Community psychological perspective of psychotherapy: A contradiction?


Evidence indicates the need for including environments and contexts as a focus for psychotherapy; however, the field continues to neglect these elements. The consideration of effective psychotherapeutic processes also tends to lack a prevention-based value orientation. This article provides a first step for closing this gap, by including value-driven and contextually oriented theoretical approaches (e.g. ecological models, recovery models, capability approach, sense of community, empowerment) that are essential for psychotherapy in a community psychology perspective. As a second step, this article emphasizes the need for integrating psychotherapeutic interventions with different preventive strategies. Finally, the article summarizes the additional value that community psychological factors bear for increasing treatment efficacy.


DOI Code: 10.1285/i24212113v5i1p7

Keywords: Keywords: Psychotherapy, Context, Ecology, Capability, Recovery, Prevention,


Aardoom, J.J., Dingemans, A.E., Boogaard, L.H., & Van Furth, E.F. (2014). Internet and patient empowerment in individuals with symptoms of an eating disorder: A cross-sectional investigation of a pro-recovery focused e-community. Eating Behaviors, 15, 350–356.

Adler, A. (1938). Social interest: A challenge to mankind. London: Faber and Faber.

Ali, A., & Lees, K.E. (2013). The therapist as advocate: Anti-oppression advocacy in psychological practice. Journal of Clinical Psychology: In Session, 69(2), 162–171.

Altman, N. (2009). The analyst in the city: Race, class, and culture through a psychoanalytic lens. New York: Analytic Press.

Altus, D.E., & Morris, E.K. (2009). B. F. Skinner's utopian vision: Behind and beyond Walden Two. Behavior Analysis, 32(2), 319-335.

Andrade, F.B., Ferreira Filha, M., Toledo Vianna, R.P., Silva, A.O., & Costa, I.C.C. (2012). Evaluation of participant satisfaction with community therapy: A mental health strategy in primary care. Psychiatry Quarterly, 83, 325–334.

Argentino, P. (2001). Gestalt psychotherapy as community therapy. Therapeutic Communities, 22(2), 85-98.

Avissar, N. (2016). Psychotherapy, society, and politics: From theory to practice. New York: Palgrave Macmillan.

Baiden, P., den Dunnen, W., Arku, G., & Mkandawire, P. (2014). The role of sense of community belonging on unmet health care needs in Ontario, Canada: Findings from the 2012 Canadian community health survey. Journal of Public Health, 22(5), 467–478.

Bandura, A. (1986). Social foundations of thought and action: a social cognitive theory. 1986, Englewood Cliffs, N.J.: Prentice-Hall

Barker, C., & Pistrang, N. (2002). Psychotherapy and social support: Integrating research on psychological helping. Clinical Psychology Review, 22 (3), 361–379.

Baruch, G., & Fearon, P. (2002). The evaluation of mental health outcome at a community-based psychodynamic psychotherapy service for young people: A 12-month follow-up based on self-report data. Psychology and Psychotherapy: Theory, Research and Practice, 75(3), 261-278.

Bode, A.A., George, M.W., Weist, M.D., Lever, N., & Youngstrom, E.A. (2016). The impact of parent empowerment in children’s mental health services on parenting stress. Journal of Child and Family Studies, 25, 3044–3055.

Bronfenbrenner, U. (1979). The ecology of human development. Experiments by nature and design. Cambridge: Harvard University Press.

Bryan, A.E.B., & Arkowit, H. (2015). Meta-analysis of the effects of peer-administered psychosocial interventions on symptoms of depression. American Journal of Community Psychology, 55(3), 455–471.

Chinman, M., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S.S., Swift, A., & Delphin-Rittmon, M.E. (2014). Peer support services for individuals with serious mental illnesses: Assessing the evidence. Psychiatric Services, 65, 429–441.

Christiansen, H., Ebert, D., & Roehrle, B. (2018). Prävention und Gesundheitsförderung Bd. VI. Perspektiven. (Prevention and health promotion Vol. VI. Perspectives). Tuebingen: DGVT.

Chung, R.C.-Y., & Bemak, F.P. (2012). Social justice counseling: The next steps beyond multiculturalism. London: Sage.

