Existentialism—Philosophy and Existential Therapy - Verywell Mind
Existentialism is a philosophy of human nature that identifies people as having free will to determine the course of their lives.
Supportive and expressive
Additionally, experiential and cognitive approaches to existential therapy have not been shown to alleviate symptoms. <anchor>Supportive and expressive</anchor> existential therapy has shown only a small impact on mental health symptoms and has not been shown to improve a sense of well-being.
Supportive-Expressive Therapy: Definition, Techniques, and Efficacy
Supportive-Expressive Therapy: Definition, Techniques, and Efficacy[Skip to content](#skip-to-content)

Menu

[Visit Verywell Mind's homepage](/)

- [Conditions A-Z](https://www.verywellmind.com/conditions-a-z-4797402)  - [Addiction](https://www.verywellmind.com/addiction-overview-4581803)
  - [Depression](https://www.verywellmind.com/depression-4157261)
  - [ADHD](https://www.verywellmind.com/adhd-overview-4581801)
  - [Anxiety](https://www.verywellmind.com/anxiety-7508391)
  - [Bipolar Disorder](https://www.verywellmind.com/bipolar-disorder-4157274)
  - [PTSD](https://www.verywellmind.com/ptsd-4157229)
  - [View All](https://www.verywellmind.com/conditions-a-z-4797402)
- [Therapy](https://www.verywellmind.com/therapy-4581775)  - [Therapy Center](https://www.verywellmind.com/therapy-7092217)
  - [When To See a Therapist](https://www.verywellmind.com/how-to-know-when-it-s-time-to-see-a-therapist-5077040)
  - [Types of Therapy](https://www.verywellmind.com/how-to-choose-the-best-type-of-therapy-for-you-6500320)
  - [Best Online Therapy](https://www.verywellmind.com/best-online-therapy-4691206)
  - [Best Couples Therapy](https://www.verywellmind.com/best-online-marriage-counseling-4691952)
- [Living Well](https://www.verywellmind.com/living-well-7510832)  - [Managing Stress](https://www.verywellmind.com/stress-management-overview-4581770)
  - [Meditation](https://www.verywellmind.com/meditation-and-mindfulness-4581783)
  - [Sleep and Dreaming](https://www.verywellmind.com/sleep-and-dreaming-4157166)
  - [Understanding Emotions](https://www.verywellmind.com/emotions-4157165)
  - [Self-Improvement](https://www.verywellmind.com/self-improvement-4157212)
- [Relationships](https://www.verywellmind.com/relationships-4157190)  - [Healthy Relationships](https://www.verywellmind.com/strengthening-relationships-4162997)
  - [Dating](https://www.verywellmind.com/dating-tips-and-strategies-7511571)
  - [Intimacy](https://www.verywellmind.com/sex-and-relationships-7511610)
- [Psychology](https://www.verywellmind.com/psychology-4157187)  - [Theories](https://www.verywellmind.com/theories-of-psychology-4157184)
  - [Student Resources](https://www.verywellmind.com/student-resources-overview-4581768)
  - [Personality Types](https://www.verywellmind.com/the-myers-briggs-type-indicator-2795583)
- [Trending](https://www.verywellmind.com/news-latest-research-and-trending-topics-4846421)  - [Quizzes](https://www.verywellmind.com/quizzes-8609222)
  - [Sweepstakes](https://www.verywellmind.com/sweepstakes)
  - [Guided Meditations](https://www.verywellmind.com/guided-meditations-8609227)
  - [Verywell Mind Insights](https://www.verywellmind.com/mental-health-data-insights-5185693)
  - [2024 Verywell Mind 25](https://www.verywellmind.com/the-verywell-mind-25-2024-7484480)
  - [Mental Health in the Classroom](https://www.verywellmind.com/mental-health-in-the-classroom-survey-7569880)
  - [View All](https://www.verywellmind.com/news-latest-research-and-trending-topics-4846421)
- [About Us](/about-us-5184564)  - [Editorial Process](/our-editorial-process-4778006)
  - [Meet Our Review Board](/review-board-4796494)
  - [Crisis Support](/crisis-support-6666353)

