Addiction Recovery

All addiction, whether it's a substance addiction or a behavioral addiction, is about the same thing: FEELINGS. People use substances and behaviors to escape feelings, or to find a way to have feelings they see other people having and wish that they could have. 

I work with


If you're looking for one on one addiction therapy in Florida, start online psychotherapy sessions with me. I am experienced in dual disorders recovery counseling and offer concierge services 7 days a week. See my online counseling page for a description of the benefits of concierge counseling. 

What Does Addiction Look Like?


If you are not sure that you have a substance use or behavioral addiction, ask yourself these questions.

These are all symptoms of addiction. Statistics show that nearly 21 million Americans have at least one addiction, yet only 10% of them receive sobriety help and treatment. You don’t have to be among the 90% of people who never get substance abuse help. I can help you by providing nonjudgmental addiction support, coping strategies, recovery tools, skills training, and encouragement.

Letters on blocks spell out "mental health matters.":

You may have noticed that most of the above questions do not focus on substances. We do not always realize the connection between substance use and mental health concerns. However, research tells us that many mental disorders co-occur with substance use disorders. That's why I specialize in dual disorders recovery counseling. Some of the comorbidities we see during therapy for drug and alcohol addiction include:


You may have noticed that my two other specialty areas are stress and anxiety management and personal growth. There's a lot of cross-over in these three specialties, and that's not an accident.


Common Types of Addictions

Map of the USA. Caption: More than 140,000 people die from excessive alcohol use in the U.S. each year.
Pill bottle. Caption: 44 people die every day from overdoses involving prescription opioids. Source: CDC.gov
Drinks in cans and glasses, pills, and syringes. Caption: People who binge drink are 2 times more likely to use other substances than non-binge drinkers.

I treat both substance and behavioral addictions (aka process addictions). They have the same symptoms in common, and the same potential consequences. The same solutions work for both. 

Substance Addictions

Behavioral Addictions

You can read more about alcohol recovery, drug recovery, and the benefits of addiction recovery services on my references page. That's where you’ll find links to the research mentioned throughout my website.

Consequences of Addiction

Consequences of addiction can be mental, physical, emotional, spiritual, familial, relational, legal, financial, or vocational - or they can involve all of these areas. 

Woman lying passed out face down on a bed with hair toussled.

Poor sleep

Chronic pain

Change in body odor

Silhouette of man and woman at sunset with man in tense posture and woman turned away with head in hands.

Estranged family

Loss of friends 

Loss of respect

Disheveled older man sits on stairs outside a city residence with his head in one hand and his other hand on his knee.

Alcohol poisoning

Cirrhosis

Cancer

Woman dressed in business clothes sits across a desk from two people who appear to be in charge.

Unemployable

Dropping out of school

Arrests

Man in suit and tie sits on a park bench with a concerned expression and his hand to his temple.

Financial Debt

Stress and anxiety

Poor judgment

Casually dressed man and woman sit at a table in a poorly lighted room with a suitcase on the table between them.

Having to give up pets

Poverty

Car accidents

Woman in workout clothes has a determined and angry look and holds her arm out with muscles taut.

Anger and resentment

Restlessness

Inability to handle stress

Person covered in a hoodie sits on a cement ledge overlooking the city with their head down, looking away from the view.

Loss of child custody

Loss of driver’s license

Bad memory

Woman lies curled up on couch with no shoes on, during the day, facing the inside of the couch.

Social withdrawal

Low self-esteem

Everything seems catastrophic

Woman with tearful expression sits on the floor next to a couch holding the received of a rotary phone that's on the couch, chin resting on hands that hold the receiver.

Depression

Inability to concentrate

Confusion

An outstretched arm on a blanket with the words "lately I been feeling so dead in my own skin" written in marker on the skin.

Dissatisfaction with life

Lack of emotion

Isolation and loneliness

Woman stares at herself in the mirror with a sad expression.

Suicidal thoughts

Sense of dread

Nightmares

Slightly heavyset person with an expression of discomfort sits near a window with their top half down and their arms hugging their midsection.

Acid reflux

Constipation

Diabetes

Woman with hair over her face, eyes closed, and a pained expression.

Heart disease 

Stroke

COPD

Woman in underwear crouches next to bed with head and torso leaning into bed.

Body image distress

Overdose

Death

Can you identify with one or more of these symptoms? The good news is, you’re here, which means you recognize that you could use some help. 

Your Needs

Marquee letter lights sign says "This is the sign you've been waiting for."

