DM a guidebook PRESENT'N

THE DISCOVERY MODEL

A Practitioner’s Guide

to Holistic, Evidence-Based,

and Existentially Integrated

Mental Health Treatment

MISSION

THE DISCOVERY

MODEL

A PRACTITIONER’S GUIDE




VISION

presented by

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THE DISCOVERY MODEL | A PRACTITIONER’S GUIDE

to Holistic, Evidence-Based, and Existentially Integrated Mental Health Treatment



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TABLE OF CONTENTS

©2023 Copyright ????. All rights reserved.

Published by

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SECTION 1: Introduction and Overview . . . . . . . . . . . . . . . . . . . . . . . . . . 2

A Society in Despair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Discovery Model Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Defining the Concepts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Core Tenets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

SECTION 2: Philosophical Stance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

SECTION 3: Discovery Model Assessment. . . . . . . . . . . . . . . . . . . . . . . . 13

Assessment Dimensions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Values Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Meaning Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Spirituality Assessment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Needs Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Resources Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

SECTION 4: Treatment Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Objectives. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 5: Discovering Potential: Rewire Your Brain

and Balance the Nervous System . . . . . . . . . . . . . . . . . . . . . .

Week 1: Neuroscience of Trauma and Understanding Meditation. . . .

Week 2: Cognitive Reappraisal: Third-Party Perspective . . . . . . . . . . . .

Week 3: Life Skills: Creating Schedules and Routines. . . . . . . . . . . . . . .

Week 4: Grounding and Sensory Sensitization . . . . . . . . . . . . . . . . . . . .

Week 5: Psychoeducation: Interoception . . . . . . . . . . . . . . . . . . . . . . . . .

Week 6: Cognitive Restructuring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 7: Psychoeducation: Interoception . . . . . . . . . . . . . . . . . . . . . . . . .

Week 8: Life Skills: Building a Self-Care Regimen . . . . . . . . . . . . . . . . . .

Week 9: Cognitive Reappraisal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 10: Proprioceptive and Interoception Training . . . . . . . . . . . . . . .

Week 11: Cognitive Restructuring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 12: Cognitive Reappraisal and Gradual Exposure . . . . . . . . . . . .

SECTION 6: Discovering Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 1: Psychoeducation about Values . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 2: Possible Values Exploration . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 3: Values Exploration Continued . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 4: Life Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 5: Values in Beliefs and Attitudes. . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 6: Prioritizing Values. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 7: Values Hierarchy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 8: Making Contact with Values. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 9: Life Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 10: Values Congruence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 11: Values into Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 12: Values vs. Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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SECTION 7: Discovering Meaning & Purpose . . . . . . . . . . . . . . . . . . . . . . .

Week 1: Psychoeducation: Meaning vs. Purpose. . . . . . . . . . . . . . . . . . .

Week 2: Exploration of Purpose & Meaning. . . . . . . . . . . . . . . . . . . . . . .

Week 3: Defining Your Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 4: Constructing Meaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 5: Life Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 6: Purpose Self-Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 7: Strengths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 8: Self-Reflection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 9: Considering Recent Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 10: Life Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 11: Reframes for Meaning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 12: Finding Meaning in Difficult Times . . . . . . . . . . . . . . . . . . . . . .

SECTION 8: Discovering Authenticity . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 1: Living Out Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 2: Actions Towards Meaning & Purpose. . . . . . . . . . . . . . . . . . . . .

Week 3: Congruent Behaviors and Actions . . . . . . . . . . . . . . . . . . . . . . .

Week 4: Life Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 5: Regaining Personal Power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 6: Tools for Interpersonal Growth . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 7: Life Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 8: Living Authentically . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 9: Intentional Living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 10: More Tools for Interpersonal Growth . . . . . . . . . . . . . . . . . . . .

Week 11: Value Driven Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 12: Values Driven Goals Pt 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 9: Discovering Resiliency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 1: Learning to Regulate Emotions . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 2: Changing Emotional Responses . . . . . . . . . . . . . . . . . . . . . . . . .

Week 3: Reducing Vulnerability to the Emotional Mind . . . . . . . . . . . . .

Week 4: Building Mastery and Coping Ahead . . . . . . . . . . . . . . . . . . . . .

Week 5: Taking Care of Mind by Taking Care of Body . . . . . . . . . . . . . .

Week 6: Life Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 7: Tolerating Distress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 8: Reality Acceptance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 9: Establishing Healthy Boundaries and Relationships . . . . . . . .

Week 10: Safety and Red Flags. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 11: Life Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Week 12: Walking the Middle Path . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 10: Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Section 1

Introduction & Overview

A SOCIETY IN DESPAIR

When I began working in behavioral health care in the early 2000s, I remember hearing

from professors and supervisors that there would never be a short demand for mental

health professionals due to the prevalence of mental illness in our society. The supposition

was that we had so much mental ailment in our society that there would always be

a need for mental health treatment providers. Essentially, we’d never have a shortage of

“sick” individuals – a grim and disheartening viewpoint. During that period, the escalation

of mass shootings, community violence, drug addiction, and homelessness, which

were believed to be linked to psychological issues and mental illness, received increased

attention. Although it may be reassuring to know that one’s profession would always be

in demand, mental health professionals enter the field to reduce mental health illness and

improve mental well-being on the individual, family, and community level. The ultimate

goal is to see each successive generation become more emotionally and cognitively stable,

resilient, self-aware, and self-actualized. When I first started in the behavioral health field,

I could have never predicted that state of crisis I would witness two decades later.

The available data indicates that the mental well-being of American citizens on a national

level is severely compromised. In fact, the metrics suggest that we are in a crisis. There

has been a significant deterioration in overall mental health, with homelessness reaching

unprecedented levels, mass shootings become a far too frequent occurrence, and death

rates skyrocketing due to drug overdose, suicide, obesity complications, and liver disease.

We’ve witnessed dramatic increases in addiction, depression, and political, economic, and

spiritual turmoil. Civil unrest and political instability have hit peak levels, and in 2022

one in five adults experience crippling mental illness. This “epidemic of despair,” as

dubbed by researchers and policymakers, is shifting from a wave to a tsunami. Over the

past 20 years, the suicide death rate has surged by 33%, and in 2020, 12.2 million people

thought about suicide, 3.2 million people devised a suicide plan, and 1.2 millon followed

through with a suicide attempt.1 Additionally, drug overdose deaths in the U.S. continue

to escalate each year, with a 28.5% increase in 2021 resulting in over 100,000 lives lost.2

These metrics collectively reveal that human suffering has reached an all-time high.

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Why The Tragedy And Suffering?

If we are to boil down the core issues contributing to suffering, we would find a fundamental

degradation of self-identity and sense of self, a lack of self-worth and value, and

an overdependence on external validation and external measurements of success. People

are experiencing deep emotional pain and suffering with an inability to cope and regulate.

More and more we see a disconnection from internal values, a lack of purpose and meaning,

and little connection to others in a meaningful way. Individuals are losing touch with

their true authentic selves and their inherent value and worth. Most individuals are not

equipped with internal or external resources for resilience, making them vulnerable and

unable to tolerate and cope with pain, suffering, discomfort, loss, and victimization. Victims

turn into perpetrators, and the cycle perpetuates and escalates.

Traumatic stress and adverse childhood experiences are major contributing factors to

the epidemic of despair. Rates of traumatic experiences are rising, affecting the mental

well-being of children, adolescents, and young adults. More than 66% of children in

the U.S. are exposed to at least one traumatic event before the age 16; including psychological,

physical, or sexual abuse, community or school violence, domestic violence,

national disasters, sexual exploitation, sudden or violent loss of a loved one, refugee or

war experiences, military-related stressors, physical assault, neglect, serious accidents, or

a life-threatening illness. Traumatic stress has a profound effect on basic brain functions

responsible for processing information, determining threat, encoding memories, regulating

emotions, and responding to perceived or actual abandonment.

