Supportive-expressive therapy is an evidence-based, psychodynamic psychotherapy that is effective in the treatment of more severe substance use disorders.
With this review of treatment, including its origins and techniques, find out if this form of therapy is right for you.
Supportive-expressive therapy is based on the psychodynamic orientation derived from Freud’s psychoanalytic theory, which claims that psychological problems arose in early childhood. These mental health problems can coexist with substance use problems and can be addressed by becoming more aware of, working through, and overcoming unhelpful patterns in relationships.
How it stands out
Supportive-expressive therapy is a manual and time-limited intervention for people with more severe substance use disorders. It focuses on substance use in the context of the person and their relationships with other people.
Supportive Expressive Therapy is a combination of two main components: supportive techniques that clients are comfortable with when discussing their personal experiences, and expressive techniques that clients can use to identify and address interpersonal relationship issues.
This is done by working on three main focuses: the emotional experience of the person, for example through the person who identifies and characterizes the emotions experienced; communication between the therapist and the person being treated; and interpretation of what comes up in therapy sessions.
The goal of therapy
The goal of expressive supportive therapy is to help clients cope with their difficulties, gain self-image, and practice self-control over substance problems. It is based on the theory that the development of problematic substance use as well as the development of personality is influenced by formative life experiences.
The therapist and client explore and gain insights into conflicts that have developed within the client through early experiences, for example with parents and caregivers, and how these are presented in current situations and relationships during supportive-expressive therapy.
Supportive-expressive therapy is not a directive, which means that the client, not the therapist, decides what is important. A typical course of therapy consists of 16 to 30 sessions, each lasting about an hour.
Supportive-expressive therapy is particularly well suited for patients with severe substance use disorders, including opioid disorders, which may develop in response to drug use such as heroin and cocaine disorders.
Why the expressive supportive therapy helps with heavy substance use
Supportive-expressive therapy has been shown in research studies to be more effective at treating severe substance use disorders than drug counseling, and improvements have been found to continue 12 months after treatment has been completed.
In methadone maintenance therapy, the benefits of supportive expressive therapy included reducing drug use, reducing the need for methadone, and maintaining treatment gain. Employment improvements as measured by number of days worked and wages earned were also described. In addition, people who receive supportive expression therapy are always less likely to have serious problems than people who receive drug counseling. It’s as effective as cognitive behavioral therapy.
The best results have been obtained from the combination of drug counseling and supportive expression therapy, especially in people with severe co-occurring psychiatric problems. Supportive-expressive therapy has been recognized by the National Institute for Drug Abuse (NIDA) as an evidence-based approach to the treatment of substance use disorders.