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What is process versus content in therapy?

Process in therapy refers to the entire process of the therapeutic relationship between the therapist and the patient. Content refers to what the therapist and the patient actually talk about during their sessions. This might include the patient’s life history or things that have been bothering them lately.

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Steph Müller eNotes educator | Certified Educator

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I would explain the difference between process therapy and content therapy by discussing process therapy as what is happening in the long-term, and content therapy as what is happening in a specific counseling session. Process therapy refers to the journey towards wellness that the therapist and patient are jointly working on. This could be related to a long-term trauma that the patient is dealing with. Let us take, for example, a man who was physically abused by his father as a child. The “process” of understanding and overcoming this trauma would be classified as process therapy.

Content therapy, on the other hand, refers to what the patient chooses to speak to the counselor about in a session. Using this same example, the man may choose in a particular session to say nothing about his childhood trauma, but rather to speak about difficulties he is having in seeing eye to eye with a colleague. While his response to the colleague will be influenced by the trauma that he suffered as...

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mmack66 | Student

Process refers to the nature of the relationship between interacting individuals. This can be seen in the subtext of the conversation between two individuals, or in groups. To fully understand the subtext, or the ‘process’, of a client or a group, therapists need to also have a sense of the each person in the interaction. This can be seen through the client’s inflection, tone, and behavior. Essentially, process is “what does the content delivery say about the interpersonal relationship of the participants?”

Content is the explicit words being spoken by the person. This includes the issues the clients bring in. The diagnostic aspects of the therapeutic relationship can be considered content. This also includes information about the client, such as their occupation, their education, etc. Therapists tend to specialize in various types of content, for example depression or trauma.

Essentially, content refers to “what” the client is saying, and process refers to “why” or “how” they are saying it. Therapists need to use both content and process in each session to get a full understanding of the client. For example, if a client says “Why do you need to know that?” The content is a question. But the process could be avoidance to the question the therapist is asking, it could be resistance to therapy or the therapist, or it could be genuine curiosity on the client’s part.