by Harmony Kwiker | Founder of The Awakened Therapist Approach
In the field of psychotherapy, the phrase evidence-based is often used as a marker of legitimacy, professionalism, and ethical care. And yet, many clinicians wonder whether approaches that feel holistic, spiritual, relational, or deeply experiential can truly belong in that category.
To answer that question clearly, it helps to slow down and define what evidence-based actually means.
In psychotherapy, there is an established standard of care that emphasizes the use of evidence-based clinical approaches. This standard exists to ensure that the services we offer are not only thoughtful and ethical, but also demonstrably effective. Evidence-based has a specific meaning. It refers to interventions that have been studied through empirical research and shown to produce outcomes that are statistically significant, meaning the observed changes are reliable, measurable, and unlikely to be due to chance (American Psychological Association, 2006).
This distinction matters because evidence-based is often used loosely. It does not simply mean that an approach feels helpful, aligns with a therapist’s values, or is supported by personal or clinical intuition. Evidence-based practice refers to approaches that have been researched, measured, and shown to reliably support change. Statistical significance is the threshold. That is the standard our field has named.
Why Spiritual and Transpersonal Approaches Are Often Misunderstood
There is a common misunderstanding in psychotherapy that spiritual, transpersonal, or holistic approaches do not fit within evidence-based care. Many clinicians assume that if an approach is relational, experiential, embodied, or spiritually oriented, it must sit outside of empirically supported practice. This assumption is understandable given how evidence-based care is sometimes framed, but it is not accurate.
Transpersonal and holistic approaches are not excluded from evidence-based practice by definition. They are only excluded when they lack empirical support. The presence of embodiment, spirituality, or expanded states of consciousness does not inherently conflict with scientific rigor (Friedman & Hartelius, 2013).
Gestalt Therapy as an Evidence-Based Holistic Approach
Gestalt therapy is a clear example of this distinction. Gestalt is a holistic psychotherapy that works simultaneously with cognition, emotion, embodiment, relationship, and awareness. It includes dialogic engagement with different aspects of the self, supports somatic intelligence through attention to bodily experience, increases consciousness through present-moment awareness, and invites the integration of disowned or split-off aspects of self, often referred to as shadow. Gestalt also holds a transpersonal orientation that allows spiritual experience and subtle energy to be explored as lived, embodied phenomena rather than abstract belief systems (Kepner, 2014).
Rather than separating mind, body, emotion, and spirit into different domains of treatment, Gestalt therapy works with the whole person as a living, self-organizing system.
Importantly, Gestalt therapy has been studied and shown to produce statistically significant outcomes across a range of clinical concerns, including anxiety, depression, trauma-related symptoms, psychosomatic distress, and relational difficulties (Elliott et al., 2013; Rosner et al., 2000). When evidence-based practice is defined accurately and the research is examined directly, Gestalt therapy clearly meets the standard of care.
What the Research Actually Shows About How Change Happens
Part of the confusion around Gestalt therapy arises because it does not easily lend itself to highly manualized or technique-driven research designs. Gestalt is a process-based therapy. It focuses on how change occurs rather than isolating a single intervention and applying it uniformly across clients.
Research on Gestalt therapy often examines therapeutic process variables such as awareness, emotional engagement, relational contact, embodied experience, and moment-to-moment responsiveness, and how these variables contribute to outcome over time (Elliott et al., 2013).
This emphasis is not a weakness. It aligns closely with the broader psychotherapy research literature, which consistently shows that factors such as the quality of the therapeutic relationship, therapist attunement, emotional presence, somatic engagement, and client participation are not only clinically meaningful, but statistically significant predictors of therapeutic outcome (Norcross & Lambert, 2019; Wampold & Imel, 2015).
Gestalt therapy explicitly trains therapists in these capacities as central clinical skills, not as secondary techniques. From an evidence-based perspective, this means Gestalt therapy is working directly with the variables research consistently shows matter most for meaningful and lasting change.
