SYSTEMATIC REVIEW article
Front. Psychol.
Sec. Psychology for Clinical Settings
The Efficacy of Chairwork Interventions: A Systematic Review Experiential Therapies Including Chairwork: A Systematic Review of Randomized Controlled Trials
Provisionally accepted
- Comenius University, Bratislava, Slovakia
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract: Chairwork refers to a set of experiential psychotherapeutic interventions in which the physical posi-tioning 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 random-ized 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 ther-apies. 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). The 22 research studies supported the efficacy of Chairwork for several mental health issues, including depression, as well as for the treatment of childhood trauma, and unfinished business. Furthermore, the results of all the studies suggested that Chairwork was effective across different therapeutic approaches. The effect sizes (Cohen's d) ranged from small (d = 0.07) to very large (d = 3.6). 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.
Keywords: Chairwork, empty chair, intervention, Psychotherapy, Systematic review, two chair, Unfinished business
Received: 28 Aug 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Ottingerová, Halamová and Szitás. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Júlia Halamová
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.