My practice is a good fit for you if:



You are looking for a therapist who knows about recovery, not just addiction. One is the problem. The other is the solution. I can teach you how to live life in recovery.  We will tap into your time in active addiction for information about how you got here, but we will not use it as a source of blame or shame. There’s a huge difference between taking responsibility and living in blame and shame. We will acknowledge the things you don’t like about your feelings and actions, and we will take steps to help you accept the past, forgive yourself, and move forward. We will focus on solutions by identifying your strengths and building on them. If you’re in a head space where you do not feel as though you have many strengths, I promise you right now that you do, and I will help you recognize and expand on them.

Who Is This Therapy For?

Marquee sign hanging off a window on a city building says "You're not lost, you're here."

I always ask my clients, "Why are you here? Why now?” These are the answers I hear most often:


All of those goals are possible for you, irrespective of your history. Most people who develop an addiction have a history of trauma. You may have heard trauma referred to as “trauma with a big T” and “trauma with a little t.” Trauma is subjective. If an event had a lasting negative impact on you, it was a trauma. It’s not for someone else to tell you it wasn’t. It is common for people to deal with trauma by using substances as a temporary coping skill - until their substance use becomes compulsive or leads to other problems. I say “or” because it’s possible to lack the compulsion to use or act out and still experience negative or even dire consequences from addiction. 

Many people who develop addictions have what we call ACEs - adverse childhood experiences. Therapy can be a useful tool for dissecting the reasons behind your addiction, restoring manageability to your life, and moving forward toward your dreams and goals. 

I use a strength-based approach to therapy. The medical model focuses on what is wrong with you. We are going to shift the focus from what is wrong with you to what is right. That doesn’t mean we’re going to ignore the problems or deny maladaptive thoughts and behaviors. It means we’re not going to obsess about them. We will acknowledge your suffering, address your pain points, and determine what is needed to help you flourish.  Our priority will be to build your resilience, your strengths, and your resources. To borrow a phrase from positive psychology, we are going to focus on building a life worth living. This focus can bring profound change and meaning into your life.

Graph of a continuum from negative to positive, where negative indicates suffering, 0 indicates freedom from suffering, and positive indicates flourishing. Caption reads: Continuum of functional health and wellness.

Recovery from addiction is not just about getting rid of the thoughts and behaviors that lead you to use substances or act out on your addiction. Recovery is about learning and practicing new thoughts and behaviors that build a life worth living. We are all too aware that life is full of negative situations that cause stress, sadness, frustration, and difficulty. Trying to make all that go away does not bring us a life worth living. Why? Because it’s not a realistic expectation to think that we can make all the negative events and feelings disappear. Learning the skills to deal with stressors in any situation is realistic, and these skills help us balance life’s challenges with life’s pleasures. In a state of well-being, we can function and thrive no matter what is going on in our lives.  

Terminology

Scrabble letters spell out "Choose your words."

Semantics

Let’s get the terminology out of the way. I use the terms clean and sober interchangeably. Many people do not. Both approaches are valid, and you will choose the terminology you prefer - if you haven’t already. There are two 12-step fellowships that are sticklers for differentiating those two terms, and it causes some confusion for people who are new to recovery. Same with the terms recovery and sobriety, which I also use interchangeably. If you choose one of those two fellowships to affiliate with, I will do my best to use your preferred terminology when speaking with you. But there are over 30 twelve-step fellowships out there, and many of them also use those terms interchangeably. Most of them don’t care which terminology you prefer - they’re just glad you showed up. There are also recovery programs that are not twelve-step-based, and you will hear a variety of terms in those programs as well. On my website you can consider clean/sober and recovery/sobriety the same thing. These terms refer not only to abstinence, but also to lifestyle. Our choices change when we look at the world through a recovery lens. My role as your therapist is to help you get to a point where that recovery lens and lifestyle improve your quality of living and feel natural for you.  

You may choose to call yourself an addict, an alcoholic, or a person in recovery. You may not like to refer to yourself by any of those terms. That’s up to you. It’s not my place to tell you how you should identify yourself. Some recovery programs stress the importance of taking ownership of your identity as an addict, an alcoholic, or a person in recovery. One of my tasks is to provide you with the resources to make an informed choice about which type of recovery program will work best for you. It’s not a lifetime decision; you’re not locked in, and you may change programs often or work more than one. I will say that without some kind of recovery program or community, your chances of staying in long term recovery are poor. 

You want to know what works the best, right? Of course you do; I hear that question a lot. I’m happy to solve that mystery for you. In my experience, the number one determinant of whether or not someone stays in recovery is whether they build a strong recovery support system. And you know what? Research backs that up. Don’t know where to start? I can help you with that. 


