Cognitive-Behavioral Therapy (CBT) Can Go Deeper Than You Think. Thousands of studies each year validate its effectiveness in treating a broad range of psychological conditions. Its structured, time-limited nature makes it a favored approach in clinical research and practice. However, many practicing therapists have noted that clients often come to therapy with needs that go beyond what standard CBT protocols are designed to address.
One area where this is especially evident is in the realm of existential concerns—questions about meaning, purpose, identity, and mortality. Clients often bring to therapy a desire to understand what their lives mean, what values should guide them, or how to make peace with the limits of their time on Earth. These are not problems that always lend themselves to brief interventions or manualized treatment protocols. Yet they are deeply human and therapeutically essential.
Recent scholarship suggests that CBT can be expanded to incorporate these deeper existential themes. For example, Heidenreich and colleagues (2021) argue that CBT’s focus on cognition aligns well with existential therapy’s emphasis on meaning-making. Likewise, research by Golovchanova and Vanhooren (2022) highlights how therapists can effectively explore meaning in life, particularly with adolescents coping with trauma, by blending existential inquiry with cognitive-behavioral techniques.
In clinical practice, approaches like Acceptance and Commitment Therapy (ACT)—a form of CBT—have already started to move in this direction by emphasizing personal values. However, as the uploaded commentary notes, even ACT may fall short in helping clients deeply explore and define those values when they are grounded in life’s larger philosophical questions. What is the purpose of life? What makes life meaningful? These questions are more than abstract—they often surface in sessions when clients reflect on identity, loss, or the passage of time.
Far from being incompatible, CBT and existential therapy can complement each other. CBT provides structure and evidence-based strategies for change, while existential therapy offers a framework for grappling with life’s most profound dilemmas. Ghaemi (2023) underscores that addressing existential issues—such as death, freedom, and isolation—can enrich any therapeutic approach. In palliative care, as noted by Breitbart and Poppet (2022), existential-CBT interventions help clients face mortality with dignity and insight, demonstrating the clinical value of this integrative approach.
Therapists do not have to choose between addressing symptoms and addressing deeper aspects of the human individual. When CBT is practiced flexibly and creatively, it becomes a vehicle for helping clients do both. In fact, this integration may be one of the most promising directions for psychotherapy in the coming years.
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