Addiction and Substance Use Therapy
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Addiction and Substance Use Therapy in New Jersey, New York, and Online
Most people don’t come in saying, “I have a substance use problem.”
They say things like:
“I don’t know if it’s that bad.”
“I’ve tried to cut back.”
“I feel a lot of shame about this.”
“I can’t imagine life without alcohol.”
You are not alone.
For many people, there is a push and pull. Part of you wants things to change. Another part is not sure how, or even if you want to.
That tension is real. And it makes sense.
We do not start by telling you what you should do. We start by understanding where you are.
What Is Addiction and Substance Use?
Substance use exists on a spectrum.
Not everyone who drinks or uses substances has a problem. But it can become one when things start to shift.
You might notice:
- Using more than you intended, or for longer than you planned
- Trying to cut back and finding it harder than expected
- Continuing to use even when there are consequences
- Spending more time obtaining, using, or recovering from use
- Substances interfering with work, relationships, or things that matter to you
Substances can reduce stress, quiet anxiety, help you sleep, or give you a break from what you are feeling. That is part of why people keep going back to them. They work, at least in the short term.
But over time, the costs tend to grow. What started as a way to cope can start to get in the way of the life you actually want.
Substance use rarely exists on its own. It often overlaps with anxiety, depression, trauma, and chronic stress. For many people, substances are a way of managing something else that has not yet been directly addressed.
Treatment that only focuses on the substance, without addressing what is underneath, tends to miss the most important part of the picture.
About the Shame
A lot of people carry enormous shame about their relationship with substances.
The shame can be louder than anything else. Louder than the worry. Louder than the desire to change.
You might tell yourself:
“I should be able to control this.”
“What kind of person does this?”
“I’ve tried before and failed.”
“I don’t deserve help.”
We want to say this clearly: shame is one of the biggest barriers to getting help. It is also one of the least useful responses to substance use. Research consistently shows that shame tends to increase use, not reduce it.
You are not a label. You are not your worst moments. You are a person who found a way to cope with something real. And you deserve support in figuring out a better path.
We do not define people by their substance use. We do not see addiction as a moral failure. We see it as a human response to pain, stress, and unmet needs. Our approach reflects that.
Our Expertise in Addiction and Substance Use Treatment
The CBT Center was founded by Dr. Michelle Drapkin, a licensed psychologist with specialized training in Cognitive Behavioral Therapy. Dr. Drapkin and Dr. Andrew Keenan are both board-certified in Cognitive Behavioral Therapy through the American Board of Professional Psychology (ABPP), the oldest and most rigorous board certification body in psychology, founded in 1947.
Dr. Drapkin and Jamie Schwartz are also Diplomates of the Academy of Cognitive and Behavioral Therapies (A-CBT), the leading certifying organization specifically for cognitive and behavioral therapy.
Motivational Interviewing is a specialized focus of Dr. Drapkin’s clinical training and research. During her time on faculty at the University of Pennsylvania, Dr. Drapkin contributed to research integrating Motivational Interviewing with exposure-based approaches for individuals with co-occurring PTSD (Post-Traumatic Stress Disorder) and substance use. That work reflects a clinical truth we see every day: when trauma and substance use occur together, you need clinicians who understand both deeply and can treat them in an integrated way.
Dr. Drapkin is a member of the Anxiety and Depression Association of America (ADAA) and will be presenting at the ADAA 2026 Annual Conference in Chicago in a State of the Art Clinical session.
We bring the same depth and rigor to substance use treatment that we bring to everything else we do. And we understand that for most people who come to us with substance use concerns, it is not the whole story.
Motivational Interviewing: The Heart of How We Work
Motivational Interviewing (MI) is not just a technique we use. It is a philosophy about how change actually happens.
Most treatment approaches for substance use assume the person is ready to change and then give them strategies. MI starts somewhere different. It starts with the person’s own ambivalence, their own reasons, their own values, and their own timeline.