Constantino, M.J., Morrison, N.R., Coyne, A.E., & Howard, T. (2017). Exploring therapeutic alliance training in clinical and counseling psychology graduate programs. Training and Education in Professional Psychology, 11(4), 219–226.

Costello, E.J., Erkanli, A., Copeland, W., & Angold, A. (2010). Association of family income supplements in adolescence with development of psychiatric and substance use disorders in adulthood among an American Indian population. Journal of the American Medical Association, 303(19), 1954–1960.

Cuijpers, P., van Straten, F., & Smit, A. (2007). Psychological treatments of subthreshold depression: A meta-analytic review. Acta Psychiatrica Scandinavica, 115 (6), 434–441.

Curtin, K.A., & Eacho, C. (2012). Dimensions of social climate as predictors of satisfaction with multifamily therapy groups for families of students with emotional and behavioral disorders. Group, 36(4), 283–301.

Cutts, L.A. (2013). Considering a social justice agenda for counselling psychology in the UK. Counselling Psychology Review, 28(2), 8–15.

Doyle, P., Quayle, E., & Newman, E. (2017) Social climate in forensic mental health settings: A systematic review of qualitative studies. Aggression and Violent Behavior, 36, 118-136

Ehsan, A.M., & DeSilva, M.J. (2015). Social capital and common mental disorder: a systematic review. Journal of Epidemiological Community Health, 69, 1021–1028.

Engbers, T.A., Thompson, M.F., & Slaper, T.F. (2016). Theory and measurement in social capital research. Social Indicator Research, 132(2), 537-558. DOI 10.1007/s11205-016-1299-0

Engström, M., Westerberg Jacobson, J., & Mårtensson, G. (2015). Staff assessment of structural empowerment and ability to work according to evidence‐based practice in mental health care. Journal of Nursing Management, 23(6), 765–774.

Epping, J., Muschik, D., & Geyer, S. (2017). Social inequalities in the utilization of outpatient psychotherapy: analyses of registry data from German statutory health insurance. International Journal for Equity in Health, 16, 147-155.

Fine, P. (2007). Psychodynamic psychiatry in community settings. Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 35(3), 431-441.

Finegan, M., Firth, N., Wojnarowski, C., & Delgadillo, J. (2017). Associations between socioeconomic status and psychological therapy outcomes: A systematic review and meta-analysis. Depression and Anxiety, 35, 560–573.

Fitzsimons, S., & Fuller, R. (2002). Empowerment and its implications for clinical practice in mental health: A review. Journal of Mental Health, 11(5), 481–499.

Flückiger, C., Del Re, A.C., Wampold, B.E., & Horvath, A.O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316-340.

Folgheraiter, F., & Pasin, A. (2009). Self-help groups and social capital: New directions in welfare policies? Social Work Education, 28(3), 253–267.

Flückiger, C., Wüsten, G., Zinbarg, R. E. & Wampold, B. E. (2010). Resource activation –Working with the patient strengths. Göttingen, Germany: Hogrefe.

Fontana, A., Dowds, B.N., & Eisenstadt, R.L. (1980). Social class and suitability for psychodynamic psychotherapy: A causal model. Journal of Nervous and Mental Disease, 168 (11), 658–665.

Forget, E.L. (2011). The town without poverty. Using health administration data to revisit outcomes of a Canadian guaranteed annual income field experiment. University of Manitoba. Retrieved from [29.11.16].

Frost, B.G., Tirupati, S., Johnston, S., Turrell, M., Lewin, T.J., Sly, K.A., & Conrad, A. (2017). An integrated recovery-oriented model (IRM) for mental health services: evolution and challenges. BMC Psychiatry, 17(1).

Fuller, R.C. (1982). Carl Rogers, religion, and the role of psychology in the American culture. Journal of Humanistic Psychology, 22(4), 21-32.

Garcia-Reid, P., Peterson, C.H., Reid, R.J., & Peterson, A. (2013). The protective effects of sense of community, multigroup ethnic identity, and self-esteem against internalizing problems among dominican youth: Implications for social workers. Social Work in Mental Health, 11(3), 199–222.

