Logotherapy: How It Works, Cost, & What to Expect

What Is Logotherapy?

In logotherapy, you will explore and become more aware of what makes your life meaningful so you can better deal with difficulties and overcome problems.^1,2 Logotherapy seeks to help people discover and recognize their freedom to find meaning despite problems and challenges and to determine ways to turn it into positive, goal-directed action in their lives.³

Logotherapy is recognized as a scientifically valid approach to mental health therapy.¹

Logotherapy is guided by the principle that its founder, Victor Frankl called “will to meaning.” This means that people are ultimately motivated by a sense of meaning. Problems happen when we veer off track and lose sight of our inner purpose. A therapist drawing from logotherapy believes that all people have strengths and inner resources to develop and use to deal with a wide range of difficulties.⁴ Further, everyone has the ability to separate themselves from any problem and go beyond themselves and their own thoughts and feelings to find meaning.⁵

The Viktor Frankl Institute of Logotherapy explains six basic assumptions that underlie logotherapy:⁶

1. All people are composed of body, mind, and spirit. We have a body, and we have a mind. We are spirit (our greater purpose). (It’s important to note that logotherapy is a secular approach to mental health, but the basic principles are part of many spiritual traditions.)
2. Every life situation, even the most dreadful, has meaning.
3. People are driven to discover meaning and live a purposeful life.
4. We all have the freedom to find meaning and to choose our attitude and response to any circumstance.
5. Freedom and purpose come from finding the meaning of the moment. No matter what a given situation is like, we can accept it, face it, choose our response, and live with purpose.
6. Each person is unique, and so is their sense of meaning and purpose.

The goal of logotherapy is to activate someone’s will to meaning by doing activities like:^2,6,7

• Creating or doing something
• Experiencing something (a situation or a relationship) fully, living in the present moment, accepting it for what it is
• Choosing your attitude, perspective, and response in all situations, even negative ones

A therapist incorporating logotherapy works with you based on these core beliefs and principles. They drive the conversation and activities you do in therapy.

Logotherapy Techniques

Logotherapy uses specific techniques to help people discover their sense of purpose, shape their outlook, and take positive action in their lives. The four primary techniques are Socratic dialogue, paradoxical intention, dereflection, and logoanalysis.^1,3,4 A handful of other, lesser known, techniques are used as well.⁴

1. Socratic Dialogue

Socratic dialogue, or socratic questioning, is the most frequently used technique in logotherapy. During sessions together, the therapist asks the client questions to facilitate self-discovery. As clients answer the questions, the therapist helps them see themes and patterns that provide clues to their sense of meaning. Questions focus on increasing self-awareness, identifying goals, and making choices consistent with meaning.

2. Paradoxical Intention

In this intervention, a therapist helps a client directly face fears and problems. A normal human reaction to difficulties is to avoid them. However, when we avoid problems they actually grow bigger and more powerful because we end up living in our mind, in our thoughts and feelings about the problem.

We don’t give ourselves the chance to experience and handle difficulties directly. It is only in facing our challenges that we can move past them. Paradoxical intention is very similar to exposure therapy, a process for facing anxiety, fear, and phobias. In therapy, it is done in a safe and supportive manner.

3. Dereflection

This technique involves helping people change their focus and to think differently about problems. Similar to detachment in acceptance and commitment therapy, it teaches people to take a break, step back, and to think differently about challenges. Instead of hyperfocusing on something (whether that’s a goal or a difficulty), dereflection helps change thinking and frees people to act in more meaningful ways.

4. Logoanalysis

This involves exercises, frequently written, to help people identify their own sense of meaning and shape goals. Often an extension of Socratic questioning, logoanalysis helps people clarify their values and develop action steps to infuse their life with a greater sense of purpose.

One tool that therapists sometimes use to foster their clients’ self-discovery is an assessment called the Meaning In Life Evaluation scale (MILE). This is a paper-and-pencil or computerized test that asks a series of questions about attitudes and approaches to various situations. Therapist and client discuss the answers together to explore them more fully.