Trauma responses, emotional suffering, and perceptions of worthlessness and hopelessness

manifest as self-destructive behaviors, maladaptive attempts at coping, chemical and

behavioral addictions, interpersonal chaos, violence, and self-harm.

Why Haven’t Current Interventions Worked?

As the mental health crisis grows, so do resources, funding, and programs designed to

intervene. However, despite attention and intervention, the problems continue to get

worse. There are a growing number of mental health and addiction treatment programs,

housing programs, and welfare programs. Local and federal governments have increased

resources and created policies designed to increase equity. Yet our citizens continue to

get more and more ill. The percentage of adults with mental illness who report having

unmet needs for treatment has increased every year since 2011. Why?

continually report inadequate education and training on how to address implicit or explicit

spirituality in psychotherapy, lacking confidence and competence. The integration

of spiritual and existential concepts into behavioral health treatment programs has been

chronically sub-par, despite mandates from licensing and credentialing bodies to assess

spiritual preferences and needs.

When spirituality and existential concepts are assessed and addressed in treatment, often

it is explicit spirituality and religiosity that are examined. Clinicians are often asking,

“Does the client consider themselves spiritual or religious, and are there spiritual and/or

religious issues that act as resources or barriers to wellness?” When clients reject or deny

explicit spirituality or religiosity, most psychotherapeutic assessments or conversations

around spirituality and the client’s existence come to an abrupt halt. The assumption is

that the client doesn’t resonate with spirituality or religiosity, and therefor there is no need

to explore further.

Most mental health professionals are not trained or savvy with addressing existential

issues and implicit spirituality. Implicit spirituality explores inherently spiritual concepts

such as connection, purpose, meaning, and kindness that are not attached to religious

language, and offer a way to address core components of humanity with individuals who

do not consider themselves spiritual or religious. Existential concepts such as meaning

of life, death, freedom, and responsibility are universally applicable to all individuals and

have powerful influence over how humans assign meaning and navigate tragedies and

suffering.

To fully understand and treat a client’s health and wellbeing, providers must explore and

address the entire humanity of the client, including their existential and spiritual parts

of self. It is imperative that mental health providers don’t let their own discomfort and

hesitation get in the way of exploring potentially groundbreaking insights, needs, and

resources for clients.

It is the belief of the writers and contributors of this manual that there are core existential

and spiritual issues at the center of this crisis that are consistently and chronically ignored

or (at best) inadequately addressed. Social and welfare program focus too heavily on the

absence of external resources rather than recognizing internal, intrapsychic, and existential

needs. For those who are lucky enough to get access to mental health treatment and

psychotherapy, the therapy often misses a monumental aspect of the client’s humanity.

Therapy usually addresses a few dimensions of the individual’s life but fails to be truly

holistic in looking at every aspect of the individual’s spirit and existential experience.

Traditional forms of psychotherapy overlook existential and spiritual health and the

impact of existential concepts on an individual’s well-being. Mental health professionals

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THE DISCOVERY MODEL OVERVIEW

So Now What?

The Discovery Model was created to address gaps in psychotherapy, integrating existential

and spiritual concepts, to provide a truly holistic approach to healing.

The Discovery Model is intrinsically holistic and constructivist. It is designed to assess

and treat the whole of an individual: mind,

body, spirit, and connectedness to others. The

The Discovery Model

aims to help individuals

• find hope and optimism in even the most tragic

circumstances,

• uncover and capitalize on their human capacity

to thrive,

• discover their intrinsic value and worth,

• live deliberately rather than by default,

• find personal transformation through congruce

with their authentic self,

• develop resilience to manage future pain,

suffering, grief, and loss.

model integrates evidence-based modalities

that we know have positive outcomes – notably

integrating recent neuroscience and trauma

resiliency models, while also helping individual

explore their core authentic self and the

essence of their humanity. The individual is

treated as the expert on themself, and the one

with the power to uncover and discover their

true potential to thrive. The Discovery Model

integrates logotherapy, meaning-centered

therapy, and existential therapy principles and

techniques with Cognitive Behavioral Therapy,

Dialectical Behavior Therapy, Acceptance

and Commitment Therapy, and Trauma Resiliency.

This manual not only gives an overview of

how to help individuals heal, but provides

step-by-step guidance through assessment,

problem identification, treatment planning,

and interventions that can be used in both

group and individual therapy forums.

DEFINING THE CONCEPTS

We recognize that mental health treatment providers might have some trepidation approaching

concepts that are spiritual in nature, due to fears of inadvertently introducing

their own beliefs or biases, concerns about training and competence, or general discomfort

with spiritual concepts. Concerns are understandable, given the historical lack of

integration of existential or spiritual dimensions into clinical training and supervision.

For this reason, we want to start by giving clear definitions to the terms that will be used

throughout this manual. Our goal is to demystify spiritual and existential concepts and

make them more accessible to integrate with behavioral health treatment. You’ll find as

we get into the meat and potatoes of the model that the concepts we strive to integrate

into therapy are universal in application and speak to core aspects of humanity, rather

than being overtly “spiritual” or “religious.”

Spirituality

Spirituality involves the recognition that there is something greater than the physical self. It is a

belief that we are more than just the sum of our physical parts and biological processes, that there

is something more to being human than sensory experiences, and that we are a part of a greater

whole. It is a recognition that we are not our thoughts and feelings. Spirituality is an experience,

something we feel and something that affects us. It includes a search for meaning and a hunger to

understand life and live it well.

Some examples of spiritual beliefs and reframes include:

• “We are never alone.”

• “Nothing is impossible.”

• “Life is a test.”

• “We can only control the process, not the outcome.”

• “Everything happens for a reason.”

• “Nothing is permanent.”

Spiritual concepts include love, compassion, kindness, humility, courage, forgiveness,

meaning, and purpose. Spirituality can include a religious belief system and practices,

but that is not required for one to have spiritual beliefs.

Explicit spirituality refers to having a connection and alignment with a particular spiritual

belief system, practices, rituals, and/or network. Implicit spirituality refers to a connection

with concepts and qualities that speak to our spirit and the essence of humanity.

In the Discovery Model, we explore inherently spiritual beliefs, attitudes, and behaviors

that fall into the category of implicit spirituality. While we create space for clients to

share their explicitly spiritual beliefs and practices, the model is not designed to prescribe,

emphasize, or make judgments about how spirituality is expressed or experienced.

We act as a guide and conduit for insight, awareness, growth, and transformation.

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Religion

Religion refers to a personal or institutionalized set of attitudes, beliefs, and practices that

center around worship of a God or the supernatural. It is a socio-cultural system of designated

behaviors, practices, morals, beliefs, worldviews, texts, and ethics that relate humanity

to supernatural, transcendental, and spiritual elements. To be religious, one must

be spiritual; however, being spiritual does not require one to be religious. Religiosity is a

sub-set of spirituality. It is structured way one expresses and experiences spirituality.

Existentialism

Existentialism refers to the exploration of human existence, the unique experience of

being human, and issues such as meaning, purpose, value, and authenticity. The philosophical

belief is that we are each responsible for creating purpose and meaning in our

lives. Our individual purpose and meaning is not given to us by a higher authority, but

something we personally define and claim. Existentialism stresses the importance of personal

responsibility and being responsible for the results of our own actions. It is secular

in nature, and while speaking to concepts that can be considered implicitly spiritual, does

not have a religious or overtly spiritual basis.

