-
strate statistically significant improvement in pro-
grams that incorporated a life purpose component
(Burnette, Swan, Robinson, Lester, & Little,
2003; Kish & Moody, 1989; Melton & Schulen-
berg, 2008; Schulenberg, 2004a).
The Seeking of Noetic Goals (SONG) test
(Crumbaugh, 1977a, 1977b) was developed to
assess motivation to find meaning. There is much
less empirical data available in the published
literature on its psychometric properties (Hutzell,
1987b; Schulenberg, 2004a).
Schulenberg, Hutzell, Nassif, and Rogina
Empirical Support and Future
Research Needs
Frankl was well aware of the emphasis placed
on empirical scrutiny, and he encouraged re-
searchers to investigate logotherapy (Fabry,
1978/1979). Many studies have appeared with a
focus on the logotherapy paradigm, meaning in
general, and meaning-related constructs. Schul-
enberg (2003a) described research progress with
direct relevance for logotherapy, including such
areas as paradoxical intention and assessment, as
well as positive psychology constructs such as
gratitude, humor, hope, and love (all of which are
central to logotherapy).
For a recent and comprehensive source of em-
pirical articles relevant to logotherapy, the reader
is referred to Batthyany and Guttmann’s (2006)
annotated bibliography, which is an important
step in the advancement of the scientific study of
logotherapy because of its collection of abstracts
on general theory, techniques, psychopathology,
and test construction and validation. It documents
how far the empirical study of logotherapy has
come, and it is clear that meaning-related re-
search continues to advance. However, while em-
pirical studies continue to be conducted, research
needs remain a priority. Research is one means
that may facilitate the continued evolution of
logotherapy into the mainstream of the mental
health field (DuBois, 2007; Guttmann, 1996;
Hutzell, 2000; Schulenberg, 2003a). Areas of
particular importance include expanding the psy-
chometric properties of logotherapy assessment
tools, isolating and studying specific logotherapy
tenets, conducting studies of logotherapy’s utility
in relation to specific mental health diagnoses,
and empirically examining logotherapy’s rele-
vance to clinical/disaster psychology, diverse
populations, and psychoneuroimmunology.
Logotherapy measures: Expanding the psycho-
metric foundation. One area to target for future
research is that of continuing to expand the psy-
chometric properties of various logotherapy mea-
sures with different populations and under differ-
ent contexts (Guttmann, 1996; Melton &
Schulenberg, 2008). Procedures such as explor-
atory and confirmatory factor analyses may have
particular relevance for logotherapy measures
and the meaning construct in general as assessed
by these instruments (Melton & Schulenberg,
2008; Reker, 2000; Reker & Chamberlain, 2000).
For example, the PIL continues to be of interest
from a factor analytic standpoint, as in the case of
the development of psychometrically sound alter-
native forms of the measure. In a new study using
samples of undergraduate students, Schulenberg
and Melton (in press) took the 20 items of the PIL
and demonstrated how factor analysis is of assis-
tance in the assessment of the meaning construct,
in this instance, in providing preliminary support
for a replicable two-factor model of the PIL, as
well as a psychometrically viable short form that
may be useful for future research. In addition to
this study, other recent factor analytic studies
have been completed (e.g., Schulenberg &
Gohm, in press; Schulenberg, Gohm, & Ander-
son, 2006); however, such studies require repli-
cation. Samples should be drawn from increas-
ingly diverse populations (in each of the
previously mentioned studies, samples were pri-
marily female, Caucasian undergraduates), as
factor structure may vary by population.
Isolating and examining logotherapy tenets.
While there is growing research assessing various
aspects of logotherapy, more research is needed
in isolating and testing specific logotherapy pos-
tulates using increasingly stringent research de-
signs. As one example of such, Melton and Schu-
lenberg (2007) conducted a study examining
Frankl’s oft-noted postulate that boredom is one
outcome of meaninglessness. Melton and Schul-
enberg (2007) found support for the association
of the two constructs via a statistically significant
negative correlation between the PIL and the
Boredom Proneness Scale (BPS; Farmer & Sund-
berg, 1986) with a sample of psychology under-
graduate students. In this case, higher PIL scores
(greater meaning) were associated with lower
BPS scores (less boredom proneness). However,
the study was correlational in nature, and state-
ments with regard to causation could not be
made. Since Frankl’s postulate indicates a causal
path, that is, boredom results from meaningless-
ness, stronger research designs are necessary to
further delineate the relationship (Melton &
Schulenberg, 2007). For example, one idea posed
by the authors is whether an experimental group
writing about meaningful experiences will report
less boredom and greater meaning than would a
control group writing about more neutral topics.