Other Logotherapy Techniques

Logotherapists use a variety of other tools during sessions with clients, including:

• Use of stories and metaphors to help people see how others find meaning in difficult situations
• Mountain range exercise where the client receives a drawing of a mountain range and places people of importance (people they know in their personal life as well as those they respect in society) on various mountain peaks, reflecting on what they have in common with these people and clarifying which mountain peaks they’d like to be a part of
• Movies exercise that asks the client to conceptualize their life as a movie (including past, present, and future) so they can better understand the “characters” in their movie and the roles each person plays, interaction patterns, themes, and more
• Family shoebox game in family therapy in which family members tape images and pictures to the outside and inside of a shoebox to represent family values and meaning

The techniques of logotherapy help people choose and shape their attitude and response to difficulties so they can find acceptance, meaning, and purpose.⁷ Logotherapy and its tools exist to help people hone their sense of meaning, help them discover their true sense of self and place in the world, and to pursue what matters to them in order to improve their own lives as well as the lives of others.⁸

What Can Logotherapy Help With?

Logotherapy can help with a wide variety of challenges. It can help people deal with difficulties they encounter in their lives, and it can help people deal positively and even overcome mental health disorders.

Frankl originally designed logotherapy to help with anticipatory anxiety (excessive worry about something that might happen in the future), feelings of emptiness, and what he called “the neurotic triad”—aggression, depression, and addiction.⁴

In addition to these challenges, logotherapy has been used for such things as:^4,8

• Chronic pain
• Guilt
• Grief and loss
• Dealing with chronic illness or serious mental illness (not as a cure for the illness but as a way to positively cope with it)
• Neurodevelopmental disabilities (including, but not limited to, autism, ADHD, and Tourette’s syndrome)
• Family and relationship struggles
• Rehabilitation
• Aging

Having a defined sense of purpose and living with meaning has been shown to improve overall mental health and wellbeing; sleep, physical health, longevity, and healthy aging.^1,9,10,11

Logotherapy Examples

Because living a life with meaning is so important to well-being, logotherapy can be used to help people facing many different challenges. It is often incorporated into other therapeutic approaches such as cognitive-behavioral therapy (CBT), so its use is nearly unlimited.^1,4 These are just a few examples of how logotherapy can be used to help people overcome specific challenges.

Logotherapy for Anxiety

Logotherapy is especially suited for existential anxiety, the often vague feeling of unease, discontent, worry, and distress related to the struggle to understand life, yourself, and your place in the world. Particular existential themes that are bothersome for people include the idea or fear of death, meaninglessness, isolation, and the responsibility that comes with freedom.³

With its emphasis on finding and living with meaning, logotherapy is considered a type of existential therapy and thus, is perfectly suited to helping people experiencing existential dread or going through an existential crisis. With its paradoxical intention, logotherapy is helpful for other anxiety types and anxiety disorders as well. With the help and support of a therapist, people are encouraged to not just face their fears and worries but to learn how to respond to them positively.²

When people are aware of their sense of purpose and core values and know-how to incorporate them into daily life, they can respond to challenges intentionally rather than merely reacting out of fear or worry. Logotherapy helps people reduce the negative effects of anxiety on their life.

Logotherapy for Depression

Viktor Frankl addressed what he called an “existential vacuum,” a loss of motivation to engage in life—both responsibilities and pleasures—and even interest in things or people once enjoyed.⁵ These are hallmarks of depression, especially existential depression, and they can both cause and be caused by feelings of meaninglessness.

In its emphasis on living purposefully and creating and meeting goals based on personal values, logotherapy directly decreases symptoms of depression and makes them more manageable. It can reduce depression symptoms in the short term as well as prevent depression relapse.²

Logotherapy for Addiction

Numerous studies indicate that a sense of meaninglessness is often at work in addictions and that developing a deep sense of purpose is helpful in overcoming addictions.⁴ Living with meaning is a fundamental concept of a variety of approaches to addiction, including Alcoholics Anonymous and Narcotics Anonymous.

