Substance Use & Addiction therapists

About substance use & addiction

Substance use becomes a problem at the point where it stops working for you and starts working against you — when the thing that helped you sleep, manage anxiety, get through social situations, or stop the noise becomes another thing you have to manage. Most people who develop substance-use disorders aren't using because they don't know it's bad; they're using because, in the short term, it does something useful. The work of recovery is partly about finding other things that do the same job, and partly about addressing what made the using necessary in the first place.

The therapists in this directory who treat substance use take a range of approaches, and the right one depends on what you're working with. Motivational Interviewing (MI) is a foundational approach — it's evidence-based for people who aren't sure whether they want to change, and most addiction-trained therapists use it as a starting point. Cognitive Behavioral Therapy targets the specific situations and thoughts that drive use. Harm-reduction approaches recognize that abstinence isn't the only legitimate goal — for some substances and some people, moderation is the right target. Trauma-focused therapy matters because substance use and trauma are deeply linked; many people are using to manage trauma symptoms whether they've named that or not. For severe or long-standing addiction, 12-step programs alongside therapy add a community dimension that some people find essential and others can take or leave.

Medications for addiction (MAT — Medication-Assisted Treatment) deserve more attention than they get. For opioid use disorder, buprenorphine and methadone are highly effective and dramatically reduce overdose risk; the stigma against them is medically unsupported. For alcohol use disorder, naltrexone and acamprosate can meaningfully help. Most of the therapists here coordinate with prescribing physicians for clients where medication is part of the picture.

For people who aren't sure whether they have a substance-use problem: a useful question is whether you'd be willing to stop or significantly cut back for a defined period — say a month — to see how it goes. If that question feels harder than it should, that's information worth bringing to a therapist.

For families and partners of someone with a substance-use problem, CRAFT (Community Reinforcement and Family Training) is an evidence-based approach designed for loved ones; several therapists here offer it. Al-Anon (free, peer-led) is also a useful resource.

If you're in withdrawal from alcohol, benzodiazepines, or opioids, the medical safety risks are real and immediate medical attention may be needed before outpatient therapy. Call SAMHSA's 24/7 helpline at 1-800-662-4357 for treatment referrals, including detox programs.

To find a therapist for substance use, browse the profiles below or submit the matching form.