Substance use disorders
Understand the function. Change what isn't working.
Your goals can be clear — and still evolve
Some people want to stop using entirely. Others want to reduce their use, use more safely, or begin by protecting the parts of life that matter most to them. We don't have to choose between accepting where you are and working toward meaningful change.
A dialectical approach allows us to hold both: acceptance of your current reality and a commitment to change what isn't working. For some people, that ultimately means abstinence. For others, it may mean harm reduction or another meaningful change in how they use substances. Your goals are part of the treatment, and they can change as your circumstances change.
Abstinence without all-or-nothing thinking
If abstinence is your goal, we take that goal seriously. At the same time, a commitment to abstinence doesn't have to mean that one lapse becomes a reason to give up. A dialectical approach holds both the commitment to stop using and the reality that change can be difficult. We plan for vulnerability, learn from setbacks, and return to the goal rather than treating a lapse as failure.
For others, harm reduction may be the more appropriate starting point. The goal is to reduce the risks and consequences of substance use while working toward changes that are realistic and meaningful.
Treating what sits underneath
Substance use rarely exists in isolation. Emotion dysregulation, PTSD, anxiety, grief, and other difficulties may all play a role in why someone uses — and why changing that use can be difficult. Rather than treating these concerns as completely separate problems, we look at how they interact. That may mean building emotion regulation skills, addressing trauma when the timing is right, and finding other ways to meet the needs that substance use has been serving.
When outpatient therapy isn't enough
Withdrawal from alcohol and some other substances can be medically dangerous. If detox, medication for addiction treatment, intensive outpatient, or residential care is indicated, I'll tell you directly and help you pursue it. When a higher level of care is needed, my role is to help you get there — not keep you in a level of treatment that can't provide what you need.
What the work looks like
A clear structure, at a pace that is workable
- 01
Honest assessment
We look at your substance use honestly and without judgment — how much, how often, when you use, what is happening around it, and what impact it is having on your life. We also assess safety and whether a higher level of care is needed.
- 02
Your goals, named clearly
We identify what you want to change — whether that's reducing use, using more safely, or working toward abstinence. Having a clear goal gives us something concrete to work toward and a way to recognize when things are changing.
- 03
Function & replacement
We identify what use accomplishes and build skills that meet the same need with less cost.
- 04
Lapse planning
Setbacks are treated as data. We plan for them in advance so one hard night doesn't become a return to square one.
Common questions
Questions people ask first
- Do I have to be abstinent to start therapy?
- No. You do not need to have stopped using to begin. We start where you actually are, clarify what you want to change, and choose goals accordingly — whether that is reduced use, safer use, or abstinence.
- Do you require a 12-step program?
- No. Twelve-step involvement is welcome if it helps you, and it is never a requirement. Treatment is built around your goals and what the evidence supports, not a single recovery philosophy.
- Can outpatient therapy be enough for substance use?
- Sometimes. It depends on withdrawal risk, medical concerns, and how much structure you need. If detox, medication support, or a higher level of care is indicated, that will be named clearly and referral options discussed.
- Will substance use be treated separately from my mental health?
- No — they are addressed together. Emotional pain, trauma, and use patterns usually reinforce each other, so treatment targets the whole loop with a workable order of operations.
Also offered
Other ways we might work together
Many people arrive with more than one concern. These areas often overlap in treatment.
DBT Individual Therapy
Individual therapy that draws on DBT skills and strategies. This is DBT-informed care, not comprehensive DBT.
Prolonged Exposure for PTSD
A structured, evidence-based trauma treatment that gradually reduces the grip of avoidance and fear.
Teens, Young Adults & Families
Support for teens and young adults navigating emotional, behavioral, academic, or life transitions—and for parents who aren't sure what to do next.
Mindfulness-Informed Therapy
A mindfulness-informed approach that uses attention and awareness skills to help you notice what is happening in the present moment and respond with greater intention.
Qualified Supervision
Florida qualified supervision for registered interns working toward licensure, plus clinical consultation.