Gendlin, E.T. (1968). Psychotherapy and community psychology. Psychotherapy: Theory, Research and Practice, 5 (2), 67–72. Retrieved from [23.11.16].

Gibbons, M.B.C., Rothbard, A., Farris, K D., Wiltsey, S., Thompson, S.M., Scott, K., Heintz, L.E., Gallop, R., & Crits-Christoph, P. (2011). Changes in psychotherapy utilization among consumers of services for major depressive disorder in the community mental health system. Administration and Policy in Mental Health and Mental Health Services Research, 38(6), 495-503.

Gillard, S., & Holley, J. (2014). Peer workers in mental health services: Literature overview. Advances in Psychiatric Treatment, 20, 286–292.

Goldstein, A.P. (1973). Structured learning therapy: Toward a psychotherapy fort the poor. Oxford: Academic press.

Goodman, L. A., Pugach, M., Skolnik, A., & Smith, L. (2013). Poverty and mental health practice: Within and beyond the 50-minute hour. Journal of Clinical Psychology: In Session, 69(2), 182–190.

Griner, D., & Smith, T.B. (2006). Cultural adapted mental interventions: A meta-analytic review. Psychotherapy Theory, research, and Practice, Training, 43(4), 531–548.

Hage, S.M, & Kenny, M.E. (2009). Promoting a social justice approach to prevention: Future directions for training, practice, and research. Journal of Primary Prevention, 30, 75–87.

Hegedues, A., Seidel, E., & Steinauer, R. (2016). Participants’ employment status and experiences in the year after the Experienced Involvement training. International Journal of Social Psychiatry, 62(3), 214-220.

Hinshelwood, R.D. (2005). The individual and the influence of social settings: A psychoanalytic perspective on the interaction of the individual and society. British Journal of Psychotherapy, 22(2), 155-166.

Hofmann, S.G., Wu, J.Q. & Boettcher, H. (2014). Effect of cognitive-behavioral therapy for anxiety disorders on quality of life: A meta-analysis. Journal of Consulting and Clinical Psychology, 82(3), 375-91. doi: 10.1037/a0035491.

Jason, L.A., Stevens, E., & Light, J.M. (2016). The relationship of sense of community and trust to hope. Journal of Community Psychology, 44(3), 334–341.

Jenson, J.M., & Bender, K.A. (2014). Preventing child and adolescent problem behavior. Evidence-based strategies in schools, families, and communities. New York: Oxford University Press.

Jones, S.H., Smith, G., Mulligan, L.D., Lobban, F., Law, H., Dunn, G., Welford, M., Kelly, J., Mulligan, J., & Morrisoon, A.P. (2015). Recovery focused cognitive–behavioural therapy for recent-onset bipolar disorder: randomized controlled pilot trial. The British Journal of Psychiatry, 206, 58–66.

Kagan, C.M., Burton, M., Duckett, P.S., Lawthom, R., & Siddiquee, A. (2011). Critical community psychology. New York: Wiley-Blackwell.

Kelly, J.G. (1986). An ecological paradigm: Defining mental health consultation as a preventive service. Prevention in Human Services, 4, 1–36.

Kelly, T.A., & Strupp, H.H. (1992). Patient and therapist values in psychotherapy: Perceived changes, assimilation, similarity, and outcome. Journal of Consulting and Clinical Psychology, 60(1), 34–40.

Keyes, C.L M. (1998). Social well-being. Social Psychology Quarterly, 61(2), 121–140.

Kim, S. & Cardemil, E. (2012). Effective psychotherapy with low-income clients: The importance of attending to social class. Journal of Contemporary Psychotherapy, 42, 27–35.

King, R.A., & Shelley, C.A. (2008). Community feeling and social interest: Adlerian parallels, synergy and differences with the field of community psychology. Journal of Community and Applied Social Psychology, 18, 96–107.

Kirschenbaum, H. (2013). Values clarification in counseling and psychotherapy: practical strategies for individual and group settings. New York: Oxford University Press.

Kitchen, P., Williams, A., & Chowhan, J. (2012). Sense of community belonging and health in Canada: A regional analysis. Social Indicators Research, 107(1), 103–126.

