Existential Therapists in Surrey, BC

Photo of Karina Crow, Clinical Social Work/Therapist in Surrey, BC
Karina Crow
Clinical Social Work/Therapist, BSW, MSW, RSW
Verified Verified
2 Endorsed
Surrey, BC V3S
Utilizing person-centered, trauma-informed, evidence-based treatments that integrate professional training such as Dialectical Behavior Therapy, Cognitive Behavior Therapy, Solution Focused Therapy, Existential Therapy, and Accelerated Resolution Therapy (ART).
My practice offers integrative, individualized counselling and wellness sessions to individuals and couples in a non-judgmental and safe space. I am an ally in supporting diversity and welcome people who identify as counter-culturalists, nonconformists, creatives, musicians, and people exploring their meaning in the world. I provide virtual counseling and in-person Accelerated Resolution Therapy. I am a Registered Social Worker and have close to two decades of front-line and clinical practice in mental health and addictions. I have experience working with mood disorders, complicated relationships, trauma, anxiety, and depression.
Utilizing person-centered, trauma-informed, evidence-based treatments that integrate professional training such as Dialectical Behavior Therapy, Cognitive Behavior Therapy, Solution Focused Therapy, Existential Therapy, and Accelerated Resolution Therapy (ART).
My practice offers integrative, individualized counselling and wellness sessions to individuals and couples in a non-judgmental and safe space. I am an ally in supporting diversity and welcome people who identify as counter-culturalists, nonconformists, creatives, musicians, and people exploring their meaning in the world. I provide virtual counseling and in-person Accelerated Resolution Therapy. I am a Registered Social Worker and have close to two decades of front-line and clinical practice in mental health and addictions. I have experience working with mood disorders, complicated relationships, trauma, anxiety, and depression.
(604) 706-5052 View (604) 706-5052
Photo of Dominika Nelly Szymanska - McDonald in Surrey, BC
Dominika Nelly Szymanska - McDonald
MA, CCC, BCaBA
Verified Verified
1 Endorsed
Surrey, BC V4A
For over 24 years, Dominika has provided behavior treatment to children, teens, and adults who have been diagnosed with Autism Spectrum disorder, ADHD, anxiety, or other developmental disabilities. Currently, Dominika’s focus lies in guiding teens and young adults through their major life transitions, and helping them navigate their peer and family relations, academic pursuits, career goals and existential challenges. In addition, Dominika provides support to individuals and families dealing with depression, grief, immigration issues and existential crises. She utilizes her clinical experience to provide solution-focused treatment.
For over 24 years, Dominika has provided behavior treatment to children, teens, and adults who have been diagnosed with Autism Spectrum disorder, ADHD, anxiety, or other developmental disabilities. Currently, Dominika’s focus lies in guiding teens and young adults through their major life transitions, and helping them navigate their peer and family relations, academic pursuits, career goals and existential challenges. In addition, Dominika provides support to individuals and families dealing with depression, grief, immigration issues and existential crises. She utilizes her clinical experience to provide solution-focused treatment.
(709) 703-8733 View (709) 703-8733
Photo of San Samra, Counsellor in Surrey, BC
San Samra
Counsellor, MA, RCC
Verified Verified
1 Endorsed
Surrey, BC V3S
I am able to offer CBT, Narrative Therapy, and Existential Psychotherapy.
Do you struggle with your emotions? Do they lead you to engage in behaviours that you regret? Are you struggling with interpersonal conflicts, substance use, self harm, or mental health concerns? I can help you achieve your goals and to go from surviving to thriving. I am a Registered Clinical Counsellor with the British Columbia Association of Clinical Counsellors. With having worked in both private and public mental health settings, I've been able to work with people struggling with addiction, depression, intense emotions, life transitions, self-harm, stress/anxiety, suicidal ideation, trauma/PTSD, and many others.
I am able to offer CBT, Narrative Therapy, and Existential Psychotherapy.
Do you struggle with your emotions? Do they lead you to engage in behaviours that you regret? Are you struggling with interpersonal conflicts, substance use, self harm, or mental health concerns? I can help you achieve your goals and to go from surviving to thriving. I am a Registered Clinical Counsellor with the British Columbia Association of Clinical Counsellors. With having worked in both private and public mental health settings, I've been able to work with people struggling with addiction, depression, intense emotions, life transitions, self-harm, stress/anxiety, suicidal ideation, trauma/PTSD, and many others.
(604) 706-1378 View (604) 706-1378