Recovery

I favor the SAMHSA definition of recovery, because it is inclusive enough to cover mental health, addictions, overall well-being, and personal growth. 

“Recovery is a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential.” (Substance Abuse and Mental Health Services Administration, n.d.)


What does it mean to be "in recovery"? 

If you identify as a person in recovery, then I consider you to be "in recovery."

Recovery is universal. Everyone is recovering from something:

Lack of control. Low self-esteem. Insecurity. Substance Addiction. Behavioral Addiction. Depression. Stress. Anxiety. Overwhelm. Imbalance. Disease. Injury. Disability. Infirmity. Grief. Loss. Sorrow. Heartbreak. Childhood. Bullying. Family dysfunction. Fear. Poverty. Trauma. Abuse. Intimate Partner Violence. Motivational bankruptcy. Moral bankruptcy. Financial bankruptcy. Social bankruptcy. Spiritual bankruptcy. 

I rarely encounter a person who is in recovery from just one thing. My clients are 18+ adults looking to recover. I work with the whole you - not just this or that problem. Active recovery permeates all areas of our lives - physical, mental, emotional, spiritual, intellectual, relational, educational, social, familial, legal, financial, and vocational. I love that aspect of my job - that I get to work with the whole you instead of this diagnosis or that behavioral issue. A colleague of mine shared that she loves helping humans learn how to human, and I think that's a perfect way to describe it. Learning how to human is sort of like learning how to "adult", but with a softer, less unnerving sound to it. 

For comparison, I offer the following definition of recovery from White and Kurtz (2006):

"Recovery is the process through which severe alcohol and other drug problems (here defined as those problems meeting DSM-IV criteria for substance abuse or substance dependence) are resolved in tandem with the development of physical, emotional, ontological (spirituality, life meaning), relational and occupational health." 

As you can see, their definition focused on addiction recovery, but nevertheless, it also framed recovery in the context of improving other life areas, supporting the notion that abstinence alone does not define recovery. Pursuit of a recovery lifestyle is transformative for all areas of your life.


Harm Reduction

Harm reduction refers primarily to the use of prescribed medication as a path to recovery. It can also refer to the practice of reduced substance use or the replacement of higher-risk substances with the use of lower-risk substances. The goal of harm reduction is to decrease the incidence of overdose and death and reduce the spread of infectious diseases. 

When prescription medications are used in harm reduction, this protocol is referred to by several names: medication-assisted treatment (MAT) or medications for addiction treatment (MAT), drug replacement therapy (DRT), and medication-assisted recovery (MAR), among others. Examples of prescription medications used for this purpose are suboxone, naltrexone, and methadone. I have no problem supporting your use of these medications for your recovery with the understanding that they should be taken the same way as any other prescription medication - as prescribed. If you don’t take them as prescribed, you risk the likelihood that these prescriptions will shift from their role as medications into a role as abused drugs. In my experience, it is common for people with a history of substance use to hoard, binge, and sell these medications rather than taking them as intended by the prescriber. That’s not recovery; that’s what recovery circles call “addict behavior.” 

But know this: If all you do for your recovery is replace your drug of choice with MAT/DRT/MAR, that isn’t going to address how you developed an addiction in the first place, and it isn’t going to resolve the fallout that resulted from it in many areas of your life - mental, emotional, familial, relational, spiritual, physical, financial, legal, educational and vocational areas. In therapy, we can address what led you here and how addiction has affected your life, and it will take a lot of work on your part. But it is doable, and I believe in you. You’ll hear me tell you that a lot, because it’s true, and because it’s important. I believe in you.   


Abstinence versus Harm Reduction

In their discussion of a study on abstinence versus low-risk substance use, the Recovery Research Institute wrote that "Lower risk substance use status was associated independently with greater recovery capital, less psychological distress, greater self-esteem, greater happiness, and greater quality of life and functioning; whereas higher risk substance use status was associated independently with less recovery capital, greater psychological distress, less self-esteem, less happiness, and less quality of life and functioning." More support for the realization that if you’re looking for a life overhaul, some things have got to change. What you’re willing to change, how quickly, and to what degree is going to differ for each of you. 


My Position on Harm Reduction and Recovery

I do accept clients who are still struggling to sustain consistent abstinence from substances or acting out behaviors. After all, if you could do it on your own, you wouldn't be seeking help. If you are able to actively participate in therapy sessions, that’s what’s important. It’s your place to decide whether or not recovery means abstinence - for you. It’s my place to provide information and resources about the many paths to recovery that are out there for your consideration, and to help you work through choosing which one (or more than one) works best for you. Whatever path you choose will probably change several times over the course of your life, because your needs will change. So will your values and priorities. And that’s a good thing, because it’s a sign of growth.