The Discovery Model integrates universal existential concepts at the core of our humanity,

while also creating space for individuals to explore and evaluate spiritual and religious

beliefs and practices as personally relevant.

CORE TENETS

Before we can get into the nitty gritty of the Discovery Model, we must review the foundational

assumptions and core underpinnings of the model. These are the tenets upon

which the Discovery Model is built.

1. The human spirit is healthy and primed to thrive.

We are all born with limitless potential for wellness and well-being, and our natural

desire and drive as humans is to thrive. When we are born into this world, we possess everything

we need for joy and fulfillment. Rather than seek to “fix,” our task is to uncover

the potential and resources that already exist within. We are not “giving” our clients

something they do not already possess for wellness; we are helping them to discover what

is already there.

Our potential for wellness and well-being can be blocked by circumstances, events, and

illnesses. Experiences in life can derail an individual’s growth and fulfilment and block

their potential for wellness. Biological, psychological, and neurological illnesses can

be barriers, as well as adverse childhood experiences, trauma, and genetic vulnerability.

When faced with blockages and barriers, it is essential to access deeply rooted internal

resources as part of the healing process.

2. Humans are intrinsically valuable and validated.

Our presence on this earth is evidence of uniqueness and indispensability. Every human

is intrinsically worthy and complete with indispensable value, regardless of validation or

lack thereof from external sources.

Attachment injuries, adverse childhood events, and relational trauma wreak havoc on an

individual’s core sense of self and beliefs about their intrinsic worth and value. When

this happens, the task at hand is re-discovering and re-connecting with the valuable and

validated authentic self.

3. Happiness is an inside job.

Happiness is not something to be pursued, it is something that exists within. It is a natural

state of being, and it emerges when we are tapping into our authentic self and living

intentionally in a manner congruent with our mission, purpose, and values.

Happiness is not contingent on material possessions, relationships, status, or other external

sources. It can exist and flourish in any set of circumstances when turning inward to

internal resources.

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4. Humans are meaning-seeking and meaning-making creatures.

We all possess a part of our selves that desires meaning and purpose in life. This is an

intrinsic part of our humanity, and an essential building block for fulfilment, resiliency,

and adaptability. An absence of meaning and purpose makes one vulnerable to feelings

of inadequacy, disconnection, and despair. Having a health sense of self, mission, and

purpose in life is essential to well-being.

Suffering exists when there is an absence of meaning and purpose in life, or an incongruence

between one’s values and one’s daily thoughts, behaviors, emotions, and lifestyle.

Purpose and meaning also act as tools of resilience to help individuals cope with extreme

suffering. Viktor Frankl famously spearheaded this theory in logotherapy, asserting

“Those who have a ‘why’ to live, can bear with almost any ‘how.’” 7-+++

5. Everyone has an intrinsic sense of their humanity

and existence that speaks to implicit spirituality.

Everyone has some idea of who they are beyond their physical body. An understanding

of qualities that speak to their spirit, connection to the world and others, mission in life,

and purpose. We refer to this as implicit spirituality. Many have an aversion to explicitly

religious or spiritual language but connect with broader existential issues that fall under

the domain of implicit spirituality.

Section 2

Philosophical Stance

Prior to using the Discovery Model in treatment with clients, it’s important to understand

the philosophical stance of the model and how the therapist should (metaphorically) position

themselves with the client. This is how the therapist shows up mentally and emotionally

in session, the lens the therapist uses to view clients and their issues, therapeutic

strategies used, and qualities the therapist will want to emphasize or emulate.

1. Set aside your own notions of spirituality or religiosity.

Approach sessions with curiosity as to how the client experiences life and their humanity,

and how they make sense of things. Avoid making assumptions or generalizations. No

two clients will have the same relationship or experience with spirituality or religion,

even if belonging to the same faith or group.

2. Be mindful of the differences between implicit and explicit

spirituality, aiming to lean into implicit content and language

that can be universally applied.

When exploring each client’s belief system, worldview, and experiences with the existential;

the goal is to approach from content and language that is neutral and universal.

3. Don’t be overly attached or overly reactive to any particular

language.

Let clients teach us their spiritual or existential language and we can follow their lead.

4. Pay attention to the “Self of the Therapist” and the qualities

you bring into the room.

Part of helping clients explore existential issues is personally cultivating qualities that are

universally recognized as virtuous:

• Love, compassion, care, and kindness

• Humility – we don’t have all the answers and we don’t know what’s best, but we can

get further from the not-knowing stance

• Humanness – we are people first, therapists second

• Curiosity – there is more power in asking than assuming

• Courage – willingness to show up as a real person

• Humor – therapy is serious business but there is always room for some laughter

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Section 3

Discovery Assessment

ASSESSMENT DIMENSIONS:

DEFINING VALUES:

MEANING

The Meaning Triangle

(Frankl, 2006)

Attitudes

Creativity

Assessment Dimensions:

1. What values are most important to the

client?

1. 2. What Does values the client are relate most to important explicit spirituality/religiosity,

client? implicit spirituality, and/or

2. Does existentialism?

the client relate to explicit spiri-

3. tuality/religiosity, What language does implicit the client spirituality,

want to use

to

the

and/or to address existentialism?

and spiritual issues?

3. 4. What What language are the client’s does spiritual the client and want

existential

use resources?

to address existential and spir-

5. itual What issues?

are the client’s spiritual and existen-

to

4. What tial struggles are the client’s and needs?

spiritual and

6. existential Choices/Mindset/Behaviors resources?

How does this

5. What client’s are current the client’s lifestyle spiritual and habits and (includ-

existential ing thoughts, struggles feelings, and beliefs, needs? actions)

6. Choices/Mindset/Behaviors align with the client’s values, mission, How and

does purpose.

this client’s current lifestyle and

habits (including thoughts, feelings,

beliefs, actions) align with the client’s

values, mission, and purpose.

Defining Values

1. Identify times when you were the happiest.

• What were you doing?

1. Identify times when you were the

• Were happiest.

you with other people? Who?

• What • What other factors were you contributed doing? to your

happiness?

• Were you with other people?

2. Identify Who? times when you were the proudest.

• What other factors contributed to

• Why your

were you happiness?

proud?

• 2. Did Identify other people times share when your pride?

were the

• What proudest. other factors contributed to feelings

of • pride?

Why were you proud?

• Did other people share your

3. Identify pride?

times when you were the most

fulfilled • What and other satisfied.

factors contributed to

• What feelings need or desire of pride? was fulfilled?

• 3. How Identify and why times did when the experience you were give the your

most

life meaning?

fulfilled and satisfied.

• What • What other factors need or contributed?

desire was fulfilled?

• How and why did the experience

give your life meaning?

Attitudes:

The courageous and self-transcending

values we realize by taking a stance toward

and changing our perspective about unavoidable

pain, guilt, or death.

• “What stance do I take towards life

with my daily attitude?”

• “What attitude do I have towards challenging

situations, pain, or suffering?”

• “When have there been times when my attitude

towards a situation or blow of fate was courageous

or self-transcending?”

Creativity:

Experiences

Our innate talents that we give the world and others

through our endeavors, work, deeds, and goals

accomplished, including creating a family

and raising children.

• “What do I give to life through my creativity?”

• “What creative gifts have I offered through my talents,

my work, deeds, and accomplishments that held

meaning for me?”

