Therapeutic presence refers to the capacity to bring one’s whole self into encounters with clients by being present on multiple levels: physically, emotionally, cognitively, and spiritually. It has been suggested that mindfulness influences therapeutic presence in various ways, for example through the fostering of self-compassion or through the reduction of anxiety and depression symptoms in the psychologist. The main objective of this research is to examine the mediating roles of self-compassion and psychological distress in the relationship between mindfulness and therapeutic presence. Questionnaires were administered online to a sample of 178 French-Canadian psychologists. Results show that mindfulness is significantly correlated with self-compassion (r = 0.72) and psychological distress (r = − 0.41), while therapeutic presence is positively correlated with self-compassion (r = 0.54) and negatively correlated with psychological distress (r = − 0.41). Therapeutic presence is significantly correlated to all facets of mindfulness. In the mediation model, the self-compassion pathway indicates the indirect effect of self-compassion (b = 0.184), with a 95% confidence interval (CI = 0.040 to 0.336). The psychological distress pathway shows the indirect effect of psychological distress (b = 0.074), with a 95% confidence interval (CI = 0.004 to 0.163). These results support the mediation model with significant indirect effects. The results also support the link between mindfulness and therapeutic presence in psychotherapists, and offer a better understanding of the ways in which therapeutic presence and mindfulness interact. Avenues for future research are discussed.
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Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45.
Black, D. S. (2014). Mindfulness-based interventions: An antidote to suffering in the context of substance use, misuse, and addiction. Substance Use & Misuse, 49(5), 487–491.
Boellinghaus, I., Jones, F. W., & Hutton, J. (2012). The role of mindfulness and loving-kindness meditation in cultivating self-compassion and other-focused concern in health care professionals. Mindfulness, 5(2), 129–138.
Bollen, K. A., & Stine, R. (1990). Direct and indirect effects: Classical and bootstrap estimates of variability. Sociological Methodology, 20, 115–140.
Buber, M. (1958). I and thou (2nd ed.). New York, NY: Scribner.
Bugental, J. F. T. (1987). The art of the psychotherapist. New York, NY: Norton.
Cain, N. R. (2000). Psychotherapists with personal histories of psychiatric hospitalization: Countertransference in wounded healers. Psychiatric Rehabilitation Journal, 24(1), 22–28.
Charlemagne-Odle, S., Harmon, G., & Maltby, M. (2014). Clinical psychologists’ experiences of personal significant distress. Psychology and Psychotherapy: Theory, Research and Practice, 87(2), 237–252.
Colosimo, K. A., & Pos, A. E. (2015). A rational model of expressed therapeutic presence. Journal of Psychotherapy Integration, 25(2), 100–114.
Dalaï-Lama. (2001). An open heart: Practicing compassion in everyday life. Boston, MA: Little, Brown.
Davis, D. M., & Hayes, J. A. (2011). What are the benefits of mindfulness? A practice review of psychotherapy-related research. Psychotherapy, 48(2), 198–208.
Dunn, R., Callahan, J. L., Swift, J. K., & Ivanovic, M. (2013). Effects of pre-session centering for psychotherapists on session presence and effectiveness. Psychotherapy Research, 23(1), 78–85.
Escuriex, B. F., & Labbé, E. E. (2011). Health care providers’ mindfulness and treatment outcomes: A critical review of the research literature. Mindfulness, 2(4), 242–253.
Gehart, D. R., & McCullom, E. E. (2008). Inviting therapeutic presence: A mindfulness-based approach. In S. F. Hicks & T. Bien (Eds.), Mindfulness and therapeutic relation (pp. 176–194). New York, NY: Guilford Press.
Geller, S. M. q q (2002). Psychotherapists' presence: The development of a model and a measure. Accessible through ProQuest Dissertations & Theses. (NQ66348).
Geller, S. M. (2003). Becoming whole: A collaboration between experiential psychotherapies and mindfulness meditation. Person-Centered and Experiential Psychotherapies, 2(4), 258–273.
