Running Head: COGNITIVE AND EXISTENTIAL THERAPY

A Comparison of Theoretical Elements:

Cognitive Therapy and Existential Psychotherapy
Christina Majcher
University of Calgary

COGNITIVE AND EXISTENTIAL THERAPY

A Comparison of Theoretical Elements:

Cognitive Therapy and Existential Psychotherapy
A myriad of therapeutic approaches are available to counsellors. Each theory offers its
own unique set of contributions to increase our understanding of human behaviour while
providing a framework for supporting clients. Although research evidence indicates the
effectiveness of counselling, there is not one therapeutic approach that stands out as the most
effective (Mulhauser, 2011). Empirical studies indicate that while some approaches are more
effectively matched to certain challenges, clients demonstrate the most therapeutic change
when they are committed to the therapeutic approach offered (Mulhauser, 2011). As such,
counsellors must have a strong understanding of the theoretical underpinnings of the major
approaches. This paper will explore and compare the theoretical elements of cognitive therapy
and existential psychotherapy to gain a greater understanding of these theories and their goal of
supporting client well being.
There are many reasons to compare these two approaches. Both theories share a
common phenomenological perspective (Corey, 2009). They are both person-centered, with a
common concern for a clients interpretation of self, significant others and their world to work
towards psychological growth and change (Corrie & Milton, 2000; Hickes & Mirea, 2012). Both
approaches aim to empower clients by emphasizing that an individual has responsibility for their
own life, opportunity to make choices and change their current living situations. However,
cognitive therapy and existential psychotherapy are also vastly different in their interpretations
and assumptions of human nature. In particular, unlike cognitive therapy, existential therapy is
not considered an independent school of therapy (Yallom & Josselson, 2011). Existential
therapy does not use prescribed techniques, but is based on and guided by strong philosophical
and theoretical principles. Existential psychotherapy is said to be a way to think about human
experience with the potential to be integrated into other existing theories (Yalom & Jossleson,
2011).

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These two approaches to psychotherapy are dense with such a vast amount of
information that one may wonder the best method to evaluate, compare and contrast these
theories. The EDPS 602 course notes (Nature of Theory, n.d.) offer a framework for
comparing counselling theories using four basic characteristics, or elements, to identify a good
theory. These four componentsthe philosophical element, the descriptive element, the
prescriptive element and the evaluative elementwill be explored within this paper to help
identify the theoretical components and therapeutic value of existential therapy and cognitive
therapy.
The Philosophical Element
The first element of a good theory, the philosophical element, posits that every theory
has a foundation of philosophical assumptions that outline the overall concept and basis of the
theory (Nature of Theory, n.d.). Although cognitive therapy and existential therapy differ in their
philosophical views of individuals and their world as well as their stance on the causes of
psychological distress and pathology, they share some basic theoretical underpinnings. This
includes the belief that people are shaped by their experiences, but not bound by them, and the
belief that humans are capable of self-awareness.
These two theories differ in the way the views of how individuals interact and make
sense of their world. Cognitive therapy is a theory or set of techniques based on the belief that
an individuals view of self and their personal world are central to behaviour (Beck & Weishaar,
2011, p.280). People feel, behave and respond to life events based on human evolution and an
individuals learning history (Corey, 2005; Beck & Weishaar, 2011). A cognitive therapist views
individuals as active beings that interact with their world and constructing meaning (Corrie &
Milton, 2000). In contrast, the existential paradigm is not a psychotherapeutic system, but is
better described as a framework or philosophical approach that influences therapeutic practice
to understand human behaviour (Corey, 2005). Unlike cognitive therapy, existential therapy
does not consider the person as an individual (Corrie & Milton, 2000). People are considered

