IJSP Number 8, 2026

International Journal of Supervision in Psychotherapy, Number 8, 2026 Page | 75 Figure 1. Foundational premises of radical psychotherapy (a) Distress has psychological and socio-structural causes Radical psychotherapy insists on dual causality without reductionism. The symptom is not only a product of cognition, affect regulation, or unconscious conflict; it is also shaped by structural exposures, racism, sexism, poverty, labor exploitation, institutional betrayal, and social marginalization. This premise prevents a therapeutic error that is both clinical and moral: treating structural injury as an individual defect. At the same time, radical psychotherapy does not romanticize context as if it explains everything. Psychoanalytic insight remains essential: individuals metabolize social forces differently, depending on temperament, early attachment, trauma histories, and internal object relations. The radical move is to hold both: the inner world and the world as it presses into the inner world. (b) Healing includes agency and dignity A second premise is teleological: it concerns what therapy is for . In many mainstream frames, “improvement” is measured via symptom reduction and functioning. Radical psychotherapy expands the outcome space to include agency and dignity, capacity to choose, to set limits, to claim voice, to negotiate recognition, and to remain connected to oneself without collapsing into shame. This does not mean that symptom relief is irrelevant; rather, radical psychotherapy asks what symptom relief costs when it is achieved through adaptation to dehumanizing conditions. Healing, in a radical frame, includes the restoration of the self as a subject, not merely as a performer of coping skills. This is why radical approaches often use the language of liberation, reclamation, authenticity, and resistance, not as political branding but as clinical descriptors of agency regained.