Experiential therapies including Chairwork: a systematic review of randomized controlled trials

Chairwork refers to a set of experiential psychotherapeutic interventions in which the physical positioning of the chairs facilitates internal and interpersonal dialogue. This study is an attempt to rectify the lack of a systematic review of the research on the effectiveness of Chairwork by offering a systematic review of randomized controlled trials (RCTs) that assess the effectiveness of Chairwork-based interventions used in various psychotherapeutic approaches for the treatment of psychological disorders, difficulties, and mental health conditions. It considers various psychotherapy modalities and formats, including individual, couple, group, and family therapies. We followed the updated criteria of the Preferred Reporting Items for Systematic Review. Our systematic review examines the relevant literature from two scientometric databases: Web of Science and Scopus published up to August 30, 2024. An independent assessment of the risk of bias in the studies was performed using the Cochrane Risk of Bias 2.0 along with a certainty assessment. A total of 22 RCTs were included in the final analysis, providing robust empirical support for Chairwork’s efficacy across several clinical domains, including depression, childhood trauma, unfinished business, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety, and eating disorders. The results demonstrated efficacy across different therapeutic approaches, with Chairwork utilized both as a core experiential component within broader frameworks (e.g., EFT) and as a stand-alone intervention. Effect sizes (Cohen’s d) varied depending on the outcome measure, ranging from small ( d = 0.20) to large ( d = 1.73). Our findings show that Chairwork seems to be a promising psychotherapeutic intervention for individuals, groups, and families. We provide a detailed analysis of these findings. We did not find any relevant studies relating to couple therapy.