Expressive-experiential therapies

Domain XVI · Historical, discredited & harmful

What it is

"Expressive-experiential psychotherapies" is a category, not a single therapy. Lilienfeld placed it on a provisional list of treatments with some published evidence of harm for some clients, and called the list "a work in progress to be revised and refined". Exactly which named therapies the…

Format

• Historical outline of the practice (for literacy only). The encounter and growth-group movement of the late 1960s and early 1970s ran short intensive groups led by leaders of very different styles. The Stanford study by Lieberman, Yalom and Miles, published as Encounter Groups: First Facts (Basic…
• Phase 1: Recognition and history. Goal: learn whether the client has been in, is in, or is considering an emotion-intensive or confrontational format, and what happened. Format: part of intake and of any session where such a format is mentioned. Move on when the format, setting, leader style and…

Evidence status, as the guide reports it

• Version followed: Lilienfeld (2007), "Psychological Treatments That Cause Harm", Perspectives on Psychological Science 2(1), DOI 10.1111/j.1745-6916.2007.00029.x, as the source of the category "expressive-experiential psychotherapies" on its provisional list of potentially harmful therapies (PHTs);…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Defensiveness. It is working when changes to practice follow.
• Delayed reactions. It is working when difficulties are caught early.
• Conflicts of interest and loyalty. It is working when concerns are documented and acted on.
• Referral that feels like rejection. It is working when the client engages with the new service.
• Rising risk after intense sessions. It is working when the client has a usable plan and risk falls.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.