Benefits of Recovery

Brick road with the word happiness painted in yellow and a painted yellow arrow pointing forward.

There are so many positive changes you can expect to see as you stay sober.

Emotional stability

Ability to feel your feelings

Relief from stress, worry, and anxiety

Rising motivation

Stronger self-esteem

Clearer thoughts

Sharper senses

Improved memory

Elevated awareness

New-found energy

Better sleep

Better balance and coordination

Better skin complexion

Decreased risk of health problems

Extended longevity

Mended relationships.

Healed hurts

Renewed interest in life

Restoration of trust in yourself and from others

Deeper connections to others

Acceptance of imperfections

Increased sense of excitement for life

Spiritual growth

Faith in your abilities

Fresh confidence

Find out who you are

Prolonged general health

Financial stability

Employment longevity and mobility

Ability to make plans

More choices

Peace of mind

What's Different about My Services?

Sign pinned to a tree says "You are worthy of love."

Freedom and comfort.  

If you are able to remain in the comfort of familiar surroundings, doing so may be less disruptive for you. If you commit to treatment through a treatment center, you are limited to their accommodations, their food, their amenities, their schedule. You are stuck going to whatever support meetings or recreational activities they decide to take you to. Structure is vital for people in recovery. But you don’t learn to self-monitor when that structure is enforced by someone else. Working with me, you will learn to integrate structure rather than imposing it - right from your own home. If your current living situation is contributing to your presenting problems, I may recommend that you seek treatment away from home. If that is not desirable or feasible, we will work on building and maintaining your boundaries instead. 


I will meet you where you’re at.

In many cases, therapy is goal oriented and focused on finding solutions. But if you’re struggling with addiction, sometimes just the goal of showing up for a therapy session may be all the challenge you can handle right now. If that’s the case, then that’s where you’re at, and we’ll start there. First things first. Maybe we’ll start with talking, and that will be enough at the beginning. Maybe you’ll ask me to read to you, and I’m totally up for that if you find it helpful. Maybe you want to do the work, but you don’t know where to start, so we’ll start it together, in session. We’ll work on goal-setting when you are ready. You’ll let me know when that is, and if communicating your needs is hard for you, then we’ll work on that. It’s my job to help you start setting and achieving manageable goals one small step at a time. It may sound corny coming from a stranger, but I will always come from a place of love. 

When I first came into the recovery rooms, people I barely knew would tell me, "I love you, Michelle." And I would think, "How absurd! You don't even know me!" After a few years, I realized they did not mean that they loved me, Michelle. They meant, "I am loving to you. I give you my love." Coming from a place of love doesn't have to be about the other person, although it certainly can be. It's about honoring others' humanity, and it's about my humanity. It's about being the best kind of person I know how to be. I don't always practice love perfectly, but I always keep it in mind. It's an ideal, and it is always worth the effort.


You’ll know what to expect.

You’ll be given a treatment plan and an opportunity to ask questions about it. A treatment plan is like a school syllabus. Can you imagine taking a college course without receiving a syllabus? You wouldn’t know what to do - what to expect of the instructor or what they expect of you! When I worked in treatment facilities and took over cases from other clinicians, I always asked the clients what they’d been working on in their treatment plans. Believe it or not, the most common response was, “I don’t have one.” This is not likely at treatment facilities. Treatment centers are required to generate treatment plans for all clients in order to get paid. So why would a client say they did not have one? It is possible that the clinician did not review the treatment plan with the client, did not provide the client with a copy of it, or wrote it in such clinical language that the client had no idea what was expected of them. With my services, that will not happen. I will make sure you understand every aspect of your treatment plan, and I will personalize your program based on your needs. 

In addition to your therapy sessions, I will provide you with training materials to work on between sessions. This training will empower you and help you work through the issues you want to focus on. Much of this content will be housed on a private Google Site that only you have permission to access. The material will include readings, videos, interactive e-learning modules, role playing scenarios, and knowledge checks. You will have access to books and activities that are not publicly available. In the program I design for you, every lesson is designed to target specific knowledge, skills, or attitudes so you’re clear on what  you'll gain from the lesson. You'll know what you're expected to do and how it will serve you in the real world in observable, measurable results. 

Your needs are likely to evolve and change throughout the course of your therapy, so we will talk often about the type of content that suits you and the format you feel works best for you (talking, reading, writing, watching, listening, etc.). Occasionally, you may find a shift in format helpful depending on what else is going on in your life in terms of demands on your time and attention. I will supply materials as we come to each topic to prevent you from feeling overwhelmed. That’s the intention, anyway. Overwhelm is a natural and common feeling in therapy. If you do find yourself feeling overwhelmed, speak up and we will make adjustments.  

