The Supportive–Expressive Continuum

Abstract

Psychodynamic therapy can be flexibly applied to a wide range of psychopathology. However, different patient problems imply different techniques. If inappropriate interventions are used, therapy progress could stall or negative patient events could occur. A useful tool for selecting the best mix of psychodynamic techniques is the supportive–expressive continuum. When patients are properly situated on this continuum, it is far easier to choose interventions. After the different intentions of the more purely supportive or expressive therapies are described, the clinical indicators for each approach are listed. Finally, patient transitions along the continuum (i.e., they require a different mix of supportive and expressive techniques) are discussed with suggestions on how to make these changes while minimizing therapy disruptions.