Koh, E., & Twemlow, S. (2016). Towards a psychoanalytic concept of community (II): Relevant psychoanalytic principles. International Journal of Applied Psychoanalytic Studies, 13(2), 124–141.

Koh, E., & Twemlow, S. (2018). Towards a psychoanalytic concept of community (IV): The well‐functioning community. International Journal of Applied Psychoanalytic Studies, 15, 5–15.

Krajewski, C., Burazeri, G., & Brand, H. (2013). Self-stigma, perceived discrimination and empowerment among people with a mental illness in six countries: Pan European stigma study. Psychiatry Research, 210(3), 1136–1146.

Lawlor, J.A., & Neal, Z.P. (2016). Networked community change: Understanding community systems change through the lens of social network analysis. American Journal of Community Psychology, 57(3–4), 426–436.

Leijten, P., Raaijmakers, M.A.J., Orobio de Castro, B., & Matthys, W. (2013). Does socioeconomic status matter? A meta-analysis on parent training effectiveness for disruptive child behavior. Journal of Clinical Child, & Adolescent Psychology, 42(3), 384–392.

Lenze, S.N., Cyranowski, J.M., Thompson, W.K., Anderson, B., & Frank, E. (2008). The cumulative impact of non-severe life events predicts depression recurrence during maintenance treatment with interpersonal psychotherapy. Journal of Consulting and Clinical Psychology, 76(6), 979–987.

Levy, L.B., & O’Hara, M.W. (2010). Psychotherapeutic interventions for depressed, low income women: A review of the literature. Clinical Psychology Review, 30, 934–950.

Liang, B., Tummala-Narra, P., & West, J. (2011). Revisiting community work from a psychodynamic perspective. Professional Psychology: Research and Practice, 42(5), 398-404.

Long, D. A., & Perkins, D. D. (2003). Confirmatory factor analysis of the sense of community index and development of a brief SCI. Journal of Community Psychology, 31, 279–296.

Mahlke, C.I., Kraemer, U.M., Becker, T., & Bock, T. (2014). Peer support in mental health services. Current Opinion in Psychiatry, 27, 276–281.

Mahlke, C.I., Priebe, S., Heumann, K., & Bock, T. (2017). Effectiveness of one-to-one peer support for patients with severe mental illness – a randomized controlled trial. European Psychiatry, 42, 103-110.

Maurer, R., & Gaffiney, S. (2005). Gestalt approaches with organizations and large systems. In A. Woldt, & S. Toman (Eds), Gestalt therapy: History, theory, and practice (pp 237-256). Thousand Oaks: Sage.

McMillan, D.W., & Chavis, D.M. (1986). Sense of community: A definition and theory. Journal of Community Psychology, 14(1), 6–23.

McNamara, N., Stevenson, C., & Muldoon, O.T. (2013). Community identity as resource and context: A mixed method investigation of coping and collective action in a disadvantaged community. European Journal of Social Psychology, 43, 393–403.

Meis, L.A., Griffin, J.M., Greer, N., Jensen, A.C., MacDonald, R., Carlyle, M., Rutsk, I., & Wilt, T.J. (2013). Couple and family involvement in adult mental health treatment: A systematic review. Clinical Psychology Review, 33, 275–286.

Montery Declaration of Critical Community Psychology (2011). (Retrieved from [15.11.16]).

Munger, F., MacLeod, T., & Loomis, C. (2016). Social change: Toward an informed and critical understanding of social justice and the capabilities approach in community psychology. American Journal of Community Psychology, 57, 171–180.

Muntaner, C., Ng, E., Vanroelen, C., Christ, S., & Eaton, W.W. (2013). Social stratification, social closure, and social class as determinants of mental health disparities. In C.S. Aneshensel, J.C. Phelan & A. Bierman (Eds.), Handbook of the sociology of mental health (pp. 205-227), 2nd ed. New York: Springer.

Nelson, G., & Prilleltensky, I. (2010). Community psychology: In pursuit of liberation and well-being. New York: Palgrave.

Nussbaum, M. (2011). Creating capabilities. The human development approach. Cambridge: Belknap Press, Harvard University Press.