When you complete treatment, you should be able to write a resume of your recovery skills, experience, and education. If you have nothing to put on it, it's time to get to work. That's what I'm here for. I will help you build that resume. Putting those skills, experience, and knowledge on paper will give you a roadmap for the kind of opportunities you might pursue. Having that roadmap will help you get jobs, get into schools, establish credibility with family, and feel better about yourself. It’s not something you’d give to prospective employers or loved ones, but writing it will give you the language to use during job interviews and in communications with family and friends. 


Long Term Goals Lead to Long Term Change

Treatment centers typically keep you for anywhere from two weeks to 30 days. Thirty days is the average stay approved by insurance, so that’s become the standard. Your treatment is terminated because the insurance company stops paying the claims as soon as your initial presenting problem is thought to be stabilized when you’ve been abstinent for 30 days. Just as you start to make headway toward working on the underlying causes of your problem, you have to leave and either fend for yourself or start over with another therapist or outpatient facility. That constraint is one of the reasons I don't deal with insurance in my practice. Thirty days is barely long enough for excessively-used substances to clear your body. It's seldom long enough to clear your head. After 30 days of abstinence, you’re still experiencing the symptoms of post-acute withdrawal, something you will learn to manage as we work together. 

Because I am a private-pay provider, there is no time limit to your treatment with me. Research shows that people who receive continuous treatment for 1-5 years are more successful at maintaining a healthy lifestyle. While you are welcome to remain with me for as long as you can benefit, our goal is to get you as independent of therapy as possible. That brings me to my favorite adage, which you may have seen on my counseling services page: Give a person a fish, and you feed them for a day. Teach a person to fish, and you feed them for a lifetime. I’m going to teach you to fish - figuratively, that is. 


Less Costly Than a Treatment Facility.

With a private practice, there are no unnecessary accountability activities for you to fund. Treatment centers must demonstrate your continued abstinence through drug screenings, and many facilities perform these accountability screenings several times a week. Your treatment with me is not contingent upon your abstinence as long as your substance use does not make it prohibitive for you to participate in therapy sessions. I do not require drug screenings. Your physician or family may require them to treat or support you, but I do not. To be honest, I don’t usually need a drug screen to know if someone is under the influence. If it impairs your ability to participate in a session, we will reschedule and discuss the situation when you are in a better condition to communicate. Be aware that you will still be financially responsible for any scheduled session in which you were unable to participate. 

In contrast to a treatment center, with private therapy, you will not spend six long hours a day in groups that may not provide clear learning objectives or prepare you for the world outside treatment. Treatment facilities are designed to keep you insulated in a structured environment. This may offer a layer of protection, but that insulation makes it harder for you to apply what you’ve learned until you leave. Therapy in such settings tends to be information-based rather than performance-based. Information without application seldom results in learning that lasts. For training to stick, learners need to practice and apply what they’ve learned in real life. In treatment with me, you get that chance.


Let’s look at the typical cost of rehab at a treatment facility.

Help.org reported that the average cost for outpatient treatment ranges from:


That’s for 1-3 months of treatment, most of which is group therapy, not individual therapy.


How does this compare to online counseling with me? 

The short answer: One year of weekly personalized psychotherapy with me costs the same as 1-2 months of inpatient treatment at a substance use facility.

With my practice, at $575 for the initial evaluation, plus $240/week for an average of one session a week for one year, your cost is $12,815 for a full year of weekly psychotherapy. That therapy includes individual sessions, training with feedback, skills acquisition, and resources for you to continue using post-treatment. It also includes access to communicate directly with me 7 days a week - no going through administrative or support staff. You have the option to add additional appointments or schedule less frequently, which will affect your cost. I provide a written good faith estimate for all fees and you will always have the opportunity to ask questions before making your cost-based decisions.


Why such a difference? 

There are several reasons.


Why long term if the typical stay at a treatment center is 30 days? 

Studies show that long term treatment is more likely to lead to long term recovery. Online treatment gives you the chance to keep your job, stay in school, or continue caring for your family while living in your home environment. This negates the cost associated with inpatient services. On-site treatment typically costs 1K-3K per day. My services are billed by the hour or by the task, not by the day. You only pay for what you need. You are not paying the salaries of behavioral health technicians and administrative and maintenance staff. You are not paying for meals in which your options are limited. You are not paying for rent or property taxes or electricity or any of the other costs associated with a residential or outpatient facility. You are not paying for 25 hours a week of psychoeducational groups where you read packets and listen to videos or lectures with a group of strangers who were not specifically screened to work together as a group. I’ll provide you access to materials, you’ll do that work independently, and we’ll talk about it in your therapy sessions. 