Photo of Leanne Weenk, Counsellor in Surrey, BC
Leanne Weenk
Counsellor, MA, RCC
Verified Verified
2 Endorsed
Surrey, BC V3S
I apply strategies from somatic therapy, existential therapy, cognitive behavioural therapy and emotion-focused therapy to deepen my work with my clients.
I believe we all have the capacity for positive change and growth when we have access to a safe and supportive environment to share our stories. My work as a counsellor is person-centered, meaning I approach my clients with compassion, curiousity and non-judgment. I am trained to work with clients with a variety of presenting concerns such as depression, anxiety, relationship and communication issues, attachment, grief, body image, self-worth, life transitions, and others. In my clinical practice, I specialize in and am passionate about working with youth, couples, and adults of all genders and sexualities.
I apply strategies from somatic therapy, existential therapy, cognitive behavioural therapy and emotion-focused therapy to deepen my work with my clients.
I believe we all have the capacity for positive change and growth when we have access to a safe and supportive environment to share our stories. My work as a counsellor is person-centered, meaning I approach my clients with compassion, curiousity and non-judgment. I am trained to work with clients with a variety of presenting concerns such as depression, anxiety, relationship and communication issues, attachment, grief, body image, self-worth, life transitions, and others. In my clinical practice, I specialize in and am passionate about working with youth, couples, and adults of all genders and sexualities.
(365) 645-8142 View (365) 645-8142
Photo of Andrea Hendy, Counsellor in Surrey, BC
Andrea Hendy
Counsellor, MA, RCC
Verified Verified
Surrey, BC V3R
My approach is trauma informed, and shaped by attachment theory, emotionally focused therapy, and existential themes involving meaning & purpose.
Oftentimes we feel ‘stuck’ as though no movement forward is possible, or that our story is too complex to navigate and find healing from. Through my own experience, and in journeying alongside others, I have come to believe that freedom and life, even in the midst of significant pain and loss is possible. My clinical approach is unique, as I seek to incorporate the spiritual journey of the client, as understood through a Christian worldview, into the therapeutic process. I work using a parallel process of deepening your understanding of Self, and of God as you begin to reflect on your story.
My approach is trauma informed, and shaped by attachment theory, emotionally focused therapy, and existential themes involving meaning & purpose.
Oftentimes we feel ‘stuck’ as though no movement forward is possible, or that our story is too complex to navigate and find healing from. Through my own experience, and in journeying alongside others, I have come to believe that freedom and life, even in the midst of significant pain and loss is possible. My clinical approach is unique, as I seek to incorporate the spiritual journey of the client, as understood through a Christian worldview, into the therapeutic process. I work using a parallel process of deepening your understanding of Self, and of God as you begin to reflect on your story.
(236) 458-0363 View (236) 458-0363
Photo of Mark Majewski, Counsellor in Surrey, BC
Mark Majewski
Counsellor, MC, RCC
Verified Verified
2 Endorsed
Surrey, BC V3R  (Online Only)
Clients tell me I’m calm, curious, and compassionate—a patient, friendly collaborator who helps them find insight, connection, and direction. I'm a good fit with people who sometimes feel a bit “different” or want something a bit different in life. Like most, I am somewhat wounded myself (and relatively comfortable with it), and that helps me connect with people experiencing loneliness, anxiety, depression, feelings of day-to-day boredom and restlessness, and (perhaps especially) existential angst.
Clients tell me I’m calm, curious, and compassionate—a patient, friendly collaborator who helps them find insight, connection, and direction. I'm a good fit with people who sometimes feel a bit “different” or want something a bit different in life. Like most, I am somewhat wounded myself (and relatively comfortable with it), and that helps me connect with people experiencing loneliness, anxiety, depression, feelings of day-to-day boredom and restlessness, and (perhaps especially) existential angst.
(226) 240-2338 View (226) 240-2338
Photo of Ihab Darwiche, Counsellor in Surrey, BC
Ihab Darwiche
Counsellor, MA, CCC
Verified Verified
4 Endorsed
Surrey, BC V3X  (Online Only)
I mainly use existential therapeutic practices to guide my sessions alongside CBT, mindfulness, positive psychology, and psycho-analytical modalities.
