7 Commentsby   |  10.23.09  |  Uncategorized

Yalom (1985) states, “The content consists of the explicit words spoken, the substantive issues, the arguments advanced” (p. 137). In therapy, the content consists of the facts of the session. It is a description of what happened or what is said. Nichols and Schwartz (2007) give the example of a mother who tells her daughter that she shouldn’t play with Barbie dolls because she shouldn’t aspire to an image of bubble-headed beauty. The content of the mother’s message to her daughter is: I want you to respect yourself as a person, not as an ornament. This is only the facts of the situation. Content is not concerned with emotions of interpretations of interactions. Consider this example (Meier & Davis, 2008):

Client: The problems in my marriage are not my fault.

Counselor: She has…

Client (content): Started a job. She’s not spending any time with me or the kids.

In this example, the therapist focused on obtaining the facts of the situation. The content is the client’s belief that his wife is the cause of the problem. Notice how the therapist is not focusing on the what the client is feeling and experiencing at the moment.

It is important for a therapist not to get sidetracked on the content of a discussion. In another example, a therapist invites a teenage boy to talk with his mother about wanting to drop out of school (Nichols & Schwartz, 2007). The boy says something about school being stupid, and the mother responds with a lecture about the need for education. Focusing on the content would draw the therapist in to support the mother’s position. This is a mistake. While a high school diploma is handy, the more important issues are that the boy speaks up for himself, and for the mother to listen. In this case, focusing exclusively on content prevents the family from becoming a better functioning family.    

Focusing on content is a needed because it allows therapists to dive into the processes of family interactions, relationships, and emotions (see Aimee’s blog post on process). The minute a therapist gets caught up in the content details of a family’s problems or thinks about solving them, they lose the opportunity to discover the process of what family members are doing that prevents them from working out their own solutions (Nichols & Schwartz, 2006). There are times when focusing exclusively on content is important. For example, if a wife is drinking to drown her worries, or a husband is abusing is daughter, there is an immediate need to act. In spite of these exceptions, a therapist who focuses exclusively on content is unlikely to help families become better functioning systems.  


1)      When with a client, do you feel that focusing on content is an important step in therapy? Why or why not?

2)      As a therapist, how do you know when you are focusing too much on the content of what is being said?

3)      What are some example questions that can lead the client from focusing on content to focusing on process?  


Meier, S.T., & Davis, S.D. (2008). The elements of counseling (6th ed.). Belmont, CA: Thomson/Brooks/Cole.

Nichols, M.P., & Schwartz, R.C. (2006). Family therapy concepts and methods (7th ed.). Boston: Pearson.

Nichols, M.P., & Schwartz, R.C. (2007). Essentials of family therapy (3rd ed.). New York: Allyn and Bacon.

Yalom, I.D. (1985). The theory and practice of group psychotherapy (3rd ed.). New York: Basic Books, Inc.   





  1. Jaime Goff
    6:59 pm, 10.26.09

    I think the tell-tale sign that a therapist is focusing too much on content is when change is not occurring. Granted, there may be other factors at play, such as the client’s specific stage of change, his/her motivation, etc. Generally, however, if focusing on content to the neglect of process, change will not be occurring. The most salient example of this is the client who comes in every week and tells detailed stories about what happened since his/her last session. Interns often feel stuck in these situations, but when watching their sessions, I see them going along and allowing themselves to get sucked into the content. Focusing on content is easier, and when you’re tired, you may be tempted to just allow the client to ramble while you ask therapeutically insignificant questions. I’m not pointing the finger here…I’ve done it too! I often tell interns in this situation to do something different to get the session started, and that typically entails focusing on process in some way or another.

    • Blake Berryhill
      10:31 am, 10.29.09

      I agree that focusing on content is a lot easier, especially when you are tired. As a therapist, there are going to be times when we are tired and emotionally spent. In these times it will be hard to engage with clients. When seeing clients all day, how does a therapist “recharge” to be present with every single client?

  2. Sabrina Johnson
    2:33 pm, 10.28.09

    I would add that another way you can tell that the focus of a session is on content rather than process is if the client does not talk about himself directly. I have observed in other sessions, and noticed in our dyads, that it is easy for people to talk about how others outside the therapy room influence them, both negatively and positively. It is important for the client to talk about the only person he or she can control, himself or herself. If the conversation switches to the individual, it usually helps to get at the process rather than the content of the session.

    • Blake Berryhill
      10:32 am, 10.29.09

      Thanks for a great reminder. What are some questions to help clients focus on themselves and get to the “process?”

  3. Sarah Osborn
    12:43 pm, 11.12.09

    I like to think that the client speaks in code. They use a combination of process and content to communicate their message. It is the therapists task to find the patterns in the code so they can decipher it. In dyads and sessions I have observed, I have noticed that people tend to repeat certain phrases or key words, or will always go back to a certain topic. I think a good way for the therapist to get past the content and “decode” the client’s language is to point out the patterns/repetitions and ask the client directly about them. I think it would also be helpful for the therapist to ask about patterns in process they have seen. If the client gets especially fidgety when talking about a certain topic, that may be a code for something deeper. The therapist can ask directly in order to get the client to talk about it.

  4. Emily Savage
    2:48 pm, 12.04.09

    1) When with a client, do you feel that focusing on content is an important step in therapy? Why or why not?
    I do think spending some serious time focusing on content is important. I think we felt this acutely when doing or dyads this semester. We were in a time crunch and we needed to get to deeper “process” issues so we had to rush people’s stories. I think for the client to feel safe with us the client needs to know that we have really heard their whole story. And for us it is important as well. We may be focusing on the relationships “process” between mother and daughter, but because we haven’t asked the daughter enough about her life and struggles we don’t really she is being constantly belittled by her teachers at school.

    2) As a therapist, how do you know when you are focusing too much on the content of what is being said? You know, so far the only thing I’ve come with is I know when I start trying to come up with a literal solution to someone’s problem that I can dictate to them, I know I’m focusing too much on the content.

    3) What are some example questions that can lead the client from focusing on content to focusing on process? “When that happened, what were you thinking?” “Is it usually like this with you two?” “Do you ever feel stuck in this, doing the same thing again and again?”

    • Kevin Burnette
      5:48 pm, 12.06.09

      Emily, great point. Just the other day when I was recording my final dyad, I found myself starting to try to answer my client’s questions and offer literal solutions to his problems. I kept switching back and forth. I was trying to focus on process stuff, but then I was treating it like it was content in the sense that I found myself thinking well, if A is true and B is true, then C must be true. In other words, if you feel this way about A, and this way about B, then the solution must be C.

      I think for me a sign that I’m focusing on content too much is my personal discomfort in the session. I think that I tend to drift back to content level stuff when I’m not sure what to do with the process level stuff. I mean that in the sense that if I’m uncomfortable, odds are that the client has just put some emotion stuff out there, and I don’t know what to tell them, so if I pay attention, I bet that I will discover that in that moment I’m asking a lot of detail oriented questions.

      The one good thing I can say is that I’m getting to the place that I recognize this in myself, and can force my self to go back to the process level, but it’s hard.

      I do think that paying attention to content is important, and not just for rapport building purposes as Emily pointed out.

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