Addiction Recovery FAQs

What is addiction?

We will probably spend a lot of time on this in your online psychotherapy sessions, but for now, I share with you these resources:

The American Society of Addiction Medicine updates its definition of addiction every few years from a medical point of view.

The American Psychological Association includes both substances and behaviors in their definition of addiction.

The definition of addiction from the National Institute on Drug Abuse mentions relapse, consequences,, and the chronic nature of addiction. 

The bulletin titled What is Addiction? from the narcotics Anonymous World Service Board of Trustees discusses the definition of addiction from the perspective of the Narcotics Anonymous fellowship.

We will do a deeper dive into the hallmarks of addiction in your one on one addiction therapy.

What is recovery?

I tend to favor the definition of recovery from the Substance Abuse and Mental Health Services Administration, which is inclusive enough to cover mental health, addictions, overall wellness, and personal growth. 

"Recovery is a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential." 

If you identify as a person in recovery, then I consider you to be "in recovery."

Recovery is universal. Everyone is recovering from something: Lack of control. Low self-esteem. Insecurity. Substance Addiction. Behavioral Addiction. Depression. Stress. Anxiety. Overwhelm. Imbalance. Disease. Injury. Disability. Infirmity. Grief. Loss. Sorrow. Heartbreak. Childhood. Bullying. Family dysfunction. Fear. Poverty. Trauma. Abuse. Intimate Partner Violence. Motivational bankruptcy. Moral bankruptcy. Financial bankruptcy. Social bankruptcy. Spiritual bankruptcy. 

I rarely encounter a person who is in recovery from just one thing. My clients are adults looking to recover. I work with the whole you - not just this or that problem. Active recovery permeates all areas of our lives - physical, mental, emotional, spiritual, relational, educational, social, familial, and vocational. 

For comparison, I offer the following definition of recovery from White and Kurtz (2006):

Recovery is the process through which severe alcohol and other drug problems (here defined as those problems meeting DSM-IV criteria for substance abuse or substance dependence) are resolved in tandem with the development of physical, emotional, ontological (spirituality, life meaning), relational and occupational health. 

As you can see, their definition focused on addiction recovery, but nevertheless, it also framed recovery in the context of improving other life areas, supporting the notion that abstinence alone does not define recovery.

Do you require drug testing if I'm being treated for addiction recovery?

I do not refer my clients for drug or alcohol testing. If you are recovering from an addiction, you do not need a drug test to tell you whether or not you are using alcohol or other drugs. You know. Generally speaking, I know too. It's pretty easy to tell when someone is still struggling with alcohol or drug use, or is acting out on a behavioral addiction. Since I do not deal with insurance companies, I am not required to report negative substance screenings to justify continued treatment coverage. I do not think anyone benefits from me asking you to pay for drug or alcohol screenings except for the company that bills you for the labs. Making someone else responsible for tracking your drug or alcohol use may provide accountability, but it does not improve your personal sense of responsibility and can contribute to your feelings of shame and guilt. You'll benefit a lot more from developing an honest therapeutic relationship in which we can work on your coping skills, relapse prevention skills, and self-monitoring skills. 

Which recovery program is right for me? 

That is something you will decide after reading about the options, attending some of the meetings, and processing your experiences in therapy. I do not advocate one type of program over another. I do strongly suggest you try as many as possible so you can make an informed decision. What all recovery programs have in common is some type of mentorship, whether it be individual or group mentorship. Support from like-minded people who share your experiences, issues, and feelings is crucial for any type of recovery.  

To clarify what I mean by meetings: Meetings may be self-help, facilitated, task-oriented, process-oriented, 12-step, educational, or just two people getting together to work on recovery. Work in this context may mean formal activities or it may mean conversation and emotional support. Meetings may be structured or unstructured. 

I find it works really well for most folks to approach each program with a "keep what you can use and leave the rest" attitude. You may love the concepts of one program, but dislike the structure, and vice versa. You may consider the ideology problematic but find the strategies useful. You may like the mantras and catch-phrases but prefer a different interpersonal dynamic. You may gravitate toward spirituality but prefer to avoid religion. You may eschew spirituality altogether and prefer language that is more clinical or business-like. You may decide to embrace one program primarily or exclusively, or you may decide to participate in several. You will figure out what works for you over time. 

I will not push you in any one direction, but I will push you to gather as much information and experience as you can until you can make an education choice. 

