Start with a focused assessment (substances, patterns, withdrawal risk, medical/mental health, safety) and clear goals you actually want—quit, reduce, or contain. Treatment blends motivational interviewing (to resolve “part of me wants to stop” ambivalence), CBT for triggers and thinking traps, contingency management (earn rewards for change), and skills from DBT for urges and emotions. We build a concrete plan: stimulus control and device/bar hygiene, high-risk maps, if-then routines for cravings, sleep and nutrition basics, and a written slip protocol that turns setbacks into data. Medication options are coordinated when appropriate (e.g., naltrexone, buprenorphine, acamprosate, disulfiram). Family involvement is available using CRAFT to reduce enabling and increase support. You’ll get options for peer support that fit you (12-Step, SMART, Refuge). Co-occurring issues (anxiety, depression, ADHD, trauma) are treated in parallel. We track outcomes you can feel—fewer use days, lower spend, cravings down, trust and functioning up—and step up care quickly if needed (detox, IOP/PHP, or residential). The aim: fewer crises, more choice, and durable self-trust.