Maintaining therapeutic presence and empathy when engaging with a client's existential concerns

Research shows how therapists struggle to stay present with their clients' existential concerns. Our goal was to explore what hinders and enables therapists to stay present and engaged when existential concerns surface in the session. We invited 22 therapists (12 novice and 10 experienced) to engage in a role-play with a client expressing her existential concerns using a standardized script. Subsequently, the therapists were interviewed using a videotape-assisted recall procedure. Data were analyzed according to the descriptive-interpretive qualitative research approach. When confronted with existential themes in the session, novice therapists experienced overwhelming feelings of powerlessness and uncertainty, blocking their ability to remain open to the client's existential experiences. Lack of knowledge and encountering their own existential vulnerability were mentioned as triggers. For experienced therapists, the main challenge was to stay present while feeling impacted by the existential topic, which they managed by grounding and reanchoring themselves. Our findings support the idea that embracing one's own existential issues and being at ease with existential themes may be essential conditions for staying present and fostering an authentic therapeutic encounter. Furthermore, our findings suggest that gaining knowledge about the existential process and learning to ground and reanchor oneself are essential for therapists. (PsycInfo Database Record (c) 2025 APA, all rights reserved).