In addition to further studying the aforemen-
tioned relationship, empirical studies should be
designed to target other logotherapeutic postu-
lates that have been put forth over the years.
Researchers should also continue to investigate
Logotherapy for Clinical Practice
the meaning construct and related postulates in
different cultures, because how meaning is de-
fined, and the pathways to a sense of life mean-
ing, may differ cross-culturally (Savolaine &
Granello, 2002; Schulenberg, 2003a).
Logotherapy’s relevance to mental health
problems: Serious mental illness as case in point.
Earlier in this article the incorporation of logoth-
erapy into the treatment protocols for various
DSM–IV–TR diagnoses was noted. Outcome
studies integrating logotherapy with other treat-
ment approaches to better document its effective-
ness are needed as follow-up. People with a va-
riety of forms of mental illness may benefit from
logotherapy, given its focus on the motivational
effects of personal life meaning; empowerment to
be positive, hopeful, and proactive (in life and in
treatment); and encouragement to recognize the
choices that may be made in spite of unchange-
able circumstances. Given the emphasis on client
attributes and abilities, logotherapy may be par-
ticularly helpful in developing diagnostic formu-
lations, communicating diagnostic feedback to
clients (Winters & Schulenberg, 2006), and ad-
dressing questions as to how people may adap-
tively respond when facing mental illness. De-
spite their difficulties, clients can still have “a
personal identity, a meaning for existence, a
place in life, a worthwhile cause” (Crumbaugh,
1973, p. ix).
These concepts have become increasingly im-
portant in the mental health literature. One recent
example has to do with empowerment and indi-
viduals with serious mental illness, for whom
empowerment refers to attempts to free individ-
uals from the grip of their symptoms as well as
enhancing their ability to be proactive and for
whom serious mental illness refers to disorders
such as schizophrenia, schizoaffective disorder,
and major depression (Strack, 2008; Strack, Deal,
& Schulenberg, 2007). There is an indication that
individuals with serious mental illness perceive
recovery from their disorder in terms of areas
directly relevant to logotherapy, such as meaning,
self-determination, and hope (Strack, 2008). In
logotherapy terms they can still be “Somebody”
despite their symptoms (Crumbaugh, 1973, p. ix).
In a new study of meaning and empowerment
in individuals with serious mental illness, Strack
(2008) found through a serious of regression
analyses that empowerment is dependent on
meaning in life and psychiatric symptoms (those
reporting greater empowerment reported fewer
mental health symptoms and greater meaning).
The study offered support for the importance of
meaning to individuals with serious mental ill-
ness, particularly via its relationship to empow-
erment. These results suggest future research di-
rections, such as investigating the degree to
which meaning-related interventions directly re-
sult in increases in empowerment. In addition, it
supports the rationale that meaning is a construct
of much significance to those with serious mental
illness and should be considered in mental health
evaluations and interventions.
Clinical/disaster psychology. Clinical/
disaster psychology is a rapidly growing field, in
which mental health professionals are taught how
to readily assist individuals directly affected by
disasters. Often a community approach is taken,
in which clinicians respond to traumatic events in
the field (e.g., the terrorist attacks of September
11, 2001; Hurricane Katrina). Clinicians may
work with individuals in the immediate aftermath
of a disaster or in an ongoing therapeutic capacity
in an office setting. They work with a wide vari-
ety of disaster-related presenting complaints,
such as those that may meet formal DSM–IV–TR
criteria for Acute Stress Disorder or Posttrau-
matic Stress Disorder (PTSD).
