Substance Use Therapy in Oakland and the East Bay
Most people who seek therapy for substance use aren't in crisis. They're often functioning well (often overachieving), at least on the outside: going to work, managing their responsibilities, maintaining relationships, and generally holding it all together. But somewhere along the way, drinking or using stopped feeling like a choice they were making and felt more like something that was happening to them. The amount crept up. Stopping for a few days felt harder than it used to. The relief it used to bring became less reliable, and the costs got harder to ignore. And the risks of things getting much worse became impossible to ignore.
If that sounds like where you’re at, a clear-eyed, non-judgmental, evidence-based approach can help. That’s where I come in. I work primarily with adults managing substance use alongside demanding careers, often in combination with anxiety. This is my clinical specialty, and it's where I do my best work.
What Brings People to Therapy for Substance Use
People come to this kind of work from a lot of different starting points. Some of the most common:
Alcohol use that has quietly escalated to a nightly necessity
Cannabis use that started recreationally and has become a way of managing anxiety or sleep
Prescription medication misuse (stimulants, benzodiazepines, opioids) often originating from legitimate prescriptions
A partner, family member, or doctor who has expressed concern
A work incident, legal incident, or health scare that served as a wake-up call
A growing internal sense that something needs to change, even without a dramatic external consequence
You don't have to “hit rock bottom” to benefit from therapy. In fact, the earlier the intervention, the better the outcomes. (And “rock bottom” is always defined retrospectively and means different things to different people anyway.) Many of the people I work with are high-functioning by every external measure, but they're seeking help because they can see where things are heading, and they'd rather change course before they get there.
How I Approach Substance Use Treatment
I don't subscribe to a single rigid framework. Recovery looks different for different people, and good therapy reflects that. Depending on your goals and your situation, I draw on:
EMDR (Eye Movement Desensitization and Reprocessing) is particularly useful when substance use is entangled with anxiety, trauma, or chronic stress. It reduces the emotional charge of the internal states and external triggers that drive use, often in ways that talk therapy alone can't reach.
Motivational Interviewing (MI) helps you honestly examine both the costs and the benefits of your substance use. Cognizance of what it's doing for you (there’s always something) as well as what it's doing to you, helps clarify your own motivations for change. It's non-confrontational and meets you exactly where you are, and tends to provide a framework for all the substance use work I do.
Internal Family Systems (IFS) is one of the most powerful frameworks I've found for understanding why someone uses. It helps clients recognize the part of themselves that wants to drink or use, understand what that part is trying to do or to avoid, and find other parts and other strategies that can help meet those underlying needs in healthier, more sustainable ways.
Cognitive Behavioral Therapy (CBT) builds concrete skills: identifying high-risk situations, restructuring the thinking patterns around use, and developing genuine coping alternatives.
I also work comfortably alongside Medication-Assisted Treatment (MAT). Medications like naltrexone, buprenorphine, and acamprosate can be valuable tools in recovery, especially for alcohol or opioid use disorders. I'm not a prescriber, but I can work alongside your physician or psychiatrist if MAT is part of your plan.
Abstinence vs. Harm Reduction
Not everyone who comes to therapy for substance use wants to pursue complete abstinence, and I don't impose that goal on anyone. Some people's goal is controlled/reduced use; others want to stop entirely. I'll work with your goals, while also being direct with you about what the clinical evidence says and what I observe in our work together.
When Anxiety and Substance Use Are Both in the Picture
Anxiety and problematic substance use are so frequently intertwined that treating one without addressing the other usually either impossible or futile.v I work with both simultaneously, as this is where I have the most clinical experience and, I believe, where I bring the most value.
Working with Me
I see clients in person at my office in Oakland and via telemedicine throughout California. I work outside of insurance, which means your treatment records stay private: no diagnosis codes shared with insurers, no third-party review of our work. For people managing sensitive issues in professional environments, that matters.
I offer a free 20-minute consultation by phone or video. If you've been thinking about getting help and just haven't quite pulled the trigger, that call is a low-pressure place to start.