'Stay Curious': guest experiences of philosophical counselling in palliative care - a qualitative study.

Abstract

Background: Philosophical counselling creates a dialogical space for exploring existential questions arising from serious illness, confrontation with mortality, bereavement, and caregiving. Although philosophy has long engaged with mortality and existential concerns, philosophy in form of philosophical counselling is not established in palliative care and has seldom been empirically studied. This study examines the views and experiences of individuals who engaged in philosophical counselling in palliative care-related contexts.

Methods: Nine counselling processes were completed; post-counselling interviews were obtained from eight guests and analysed. Purposive sampling identified practitioners via professional associations in Austria, Germany, and Switzerland; guests were recruited by these practitioners in naturalistic practice settings. A qualitative content analysis was used to identify categories and subthemes.

Results: Through iterative, interpretive analysis, we generated four main categories: distinctive features of philosophical counselling; how guests perceived the philosophical practitioner; perceived effects; and strengths and limits. Participants valued freedom to explore open-ended questions without pressure to act or solve problems. Conversations were described as inspiring and created space for a "stepping out"-being seen as a person rather than only as affected. We interpreted philosophical curiosity as a grounding stance toward mortality. At the same time, critical questioning could become destabilizing, underscoring the need for calibrated movement between personal involvement and abstract reflection within an empathetic dialogical relationship.

Conclusions: Philosophical counselling seems to offer a space for reflective depth and existential inquiry in palliative care, fostering curiosity, wonder, and connectedness. It is described as offering intellectual freedom and an open, goal-free space. Practice implications include preserving this space, resisting help-driven agendas and didactic, overly abstract lecturing, and calibrating critical inquiry within empathetic dialogue. Philosophical counselling may contribute to facets of death literacy. Our findings indicate that end-of-life themes are already being addressed within philosophical counselling and offer guidance for introducing practice in palliative care contexts.