Experiences:

The experiences we engage in through encountering

others in relationships of all kinds, and from our

appreciation or encounter with nature, culture, and/or religion.

• “What life experiences have been the most meaningful to me?”

• “When I look back on experiences with other people, nature,

culture, or religion; what stands out as the most impactful?

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SPIRITUALITY

PAST, PRESENT, & FUTURE

Past spirituality

Present spirituality

• What sort of experiences stood out for you when you were growing up?

• When you think back, what gave you a sense of meaning (or purpose, or hope for the future)?

When were you happiest (or most joyful)?

• As you consider Understanding your life, what accomplishments how the are transcendent

you particularly proud of?

• How did you cope with challenging situations in the past?

or sacred is manifested


• When do you feel most fully alive?

Understanding • how Who/what the transcendent gives you or sacred a sense is manifested of purpose

• When do you feel most and fully meaning alive? in life?

• Who/what gives • What you a sense causes of purpose you and the meaning greatest in life? despair/

• What causes you the suffering? greatest despair/suffering?

• Can you describe • Can recent you experiences describe (for recent example, experiences “aha moments”) that (for

sparked new insights?

• What things are you example, most passionate “aha about moments”) in life? that sparked

• If you had a magic wand, what would you change to make your life more meaningful?

• What helps you feel new most insights? aware (or centered)?

• Who/what do • you What rely on things most are life? you most passionate

• Who/what do you put about your hope in life? in?

• For what are • you If most you deeply had grateful? a magic wand, what would you

• To whom/what are you most devoted?

• To whom/what do you change most freely to make express your love? life more meaningful?

and discourages you?

• What pulls you down

• What are your • deepest What regrets? helps you feel most aware (or centered)?

your situation?

• Who best understands

• When in your • life Who/what have you experienced do you forgiveness? rely on most in life?

Understanding how spirituality facilitates health, wellness, and coping

• What rituals/practices • Who/what are especially do you important put (or your significant) hope to in? you?

• What kinds of • experiences For what provide are you with most the deeply deepest sense grateful? of meaning in life?

• How do you commemorate • To whom/what special occasions/accomplishments?

are you most devoted?

• At the deepest • levels To whom/what of your being, what do strengthens you most (or freely nurtures) express you?

• What sustains you through difficulties?

• What sources of strength love? do you draw on to keep pressing forward?

• What nourishes • your What soul? pulls you down and discourages

• Where do you find you? a sense of peace (or inspiration)?

• When you are • in What pain (or are afraid), your where deepest do you turn regrets? for comfort?

• How have difficult • Who situations best changed understands your life for your the better? situation?

• What gives you the strength to carry on day after day?

• What helps you • When get through in times your of life difficulty have (or you crisis)? experienced

• Who supports you forgiveness?

in hard times? How so?

• If you had just a year to live, what

are the most important things you

would like to accomplish?

• Why is it important that you are here

in this world? After you are gone,

what legacy would you like to leave

behind?

• How would you like people to remember

you after you are gone?

Past spirituality

• What sort of experiences stood out

for you when you were growing up?

• When you think back, what gave you

a sense of meaning (or purpose,

or hope for the future)?

When were you happiest

(or most joyful)?

• As you consider your life, what

accomplishments are you

particularly proud of?

• How did you cope with challenging

situations in the past?


Understanding how spirituality facilitates

health, wellness, and coping

• What rituals/practices are especially important

(or significant) to you?

• What kinds of experiences provide you

with the deepest sense of meaning in

life?

• How do you commemorate special occasions/accomplishments?

• At the deepest levels of your being, what

strengthens (or nurtures) you?


Future spirituality

• What sources of strength do you draw on

to keep pressing forward?

• What are you striving for Future in life? spirituality

• What are your goals for the future?

• What nourishes your soul?

• If you had just a year to live, what are the most important things you would like to accomplish? • Where do you find a sense of peace (or

• Why is it important

• What that you

are are

you here in

striving this world?

for After

in you

life?

are gone, what legacy would inspiration)?

you like to leave behind?

• How would you • What like people are to remember your goals you after for you the are future?

gone?

• When you are in pain (or afraid), where

do you turn for comfort?

• How have difficult situations changed

your life for the better?

• What gives you the strength to carry on

day after day?

• What helps you get through times of

difficulty (or crisis)?

• Who supports you in hard times? How

so?

NEEDS & RESOURCES

Factors blocking client from living to full potential:

❒ Mental health disorder/SUD that is organic in nature

❒ Childhood trauma

❒ Traumatic events (including experience of addiction)

❒ Attachment injuries/Relational trauma

❒ Lacking core self-esteem, self-worth, and value

❒ Lacking meaningful connection to others

❒ Lacking mission, purpose, and meaning

❒ Seeking happiness and fulfillment in the external

❒ Lacking congruence with authentic self

Internal

Needs

Needs

External

Needs

Needs

Explicit Existential/Spiritual Needs

Resources client can draw from:

❒ Connection with support system

❒ Positive/helpful belief system

❒ Positive/helpful rituals and practices

❒ Internal sense of worth and value

❒ Having mission, purpose, and meaning

❒ Having defined values

Internal

Internal Resources

Resources

External

Resources

Explicit Existential/Spiritual Resources

Explicit Existential/Spiritual Resources

Implicit Existential/Spiritual Needs

Implicit Existential/Spiritual Resources

Implicit Existential/Spiritual Resources

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Section 4:

PLAN/INTERVENTIONS:

TREATMENT PLANNING

LONG-TERM GOALS

• Reduce symptoms of MH Disorder and improve adaptive functioning.

• Reduce intensity, frequency, and severity of trauma responses.

• Increase emotional awareness, emotion regulation, and distress tolerance skills.

SHORT-TERM MEASURABLE OBJECTIVES:

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REFERENCES

1. America's Health Rankings analysis of CDC WONDER, Multiple Cause

of Death Files, United Health Foundation, AmericasHealthRankings.org,

accessed 2022.

2. NCHS, National Vital Statistics System. Estimates for 2020 are based on

provisional data. Estimates for 2015-2019 are based on final data (available

from: https://www.cdc.gov/nchs/nvss/mortality_public_use_data.htm).

3. Mental Health America www.mhanational.org/issDavid R. Hodge, Implicit

Spiritual Assessment: An Alternative Approach for Assessing Client Spirituality,

Social Work, Volume 58, Issue 3, July 2013, Pages 223–230, https://doi.

org/10.1093/sw/swt019

4. Jones, R. S. (2019). Spirit in Session. Working with Your Client’s Spirituality

(and Your Own) in Psychotherapy. Templeton Press. PA

5. Captari, L. E., Sandage, S. J., & Vandiver, R. A. (2022). Spiritually integrated

psychotherapies in real-world clinical practice: Synthesizing the literature to

identify best practices and future research directions. Psychotherapy, 59(3),

307–320. https://doi.org/10.1037/pst0000407

6. Captari, LE, Hook, JN, Hoyt, W, Davis, DE, McElroy-Heltzel, SE, Worthington,

EL. Integrating clients’ religion and spirituality within psychotherapy: A

comprehensive meta-analysis. J Clin Psychol. 2018; 74: 1938– 1951. https://

doi.org/10.1002/jclp.22681

7. Spiritual Psychotherapy for Inpatient, Residential, and Intensive Treatment

David H. Rosmarin, Sarah Salcone, David Harper, and Brent P. Forester

American Journal of Psychotherapy 2019 72:3, 75-83 https://doi.org/10.1176/

appi.psychotherapy.20180046

8. Alton G. Toward an Integrative Model of Psychospiritual Therapy: Bringing

Spirituality and Psychotherapy Together. Journal of Pastoral Care &

Counseling. 2020;74(3):159-165. doi:10.1177/1542305020946282

9. Dezelic MS: Meaning-Centered Therapy Workbook: Based on Viktor

Frankl’s Logotherapy & Existential Analysis, 1st ed. San Rafael, CA,

Palace Printing and Design, 2014 Google Scholar

10. Frankl, V. E. 1., Lasch, I., Kushner, H. S., & Winslade W. J. (2006). Man’s

search for meaning. Boston: Beacon Press.