O’Connor, B. (2013). From isolation to community: Exploratory study of a sense of community intervention. Journal of Community Psychology, 41(8), 973–991.

O’Mara-Eves, A., Brunton, G., McDaid, D., Oliver, S., Kavanagh, J., Jamal, F., & Matosevic, T. (2013). Community engagement to reduce inequalities in health: a systematic review, meta-analysis and economic analysis. Public Health Research, 1(4), 1-548.

O’Mara-Eves, A., Brunton, G., McDaid, D., Oliver, S., Kavanagh, J., Jamal, F., & Thomas, J. (2015). The effectiveness of community engagement in public health interventions for disadvantaged groups: a meta-analysis. BMC Public Health, 15, 106-129.

Orford, J. (2008). Community psychology. Challenges, controversies and emerging consensus. New York: Wiley.

Orlinsky, D.E., & Howard, K.I. (1987). A generic model of psychotherapy. Journal of Integrative and Eclective Psychotherapy, 6(6), 6–36.

Orlinsky, D.E. (2009). The “Generic Model of Psychotherapy” after 25 years: Evolution of a research-based metatheory. Journal of Psychotherapy Integration, 19(4), 319-339.

Park, M., Cuijpers, P., van Straten, A., & Reynolds, C.F. (2014). The effects of psychotherapy for adult depression on social support: A meta-analysis. Cognitive Therapy and Research, 38, 600–611.

Prendergast, N., & McCauseland, J. (2007). Dialectic behaviour therapy: A 12-month collaborative program in a local community setting. Behaviour Change, 24(1), 25-35.

Querimit, D.S., & Conner, L.C. (2003). Empowerment psychotherapy with adolescent females of color. Journal of Clinical Psychology, 59(11), 1215–1224.

Reisner, A.D. (2005). The common factor, empirically validated treatments and recovery models of therapeutic change. The Psychological Record, 55, 377-399.

Rentfrow, P.J., Jokela, M., & Lamb, M E. (2015). Regional personality differences in Great Britain. PLoS ONE, 10(3): e0122245.

Roehrle, B., & Strouse, J. (2008). Influence of social support on success of therapeutic interventions: a meta-analytic review. Psychotherapy Theory, Research, Practice, Training, 45(4), 464–476.

Roehrle, B., Akhurst, J., Lawthom, R., Arcidiano, C., & Standing Committee on Community Psychology (in preparation). Education in community psychology in Europe. Report and outline of european ideas related to basic competencies.

Sacchetto, B., Aguiar, R., Vargas-Moniz, M., Jorge-Monteiro, M.F., Neves, M. J., Cruz, M.A., Coimbra, J.A., & Ornelas, J. (2016). The capabilities questionnaire for the community mental health context (CQ-CMH): A measure inspired by the capabilities approach and constructed through consumer–researcher collaboration. Psychiatric Rehabilitation Journal, 39(1), 55–61.

Santiago, C.D., Kaltman S., & Miranda, J. (2013). Poverty and mental Health: How do low income adults and children fare in psychotherapy? Journal of Clinical Psychology: In Session, 69(2), 115–126.

Sarason, S.B. (1974). The psychological sense of community. Prospects for a community psychology. San Francisco: Jossey-Bass.

Schneider, K.J. (2015). Rediscovering awe: A new front in humanistic psychology, psychotherapy, and society. In K.J. Schneider, J.F. Pierson & J.F.T. Bugetal (Eds.), The handbook of humanistic psychology: Theory, research, and practice,2nd ed. (pp. 73-81). Thousand Oaks: Sage.

Sharma, A., Sharma, S.D., & Sharma, M. (2017). Mental health promotion: A narrative review of emerging trends. Current Opinion in Psychiatry, 30(5), 339-345.

Simon, J., Anand, P., Gray, A., Rugkåsa, J., Yeeles, K., & Burns, T. (2013). Operationalising the capability approach for outcome measurement in mental health research. Social Science and Medicine, 98, 167–196.

Skinner, B.F. (1978) Reflections on Behaviorism and Society. New York: Longman Higher Education.

