This chapter and the next two deal with ‘presence’, the word we use to thematise the heart of all good professional care, help and support in the areas of health, welfare and a habitable world. The current chapter is about presence as a concept used in different domains in healthcare and social work. The next two chapters address presence as a particular practice and as a theory.

Why presence?

The concept of presence has appeared in scholarly literature on missionary pastoral care, nursing, psychotherapy and other domains since the 1960s. It is often referred to as the centre, heart or core of the practice in question, and especially as a quality standard for good care. It has increasingly become the subject of qualitative research since the 1990s. While it may not be easy to explain why this happened, we think the main cause lies in the development of modernity. In the current stage of modernity – late modernity – institutions such as healthcare and social work are coming under increasing pressure from rule-based systems derived from utilitarian, goaldirected, production-oriented and bureaucratic management models (van Heijst, 2011). This systemic pressure burdens the work with and for people that is being done within these institutions, increasingly modelling it as the production of commodities. Many professionals as well as scholars feel that this is problematic in light of what care, help and support are and should be.

The question to which presence is an answer may be formulated as follows: what characterises activities that are regarded as essential in the social, therapeutic, nursing and medical professions and that have shown themselves to be beneficial to care receivers and their relatives in today's late modern society? If working relationally stands at the heart of good social, therapeutic, nursing and medical professional practice, how then should we deal with situations where entering into and maintaining relationships are subject to high systemic pressures? And how can good care, help and support – care, help and support that are experienced as good and beneficial to care receivers – be maintained and promoted in complex and dynamic late modern contexts? An answer to these questions can be obtained only by empirically studying what professionals actually do when they deliver good care, help and support, and what organisational and systemic forces they face.