Supportive-expressive therapy

Domain I · Psychodynamic & depth psychology · Luborsky · 1984

What it is

Supportive-expressive (SE) therapy is a manualised psychoanalytic psychotherapy with two components:

Format

• Formats.
• Open-ended (original). Individual, face-to-face, typically weekly sessions of about 45–50 minutes.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Hope that sounds false to the patient. Tie it to evidence they recognise.
• Patients who give summaries rather than incidents. Redirect to a single occasion.
• Change confined to the therapy room. Look for it in outside REs. D. Termination techniques.
• Avoidance of the sessions themselves. The therapy is a social situation, so address it as an RE (C6).
• Alliance dips mid-treatment as expressive work intensifies. Expect them and repair them (see section 5).

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.