The innate capacity of the body/person for self-recovery and healing is a key concept in osteopathy and the basis of clinical management for a broad range of conditions. It is believed that health and functionality can be improved by supporting the person's self-recovery processes; in particular, by removing structural and biomechanical obstacles that may impede the body's capacity to engage effectively in recovery. This clinical approach and its supporting conceptual framework are often referred to as the Structural Model. However, research findings in the last three decades have challenged the plausibility of the Structural Model and imply that the role of osteopathy in supporting health and recovery needs to be reconsidered. In response to these findings an alternative management called a Process Approach is proposed. This approach aims to directly support the processes associated with recovery; namely, repair, adaptation and alleviation of symptoms. This Masterclass article will discuss the current scientific challenges to the Structural Model in Osteopathy, the physiological, practical and therapeutic limitations of this model in supporting recovery processes and present the reasoning and principles of the Process Approach in osteopathic care. (C) 2016 Published by Elsevier Ltd.