Research has consistently demonstrated the role of the therapeutic alliance in effective psychotherapy. Yet, the emotional demands of therapy, combined with everyday stressors and distractions, can prevent therapists from being fully present with their clients, which makes it difficult to build and maintain a stable alliance.

This book is a much-needed guide to cultivating therapeutic presence. The techniques described will help clinicians engage more deeply with their clients on physical, emotional, cognitive, spiritual, and relational levels. These techniques will also help clinicians and their clients deepen their relationship into a healing encounter.

Shari M. Geller first reviews the empirical foundations of therapeutic presence, including its neurophysiological underpinnings. She then translates this knowledge into clinical skills and practices that therapists of all theoretical backgrounds can use to set a presession foundation for presence, cultivate that presence in session, and overcome barriers.

To be most effective, therapists must also practice self-care and hone their presence skills outside of therapy. Geller provides exercises that allow therapists to cultivate presence in all aspects of their lives.

The book culminates in a description of therapeutic relational presence, the deepest level of connection therapists and clients can achieve.

Table of Contents

Daniel J. Siegel



I. Theory

  1. Therapeutic Presence: The Foundation for Effective Therapy
  2. History of Therapeutic Presence
  3. Neurophysiology of Therapeutic Presence

II. Presence Skills in Session

  1. Preparing for Presence Prior to the Session
  2. Receptively Attuning With Clients and Ourselves
  3. Extending, Responding, and Promoting Contact With Clients
  4. Barriers and Challenges to Presence

III. Presence Practices for Daily Life

  1. Preparing the Ground for Presence: Mindfulness and Experiential Exercises
  2. Strengthening the Therapeutic Presence Process: Receptivity, Inward Attuning, Extending, and Contact Exercises
  3. Deepening the Experience of Therapeutic Presence: Grounding, Immersion, Expansion, and Compassion Exercises

IV. Integrating Therapeutic Presence in Relationships and Training

  1. Therapeutic Relational Presence: Relationship as a Pathway to Spirituality
  2. Continuing the Journey: Training and Expanding Therapeutic Presence to All Relationships

Appendix A: Additional Resources for Cultivating Presence

Appendix B: Markers of Therapists' Presence

Appendix C: Markers of Clients' Safety

Appendix D: A Model for Optimizing Presence in Your Therapy Session



About the Author

Author Bio

Shari M. Geller, PhD, is an author, clinical psychologist, and supervisor with a commitment to mindfulness practices and a passion for rhythm and drumming.

Dr. Geller has been practicing mindfulness since 1990 and weaves Buddhist philosophy and rhythm-based work into her life and clinical practice. She has been involved in researching, writing, and training in therapeutic presence as a foundational approach to optimizing health care and therapeutic relationships.

Dr. Geller coauthored (with Leslie Greenberg) the book Therapeutic Presence: A Mindful Approach to Effective Therapy. She has released a companion CD on cultivating presence, with guided practices using the healing power of music and the health benefits of mindfulness. In collaboration with APA she has also released a training video for therapeutic presence.

Dr. Geller has a clinical and supervisory practice in Toronto and Grey-Bruce County. Her training with teachers and neuroscientists, along with her personal practice, inspired her to integrate the benefits of mindfulness, group drumming, and emotion-focused awareness into one comprehensive program, Therapeutic Rhythm and Mindfulness (TRM) to cultivate presence.

Dr. Geller serves on the teaching faculty in health psychology at York University and for the Applied Mindfulness Meditation program at University of Toronto, and she is adjunct professor in the Faculty of Music at the University of Toronto, in association with Music and Health Research Collaboratory. She is the codirector of the Centre for MindBody Health, offering mindfulness and compassion-based treatment and professional training.

Reviews & Awards

This is a comprehensive training manual for the ineffable quality — presence — that lies at the heart of effective psychotherapy. On the basis of extensive research and years of practice, Geller shows us, step-by-step, how to be with our clients so they can be more fully with themselves. Destined to become a classic, this inspired work is essential reading for novice and experienced therapists.
—Christopher Germer, PhD
author of The Mindful Path to Self-Compassion and coeditor of Mindfulness and Psychotherapy, Faculty, Harvard Medical School, Cambridge, MA

Geller provides a new level of understanding of the critical role that therapeutic presence plays in the healing process, bridging clinical experience and knowledge of the neurobiological mechanisms through which psychotherapy works. Brilliantly structured exercises demonstrate how shifts in attention and intention may support or disrupt the client's unconscious surveillance of safety.
—Stephen W. Porges, PhD
Distinguished University Scientist, Kinsey Institute, Indiana University, Bloomington; author of The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation

In this clinically and theoretically rich volume, Geller provides a superb synthesis of theory and principles emerging out of the humanistic-experiential tradition, meditative and Eastern wisdom traditions, and neuroscience literature, to articulate the critical role that therapeutic presence plays in psychotherapy. With a focus on the present moment in psychotherapy, Geller explains the importance of therapists' being grounded and centered in their own embodied experience, immersed in the moment, open and receptive, and compassionately attuned to their clients. This book provides clear guidelines and therapist exercises that clinicians of all orientations will find invaluable.
—Jeremy D. Safran, PhD
Professor of Psychology, The New School for Social Research, New York, NY

Serves as a valuable springboard for theory building, research, and clinical practice. The book offers valuable insights for clinicians and researchers alike. I welcome its presence on my bookshelf!