Home / What we do / Anxiety, depression, and substance use
Dual diagnosisAnxiety, depression, and the drinking or use that goes with them.
A virtual program that treats both at the same time. Dual diagnosis, evidence-based, psychiatry on the team, evening cohorts. Most PPO plans verified before you commit.
Treating one without the other rarely sticks.
If you have been using substances to manage anxiety, depression, sleep, or trauma, the substance use is not the whole problem and it is not separable from what is underneath. We treat both, at the same time, with a team that includes psychiatry, therapy, and recovery support. This is the design, not an add-on.
Real integration, not sequential treatment.
Integrated, not sequenced
The same clinical team treats both conditions in the same week, not "first the substance use, then the mental health." Sequenced treatment was the old model. The current evidence supports integrated treatment.
Psychiatry on the team
A psychiatrist evaluates medications, adjusts them where appropriate, and works with your existing prescribers. We do not abruptly change medications that are working.
Evidence-based modalities
CBT for anxiety and depression. DBT skills for emotion regulation. Trauma-informed approaches for trauma history. Motivational interviewing for ambivalence. The modality is matched to the patient, not assigned by default.
Medication for substance use, when clinically indicated
Naltrexone, acamprosate, disulfiram for alcohol. Buprenorphine and naltrexone for opioids, depending on history. Medication is one tool. We use it when it fits.
The honest answers.
What is dual diagnosis?
The clinical term for the combination of a substance use disorder and a mental health condition (anxiety, depression, PTSD, bipolar, ADHD, others). It is the norm in adult substance use, not a special case. Roughly half of adults in treatment for substance use also meet criteria for a co-occurring mental health condition.
Will I see a psychiatrist?
Yes. Psychiatry is part of the standard treatment team. The frequency depends on your situation.
Can I stay on my medication?
Usually yes. We work with whoever is currently prescribing, and we adjust only when there is a clinical reason. We do not abruptly stop medications that are working.
Will you adjust my medication?
If clinically indicated, yes, and only with your consent and (where appropriate) coordination with your existing prescriber.
Is this CBT or DBT?
Both, plus other modalities. CBT is foundational for anxiety and depression. DBT skills are useful for emotion regulation, distress tolerance, and interpersonal effectiveness. We match modality to patient, not the other way around.
How long is the program?
The intensive outpatient portion is typically 8 to 12 weeks of three nights a week, then step-down to a less intensive maintenance phase. Length is clinical, not arbitrary.
Do I need to stop using before I start?
No. We work with you to stabilize first when needed. If withdrawal would be medically dangerous, we coordinate that step before the intensive outpatient portion begins.
I have trauma history. Is this trauma-informed?
Yes. Trauma-informed means we recognize the role of trauma in substance use and we structure care to be sensitive to it. Specific trauma-focused therapies (CPT, prolonged exposure, EMDR coordination) are available based on clinical fit.