My approach to therapy is deeply rooted in the belief that healing and growth are not limited to treating symptoms; instead, they involve discovering purpose, building meaningful connections, and creating an identity that reflects who you truly are. Over the years, I’ve trained in and integrated several evidence-based approaches that support this broader, more human-centered vision. Whether we are working to increase your overall happiness and satisfaction through Quality of Life Therapy, exploring your past for insight and closure through Life Review Therapy, or transforming your relationships through Relational Life Therapy, my goal is to help you live more fully and authentically.

Each of these models contributes something unique, and together they provide a flexible and personalized path toward emotional well-being, resilience, and lasting change.

Quality of Life Therapy (QOLT): An Overview Quality of Life Therapy

Quality of Life Therapy (QOLT) is a structured, evidence-based positive psychology intervention developed by Dr. Michael B. Frisch, a clinical psychologist and professor at Baylor University. It emerged in the early 2000s as part of a growing movement to shift behavioral health treatment from a focus solely on symptom reduction to an emphasis on flourishing, fulfillment, and overall well-being. Quality of Life Therapy is based on Frisch’s empirically derived model of happiness and satisfaction, which he outlines in his book Quality of Life Therapy: Applying a Life Satisfaction Approach to Positive Psychology and Cognitive Therapy (2006).

Quality of Life Therapy integrates traditional cognitive-behavioral therapy (CBT) techniques with a structured assessment and intervention model that targets 16 key areas of quality of life, including relationships, work, health, play, goals, and spirituality. The underlying assumption in QOLT is that psychological distress is often the result of dissatisfaction in one or more of these domains, and that enhancing fulfillment in these areas can promote well-being and prevent relapse.

Who Quality of Life Therapy Is Best For

This approach is beneficial for individuals who:

  • Are experiencing mild to moderate depression or anxiety
  • Are dealing with chronic stress or burnout
  • Want to enhance life satisfaction or personal growth
  • Are in recovery from mental illness and want to improve resilience
  • Are undergoing life transitions (e.g., divorce, retirement, illness)
  • Prefer a structured, collaborative, and goal-oriented therapeutic approach

Quality of Life Therapy can also be adapted for high-functioning individuals, couples, and groups seeking personal development or coaching.

Techniques Used in Quality of Life Therapy

QOLT uses a semi-manualized format centered around the Quality of Life Inventory (QOLI), a self-report tool that measures satisfaction and importance across 16 life areas. Based on QOLI results, individual therapy focuses on increasing fulfillment in areas rated as currently important and unsatisfying. Quality of Life Therapy techniques include:

  1. Cognitive Restructuring: Identifying and changing unhelpful beliefs that hinder satisfaction (e.g., perfectionism, pessimism).
  2. Gratitude Practices: Encouraging reflection on what’s going well in life, even amidst challenges.
  3. Goal Setting and Planning: Creating specific, meaningful goals in targeted domains.
  4. Behavioral Activation: Encouraging pleasurable and mastery-oriented activities to build momentum and joy.
  5. Forgiveness and Acceptance Work: Letting Go of Resentments That Block Well-being.
  6. Savoring and Mindfulness: Increasing awareness and appreciation of positive moments.
  7. Happiness Exercises: Including strengths-based reflection, optimism training, and envisioning best possible selves.

I use a flexible workbook-style format, guiding you through structured exercises while also addressing emotional and interpersonal barriers that arise.

Outcomes of Quality of Life Therapy

QOLT has been shown to produce meaningful improvements in both clinical and non-clinical populations. Reported outcomes include:

  • Increases in overall satisfaction and happiness
  • Reductions in depressive and anxious symptoms
  • Greater resilience to stress and adversity
  • Enhanced goal clarity and sense of purpose
  • More balanced and fulfilling lifestyles
  • Lower relapse rates in clients with chronic disorders

Several studies support the use of Quality of Life Therapy as an effective adjunct or alternative to traditional CBT, especially for clients who are motivated by growth rather than pathology-focused treatment.

Case Example: Software Engineer with Low Mood and Burnout

Marcus sought treatment after experiencing a prolonged period of burnout, low energy, and disengagement from his work and relationships. He did not meet the criteria for major depression but scored below average on measures of life satisfaction. He described his life as “on autopilot” and said he often felt unfulfilled despite material success.

Using the QOLI, Marcus identified that while work and financial security were satisfactory, he was deeply unfulfilled in areas such as friendships, fun, personal growth, and romance, all of which he rated as very important. In sessions, Marcus worked on shifting negative thought patterns (e.g., “I don’t have time for friends anymore”) and began scheduling small, meaningful activities, like weekly dinners with old friends and joining a hiking group. He also clarified personal values and set new goals related to creativity and spirituality.

After three months, Marcus reported improved mood, greater enthusiasm, and a more vibrant sense of daily purpose. By focusing on the domains that mattered most to him, he was able to construct a lifestyle more congruent with his values.

