Gestalt therapy is a humanistic and holistic psychotherapy option that can be used to treat things like anxiety, depression, and relationship issues. Gestalt therapy draws from many other counseling theories that emphasize awareness building, relationships, and personal choice. The goal is to help people overcome blockages in order to live more satisfying and fulfilling lives.1,2,3
What Is Gestalt Therapy?
Gestalt therapy is a type of psychotherapy that contains elements of many other counseling theories, including person-centered therapy, existential and humanistic therapy, as well as aspects of psychodynamic therapy. It also has elements of systems theories emphasizing that a person can’t be understood without looking at the context of their life and relationships.1,3,4,5
Gestalt therapy was also influenced by Eastern philosophies that highlight the importance of here-and-now practices like mindfulness and acceptance. While Gestalt therapists consider the relevance of certain unresolved issues from the past, they tend to address these issues in the present using experiential techniques.1,5 The Gestalt approach was first developed in the 40s and has some followers, but it’s still a relatively uncommon therapeutic approach.
Main Components of the Gestalt Approach to Therapy
There are four focal points of Gestalt therapy that help to summarize the main components. These are the phenomenological method, dialogical relationship, field theoretical strategy, and experimental freedom.
Here are the four components of the Gestalt approach:1,3,5
- Phenomenological method: phenomenological methods in Gestalt therapy involve the use of non-judgmental and unbiased perspectives to help people gain new insight into themselves and their lives. Phenomenology is particularly focused on understanding how clients make sense and meaning from their experiences.
- Dialogical relationship: the dialogical relationship in Gestalt describes the importance of the client-therapist relationship. Similar to person-centered therapy, Gestalt therapists are trained to develop strong therapeutic relationships and alliances with each client. Gestalt therapists are encouraged to be more open, authentic, and transparent with their clients to form this bond.
- Field theoretical strategy: the “field theory” is foundational to Gestalt therapy, and is constructed on the basic belief that humans can only be understood in the context of their lives. This includes their current and past relationships, experiences, situations, and settings, which all work to help shape the individual and their patterns of response.
- Experimental freedom: experimental freedom is the use of creative, experiential, and interactive activities in therapy, in addition to traditional talk therapy models. These Gestalt methods can help clients conduct “experiments” in sessions to help them become more aware of themselves and their patterns. Gestalt therapy exercises and experiments are designed to help clients identify, interrupt, and change certain patterns contributing to their problem.
What Can Gestalt Therapy Help With?
Gestalt therapy has been poorly studied, with only a few studies examining what conditions it can treat and its effectiveness.1,2,6 Gestalt therapy includes many sound clinical interventions like mindfulness, awareness building, and a strong therapeutic alliance. Most of these elements are found in other proven types of psychotherapy.1,2,3,5
However, there still hasn’t been enough research to determine which issues the Gestalt approach can treat and how effective Gestalt therapy is overall. Three studies comparing Gestalt to other proven treatments–cognitive behavioral therapy (CBT), person-centeredness, and psychodynamic therapy–found it just as effective.6
Gestalt therapy can help with these common issues:4
- Depression or mood disorders like bipolar disorder
- Anxiety disorders or general stress and anxiety
- Relationship problems or interpersonal conflicts
- Behavioral problems like gambling disorder
- Self-esteem issues or a lack of confidence
- Negative self-talk
- Identity crisis
- Improving self-awareness
Benefits of Gestalt Therapy
Some of the benefits of Gestalt therapy are related to the foundational principles and techniques, which are also found in other types of therapy.1,2,5 For example, mindfulness has many therapeutic benefits, and role-plays can help people develop and practice new communication and coping skills. Additionally, the focus on a strong client-therapist alliance has been proven to improve outcomes in therapy.7
Benefits of Gestalt therapy that aren’t fully proven, but could potentially help people include:1,2,3,5,6
- Ability to interrupt patterns and replace them with more adaptive responses
- Opportunity to practice mindfulness or communication skills in sessions
- The ability to track changes in thoughts, feelings, and bodily sensations
- Improving self-awareness and insight into problems, origins, and patterns
- Building a strong, warm, authentic relationship with a therapist
- Improving stress management or coping skills and breaking negative behavior patterns
- The ability to work through past traumas or “unfinished business” from the past
- Exploring life meaning and purpose or working through existential anxiety
- Improving relationships and situations that impact mental health and stress
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Gestalt Therapy Techniques
Depending on the issues they are trying to target, Gestalt therapists have developed a range of different techniques. Some of the most widely used and well-known Gestalt therapy exercises and Gestalt techniques include the empty chair technique, role plays, experimentation, dream work, and present moment awareness.
1. The Empty Chair
The empty chair technique is one of the best-known Gestalt techniques. It involves having the client talk to an empty chair in order to resolve old issues and conflicts. Contrary to popular belief, the empty chair technique isn’t just used for the client to create dialogue with an imaginary person from their past or current life; it can also be used for situations, dilemmas, or personal traits or habits.2,5
Here are examples of how and why the empty chair may be used:5
- To help a client “talk” with a deceased or absent loved one from the past to resolve old issues or unresolved traumas
- To allow a client to dialogue with a certain “part” of themselves they dislike (including a trait like shyness or laziness)
- To provide an opportunity to problem solve by placing a dilemma or problem in the empty chair to allow the client to talk through possible origins, options, and solutions
2. Role Plays & Re-enactments
Role plays and re-enactments are another common Gestalt therapy technique that involves helping clients practice certain skills in the present moment during a session. Role plays and re-enactments always involve constructing a “scenario” that the client (and sometimes also the therapist) acts out in the therapy session.1,2,5 These interventions can be used to resolve unfinished business, address root issues, and identify and change patterns.1
Here are examples of how and why role plays and re-enactments may be used:5
- To help a client practice assertive communication skills in a dialogue, role-play, or re-enactment with the therapist
- To have a client use different voice volume, inflection, and tone to notice changes in how they feel
- To create a “safe emergency” where a client is able to practice certain regulation or conflict management skills in a therapeutic role play
3. Experimentation Methods
Experimentation is a hallmark of Gestalt therapy. It involves the use of different Gestalt techniques, activities, role-plays, and skills to help clients notice, interrupt, and change their patterns.2,5 These experiments are used creatively and are individualized to the needs and goals of each particular client.