Search

SearchClearGO

- [Conditions A-Z](https://www.verywellmind.com/conditions-a-z-4797402)  - [Addiction](https://www.verywellmind.com/addiction-overview-4581803)
  - [Depression](https://www.verywellmind.com/depression-4157261)
  - [ADHD](https://www.verywellmind.com/adhd-overview-4581801)
  - [Anxiety](https://www.verywellmind.com/anxiety-7508391)
  - [Bipolar Disorder](https://www.verywellmind.com/bipolar-disorder-4157274)
  - [PTSD](https://www.verywellmind.com/ptsd-4157229)
  - [View All](https://www.verywellmind.com/conditions-a-z-4797402)
- [Therapy](https://www.verywellmind.com/therapy-4581775)  - [Therapy Center](https://www.verywellmind.com/therapy-7092217)
  - [When To See a Therapist](https://www.verywellmind.com/how-to-know-when-it-s-time-to-see-a-therapist-5077040)
  - [Types of Therapy](https://www.verywellmind.com/how-to-choose-the-best-type-of-therapy-for-you-6500320)
  - [Best Online Therapy](https://www.verywellmind.com/best-online-therapy-4691206)
  - [Best Couples Therapy](https://www.verywellmind.com/best-online-marriage-counseling-4691952)
  - [View All](https://www.verywellmind.com/therapy-4581775)
- [Living Well](https://www.verywellmind.com/living-well-7510832)  - [Managing Stress](https://www.verywellmind.com/stress-management-overview-4581770)
  - [Meditation](https://www.verywellmind.com/meditation-and-mindfulness-4581783)
  - [Sleep and Dreaming](https://www.verywellmind.com/sleep-and-dreaming-4157166)
  - [Understanding Emotions](https://www.verywellmind.com/emotions-4157165)
  - [Self-Improvement](https://www.verywellmind.com/self-improvement-4157212)
  - [View All](https://www.verywellmind.com/living-well-7510832)
- [Relationships](https://www.verywellmind.com/relationships-4157190)  - [Healthy Relationships](https://www.verywellmind.com/strengthening-relationships-4162997)
  - [Dating](https://www.verywellmind.com/dating-tips-and-strategies-7511571)
  - [Intimacy](https://www.verywellmind.com/sex-and-relationships-7511610)
  - [View All](https://www.verywellmind.com/relationships-4157190)
- [Psychology](https://www.verywellmind.com/psychology-4157187)  - [Theories](https://www.verywellmind.com/theories-of-psychology-4157184)
  - [Student Resources](https://www.verywellmind.com/student-resources-overview-4581768)
  - [Personality Types](https://www.verywellmind.com/the-myers-briggs-type-indicator-2795583)
  - [View All](https://www.verywellmind.com/psychology-4157187)
- [Trending](https://www.verywellmind.com/news-latest-research-and-trending-topics-4846421)  - [Quizzes](https://www.verywellmind.com/quizzes-8609222)
  - [Sweepstakes](https://www.verywellmind.com/sweepstakes)
  - [Guided Meditations](https://www.verywellmind.com/guided-meditations-8609227)
  - [Verywell Mind Insights](https://www.verywellmind.com/mental-health-data-insights-5185693)
  - [2024 Verywell Mind 25](https://www.verywellmind.com/the-verywell-mind-25-2024-7484480)
  - [Mental Health in the Classroom](https://www.verywellmind.com/mental-health-in-the-classroom-survey-7569880)
  - [View All](https://www.verywellmind.com/news-latest-research-and-trending-topics-4846421)

[More in Addiction](https://www.verywellmind.com/addiction-overview-4581803)

- [Drug Addiction](https://www.verywellmind.com/drug-addiction-4581788)  - [Coping and Recovery](https://www.verywellmind.com/drug-addiction-coping-and-recovery-7508400)
- [Alcohol Addiction](https://www.verywellmind.com/alcohol-addiction-4157302)
- [Nicotine Addiction](https://www.verywellmind.com/nicotine-addiction-4581779)

- [About Us](/about-us-5184564)
- [Editorial Process](/our-editorial-process-4778006)
- [Privacy Policy](https://www.dotdashmeredith.com/brands-privacy)
- [Contact Us](/about-us-5184564#toc-contact-us)

Verywell Mind's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

[Access TRUSTe's Enterprise Privacy Certification program](//privacy.truste.com/privacy-seal/validation?rid=8f15e7a5-6c05-47d8-bf12-8822d4d7cddd)

Ⓒ 2024 Dotdash Media, Inc. — All rights reserved

[Addiction](https://www.verywellmind.com/addiction-overview-4581803)

[Drug Addiction](https://www.verywellmind.com/drug-addiction-4581788)

[Coping and Recovery](https://www.verywellmind.com/drug-addiction-coping-and-recovery-7508400)

# What Is Supportive-Expressive Therapy?

By [Elizabeth Hartney, BSc, MSc, MA, PhD](https://www.verywellmind.com/elizabeth-hartney-phd-21801)

Updated on November 30, 2023

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](/review-board-4796494).

by
[Steven Gans, MD](https://www.verywellmind.com/steven-gans-md-4779222)

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](/our-editorial-process-4778006).

by
[Aaron Johnson](https://www.verywellmind.com/aaron-johnson-5198828)