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THE DISCOVERY MODEL

A Practitioner’s Guide




TABLE OF CONTENTS

SECTION 1: Introduction and Overview ..........................2

A Society in Despair ..........................................4

Discovery Model Overview ....................................7

Defining the Concepts ........................................8

Core Tenets ............................................... 10

SECTION 2: Philosophical Stance .............................. 12

SECTION 3: Discovery Model Assessment. ...................... 13

Assessment Dimensions. .................................... 13

Values Assessment ......................................... 13

Meaning Assessment ....................................... 15

Spirituality Assessment. ..................................... 16

Needs Assessment ......................................... 17

Resources Assessment ...................................... 18

SECTION 4: Treatment Planning ............................... 19

Goals ........................................................

Objectives. ...................................................

Interventions .................................................

SECTION 5: Discovering Potential: Rewire Your Brain

and Balance the Nervous System ......................

Week 1: Neuroscience of Trauma and Understanding Meditation. ...

Week 2: Cognitive Reappraisal: Third-Party Perspective ............

Week 3: Life Skills: Creating Schedules and Routines. ..............

Week 4: Grounding and Sensory Sensitization ....................

Week 5: Psychoeducation: Interoception .........................

Week 6: Cognitive Restructuring ................................

Week 7: Psychoeducation: Interoception .........................

Week 8: Life Skills: Building a Self-Care Regimen ..................

Week 9: Cognitive Reappraisal ..................................

Week 10: Proprioceptive and Interoception Training ...............

Week 11: Cognitive Restructuring ...............................

Week 12: Cognitive Reappraisal and Gradual Exposure ............

SECTION 6: Discovering Values ..................................

Week 1: Psychoeducation about Values ..........................

Week 2: Possible Values Exploration .............................

Week 3: Values Exploration Continued ...........................

Week 4: Life Skills .............................................

Week 5: Values in Beliefs and Attitudes. ..........................

Week 6: Prioritizing Values. .....................................

Week 7: Values Hierarchy. ......................................

Week 8: Making Contact with Values. ............................

Week 9: Life Skills .............................................

Week 10: Values Congruence ...................................

Week 11: Values into Action ....................................

Week 12: Values vs. Goals ......................................

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3

SECTION 7: Discovering Meaning & Purpose .......................

Week 1: Psychoeducation: Meaning vs. Purpose. ..................

Week 2: Exploration of Purpose & Meaning. ......................

Week 3: Defining Your Purpose .................................

Week 4: Constructing Meaning .................................

Week 5: Life Skills .............................................

Week 6: Purpose Self-Assessment ...............................

Week 7: Strengths .............................................

Week 8: Self-Reflection. ........................................

Week 9: Considering Recent Events .............................

Week 10: Life Skills ............................................

Week 11: Reframes for Meaning. ................................

Week 12: Finding Meaning in Difficult Times ......................

SECTION 8: Discovering Authenticity .............................

Week 1: Living Out Values ......................................

Week 2: Actions Towards Meaning & Purpose. ....................

Week 3: Congruent Behaviors and Actions .......................

Week 4: Life Skills .............................................

Week 5: Regaining Personal Power ..............................

Week 6: Tools for Interpersonal Growth ..........................

Week 7: Life Skills .............................................

Week 8: Living Authentically ....................................

Week 9: Intentional Living ......................................

Week 10: More Tools for Interpersonal Growth ....................

Week 11: Value Driven Goals ...................................

Week 12: Values Driven Goals Pt 2. ..............................

SECTION 9: Discovering Resiliency ...............................

Week 1: Learning to Regulate Emotions ..........................

Week 2: Changing Emotional Responses .........................

Week 3: Reducing Vulnerability to the Emotional Mind .............

Week 4: Building Mastery and Coping Ahead .....................

Week 5: Taking Care of Mind by Taking Care of Body ..............

Week 6: Life Skills .............................................

Week 7: Tolerating Distress .....................................

Week 8: Reality Acceptance ....................................

Week 9: Establishing Healthy Boundaries and Relationships ........

Week 10: Safety and Red Flags. .................................

Week 11: Life Skills ............................................

Week 12: Walking the Middle Path ..............................

SECTION 10: Conclusion ........................................

Section 1

Introduction & Overview

A SOCIETY IN DESPAIR

When I began working in behavioral health care in the early 2000s, I remember hearing

from professors and supervisors that there would never be a short demand for mental

health professionals due to the prevalence of mental illness in our society. The supposition

was that we had so much mental ailment in our society that there would always be

a need for mental health treatment providers. Essentially, we’d never have a shortage of

“sick” individuals – a grim and disheartening viewpoint. During that period, the escalation

of mass shootings, community violence, drug addiction, and homelessness, which

were believed to be linked to psychological issues and mental illness, received increased

attention. Although it may be reassuring to know that one’s profession would always be

in demand, mental health professionals enter the field to reduce mental health illness and

improve mental well-being on the individual, family, and community level. The ultimate

goal is to see each successive generation become more emotionally and cognitively stable,

resilient, self-aware, and self-actualized. When I first started in the behavioral health field,

I could have never predicted that state of crisis I would witness two decades later.

The available data indicates that the mental well-being of American citizens on a national

level is severely compromised. In fact, the metrics suggest that we are in a crisis. There

has been a significant deterioration in overall mental health, with homelessness reaching

unprecedented levels, mass shootings become a far too frequent occurrence, and death

rates skyrocketing due to drug overdose, suicide, obesity complications, and liver disease.

We’ve witnessed dramatic increases in addiction, depression, and political, economic, and

spiritual turmoil. Civil unrest and political instability have hit peak levels, and in 2022

one in five adults experience crippling mental illness. This “epidemic of despair,” as

dubbed by researchers and policymakers, is shifting from a wave to a tsunami. Over the

past 20 years, the suicide death rate has surged by 33%, and in 2020, 12.2 million people

thought about suicide, 3.2 million people devised a suicide plan, and 1.2 millon followed

through with a suicide attempt.1 Additionally, drug overdose deaths in the U.S. continue

to escalate each year, with a 28.5% increase in 2021 resulting in over 100,000 lives lost.2

These metrics collectively reveal that human suffering has reached an all-time high.

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5

Why The Tragedy And Suffering?

If we are to boil down the core issues contributing to suffering, we would find a fundamental

degradation of self-identity and sense of self, a lack of self-worth and value, and

an overdependence on external validation and external measurements of success. People

are experiencing deep emotional pain and suffering with an inability to cope and regulate.

More and more we see a disconnection from internal values, a lack of purpose and meaning,

and little connection to others in a meaningful way. Individuals are losing touch with

their true authentic selves and their inherent value and worth. Most individuals are not

equipped with internal or external resources for resilience, making them vulnerable and

unable to tolerate and cope with pain, suffering, discomfort, loss, and victimization. Victims

turn into perpetrators, and the cycle perpetuates and escalates.

