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The complexity of the depth that existential counseling entails may be overwhelming. Although existentialism may be used with a wide spectrum of concerns, it requires individuals to face their fears, anxieties, and responsibilities and to realize that change is a lifelong process. An existential approach also focuses on the interpersonal nature of counseling and psychotherapy and provides the client insight into other relationships. Individuals who avoid contact with others will find this approach intrusive. Nevertheless, not providing clients with specific direction and solutions to their problems may be unsettling to those who want a more prescriptive, albeit dispassionate, approach.

Understandably, some clients may also be skeptical because of the lack of clearly defined steps in treatment. Existentialism is not for clients who want to avoid pain or get immediate relief from the struggle. Whether or not existential counseling or psychotherapy is brief, the existential search tends to go beyond four or five sessions.

Probably the most evident challenge for existentialism is the lack of scientific exploration specifically focused solely on existential interventions. Existentialists have been building research validating their approach, but the unscripted nature of the existential journey does not easily lend itself to the scientific process. While cognitive behaviorists are generating incremental, specific studies to validate each aspect of their theory, existential research is being evidenced in different forms. In medicine, counseling, and related health care fields, existential concerns are being discussed and studied in outcome, developmental, meta-analysis, and applied research. In the integrated existential approaches, the power of the struggle to answer questions of being and relating is an important addition to brief or combined theories. Existentialists would seem to be vulnerable in a battle of science but in actuality are becoming woven into the fabric of the healing process.

The studies cited in this chapter show that the struggle over theoretical validation has not yet been resolved. Not only is the lack of proof of the specific theoretical approach problematic, but also individuals without a sense of purpose can be attracted to a model lacking a sequence of techniques and guidelines. Existential counselors or psychotherapists need to continue to validate their approach and ensure specific training for counselors. If they do not, existentialism will be a haven for critical scientific scrutiny and approaches with no substance.

Because most strengths also embody weaknesses, the underlying focus on "being" as well as a client's potential for growth may appear deep and complex. Met at a concrete level, the question of "Who am I?" appears inconsequential when a person is in psychological distress. Existentialism's strength in honoring the person and the struggle may be comprehended as a cursory gesture that does not intend to alleviate the pain.

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