Conclusion

Quality of Life Therapy offers a unique, integrative approach to well-being by blending the scientific rigor of CBT with the empowering lens of positive psychology. Rather than focusing exclusively on symptom reduction, QOLT invites clients to build fulfilling, values-driven lives across multiple domains. It is particularly well-suited for individuals seeking not just to heal but to thrive. Thus, it is an ideal model for those navigating stress, dissatisfaction, or personal transitions who desire purposeful change.

Relational Life Therapy (RLT): An Overview

Relational Life Therapy (RLT) is a form of couples and relational treatment developed by Terry Real, a family therapist and author of The New Rules of Marriage and Us: Getting Past You and Me to Build a More Loving Relationship. Emerging in the 1990s, RLT was created in response to what Real saw as the limitations of traditional marriage counseling, especially its inability to address power imbalances, emotional disconnection, and gender-role conditioning in intimate partnerships.

Rooted in feminist theory, systems thinking, and attachment-based theory, relational life therapy integrates blunt truth-telling, compassionate confrontation, and skills training to foster connection, accountability, and authenticity in relationships. It is distinct for its direct, therapist-led style and its emphasis on both partners doing the internal and relational work needed to transform their dynamic.

Who Relational Life Therapy Is Best For

RLT is beneficial for:

  • Couples experiencing frequent conflict, emotional disconnection, or dissatisfaction
  • Relationships affected by traditional gender role expectations or power struggles
  • Partners who struggle with emotional expression or accountability (a common focus of RLT)
  • High-conflict relationships with a history of blame, resentment, or defensiveness
  • Individuals or couples who want both personal growth and relationship repair
  • Clients who feel traditional couples therapy is too passive or lacks direction

Relational life therapy is also used with individuals to help people become better relational partners by examining their family-of-origin issues, relational trauma, and internalized beliefs about love, power, and vulnerability.

Techniques Used in Relational Life Therapy

RLT is structured around three key phases: Waking Up, Owning Up, and Growing Up. Across these phases of relational life therapy, we use a variety of techniques:

  1. Blunt, Loving Confrontation: I directly challenge destructive behaviors without shaming, offering a mix of firmness and compassion.
  2. Relational Diagnosis: Rather than pathologizing individuals, the focus is on identifying patterns that damage the relationship (e.g., grandiosity, avoidance, withdrawal).
  3. Trauma Work: Exploring family-of-origin wounds that shaped each partner’s relational style.
  4. Relational Skill Building: Teaching skills such as active listening, healthy self-expression, boundary setting, and mutual empowerment.
  5. Accountability and Repair: Encouraging personal responsibility rather than blame; promoting apology, change, and follow-through.
  6. Gender Role Deconstruction: Challenging traditional masculinity/femininity scripts that prevent intimacy and equality.

Unlike many approaches that aim only to create understanding, relational life therapy actively teaches how to behave differently, increasing both insight and action.

Outcomes of Relational Life Therapy

Outcomes of RLT include:

  • Greater intimacy, vulnerability, and emotional connection
  • Increased mutual respect, empathy, and fairness
  • Enhanced communication and conflict resolution skills
  • Reduction in power struggles and blame cycles
  • A deeper understanding of each partner’s internal wounds and how they play out relationally
  • Stronger commitment to relational integrity and long-term repair

Many couples who have struggled for years report that relational life therapy provides clarity, movement, and tools that were missing from more passive or insight-focused approaches..

Case Example: Married Couple

James and Elena entered therapy after 15 years of marriage marked by increasing emotional distance, conflict, and resentment. James often withdrew emotionally or responded with anger, while Elena felt lonely and unsupported. She frequently criticized him for being “checked out.” Traditional couples treatment had failed them. They felt it focused too much on talking about feelings without actually changing behavior. Relational life therapy seemed like a perfect fit.

In RLT, I began by directly addressing the unhealthy dynamic: James was gently confronted about his passive-aggressive withdrawal and emotional unavailability, while Elena was helped to see how her criticism, though understandable, was pushing him further away. Both were guided to see how childhood wounds, including James’s emotionally distant father and Elena’s volatile home life, shaped their adult responses.

I taught both partners new relational skills: James practiced emotional expression and presence, while Elena learned to voice needs without blame. Throughout treatment, James became more accountable and communicative, and Elena adjusted her delivery to remain assertive while being more considerate. They both reported a renewed sense of connection and mutual understanding.

Conclusion

Relational Life Therapy provides a powerful and transformative approach for individuals and couples who are ready to confront difficult truths, take responsibility, and actively develop healthier relational patterns. By blending directness with deep compassion and focusing equally on inner healing and skill development, relational life therapy stands out as a model for sustainable relationship change that emphasizes action-oriented approaches. It is especially well-suited for couples in crisis or those who feel stuck despite prior attempts at treatment.

