The Codependency Treatment Guide: CBT, Somatic Strategies and More to Disentangle Clients from Dysfunctional Relationships and Recover Self

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Handouts

Faculty

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

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Nancy L. Johnston, MS, LPC, LSATP, MAC, NCC, is in private practice in Virginia. With 49 years of clinical experience, Nancy is master addiction counselor and an American Mental Health Counselors Association (AMCHA) diplomate in substance abuse and co-occurring disorders. A sought-after speaker and trainer, Nancy has been a faculty member the Psychotherapy Networker Symposium, The Ferentz Institute, numerous other professional conferences including Cape Cod Symposium on Addictive Disorders, the American Mental Health Counselors Association’s Annual Conference, the Virginia Counselors Association’s Annual Conference, and Specialty Docket Training for the Virginia Supreme Court.

Her work was recently featured in a New York Times article on enmeshment in relationships. In addition to teaching clinical professionals, Nancy offers online self-recovery workshops and delights in designing and facilitating Codependence Camp biannually at a retreat center in Virginia. Nancy has authored four books on codependency, including You. Here. Today.: 200 Readings for Growth from Codependency to Self-Recovery (2026); The Clinician’s Codependency Treatment Workbook (2024); Disentangle: When You've Lost Your Self in Someone Else 2nd Edition (2020); and My Life as a Border Collie: Freedom from Codependency (2012). When she is not teaching or writing, Nancy enjoys extended time with family and friends, gardening, collaging, writing haiku, dancing, walking in the woods, and sitting by the river near her country home. To learn more about Nancy and her work, please visit www.nancyljohnston.com.

Speaker Disclosures:
Financial: Nancy Johnston receives compensation as a designer and facilitator of workshops and retreats. She receives royalties as a published author. Nancy Johnston 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.

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Objectives

1. Learn to identify the intra/interpersonal dynamics of codependency in clients presenting with anxiety, depression, and relationship problems and understand how codependency/loss of self in others can be foundational to worry, exhaustion, resentment, entrapment, sadness, hopelessness, and health problems.
2. Determine the origins of codependent behaviors to support case conceptualization.
3. Utilize mindfulness techniques to increase codependent clients’ awareness of their own feelings.
4. Learn more than 15 cognitive strategies to develop and sustain self-recovery, including increased awareness of thoughts, feelings, and behaviors, self-monitoring, skill building, corrections of thoughts, psychoeducation through multiple visual tools and bulleted lists, and the development of daily practices.
5. Use present moment awareness training to help clients tolerate frustration and respond rather than react.
6. Use acceptance exercises that help clients let go of what they cannot control.

Outline

• Conceptualizing codependence as loss of self in someone else
• Developmental sources of codependence
• Codependent behaviors vs. the label
• Identifying codependence – how codependent clients look in therapy
• Research, risks and treatment limitations

• Clinical dynamics to notice as you use your standard intake
• Using the Holyoake Codependency Index
• Relationship patterns/themes to look for
• Establishment of mutuality in treatment work
• Client goal setting
• Case Study: 24 year-old in a serious relationship with a dominating partner

• Tools for educating the client about external vs. internal focus
• How to avoid becoming the client’s external source of direction
• Strategies to encourage self-empowerment from the very first session
• Addressing clinical challenges and codependence in self
• Case Study: Continue with 24 year-old feeling dominated by partner

• Influences on self: Individual, family systems, and social/cultural
• Parts of self that emerged from family-of-origin experiences
• Visual tools to teach relationships between self and other(s)
• Gathering your clients’ trauma history
• Case Study: 50 year-old mother of an alcoholic adult son who chronically relapses

• Mindfulness techniques to increase awareness of body, mind and feelings
• Bottom-up grounding tools to notice self in the moment
• Cognitive strategies to increase awareness of thoughts
• Exercises to help clients be with their feelings in safe, manageable ways
• Tools clients can use to intervene on their own behalf

Build Self-Competence in Codependent Clients:
Strategies to Set Healthy Boundaries, Quiet Guilt, Manage Anxiety and More

• Addressing the grief of accepting the realities of self, others and situation
• Respond vs. react - present moment awareness to help clients tolerate frustration
• Mindful breathing techniques for anxiety management
• Set healthy boundaries with “I” statements
• Tools for quieting guilty thoughts
• Case Study: Continue with 50 year-old mother of relapsing adult son

Increasing Self-Empowerment and Self-Attunement:
Exercises and Practices That Show Clients They Can Count on Themselves

• Acceptance exercises that help clients let go of what they cannot control
• Show clients how to plan with self in mind
• Practice acting on goals
• Developing daily practices for self-awareness and self-responsiveness
• Returning to self as a secure base and an anchor in the storms and delights of life

Target Audience

• Counselors
• Social Workers
• Addiction Counselors
• Psychologists
• Marriage and Family Therapists
• Other Mental Health Professionals