Therapeutic Process & Therapeutic Steps – Easy Explained (2024)

Your therapeutic process will be unique and that is because you and your experiences are unique.

Here we’ll break down the process so you can have an idea what to expect when you begin psychotherapy.

Let’s dive right into it.

Therapeutic Process & Therapeutic Steps
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The Therapeutic Process

Stress, pain and emotions are connected, as more and more data from research is showing us. We’re realizing how our thoughts and emotional responses are influenced by how strongly we’re attached to a particular situation.

Research shows that powerful, overwhelming physical and emotional events can change the function of your brain and nervous system. Research also shows they affect your muscles, digestion, blood pressure and other bodily systems.

Like all clients, you want to make progress toward change so you can live happier and develop the skills to help you cope with various challenges. 

The therapeutic process consists of related interactions and interventions that progressively enriches the nature of the relationship between therapist and client from the first hello to the final goodbye.

Related: 31 Best Cognitive Behavioral Therapy (CBT) Books

The Five Stages Of Therapy

  • Stage 1: Initial Contact

As a client, your first contact is likely to be with the office staff. In a private clinical practice, your first contact will likely be with the practitioner.

This is the time to ask questions about fees, hours (for example, evening appointment availability) and cancellation policy (for example, will you be billed for missed appointments?).

In the clinical setting, a client can get some general information about the therapist (e.g., education, general orientation). However, more details should likely be directed to the practitioner.

The staff person you speak with will ask a number of questions. After obtaining some general demographic data, they will ask for an overview of your problem, and whether anyone referred you to this particular therapist. You can also discuss any insurance or payment issues.

Based on your needs and the practitioner’s schedule, an appointment will be made. Occasionally, due to the nature of your problem and the therapist’s experience or schedule, the practitioner may decide that your problem would be better treated by someone else.

Such a situation is merely an affirmation that you deserve treatment by a therapist best able to meet your particular situation.

  • Stage 2: Orientation — Beginning to Build a Relationship with Your Therapist

Both you and your therapist will not be completely comfortable with each other at the beginning. This is normal.

During the initial meeting you might be trying to make a good impression. Maybe you’ll hold back a little.

As you chat more with your therapist, you’ll become more open about what you are expecting, thinking and feeling.

This is when rapport builds between client and therapist. You’ll see the therapist is guiding you to help yourself.

  • Stage 3: Identification — Figuring Out What To Do

This rapport is growing and now together, you start deciding exactly what you want to work on. If you had trouble opening up in the beginning, you might now find it easier to be more genuine.

If you still have defenses up hindering progress, he or she will gently help you lower them. They might test your boundaries a bit. This is also when this work begins to empower you.

Related: What Kind Of Therapy Do I Need – 7 Types Easy Explained

  • Stage 4: Exploration/Working Phase — Making Progress

The first two stages are setting you up for this stage, the part where you make the most progress. This is where you’re diving into the issues and working on the self. 

Digging into the pain is the way to release it and move toward developing a better mindset. This creates change toward a better version of yourself.

You start to look inward, rather than only focusing on external challenges. This way, you begin to regain a healthy sense of power and control over your life.

You learn to reframe painful experiences and rethink your beliefs, as well as other people’s motives. Hidden thoughts and feelings usually rise up to consciousness here.

Your therapist might become more direct about the process. This is usually when homework is assigned more regularly.

  • Phase 5: Resolution — Saying Goodbye?

Once you feel you’ve accomplished change, it’s time to consider leaving. Keep in mind you might not even reach this point. 

Some clients need to switch therapists if they feel like they have reached a limit with their current one. There’s also the option of stopping and coming back once you feel there’s more work to be done.

Therapy can be a solution to a problem. Clients want a way to feel better or work through issues. Once they’ve accomplished that, there’s no reason to continue.

For other clients, therapy is a lifelong journey to become better versions of themselves and maintain good mental health. These people aren’t concerned with reaching an end.

Once you arrive at this stage, the correct answer is the one that’s right for you.

If you decide to end your time in psychotherapy, you might feel sad and chances are your therapist will feel similarly. It’s a normal sadness that comes with parting with someone you’ve become close to, and your counsellor will guide you through this.

This is also a time to reflect on everything you have accomplished. Congratulate yourself! You did something not many people have the courage to do.

Therapeutic Process
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The 3 Types Of Therapy

If you want to research which type of psychotherapy to use, you might’ve already noticed the surprising amount of different processes available. Though some processes work best for specific conditions, others can help with a range of issues.

Here’s a quick look at three common types of psychotherapy.

Psychodynamic Therapy

Psychodynamic therapy is a model developed from psychoanalysis for clients, using a long-term approach to mental health treatment.

In psychoanalysis, you can expect to talk about anything on your mind to uncover patterns in thoughts or behavior that might contribute to distress. It’s also common to talk about your childhood and past, along with recurring dreams or fantasies you might have.

Behavioral Therapy

Behavioral therapy is a focused, action-oriented approach to mental health treatment.

According to the study of behavioral theory, certain behaviors develop from things you learned in your past. Some of these behaviors might affect you negatively or cause distress.

