Future-oriented therapy

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Future-oriented therapy (FOT) and future-directed therapy (FDT) are approaches to psychotherapy that place greater emphasis on the future than on the past or present.


The term future-oriented therapy was first used in an article by psychologist Walter O'Connell in 1964,[1] and then the term was used as the title of an article by psychiatrist Stanley Lesse in 1971.[2] Psychiatrist Frederick T. Melges also used the term in his writings in the 1970s and 1980s.[3][4][5] In the 2000s, psychiatrist Bernard Beitman, inspired in part by Melges,[6] wrote about future-oriented formulation and about how emphasis on the future is a common factor among different approaches to psychotherapy and is a basis for integrating psychotherapies.[6][7][8] Future-directed therapy, an intervention with a similar emphasis on the future (developed independently of the previous future-oriented therapies), was first tested by psychologist Jennice Vilhauer and colleagues in 2011,[9][10] and in 2014 was the subject of a self-help book that aimed to help readers "overcome negative emotions, identify what you want in life, transform limiting beliefs, take action, live ready for success".[11]

Lesse's approach[edit]

Stanley Lesse's approach, published in 1971, stressed the need for all future psychiatrists, psychologists, social scientists, and political scientists to understand the relationships between sociodynamics and individual psychodynamics.[2] Lesse viewed discussion of the future as a prophylactic (preventative) technique and guided patients over a relatively brief number of sessions to consider their role in the future in order to prepare for the impending stresses and challenges.[2][12]

Melges's approach[edit]

In 1972, Frederick T. Melges published a paper about a future-oriented intervention, which he referred to as FOT.[3] A decade later he wrote a book chapter describing the intervention.[4] Melges's FOT is based on a psychodynamic model and was intended to be an adjunctive intervention, not a treatment for psychiatric disorders. Melges described it a "useful adjunct to past- and present-oriented therapies"[3] to help patients with issues such as low self-esteem and identity diffusion. According to Melges:

The general thesis is that time distortions disrupt anticipatory control and lead to psychopathological spirals. That is, problems with time, such as distortions of sequence, rate, and temporal perspective, disrupt the normal interplay between future images, plans of action, and emotions, thereby leading to lack of anticipatory control and vicious cycles (spirals).[4]:43

Melges proposed that the harmonization of future images, plans of action, and emotions restore a person's sense of hope and control over the future: "Thus, with hope, the personal future is not certain and fixed, but is viewed as being open, unfrozen, and full of opportunities."[4]:178 There were five stages to Melges's FOT treatment:

  1. Assessment and selection of patients[4]:246
  2. Interpretation of vicious cycles
  3. Redecisions[4]:250
  4. Self-futuring[4]:258
  5. Temporal organization[4]:259,261–263

In a 1983 review of Melges's book, psychiatrist Lenore Terr said that "the author must be commended for his very ambitious attempt to characterize broadly what happens to time sense in the major mental disorders", but she also noted: "Some of the author's theoretical proposals are clear and seem to be right, but unfortunately some go too far."[13]

Philip Zimbardo and John Boyd have described how "psychologist Susan Nolen-Hoeksema extended Melges's work on time and depression in studying the ways in which preoccupation with the past reinforces depression."[14]:200 Zimbardo and Boyd explained that an obsession with the past makes people less able to think about the future, according to Nolen-Hoeksema and her colleagues. "The key to relieving depression lies not in untangling the Gordian knot of the past but in accepting and planning for the uncertain future."[14]:202

Other approaches[edit]

A wide range of approaches, such as future-oriented group training,[15] future-oriented writing therapy,[16][17] future-directed therapy,[10][18] and others,[19][20][21] have been developed to help people to confront the future and the uncertainties, complexities, and discontinuities implied by the future.

See also[edit]


