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