While logotherapy is different from these programs, in its targeted approach to discovering meaning and creating purposeful goals, logotherapy can be effective for people facing a variety of addictions.

Logotherapy for Burnout

While logotherapy lends itself well to helping people cope with diagnosable illness (both mental and physical), it can also help people who are dealing with burnout.² Burnout, sometimes called burnout syndrome, refers to feeling fatigued both physically and mentally as well as a lack of motivation or desire to keep working toward goals. A study review published in 2019 found that burnout is associated with not just work overload but by pushing toward superficial goals such as power or money rather than goals that bring meaning, purpose, and fulfillment.⁵

They also concluded that logotherapy, in helping people find meaning and engage in purposeful activities that go beyond merely satisfying basic needs, is useful in overcoming this exhaustion with life. Essentially, logotherapy allows people to discover and be who they truly are rather than remaining stuck in what they feel they have to do.

Is Logotherapy Effective?

Logotherapy is a scientific, evidence-based approach to mental health therapy. Almost 2,000 papers have been published about logotherapy’s effectiveness, and because of the evidence supporting both logotherapy and the importance of living with meaning and purpose, around 60 formal mental health assessments have been created and are in use based on logotherapy’s principles.¹

Further, since 1978 logotherapy has had its own dedicated, peer-reviewed journal, The International Forum for Logotherapy, focusing on research into the therapy’s effectiveness. Studies of logotherapy appear in a wide variety of other professional journals as well.

Logotherapy can be beneficial for people facing a wide range of difficulties because having a defined sense of meaning helps people cope. When people change the way they think about even big problems, finding positive meaning and shaping their attitude accordingly, they can more easily determine positive action steps to take to thrive despite obstacles.⁷

Just a sampling of studies indicating that logotherapy is effective include:

• A study, published in 2017 in the journal Sleep Science and Practice, involving 825 older adults without dementia examined the connection between sleep quality and having purpose. Researchers concluded that when older adults developed a strong sense of meaning in life, their sleep quality improved. They showed reduced symptoms of conditions such as sleep apnea and restless leg syndrome immediately following therapy and at follow-up checks one and two years after therapy concluded.¹⁰
• Students receiving logotherapy experienced greater improvement in depression symptoms.¹²
  Another study found that logotherapy improved anxiety and depression in mothers of children with cancer.¹³
• In a 1994 paper, psychologist Gary Reker examined studies and reported that there is a strong correlation between living with meaning and purpose and psychological well-being (having more positive emotions and experiences like happiness, joy, and inner calm than negative emotions like fear, anxiety, and depression) and that logotherapy fosters both meaning and psychological well-being.⁷
• Logotherapy effectively helps people cope with cancer, decreasing symptoms of depression and feelings of demoralization. This finding from a study of 61 women with breast or gynecological cancer was reported in the January, 2021 issue of the journal Cancer Nursing ¹⁵
• Seventeen adolescents with cancer who completed a logotherapy program experienced less suffering and a heightened sense of meaning compared to a control group of 12 adolescents also with cancer. This study appeared in 2009 in the journal Child Health Nursing Research.¹⁶
• In a study appearing in 2013 in the International Journal of Psychology & Psychological Therapy, researchers analyzed the effectiveness of logotherapy for people who are quadriplegic. They administered the Purpose in Life and Life Regard Index assessments to hospital inpatients aged 15-65. Thirty-two participants who scored low in feelings of meaning and positivity participated in the study, half received logotherapy and half received no treatment. Those that received logotherapy experienced reduced anxiety, fear, helplessness, meaninglessness, and sense of suffering.¹⁷

Limitations of Logotherapy

Logotherapy does not cure illness or erase life problems, nor does not claim to do so. What it can do is help people cope positively with and live with purpose despite even great hardship. For example, logotherapy has been shown to be useful in helping people with serious mental illness like schizophrenia lead quality lives, but it does not cure the brain itself that is responsible for schizophrenia.⁴

Logotherapy is most effective when it is incorporated into other forms of treatment rather than used as a stand-alone therapy. In fact, Frankl himself didn’t intend logotherapy to be an entirely separate, segmented approach to well-being but envisioned its principles incorporated into many different approaches to helping people.⁴ Perhaps this is because logotherapy, with its emphasis on meaning, fits extremely well with other therapies.