The research on MI is extensive and consistent. A 2023 Cochrane Review, the gold standard of evidence-based medicine, examined 93 randomized controlled trials involving 22,776 participants and found that Motivational Interviewing reduced substance use across drugs and alcohol, improved readiness to change, and increased treatment retention. That is one of the largest reviews of any psychological treatment for addiction ever conducted.
MI works because it does not try to push or persuade. It creates the conditions for people to persuade themselves. When change comes from your own values and your own reasoning, it sticks differently than when it comes from external pressure.
People often arrive uncertain. They are not sure they want to stop. They are not sure change is possible. They are not sure they deserve help.
We take all of that seriously. We do not argue with it. We work with it.
How We Treat Addiction and Substance Use
We do not start by telling you what you should do.
We start by understanding your relationship with substances. What is working. What is not. What matters to you. And what you actually want, not what you think you are supposed to want.
From there, we build a plan that fits you.
Cutting back, stopping, or starting with understanding: there is not one right path. We explore all of them together.
We draw from evidence-based approaches including:
- Motivational Interviewing (MI), which helps you clarify your own reasons for change and work through ambivalence at your own pace
- Cognitive Behavioral Therapy (CBT), which helps you identify patterns and triggers, manage urges, and build alternative coping strategies
- Acceptance and Commitment Therapy (ACT), which helps you stay connected to what matters even when urges are present
- Integrated trauma treatment, for people whose substance use is connected to unprocessed trauma or PTSD
Because substance use so often overlaps with anxiety, depression, and trauma, we address those together, not separately. Treating one without the other is not just incomplete. It often does not work.
What Addiction Therapy Looks Like in New Jersey, New York, and Online
Addiction therapy at The CBT Center follows a clear structure, but it is never rigid.
We start by understanding what has been happening and how substances fit into your life. Not to judge it. To understand it.
You have options. We explore all of them together. Abstinence is one path, but it is not the only one, and it is not always the starting point.
We help you:
- Understand the patterns and triggers that drive use
- Build skills to manage urges without acting on them
- Navigate high-risk situations with more confidence
- Develop alternative ways to meet the needs substances have been meeting
- Address the anxiety, depression, or trauma that often underlies substance use
- Reconnect with what matters to you and move toward it
We also specialize in working with couples and families. When it makes sense, we involve partners or family members to support change in a way that is constructive and sustainable. You can read more about this in the FAQ section below.
This work is not simple, and it is not easy. We partner with you through it.
When Trauma and Substance Use Occur Together
For a significant number of people, substance use and trauma are deeply connected.
Substances often start as a way to manage trauma symptoms: to quiet hypervigilance, numb intrusive memories, or get through a day when everything feels threatening. It makes sense. It works, until it does not.
What is less often discussed is how difficult it can be to treat one without the other. When trauma goes unaddressed, substance use tends to return. When substance use is addressed but trauma symptoms remain, the pull back toward substances stays strong.
This is an area where The CBT Center has specific expertise. Dr. Drapkin’s research at the University of Pennsylvania focused on integrating Motivational Interviewing with Prolonged Exposure therapy for people with co-occurring PTSD and substance use. That means we do not just understand both conditions. We have clinical training and research experience in treating them together, in a coordinated and evidence-informed way.
If you are carrying both, you do not have to choose which one to address first. We can work with the full picture.
Who We Work With
We work with adults across a wide range of substance use presentations. That includes:
- People who are not sure if their use is a problem but have started wondering
- Those who have tried to cut back or stop on their own and found it harder than expected
- People who use substances to manage anxiety, depression, stress, or trauma
- Those who are ready to stop but do not know where to start
- People who are not ready to stop but want support in understanding their relationship with substances
- Those who have tried treatment before and it did not work, or did not stick
- People with co-occurring PTSD, anxiety, or depression alongside substance use
- Partners and family members who want support in how to respond to a loved one’s substance use
You do not need to be in crisis to reach out. You do not need to have hit a bottom. You just need to be wondering whether something could be different.
