What is process vs content in therapy?

Process and content are two pieces to an overall idea of therapy and are also their own versions of therapy altogether. Process therapy deals with the actions and process, both of how something came to be (such as a negative reaction or experience) and how to resolve it (what steps need to be taken). Content therapy, focuses instead on the event or object—the content. Essentially it is a focus on the actual problem, and the therapy is revolved around confronting the issue and accepting it in order to move on.
For example, process therapy would deal with how someone came to have anxiety by addressing the stresses in the individual's life from a young age and then make a path forward to address those stresses and fix the problem. Content therapy, however, decides to address the fact that you are anxious and come to terms with that situation. By accepting it, the content therapist will be able to help them find rational ways of confronting it or working around it but in a different way than process therapists would.

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.

Process therapy is related to actions (versus what is going on in a clinical patient's mind, or what the expectations and goals motivating his or her behavior are). Content therapy examines how the patient's situation is delivered as a narrative (i.e., what is the ostensible problem and motivating force—physical hunger, pain, social needs, etc.). What a patient tells the therapist is the relevant content. What is motivating to engage in or subject themselves to such behaviors is the process. Ideally, therapists address both the content and processes of a patient's circumstances, and neither to the exclusion of the other. Therapists aim to give patients tools to address the expectations and motivators that result in certain behaviors with process-based therapy, while also identifying the specific problems (content) which the patient is combating.
Content is "what" of a discussion, argument, relationship, etc. Process is the "why" or "how," these dynamics manifest themselves. Generally, process-based therapy is helpful when patients themselves may themselves not be able to identify the reasons for certain behaviors.