International Journal of Supervision in Psychotherapy

Received: 17.02.2026; Accepted: 17.03.2026; Published: 09.05.2026

This conceptual article clarifies radical psychotherapy as a family of clinically grounded, ethically explicit approaches that treat psychological distress as simultaneously intrapsychic and socio-structural. In response to contemporary mental health pressures, precarity, polarization, violence, burnout, and persistent inequality, we argue that strictly individualistic models can unintentionally pathologize adaptive responses to unsafe environments. We propose an “inside + world” model in which symptoms are understood as functional strategies shaped by internal dynamics and external power relations, and we outline five comparative axes that distinguish radical psychotherapy from decontextualized practice: explanatory frameworks, targets of change, therapist positioning, clinical language, and technique framing. A set of clinical postulates is advanced to guide practice: contextualization without erasing personal responsibility, explicit attention to power in the consulting room, shame as socially produced and relationally maintained, an anti-blame stance that avoids both culpabilization and romanticization of suffering, and the primacy of safety and dignity over therapeutic performance. We then translate these principles into practical strategies, including contextual case formulation, power mapping, depathologizing reframes, work with shame and internalized oppression, agency-building micro-interventions, ethical transparency, resource-oriented/community linkage, and evidence-based techniques (CBT/ACT/DBT) deployed within a radical frame. Finally, we address dilemmas concerning politicization, biological and trauma-informed balance, therapist competencies, and multidimensional evaluation. We conclude that radical psychotherapy does not replace established therapies; it recontextualizes them toward root causes power, context, and dignity so that healing is defined as symptom reduction alongside increased agency, protection, and socially recognized personhood.

radical psychotherapy; power; social determinants of mental health; contextual formulation; depathologization; dignity; agency; internalized oppression; shame; radical healing; critical psychotherapy; radical relationality

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