Substance Use Counseling
It did not begin with the substance.
For most people, substance use starts as a response, not a problem. Long before the first drink, pill, or high, there were moments of overwhelm, disconnection, pressure, or pain. Maybe it was growing up feeling unseen or unheard. Maybe it was trauma, loss, or responsibility you were never meant to carry alone. For some, it was loneliness, identity conflict, or the constant effort of trying to be enough.
At first, the substance helped. It soothed, energized, quieted, connected, or numbed. It worked. Until it slowly stopped working the way it once did.
What once felt like choice can begin to feel automatic. The highs may still offer relief or intensity, but the aftermath brings anxiety, emptiness, shame, or self doubt. You might tell yourself it will be different next time. Or you might not be sure you want to stop at all, only that something feels off. This is not a moral failure. It is a pattern that makes sense.
Substance use is often a survival strategy that formed in response to something real. And patterns that were learned for survival can be understood, softened, and changed.
My work with substance use is grounded in harm reduction, trauma informed care, and respect for your autonomy. That means therapy is not about forcing abstinence, applying labels, or following a one size fits all recovery model.
Instead, we focus on understanding:
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What substances do for you
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What they cost you
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What you want your relationship with them to look like now
Your goals matter. Whether you want to cut back, find balance, use more intentionally, or pursue sobriety, we work collaboratively and without judgment. Ambivalence is welcome. Curiosity is enough to begin.
A Different Way to Approach Change
What We Work Toward Together
Therapy may help you:
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Reduce harmful or unwanted patterns around substance use
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Understand the emotional or relational pull toward escape or intensity
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Interrupt cycles of chasing relief that never fully lasts
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Develop safer and more intentional ways of coping
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Reconnect with parts of yourself that have been buried or ignored
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Build honesty with yourself in a space without shame
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Address the loneliness or disconnection that substances were trying to fill
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Wake up feeling more aligned with who you want to be
This work is not about taking something away without replacing it. It is about helping you build a life that feels worth being present for.
What Harm Reduction Looks Like in Therapy
Harm reduction acknowledges that:
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People use substances for meaningful reasons
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Change happens in stages, not all at once
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Abstinence is not the only valid outcome
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Safety, dignity, and choice come first
There are no mandates here. No rigid programs. No pressure to define yourself by a diagnosis or a label. We focus on your lived experience and what feels realistic and sustainable for you.
You Are Not Broken
This is not about losing control or losing yourself. It is about understanding what your system learned to do to survive, and deciding what you want moving forward. You deserve support that meets you where you are, honors your complexity, and helps you move toward change on your own terms.
Harm reduction therapy can be provided through online sessions throughout California.
You do not have to do this alone.
Frequently Asked Questions
No. Abstinence is not a requirement to begin or continue therapy at Mai Mental Health.
Harm reduction therapy recognizes that people are at different places in their relationship with substances. Some clients want to stop entirely. Others want to reduce use, regain a sense of control, or better understand why substances have become so central. All of these goals are valid starting points.
If abstinence becomes a goal later, therapy can support that. If it does not, we still focus on safety, insight, and meaningful change.
Yes. Therapy does not require you to be “ready” or fully committed to change.
Many people seek therapy while still using and feeling conflicted. That ambivalence is not a barrier. It is often the work itself. Therapy can help you slow things down, understand patterns, reduce harm, and make more intentional choices rather than operating on autopilot.
Change often begins with awareness, not willpower.
Traditional abstinence based models often focus on stopping substance use as the primary goal. Harm reduction focuses on your relationship with substances and the function they serve.
Harm reduction therapy:
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Does not rely on shame or fear
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Does not assume substance use equals failure
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Does not impose a single definition of recovery
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Centers your autonomy, values, and lived experience
Instead of asking “How do we make this stop?” we ask:
“What is happening here, and what do you want to change now?”
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That is very common.
Wanting sobriety and feeling afraid of it can exist at the same time. Therapy can help you explore those fears without pressure, understand what sobriety would mean for you personally, and move at a pace that feels sustainable.
There is no requirement to commit to a lifetime decision upfront.
We focus on the next honest step.
No.
My role is not to control your behavior or dictate your choices. My role is to help you understand yourself more deeply, assess risks realistically, and support the direction you decide to move toward.
Therapy is collaborative. You are the expert on your life.
No. Harm reduction is about reducing harm, increasing safety, and expanding choice.
Ignoring substance use or moralizing it both tend to keep people stuck. Understanding it allows for change. Research consistently shows that people are more likely to make lasting changes when they feel respected, supported, and empowered rather than shamed.
Clients often report:
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Feeling less controlled by substances
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Increased honesty with themselves and others
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Reduced risky or compulsive patterns
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Greater emotional regulation
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Clearer boundaries and values
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A stronger sense of agency and self trust
Change does not always look dramatic. Often it looks quieter, steadier, and more sustainable.
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Yes. Therapy is confidential within the limits of California law. Substance use alone does not automatically require reporting. We will always discuss limits of confidentiality clearly so you know what to expect.
This approach may be a good fit if you:
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Are questioning your substance use
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Feel conflicted about stopping or cutting back
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Are high functioning but internally struggling
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Want support without shame or pressure
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Are interested in understanding deeper patterns, not just behavior
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Want therapy that respects your autonomy
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