As my mentors have helped me in my life, and as they have guided me through difficult points of self-growth and reflection, I have come to learn the value of being there for others to progress through our own difficult times. We need each other. I do believe it is far less problematic to overcome challenges with guidance and direction. Even more so when that guidance is refined through education, experience, and a standardized expectation of practice. I am capable of direct billing for ICBC and CVAP and can be accepted through other insurance agencies (i.e. Sunlife, BlueCross)
I mainly use existential therapeutic practices to guide my sessions alongside CBT, mindfulness, positive psychology, and psycho-analytical modalities.
As my mentors have helped me in my life, and as they have guided me through difficult points of self-growth and reflection, I have come to learn the value of being there for others to progress through our own difficult times. We need each other. I do believe it is far less problematic to overcome challenges with guidance and direction. Even more so when that guidance is refined through education, experience, and a standardized expectation of practice. I am capable of direct billing for ICBC and CVAP and can be accepted through other insurance agencies (i.e. Sunlife, BlueCross)
(902) 901-5336 View (902) 901-5336
Photo of Mike Mathers - Wellness Evolved Counselling, Counsellor in Surrey, BC
Mike Mathers - Wellness Evolved Counselling
Counsellor, MSc, MA, RCC
Verified Verified
2 Endorsed
Surrey, BC V3R
If you or a loved one are suffering from addictions or are concerned about emotional well being please get in touch for a FREE 20 minute phone consult. I am a Counsellor with 15 years of experience working in residential and outpatient treatment programs with both individuals and groups. I have a passion for helping individuals and families impacted by substance use disorders as well as for supporting first responders dealing with operational stress injuries. I use a blend of approaches including motivational interviewing, cognitive behavioural therapy, acceptance and commitment therapy, existential therapy and mindfulness.
If you or a loved one are suffering from addictions or are concerned about emotional well being please get in touch for a FREE 20 minute phone consult. I am a Counsellor with 15 years of experience working in residential and outpatient treatment programs with both individuals and groups. I have a passion for helping individuals and families impacted by substance use disorders as well as for supporting first responders dealing with operational stress injuries. I use a blend of approaches including motivational interviewing, cognitive behavioural therapy, acceptance and commitment therapy, existential therapy and mindfulness.
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Photo of Benjamin Schulz, Counsellor in Surrey, BC
Benjamin Schulz
Counsellor, PhD, CCC
Verified Verified
Surrey, BC V3S
My philosophy of counselling is strongly influenced by my Christian worldview and my motivation to help others. I draw primarily from Person-centered, Cognitive Behaviour Therapy (CBT), Dialectical Behaviour Therapy (DBT), Acceptance and Commitment Therapy (ACT), and existential therapeutic approaches. In my practice I work with youth and adults to treat depression, anxiety, past trauma, relationship conflict, career change, and other life transitions. An overarching theme of my practice is working alongside clients to help them gain a greater sense of meaning and purpose in their lives.
My philosophy of counselling is strongly influenced by my Christian worldview and my motivation to help others. I draw primarily from Person-centered, Cognitive Behaviour Therapy (CBT), Dialectical Behaviour Therapy (DBT), Acceptance and Commitment Therapy (ACT), and existential therapeutic approaches. In my practice I work with youth and adults to treat depression, anxiety, past trauma, relationship conflict, career change, and other life transitions. An overarching theme of my practice is working alongside clients to help them gain a greater sense of meaning and purpose in their lives.
(778) 744-0934 View (778) 744-0934
Photo of Renu Nijjar, Counsellor in Surrey, BC
Renu Nijjar
Counsellor, RCC, BA, MC
Verified Verified
8 Endorsed
Surrey, BC V3R
My goal is to be a rock-steady supportive force in my client’s lives as we work, first, to make the most out of the adversities and suffering they encounter, and then, to help fulfill their vision of a life worth living. With fierce compassion and companionship, cultural humility, coping skills, solution-focused strategies, and a dash of existential humor, I cater to my clients as unique human beings with individual needs. I intimately know what it’s like to not have a safe space where you can be seen for who you truly are, so I understand how exceptionally important it is for my clients to have our therapy be that secure base.
My goal is to be a rock-steady supportive force in my client’s lives as we work, first, to make the most out of the adversities and suffering they encounter, and then, to help fulfill their vision of a life worth living. With fierce compassion and companionship, cultural humility, coping skills, solution-focused strategies, and a dash of existential humor, I cater to my clients as unique human beings with individual needs. I intimately know what it’s like to not have a safe space where you can be seen for who you truly are, so I understand how exceptionally important it is for my clients to have our therapy be that secure base.
