IntroductionThe aim of this study was to explore the therapeutic process between contemporary spiritual healers and their clients in Germany.MethodsThis prospective observational case study was supported by questionnaires and semi-structured interviews with clients and healers from the first encounter through a period of 6 months. The qualitative analysis is based on a directed content analysis with focus in this article on the results relating to the therapeutic process.ResultsSeven healers and seven clients were included, and 22 interviews with healers and 20 interviews with clients were conducted. The first treatment session was perceived as laying a foundation for the therapeutic process and the relationship, which was seen as crucial for healing to take place. Healers perceived the therapeutic process as highly individualized and multi-layered, with the perceived effects of spiritual healing sessions layered upon each other. The capacities to connect and to trust were seen as key elements of the healing process. Trust and connection operate multidimensionally: to oneself, to others, and to a transcendent or spiritual source. Clients' spiritual attitudes were regarded as fundamental resources.ConclusionThe therapeutic process between spiritual healers and their clients was understood as a dynamic and individual activity, building up on a trustful relationship from the first encounter.