Traumatic stress and adverse childhood experiences are major contributing factors to

the epidemic of despair. Rates of traumatic experiences are rising, affecting the mental

well-being of children, adolescents, and young adults. More than 66% of children in

the U.S. are exposed to at least one traumatic event before the age 16; including psychological,

physical, or sexual abuse, community or school violence, domestic violence,

national disasters, sexual exploitation, sudden or violent loss of a loved one, refugee or

war experiences, military-related stressors, physical assault, neglect, serious accidents, or

a life-threatening illness. Traumatic stress has a profound effect on basic brain functions

responsible for processing information, determining threat, encoding memories, regulating

emotions, and responding to perceived or actual abandonment.

Trauma responses, emotional suffering, and perceptions of worthlessness and hopelessness

manifest as self-destructive behaviors, maladaptive attempts at coping, chemical and

behavioral addictions, interpersonal chaos, violence, and self-harm.

Why Haven’t Current Interventions Worked?

As the mental health crisis grows, so do resources, funding, and programs designed to

intervene. However, despite attention and intervention, the problems continue to get

worse. There are a growing number of mental health and addiction treatment programs,

housing programs, and welfare programs. Local and federal governments have increased

resources and created policies designed to increase equity. Yet our citizens continue to

get more and more ill. The percentage of adults with mental illness who report having

unmet needs for treatment has increased every year since 2011. Why?

continually report inadequate education and training on how to address implicit or explicit

spirituality in psychotherapy, lacking confidence and competence. The integration

of spiritual and existential concepts into behavioral health treatment programs has been

chronically sub-par, despite mandates from licensing and credentialing bodies to assess

spiritual preferences and needs.

When spirituality and existential concepts are assessed and addressed in treatment, often

it is explicit spirituality and religiosity that are examined. Clinicians are often asking,

“Does the client consider themselves spiritual or religious, and are there spiritual and/or

religious issues that act as resources or barriers to wellness?” When clients reject or deny

explicit spirituality or religiosity, most psychotherapeutic assessments or conversations

around spirituality and the client’s existence come to an abrupt halt. The assumption is

that the client doesn’t resonate with spirituality or religiosity, and therefor there is no need

to explore further.

Most mental health professionals are not trained or savvy with addressing existential

issues and implicit spirituality. Implicit spirituality explores inherently spiritual concepts

such as connection, purpose, meaning, and kindness that are not attached to religious

language, and offer a way to address core components of humanity with individuals who

do not consider themselves spiritual or religious. Existential concepts such as meaning

of life, death, freedom, and responsibility are universally applicable to all individuals and

have powerful influence over how humans assign meaning and navigate tragedies and

suffering.

To fully understand and treat a client’s health and wellbeing, providers must explore and

address the entire humanity of the client, including their existential and spiritual parts

of self. It is imperative that mental health providers don’t let their own discomfort and

hesitation get in the way of exploring potentially groundbreaking insights, needs, and

resources for clients.

It is the belief of the writers and contributors of this manual that there are core existential

and spiritual issues at the center of this crisis that are consistently and chronically ignored

or (at best) inadequately addressed. Social and welfare program focus too heavily on the

absence of external resources rather than recognizing internal, intrapsychic, and existential

needs. For those who are lucky enough to get access to mental health treatment and

psychotherapy, the therapy often misses a monumental aspect of the client’s humanity.

Therapy usually addresses a few dimensions of the individual’s life but fails to be truly

holistic in looking at every aspect of the individual’s spirit and existential experience.

Traditional forms of psychotherapy overlook existential and spiritual health and the

impact of existential concepts on an individual’s well-being. Mental health professionals

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THE DISCOVERY MODEL OVERVIEW

So Now What?

The Discovery Model was created to address gaps in psychotherapy, integrating existential

and spiritual concepts, to provide a truly holistic approach to healing.

The Discovery Model is intrinsically holistic and constructivist. It is designed to assess

and treat the whole of an individual: mind,

body, spirit, and connectedness to others. The

The Discovery Model

aims to help individuals

• find hope and optimism in even the most tragic

circumstances,

• uncover and capitalize on their human capacity

to thrive,

• discover their intrinsic value and worth,

• live deliberately rather than by default,

• find personal transformation through congruce

with their authentic self,

• develop resilience to manage future pain,

suffering, grief, and loss.

model integrates evidence-based modalities

that we know have positive outcomes – notably

integrating recent neuroscience and trauma

resiliency models, while also helping individual

explore their core authentic self and the

essence of their humanity. The individual is

treated as the expert on themself, and the one

with the power to uncover and discover their

true potential to thrive. The Discovery Model

integrates logotherapy, meaning-centered

therapy, and existential therapy principles and

techniques with Cognitive Behavioral Therapy,

Dialectical Behavior Therapy, Acceptance

and Commitment Therapy, and Trauma Resiliency.

This manual not only gives an overview of

how to help individuals heal, but provides

step-by-step guidance through assessment,

problem identification, treatment planning,

and interventions that can be used in both

group and individual therapy forums.

DEFINING THE CONCEPTS

We recognize that mental health treatment providers might have some trepidation approaching

concepts that are spiritual in nature, due to fears of inadvertently introducing

their own beliefs or biases, concerns about training and competence, or general discomfort

with spiritual concepts. Concerns are understandable, given the historical lack of

integration of existential or spiritual dimensions into clinical training and supervision.

For this reason, we want to start by giving clear definitions to the terms that will be used

throughout this manual. Our goal is to demystify spiritual and existential concepts and

make them more accessible to integrate with behavioral health treatment. You’ll find as

we get into the meat and potatoes of the model that the concepts we strive to integrate

into therapy are universal in application and speak to core aspects of humanity, rather

than being overtly “spiritual” or “religious.”

Spirituality

Spirituality involves the recognition that there is something greater than the physical self. It is a

belief that we are more than just the sum of our physical parts and biological processes, that there

is something more to being human than sensory experiences, and that we are a part of a greater

whole. It is a recognition that we are not our thoughts and feelings. Spirituality is an experience,

something we feel and something that affects us. It includes a search for meaning and a hunger to

understand life and live it well.

Some examples of spiritual beliefs and reframes include:

• “We are never alone.”

• “Nothing is impossible.”

• “Life is a test.”

• “We can only control the process, not the outcome.”

• “Everything happens for a reason.”

• “Nothing is permanent.”

Spiritual concepts include love, compassion, kindness, humility, courage, forgiveness,

meaning, and purpose. Spirituality can include a religious belief system and practices,

but that is not required for one to have spiritual beliefs.

Explicit spirituality refers to having a connection and alignment with a particular spiritual

belief system, practices, rituals, and/or network. Implicit spirituality refers to a connection

with concepts and qualities that speak to our spirit and the essence of humanity.

In the Discovery Model, we explore inherently spiritual beliefs, attitudes, and behaviors

that fall into the category of implicit spirituality. While we create space for clients to

share their explicitly spiritual beliefs and practices, the model is not designed to prescribe,

emphasize, or make judgments about how spirituality is expressed or experienced.

We act as a guide and conduit for insight, awareness, growth, and transformation.

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9

Religion

Religion refers to a personal or institutionalized set of attitudes, beliefs, and practices that

center around worship of a God or the supernatural. It is a socio-cultural system of designated

behaviors, practices, morals, beliefs, worldviews, texts, and ethics that relate humanity

to supernatural, transcendental, and spiritual elements. To be religious, one must

be spiritual; however, being spiritual does not require one to be religious. Religiosity is a

sub-set of spirituality. It is structured way one expresses and experiences spirituality.