Recovery programs: Main websites

Please note that the programs on this list are peer-led programs. Their sites are not HIPAA-compliant and do not have the same level of safety and security as a mental health practice. While confidentiality and anonymity may be customary in these programs, it is not guaranteed. Peer-led recovery meetings should be thought of as public places, and you are advised to adjust your degree of self-disclosure with that in mind. If you plan to disclose something you consider private, you may want to do so with a trusted individual rather than at a meeting. In meetings, it is good practice to talk about your life, the people in it, and any events you are struggling with in generalities rather than specifics, and to focus instead on your feelings about what you are going through and how those feelings have impacted your recovery. If you are not sure how to filter yourself that way, let me know and I can work on that with you in session. 


I have been to meetings at some but not most of the programs on this list. Their inclusion here is for informational purposes and should not be considered an endorsement of any kind. I cannot vouch for them, and it is not my place to push you toward a particular recovery program even if I preferred one over the others. Choosing a recovery program is a personal decision, and it is a decision that may change over the course of your recovery. I recommend you check them out yourself to see what they provide. Most of these sites offer both in-person and remote/online/virtual meetings. If you need help navigating the sites to find meetings, I can help you with that during our sessions.


Please note that some recovery programs have been excluded from this list because their websites did not have secure connections, i.e. they did not support HTTPS. Please note also that this list is for peer-led resources only, not treatment facilities.


AA – Alcoholics Anonymous

ACA – Adult Children of Alcoholics and Dysfunctional Families

ARM - Association of Recovering Motorcyclists

CA – Cocaine Anonymous

CLA – Clutterers Anonymous 

CMA – Crystal Meth Anonymous

CR - Celebrate Recovery, Christian-focused twelve-step program for recovery from various behaviors

DA – Debtors Anonymous

EA – Emotions Anonymous, for recovery from mental and emotional illness

FA – Food Addicts in Recovery Anonymous

FAA – Food Addicts Anonymous

GA – Gamblers Anonymous

HA – Heroin Anonymous

Liars Anonymous Community Group

LSR - LifeRing Secular Recovery 

MA – Marijuana Anonymous

MM - Moderation Management

NA – Narcotics Anonymous

N/A – Neurotics Anonymous, for recovery from mental and emotional illness

NicA – Nicotine Anonymous

OA – Overeaters Anonymous

OLGA – Online Gamers Anonymous 

PA – Pills Anonymous, for recovery from prescription pill addiction

PA - Parents Anonymous 

PIR - Pagans In Recovery, for neopagans recovering from various compulsive/addictive behaviors

RA - Rageaholics Anonymous 

SA – Sexaholics Anonymous 

SAA – Sex Addicts Anonymous

SAAPP - Sex Addicts Anonymous Primary Purpose Big Book Solution Group

SCA – Sexual Compulsives Anonymous 

SIA – Survivors of Incest Anonymous, survivors of childhood sexual abuse

SIRA - Self-Injury Recovery Anonymous

SLAA – Sex and Love Addicts Anonymous

SMART Recovery - Self-Management and Recovery Training

SOS - Secular Organizations for Sobriety 

SPA/SocAA Social Anxiety Anonymous 

SRA – Sexual Recovery Anonymous 

UA – Underearners Anonymous 

WA – Workaholics Anonymous

WFS - Women For Sobriety

Wellbriety - Wellbriety Movement, culturally-based healing for indigenous people


If you have a peer-led recovery program that is not on this list, you are welcome to send me their link through my contact page. Please be advised that if the link is not a secure link (HTTPS), I will not include it on this list. 

  

Recovery programs for people whose lives have been negatively impacted by someone with an addiction

ACA – Adult Children of Alcoholics and Dysfunctional Families

Al-Anon/Alateen - Al-Anon Family Groups, for friends and families of alcoholics

Co-Anon – Co-Anon Family Groups for friends and family of addicts

CoDA – Co-Dependents Anonymous

COSA – for those whose lives have been affected by someone else's compulsive sexual behavior

COSLAA – CoSex and Love Addicts Anonymous, for adults who are dealing with sex and love addicts

FA – Families Anonymous, for relatives and friends of addicts

Gam-Anon/Gam-A-Teen, for friends and family members of problem gamblers

Nar-Anon, for friends and family members of addicts

Do you involve family members in my therapy for addiction recovery?

Sometimes. Each family situation is unique. Timing matters because sometimes family members are ready to hear from each other, and sometimes they are not. I do not offer family therapy where the family is the client. However, I believe it is invaluable for family members to participate in the client’s  treatment, and research shows better long term outcomes for clients whose families get involved in supporting their work in therapy. 

