Individual addiction therapy

You don’t need to know exactly what you want to change in order to come to therapy.

Many of the people who sit across from me for the first time know that something needs to change, but they don’t yet know what, and they’re not sure it has anything to do with their use. That’s a fine place to start.

Coming to a session is not an easy step, and I feel a great deal of appreciation and admiration for anyone who takes it. I understand well, and respect, that using has helped, and perhaps still helps, in many ways. There isn’t a trace of judgment or criticism in me. I’ll be with you through use and through recovery, unconditionally.

The goal of therapy is your goal, and I don’t decide it for you. It can be abstinence, cutting down, harm reduction, or simply understanding the place that use has in your life. I respect each of these, and each one is something we can work on.

I treat substance addictions (drugs and alcohol) and behavioral addictions: sex, pornography and gambling. I also have extensive experience with dual diagnosis, that is, when substance use comes together with a mental health condition or a personality disorder. You can talk about anything here, including the things that are hard to say out loud.

People who come to me are usually in one of two places.

• In active use

  Some people already know they want to stop. Others know there’s a problem, but aren’t yet sure whether they want to stop, or whether they even need to. Both are in the right place.

• After the initial detox

  Detox is a beginning. What comes after it is the work that lasts: maintaining recovery, preventing relapse, addressing what led to the addiction, and building a life worth living, with room to develop and grow in every area.

The first meeting

The first meeting is a thorough assessment and consultation, but above all it’s a chance to get to know each other. I want to get to know you: what brought you here now in particular, what you’ve been through so far, and who is around you. Together we’ll work out what your goals are for the process, and I’ll help you sharpen them.

Then I’ll present the treatment plan that seems best suited to you: how often we’ll meet, whether it makes sense to add psychiatric care and medication, for detox or for another goal, and whether to add guidance for the family or groups alongside it.

Sometimes I’ll recommend starting in a more intensive setting, such as a day program or a rehab center, and then I’ll help you choose a place that suits you. I know the programs in Israel and quite a few abroad. I also help you prepare and get ready to enter rehab, and afterward I can stay involved from the outside, mainly in building and planning the “exit plan” and the continuing care.

You leave the first meeting with three things:

• A clearer picture of your goal.
• An initial treatment plan that suits you.
• An alternative direction, in case the goal turns out to be unrealistic. For example, when you want to cut down and it turns out that abstinence is needed.

Do I have to quit completely?

Not at all. First and foremost, what matters is showing up. Stopping, if and when it comes, will come at a time that’s right for you: when it’s ripe, when you’re ready, when the decision is yours, and when there’s a plan with tools to face the challenge. You don’t do it alone.

People who come to therapy regularly and consistently usually succeed.As they say, eighty percent of success is just showing up.