Existential Approaches and Cognitive Behavior Therapy: Challenges and Potential.

Existential concerns such as death, responsibility, meaninglessness, and isolation not only are the hallmark of existential psychotherapy but also are frequently encountered by CBT therapists-nevertheless, due to epistemological and ideological differences, existential and CBT approaches to psychotherapy had little overlap historically. During recent years, existential issues are increasingly discussed in empirical clinical psychology, e.g., the potential role of the fear of death for a variety of mental disorders by Iverach et al. (Clinical Psychology Review, 34(7), 580-593, 2014), and there is increasing experimental evidence for a causal rather than correlational role of death anxiety discussed by Menzies and Dar-Nimrod (Journal of Abnormal Psychology, 126(4), 367-377, 2017). Further, existential concerns are common themes in CBT discussed by Grober et al. (Psychotherapeut, 61(3), 229-236, 2016) and may play an important role in the training of CBT therapists discussed by Worrell et al. (Journal of Psychotherapy and Counselling Psychology Reflections, 3(1), 9-16, 2018) as well as in personal therapy and supervision.

[Factors which influence the position towards euthanasia : Results of a representative survey among older people in Germany]. / Einflussfaktoren auf die Positionierung gegenüber Sterbehilfe : Ergebnisse einer repräsentativen Studie in der Altenbevölkerung.

BACKGROUND: Until now older adults have not been a target group for surveys regarding their personal attitudes towards euthanasia, although they are closest to chronic illness and death. OBJECTIVE: To determine the attitudes of older adults towards euthanasia and controversial topics in the context of illness, euthanasia and care (e. g. palliative care) on the basis of a representative sample. MATERIAL AND METHODS: The study was based on a postal survey of a representative random sample of the population aged 65 years and older (n = 3500) from a city in southern Germany using a standardized questionnaire. RESULTS: A total of 1068 persons completed the questionnaire (response rate 30.5%). Assisted death was supported by 74.2% of the respondants and assisted suicide by 80.4%. According to multiple logistic regression analysis the support decreased with increasing strength of religious faith and a non-German country of origin. Of the participants 53.3% were worried about being a burden to their family, especially people with a limited state of health. People who shared this concern showed significantly more support for both types of euthanasia. More than 40% feared that people with severe and incurable illnesses would be more likely to be forced into a premature death (slippery slope argument). This concern was associated with a decreasing support of euthanasia. CONCLUSION: The results indicate that the strong approval of the legalization of assisted death and assisted suicide by older people is motivated not only by their desire for a self-determined death but also by fears and concerns. The findings have important implications for counseling, palliative care and treatment.