There is a wealth of literature on the topic of
logotherapy’s utility in assisting people with
adapting to and overcoming traumatic experi-
ences, and Frankl’s own life experiences in the
concentration camps during World War II offers
added support for logotherapy’s relevance in an
array of disaster situations, such as natural disas-
ters (Halpern & Tramontin, 2007; Schulenberg,
2003a) and refugee mental health,
in which in-
dividuals may be displaced from their countries
of origin for a variety of reasons, including per-
secution on the basis of sex, racial or ethnic
background, or spiritual beliefs. Refugees must
not only deal with the traumas associated with
their displacement, but they must also deal with
postmigration stressors as well (i.e., stressors as-
sociated with moving from one country to an-
other under duress). Halpern and Tramontin
(2007) noted that Frankl’s perspective advocates
for the ability of disaster survivors to learn how
to triumph over suffering, assisting individuals
directly affected by disasters to not only discover
See Reyes and Jacobs (2006) for a primer on issues in
refugee mental health.
Schulenberg, Hutzell, Nassif, and Rogina
meaning in the events but also serve as a means
of facilitating posttraumatic growth.
As a follow-up to the previous section refer-
encing serious mental illness, one area to inves-
tigate systematically is logotherapy’s usefulness
as an adjunctive treatment approach with individ-
uals with Acute Stress Disorder or PTSD. There
is logotherapy literature available on these topics,
although primarily related to PTSD. For instance,
Gilmartin and Southwick (2004) and Southwick,
Gilmartin, McDonough, and Morrissey (2006)
noted a rationale for logotherapy’s application to
combat-related PTSD, describing multiple case
studies. Schiraldi (2000) noted logotherapy and
the relevance of the meaning construct to indi-
viduals with PTSD, listing several exercises to
identify and enhance meaning. There is a strong
rationale for considering logotherapy in relation
to traumatic experiences and specific diagnoses
such as PTSD; however, much of the literature
available is either conceptual or based on case
studies. Systematic outcome studies are war-
ranted to better delineate the aspects of logoth-
erapy that are of particular relevance in treating
people who have experienced traumatic events.
For example, for those diagnosed with a disorder
such as PTSD, would enhancement of meaning
result in a better prognosis? To what measurable
extent does logotherapy enhance client
In addition, are there certain elements of logo-
therapy that could be incorporated into the Psy-
chological First Aid (PFA) training of mental
health professionals who respond to disasters?
PFA is a fundamental aspect of the training of
mental health disaster responders (Schulenberg et
al., 2008). The tenets of PFA include fostering a
sense of hope and focusing on problem solving
(being proactive), self-reliance, and strengths.
Dereflection may be a particularly useful tech-
nique in this respect. Finally, while logotherapy
may be integrated with PFA training that is of-
fered to mental health professionals, it would be
interesting to study whether certain aspects of
logotherapy should be included in PFA training
that is offered to paraprofessionals, such as di-
saster responders of the American Red Cross, as
PFA training tends to teach basic skills that can
be applied by mental health professionals and
paraprofessionals alike. For instance, under the
supervision of mental health professionals, could
paraprofessionals at an American Red Cross shel-
ter be trained to administer meaning-enhancing
activities to groups of individuals receiving ser-
vices? If so, how effective would such interven-
tions be? While these and other questions await
the attention of researchers, what is known is
that the meaning construct holds much promise
in terms of applicability to different types of
trauma responses and conditions, and logoth-
erapy is one specific means of facilitating the
discovery of meaning.
Logotherapy and diversity. The number of
logotherapy organizations established worldwide
exemplifies the fact that cross-cultural applica-
tions and implications are integral to the ap-
proach (see the Appendix for further informa-
tion). Because of logotherapy’s emphasis on
values clarification within a given person, it af-
fords mental health professionals opportunities to
consider the unique cultural context of the indi-
vidual. However, while there is much cross-
cultural, or international, literature published,
there is little research or descriptive information
available on logotherapy and multicultural issues
in the United States. A notable exception is Corey
(2005), who discusses multicultural issues in ex-
istential therapy and mentions logotherapy
Logotherapy is one means of empowerment. It
helps people to facilitate identity development
through the recognition and clarification of val-
ues, and it galvanizes people to find ways to deal
with adversity. For these reasons, logotherapy
should be studied empirically in relation to diver-
sity issues, such as racial and ethnic identity
formation, acculturation and acculturative stress,
racism and discrimination, and sexual orientation
or gender identity development, each of which
may influence an individual’s functioning in sub-
tle to profound ways (Hunter & Lewis-Coles,
2004; Paniagua, 2005; Schneider, 2008; Strack,
Dunaway, & Schulenberg, 2008). Logotherapy
may assist individuals in determining how much
importance they wish to place on their diversity
and how to deal with individuals and a larger
society whose values may differ markedly from
their own. Logotherapy inspires people toward
discovering their individuality, their uniqueness,
and how to feel comfortable within themselves
See Schulenberg et al. (2008) for a review of the PFA
literature and a discussion of the roles of psychologists in
clinical/disaster psychology, specifically, natural disaster
Logotherapy for Clinical Practice
and within the larger world in which they live. As
a meaning-based approach, logotherapy may
prove to be one means of stimulating people to
respond adaptively to stressors and find a positive
voice in the face of oppression.