Print

![man talking to therapist in therapy](https://www.verywellmind.com/thmb/PY4OdeN91cok9-zs89Ovzg5fSIo=/1500x0/filters:no_upscale():max_bytes(150000):strip_icc()/GettyImages-591404501-570d38e75f9b581408749d8f.jpg)

Tom M Johnson / Blend Images / Getty Images

Table of Contents

View All

Table of Contents

- [Definition](#toc-what-is-supportive-expressive-therapy)

- [Techniques](#toc-techniques)

- [Uses](#toc-what-supportive-expressive-therapy-can-help-with)

- [Benefits](#toc-benefits-of-supportive-expressive-therapy)

- [Effectiveness](#toc-effectiveness)

- [Things to Consider](#toc-things-to-consider)

- [How to Get Started](#toc-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](https://www.verywellmind.com/dsm-5-criteria-for-substance-use-disorders-21926).

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](https://www.verywellmind.com/what-is-psychoanalysis-2795246), 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?](https://www.verywellmind.com/psychodynamic-therapy-definition-uses-effectiveness-5094933)

## 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 experiences
- **Expressive 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 experiencing
- **Communication** between the therapist and the person receiving treatment
- **Interpretation** 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](https://www.verywellmind.com/what-is-clinical-depression-1067309)
- Eating disorders
- Interpersonal problems
- [Personality disorders](https://www.verywellmind.com/personality-disorders-a2-425427)
- Psychological distress
- Post-traumatic stress disorder (PTSD)
- Social anxiety disorder
- [Substance use disorders](https://www.verywellmind.com/dsm-5-criteria-for-substance-use-disorders-21926)

[The Best Online Therapy for Anxiety of 2024, Tried and Tested](https://www.verywellmind.com/the-11-best-online-therapy-companies-for-anxiety-tried-and-tested-8424779)

## 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](https://www.verywellmind.com/co-occurring-disorders-mental-health-and-addiction-4158280).

This approach to therapy also works to influence how people think, feel, and act, promoting better coping skills, self-reflection, insight, and emotional growth.

[The Best Online Help for Depression of 2024](https://www.verywellmind.com/best-online-help-for-depression-4691259)

## 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](https://www.verywellmind.com/what-are-stimulants-2795573) 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](https://www.verywellmind.com/addiction-overview-4581803), it's also important to remember that the reality of recovery includes dealing with urges, cravings, and even [relapses](https://www.verywellmind.com/what-is-relapse-22106), 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](https://www.verywellmind.com/sliding-scale-definition-benefits-finding-therapists-5188855), or rates based on your ability to pay.
- **Choose the right therapist**. When [selecting a therapist](https://www.verywellmind.com/who-can-provide-psychotherapy-2795763), 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.

### Get Help Now

We've tried, tested, and written unbiased reviews of the [best online therapy programs](https://www.verywellmind.com/best-online-therapy-4691206) including Talkspace, BetterHelp, and ReGain. Find out which option is the best for you.

8 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our [editorial process](/our-editorial-process-4778006) to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. 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](https://doi.org/10.1080/10503307.2015.1051160). _Psychotherapy Research_. 2015;26(4). doi:10.1080/10503307.2015.1051160

2. Gottdiener WH. [Understanding, treating, and preventing the development of substance use disorders](https://psycnet.apa.org/doi/10.1093/med:psych/9780199743100.003.0005). _Parenting and Substance Abuse_. Published online March 2013. doi:10.1093/med:psych/9780199743100.003.0005

3. Vos J, Craig M, Cooper M. [Existential therapies: A meta-analysis of their effects on psychological outcomes](https://doi.org/10.1037/a0037167). _Journal of Consulting and Clinical Psychology_. 2015;83(1). doi:10.1037/a0037167

4. Fonagy P. [The effectiveness of psychodynamic psychotherapies: An update](https://doi.org/10.1002/wps.20235). _World Psychiatry_. 2015;14(2). doi:10.1002/wps.20235

5. Knopf A. NIDA: [Plethora of treatments for SUDs, regardless of substance](https://doi.org/10.1002/adaw.32751). _Alcoholism & Drug Abuse Weekly_. 2020;32(24). doi:10.1002/adaw.32751

6. López G, Orchowski LM, Reddy MK, Nargiso J, Johnson JE. [A review of research-supported group treatments for drug use disorders](https://doi.org/10.1186/s13011-021-00371-0). _Substance Abuse Treatment, Prevention, and Policy_. 2021;16(1). doi:10.1186/s13011-021-00371-0

7. 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](https://doi.org/10.1097/ADM.0000000000000193). _Journal of Addiction Medicine_. 2016;10(2):93-103. doi:10.1097/ADM.0000000000000193

8. Leibovich L, Zilcha-Mano S. [What is the right time for supportive versus expressive interventions in supervision? An illustration based on a clinical mistake](https://doi.org/10.1037/pst0000078). _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](https://doi.org/10.1037/a0032404). _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](https://www.verywellmind.com/elizabeth-hartney-phd-21801)

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](/our-editorial-process-4778006)

[Meet Our Review Board](/review-board-4796494)

Share Feedback

Was this page helpful?