Existentialism

Existentialism refers to the exploration of human existence, the unique experience of

being human, and issues such as meaning, purpose, value, and authenticity. The philosophical

belief is that we are each responsible for creating purpose and meaning in our

lives. Our individual purpose and meaning is not given to us by a higher authority, but

something we personally define and claim. Existentialism stresses the importance of personal

responsibility and being responsible for the results of our own actions. It is secular

in nature, and while speaking to concepts that can be considered implicitly spiritual, does

not have a religious or overtly spiritual basis.

The Discovery Model integrates universal existential concepts at the core of our humanity,

while also creating space for individuals to explore and evaluate spiritual and religious

beliefs and practices as personally relevant.

CORE TENETS

Before we can get into the nitty gritty of the Discovery Model, we must review the foundational

assumptions and core underpinnings of the model. These are the tenets upon

which the Discovery Model is built.

1. The human spirit is healthy and primed to thrive.

We are all born with limitless potential for wellness and well-being, and our natural

desire and drive as humans is to thrive. When we are born into this world, we possess everything

we need for joy and fulfillment. Rather than seek to “fix,” our task is to uncover

the potential and resources that already exist within. We are not “giving” our clients

something they do not already possess for wellness; we are helping them to discover what

is already there.

Our potential for wellness and well-being can be blocked by circumstances, events, and

illnesses. Experiences in life can derail an individual’s growth and fulfilment and block

their potential for wellness. Biological, psychological, and neurological illnesses can

be barriers, as well as adverse childhood experiences, trauma, and genetic vulnerability.

When faced with blockages and barriers, it is essential to access deeply rooted internal

resources as part of the healing process.

2. Humans are intrinsically valuable and validated.

Our presence on this earth is evidence of uniqueness and indispensability. Every human

is intrinsically worthy and complete with indispensable value, regardless of validation or

lack thereof from external sources.

Attachment injuries, adverse childhood events, and relational trauma wreak havoc on an

individual’s core sense of self and beliefs about their intrinsic worth and value. When

this happens, the task at hand is re-discovering and re-connecting with the valuable and

validated authentic self.

3. Happiness is an inside job.

Happiness is not something to be pursued, it is something that exists within. It is a natural

state of being, and it emerges when we are tapping into our authentic self and living

intentionally in a manner congruent with our mission, purpose, and values.

Happiness is not contingent on material possessions, relationships, status, or other external

sources. It can exist and flourish in any set of circumstances when turning inward to

internal resources.

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11

4. Humans are meaning-seeking and meaning-making creatures.

We all possess a part of our selves that desires meaning and purpose in life. This is an

intrinsic part of our humanity, and an essential building block for fulfilment, resiliency,

and adaptability. An absence of meaning and purpose makes one vulnerable to feelings

of inadequacy, disconnection, and despair. Having a health sense of self, mission, and

purpose in life is essential to well-being.

Suffering exists when there is an absence of meaning and purpose in life, or an incongruence

between one’s values and one’s daily thoughts, behaviors, emotions, and lifestyle.

Purpose and meaning also act as tools of resilience to help individuals cope with extreme

suffering. Viktor Frankl famously spearheaded this theory in logotherapy, asserting

“Those who have a ‘why’ to live, can bear with almost any ‘how.’” 7-+++

5. Everyone has an intrinsic sense of their humanity

and existence that speaks to implicit spirituality.

Everyone has some idea of who they are beyond their physical body. An understanding

of qualities that speak to their spirit, connection to the world and others, mission in life,

and purpose. We refer to this as implicit spirituality. Many have an aversion to explicitly

religious or spiritual language but connect with broader existential issues that fall under

the domain of implicit spirituality.

Section 2

Philosophical Stance

Prior to using the Discovery Model in treatment with clients, it’s important to understand

the philosophical stance of the model and how the therapist should (metaphorically) position

themselves with the client. This is how the therapist shows up mentally and emotionally

in session, the lens the therapist uses to view clients and their issues, therapeutic

strategies used, and qualities the therapist will want to emphasize or emulate.

1. Set aside your own notions of spirituality or religiosity.

Approach sessions with curiosity as to how the client experiences life and their humanity,

and how they make sense of things. Avoid making assumptions or generalizations. No

two clients will have the same relationship or experience with spirituality or religion,

even if belonging to the same faith or group.

2. Be mindful of the differences between implicit and explicit

spirituality, aiming to lean into implicit content and language

that can be universally applied.

When exploring each client’s belief system, worldview, and experiences with the existential;

the goal is to approach from content and language that is neutral and universal.

3. Don’t be overly attached or overly reactive to any particular

language.

Let clients teach us their spiritual or existential language and we can follow their lead.

4. Pay attention to the “Self of the Therapist” and the qualities

you bring into the room.

Part of helping clients explore existential issues is personally cultivating qualities that are

universally recognized as virtuous:

• Love, compassion, care, and kindness

• Humility – we don’t have all the answers and we don’t know what’s best, but we can

get further from the not-knowing stance

• Humanness – we are people first, therapists second

• Curiosity – there is more power in asking than assuming

• Courage – willingness to show up as a real person

• Humor – therapy is serious business but there is always room for some laughter

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Section 3

Discovery Assessment

MEANING

The Meaning Triangle

(Frankl, 2006)

Attitudes

Creativity

ASSESSMENT DIMENSIONS:

Assessment Dimensions:

1.

1.

What

What

values

values

are

are

most

most important

important

to

to

the

the

client?

client?

2.

2.

Does

Does

the

the

client

client

relate

relate to

to

explicit

explicit

spirituality/religiosity,

implicit

spirituality/religiosity,

implicit

spirituality,

spirituality,

and/or

and/or

existentialism?

existentialism?

3.

3.

What

What

language

language

does

does the

the

client

client

want

want

to use

to

to

use

address

to address

existential

existential

and spiritual

and

issues?

spiritual

4. What

issues?

are the client’s spiritual and existential

resources?

4. What are the client’s spiritual and

5.

existential

What are the

resources?

client’s spiritual and existential

struggles

5. What are the client’s

and needs?

spiritual and

6.

existential

Choices/Mindset/Behaviors

struggles and needs?

How does this

6. Choices/Mindset/Behaviors

client’s current lifestyle and habits

How

(including

does this

thoughts,

client’s

feelings,

current

beliefs,

lifestyle

actions)

and

habits

align

(including

with the client’s

thoughts,

values,

feelings,

mission, and

beliefs,

purpose.

actions) align with the client’s

values, mission, and purpose.

DEFINING VALUES:

Defining Values

1. 1. Identify times times when when you you were were the happiest. the

• What happiest. were you doing?

• Were • What you with were other you people? doing? Who?

• Were you with other people?

• What

Who?

other factors contributed to your

happiness? • What other factors contributed to

2. Identify your times happiness? when you were the proudest.

• 2. Why Identify were times you proud? when you were the

proudest.

• Did

•

other

Why

people

were

share

you proud?

your pride?

• What • Did other other factors people contributed share to your feelings

of pride? pride?

3. Identify • What times other when factors you were contributed the most to

feelings of pride?

3.

fulfilled

Identify

and

times

satisfied.

when you were the

• What most need or desire was fulfilled?

• How fulfilled and why and did the satisfied. experience give your

life • meaning? What need or desire was fulfilled?

• What

• How

other

and

factors

why

contributed?

did the experience

give your life meaning?

Attitudes:

The courageous and self-transcending

values we realize by taking a stance toward

and changing our perspective about unavoidable

pain, guilt, or death.

• “What stance do I take towards life

with my daily attitude?”

• “What attitude do I have towards challenging

situations, pain, or suffering?”

