Mental Health

How Therapy Works: Stages of Development Theory

By Dr. Roya Sakhai

Therapy is a collaborative process. In therapy, a person works with a psychologist to identify the thoughts and behaviors that create challenges in their life. Psychologists use different modalities that are based on scientific theories to guide their questions. Some approaches have been used for a long time while others are newer. 

For example, some therapists follow Dr. Erik Erikson’s stages of development theory. Dr. Erikson believed that a person’s personality is created in different stages in their life, based on age.

Here are the stages and the questions that a therapist may ask about each stage in your life:

Ages 0-18 months: Trust and Mistrust

  • A baby will either develop trust or view the world as dangerous depending on their care.
  • Therapist question: Do you have problems with trusting others?

Ages 1-3 years: Autonomy and Shame

  • During early childhood, children learn about independence and shame
  • Therapist question: Do you feel as if you are independent or shy?

Ages 3-5 years: Initiative and Guilt

  • Children develop a sense of independence if they are able to explore their environment and make decisions. If the child feels shame about their choices, they may develop a sense of guilt. 
  • Therapist question: Do you make your own plans or do you feel guilty to do so?

Ages 6-11 years: Industry and Inferiority

  • Children begin to compare themselves to others during this phase of life. They can either develop self- confidence or feelings of inferiority .
  • Therapist question: Do you feel competent or have a sense of inferiority

Ages 12-18 years: Identity and Confusion

  • During these years, teens may begin to question their role in the world and their goals. 
  • Therapist question: Do you feel confused about your role in the world?

Ages 18-40 years: Intimacy and Isolation

  • The development of healthy friendships and relationships can help people feel intimacy or isolation
  • Therapist question: Do you feel isolated

Ages 40-60 years: Generativity and Stagnation

  • People can either find a sense of purpose during this stage or they may feel stagnate (or stuck). 
  • Therapist question: Do you have a passion or a goal that you care about?

Ages 60+ years: Integrity and Despair

  • People begin to look back on their lives and feel joy or regret. 
  • Therapist question: Are you happy with where you are? Do you wish you had done anything different?

Other general questions that a therapist might ask based on Dr. Erikson’s stages of development theory include:

  • Did you have parents who gave you everything or nothing at all or was there a balance?
  • Do you have challenges with overeating? Smoking? Drinking?
  • Do you feel a need to control?
  • Do you have challenges with your romantic relationships?
  • Are you impulsive
  • Do you make realistic choices?
  • Do you constantly criticize yourself?
  • Can you name the people who made you who you are?
  • Tell me about your childhood experiences?