Thanks for your feedback!

What is your feedback?

Helpful
Report an Error
Other
Submit

Related Articles

[How to Deal With Withdrawal Symptoms](https://www.verywellmind.com/how-can-i-feel-better-during-drug-or-alcohol-withdrawal-4160020) [What Are the 12 Steps of Narcotics Anonymous (NA)?](https://www.verywellmind.com/what-are-the-12-steps-of-na-narcotics-anonymous-5525334) [How to Ease Withdrawal Insomnia During Recovery](https://www.verywellmind.com/withdrawal-insomnia-tips-22376) [Coping With Drug Withdrawal Diarrhea](https://www.verywellmind.com/diarrhea-stomach-pain-treatment-during-drug-withdrawal-22372) [What Is ETOH Abuse?](https://www.verywellmind.com/what-is-etoh-abuse-5496755) [What Are the 12 Steps of Recovery?](https://www.verywellmind.com/the-twelve-steps-63284) [How to Stay Sober](https://www.verywellmind.com/tips-for-staying-clean-and-sober-67900) [Types of Weed (Cannabis) and Strains](https://www.verywellmind.com/types-of-marijuana-22323)

[How to Support Someone Who Lost a Loved One to Drugs](https://www.verywellmind.com/support-after-death-from-drugs-22137) [How Long Does Klonopin Withdrawal Last?](https://www.verywellmind.com/klonopin-withdrawal-symptoms-timeline-and-treatment-4176203) [What to Expect at NA Meetings](https://www.verywellmind.com/state-by-state-na-meetings-63424) [The Difference Between Impulsive and Compulsive Shopping](https://www.verywellmind.com/difference-between-compulsive-and-impulsive-shopping-22336) [How Long Does Withdrawal From Methadone Last?](https://www.verywellmind.com/methadone-withdrawal-4178352) [Ativan Withdrawal Symptoms and Coping](https://www.verywellmind.com/ativan-withdrawal-symptoms-4588394) [How to Recognize Enabling](https://www.verywellmind.com/enabling-alcoholic-is-not-helping-63297) [Adderall Withdrawal: Symptoms, Timeline, and Treatment](https://www.verywellmind.com/adderall-withdrawal-symptoms-timeline-and-treatment-4177486)

[Visit Verywell Mind's homepage](/)

Daily Tips for a Healthy Mind to Your Inbox

Sign Up

You're in!

Thank you, {{form.email}}, for signing up.

There was an error. Please try again.

- [Conditions A-Z](https://www.verywellmind.com/conditions-a-z-4797402)
- [Therapy](https://www.verywellmind.com/therapy-4581775)
- [Living Well](https://www.verywellmind.com/living-well-7510832)
- [Relationships](https://www.verywellmind.com/relationships-4157190)
- [Psychology](https://www.verywellmind.com/psychology-4157187)
- [Trending](https://www.verywellmind.com/news-latest-research-and-trending-topics-4846421)

- [Meet Our Review Board](/review-board-4796494)
- [About Us](/about-us-5184564)
- [Editorial Process](/our-editorial-process-4778006)
- [Diversity Pledge](/anti-racism-and-diversity-pledge-4869798)
- [Privacy Policy](https://www.dotdashmeredith.com/brands-privacy)
- [In the News](/in-the-news-4782525)
- [Advertise](https://www.dotdash.com/our-brands/)
- [Terms of Service](https://www.dotdashmeredith.com/brands-termsofservice)
- [Careers](https://www.dotdash.com/careers/)
- [Contact](/about-us-5184564#toc-contact-us)
- Your Privacy Choices
- [Crisis Support](/crisis-support-6666353)

Follow Us

- [Visit Verywell Mind's Instagram](https://www.instagram.com/verywellmind/)
- [Visit Verywell Mind's TikTok](https://www.tiktok.com/@verywellmind)
- [Visit Verywell Mind's Facebook](https://www.facebook.com/verywell/)
- [Visit Verywell Mind's Flipboard](https://flipboard.com/@VerywellMind)

Verywell Mind's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

[Access TRUSTe's Enterprise Privacy Certification program](//privacy.truste.com/privacy-seal/validation?rid=8f15e7a5-6c05-47d8-bf12-8822d4d7cddd)

Ⓒ 2024 Dotdash Media, Inc. — All rights reserved

Verywell Mind
is part of the [Dotdash Meredith](https://www.dotdashmeredith.com) publishing family.

By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts.

Cookies SettingsAccept All Cookies