The role of life meaning in psychotherapy

Changes in meaning in life, working alliance, and outcome in psychodynamic psychotherapy: What leads to what?

“…In addition, we found no changes across time in MILM-E and MILM-R, but rather they seemed to fluctuate across time, perhaps reflecting that sometimes meaning was discussed and sometimes not. Thus, we did not replicate Brandau's (2008) findings of increases on MLQ-P, Volkert et al (2014) findings of increases on the SMiLE, or Hill, Kline, Kivlighan, et al (2019) findings of different patterns for MLQ-P and MLQ-S. Given that we used a new measure (the MILM) and different sampling than the other studies, these results require replication.…”

“…Although MIL has been associated with well-being (Dursun, 2012;King et al, 2006;Steger et al, 2006Steger et al, , 2009Steger & Kashdan, 2007;Zika & Chamberlain, 1992) and has been found to change over the course of psychotherapy (Brandau, 2008;Hill, Kline, Kivlighan, et al, 2019;Volkert et al, 2014), there is still a lack of research clarifying how MIL changes throughout therapy and whether these changes are associated with other aspects of the therapeutic process and outcome. Thus, we sought to address these questions through examining changes in MIL, working alliance, and client outcomes over the first 24 sessions of open-ended individual psychodynamic psychotherapy for 94 clients nested within 12 therapists.…”

“…In summary, we found only three studies examining changes in MIL in nonmanualized, general (not meaning-focused) psychotherapy. Brandau (2008) and Volkert et al (2014) found that clients increased in MIL over the course of therapy, whereas Hill, Kline, Kivlighan, et al (2019) found more nuanced patterns that differed for the presence versus search for MIL. In addition, both Brandau’s and Hill, Kline, Kivlighan, et al’s results suggest that changes in MIL may be associated with changes in client outcomes.…”

“…Although there are studies showing increases in MIL (broadly defined) in manualized brief group treatment approaches with specific clinical samples (e.g., substance dependent and cancer patients; e.g., Breitbart & Poppito, 2014a, 2014bMartin et al, 2011;Saeedi et al, 2019), we focus instead on studies of naturally occurring, nonmanualized, general (not specifically meaning-focused) individual psychotherapy because these are most similar to psychodynamic psychotherapy. Using the Meaning in Life Questionnaire (MLQ; Steger et al, 2006), with its subscale of Presence, MLQ-P (which assesses the extent to which individuals feel they have MIL), and Search, MLQ-S (which assesses the extent to which individuals feel they are searching for MIL), 259 clients receiving an average of 2.9 counseling sessions at a university counseling center increased in the MLQ-Presence over the course of therapy, and changes in MLQ-P predicted changes in client well-being and psychological problems (Brandau, 2008). In addition, 214 inpatient German clients diagnosed with depressive, anxiety, and somatoform disorders receiving an average of nine sessions of psychodynamic therapy increased in scores on the Schedule for Meaning in Life Evaluation (SMiLE; Fegg et al, 2007) across therapy and scores remained stable at a 6-month followup (Volkert et al, 2014).…”

“…The existing research on the relationship between MIL, working alliance, and outcomes in psychotherapy is limited and inconclusive. Although Brandau (2008) hypothesized that working alliance would mediate the relationship between initial MIL and client outcomes, they were unable to test this hypothesis due to nonsignificant findings between MIL and client outcomes (also, clients on average only had about three sessions, which may have made it difficult to establish the working alliance). In Hill et al's (2017) qualitative study with experienced therapists and clients with MIL concerns, they concluded that a safe, caring therapeutic relationship was essential.…”