Advanced Codependency Treatment: A Complete Guide to CBT, Somatic, and Family-of-Origin Strategies to Disentangle Clients from Toxic Relationships and Recover Self

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Nancy L. Johnston, LPC, LSATP, MAC, NCC Related seminars and products

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Nancy Johnston, LPC, LSATP, MAC, NCC, has been a therapist for over 40 years and is an expert in the field of codependent relationships. The author of Disentangle: When You’ve Lost Your Self in Someone Else. (2020), Nancy has helped thousands of clients extricate themselves from toxic codependency, connect with self, and live with more peace and confidence.

Nancy is a Master Addiction Counselor and an AMHCA Diplomate in Substance Abuse & Co-Occurring Disorders. She has also authored two other books; My Life as a Border Collie: Freedom from Codependency (2012) and Your Healthy Self: Skills for Working with Codependent Behaviors (2015).

In addition to working with individuals, couples, and families, she offers online workshops on “self-recovery” and designs and facilitates a codependence camp twice a year. Over the past 15 years, Nancy has presented at numerous conferences including the Cape Cod Symposium on Addictive Disorders, the Carolinas Conference for Addiction and Recovery, Addiction: Focus on Women, the Virginia Summer Institute for Addiction Studies, the American Mental Health Counselors Associaton’s Annual Conference, the Virginia Counselors Association’s Annual Conference, and Specialty Docket Training for the Virginia Supreme Court. More information about Nancy and her work is available at her website: nancyljohnston.com.  

 

Speaker Disclosures:
Financial: Nancy Johnston maintains a private practice and is an independent contractor with Dr. Kuley and Associates. She receives royalties as a published author. Nancy Johnston receives a speaking honorarium from Virginia Summer Institute for Addiction Studies. She receives a speaking honorarium and recording royalties from Psychotherapy Networker and PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Nancy Johnston is a member of the American Mental Health Counselors' Association, the Virginia Counselors' Association, the National Association of Alcohol and Drug Abuse Counselors, and the Virginia Association of Addiction Professionals.

 

Additional Info

Program Information

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Objectives

1. Identify functioning patterns exhibited by codependent individuals.
2. Use assessment tools to identify the dominant external orientation of codependent clients.
3. Choose psychoeducational interventions that clarify the precise nature of codependency to clients.
4. Examine how codependency influences responses to the person’s own feelings of vulnerability.
5. Evaluate the potential correlation between codependency and growing up in a family environment where children are parentified.
6. Identify the intra/interpersonal dynamics of codependency.
7. Evaluate the potential link between codependency and the selection of partners with problematic behavior.
8. Identify countertransference dynamics in codependency treatment.
9. Use thoughts, feelings, inclinations, and needs to develop an authentic sense of self.
10. Utilize cognitive therapy interventions to foster positive changes in self-awareness, self-image, and interpersonal communications within the context of codependency treatment.
11. Use somatic strategies to help clients safely ground and calm self so they can attend more fully to their body, mind, and emotions.
12. Choose skills sets to help codependent clients address their emotional expression, shame, guilt, assertiveness, and boundary setting.
13. Develop a working knowledge of self-attunement to help clients cultivate a secure, safe, and reliable relationship-with-self.

Outline

Intake and Assessment of Clients with Codependent Behaviors

• Identify codependency in a variety of clients – how it looks in therapy
  • Dominant external focus: other-centered
  • Loss of self in someone else
  • Behavior vs. label
• Assessment tools for codependent characteristics
• Relationship patterns/themes to look for
• Codependency in clients presenting with anxiety, depression
• Connect internally as a foundational treatment goal
• Research, risks and treatment limitations
• Case Study: a 57-year-old primary caregiver for his mother who is developing memory problems

Establish a Therapeutic Relationship with a Codependent Client

• Foster your client’s autonomy and join their stage of change
• Ingredients of change
• Avoid becoming the client’s external source of direction
• Strategies for self-empowerment from the very first session
• Manage countertransference & your own codependency
• Ethical considerations

Psychoeducation and Early Sessions

• Educate clients about external vs. internal focus
• Client-ready visual tools illustrate codependent dynamics
• Shift to an aware, responsive, internal focus
• Goal setting
• The 4 interlocking elements of self-recovery
• Case Study: Continue with the 57-year-old primary caregiver for his mother who is developing memory problems

Family of Origin and Parts Work to Help Clients Understand their Codependent Characteristics

• Influences on self-development: Individual, family systems, social/cultural/political/religious worlds
• Gather your clients’ trauma history
• Parts of self developed from formative experiences
• Grief that can arise and strengths embedded in self-understanding
• Case Study: 24-year-old in a serious relationship with a dominating partner

Somatic and Cognitive Techniques to Enhance Codependent Clients’ Awareness of Body, Mind, Emotions, and Spirit

• Mindfulness techniques
• Bottom-up grounding tools to calm and connect with self
• Cognitive strategies to increase awareness of thoughts
• Exercises to help clients correct their thoughts
• Emotional awareness and self-expression strategies
• Spirituality as an internal resource
• Case Study: Continue with 24-year-old in a serious relationship with a dominating partner

Skills to Transform Shame, Manage Guilt, Be Assertive, and Set Healthy Boundaries

• Recognize shame, sharing with safe others, and releasing
• Cognitive corrections for quieting guilty thoughts
• Learning to construct “I” statements
• Three-part boundary setting process:
  • Listen to self to discern your boundaries
  • Express boundaries to others
  • Live with your boundaries
• Case Study: 50-year-old mother of a chronically relapsing alcoholic adult daughter

Exercises and Practices That Help Clients Learn How to Count on Self

• Self-attunement and relationship-with-self
• Qualities of a secure relationship-with-self
• Exercises to deepen internal connections and offer supportive self-regard
• Gatekeepers – parts that keep clients from accessing self
• Release exercises – let go of what clients cannot control
• Cultivate self as a secure base and an anchor
• Case Study:  Continue with 50-year-old mother of a chronically releasing alcoholic adult daughter

Make Self-Recovery a Way of Being

• Maintain connection with goals and self-recovery strategies
• Daily practices for self-awareness and self-responsiveness
• Ongoing ways to use internal focus
• Tools to continue to develop their relationship-with-self

Clinical Applications

• Individual therapy
• Group settings
  • Value of group settings
  • Psychoeducational workshops
  • Outpatient/inpatient groups
• Usefulness to various populations

Target Audience

• Counsellors
• Social Workers
• Addiction Counsellors
• Psychologists
• Art Therapists
• Marriage and Family Therapists
• Other Mental Health Professionals
• Physicians