(604) 313-6818 View (604) 313-6818
Photo of MALM Counselling, Counsellor in Surrey, BC
MALM Counselling
Counsellor, BEng, DipPSR, MEd, RCC
Verified Verified
3 Endorsed
Surrey, BC V3R
We work from trauma-informed and existential lenses to help you process, restore and develop new ways of engaging the world.
Kitsilano In-Person/Online: Over 15 years ago I transitioned from working in Electrical/Project Engineering to Mental Health/Clinical Counselling and since then developed valuable professional experience working in psychiatric, clinical, community, addiction treatment, educational, career & private settings. I have completed my Master's Degree in Counselling Psychology from the University of British Columbia (UBC) and hold two post-baccalaureate diplomas in Psychosocial Rehabilitation (PSR) and Guidance Studies. Currently, I am the Clinical Director and Registered Clinical Counsellor (RCC) at MALM Counselling.
We work from trauma-informed and existential lenses to help you process, restore and develop new ways of engaging the world.
Kitsilano In-Person/Online: Over 15 years ago I transitioned from working in Electrical/Project Engineering to Mental Health/Clinical Counselling and since then developed valuable professional experience working in psychiatric, clinical, community, addiction treatment, educational, career & private settings. I have completed my Master's Degree in Counselling Psychology from the University of British Columbia (UBC) and hold two post-baccalaureate diplomas in Psychosocial Rehabilitation (PSR) and Guidance Studies. Currently, I am the Clinical Director and Registered Clinical Counsellor (RCC) at MALM Counselling.
(604) 913-7293 View (604) 913-7293
Photo of Rina Mangat, Counsellor in Surrey, BC
Rina Mangat
Counsellor, RTC
Verified Verified
4 Endorsed
Surrey, BC V3W
Hello, my name is Rina. I am passionate about helping empower individuals to discover who they are and the resources they possess within themselves. We can all become stuck in old patterns that no longer serve who we are today. The first step is the courage to seek help to change what is not working. I am here to listen to what you have to say so that we can both explore options to get you unstuck. This is your session where you will have complete confidentiality, feel safe, comfortable and heard. I offer sliding scale for those who have no extended benefits, are low-income, seniors, students or new immigrants.
Hello, my name is Rina. I am passionate about helping empower individuals to discover who they are and the resources they possess within themselves. We can all become stuck in old patterns that no longer serve who we are today. The first step is the courage to seek help to change what is not working. I am here to listen to what you have to say so that we can both explore options to get you unstuck. This is your session where you will have complete confidentiality, feel safe, comfortable and heard. I offer sliding scale for those who have no extended benefits, are low-income, seniors, students or new immigrants.
(709) 700-3241 View (709) 700-3241
Photo of Brenda Randhawa, Counsellor in Surrey, BC
Brenda Randhawa
Counsellor, RTC, RPC-C
Verified Verified
2 Endorsed
Surrey, BC V3W
Your emotions are valid…feel them. It’s okay to feel overwhelmed. It’s common for transitions in life to bring up heavy emotions. This heaviness may be surfacing for you as feelings of being stuck, anxiety, frustration and even fear. You are taking the first step in acknowledging these difficult experiences and seeking support in working through them to live a more fulfilling life.
Your emotions are valid…feel them. It’s okay to feel overwhelmed. It’s common for transitions in life to bring up heavy emotions. This heaviness may be surfacing for you as feelings of being stuck, anxiety, frustration and even fear. You are taking the first step in acknowledging these difficult experiences and seeking support in working through them to live a more fulfilling life.
(204) 817-0692 View (204) 817-0692
Photo of Dmitry Alexandrovich, Counsellor in Surrey, BC
Dmitry Alexandrovich
Counsellor, RCC, CCC
Verified Verified
1 Endorsed
Surrey, BC V3S
My purpose is to assist you in facing and processing traumatic / adverse life experiences that could have resulted in anxiety, depression, PTSD, addictions, anger issues, etc. Together, we will explore and unravel the nature and roots of what prevents you from living a happier life. Despite the possible challenges that may arise on this way, please know that you have a huge potential to live your life based on what is right with you. As a clinician, I am committed to do to the best of my abilities for facilitating this process and helping you reach your goals.