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as Dasein, or Being-in-the-World, which suggests that individuals do not interact with the world,
but are instead embedded within the world (Corrie & Milton, 2000).
The two theories also differ in the way they interpret psychopathology or psychological
distress. Cognitive therapists see psychological distress as a consequence or response to life
stressors based on an individuals learning history (Beck & Weishaar, 2011). In cognitive
therapy, psychological distress is manifested when an individual perceives that a situation is
threatening their vital interests (Corrie & Milton, 2000). The emotions felt are normal reactions;
however, they are exaggerated and persistent. The goal of cognitive therapy is one where the
therapist and client collaborate to explore the patients worldview as well as their own feelings
and beliefs (Beck & Weishaar, 2011). Alternate interpretations are encouraged to adapt current
beliefs, leading to growth and change.
In contrast, existentialists believe that we live in a universe without inherent design in
which we are the authors of our own lives (Beck & Weishaar, 2011 p.328). Each of us is
responsible for who we are and who we become, including our interpretation or our world, our
action and our inaction (Beck & Weishaar, 2011). Existentialists feel authentic experience is
more important than false explanations devoid of authenticity and detached from the individual
experiencing them (Beck & Weishaar, 2011). As a result, existential therapy focuses on
individuals and their personal reality instead of person meeting a set of diagnostic criteria.
Existentialists believe that psychopathology happens when people resort to creating defenses to
protect them from overwhelming feelings of dread associated with the responsibility of our
ultimate freedom (Beck & Weishaar, 2011). The goal of therapy is one where the client moves
towards and accepts personal freedom instead of falling into the trap of self-imposed habits or
self-limiting beliefs (Beck & Weishaar, 2011).
Areas of commonality do exist between existential therapy and cognitive therapies. Both
follow a constructivist approach and acknowledge choice and freedom in the individual to create
and change who he or she wants to be (Prasko, Jelenova, Kamaradova and Sigmundova,

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2012). Cognitive therapy sees meaning in how individuals process the information about the
world to create a sense of self and the environment that is crucial to survival (Corrie & Milton,
2000; Beck & Weishaar, 2011). Over the course of a lifetime an individual creates schemas to
make sense of the world, but also to screen, process and use information to experience and
respond to life (Corrie & Milton, 2000). This is similar to existentialist theory which purposes
that although one does not have choice of being born nor a predestined life structure, we do
have choice over the way we live, and what we become is the result of those choices (Correy,
2005, Yalom & Josselson, 2011).
Another commonality between these approaches is the belief that people can reflect and
make choices because we have the capacity for self-awareness (Corey, 2005). Cognitive
therapy involves exploring cognitive schemas to better understand emotional response (Beck &
Weishaar, 2011). In addition, there is a theoretical assumption that people can access and
interpret internal thoughts on their own without the interpretation of a therapist (Corey, 2005).
Likewise, self-awareness is an integral part of existential therapy. The overlying belief of
existentialists is that it is only in our reflecting on our mortality that we can learn how to live
(Yalom & Josselson, 2011, p. 311). There is an understanding that individuals may not be able
to change certain life events, but they may be able to change how they view or react to them.
Descriptive element
The second criteria of a good theory, the descriptive element, is the ability to explain
human experience across gender, culture and general populations (Nature of Theory, n.d.).
Exploring this element also raises questions regarding specific evaluative criteria of these
theories including their comprehensiveness and parsimony (Nature of Theory, n.d.). The
descriptive element represents a major point of contrast between these two therapies.
Comprehensiveness
Cognitive therapy and existential psychotherapy differ in the range of experiences that
they are able to describe. The goal in cognitive therapy is to encourage a client to examine the

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potential causes of the difficulties in life events by exploring core beliefs and values, behaviors,
thoughts and emotions (Hickes & Mirea, 2012). Cognitive therapy is able to describe and
explain a variety of psychological disorders and has a reputation for being a positive intervention
for many of these disorders. Cognitive therapy has proven to be successful in treating
depression, generalized anxiety disorders, drug abuse, panic disorders, obsessive-compulsive
disorder, eating disorders and a wide range of many other disorders (Beck & Weishaar, 2011).
In contrast, the goal in existential therapy is to help a client make sense of their lives by
exploring their life context of underlying beliefs, values and aspirations and the meaning they
take from these elements (Hickes & Mirea, 2012). Existential therapy focuses on the ultimate
concerns in life, symptomology and patterns of behaviour. There is a feeling with existentialist
therapists that therapies that offer artificial explanations of behaviour dehumanize people and
render them as objects (Yalom & Josselson, 2011, p. 311). As noted by Corrie and Milton
(2000), existential therapists view psychological disturbance and health as functions of
meaning (p. 9). This is based on the belief that different people can experience the same
phenomena in differing ways and psychological distress is what develops as a result of a
persons take on a particular issue or experience (Corrie & Milton, 2000).
The two theories also differ in the extent to which they can explain the experiences of
people across gender, cohort, or culture. Cognitive therapy is suitable for clients of varying age
and with varying levels of income, education and background (Corey, 2009; Beck & Weishaar,
2011). This therapy focuses on understanding a clients beliefs, values and attitudes within a
cultural context that is understood by the therapist (Beck & Weishaar, 2011). Because cognitive
therapy helps a person understand and examine their own belief system, it is an effective
therapy with multicultural application (Beck & Weishaar, 2011). There is extensive literature
available regarding cognitive therapy that is accessible worldwide.
Existential therapy can also be applied to a widely varied population. However, it is not
considered a comprehensive therapeutic system but rather a framework to help view and