When to Consider Therapy for Substance Use
If you’re here reading this, something brought you here.
You might feel alone in this. You might not be ready to stop. And at the same time, you are wondering.
You do not have to be ready to quit.
You do not need a perfect plan.
You just need a place to begin.
We do not see you as a label. We see you as a person who found a way to cope, and who deserves real support in finding a better path.
Get Started
We serve clients in New Jersey, New York, and across 40 or more states through PSYPACT, a national compact that allows licensed psychologists to practice across state lines. Wherever you are, we can likely work together.
We’ll follow up within a few hours to connect, learn a bit more about what you’re looking for, and help you figure out next steps.
Related Services
Anxiety Therapy
Anxiety is exhausting — the racing thoughts, the avoidance, the "what ifs." CBT gives you real tools to break the cycle and get your life back.
Depression Therapy
Depression lies to you — it tells you nothing will help and you don't deserve better. We know that's not true, and we'll help you find your way back.
Trauma and PTSD Therapy
What happened to you matters — and so does what comes next. We use evidence-based approaches to help you process the past and move forward.
Cognitive Behavioral Therapy (CBT)
CBT is the most researched, most effective talk therapy available. We don't just use CBT — we're board-certified in it. This is what we do, and we're really good at it.
Individual Therapy
One clinician, focused entirely on you. Full-hour sessions, real follow-through between appointments, and a team that actually picks up the phone.
Virtual Therapy
Great care shouldn't depend on where you live. We're licensed in NJ, NY, and 40+ states — so wherever you are, we can likely work together.
Frequently Asked Questions
No. There are different paths, and we help you find what fits. Some people come in wanting to stop entirely. Others want to reduce use or understand their patterns before deciding. Abstinence is one option, not a requirement. We start with what you actually want, not what we think you should want.
Motivational Interviewing (MI) is a collaborative, evidence-based approach that helps people explore and resolve their own ambivalence about change. Rather than pushing or persuading, MI helps you clarify what you want, why it matters to you, and how you want to get there. A 2023 Cochrane Review of 93 randomized controlled trials found MI significantly reduces substance use and improves treatment retention. It is central to how we work.
That is okay. Readiness exists on a spectrum. We work with people at every stage, including people who are curious, ambivalent, or just starting to wonder. You do not have to arrive ready. Part of our job is helping you figure out what you actually want.
That is more common than you might think. And it is useful information, not evidence that you cannot change. When something has not worked, we want to understand why. What was tried, what got in the way, what was missing. We use that experience to guide what we try next.
Yes. Twelve-step programs are one path, but they are not the only one. We also draw on SMART Recovery, which is a science-based, secular alternative focused on self-management and behavioral tools. And individual therapy itself is a strong, evidence-based approach to substance use that does not require any group attendance.
This is extremely common and something we have specific expertise in. For many people, substances are a way of managing symptoms that have not been directly treated. We address both at the same time, not separately. If trauma and substance use are both present, we have research-informed approaches specifically designed for that combination.
You cannot force change, but your responses genuinely matter. We work with family members and partners to help them understand substance use, reduce accommodation behaviors that may be maintaining the problem, and find more effective ways to support change. Sometimes that work happens alongside the person who is struggling, and sometimes it happens independently.
No. We have heard it all, and we approach this work without judgment. Shame is one of the biggest barriers to change. Our job is to create a space where you can be honest about what is happening and start to figure out what you want to do about it.
It depends on the complexity of what is going on and what your goals are. Some people make significant progress in 12 to 16 sessions. Others with more complex presentations, including co-occurring trauma or long-standing patterns, may need more time. We talk about realistic expectations early and adjust as we go.
Yes. We offer virtual therapy for clients throughout New Jersey, New York, and more than 40 states through PSYPACT. Research supports the effectiveness of Motivational Interviewing and CBT for substance use delivered via telehealth, with outcomes comparable to in-person care.