Because of its emphasis on reshaping thoughts and choosing one’s attitude and perspective on events, many consider it to be a precursor to cognitive therapies, including CBT; additionally, logotherapy shares similarities with narrative therapies, ACT, strengths-based therapies like positive psychology, and rational emotive behavior therapy (REBT).

Criticisms

Logotherapy, especially in its early years, has been criticized for being rather authoritarian, with the therapist rather than the client driving much of the process. Logotherapy has sometimes been considered to be too spiritual in nature, perhaps because Frankl initially found much support in the United States from leaders of many different religious traditions.^1,18

In reality, while a therapist does drive the questions and suggest certain interventions, the client is an active participant in the process, engaging in discussion, activities, and shaping their own goals and sense of meaning. The client discovers their own purpose with the guidance of the therapist. Regarding the spiritual nature of logotherapy, meaning is an integral component of most religious traditions worldwide; however, logotherapy itself is not religious and doesn’t steer clients toward spirituality or religion.

Much of the criticism of logotherapy (that it is too spiritual and is authoritarian) was driven by Rollo May, founder of existential therapy and contemporary of Frankl.¹⁸ May wasn’t fond of Frankl personally, describing him as arrogant and accusing him of capitalizing on his time in the Nazi concentration camps by working on his theory.

How to Find a Therapist Who Practices Logotherapy

While logotherapy is an approach to mental health in its own right, it often isn’t offered directly as are specialties such as CBT, acceptance and commitment therapy (ACT), solution-focused brief therapy, or other types of therapy,^1,3 Accordingly, finding a therapist who practices logotherapy is similar to the process of finding a mental health therapist in general.

Ask people you know and trust if they have recommendations for therapists, including friends and family members, your doctor, or a faith leader. You can also find resources and recommendations for mental health providers by visiting local mental health organizations.

Additionally, community centers and libraries often have bulletin boards or dedicated displays offering brochures, business cards, and other information about local service providers, including therapists. A great resource for finding therapists who use logotherapy is an online therapist directory.

When looking for a therapist who practices logotherapy, check their online information and bio for their credentials and areas of specialty. Those that use logotherapy in their work with people will often clearly indicate this. Some, however, don’t list the therapeutic approaches they use because they personalize their methods according to the needs of each individual client. If nothing is mentioned, you can contact them to ask, or if you schedule an initial consultation, you can ask them during this meeting if they use logotherapy.

Who Is Able to Offer Logotherapy?

Any licensed mental health professional can offer logotherapy. Some licensed therapists choose to receive special certification in logotherapy, which adds a level of skill and precision to their work.⁴

The Viktor Frankl Institute of Logotherapy, an international organization that in the U.S. is located in Texas, offers a logotherapy certification program that is approved by the American Psychological Association for continuing education for mental health professionals.¹⁴ This means that to be accepted into the program, someone must already have an advanced degree and be licensed or certified in a mental health profession. The program involves four core courses in the concepts and application of logotherapy.

While this certification isn’t required for someone to offer logotherapy, if someone has this credential it means that they are well-versed in using logotherapy to help you. Typically, such certification is listed on a therapist’s website or and/or is displayed in their office.