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understand a clients suffering by employing existential insights and approaches (Yalom &
Josselson, 2011, p. 339). Within this framework an existential therapist believes that all people,
regardless of cultural background struggle with issues of freedom, isolation, meaning and death
(Yalom & Josselson, 2011). Existential therapy focuses on both the commonalities and
differences of humans, encouraging clients to examine how much their behaviour is influenced
by social and cultural conditioning (Corey, 2005; Yalom & Josselson, 2011). However, there are
also difficulties and limitations when existential psychotherapy is applied to multicultural
populations. This approach weighs heavily on the self-determination of individuals, which does
not always correspond with individuals who come from a culture of oppression (Corey, 2005).
Parsimony
EDPS 602 course notes (Nature of Theory, n.d.) state that good theories need have
parsimony. They need to be clearly described and organized to allow the therapist to
understand their clients issues efficiently. There is a stark contrast in the clarity and ease of
understanding the theoretical components between these two therapies.
As Beck & Weishaar (2011) indicate, cognitive therapy has a solid theoretical foundation
with a set of well-defined therapeutic strategies, and a wide variety of therapeutic techniques
(p. 322). It has a reputation for being parsimonious and accessible. This comprehensive
therapy is readily teachable, with such clearly described and defined techniques that a
psychotherapist could be competent as a cognitive therapist after one year of training (Beck &
Weishaar, 2011). In contrast, a major criticism of the existential approach is its lack of
systematic principles and practices (Corey, 2005). Its therapeutic style is often described
vaguely with a lack of precision that causes confusion and has resulted in a lack of research on
the process and efficacy of existential psychotherapy (Corey, 2005). Due to a lack of
comprehensive training programs, very few existentialist psychotherapists have received formal
training (Yalom & Josselson, 2011). Furthermore, Yalom and Josselson (2011) note that there is
only one book that presents a systematic and comprehensive view of this approach.

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Prescriptive Element
The third criteria of a good theory, the prescriptive element, centers around the efficacy
of a theorys prescriptive elements and applied benefits of change that help guide therapeutic
decisions (Nature of Theory, n.d.). When evaluating the prescriptive element of a theory, it is
useful to consider the operationalization of the theory (Nature of Theory, n.d.). This element
provides another significant contrast between the two analyzed theories. Cognitive therapy is a
prescriptive system that is highly structured and usually short term whereas existential therapy
is long term and unstructured (Beck & Weishaar, 2011).
Operationalization
One of the hallmarks of cognitive therapy is that treatment goals and direct intervention
strategies are clear. Techniques focus on therapists working with their client collaboratively to
help identify information processing errors to affect change on cognitive systems (Beck &
Weishaar, 2011). Therapists use Socratic dialogue to help encourage clients to examine their
personal belief system to help determine maladaptive responses and interpretations and then
modify them (Beck & Weishaar, 2011).
In contrast, existential therapy rejects a technical approach and posits itself as a method
to understand human experience that can integrated into all theories (Yalom & Josselson, 2011).
There are no rules to this style of therapy. As Corey (2009) states, the crucial significance of
the existential movement is that it reacts against the tendency to identify therapy with a set of
techniques (p.136). An existential therapist focuses on helping their client reach new
understanding and options in life (Corey, 2009). Therapists employ techniques to help their
clients live authentically, making choices that allow them to live life to his or her full capacity
(Corey, 2009). Therapists attempt to inspire instead of imposing anything on their clients (Yalom
& Josselson, 2011). The lack of particular techniques or standards in existential therapy lends
itself to therapists and clients looking for freedom from technique and an ability to adapt therapy
to their individual and client needs (Yalom & Josselson, 2011). This flexibility is a clear strength