My purpose is to assist you in facing and processing traumatic / adverse life experiences that could have resulted in anxiety, depression, PTSD, addictions, anger issues, etc. Together, we will explore and unravel the nature and roots of what prevents you from living a happier life. Despite the possible challenges that may arise on this way, please know that you have a huge potential to live your life based on what is right with you. As a clinician, I am committed to do to the best of my abilities for facilitating this process and helping you reach your goals.
(833) 634-0972 View (833) 634-0972
Photo of Mandala Counselling Services, Counsellor in Surrey, BC
Mandala Counselling Services
Counsellor, MA, RCC
Verified Verified
Surrey, BC V3Z
We all have our unique journeys that is often filled with challenges and obstacles that can be extremely difficult to solely manage effectively. We are all worthy and deserving of healing and inner peace. I create a safe and confidential place where the individuals, couples and family and children experiencing depression, anxiety, stress, loss, communication, sexual abuse, relationship difficulties, drug and alcohol, eating disorder, trauma, separation and divorce, family violence and Indian Residential School effects. You will know what your needs are, what you want and why, make reachable goals and take steps to get them.
We all have our unique journeys that is often filled with challenges and obstacles that can be extremely difficult to solely manage effectively. We are all worthy and deserving of healing and inner peace. I create a safe and confidential place where the individuals, couples and family and children experiencing depression, anxiety, stress, loss, communication, sexual abuse, relationship difficulties, drug and alcohol, eating disorder, trauma, separation and divorce, family violence and Indian Residential School effects. You will know what your needs are, what you want and why, make reachable goals and take steps to get them.
(604) 670-4713 View (604) 670-4713
Photo of Jas Sandhu, Counsellor in Surrey, BC
Jas Sandhu
Counsellor, MEd, RCC, CCC
Verified Verified
Surrey, BC V3S
Are you feeling unsure, overwhelmed, or alone in your life situation? Is your mental, emotional, physical, or social wellness being compromised by stress and unhealthy coping? Therapeutic counselling offers a compassionate and supportive space where you can press pause on the daily grind and engage in a personal growth journey to identify, manage and overcome the obstacles blocking you from living a satisfying and successful life.
Are you feeling unsure, overwhelmed, or alone in your life situation? Is your mental, emotional, physical, or social wellness being compromised by stress and unhealthy coping? Therapeutic counselling offers a compassionate and supportive space where you can press pause on the daily grind and engage in a personal growth journey to identify, manage and overcome the obstacles blocking you from living a satisfying and successful life.
(236) 302-4252 View (236) 302-4252
Photo of Within Reach Counselling Services, Counsellor in Surrey, BC
Within Reach Counselling Services
Counsellor, RTC
Verified Verified
Surrey, BC V4N
Waitlist for new clients
"Although the world is full of suffering, it is also full of the overcoming of it." - Helen Keller. Understanding. Clarity. Acceptance. I create a safe place where you are treated without judgement or bias. The resources of change are within all of us to create personal growth in today's challenging world. It is my job to support you through the process toward the changes you choose to make. I will guide you toward finding your strengths, assisting you to capitalize on their full potential. I work with you to explore where you are and where you want to be. I will do my best to supply you with the resources required to move forward.
"Although the world is full of suffering, it is also full of the overcoming of it." - Helen Keller. Understanding. Clarity. Acceptance. I create a safe place where you are treated without judgement or bias. The resources of change are within all of us to create personal growth in today's challenging world. It is my job to support you through the process toward the changes you choose to make. I will guide you toward finding your strengths, assisting you to capitalize on their full potential. I work with you to explore where you are and where you want to be. I will do my best to supply you with the resources required to move forward.
(604) 256-9577 View (604) 256-9577
Photo of Tejinder Sandhu, Counsellor in Surrey, BC
Tejinder Sandhu
Counsellor, MC, RCC
Verified Verified
Surrey, BC V3W
There are times where the challenges we face in our daily lives become too difficult to manage on our own. I can help navigate those who are looking to add meaning and purpose to their lives, generating motivation, and regaining control. The ability to achieve wellness and stability in our lives, exists somewhere inside of us. The disconnection we experience from the things that bring us happiness and joy may cause us to feel overwhelmed and paralyzed by stress. My aim is to provide a supportive, non-judgemental, and safe environment to help support you through life’s difficulties that may have you feeling stuck and under pressure.