I will invite a family member to join you for your session if you and I agree that it would be helpful. There are two ways I involve family members or other support persons: Collateral sessions and collateral interviews. :

A collateral is a term we therapists use when we speak to or meet with anyone in the client’s sphere, such as family, friends, other emotional or recovery supports, other healthcare workers, and legal professionals. 


Collateral Sessions

The purpose of a collateral session is to provide insight or assistance with the therapeutic process for the support of the client. As the clinician, my role in a collateral session is to gather information, facilitate communication, and provide educational resources or clinical referrals when beneficial. 

It is also my role to discourage triangulation in therapy. Triangulation is when you have three people and one of them pits the other two against each other, one of them tries to control or repair conflicts between the other two, or two of them gang up on the third. Triangulation can increase stress and conflict and stall or prevent conflict resolution. In these cases triangulation is counterproductive to the healing process and can twist therapy sessions from empowering experiences into wearisome and soul-crushing experiences. When triangulation is present, I may advise against collateral sessions at that time. 


Collateral Interviews

A collateral interview may be a phone conversation, email, or video session that takes place without the presence of the client. The purpose of a collateral interview  is for the collateral to 


It is essential for family members and other collaterals to understand the following points:


Note to family members and other support persons

If you contact me about a client, and I do not have the client’s consent to speak with you, I will 

What’s the difference between religion and spirituality?

My definition of spirituality:

Spirituality is about realizing that you don't exist alone, and deciding what to do with that realization. Spirituality is about our connection to the world around us. 

My definition of religion:

Religion is the formal practice of a system of belief in a deity or deities. 

What’s the difference between “clean” and “sober”?

See my discussion about this further up on the page under the subheading "Semantics".

Can I be on medication and be in recovery?

Short answer: Yes. 

Long answer: That discussion could take up a whole therapy session! Substance use disorders are in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) and are considered a medical diagnosis, and at least one process addiction made the latest DSM edition as well. We don't judge people who take medication to treat thyroid irregularities, heart disease, diabetes, or cancer, so why shouldn't people with mental health diagnoses take medication as a tool of their treatment? For more on this, read my answer to the next question. 

What is your position on medication assisted therapy (aka drug assisted therapy, medication assisted recovery, drug replacement therapy, harm reduction) versus abstinence?

I have mixed feelings about it. On the one hand, research shows us that drug replacement therapy saves lives. On the other hand, people with substance use problems don't always take medication as prescribed.

It is important to differentiate between taking medication and abusing drugs. Medication is a drug we take as prescribed, under a doctor's supervision, with the intention of treating an illness or imbalance. When we hoard, binge, sell, or go off-script because we think we are better qualified to control the dosage than our doctor, that's when we tend to develop a problem with drug abuse. Intention is relevant here. If our intention is to get high, block out or dull our feelings, or avoid life, then it's time to evaluate our motives for taking a medication. That goes for any medication, including drug replacement therapy (DRT), also known as medication-assisted therapy (MAT), medications for addiction treatment (MAT), or medication-assisted recovery (MAR). You can read more about MAT on my references page.

Years ago, on the manufacturer's website for Suboxone, a medication-assisted therapy, there used to be a caveat that said Suboxone wasn't intended for use for longer than seven days. That caveat has since disappeared as the medical field embraced the harm reduction approach to substance addictions. Without the lived experience of participating in abstinence-based recovery programs or fellowships, the medical community lacks a full understanding of what such programs and fellowships have to offer. A few courses on addiction in medical school is not the same as an education on recovery, yet the medical community is often where policy makers turn for guidance in handling the addiction epidemic

Instead of strongly supporting established peer-led recovery communities, the United States government chooses to champion drug replacement therapy, a decidedly medical model. While statistics show us that harm reduction saves a lot of lives, this focus on drug replacement undervalues the crucial role of lifestyle change in improving quality of life. Research supports lifestyle change as well, and I believe that's where our focus belongs.

Large segments of the recovery community favor total abstinence, while academia and the treatment industry are more open to harm reduction. Research does show better long term outcomes for addiction recovery, mental health, and overall wellbeing when abstinence is practiced. But that doesn't mean abstinence is the path for everyone at all times. 

Abstinence is a huge decision. It is literally a life-changing decision. Some people get there after years of misery. Some people get there after seeds are planted over many years of encouragement. And some people choose reduced substance use over complete abstinence. In all of those cases, without lifestyle change, quality of life is not going to improve all that much. There is a popular recovery aphorism that sums it up: If nothing changes, nothing changes. The introduction of medication is one change. In my personal and professional experience, more change is needed for those in addiction recovery to thrive.   


People change when they are ready. Are you ready?