Sledge, W.H., Lawless, M., Sells, D., Wieland M., O’Connell, M.J., & Davidson, L. (2011). Effectiveness of peer support in reducing readmissions of persons with multiple psychiatric hospitalizations. Psychiatric Services, 62(5), 541-544.

Smith-Hansen, L. (2016). The therapeutic alliance: From correlational studies to training models. Journal of Psychotherapy Integration, 26(3), 217-229.

Staats, A., & Staats, C K. (1963). Complex human behavior: A systematic extension of learning principles. New York: Holt, Rinehart & Winston.

Stabb, S.D., & Reimers, F.A. (2013). Competent poverty training. Journal of Clinical Psychology: In Session, 69(2), 172–181.

Stuart, S., Schultz, J., & Ashen, C. (2018). A new community-based model for training in evidence-based psychotherapy practice. Community Mental Health Journal, 54, 912–920.

Talò, C., Mannarini, T., & Rochira, A. (2014). Sense of community and community participation: A meta-analytic review. Social Indicators Research, 117(1), 1–28.

Taylor, T.L., Killaspy, H., Wright, C., Turton, P., White, S., Kallert, T.W., Schuster, M., Cervilla, J.A., Brangier, P., Raboch, J., Kalisová, L., Onchev G., Dimitrov, H., Mezzina, R., Wolf, K., Wiersma, D., Visser, E., Kiejana, A., Ptetrowski, P., Ploumpidis, D., Gonidakis, F., Caldas-de-Almeida, J., Cardoso, G., & King, M.B (2009). A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problems. BMC Psychiatry, 9, 55–84. doi:10.1186/1471-244X-9-55.

Thatcher, M., & Manktelow, K. (2007). The cost of individualism. Counseling Psychology Review, 22(4), 31-43.

Tonkin, M. (2016). A review of questionnaire measures for assessing the social climate in prisons and forensic psychiatric hospitals. International Journal of Offender Therapy and Comparative Criminology, 60(12), 1376–1405.

Townley, G., & Kloos, B. (2009). Development of a measure of sense of community for individuals with serious mental illness residing in community settings. Journal of Community Psychology, 37(3), 362–380.

Townley, G., & Kloos, B. (2011). Examining the psychological sense of community for individuals with serious mental illness residing in supported housing environments. Community Mental Health Journal, 47, 436–446.

Trickett, E.J. (2009). Community psychology: Individuals and interventions in community context. Annual Review of Psychology, 60, 395–419.

Tummala-Narra, P. (2013). Psychoanalytic applications in a diverse society. Psychoanalytic Psychology, 30(3), 471-487.

Utschakowski, J. (2008). Training programme for people with experience in mental health crisis to work as trainer and peer supporter. Retrieved from

Uutela, A. (2010). Economic crisis and mental health. Current Opinion in Psychiatry, 23(2), 127–130.

Voss Horrell, S.C. (2008). Effectiveness of cognitive–behavioral therapy with adult ethnic minority clients: A review. Professional Psychology: Research and Practice, 39(2), 160–168.

Wachtel, P.L. (2014). Cyclical psychodynamics and the contextual self. New York: Routledge

Wakefield, J.C. (1988a). Psychotherapy, distributive justice, and social work. Part 1: Distributive justice as a conceptual framework for social work. Social Service Review, 62(2), 187–210.

Wakefield, J.C. (1988b). Psychotherapy, distributive justice, and social work. Part 2: Psychotherapy and the pursuit of justice. Social Service Review, 62 (3), 353–382.

Watkins, C.E. (2011). Does psychotherapy supervision contribute to patient outcomes? Considering thirty years of research. The Clinical Supervisor, 30, 235–256.

Wilkinson, R. (1979). Social well-being and community. Journal of the Community Development Society, 10(1), 5–16.

Willi, J. (1999). Ecological psychotherapy: Developing by shaping the personal niche. Goettingen: Hogrefe & Huber Publishers.

Willi, J., Frei, R., & Guenther, E. (2000). Psychotherapy of panic syndrome: Focusing on ecological aspects of relationships. American Journal of Psychotherapy, 54(2), 226-242.

Full Text: PDF


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribuzione - Non commerciale - Non opere derivate 3.0 Italia License.