With respect to women, sexism, and feminist
therapies, logotherapy also has a wide range of
applicability. However, these topics are rarely
discussed in the logotherapy literature. Feminist
therapies have traditionally focused on empow-
erment and perception of meaning, as well as
how aspects such as oppression and marginaliza-
tion affect clients (Brown, 2008). The egalitarian
partnership of client and therapist within feminist
therapies is similar to the structure of the thera-
peutic relationship within logotherapy. Brown
(2008) is one of the few authors who specifically
mentions Frankl and the relevance of Man’s
Search for Meaning with respect to these issues.
Psychoneuroimmunology. Another research
area in which logotherapy has applicability is
psychoneuroimmunology, which is a field that
encompasses many disciplines (psychology, psy-
chiatry, immunology, endocrinology, and neurol-
ogy) in order to better understand health and
disease processes (Ader, 2007; Goodkin & Vis-
ser, 2000). The relationship between sense of life
meaning and well-being was noted previously
(e.g., Melton & Schulenberg, 2008; Ryff, 2000;
Ryff & Singer, 1998a, 1998b; Savolaine &
Granello, 2002). With regard to physical well-
being specifically, some have noted that meaning
may be of special importance in prognoses with
illnesses such as cancer (Spiegel & Fawzy,
2002). By implication, logotherapy has relevance
to the field of psychoneuroimmunology theoreti-
cally, anecdotally, and empirically. However, the
need for additional research on the sense of per-
sonal life meaning in relation to health and dis-
ease processes remains (Ryff, 2000). As studies
in the field of psychoneuroimmunology continue
to proliferate, logotherapy as a meaning-based
therapy could become an increasingly important
part of the empirical dialogue.
A central theme of this article is the idea that
meaning-centered interventions such as logoth-
erapy are of prime importance to the human con-
dition, with applicability to an array of presenting
mental health complaints. The presence of mean-
ing is associated with a range of positive out-
comes, and logotherapy is particularly attractive,
given its ability to work in collaboration with
other approaches. Frankl synthesized the thinking
of others and added his experiences (both with
human beings and as a human being) to develop
logotherapy. As a result, logotherapy has much in
common with other schools of psychotherapy.
Thus, therapists may find that logotherapy fits
with their existing ideas and work. Furthermore,
because of Frankl’s emphasis on human experi-
ence in general and spirituality in specific, his
ideas ring true to many clients.
In addition to describing logotherapy and its
applications, we sought to present examples of
well-known logotherapy techniques that clini-
cians may find useful and to denote lesser-known
examples in the logotherapy literature. Measures
to assess meaning have been developed within
the logotherapy paradigm and were summarized
with regard to their psychometric properties. Fi-
nally, research progress was discussed, along
with the need for expanding the psychometric
properties of logotherapy measures and advanc-
ing the study of logotherapy in relation to specific
mental health diagnoses and diverse populations,
as well as growing fields such as clinical/disaster
psychology and psychoneuroimmunology.
The Appendix includes a brief discussion of
logotherapy research, educational, and training
resources. While one may learn about the theo-
retical, descriptive, and empirical underpinnings
of logotherapy through such outlets, and how
various techniques are applied, each therapist–
client pairing forms a unique dyad with its own
unique challenges. When asked what advice he
would give to clinicians interested in logoth-
erapy, J. C. Crumbaugh encouraged them to uti-
lize dereflection to help individuals focus on suc-
cesses (toward the positives), to find what will
work in a specific situation (Schulenberg & Hen-
rion, 2005). For logotherapy to be conducted
successfully, clinicians must not only study logo-
therapy and work to apply it clinically, they must
learn to live logotherapy as well; and each day,
each moment, presents new opportunities to live
meaningfully—this is the essence of logotherapy.
