Therapeutic presence (TP) lies at the heart of positive and effective therapeutic relationships. Twenty years of research on the art and science of presence is the foundation and the basis of an empirically validated model of therapeutic presence. Therapeutic presence provides clients with a neurophysiological sense of safety that allows them to be seen, heard, understood, and “feel felt.” Presence includes a balance between attunement with clients as well as attunement with one’s self. It leads to building, strengthening and sustaining a therapeutic alliance and working effectively with therapeutic ruptures. TP also asks therapists to care for themselves and work on their own balance of presence and compassion with themselves and their clients.