This therapeutic modality proposes a belief that inner conflicts are a result of the individual's confrontations with the four "givens" of death or failure, freedom and responsibility, meaninglessness, and isolation (alienation from others), which directly contrast and give rise to tension with the four dimensions of human existence, including: physical, social, spiritual, and personal.

Some of the techniques used in existential therapy:

1. Relationship: the role of the psychotherapist is primary in the therapy. Authentic integration of the interpersonal tensions is addressed through the primacy of experience, specifically by the therapist not manipulating the client by offering how to adjust, overcome culture, or otherwise adapt, which would deprive the client of genuine growth. Rather, the role is to guide through demonstration, to be a humble model of what is possible, and provide a sense of assurance that the quest the client seeks is worthwhile.

2. Using all techniques: this technique is required to facilitate empowerment of the individual within the context of the individual's cultural reality. If there is a sense of disempowerment, techniques from feminist theory may be used (e.g. power analysis, reframing), and if there is a strong extended family presence, elements of Bowenian, family systems theory, or general systems theory may be used (e.g. genogram, ecogram, "I" position).