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Schulenberg, Hutzell, Nassif, and Rogina
Research, Training, and Educational Resources in Logotherapy
To enhance the study of logotherapy, a web-
based logotherapy research discussion group has
been established by the scientific board of the
Viktor Frankl Institute of Vienna (http://
In addition to facilitating discussion, the website
includes an annotated list of meaning-related
measures of interest to researchers.
There are logotherapy organizations world-
wide, and these often offer training and educa-
tion; a good place to start looking for these is the
Logotherapy Vienna website at http:// The website lists over
50 societies and institutes in 24 countries
(DuBois, 2007). In the United States, training is
offered through the Viktor Frankl Institute of
Logotherapy, which currently headquarters out of
Texas and maintains a website at http:// Training in the
United States includes introductory (providing a
basic foundation for principles of logotherapy),
intermediate (focusing on applications of logoth-
erapy, such as attitudinal change), and advanced
(focusing on Franklian theory and therapy of
mental disorders) courses to reach Associate Cer-
tification. In addition, through advanced super-
vised study, qualified mental health professionals
may achieve Diplomate Clinician or Educator/
Administrator Certification. The institutes logo-
therapy curriculum is available for purchase for
educational use in the form of a set of CDs (Rice,
Graber, Pitts, Rogina, & Sjolie, 2005). The U.S.
institute also conducts a bi-annual world congress
on logotherapy, which provides a forum for the
exchange of information, research, and practical
applications. Finally, The International Forum
for Logotherapy, published since 1978, is a peer-
reviewed journal that specifically focuses on the
theoretical, descriptive, and empirical aspects of
Logotherapy for Clinical Practice
... The spiritual dimension is considered a unique human dimension which provides us with the possibilities to find meaning in life. Two unique human capacities from the spiritual dimension are highlighted: self-distancing and self-transcendence (Frankl, 2008;Schulenberg et al., 2008). Self-distancing suggests that we are able to maintain a distance from our current problem-saturated situation and in turn allows us to re-experience our freedom to respond to the situations. ...
... One may say this is one of the limitations of logotherapy: lack of a concrete and detailed description of the intervention approach, including the skills. Many original teachings of Viktor Frankl may be rather conceptual and philosophical, and some of the skills taught by Frankl focus on dealing with psychiatric symptoms like phobia and anxiety (Schulenberg et al., 2008;Southwick et al., 2016). Other followers, like Elisabeth Lukas, have attempted to apply logotherapy in various clinical contexts (Lukas and Sch€ onfeld, 2019), but it may lack clarity in the intervention process. ...
Full-text available
Meaning in life is an important topic for professional training and social work education. This article aims to illustrate how Viktor Frankl’s logotherapy could be applied as the framework in teaching meaning in life to social work students and helping professionals. It critically examines the experience of teaching meaning in life and integrating it with various training and education components, such as human behaviours, end-of-life and bereavement care, and self-care of helping professionals. Reflections on these teaching experiences suggest that the significance of teaching meaning in life is recognised by helping professionals and students, especially its dual influence on both personal and professional aspects. Lack of systematic and continuous training and education of meaning in life may be a hindrance for more in-depth understanding and learning. More case examples and discussion may help advance helping professionals’ practice to facilitate service users’ meaning searching. Reflecting on meaning in life may also facilitate helping professionals’ coping with existential challenges in work, but such self-care training should be offered regularly to provide continuous support. This article suggests that teaching meaning in life may have great implications for the psychological health of helping professionals and the service users who receive their professional services.
... Logo therapy focuses on the meaning of life and advocates that the attempt to find meaning is one of the most powerful motivator factors (Morgan, 2013). One of the main objectives of logo therapy is the creation of hope in an individual, which is a positive motivation that focuses on a clear goal for life (Schulenberg et al., 2008). Hence, logo therapy could help caregivers to seek meaning in their lives, encouraging them to remain optimistic and hopeful toward their life despite the demanding caregiving tasks they bear. ...
