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Alcohol Counseling & Moderation Management

Harm-reduction counseling to help you manage or reduce alcohol or other drug use.

“Observing desire without acting on it enlarges our freedom to choose how we live.”

Tara Brach

Alcohol, cannabis, and other substances naturally weave into the fabric of our social lives: A coffee in the morning, a drink after work, a smoke before bed. For some, these feel like helpful supplements in life. For others, these feel like necessary fixtures that seem to control you more than you control them.

 

Maybe you can relate to these feelings:

  • You don’t want to quit entirely—you just wish you could control it better.

  • You’ve tried setting limits but struggle to stick to them.

  • Once you’ve started using drugs or alcohol, there’s part of you that believes “more = better time.”

  • You wish you could use intoxicants “like normal people do.”

  • Drugs and alcohol remind you of happy times you wish to relive.

  • Drinking, smoking, or using drugs feels interwoven in your lifestyle and/or social life.

 

I hear you and strive to meet clients where they're at in their personal choices with intoxicants—whether you’d like to break it off with them entirely or cut back on alcohol or drug use.

Many treatment and peer-support programs abide by an abstinence-only model where you essentially “break up” with substance use entirely. Like a bad relationship that was likely never going to get better, this may be the preferred choice for many reasons.

I also want to make room for individuals who don’t necessarily want to (or are not ready to) quit outright—people who wish to “work on their relationship” with substances. When we slow down and curiously examine this relationship, it can teach us about the things we really want out of life.

Together, we can take a judgment-free look at your substance use to understand its history, its current place in your life, and the future you want with it.

Who is a good fit for moderation?

 

This is one of the questions we can explore together in therapy. Your experience is one of a kind, and my role is to help you sort through all of the medical, social, legal, spiritual, and many other factors that influence your challenges and goals. Through this process, you may find a clearer sense of whether moderation is or isn't right for you.

Effective moderation asks us to be honest with ourselves, and through non-judgmental support, I hope therapy offers you a place where honest self-reflection feels safe to explore. The relationships we hold with substance use are complicated. I believe treatment should be willing to meet you in the complexity. 

What are the risks of drug and alcohol moderation?

According to a 2023 statement by the World Health Organization, any level of alcohol consumption increases health risks. For all intoxicants, it goes without saying that abstinence is the only way to eliminate any and all risk. Moderation is a harm-reduction approach—it does not eliminate harm entirely.

For some, moderation can be a difficult and tiring process of always holding boundaries with drinking or drug use. One might feel that moderation was an unhelpful distraction that delayed a relationship to abstinence, after ultimately deciding sobriety was the right choice for them.

Moderation can offer some individuals with problematic use patterns a recovery experience that feels nuanced, destigmatized, and compatible with their current goals or stage of readiness. Sticking to the tenets of harm reduction, I strive to educate clients with information that suits their level of need and take seriously the very real harms of addiction.

How does it look to work on moderation in therapy?

 

It depends! I believe therapy should be highly personalized and tailored to the person you are. We will collaborate on the moderation plan that works best for you, but in general, here are some approaches I may offer:

  • Mindfulness — Skills that allow you to curiously observe yourself and the world around you, which may help reduce “autopilot” behaviors and gain opportunities for intentional choice.

  • Narrative Therapy — We’ll examine the personal, social, and cultural factors that relate to your substance use story, and put together new narratives that align with the life you want to live.

  • Psychodynamic/Attachment Therapy — Our relationship to substances is often bound to the human relationships we hold or yearn for, and tending to this aspect of life can have ripple effects on our substance use. 

  • Internal Family Systems — An approach that seeks to intimately understand the part of you that clings to your current relationship to substances—and explore ways of supporting this part of you.

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