Stages and Sub-Stages of Therapy
Regardless of type, all effective therapy moves through the same general six stages:
- The issue(s) are defined with respect to
- Present context, and
- Further direction, from which
- The goals naturally arise, and all the while
- Therapeutic alliance is simultaneously being formed.
If change is the chief goal of therapy, then this process of change is further divided into six sub-stages:
- Relinquishing an old pattern – internal, e.g. thought process, and/or external, e.g. behavior
- Initiating a new pattern
- Maintaining the new pattern
- Applying current understanding to the past, changing one’s personal narrative/memory-set (subjective biography)
- Incorporating the new pattern into current life
- After leaving therapy, continuing to use the skills/patterns.
The nature of outpatient therapy, by definition, usually means that the client spends 167 hours a week away from the therapist, making it crucial to supplement the 50 minute session with interventions for the client outside of the office. These include an infinite number and type of “homework” assignments, e.g. readings, journaling, self-help groups and/or therapy groups, practicing behaviors, self-observations, implementing communication strategies, dreamwork, relaxation techniques, etc.