Full-text available
Caregivers for dialysis patients have endured tremendous burden and responsibilities in their daily lives from caregiving. Interventions that cater to them are essential, considering that they play an essential role in the illness management of patients. The purpose of this review is to examine the interventions implemented among the caregivers caring for patients diagnosed CKD and its effectiveness in alleviating the caregiver burden. PRISMA-ScR checklist was utilized as the reporting standard. Past studies were searched in four major citation databases (MEDLINE, Cochrane Library, PubMed, and Web of Science) in the timeframe of February 2022. Nine studies were identified, comprised of randomized controlled trials (RCTs) and quasi-experimental studies. The types of intervention programs reviewed were educational programs, supportive programs, family-centered programs, and psychological interventions. The evidences have suggested that these programs are effective in reducing caregiver burden among the caregivers of CKD patients.
... Self-transcendence, or beyond-the-self purpose, refers to a sense of purpose that stems from contributions to a broader world-from living for a cause greater than one's own well-being. Purpose beyond-the-self has deep theoretical roots in the early humanistic psychology movement, yet far less research has examined beyond-the-self purpose compared to the empirical studies on general meaning and goaldirectedness (Schulenberg et al., 2008). Qualitative research on emerging adults suggests that they tend to focus on individualist pursuits when asked about future goals; however, when asked specifically about purpose, they describe more self-transcendent sources of meaning (Glanzer et al., 2018). ...
Purpose is a key protective factor for well-being, resilience, and satisfaction with life. The Claremont Purpose Scale (CPS) was developed by Bronk and colleagues with adolescents and emerging adults to measure three dimensions of purpose: Meaning, Goal-Directedness, and Beyond-the-Self. The psychometric properties examined in the original scale development paper were replicated with our independent, emerging adult college student sample: confirmatory factor analysis (CFA) of a 3-factor model, good-to-excellent internal consistency, convergent validity with a measure of general perceived meaning in life (MLQ-P), and discriminant validity with a measure of self-reported depression (DASS-21-D). Additional psychometrics examined in this study were test–retest reliability, a 1-factor CFA model, correlations with stress and anxiety, and descriptive statistics that had not yet been reported in the literature. Beyond-the-self items did not load well onto the overall factor in the 1-factor model, and their correlations with other scales (MLQ-S, DASS-21 subscales) differed significantly from the correlations between these other scales and the CPS total, General Meaning, and Goal-Directedness scores. Implications of these data include strong support for the use of each subscale as a distinct, psychometric index, and we recommend the total scale score not be used as a measure of overall purpose. Clearly, there are separate, but related, facets to this measure that, while positive, undermine the utility of a global purpose score. A slightly changed naming of the CPS to the “Claremont Purpose Scales” could promote their use as three separate scales instead of a single, total scale score.
... In contrast, several psychotherapies associated with the positive psychology movement and existential psychotherapies highlight the importance of purpose in life as a therapeutic theme. These include closely related varieties based on Victor Frankl's Logotherapy (Frankl, 1967;Kim and Choi, 2020;Schulenberg et al., 2008) and also include several others that have been manualized, including Integrated Meaning Therapy (Wong, 2016), Life Crafting (Schippers and Ziegler, 2019), Meaning-Centered Therapy (Breitbart et al., 2010;Holtmaat et al., 2017;, Meaning and Purpose Therapy (Kissane et al., 2019), and Well-Being Therapy (Guidi and Fava, 2020;LeMay and Wilson, 2008;Mansueto and Cosci, 2021), among others. In a number of (mostly controlled) clinical trials, notably with depressed patients with cancer (Breitbart et al., 2010;Holtmaat et al., 2017;Kissane et al., 2019;van der Spek et al., 2017) and patients with other depressive disorders (Guidi and Fava, 2020), these therapies have been credited with improving depressive symptoms and a number of measures of well-being and increasing purpose in life. ...
