Substance Use and Addiction Counselling

You might be here because

• The amount has changed, or the reasons have
• You have tried to stop and it has not held
• It is affecting work, money or the people close to you
• Someone in your family is using and you do not know how to help
• You are managing something else underneath it

None of that has to apply exactly. People often arrive unable to name what is wrong, and that is a perfectly good place to start from.

What the work looks like

Substance use rarely stands on its own — it often sits on top of anxiety, trauma or grief, and the work usually has to address both. Sessions are available for the person using and for family members carrying it, which are different kinds of support. Nothing here requires you to have already decided to stop.

Approaches most often used

• Cognitive Behavioural Therapy

  CBT is a short-term, goal-oriented, practical approach to problem-solving. I use it to change the patterns of thinking or behaviour sitting behind a difficulty, and so change the way you feel. It is used for everything from sleep problems and relationship difficulties to substance use, anxiety and depression.

  More on CBT →

• Dialectical Behavioural Therapy

  DBT is a form of cognitive behavioural therapy focused on teaching skills to manage stress, regulate emotions and improve relationships. It emphasises living in the present moment while building healthier ways of coping, so that life’s challenges become more navigable.

  More on DBT →

• Motivational Interviewing

  A way of working with ambivalence that does not argue with it. Most people wanting to change something already know the arguments on both sides, and being pushed tends to entrench the other half. MI works with your own reasons for change rather than supplying them, which is why it is non-confrontational by design and why it is standard in substance use work.

  More on MI →

Further reading

• How therapy works

  What "trauma-informed" actually means, and what it should look like in the room

  Trauma-informed appears on nearly every counselling website in British Columbia, which has worn the phrase close to meaningless. Used properly it describes how a session is run — pace, choice, safety, and what happens when something surfaces — rather than a technique anyone performs on you.

• Before you book

  What actually happens in a first counselling session

  A first session is mostly you talking and me listening, with no obligation to tell the worst of it straight away. Here is what the hour is actually spent on, what I will ask, and what you are free not to answer.