IJSP Number 8, 2026

International Journal of Supervision in Psychotherapy, Number 8, 2026 Page | 74 Praxis-oriented lineages intensify this critique. Praxis here is not simply “practice” as applied technique; it is ethically oriented action that integrates reflection and transformation. A praxis framework has been proposed as a radical alternative to strictly scientific paradigms when those paradigms reduce lived experience to variables and thereby miss what matters ethically and existentially in suffering [18]. This is not a rejection of evidence, but a critique of narrow evidentialism. In praxis terms, the question becomes: evidence for what ends, and under what assumptions about the person and the world? Existential and psychoanalytic crossings contribute another strand: radical psychotherapy can mean refusing the cultural pressure to treat mental health as a productivity tool. Existentially influenced psychoanalytic psychotherapy, for instance, emphasizes that distress is often a signal of rupture in meaning, freedom, and relational truth, and that such ruptures are frequently intensified by social fragmentation and coercive normativity [19]. This helps radical psychotherapy retain a central psychoanalytic insight: the psyche is not only wounded by events, but also by the loss of symbolization, recognition, and narrative continuity. Radical relationality has become an increasingly explicit philosophical foundation for psychotherapy. If the self is fundamentally relational, then power is not an “external factor” but a structural dimension of relations, inside and outside therapy. Philosophical accounts of radical relationality argue that therapeutic change involves reworking the relational conditions of being, including those shaped by history, culture, and exclusion [20]. Clinical implications follow: therapy must attend to how recognition is distributed; how safety is constructed; and how the client’s identity is negotiated within relational fields that may be oppressive. Developmental and population-specific applications also demonstrate the breadth of the family. Radical relational approaches to adolescent psychotherapy, for example, emphasize that adolescent distress is often amplified by social regulation, institutional surveillance, and identity-based marginalization, making the therapeutic project as much about reclaiming relational space as about symptom management [21]. Radical psychotherapy thus becomes a way to articulate how development unfolds within social constraints, not merely within a dyad or family system. Finally, professional and institutional critiques show why the radical question is inseparable from how psychotherapy is regulated and professionalized. Contemporary analyses of professionalization and state regulation raise concerns about how institutional frameworks can standardize psychotherapy in ways that prioritize compliance, risk- management, and credentialed legitimacy over relational depth, ethical reflexivity, and contextual truth [22]. In this view, radical psychotherapy also includes a critique of the profession’s own power: who is authorized to heal, under what rules, and whose suffering becomes legible in official terms? These lineages together show why radical psychotherapy is not a niche ideology but an integrative conceptual field. Its shared premise is that psychotherapy cannot be clinically adequate if it ignores how power organizes experience. 2.3 THREE FOUNDATIONAL PREMISES OF RADICAL PSYCHOTHERAPY Despite theoretical diversity, radical psychotherapy is held together by several premises that can guide formulation, technique selection, and ethical stance (Figure 1).