• “When have there been times when my attitude

towards a situation or blow of fate was courageous

or self-transcending?”

Creativity:

Experiences

Our innate talents that we give the world and others

through our endeavors, work, deeds, and goals

accomplished, including creating a family

and raising children.

• “What do I give to life through my creativity?”

• “What creative gifts have I offered through my talents,

my work, deeds, and accomplishments that held

meaning for me?”

Experiences:

The experiences we engage in through encountering

others in relationships of all kinds, and from our

appreciation or encounter with nature, culture, and/or religion.

• “What life experiences have been the most meaningful to me?”

• “When I look back on experiences with other people, nature,

culture, or religion; what stands out as the most impactful?

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15

SPIRITUALITY

PAST, PRESENT, & FUTURE

Past spirituality


• What sort of experiences stood out for you when you were growing up?

• When you think back, what gave you a sense of meaning (or purpose, or hope for the future)?

When were you happiest (or most joyful)?

• As you consider Understanding your life, what accomplishments how the are transcendent

you particularly proud of?

• How did you cope with challenging situations in the past?

or sacred is manifested


• When do you feel most fully alive?

Understanding • how Who/what the transcendent gives you or sacred a sense is manifested of purpose

• When do you feel most and fully meaning alive? in life?

• Who/what gives • What you a sense causes of purpose you and the meaning greatest in life? despair/

• What causes you the suffering? greatest despair/suffering?

• Can you describe • Can recent you experiences describe (for recent example, experiences “aha moments”) that (for sparked new insights?

• What things are you example, most passionate “aha about moments”) in life? that sparked

• If you had a magic wand, what would you change to make your life more meaningful?

• What helps you feel new most insights? aware (or centered)?

• Who/what do • you What rely on things most are life? you most passionate

• Who/what do you put about your hope in life? in?

• For what are • you If most you deeply had grateful? a magic wand, what would you

• To whom/what are you most devoted?

• To whom/what do you change most freely to make express your love? life more meaningful?

and discourages you?

• What pulls you down

• What are your • deepest What regrets? helps you feel most aware (or centered)?

your situation?

• Who best understands

• When in your • life Who/what have you experienced do you forgiveness? rely on most in life?

Understanding how spirituality facilitates health, wellness, and coping

• What rituals/practices • Who/what are especially do you important put (or your significant) hope to in? you?

• What kinds of • experiences For what provide are you with most the deeply deepest sense grateful? of meaning in life?

• How do you commemorate • To whom/what special occasions/accomplishments?

are you most devoted?

• At the deepest • levels To whom/what of your being, what do strengthens you most (or freely nurtures) express you?


• What sources of strength love? do you draw on to keep pressing forward?

• What nourishes • your What soul? pulls you down and discourages

• Where do you find you? a sense of peace (or inspiration)?

• When you are • in What pain (or are afraid), your where deepest do you turn regrets? for comfort?

• How have difficult • Who situations best changed understands your life for your the better? situation?

• What gives you the strength to carry on day after day?

• What helps you • When get through in times your of life difficulty have (or you crisis)? experienced

• Who supports you forgiveness?

in hard times? How so?

• If you had just a year to live, what

are the most important things you

would like to accomplish?

• Why is it important that you are here

in this world? After you are gone,

what legacy would you like to leave

behind?

• How would you like people to remember

you after you are gone?

Past spirituality

• What sort of experiences stood out

for you when you were growing up?

• When you think back, what gave you

a sense of meaning (or purpose,

or hope for the future)?

When were you happiest

(or most joyful)?

• As you consider your life, what

accomplishments are you

particularly proud of?

• How did you cope with challenging

situations in the past?


Understanding how spirituality facilitates

health, wellness, and coping

• What rituals/practices are especially important

(or significant) to you?

• What kinds of experiences provide you

with the deepest sense of meaning in

life?

• How do you commemorate special occasions/accomplishments?

• At the deepest levels of your being, what

strengthens (or nurtures) you?


Future spirituality

• What sources of strength do you draw on

to keep pressing forward?

• What are you striving for Future in life? spirituality

• What are your goals for the future?

• What nourishes your soul?

• If you had just a year to live, what are the most important things you would like to accomplish? • Where do you find a sense of peace (or

• Why is it important

• What

that you

are

are

you

here in

striving

this world?

for

After

in

you

life?

are gone, what legacy would inspiration)?

you like to leave behind?

• How would you • What like people are to remember your goals you after for you the are future? gone?

• When you are in pain (or afraid), where

do you turn for comfort?

• How have difficult situations changed

your life for the better?

• What gives you the strength to carry on

day after day?

• What helps you get through times of

difficulty (or crisis)?

• Who supports you in hard times? How

so?

NEEDS & RESOURCES

Factors blocking client from living to full potential:

• Mental health disorder/SUD that is organic in nature

• Childhood trauma

• Traumatic events (including experience of addiction)

• Attachment injuries/Relational trauma

• Lacking core self-esteem, self-worth, and value

• Lacking meaningful connection to others

• Lacking mission, purpose, and meaning

• Seeking happiness and fulfillment in the external

• Lacking congruence with authentic self

Internal Needs

External Needs


Resources client can draw from:

• Connection with support system

• Positive/helpful belief system

• Positive/helpful rituals and practices

• Internal sense of worth and value

• Having mission, purpose, and meaning

• Having defined values

Internal Needs

External Needs




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Section 4:

PLAN/INTERVENTIONS:

TREATMENT PLANNING

LONG-TERM GOALS

• Reduce symptoms of MH Disorder and improve adaptive functioning.

• Reduce intensity, frequency, and severity of trauma responses.

• Increase emotional awareness, emotion regulation, and distress tolerance skills.

SHORT-TERM MEASURABLE OBJECTIVES:

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provisional data. Estimates for 2015-2019 are based on final data (available

from: https://www.cdc.gov/nchs/nvss/mortality_public_use_data.htm).

3. Mental Health America www.mhanational.org/issDavid R. Hodge, Implicit

Spiritual Assessment: An Alternative Approach for Assessing Client Spirituality,

Social Work, Volume 58, Issue 3, July 2013, Pages 223–230, https://doi.

org/10.1093/sw/swt019

4. Jones, R. S. (2019). Spirit in Session. Working with Your Client’s Spirituality

(and Your Own) in Psychotherapy. Templeton Press. PA

5. Captari, L. E., Sandage, S. J., & Vandiver, R. A. (2022). Spiritually integrated

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identify best practices and future research directions. Psychotherapy, 59(3),

307–320. https://doi.org/10.1037/pst0000407

6. Captari, LE, Hook, JN, Hoyt, W, Davis, DE, McElroy-Heltzel, SE, Worthington,

EL. Integrating clients’ religion and spirituality within psychotherapy: A

comprehensive meta-analysis. J Clin Psychol. 2018; 74: 1938– 1951. https://

doi.org/10.1002/jclp.22681

7. Spiritual Psychotherapy for Inpatient, Residential, and Intensive Treatment

David H. Rosmarin, Sarah Salcone, David Harper, and Brent P. Forester

American Journal of Psychotherapy 2019 72:3, 75-83 https://doi.org/10.1176/

appi.psychotherapy.20180046

8. Alton G. Toward an Integrative Model of Psychospiritual Therapy: Bringing

Spirituality and Psychotherapy Together. Journal of Pastoral Care &

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9. Dezelic MS: Meaning-Centered Therapy Workbook: Based on Viktor

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10. Frankl, V. E. 1., Lasch, I., Kushner, H. S., & Winslade W. J. (2006). Man’s

search for meaning. Boston: Beacon Press.

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