Talking about life in a serious way: existential-phenomenological therapeutic practice in primary care

Koebbel, Christian Max (2016) Talking about life in a serious way: existential-phenomenological therapeutic practice in primary care. Other thesis, Middlesex University. [Thesis]

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Abstract

Theoretical literature suggests that the counselling psychology core modality of existential therapy provides a good fit with the NHS primary care context, despite a lack of research and official recognition.

The outlined research qualitatively enquires into the experience of practitioners delivering existential-phenomenological practice within primary care. The focus lies on developing a theory of how these practitioners negotiate their professional practice.

Nine practitioners of varying degrees of experience were interviewed and a theory was iteratively constructed, employing a constructionist Grounded Theory methodology. The resulting theory comprises of four major categories: ‘The Medicalness of Primary care’, ‘Existential-phenomenological Practice in Primary Care’, ‘Negotiating Practice in Primary Care’ and ‘The Impact of Professional Experience’. These were verified through a member check with a subsample of seven participants.

Existential-phenomenological practice in primary care is conceptualised as a multi-faceted practice, integrated by a flexible existential-phenomenological ‘attitude’. Working to the demands of the medical model of primary care present a departure from more traditional existential therapy and practitioners are often ambivalent about this. Yet, the grounded
theory suggests that practitioners are able to maintain their existential-phenomenological identity, and that they perceive their work to be both possible and valuable.

The present theory outlines some of the demands that primary care makes on existential-phenomenological practice, but also the practice-strategies employed to negotiate these. These include limitations in time, goal-setting, psychometric tests, diagnostic labels and differing levels of practitioner experience. Especially for novice practitioners, but also training institutions this outline might serve to tackle the lack of practice guidelines in the
field of existential-phenomenological practice in primary care.

Overall, the findings contribute to a dialogue between the community of existential-phenomenological practitioners and the medical model. Further, they support future research that might argue for an inclusion of existential-phenomenological practice into primary care offerings.

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