Codependence: Treatment Strategies for Clients Who Lose Themselves in Others

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Planning Committee Disclosure - No relevant relationships

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners.  For speaker disclosures, please see the faculty biography.

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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 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.

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Objectives

1. Apply the codependency paradigm as an underlying factor for common presenting problems, symptoms and diagnoses.   
2. Determine the origins of codependent behaviors to support case conceptualization and decrease pathology or stigma.   
3. Utilize clinical strategies to increase client’s self-understanding, self-awareness, and skills to attend to their internal well-being.   

Outline

Conceptualizing Codependent Dynamics in a Practical Way 

• Over-functioning for others while under-functioning for the Self 
• The physical and emotional costs of a “dominant external focus” 
• Codependence as a precursor to anxiety, depression, and relationship difficulties 
• Limitations of the research and potential risks 

Assessment:  Broadening Your Lens to Include the Codependence Paradigm 

• How to identify and address codependence without stigmatizing 
• Self-understanding (the why), self-awareness (the what), and skill sets (the how) 
• Addressing the grief that underlies acceptance of reality 
• What’s missing from the Stages of Change 

Treatment Tools:  Help Clients Detach from Codependence and Anchor Within the Self  

• Setting goals that make sense 
• Shifting focus from external to internal 
• 3-part boundary setting skills 
• Visuals to illustrate the relationship between the self and others 
• Building “quiet reactivity” 
• Breaking through the illusion of control 
• Daily practices for self-awareness and self-care 
• And more! 

Case Studies: 

• 50 y/o mother, overly enmeshed with adult child who repeatedly relapses from alcohol recovery 
• 36 y/o, depressed and insecure, unsure of role at work, feels excluded and inconsequential  
• 17 y/o, discouraged and hesitant to share true thoughts and feelings with partner

Target Audience

• Psychologists 
• Social Workers 
• Counselors 
• Addiction Counselors 
• Marriage and Family Therapists 
• Case Managers