Online Therapy for Co-Occurring Disorders — Dual Diagnosis
What Are Co-Occurring Disorders?
Co-occurring disorders — also called dual diagnosis — refers to the simultaneous presence of a mental health condition and a substance use disorder. This is far more common than most people realize. Research consistently shows that roughly half of people with a substance use disorder also live with at least one mental health condition, and vice versa.
This isn't coincidence. Mental health struggles and substance use are deeply interconnected — often sharing underlying neurological, psychological, and environmental roots.
Common co-occurring combinations include:
- Anxiety disorder and alcohol use disorder
- Depression and cannabis or opioid use disorder
- PTSD and substance use
- Bipolar disorder and stimulant or alcohol use
- ADHD and substance misuse
- Borderline Personality Disorder (BPD) and substance use
- Chronic pain, depression, and opioid dependence
If you've ever used substances to cope with emotional pain, silence intrusive thoughts, get through social situations, or simply feel normal — that's not a moral failure. That's a pattern with deep psychological roots, and it's exactly what integrated dual diagnosis treatment is designed to address.
Why Treating Both Conditions Together Changes Everything
When mental health and substance use are treated separately — in different programs, by different providers, without coordination — important clinical information falls through the cracks. Triggers go unaddressed. Coping patterns get reinforced. Relapse rates stay high.
Integrated dual diagnosis treatment keeps both conditions in view at the same time, understanding how they interact, what they're each responding to, and how progress in one area supports progress in the other.
This is the clinical standard of care for co-occurring disorders — and it's the only approach I use.
A Rare Combination of Credentials for Complex Presentations
Most psychologists are not trained in substance use treatment. Most substance use counselors are not doctoral-level mental health clinicians. I am both.
I hold a Doctor of Psychology (PsyD) from California Southern University, where I graduated Summa Cum Laude, and I am a Credentialed Alcoholism and Substance Abuse Counselor (CASAC) in New York State. My clinical background spans inpatient psychiatric units, outpatient mental health programs, and community-based substance use services — giving me a rare, ground-level understanding of how co-occurring disorders present across the full spectrum of severity.
This means that when you work with me, you're not getting a generalist who occasionally addresses substance use. You're getting a dual-diagnosis specialist who understands the clinical complexity of your experience from the inside out.
An Integrated, Evidence-Based Approach to Dual Diagnosis Treatment
Treatment for co-occurring disorders requires clinical flexibility — meeting you where you are, adjusting as your needs evolve, and always keeping both conditions in view simultaneously. My approach draws from the most well-researched, effective modalities for dual diagnosis work.
Cognitive Behavioral Therapy (CBT)
CBT is one of the most extensively validated treatments for both mental health conditions and substance use disorders. We use it to identify the thought patterns and beliefs that drive both emotional distress and substance use — and to build practical, evidence-based alternatives.
Dialectical Behavior Therapy (DBT)
Originally developed for individuals with intense emotional experiences and self-destructive behaviors, DBT is particularly effective for co-occurring presentations. Its four skill modules — mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness — directly address the emotional dysregulation that underlies much of co-occurring disorder complexity.
Motivational Interviewing (MI)
Change is rarely linear, and ambivalence is a normal part of recovery. Motivational Interviewing is a collaborative, evidence-based approach that helps you explore and resolve ambivalence about change — without judgment, pressure, or shame.
Trauma-Informed Care
Trauma is one of the most common underlying factors in co-occurring disorders. A trauma-informed lens ensures we address the root experiences driving both mental health symptoms and substance use, not just the surface behaviors.
Relapse Prevention Planning
Recovery is not a destination — it's an ongoing process. We'll build concrete, personalized relapse prevention strategies that account for your specific triggers, patterns, and life circumstances, so you have a real plan for the moments that feel hardest.
Who This Is For?
I work with adults who are tired of being shuffled between systems that don't talk to each other — or who have tried treatment before and found it didn't address the full complexity of what they were carrying.
My clients often describe feeling like they don't quite fit in traditional mental health spaces because of their substance use history, or don't fit in traditional recovery spaces because of the severity of their mental health needs. This practice is built for exactly that experience.
I work with adults navigating:
- Alcohol use disorder alongside anxiety or depression
- Opioid use disorder and co-occurring mood disorders
- Cannabis use disorder and psychosis or anxiety
- Stimulant use and ADHD or bipolar disorder
- Substance use connected to trauma or PTSD
- Early recovery with ongoing mental health needs
- High-functioning substance use — the kind that looks fine from the outside
- Co-occurring disorders in LGBTQ+ adults
- Professionals, executives, and high-achievers navigating dual diagnosis in private
Dual Diagnosis Treatment Online — Private, Flexible, and Accessible
Seeking treatment for co-occurring disorders takes significant courage — and the last thing you need is logistical barriers in the way. All sessions take place via secure, HIPAA-compliant video, from the privacy of your own space.
If you're looking for an online dual diagnosis therapist in New York, a co-occurring disorders psychologist in Texas, or integrated mental health and substance use treatment in Colorado, Virginia, Wisconsin, or Delaware — I'm licensed and ready to work with you.
Evening appointments available. Confidentiality strictly maintained.
Frequently Asked Questions About Co-Occurring Disorder Treatment
What's the difference between a CASAC and a psychologist for substance use treatment?
A CASAC is a credentialed substance use counselor trained specifically in addiction and recovery. A psychologist is a doctoral-level mental health clinician trained in assessment, diagnosis, and treatment of mental health conditions. I hold both credentials — which means I can provide fully integrated care for both dimensions of co-occurring disorders without referring you elsewhere.
Do I need to be sober before starting therapy?
No. You do not need to be sober, in a program, or at any particular stage of change to begin. We start from wherever you are. Waiting until things are "under control" before seeking help is one of the most common barriers to treatment — and it's one we can work around together.
Is telehealth appropriate for dual diagnosis treatment?
Yes — research supports telehealth as an effective format for both mental health and substance use treatment. Remote sessions can actually reduce barriers to consistent engagement, which is one of the most important predictors of positive outcomes in dual diagnosis work.
Will you work alongside my existing treatment team?
Absolutely. If you're working with a prescriber, a recovery coach, a psychiatrist, or a program, coordinated care is always in your best interest. With your consent, I'm happy to communicate and collaborate with your broader treatment team.
What if I've relapsed before and feel like treatment hasn't worked?
Relapse is a common part of recovery — not a sign that you've failed or that treatment can't work. It's usually a sign that something important wasn't addressed. That's exactly the kind of clinical complexity this practice is designed for.
You Don't Have to Choose Which Part of Yourself to Heal
Co-occurring disorders are complex — but they are treatable. With integrated, doctoral-level clinical support that understands both mental health and substance use from the ground up, lasting change is not just possible. It's the goal.
Let's talk about where you are and where you want to be.
If you are experiencing a mental health emergency, please call 911, visit your nearest emergency room, or contact the Suicide & Crisis Lifeline at 988.