All experiments are only done when a strong therapeutic alliance is formed, and are always focused on maintaining present moment awareness of physical, emotional, and cognitive changes.1,2,3
Here are examples of how and why experimentation may be used:5
- Exaggeration where the client is asked to over-emphasize a certain word, movement or behavior to notice immediate changes in their body, brain, and emotions
- Reversals where the client is asked to do the opposite of a certain behavior or reverse something they said previously or when a client is asked to role-play a past scenario with the therapist playing the role of client
- Clients may be asked to ‘stay with a feeling’ or even try to make certain painful thoughts or feelings even more painful in order to process through them
4. Dream Work
Dream work is an element of Gestalt therapy that involves re-enacting a client’s dreams inside the therapy session. Because Gestalt is primarily a present-focused therapy, the goal is always to bring memories, thoughts, and even dreams from the past into the here-and-now. Unlike other forms of psychotherapy and analysis, Gestalt therapists do not interpret dreams, but instead use them to help clients build awareness and work through blockages.5,8
Here are examples of how and why dream work may be used:8
- A client experiencing vivid dreams may be asked to re-enact or role-play these dreams to bring up emotions, underlying thoughts, and associated issues
- A client may be asked to identify the main conflict within the dream and then act this conflict out in therapy using the therapist or the empty chair technique
- The therapist may use questions like, “What did you want to happen next?” or “How should this end?” in order to help the client resolve unfinished business or conflicts
5. Present Moment Awareness
Gestalt therapists are always working in the present moment to help track clients’ body language and notice subtle changes that indicate what they’re thinking, feeling, and experiencing. Many Gestalt methods are aimed at helping clients develop this kind of self-awareness during therapy sessions by asking them to notice, track, and describe changes in their body, thoughts, and feelings.1,2,5
Here are examples of how and why present moment awareness may be used:2,5
- A therapist may notice a client shut down, cross their arms, or look down and use this as a cue to ask the client what they’re thinking or feeling
- A client may be asked to track sensations in their body when they think about a certain past traumatic event in order to build awareness of how this still affects them now
- While discussing certain problems or issues, a client may be asked to describe the emotions they’re having, process them, and allow them to pass
Is Gestalt Therapy Effective?
Because of the lack of research, it’s hard to list the issues and conditions that Gestalt therapy can help with. Limited data may explain why Gestalt therapy is not more mainstream, and also why it is not listed as an approved “evidence-based practice” by major associations like the American Psychological Association (APA).1,2,6
Limited data suggests Gestalt therapy can be effective in these situations:6
- In group therapy settings improve their social and emotional wellbeing and conduct
- With children who are struggling with depressive symptoms or mood problems
- With recently divorced women who are trying to move on and become more confident
- With anxious moms to reduce anxiety, improve self compassion, and increase self awareness
Gestalt therapy is not as well-researched or common as other kinds of psychotherapy, but the Gestalt approach focuses on developing a profound respect and connection with each client. This matters because research has consistently proven the therapeutic relationship to be the single most important factor that determines whether a person will benefit from therapy or not.7
Cost of Gestalt Therapy
Gestalt therapy is usually practiced by licensed therapists, social workers, and psychologists in individual or group therapy sessions. These are often covered by insurance, but the specific copay or deductible on your plan will determine your out-of-pocket cost. For those without insurance or who are self-paying, the cost of therapy varies considerably depending on a number of factors.
Factors that can affect pricing of Gestalt therapy sessions include where you live, what kind of provider you see, and the rates the provider sets. As of 2018, the average cost per session was between $100 and $200. In bigger cities, that might be closer to $300. There isn’t a set number of sessions required for Gestalt therapy, although some studies have found positive results in about 12 sessions.6
How to Find a Gestalt Therapist
It can be difficult to find a Gestalt therapist, as not many contemporary therapists use this approach. In 2022, it was estimated that only 3 or 4 out of 100 therapists use Gestalt therapy. Of those who do, some seek out informal training while others choose to get certified by one of the many national or international Gestalt therapy training institutes.
When looking for a therapist, many people begin online by using a free therapist directory that allows them to filter their search by location, insurance type, and specialty areas of practice. One of the most important aspects of choosing a therapist is to find a good “fit,” meaning you select someone with a style and approach that you think is a good match for your needs.7 Most therapists offer a free consultation call to help clients make this decision.
Gestalt therapy is a humanistic and person-centered type of psychotherapy that focuses on present moment awareness, increased insight, personal responsibility, choice, and freedom. The Gestalt method of therapy involves a lot of interactive role-plays, re-enactments, and experiments aimed to help people resolve and change the patterns keeping them stuck and pursue a more meaningful life.1,2,3,5