Life Review Therapy: An Overview

Life Review Therapy is a structured therapeutic process that involves guided reflection on one’s life experiences to promote understanding, acceptance, and psychological integration. The roots of this approach lie in the work of Dr. Robert Butler, a geriatric psychiatrist who first proposed the concept of a “life review” in the 1960s. Butler argued that as individuals age, they naturally engage in a process of reflecting on their past, and that this reflection, if facilitated in a supportive environment, can lead to emotional healing, deep satisfaction, and a sense of integrity.

Life Review Therapy has since evolved into a widely used intervention in geriatric mental health, palliative care, narrative therapy, and trauma-informed work. While it is particularly popular in elder care settings, it has also found relevance among younger adults facing identity crises, major transitions, or trauma recovery.

Who Life Review Therapy Is Best For

This method is especially beneficial for:

  • Older adults processing aging, grief, and legacy
  • Individuals in palliative or hospice care seeking peace or meaning
  • People coping with life transitions, such as retirement, relocation, or empty nesting
  • Those struggling with regret, guilt, or unresolved trauma
  • Individuals experiencing existential distress or a loss of purpose
  • Clients with cognitive impairment (e.g., early-stage dementia), where it can stimulate memory and improve mood

This approach is also suitable for adults of any age who wish to make sense of their personal history and develop a more cohesive understanding of identity.

Life Review Therapy Techniques

Life Review Therapy typically unfolds over several sessions and may involve the following techniques:

  1. Chronological Exploration: Clients are guided to reflect on different life stages (childhood, adolescence, adulthood, etc.) in sequence.
  2. Thematic Reflection: The focus is placed on recurring themes, such as love, work, family, achievements, failures, or turning points.
  3. Memory-Prompting Tools: Photographs, music, letters, or personal artifacts are used to elicit memories and evoke emotions.
  4. Narrative Reconstruction: Clients are assisted in reinterpreting painful events in a more integrated and compassionate manner.
  5. Meaning-Making Exercises: I facilitate insight into what life events meant, how the client has grown, and what legacy they wish to leave.
  6. Written or Creative Expression: Some clients write memoirs, create timelines, or engage in art, poetry, or storytelling.
  7. Forgiveness Work: Encouraging reconciliation with oneself and others, particularly in addressing unresolved issues and conflicts.

I work with a tone of respect, empathy, and validation, encouraging clients to share openly while offering reframing and emotional support when needed.

Outcomes of Life Review Therapy

Evidence and clinical reports suggest several beneficial outcomes from Life Review Therapy, including:

  • Increased overall satisfaction and a sense of meaning
  • Decreased depression and anxiety, especially in older adults
  • Greater self-acceptance and reduced regret
  • Improved emotional resilience and peace with past choices
  • Enhanced interpersonal relationships through reconciliation and sharing
  • Slower cognitive decline and improved memory recall in early-stage dementia
  • A renewed sense of legacy and personal worth

Life Review Therapy is often considered not only psychologically therapeutic but also spiritually affirming.

Case Example: Widow in Assisted Living

Mildred began Life Review Therapy after showing signs of sadness, withdrawal, and preoccupation with past mistakes. She had recently moved into an assisted living facility following the death of her husband, and she expressed feelings of guilt for not being a more patient mother and regret over missed career opportunities.

In Life Review Therapy, Mildred was guided to recount her life chronologically, beginning with joyful childhood summers, her wartime romance, and the years of raising children. She brought in photo albums, letters, and music from her youth. With my support, she was able to see how she had made the best choices available to her at the time, given her circumstances. Sessions focused on validating her contributions as a mother and wife, reframing her regrets, and exploring the meaning behind both joyful and painful events.

Over time, Mildred’s mood improved, and she became more engaged in social activities at the facility. She wrote a letter to each of her grandchildren, sharing lessons that brought her great peace. She described the treatment as “finally tying a bow” on her story.

Conclusion

Life Review Therapy is a deeply reflective and compassionate approach that helps individuals of all ages—especially older adults—make peace with their past, find meaning in their journey, and feel whole as they move into later stages. By promoting emotional resolution and narrative integration, it supports not just psychological well-being but also the spiritual and existential dimensions of human experience.

Summary and My Work

Ultimately, therapy is not just about reducing distress. It’s about helping you thrive. My work draws from a rich blend of relational, cognitive-behavioral, and meaning-centered approaches because I believe that each person’s journey is multidimensional. Whether you’re facing a transition, relationship challenge, emotional block, or simply a desire to live more intentionally, these integrative methods allow us to work holistically, honoring your story, fostering your strengths, and supporting you in feeling not just functional, but deeply fulfilling. It’s never too late to heal, reflect, connect, and grow.

If you have any questions about Relational Life Therapy, Quality of Life Therapy, or Life Review Therapy, please contact me or schedule a consultation anytime.

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Dr. Alan Jacobson Founder and President
Dr. Jacobson is a licensed clinical psychologist providing individual, couples, and family therapy for over 20 years. He uses an integrative approach. choosing from a variety of proven and powerful therapeutic methods.