Decolonizing Evidence-Based Care
There is also an important cultural layer to this conversation. Much of what we now consider evidence-based care has emerged from Western, medicalized frameworks that prioritize control, standardization, linear causality, and externally imposed measures of change. While these frameworks have contributed valuable research methodologies, they have also participated in a narrowing of what has been recognized as legitimate healing (Gone, 2010).
Within this paradigm, approaches that center embodiment, relational attunement, inner authority, spirituality, subtle energy, and community have often been marginalized not because they lack effectiveness, but because they do not conform easily to reductionist models of study. This has especially impacted holistic, experiential, transpersonal, and indigenous-informed approaches that understand healing as something that emerges from within the person and within relationship rather than something imposed from the outside (Hartmann et al., 2017).
Gestalt therapy offers a decolonized relationship to evidence-based care. It does not reject empirical research or statistical significance. Instead, it expands what is recognized as valid evidence by honoring phenomenological experience, somatic intelligence, relational process, consciousness, and organismic self-regulation as legitimate and measurable contributors to change. It allows room for spiritual experience and subtle energy to be explored as part of human experience without bypassing empirical accountability.
Gestalt does not position the therapist as the expert who delivers healing, nor does it position the client as a passive recipient of intervention. Instead, it restores agency, dignity, and inner authority to the client while remaining accountable to outcomes.
Holding Rigor and Wholeness Together
Gestalt therapy demonstrates that evidence-based practice does not have to be mechanistic, hierarchical, or disconnected from meaning. It can be rigorous and relational. It can be statistically supported and spiritually informed. It can be holistic without abandoning scientific accountability.
When evidence-based practice is understood accurately, Gestalt therapy does not sit at the margins of psychotherapy. It stands as a living example of how clinical rigor and human wholeness can coexist, offering care that is measurable, ethical, deeply relational, and profoundly alive.
References
American Psychological Association. (2006). Evidence-based practice in psychology. American Psychologist, 61(4), 271–285. https://doi.org/10.1037/0003-066X.61.4.271
Elliott, R., Watson, J. C., Goldman, R. N., & Greenberg, L. S. (2013). Learning emotion-focused therapy: The process-experiential approach to change. American Psychological Association. https://doi.org/10.1037/14043-000
Friedman, H. L., & Hartelius, G. (2013). The Wiley-Blackwell handbook of transpersonal psychology. Wiley-Blackwell.
Gone, J. P. (2010). Psychotherapy and traditional healing for American Indians: Exploring the prospects for cultural integration. Journal of Counseling Psychology, 57(2), 151–162. https://doi.org/10.1037/a0018932
Hartmann, W. E., Gone, J. P., & Wendt, D. C. (2017). Decolonizing psychotherapy for Indigenous clients: A critical review of the literature. American Journal of Community Psychology, 59(3–4), 343–358. https://doi.org/10.1002/ajcp.12180
Kepner, J. I. (2014). Body process: Working with the body in psychotherapy. GestaltPress.
Norcross, J. C., & Lambert, M. J. (2019). Psychotherapy relationships that work III. Psychotherapy, 56(4), 423–430. https://doi.org/10.1037/pst0000230
Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.). Routledge.
Learn more
If this perspective on evidence-based, holistic, and spiritually grounded psychotherapy resonates, there are many ways to continue exploring this work.
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The Awakened Therapist Trainings are designed for clinicians who want to practice in a way that is evidence-based, embodied, relational, and spiritually integrated. Our programs weave together Gestalt therapy, somatic intelligence, nervous system literacy, parts work, transpersonal psychology, and decolonized approaches to healing.
Learn more about upcoming trainings and certification pathways through the Institute for Spiritual Alignment.
Trainings: https://awakenedtherapist.com/trainings
Explore the Books
Harmony Kwiker is the author of several books that deepen and expand the ideas explored in this post, including The Awakened Therapist, Holistic Co-Regulation, Align, and Reveal. These works integrate clinical insight, embodied practice, and spiritual awareness for therapists and seekers alike.
Books: https://awakenedtherapist.com/books
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