Substance Use
When drinking or using has stopped feeling like a choice
You do not have to hit a bottom to get help, and you do not have to go away somewhere to do it.
Most people who work with us are holding down a job, raising children, and looking fine from the outside. What has changed is that the thing they used to decide about now decides for them.
The first conversation is free and it lasts 55 minutes.
Open seven days a week.
Office and video based psychotherapy, which means it fits alongside a life
This is a psychotherapy service focused on supporting change and addressing the impacts of addiction. Sessions are an hour, weekly or fortnightly, in our Tigard office or by video anywhere in Oregon. You keep going to work. Nobody moves anywhere.
That suits a lot of people and it does not suit everybody. If what you need is medically supervised withdrawal, or a residential program, we will say so in the first hour and help you find it rather than taking you on. Being clear about the edge of what we do is part of doing it well.
Our licensed clinicians hold CADC III, the top tier of Oregon’s alcohol and drug counselor certification, and CADC I. Between them the practice has more substance use credentialing than most general counseling practices carry, which is the reason this is a service page rather than a line on a list.
What we work with
- Alcohol, which is the one people wait longest to bring, because it is legal and because everybody around them drinks too.
- Drugs, prescribed or otherwise.
- Early recovery, when the using has stopped and the reason for it has not been touched yet.
- Returning to use after a period away. Common, and information rather than failure.
- Substance use alongside something else. Trauma, anxiety, depression, a marriage in trouble. Most of the time these are not separate problems that happen to share a person, and treating one while ignoring the others is why some attempts do not hold.
What actually happens in the first hour
Nobody is told what to do. Not in the first session, not ever.
We do not open by asking you to name a goal, because most people have already been asked that and have already given the answer they thought was wanted. The hour goes into what the substance is doing for you. What it quiets, when it started being the thing you reach for, and what happens on the days it is not available.
You will not be asked to accept a label. You will not be told you have to abstain in order to be worked with. Where you want to end up is your decision, and we will be honest with you about what we think is realistic.
If it is somebody else who is using
You are welcome here as a client in your own right, and you do not need them to agree to anything.
We work with partners, parents and adult children of people who are using. Often that is who calls first, and often the honest answer is that we cannot make somebody else stop, but we can work on what living with it has done to you and on what you actually control.
Adult children of alcoholics. If you grew up with it, some of what you learned to do at nine years old is still running now, decades after it stopped being useful. That is workable, and it is a large part of what people come here for once they realize the pattern is theirs rather than inherited bad luck.
Codependency, which is a word people use to mean very different things. We will find out what you mean by it before doing anything with it.
How we work with it
Attachment-based work, because the question of what a substance is replacing is usually a relationship question.
Acceptance and Commitment Therapy, which is about being able to have a craving without it deciding the afternoon. It is the main approach of Cynthia Keavney, Professional Counselor Associate, and Abby Feinstein, Marriage and Family Therapist Associate, both of whom practice under supervision at the lower rate.
- CBT, for the parts that respond to noticing a pattern and interrupting it.
- EMDR, when trauma is underneath the using. We are trained in it.
- Family and couples work, when the household needs to be part of it.
None of these are promised as an outcome. Movement is the thing therapy can honestly commit to.
What this costs
$205 an hour with a licensed clinician, $180 with a supervised associate. Couples $230 and $205. Families $245 and $210.
We are in network with Kaiser, PacificSource, Cigna, Aetna, and United Healthcare and Optum, and with Medicare, both Open Card and in-network Advantage plans. Regence Blue Cross Blue Shield is expected from 1 October 2026 and Moda from 15 October 2026, both for associates as well as licensed clinicians. For the Oregon Health Plan we can bill Open Card, but not the coordinated care organizations, and most OHP members are enrolled with a CCO rather than Open Card. There is no sliding scale.
Questions people ask
Do I have a drinking problem?
If you are asking, the question is worth an hour. The clinical definitions matter less than whether it is costing you something you are not willing to keep paying.
Do I have to quit completely?
That is your call, not ours. Some people here are working toward abstinence and some are working toward less. We will tell you honestly what we think is achievable for you, and then we will work on what you have chosen.
Can I do this without going to rehab?
For many people, yes. Psychotherapy for addiction is enough for a lot of substance use, and it is what this practice provides. It is not a state approved ASAM level of care program and we do not describe it as one. If you need that, we will say so early rather than late.
Is this AA?
No. Some clients here also attend twelve-step meetings and find them useful, and some do not. Neither is required.
Will my employer or my insurer find out?
What you tell a clinician is confidential, with the narrow legal exceptions we will go through with you in the first hour. If you pay directly, no claim is filed with an insurer at all.
How fast can I be seen?
Usually within days. Seven days a week, and inquiries are answered the same day.
Book a free 55 minute consultation
An hour, at no cost, with a clinician rather than an intake screener.
Book online · In person in Tigard, by video anywhere in Oregon