Having a purpose in life is strongly associated with well-being and quality of life. Some individuals develop their sense of purpose early in life and can sustain lifelong ideals. In contrast, we identify four transdiagnostic syndromes where purpose in life is impaired: 1) deficiencies in generating purpose; 2) loss of purpose due to traumatic events such as catastrophic illnesses or bereavements; 3) conflicts due to crossed purposes; and 4) maladaptive purposes, such as life-limiting single-minded goals, dominating others, or exacting revenge. Several psychotherapies associated with positive and existential psychologies help patients construct, reconstruct, or retain a sense of purpose. However, given the strong links between a sense of purpose and beneficial health and mental health outcomes, the authors suggest that many patients in psychiatric treatment including psychotherapies will benefit from attention to these issues. This article reviews approaches for assessing and addressing purpose in life in psychiatric treatment, to enhance patients' healthy sense of purpose where this characteristic is impaired.
... In spite of 120 years of psychological science, and almost 25 years of positive psychology existence, yet the only practical thing creating an actionable methodology for finding or expanding meaning of life can be find in the concept of logotherapy formulated by Viktor Emil Frankl (Marshall & Marshall, 2012). Nevertheless, logotherapy using the method of logo analysis (Schulenberg, Nassif & Rogina, 2008) is not a universal method 2 of 12 that deals with the meaning of human life. The reasons for this are the low availability of this method -not all groups of the population can afford long-term therapy and treatments. ...
The debate about the meaning of life in the literature has been around for a while and portraits a fundamental human need to find a personal path of existence. The meaning of life phenomenon purpose lies in its impact on the psychological wellbeing. Knowing your purpose in life can make it more structured and in balance, therefore more meaningful and comprehensible. However, in the existing body of the academic literature meaning of life is discussed more from the philosophic perspective rather than a practical area, which is not helping to solve the global issues of increasing mental health problems. When social and emotional wellbeing is being affected, it is urgent to apply a practical approach to effectively overcome these states. Introduction of a new, holistic meaning of life model is an attempt to offer a practical solution for society to maintain their mental health through awareness of their life’s purpose. Previously in the pilot study (Dombrovskis, 2017) in a sample group of 100 citizens of Latvia who self-reported being in a crisis situation at the given moment, using qualitive analysis the first component for the model structure was identified – antecedent. In our research antecedent is defined as something that triggers certain action, so in crisis situation person can regain a structure and stability in life. We found 8 different antecedents that trigger behavior of those affected by crisis: achievements; power; success; development; freedom; uniqueness; interesting life and fleeing. To continue to explore other components for our model in the setting of Latvia, this study aims to investigate the demographic and personality related variables that may serve as antecedents and as such become one of component in our model structure. The study used a sample of residents of Latvia representing the total population of 1,110 respondents (633 women, 57%, and 477 men, 43%) who have completed the self-assessment questionnaire Meaning of life scale (MOLS) (online and frontally) designed by the authors on their satisfaction with different factors regarding the meaning of life. Average age of respondents (M=33.88; SD=8,527) varied from 18 to 67. The exploratory and confirmatory analysis confirms the data regarding existence of totally 16 factors: 8 antecedents identified in the pilot study and 8 new antecedents identified in the present study - family relations; level of income; relations with friends/acquaintances; state of health; organization of free time; career growth (achievements); sexual life quality and quality of education. Findings confirm a model’s structure to be complex phenomenon consisting of various components. However, findings suggest that more research should be done to fill the following gaps: 1) identify actions, which are triggered by 16 antecedents; 2) figure out F1, F2 and F3 factor role in the model structure.
... Unfortunately, policymakers and practitioners tend to use mental health interventions, which are limited in various ways [6]. First, due to a lack of sufficient evidence on the mental health issues of the immigrant population, the therapeutic models used are developed based on studies conducted on Caucasian populations [7]. Second, policymakers and practitioners assume that specific mental health therapies can be universally applied even in a culturally diverse population. ...