Key Questions to Ask When Considering Logotherapy

It’s normal to have questions when considering any type of therapy, including logotherapy. Therapists are very open to questions, and one sign of a good therapist is their willingness to answer questions over the phone or during a consultation. Sometimes, though, the process is a bit intimidating and/or you are too caught up in the challenges that motivate you to work with a therapist to think about what to ask on the spot, so it can be helpful to have an idea of helpful questions.

Key questions to ask before beginning logotherapy include:

• Have you used logotherapy to help other people with the problem I’m having?
• Will we address solving my problem directly, or will we only focus on finding meaning in life?
• What will our relationship be like? Will we work together collaboratively, or do you lead the process?
• What will happen during our sessions?
• How long will therapy last, or how many sessions will I have?
• What is your fee?

How Much Does Logotherapy Cost?

Because logotherapy isn’t typically a stand-alone therapy but can be offered by any mental health therapist, the cost of logotherapy is the same as what a given therapist charges for their services. The median cost of therapy is approximately $130.¹⁴

That said, the cost can be as low as $50 per session or above $200, depending on a therapist’s geographic location, level of education and experience, and setting (a community mental health center versus a private practice). Some therapists offer a sliding fee scale in which the cost is determined by income level.

Insurance companies are increasingly covering mental health therapy, but coverage is still limited to certain diagnosed mental health disorders and approved treatments for those conditions. Check with your insurance company to determine if they pay for all or part of therapy and what their requirements and limitations are.

What to Expect at Your First Appointment

Logotherapy typically has four phases or steps, and the number of sessions spent on each step varies according to both the therapist and the individual client.

The four phases of logotherapy are:^4,5

1. Shaping a realistic perception of what is causing you difficulty
2. Developing a different attitude about problems and overcoming difficult emotions
3. Reducing symptoms, acquiring coping skills, and enhancing decision-making abilities
4. Choosing positive action to maintain mental health and wellbeing

Diving into everything at once would be incredibly overwhelming if not impossible, so logotherapy is a gradual process. Initially, you’ll begin developing insight and understanding of yourself and your challenges. Even before this, though, at your first appointment, you and your therapist will get to know each other and begin to feel comfortable together. Your therapist will likely use Socratic questioning even in this first visit, as asking questions will help your therapist understand you and your experiences. This will shape the subsequent sessions.

You will also be allowed to ask questions of your therapist. If you have concerns or hesitations, you’ll be allowed and encouraged to voice them. It’s important to feel comfortable with your therapist, feeling respected and heard as well as knowing you can trust them, and this relationship begins with the first appointment.

History of Logotherapy

Viktor Frankl founded logotherapy largely inspired by his experiences and losses as a prisoner in Adolf Hitler’s concentration and death camps. Before his arrest, Frankl was a psychiatrist and from 1940-1942 had been the director of the Neurological Department of the Rothschild Hospital in Vienna. He and his family were arrested and imprisoned.

Frankl was imprisoned in a total of four concentration camps, including the death camps Dachau and Auschwitz.³ He was the only surviving member of his family. He lost his parents, brother, first wife, and their children, and he witnessed great loss and unspeakable horrors. He observed firsthand the will to meaning and the great power and potential it has to help people transcend suffering.

Frankl developed logotherapy as an official type of psychology in the 1940s and 1950s, and continued to research and develop it throughout his life (he passed away in 1997).³ Throughout his lifetime, Frankl wrote over 30 books and 700 articles on meaning and logotherapy.⁴

As a form of existentialism, logotherapy is considered to be the third school of psychotherapy, with Sigmund Freud’s psychoanalysis and Alfred Adler’s individual psychology being the first and second schools of psychology and psychotherapy.^2,3

Final Thoughts on Logotherapy

Logotherapy is a powerful approach to mental health and wellbeing. According to this approach, each person’s suffering is highly personal and unique. Whatever struggles are preventing you from living fully, working with a therapist who uses logotherapy can help you cope with and rise above your challenges to live life with meaning and purpose. Meaning, after all, doesn’t arise from being happy. It is living with meaning that leads to happiness.⁷