List of Therapeutic Interventions

A key component of mental healthcare is using and being familiar with the list of therapeutic interventions that can help clients improve their mental and emotional health.

Depending on a client’s presenting problems, these interventions can take many different forms. Once we identify the client’s major concerns, we can supply them with the most relevant tools and resources.  

Here is a list of therapeutic interventions commonly used by therapists, including therapy techniques to treat specific diagnoses. In this article we’ll also cover how to document your use of therapeutic interventions for progress notes. 

Therapy techniques

Regardless of a client’s presenting problem, there are some tenets of therapy that should be universally applied to every session. 

Active listening

First off, active listening is a vital technique in therapy. 

Our use of active listening assures clients that we’re deeply and intently listening to them, interested in their perspectives, and curious to understand their concerns. 

Active listening involves using body language and facial expressions to show alertness, leaning in toward clients, and keeping our eyes on theirs. 

Encouragement 

Using minimal encouragement is another common technique employed by therapists in-session.  

Adding brief, empathetic comments can help clients continue processing a difficult situation or topic, whereas our silence may prompt their abrupt or premature departure from the discussion.  

Verbalization of simple statements such as, “I see” or “That must have been difficult,” at the appropriate time can encourage clients to build on their train of thought and release emotional stressors.  

Time management 

Time management may not jump out as the most obvious component of facilitating therapy in a list of therapeutic interventions, but it shouldn’t be minimized.  

By structuring our time well, we can help our clients smoothly transition into and out of their sessions—without jarring beginnings that catch them off-guard or abrupt endings that leave them feeling emotionally bereft. 

For example, we may open the session by asking them what they’d like to focus on or use an icebreaker activity to begin the conversation. And, we may end the session with a grounding coping skill, like deep breathing, or with a more direct question, such as “What is your biggest takeaway from today?” 

These bookends for counseling sessions help clients better organize their thoughts and address difficult subjects. As we build more rapport with our clients, we can better adapt our therapeutic interventions to meet their unique needs—and document these therapeutic interventions for progress notes, measuring treatment effectiveness, and general record-keeping. 

Therapeutic interventions for depression

When working with clients who report depressive symptoms, a combination of cognitive behavioral therapy (CBT) and psychoeducation is often the best approach. 

CBT tends to be effective in treating depression  by unearthing the negative cognitions that perpetuate depression. 

Psychoeducation, the method of teaching our clients information about mental health, is equally important to weave into therapy sessions so that clients learn relevant details about depression and appropriate coping skills. 

Several therapeutic exercises, which combine psychoeducation and CBT, can be used to treat depression, including:

Cognitive triangle

Steps for this exercise include:

• Draw a large triangle on a piece of paper and label each corner as follows:  “thoughts,”  “emotions,” and “actions.”
  
• Draw an arrow next to the triangle with the word “trigger” above it.
  
• Guide your client in completing the triangle by first asking them to identify a recent time during which they felt depressed and then write that event alongside the “trigger” arrow.
  
• Ask your client what they thought about themselves during the event and write it next to the “thoughts” corner,  then write all the feelings they experienced next to the “feelings” corner,  and what they did as a result next to the “actions” corner.
  
• Discuss how all these elements are connected and how changing their thoughts can produce more positive feelings, actions, and overall experiences. 

Thought replacement
Steps for this exercise include:

• Present your client with a list of common negative and positive cognitions. 
• Ask them to identify the three most common negative thoughts, which lead to their feelings of depression. 
• Discuss where these thoughts originated, how they’re sustained, and their negative impacts with your client. 
• Introduce positive replacement cognitions and reflect on the changes your client  would experience if they focused on these thoughts instead.
• Challenge them to write these new thoughts down and post them in noticeable areas, such as on their bathroom mirror or in their daily planner. 

Relationship-based interventions

Some clients look to counseling as a resource for handling difficult relationships, such as parent-child, spouse or partner, or workplace relationships. 

Several well-researched modalities can help foster healthy relationships, including The Gottman Method for couples therapy, parent-child interaction therapy (PCIT), and child-parent relationship therapy (CPRT). 

While these three modalities have their own specific assessments and techniques, the following two relationship-based interventions can be easily incorporated into your sessions: 

Karpman Drama Triangle

This diagram was developed by Stephen Karpman, MD, to illustrate how we can fall into toxic relationships as a result of poor communication and low self-awareness. 

Steps for this exercise include:

• Print copies of the diagram and share one with your client during the session.
  
• Discuss the different roles we can assume (victim, savior, and persecutor), the consequences of assuming each role, and how to solve conflicts by evolving into the healthy adaptation of each role (from victim to survivor, savior to coach, or persecutor to challenger).
  
• Ask your client to identify any familiar roles and review different ways they can employ boundaries and cognitive adjustments to thwart toxic communication and resolve conflict.

The 5 Love Languages Quiz

Designed by Gary Chapman, PhD, as a companion to his book, “The 5 Love Languages,” this short and simple assessment can help your client improve their relationship awareness. 

Steps for this exercise include:

• Direct your client and their partner to complete this quiz as homework or during a session, and discuss the impact of their scores.
  
• The final scores include a primary and secondary love language, which tell how your client most often experiences and offers love.
  
• Ask how this information can help each person to better understand the other, as well as what changes they want to make for a healthier relationship. 

Activity-based therapies

If you’re working with young clients or adults who seem resistant to processing emotions via talk-therapy, it can be helpful to introduce activity-based therapies. 

Just as the name suggests, this list of therapeutic interventions is rooted in activities designed to make therapy more enjoyable and less stressful for clients. 

There are many options to consider based on your office space, access to resources, and availability. 

Popular activities include play therapy, art therapy, and sandplay therapy. 

A more novel approach that’s gaining traction is adventure therapy, in which the therapist and client explore and utilize adventure-based activities for therapeutic gains. 

Systemic intervention

Systemic intervention involves the facilitation of a meeting between the client and other relevant parties to focus on a problem which affects the entire system, or group of people. 

For example, a therapist may conduct this kind of intervention for a family, in which the client, their spouse, and their adult children attend a session to address the harmfulness of the spouse’s drinking habits. 

Another example could be a therapist working with a  young client, their parents, and their siblings to discuss the severity of the client’s depression and their persistent self-harm behavior. 

This therapy technique requires more tact and caution than other interventions due to its sensitive nature and involvement from other participants. 

Documenting therapeutic interventions for progress notes

Whichever technique you choose from the list of therapeutic interventions, you’ll want to keep a comprehensive record of which ones you use for each session in your clients’ progress notes.. 

These details about therapeutic interventions for progress notes provide substance to our documentation by noting techniques used and their outcomes. 

Progress notes help us better track the route we’re taking in treatment and show insurance companies that we are diligent and thorough in the treatment we provide. 

Here are some examples of how to include a list of therapeutic interventions in your clients’ therapy progress notes:

• Therapist used the “Cognitive Triangle” as a form of psychoeducation to help the client increase their awareness of negative thoughts.
  
• Therapist facilitated the client’s completion of a sand tray, entitled “Last Year”, to help them release strong emotions connected to their traumatic experience last year.
  
• Therapist provided the client and their spouse with copies of “The 5 Love Languages Quiz” and discussed how their results are connected to their level of marital satisfaction. 

As counselors, we have the privilege of sharing diverse resources with clients. We gain more confidence about which therapeutic interventions to offer as we increase our rapport with them. 

When planning your next therapy sessions, take into account the many different approaches available by referencing this list of therapeutic interventions. 

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