There are times where the challenges we face in our daily lives become too difficult to manage on our own. I can help navigate those who are looking to add meaning and purpose to their lives, generating motivation, and regaining control. The ability to achieve wellness and stability in our lives, exists somewhere inside of us. The disconnection we experience from the things that bring us happiness and joy may cause us to feel overwhelmed and paralyzed by stress. My aim is to provide a supportive, non-judgemental, and safe environment to help support you through life’s difficulties that may have you feeling stuck and under pressure.
(604) 532-5340 View (604) 532-5340
Photo of Allison Ashbee Counselling, Counsellor in Surrey, BC
Allison Ashbee Counselling
Counsellor, RTC
Verified Verified
3 Endorsed
Surrey, BC V3X
Life is a journey, and sometimes life's path offers rough terrain. Sometimes all we need is for someone to walk with us, and support us through life's challenges. As a Registered Therapeutic Counsellor I strive to help clients gain awareness into their personal struggles, and ultimately find healing in such areas. I aim to offer a safe, warm and welcoming environment where clients can feel supported, validated and ultimately find hope.
Life is a journey, and sometimes life's path offers rough terrain. Sometimes all we need is for someone to walk with us, and support us through life's challenges. As a Registered Therapeutic Counsellor I strive to help clients gain awareness into their personal struggles, and ultimately find healing in such areas. I aim to offer a safe, warm and welcoming environment where clients can feel supported, validated and ultimately find hope.
(866) 229-9149 View (866) 229-9149
Photo of Danleigh Sokerov, Counsellor in Surrey, BC
Danleigh Sokerov
Counsellor, MA, RCC
Verified Verified
4 Endorsed
Surrey, BC V3S
Are you feeling the weight of being stuck, despite your best efforts? You’ve had some success but also feel exhausted. Life's hurdles have felt overwhelming, adding to the stress and disconnection you're experiencing. You long to rediscover a sense of connection and presence, to feel whole again. While you know deep down that change is possible, the journey seems daunting, especially when facing it alone. That's why you're seeking support, a safe and nurturing environment where judgment is left at the door. I work with youth, adults and couples as well as those finding they need support as partners, caregivers and parents.
Are you feeling the weight of being stuck, despite your best efforts? You’ve had some success but also feel exhausted. Life's hurdles have felt overwhelming, adding to the stress and disconnection you're experiencing. You long to rediscover a sense of connection and presence, to feel whole again. While you know deep down that change is possible, the journey seems daunting, especially when facing it alone. That's why you're seeking support, a safe and nurturing environment where judgment is left at the door. I work with youth, adults and couples as well as those finding they need support as partners, caregivers and parents.
(236) 326-9579 View (236) 326-9579

See more therapy options for Surrey

Existential Counsellors

How does existential therapy work?

Existential therapy focuses on a patient’s inner experiences. The therapist tries to help the individual comprehend and alleviate symptoms by exploring their interior life. By confronting negative disquiet and emotions, the individual will hopefully become more open to finding meaning and purpose. This therapy can be administered to individuals or groups.

Is existential therapy evidence-based?

Existential therapy is an evidence-based practice. Research has determined that existential therapy can lead to significant improvement in the mental health of patients, and for some people it can be just as effective as cognitive behavioural therapy. The benefits of existential therapy are enduring, even long after treatment has ended.

How long does existential therapy last?

The goal of existential therapy is to understand a person’s internal experiences, which may sound like a lengthy process, but it does not have to be so in-depth. However, sessions are not short-term, and therapy can continue for months or up to a year. And because patients learn the theory behind existential therapy during treatment, they can also practice its tenets throughout life after therapy sessions have been completed.

Is existential therapy effective?

According to research, many patients find success with existential therapy. Researchers note that the therapy is particularly useful in improving feelings of isolation, feelings of purposelessness, as well as conditions such as anxiety and depression. Improvements in problem areas can persist even after the end of existential therapy, as individuals can continue working on themselves by using the tools they’ve developed during treatment.