Addiction Coping and Recovery Methods and Support What Is Supportive-Expressive Therapy? By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. Learn about our editorial process Updated on September 19, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Fact checked Verywell Mind content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Aaron Johnson Fact checked by Aaron Johnson Aaron Johnson is a fact checker and expert on qualitative research design and methodology. Learn about our editorial process Print Tom M Johnson / Blend Images / Getty Images Table of Contents View All Table of Contents Definition Techniques Uses Benefits Effectiveness Things to Consider How to Get Started What Is Supportive-Expressive Therapy? Supportive-expressive therapy is an evidence-based, psychodynamic psychotherapy that has been found to be effective in treating certain substance use disorders. The goal of supportive-expressive therapy is to help clients achieve mastery over their difficulties, gain self-understanding, and practice self-control over substance use problems. It is based on the theory that the development of problematic substance use, as with the development of personality, is influenced by formative life experiences. Supportive-expressive therapy draws from the psychodynamic orientation that originated with Freud's psychoanalytic theory, which claimed that psychological problems originate in early childhood. The belief is that these psychological problems can occur alongside problems associated with substance use and can be treated by becoming more aware of, working through, and overcoming internal conflicts and unhelpful patterns in relationships. What Is Psychodynamic Therapy? Techniques Supportive-expressive therapy is a manualized and time-limited intervention for individuals with more severe substance use disorders. It focuses on substance use within the context of the person and their relationships with other people. A typical course of therapy consists of 16 to 30 sessions, which last about an hour each. Supportive-expressive therapy is a combination of two main components: Supportive techniques to help clients feel comfortable in discussing their personal experiencesExpressive techniques to help clients identify and work through central relational patterns This is done through working on three areas of focus: Emotional experience, for example, through the person identifying and labeling the emotions they have been experiencingCommunication between the therapist and the person receiving treatmentInterpretation of what comes up in therapy sessions Through supportive-expressive therapy, the therapist and client explore and gain insight into conflicts that developed within the client through early experiences and how these are represented in current situations and relationships. What Supportive-Expressive Therapy Can Help With Like other forms of therapy, supportive-expressive therapy can be used to treat a variety of mental health problems, including: Anxiety Depression Eating disorders Interpersonal problems Personality disorders Psychological distress Post-traumatic stress disorder (PTSD) Social anxiety disorder Substance use disorders Benefits of Supportive-Expressive Therapy Supportive-expressive therapy has been recognized by the National Institute on Drug Abuse (NIDA) as an evidence-based approach to treating substance use disorders. The best outcomes have been found by combining drug counseling and supportive-expressive therapy, especially for people with severe co-occurring psychiatric problems. This approach to therapy also works to influence how people think, feel, and act, promoting better coping skills, self-reflection, insight, and emotional growth. Effectiveness Research has shown that supportive-expressive therapy is more effective in treating severe substance use disorders than drug counseling, and improvements have been found to continue to be present 12 months after completing treatment. Supportive-expressive therapy may be particularly well suited to clients with severe substance use disorders and cocaine use disorder when someone is open to discussing and exploring their internal experience. In methadone maintenance treatment, the benefits from supportive-expressive therapy included reductions in drug use and need for less methadone and maintenance of treatment gains. Improvements in employment, measured by the number of days worked and wages earned, have also been described. Things to Consider Although supportive-expressive psychotherapy has been studied for the use of substance use disorders and other mental health conditions, there is still little known about which strategies are most effective, or when it's best for therapists to use supportive versus expressive techniques. However, supportive-expressive therapy is non-directive, which means that the client, not the therapist, decides what is important to focus on. While the therapist is the guiding hand, you must do the hard work, including being vulnerable, opening up, and committing to the therapy process. With any type of addiction treatment, it's also important to remember that the reality of recovery includes dealing with urges, cravings, and even relapses, so you must be honest with your therapy. How to Get Started If you feel that you or someone you love might benefit from supportive-expressive therapy, consider the following steps: Ask for a referral. Your primary care doctor or addiction counselor can refer you to a mental health professional who is qualified to provide supportive-expressive therapy. Inquire about coverage. Contact your health insurance provider to see if supportive-expressive therapy is covered under your plan, or if not, ask your therapist if they offer sliding scale fees, or rates based on your ability to pay. Choose the right therapist. When selecting a therapist, consider their qualifications as well as your own comfort level. Consider "shopping" around. If you're not "clicking" with your therapist or feel like your sessions aren't helpful, consider trying another therapist until you find someone with whom you're comfortable. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. 8 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Leichsenring F, Ablon S, Barber JP, et al. Developing a prototype for short-term psychodynamic (supportive-expressive) therapy: An empirical study with the psychotherapy process Q-set. Psychotherapy Research. 2015;26(4). doi:10.1080/10503307.2015.1051160 Gottdiener WH. Understanding, treating, and preventing the development of substance use disorders. Parenting and Substance Abuse. Published online March 2013. doi:10.1093/med:psych/9780199743100.003.0005 Vos J, Craig M, Cooper M. Existential therapies: A meta-analysis of their effects on psychological outcomes. Journal of Consulting and Clinical Psychology. 2015;83(1). doi:10.1037/a0037167 Fonagy P. The effectiveness of psychodynamic psychotherapies: An update. World Psychiatry. 2015;14(2). doi:10.1002/wps.20235 Knopf A. NIDA: Plethora of treatments for SUDs, regardless of substance. Alcoholism & Drug Abuse Weekly. 2020;32(24). doi:10.1002/adaw.32751 López G, Orchowski LM, Reddy MK, Nargiso J, Johnson JE. A review of research-supported group treatments for drug use disorders. Substance Abuse Treatment, Prevention, and Policy. 2021;16(1). doi:10.1186/s13011-021-00371-0 Dugosh K, Abraham A, Seymour B, McLoyd K, Chalk M, Festinger D. A systematic review on the use of psychosocial interventions in conjunction with medications for the treatment of opioid addiction. Journal of Addiction Medicine. 2016;10(2):93-103. doi:10.1097/ADM.0000000000000193 Leibovich L, Zilcha-Mano S. What is the right time for supportive versus expressive interventions in supervision? An illustration based on a clinical mistake. Psychotherapy. 2016;53(3):297-301. doi:10.1037/pst0000078 Additional Reading Diener MJ, Pierson MM. Technique and therapeutic process from a supportive-expressive relational psychodynamic approach. Psychotherapy. 2013;50(3):424-427. doi:10.1037/a0032404 Luborsky, L. Principles of psychoanalytic psychotherapy: A manual for supportive-expressive treatment. Basic Books. 1984. By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Get Treatment for Addiction Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.