When the thing that helped starts to cost.

Substance use therapy is clinical treatment for a person's relationship with alcohol, drugs, or other substances, delivered in an outpatient setting that doesn't require residential care or a formal recovery program. The DSM-5 classifies substance use along a spectrum of severity rather than as a binary condition — reflecting what clinical practice has shown for decades: people's relationships with substances are complex, often functional for periods, and shaped by factors abstinence-only models rarely address adequately.

Effective treatment begins by understanding the substance in context. What is it doing for the person? What need is it meeting? What is it protecting against? For most adults I work with, substance use developed as a response to something — pain, trauma, chronic stress, anxiety, or an environment that offered no other reliable means of regulation. Addressing the substance without addressing what it was in service of rarely produces lasting change.

Treatment begins with a biopsychosocial assessment covering the full history: the substance use itself, the contexts in which it developed, the trauma and mental health factors that interact with it, and what you're actually hoping for. Goals vary significantly. Some clients want to stop entirely. Some want to reduce and regulate. Some want to understand their patterns before deciding what change looks like. Some are addressing a co-occurring condition where substance use is one part of a more complex picture.

Sessions are conducted via secure, HIPAA-compliant telehealth, removing the logistical and social barriers that prevent many adults from seeking help in person — no waiting rooms, no risk of being seen entering a treatment facility. The clinical work draws on Motivational Interviewing, CBT, DBT, Internal Family Systems, psychodynamic therapy, and Somatic Experiencing, matched to what your goals and nervous system can access at each stage.

My approach is harm-reduction-informed and trauma-integrated. Harm reduction means the goal of treatment isn't defined in advance by an external standard of abstinence — it's defined by you, based on your values, your life, and what change actually means to you. Research consistently supports harm reduction as effective for adults who would not otherwise seek or remain in treatment. I hold an LCADC credential in New Jersey, which requires specific training in substance use assessment, motivational approaches, and co-occurring mental health treatment — distinct from general therapist training, where substance use is often addressed briefly and treated as secondary.

Motivational Interviewing is the primary framework I use for exploring ambivalence about change, which is nearly universal and which confrontational approaches tend to worsen. IFS and psychodynamic work address the protective function the substance use has been serving. Somatic Experiencing addresses the nervous system dysregulation that drives craving and relapse in ways cognitive approaches alone often can't reach.

I work with adults whose relationship with substances has become something they want to examine and potentially change, at whatever stage they're in. That includes adults who want to reduce rather than stop entirely, adults in early recovery seeking support beyond a 12-step program, adults questioning whether their use is a problem, and adults where substance use is one thread in a more complex picture involving trauma, burnout, anxiety, or relational stress.

Many of my clients are high-functioning: employed, credentialed, and maintaining their obligations while managing a pattern that has become more than recreational. They're not looking for residential treatment — they're looking for outpatient support from a clinician who can hold both the substance use and the complexity underneath it. Research indicates roughly 70 percent of adults with substance use disorders have a significant trauma history; for many, the substance use and the trauma are the same clinical problem approached from different angles, and treating one without the other rarely holds.

Alchemy Psychotherapy is a private-pay, out-of-network practice. A reduced fee is available in limited circumstances based on financial need and current caseload. I do not bill insurance directly, but I provide a Superbill on the first of each month for clients with out-of-network mental health benefits, and HSA and FSA cards are accepted. Under the No Surprises Act, you have the right to a Good Faith Estimate of expected charges before treatment begins.