Substance Use Therapy

You Don't Have to Navigate This Alone

Whether it's alcohol, cannabis, caffeine, nicotine, or other substances, the relationship between you and the thing you're using is rarely as simple as "just stop." Substance use and addiction aren't a character flaw or a lack of willpower — they're complex patterns that develop for real reasons, often as a way of coping with something else. Therapy can help you understand that pattern and build a different relationship with yourself, with stress, and with the substance itself.

Please note: I provide outpatient therapy, which is most appropriate for individuals who are stable enough to attend regular sessions while living their daily lives. If you or a loved one is dealing with a more severe substance use disorder — including risk of dangerous withdrawal, recent overdose, or inability to function day-to-day — a higher level of care such as detox or inpatient rehab may be necessary first or alongside outpatient work. See resources below.

What Struggles With Substance Use Can Look Like

Substance use exists on a spectrum, and you don't need to hit a dramatic "rock bottom" to benefit from support. About 1 in 6 people in the U.S. meet the criteria for a diagnosable substance use disorder, yet most never receive treatment — often because they're not sure their struggle is "bad enough" to warrant it.

You might recognize it as:

• Using more than you intend to — telling yourself "just one" and finding it rarely stays that way.

• Difficulty cutting back — wanting to stop or moderate, but finding it harder than expected.

• Using to cope — reaching for a substance to manage stress, anxiety, boredom, sadness, or to relax.

• Preoccupation — thinking about your next drink, smoke, or use more than feels comfortable.

• Tolerance — needing more over time to get the same effect.

• Withdrawal — irritability, anxiety, headaches, or other symptoms when you go without.

• Impact on daily life — strain on relationships, work, sleep, finances, or health that you've minimized or hidden.

• Shame and secrecy — hiding how much you use, or feeling judged by yourself before anyone else gets the chance to.

This isn't limited to alcohol or drugs. Caffeine dependence, cannabis use that's become harder to control, or any substance that's started running the show rather than supporting your life is worth examining.

What Drives Substance Use and Addiction?

Substance use rarely develops in a vacuum. It's often a learned, effective — if ultimately costly — way of managing something underneath: anxiety, depression, trauma, chronic stress, loneliness, or simply the demands of daily life. Many people are also navigating co-occurring mental health concerns alongside substance use, which means treating one without the other rarely produces lasting change.

Common contributing factors include:

• Underlying mental health conditions — anxiety, depression, or trauma that substances temporarily numb or quiet.

• Family history — genetic predisposition or growing up around substance use as a coping model.

• Chronic stress — using as a release valve for pressure that's built up over time with no other outlet.

• Social and environmental factors — workplace culture, social circles, or life circumstances that normalize or encourage use.

• Habit and avoidance — substance use that started as situational and gradually became automatic.

Understanding why the pattern developed is often the key to actually changing it — more so than sheer willpower ever could be.

Therapy Isn't One-Size-Fits-All — And Neither Is the Goal

One of the biggest misconceptions about substance use therapy is that the only valid outcome is total abstinence. That's not true here. Some clients do want to stop using entirely, and we'll work toward that. Others are looking for moderation, harm reduction, or simply a healthier and more intentional relationship with a substance that isn't currently serving them.

There's no single "right" way to approach this. My role isn't to impose a goal on you — it's to help you get honest about your relationship with substance use, understand what's driving it, and define what change actually looks like for your life. That goal can also shift over time as you learn more about yourself through the work.

What I Work With

This is outpatient, talk-therapy-based support — meaning it's best suited for individuals who are not in acute medical danger and can engage in weekly sessions as part of daily life. I work with:

• Alcohol Use — from "gray area" drinking that's started to concern you, to more significant alcohol use disorder.

• Cannabis Use — including dependence that's developed as legalization has made daily use more normalized and accessible.

• Caffeine and Nicotine Dependence — substances often minimized as "not a real addiction" but that can still drive compulsive use and withdrawal.

• Other Substance Use — prescription medications, stimulants, or other substances that have become difficult to control.

• Co-Occurring Concerns — substance use alongside anxiety, depression, or trauma, treated together rather than in isolation.

If you're dealing with a more severe addiction — particularly involving opioids, alcohol withdrawal risk, or polysubstance use — outpatient therapy alone may not be enough, and I'll help you find the right level of care alongside or before our work together.

How Substance Use and Addiction Therapy Works

This isn't about being told what to do or shamed into change. It's about understanding your relationship with the substance, what it's doing for you, and what's possible without it.

Approaches I draw on include:

Psychodynamic Therapy — exploring the deeper emotional needs, history, and patterns that substance use has been serving. Lasting change tends to come from understanding what you're actually seeking — relief, connection, control — and finding healthier ways to get there.

Cognitive Behavioral Therapy (CBT) — identifying the thoughts, triggers, and situations that drive use, and building practical strategies to interrupt the cycle before it starts.

Motivational Interviewing — meeting you exactly where you are, whether you're certain you want to stop, still ambivalent, or just starting to question your relationship with a substance. Change has to come from you — this approach helps you find and strengthen your own reasons.

Harm Reduction — focusing on minimizing the risks and negative consequences of substance use rather than requiring complete cessation as the only valid goal. This might mean safer use practices, reducing frequency or quantity, or addressing the most dangerous aspects of use first. It meets you where you are, without judgment.

Coping and Relapse Prevention Skills — building a realistic toolkit for managing cravings, navigating triggers, and handling setbacks without spiraling into shame or giving up entirely.

What to Expect From Treatment

You don't have to commit to a label or a single "right" goal before starting therapy — whether that's full abstinence, harm reduction, or simply understanding your patterns better is something we can figure out together. Over time, therapy can help you:

• Understand what's really driving your substance use.

• Reduce reliance on substances to cope with difficult emotions.

• Build healthier, more sustainable coping strategies.

• Repair relationships and trust that substance use may have strained.

• Approach setbacks with self-compassion instead of shame.

• Feel more in control of your choices, rather than controlled by a habit.

Ready to Take the First Step?

Whatever stage you're at — questioning, ready for change, or somewhere in between — reaching out is a meaningful first step. I offer a free 15-minute consultation so we can talk about what's going on and whether working together feels like the right fit.