Geller, S. M. (2013). Therapeutic presence: An essential way of being. In M. Cooper, P. F. Schmid, M. O'Hara, & A. C. Bohart (Eds.), The handbook of person-centered psychotherapy and counseling (2nd ed., pp. 209–222). Basingstoke: Palgrave.
Geller, S. M., & Greenberg, L. S. (2002). Therapeutic presence: Psychotherapists’ experience of presence in the psychotherapy encounter. Person-Centered and Experiential Psychotherapies, 1(1–2), 71–86.
Geller, S. M., & Greenberg, L. S. (2012). Therapeutic presence: A mindful approach to effective therapy. Washington, DC: American Psychological Association.
Geller, S. M., Greenberg, L. S., & Watson, J. C. (2010). Psychotherapist and client perceptions of therapeutic presence: The development of a measure. Psychotherapy Research, 20(5), 599–610.
Geller, S. M., & Porges, S. W. (2014). Therapeutic presence: Neurophysiological mechanisms mediating feeling safe in therapeutic relations. Journal of Psychotherapy Integration, 24(3), 178–192.
Greason, P. B., & Cashwell, C. S. (2009). Mindfulness and counseling self-efficacy: The mediating role of attention and empathy. Counselor Education and Supervision, 49(1), 2–19.
Guy, J. D., Poelstra, P. L., & Stark, M. J. (1989). Personal distress and therapeutic effectiveness: National survey of psychologists practicing psychotherapy. Professional Psychology: Research and Practice, 20(1), 48–50.
Hayes, A. F. (2016). PROCESS 2.15 for SPSS and SAS. Recovered on June 4, 2016 from http://www.processmacro.org/download.html
Heeren, A., Douilliez, C., Peschard, V., Debrauwere, L., & Philippot, P. (2011). Cross-cultural validity of the Five Facets Mindfulness Questionnaire: Adaptation and validation in a French-speaking sample. European Review of Applied Psychology / Revue Européenne de Psychologie Appliquée, 61(3), 147–151.
Hill, C. L. M., & Updegraff, J. A. (2012). Mindfulness and its relation to emotional regulation. Emotion, 12(1), 81–90.
Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6(6), 537–559.
Ilfeld, F. W. (1976). Further validation of a psychiatric symptom index in a normal population. Psychological Reports, 39((3, Pt 2)), 1215–1228.
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156.
Keng, S.-L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: A review of empirical studies. Clinical Psychology Review, 31(6), 1041–1056.
Kotsou, I., & Leys, C. (2016). Self-compassion scale (SCS): Psychometric properties of the French translation and its relations with psychological well-being, affect and depression. PLoS ONE, 11((4)), e0152880. https://doi.org/10.1371/journal.pone.0152880.
Leary, M. R., Tate, E. B., Adams, C. E., Batts Allen, A., & Hancock, J. (2007). Self-compassion and reactions to unpleasant self-relevant events: The implications of treating oneself kindly. Journal of Personality and Social Psychology, 92(5), 887–904.
Martel, M.-È., Gagnon, J., Bourgault, M., & Dionne, F. (2016, June). On being present in therapy: Validation of a French translation of the therapeutic presence inventory. In Poster presented at the annual World Conference of the Association for Contextual and Behavioral Sciences (ACBS). Seattle: WA.
Mirowsky, J., & Ross, C. E. (2003). Social causes of psychological distress (2nd ed.). New York, NY: Aldine de Gruyter.
Moore, K. A., & Cooper, C. L. (1996). Stress in mental health professionals: A theoretical overview. International Journal of Social Psychiatry, 42(2), 82–89.
Neff, K. D. (2003a). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250.
Neff, K. D. (2003b). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85–101.
Neff, K. D., & Dahm, K. (2015). A self-compassion: What it is, what it does, and how it relates to mindfulness. In M. Robinson, B. Meier, & B. Ostafin (Eds.), Mindfulness and self-regulation. New York: Springer.
Neff, K. D., & Pommier, E. (2013). The relation between self-compassion and other-focused concern among college undergraduates, community adults, and practicing meditators. Self and Identity, 12(2), 160–176.