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Depression, stress, anxiety disorders, and PTSD are some of the mental health problems that are prevalent among immigrant populations despite being underdiagnosed. Stigma, difficulties in adapting, cultural barriers, and reduced access to mental health support can seriously hamper their ability to build resilience and recover. Other limitations include assuming that therapies can be universally applied, the lack of sufficient evidence on mental health issues of this population, and the use of therapeutic models developed on Caucasian populations. Here, professional guidance to find the meaning of life through interventions such as logotherapy could help them in this process. The present work systematically reviewed studies investigating the effectiveness of logotherapy in diverse populations and its relevance to a Muslim immigrant population in Europe. Following PRISMA guidelines and the keywords ‘logotherapy, mental health problems, immigrant, and treatment’, the search identified 16 relevant studies conducted since 2005. The studies revealed that logotherapy could be implemented through paradoxical intention, de-reflection, Socratic dialogue, and attitude modification. All these techniques have the potential to help the client to realize long-term relief for underlying stressors associated with migration and settling in a new location. Though data on logotherapy are still scarce, it is evident that it deserves more research so that a structured, evidence-based, and effective therapy for Muslim immigrants in Europe can be developed and tested. In this regard, we propose that the four logotherapy techniques have huge potential in helping psychiatrists develop an effective therapy for mental health problems among these immigrant populations confronting adversity.
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Background: The study explored sources of meaning in older adults and the action path among family care, meaning in life, quality of life, and depression. Materials and methods: We investigated 627 older adults using the Sources of Meaning in Life Scale for the Elderly (SMSE), the Family Care Index (APGAR), the Center for Epidemiological Studies Depression Scale-10 (CES-D-10), and the EuroqOL-5 Dimensions (EQ-5D). Results: Scores categorized 454 older adults with good family function, 99 with moderate, and 47 with severe family dysfunction; 110 older adults had depression. The structural equation model showed that family care affected the quality of life and depression by influencing meaning, and depression had a significant negative effect on the quality of life (P < 0.05). The model was a good fit for the data (χ2/df = 3.300, SRMR = 0.0291, GFI = 0.975, IFI = 0.971, TLI = 0.952, CFI = 0.971, RMSEA = 0.062). Conclusion: Meaning in life is an intermediary factor that affects depression and quality of life in older adults. Family care had a significant positive impact on SMSE and a negative influence on depression. The SMSE effectively clarifies the sources of meaning in life and can be used to improve meaning and promote mental health in older adults.
Both mortality salience and absurd humor have been found to elicit fluid compensation - the automatic process of strengthening unrelated beliefs in response to a meaning threat. Previous research has suggested that perceiving absurd humor to be funny decreases people's tendency to fluid compensate, suggesting that humor is a meaning-making process. However, these results may have been confounded by mortality salience effects. Furthermore, few studies have investigated the effects of absurd humor and mortality salience on multiple beliefs. In the current study, we aimed to conceptually replicate previous research on the fluid compensatory effects of absurd humor and mortality salience under more stringent conditions and in response to a wider variety of beliefs. Participants (N = 590) recruited via MTurk were randomly assigned to a reading condition and thereafter completed a series of measures of meaning in life, moral identity, belongingness, and belief in a just world. Participants found humor in each reading condition and did not fluid compensate, suggesting that humor is a meaning-making process. Implications and directions for meaning making and humor research are discussed.
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Discusses contributions of V. E. Frankl's logotherapy in the diagnosis and treatment of patients with major depression. Frankl's dimensional ontology distinguishes between endogenous depression, reactive depression, and depression accompanying Noogenic Neurosis. A logotherapeutic treatment protocol is presented, consisting of 3 phases: diagnostic phase, therapy phase, and follow-up phase. The therapy phase includes the need to start with attention to the safety of the patient, modification of attitudes, and the use of metaphors. Emphasis is placed on teaching patients to form new attitudes toward depressive symptoms. A case study of a 28-yr-old female patient with severe depressive symptoms is included.
The Oxford Handbook of Positive Psychology studies the burgeoning field of positive psychology, which, in recent years, has transcended academia to capture the imagination of the general public. The book provides a roadmap for the psychology needed by the majority of the population-those who don't need treatment, but want to achieve the lives to which they aspire. The articles summarize all of the relevant literature in the field, and each is essentially defining a lifetime of research. The content's breadth and depth provide a cross-disciplinary look at positive psychology from diverse fields and all branches of psychology, including social, clinical, personality, counseling, school, and developmental psychology. Topics include not only happiness-which has been perhaps misrepresented in the popular media as the entirety of the field-but also hope, strengths, positive emotions, life longings, creativity, emotional creativity, courage, and more, plus guidelines for applying what has worked for people across time and cultures.