Five Dimensions of Therapy Process

Building on previous conceptual and methodological discussions, a five-dimensional model of the process of psychotherapy is proposed. The five dimensions are (1) Perspective of Observation (who observes the process: client, therapist, or researcher); (2) Person/Focus (who is observed: client, therapist, or dyad); (3) Aspect of Process (What communication feature is observed: content, action, style, or quality); (4) Unit Level (the hierarchical order or scale at which observation occurs, e.g., sentence/idea, speaking turn, episode, session, stage or treatment); and (5) Sequential Phase (the temporal orientation or purpose of observation: to understand context, process, or impact). The model and its potential value for identifying problems in existing process measures are illustreated using fifteen major process rating systems (Greenberg & Pinsof, 1986). The comprehensiveness of the model and its implications for research and theory are also discussed.