Neff, K. D., & Vonk, R. (2009). Self-compassion versus global self-esteem: Two different ways of relating to oneself. Journal of Personality, 77(1), 23–50.
O'Donovan, A., & May, S. (2007). The advantages of the mindful therapist. Psychotherapy in Australia, 13(4), 46–53.
Oghene, J. E., Pos, A. E., & Geller, S. M. (2010). Psychotherapist presence, empathy and alliance in experiential treatment for depression (unpublished doctoral these). Toronto, Canada: York University.
Prakash, R. S., Hussain, M. A., & Schirda, B. (2015). The role of emotion regulation and cognitive control in the association between mindfulness disposition and stress. Psychology and Aging, 30(1), 160–171.
Preacher, K. J., & Hayes, A. H. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891.
Préville, M., Boyer, R., Potvin, L., Perrault, C., & Légaré, G. (1992). Psychological distress: Determination of the reliability and validity of the measure used in the Santé Québec survey. Montréal: Ministère de la Santé et des Services sociaux.
Raes, F., Pommier, E., Neff, K. D., & Van Gucht, D. (2011). Construction and factorial validation of a short form of the self-compassion scale. Clinical Psychology & Psychotherapy, 18(3), 250–255.
Rimes, K. A., & Wingrove, J. (2011). Pilot study of mindfulness-based cognitive therapy for trainee clinical psychologists. Behavioral and Cognitive Psychotherapy, 39(2), 235–241.
Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21(2), 95–103.
Sauer, S., Walach, H., Schmidt, S., Hinterberger, T., Lynch, S., Büssing, A., et al. (2013). Assessment of mindfulness: Review on state of the art. Mindfulness, 4(1), 3–17.
Schneider, K. (2015). Presence: The core contextual factor of effective psychotherapy. Existential Analysis, 26(2), 304–312.
Schomaker, S. A. (2014). The impact of mindfulness training on therapeutic alliance, empathy, and lived experience: A mixed methods study with counselor trainees. Available through ProQuest Dissertations & Theses. (3566594).
Shapiro, S. L., Astin, J. A., Bishop, S. R., & Cordova, M. (2005). Mindfulness-based stress reduction for health care professionals: Results from a randomized trial. International Journal of Stress Management, 12(2), 164–176.
Shapiro, S. L., Brown, K. W., & Biegel, G. M. (2007). Teaching self-care to caregivers: Effects of mindfulness-based stress reduction on the mental health of psychotherapists in training. Training and Education in Professional Psychology, 1(2), 105–115.
Stratton, P. (2006). Psychotherapist mindfulness as a predictor of client outcomes. Available through ProQuest Dissertations & Theses. (3196740).
Vallerand, R. J. (1989). Toward a cross-cultural validation methodology of psychological questionnaires: Implications for French language research. Canadian Psychology/Psychologie Canadienne, 30(4), 662–680.
Vinca, M. A. (2009). Mindfulness and psychotherapy: A mixed methods investigation. Available through ProQuest Dissertations & Theses. (3381027).
Vinca, M. A. & Hayes, J. (2007, June). Psychotherapist mindfulness as predictive of empathy, presence and session depth. Presentation at the annual meeting for the Society for Psychotherapy Research, Madison, WI.
Williams, E. N., Hurley, K., O'Brien, K., & DeGregorio, A. (2003). Development and validation of the self-awareness and management strategies (SAMS) scales for psychotherapists. Psychotherapy: Theory, Research, Practice, Training, 40(4), 278–288.
This study is financially supported by the Fonds d’animation et de diffusion de la recherche from the Université du Québec à Trois-Rivières (UQTR).
All procedures performed in this study were in accordance with and received the approval of the Ethical Committee of the Université du Québec à Trois-Rivières. Informed consent was obtained from all individual participants included in this study
Conflict of Interest
The authors declare that they have no conflict of interest.
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Bourgault, M., Dionne, F. Therapeutic Presence and Mindfulness: Mediating Role of Self-Compassion and Psychological Distress among Psychologists. Mindfulness 10, 650–656 (2019). https://doi.org/10.1007/s12671-018-1015-z
- Therapeutic presence
- Psychological distress