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of the approach. However, this approach can lead to difficulties applying theory to practice. The
lack of structure can also leave the client feeling that they are responsible for providing the
direction of therapy (Corey, 2009).
Evaluative Element
The fourth criteria of a good theory, the evaluative element, explores the heuristic value
of a theory (Nature of Theory, n.d.). It regards the verifiability, or empirical validity of the
theory, and its applied value, which helps measure how the theory works and the impact of the
theory on actual clients (Nature of Theory, n.d.). Although there is a clear distinction between
the verifiability of these two theories, they both have heuristic and applied value.
Verifiability
There are a great number of easily accessible meta-analyses exploring the efficacy of
cognitive therapy. The efficacy and theoretical aspects of cognitive therapy have been
extensively researched over the years. In fact, it is one of the most extensively researched
forms of psychotherapy (Butler, Chapman, Foreman & Beck, 2006). It is viewed as a welldefined model that is regarded as a successful treatment of choice for many disorders (Beck &
Weishaar, 2011). Due to its strong empirical basis and proven efficacy, cognitive therapy has
developed wide appeal and grown quickly, influencing the field of psychology (Beck & Weishaar,
2011).
In contrast, there is a clear lack of studies exploring the efficacy of existential therapy.
Although existential therapy has an extensive history, dating back to Greek philosophers, it is
not a counseling practice that is based on research (Corey, 2009). As Yalom and Josselson
(2011) state, Psychotherapy evaluation is always a difficult task (p. 335). The lack of
operational definitions, testable hypotheses and the vague explanations lead to confusion and
difficulty conducting research on the process or the outcome of existential therapy (Corey,
2009).
Heuristic and Applied Value

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Cognitive therapy has a strong framework that has clear immediate and long-term
results with a variety of psychological challenges (Beck & Weishaar, 2011). It is an approach
that can be designed for people of all ages and is a useful tool to increase our understanding of
a wide range of disorders. Therapists and clients benefit from the collaborative relationship that
guides the client and therapist towards a greater understanding of the underlying issues leading
to a clients struggles (Beck & Weishaar, 2011).
Although existential theory does not pass the intense scrutiny of the empirical validity of
the theory, it most certainly has value in helping therapists understand their client. The nature of
the relationship between an existential therapist and client is one of mutual respect. Many times
an existential therapist knows their client on a deeper level than many of the individuals in their
life (Yalom & Josselson, 2011). The existential approach was originally criticized for being too
philosophical, but that assumption has been adjusting as people realize that all effective
psychotherapies have a philosophical component (Yalom & Josselson, 2011). The goal of the
founders of existential psychotherapy was that it would influence all other therapies. As Yalom
and Josselson (2011) indicate, this has been occurring and is quite clear (p. 340). The ability
to influence a wide number of diverse theories proves the true value found with existential
therapy.
Conclusion
Cognitive theory and existential theory share many commonalities. They have a similar
phenomenological view, they see the importance of self-reflection and they can be applied to
diverse populations. However, they differ greatly in their prescriptive and descriptive elements.
Despite these differences, these models have the potential to benefit one another. Cognitive
therapy has limitations in its ability to explore existential questions such as the meaning of life
(Prasko, Mainerova, Jelenova, Kamaradova & Sigmundova, 2012). As Prasko and colleagues
(2012) note, an integration of existential views to the CBT approach could notably enrich the
treatment of clients.

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References
Beck, A. T., & Weishaar, M. E. (2011). Cognitive therapy. In R. J. Corsini, & D. Wedding (Eds.),
Current psychotherapies (9th ed., pp. 276-309). Belmont, CA: Thomson Brooks/Cole.
Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of
cognitive-behavioral therapy: a review of meta-analyses. Clinical psychology review,
26(1), 17-31.
Corey, G. (2009). Theory and practice of counseling and psychotherapy (8th ed.). Belmont, CA:
Thomson Brooks/Cole.
Corrie, S., & Milton, M. (2000). The relationship between existential-phenomenological and
cognitive-behaviour therapies. European Journal of Psychotherapy, Counselling & Health,
3(1), 7-24.
The Nature of Theory [Course Handout]. (n.d.) Retrieved from
https://blackboard.ucalgary.ca/webapps/portal/frameset.jsp?tab_id=_2_1&url=%2fwebapps
%2fblackboard%2fexecute%2flauncher%3ftype%3dCourse%26id%3d_155723_1%26url%3d
Mulhauser, G. (2011). Evaluating Therapeutic Effectiveness in Counselling And Psychotherapy.
Retrieved from http://counsellingresource.com/lib/therapy/types/effectiveness/.
Prasko, J., Mainerova, B., Jelenova, D., Kamaradova, & Sigmundova, D. (2012). Existential
perspectives and cognitive behavioral therapy. Activitas Nervosa Superior Rediviva,
54(1), 3-14.
Yalom, I. D., & Josselson, R. (2011). Existential psychotherapy. In R. J. Corsini, & D. Wedding
(Eds.), Current psychotherapies (9th ed., pp. 310-341). Belmont, CA: Thomson
Brooks/Cole.

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