  1. ^ O'Connell, Walter (April 1964). "Practicing Christianity and humanistic identification". Journal of Humanistic Psychology. 4 (2): 118–129. doi:10.1177/002216786400400205. A measure of harmony might be introduced into the relationship between the social sciences and religion by emphasizing a future oriented psychotherapy based on outsight. 
  2. ^ a b c Lesse, Stanley (April 1971). "Future oriented psychotherapy—a prophylactic technique". American Journal of Psychotherapy. 25 (2): 180–193. PMID 5553254. 
  3. ^ a b c Melges, Frederick Towne (January 1972). "Future oriented psychotherapy". American Journal of Psychotherapy. 26 (1): 22–33. PMID 5060589. 
  4. ^ a b c d e f g h Melges, Frederick Towne (1982). Time and the inner future: a temporal approach to psychiatric disorders. New York: John Wiley & Sons. ISBN 0471860751. OCLC 8410226. 
  5. ^ See also: Nunn, Kenneth P. (1999). "Personal hopefulness: a conceptual review of the relevance of the perceived future to psychiatry". In Marinelli, Robert P.; Dell Orto, Arthur E. The psychological and social impact of disability (4th ed.). New York: Springer Publishing. pp. 152–172. ISBN 0826122132. OCLC 39787890.  "Melges (1982) has developed the most comprehensive psychopathology to date based on time and the perceived future" (p. 165).
  6. ^ a b Beitman, Bernard D.; Yue, Dongmei (2004) [1999]. "Future-oriented formulation". Learning psychotherapy: a time-efficient, research-based, and outcome-measured psychotherapy training program. A Norton professional book (2nd ed.). New York: W. W. Norton & Company. pp. 347–390. ISBN 0393704467. OCLC 53940457. 
  7. ^ Beitman, Bernard D.; Soth, Angela M.; Bumby, Nancy A. (2005). "The future as an integrating force through the schools of psychotherapy". In Norcross, John C.; Goldfried, Marvin R. Handbook of psychotherapy integration. Oxford series in clinical psychology (2nd ed.). Oxford; New York: Oxford University Press. pp. 65–89. ISBN 0195165799. OCLC 54803644. 
  8. ^ Beitman, Bernard D.; Soth, Angela M.; Good, Glenn E. (2006). "Integrating the psychotherapies through their emphases on the future". In Stricker, George; Gold, Jerold R. A casebook of psychotherapy integration. Washington, DC: American Psychological Association. pp. 43–54. ISBN 1591474051. doi:10.1037/11436-004. 
  9. ^ Ishak, Waguih William; Ha, Khanh; Kapitanski, Nina; Bagot, Kara; Fathy, Hassan; Swanson, Brian; Vilhauer, Jennice S.; Balayan, Konstantin; Bolotaulo, Nestor Ian; Rapaport, Mark Hyman (December 2011). "The impact of psychotherapy, pharmacotherapy, and their combination on quality of life in depression". Harvard Review of Psychiatry. 19 (6): 277–289. PMID 22098324. doi:10.3109/10673229.2011.630828. 
  10. ^ a b Vilhauer, Jennice S.; Young, Sabrina; Kealoha, Chanel; Borrmann, Josefine; IsHak, Waguih W.; Rapaport, Mark H.; Hartoonian, Narineh; Mirocha, Jim (February 2012). "Treating major depression by creating positive expectations for the future: a pilot study for the effectiveness of future-directed therapy (FDT) on symptom severity and quality of life". CNS Neuroscience & Therapeutics. 18 (2): 102–109. PMID 21615882. doi:10.1111/j.1755-5949.2011.00235.x. 
  11. ^ Vilhauer, Jennice S. (2014). Think forward to thrive: how to use the mind's power of anticipation to transcend your past and transform your life. Novato, CA: New World Library. ISBN 9781608682980. OCLC 869266658. 
  12. ^ Lesse, Stanley (1975). "Future oriented psychotherapy". In Masserman, Jules H. Current psychiatric therapies. 15. New York: Grune and Stratton. pp. 123–131. ISSN 0070-2080. OCLC 1565671. PMID 1181119. 
  13. ^ Terr, Lenore C. (October 1983). "Review of Time and the inner future: a temporal approach to psychiatric disorders". American Journal of Orthopsychiatry. 53 (4): 741–743. doi:10.1037/h0098814. 
  14. ^ a b Zimbardo, Philip G.; Boyd, John (2008). The time paradox: the new psychology of time that will change your life. New York: Free Press. ISBN 9781416541981. OCLC 191024075.  Zimbardo and Boyd cited: Nolen-Hoeksema, Susan (November 1991). "Responses to depression and their effects on the duration of depressive episodes". Journal of Abnormal Psychology. 100 (4): 569–582. PMID 1757671. doi:10.1037/0021-843X.100.4.569. 
  15. ^ Beek, Wessel; Kerkhof, Ad; Beekman, Aartjan (October 2009). "Future oriented group training for suicidal patients: a randomized clinical trial". BMC Psychiatry. 9: 65. PMID 19811638. doi:10.1186/1471-244X-9-65. 
  16. ^ Nixon, Reginald D. V.; Kling, Leonard W. (December 2009). "Treatment of adult post-traumatic stress disorder using a future-oriented writing therapy approach". The Cognitive Behaviour Therapist. 2 (4): 243–255. doi:10.1017/S1754470X09990171. 
  17. ^ Kress, Victoria E.; Gimenez Hinkle, Michelle; Protivnak, Jake J. (June 2011). "Letters from the future: suggestions for using letter writing as a school counselling intervention". Australian Journal of Guidance and Counselling. 21 (1): 74–84. doi:10.1375/ajgc.21.1.74. 
  18. ^ Vilhauer, Jennice S.; Cortes, Julissa; Moali, Nazanin; Chung, Sally; Mirocha, James; Ishak, Waguih William (March 2013). "Improving quality of life for patients with major depressive disorder by increasing hope and positive expectations with future directed therapy (FDT)". Innovations in Clinical Neuroscience. 10 (3): 12–22. PMC 3638844Freely accessible. PMID 23630646. 
  19. ^ Sword, Richard M.; Sword, Rosemary K. M.; Brunskill, Sarah R. (2015). "Time perspective therapy: transforming Zimbardo's temporal theory into clinical practice". In Stolarski, Maciej; Fieulaine, Nicolas; Beek, Wessel. Time perspective theory: review, research and application: essays in honor of Philip G. Zimbardo. Cham; New York: Springer-Verlag. pp. 481–498. ISBN 9783319073675. OCLC 896817191. doi:10.1007/978-3-319-07368-2_31. 
  20. ^ Boniwell, Ilona; Osin, Evgeny (2015). "Time perspective coaching". In Stolarski, Maciej; Fieulaine, Nicolas; Beek, Wessel. Time perspective theory: review, research and application: essays in honor of Philip G. Zimbardo. Cham; New York: Springer-Verlag. pp. 451–469. ISBN 9783319073675. OCLC 896817191. doi:10.1007/978-3-319-07368-2_29. 
  21. ^ Kazakina, Elena (2015). "The uncharted territory: time perspective research meets clinical practice: temporal focus in psychotherapy across adulthood and old age". In Stolarski, Maciej; Fieulaine, Nicolas; Beek, Wessel. Time perspective theory: review, research and application: essays in honor of Philip G. Zimbardo. Cham; New York: Springer-Verlag. pp. 499–516. ISBN 9783319073675. OCLC 896817191. doi:10.1007/978-3-319-07368-2_32. 

Further reading[edit]