The present discussion relates to the delivery of ultrasonic therapy energy to a target region in conjunction with a clear path determination that may assess one or more of: (1) presence of non-soft tissue regions within the therapy beam path (e.g., bone or bone-like structures, gas-filled cavities, and so forth), (2) partial “lift-off” of the probe head; or (3) sufficiency of acoustic coupling. Upon determination or confirmation of at least a partial clear path with respect to some or all of these factors, the therapy beam may be delivered to the target region.