Using  behavioral therapy can help you change your behavioral responses to be more positive.

Cognitive Behavioral Therapy 

Cognitive behavioral therapy (CBT) may be used as a short-term approach to mental health treatment. It’s similar to behavioral therapy, but this model also addresses unhelpful thought patterns or problematic thoughts.

The idea behind CBT is that certain feelings or beliefs you have about yourself or situations in your life can lead to distress.

This distress might contribute to negative mental health issues, occur alongside them, or develop as a complication of other mental health issues.

Related: Average Number Of Therapy Sessions – A Complete Guide

The Stages Of A Therapeutic Relationship

Unlike most social relationships, the therapeutic relationship is enabled for you to gain insight into your attitudes and expectations. Like all relationships, it will pass through different stages at different times.

Initially, you are likely to feel good about therapy. You may feel a tremendous sense of relief. Much of this comes from talking about your problem with an attentive, caring person.

There may even be relief that you now have an expert who can help you with your personal problem. Having a plan of action, which the therapist will help you with, can reduce anxiety and instill hope.

Some individuals may experience a range of intense feelings towards the therapist. Such emotions often reflect old feelings originally felt towards a parent, sibling or other significant family member. The technical term for this phenomenon is “transference,” and “working through” these feelings can help the patient grow emotionally and free themselves from emotional blocks and/or inhibitions.

Like many relationships, the therapeutic relationship can have its ups and downs. The exuberance felt during the initial stages of therapy could fade. The therapist whom you once saw as supportive and understanding can now seem challenging.

This is not unusual; it’s an indication your therapy is about to make a shift in you. It’s important for you to stick to your plan during this time and push ahead.

It helps to share your feelings with your therapist so uncomfortable emotions, which are being uncovered, can be addressed.

Therapeutic Steps
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Related: How Long Does Psychoanalysis Typically Take?

Stages Of Individual Therapy

Individual therapy, or Adlerian therapy, is an approach in which a therapist works with a client to identify obstacles and create effective strategies for working towards their goals.

  1. Relationship/Rapport Development: You and your therapist begin to establish a relationship. This relationship should consist of collaboration towards addressing your problems. 

The establishment and maintenance of an empathic, respectful and collaborative partnership, which will offer you support and encouragement.

  1. Assessment: The therapist works to learn more about your background, including early memories and family dynamics. In this part of therapy, the therapist attempts to understand how you may have developed certain styles of thinking that are no longer helpful or adaptive for you.

Included in this process is tracking the symptom the client has, or dysfunctional pattern, evaluation of functioning in your experiences, a systematic review of formative events, including: family atmosphere, gender guiding lines, big numbers, psychological birth order vantage, early recollections, etc.

  1. Interpretation/Insight: The therapist offers an interpretation of the clients’ situation and need. He or she will suggest theories about how past experiences may have contributed to issues you are currently experiencing.

A mutual effort to understand the lifestyle meanings, values and goals that made the dysfunctional pattern or symptom necessary.

Importantly, the therapist leaves it up to you to decide whether these theories can be accurate and useful.

  1. Reorientation: Your therapist helps you to develop new strategies you can use in daily life. 

This will facilitate movement toward more flexible, effective and courageous ways for you to see yourself, your world and your place of significance, security and success.

Steps Of Therapy

Starting therapy can feel overwhelming. The unknowns of a session and change are two initial concerns.

However, every experienced therapist will have been in your position in the past, so they know how you feel and will set you at ease.

Here are some steps to become familiar with:

  • Step 1 – Review and consider the significant areas you would like guidance with and why they’re so important for you. What was a starting point or trigger to the issue. What has the impact been on your life?
  • Step 2 – What do you hope to get out of your sessions? What is the marker for you to know your sessions have been successful? What would be different in your life?
  • Having an end goal of therapy can be useful, as well as having smaller goals, so you have a sense of direction and celebrate your victories.
  • Step 3 – Do you have concerns or worries about starting? It would be unusual not to and your therapist will support you in working through them.
  • Step 4 – What if you don’t connect with your him or her or decide they’re not right for you? It’s so important for you to have a comfortable rapport and trust they can guide you.
  • Not all therapists are right for everyone. It’s a very personal choice. Their clinical practice is in the caring profession because they want the best for people, so no need to feel they might be offended.
  • Let them know you’d like to use some time to explore the issues and to think before booking the next session.
  • Step 5 – If you don’t know where to start, don’t worry, go back to step one and reflect or study the main areas most important to you. 
  • Sometimes it’s not about changing, it’s about understanding the self with your therapist as your guide.

The main intentions of therapists are ensuring safety, listening, sensing and making sense, enabling change, and being present to the relational processes of their clients.

Positive outcomes of the various psychotherapy treatments used are generally based on the goal of positive interventions. This creates significant change in outcomes for the life of the client and knowing the self.

Start a new chapter and begin to see what’s possible for you.

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About The Author

Bijan Kholghi is a certified life coach with the Milton Erickson Institute Heidelberg (Germany). He helps clients and couples reach breakthroughs in their lives by changing subconscious patterns. His solution-oriented approach is based on Systemic- and Hypnotherapy.