Therapy Explained: Exploring The Therapeutic Process Steps

People may attend therapy for a variety of reasons, such as wanting help with a specific stressful situation or with management of a mental health condition. People may also seek therapy because they want to improve their relationships and social life, change unwanted thought and behavior patterns, or better develop tools to respond to life's challenges.

The therapy process can vary depending on the specific treatment modality, therapist, and the client's individual circumstances. Even so, this process often involves a series of steps or phases as the client progresses through their goals. In this article, we explore these phases in detail, describing the nature of the therapeutic relationship, what the therapeutic process may look like, and more. 

Understanding the therapeutic alliance

Before addressing the stages of the therapeutic process, it may be useful to explore the nature of the relationship between the client and therapist, also known as the “therapeutic alliance.” This term describes the unique dynamic that may evolve between clients and their counselors. 

The American Psychological Association includes the following components in its definition of the therapeutic alliance:

• Bonds, which can be defined as the circumstances and dynamics of the relationship as well as the therapist’s and client’s feelings toward one another
• Goals and objectives of therapy that the therapist and client agree upon and review periodically
• Tasks and activities carried out during the therapeutic process

Successful therapy depends on a variety of factors, which may include, but are not limited to, the therapeutic alliance. Other factors may include consistency, communication, and commitment from both parties to work toward the best possible outcome. 

What are the steps of the therapeutic process?

Because there are different types of therapy used for different situations, the therapeutic process may vary from one client to the next. Still, the therapy process can often be broken down into specific stages. General steps in the therapeutic process may include: 

Initiating the relationship

During the early stages of therapy, the therapeutic alliance is developing. The client may be getting to know their therapist, becoming more comfortable speaking to them, and learning their approach to therapy. When someone first decides to seek out therapy, they may experience feelings of hesitation, uncertainty, or nervousness. Thus, initial sessions may involve a more general discussion of the client’s life, past experiences, challenges, and relationships. This approach can help the therapist gain context and background on the situation while the client becomes more accustomed to the therapist. 

Identifying goals

Effective therapy can also involve agreed-upon goals, which a client and their therapist may work to identify once they’ve started their therapeutic relationship. This phase of therapy may consist of treatment planning in which a therapist determines the optimal course of action to address their client’s concerns and situation. The therapist may also ask questions about how they can best support their client.  

Taking steps

This stage represents the point in the process where the “work” of therapy begins. Steps may be taken to create change in the client’s life, relationships, thought patterns, habits, and more. This phase may also involve explorations of emotions and beliefs, along with “homework assignments” designed to help implement therapeutic strategies outside of regular sessions. Other treatments and therapeutic techniques may be applied, depending on the client’s needs, goals, and situation. This may be the phase of therapy in which the client notices changes in their thoughts and behaviors.  

Maintenance

The maintenance stage of therapy may occur when a client is satisfied with the progress they’ve made or the changes they’ve seen over the course of therapy. Many clients continue to attend regular therapy sessions even when they’ve reached the maintenance stage to check in with their therapist and continue to get advice. Others may decide that they’ve effectively accomplished their goals and stop attending therapy altogether. For some, therapy may be a lifelong journey without a defined end point. Because no two clients are the same, the maintenance stage may vary depending on the client, the therapist, and the circumstances of treatment. 

The therapeutic process may involve some or all of these phases. It can look different from person to person. Still, therapy can offer a range of benefits. Some of these include the ability to process emotions in a safe, nonjudgmental space, the chance to explore potential solutions to personal and professional challenges, and the opportunity to gain a new perspective on one’s thoughts, behaviors, and habits.

Online therapy as an alternative format

Despite its potential benefits, attending traditional, in-person therapy may not always be possible or practical. Some individuals experience mental health challenges, like depression and anxiety, which may make it difficult to leave the house and commute to a therapist’s office. Others may find it challenging to attend in-person therapy due to scheduling conflicts and other day-to-day commitments.

Online therapy through platforms like BetterHelp may be a viable alternative in these situations. This type of remote therapy enables individuals to attend counseling from wherever it is most convenient. Those seeking extra support in implementing the strategies they learn in therapy may also find it an attractive option due to the ability to send messages to a therapist outside of scheduled therapy sessions. 

Online therapy has been studied as a feasible alternative to in-person therapy. A 2017 study found that online cognitive behavioral therapy (CBT) can effectively treat mental health conditions like depression, generalized anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD), bipolar disorder, adjustment disorder, and phobias. 

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