Online Therapy for Co-Occurring Disorders — Dual Diagnosis
What Are Co-Occurring Disorders?
Co-occurring disorders, often referred to as dual diagnosis, indicate the simultaneous presence of a mental health condition alongside a substance use disorder. This phenomenon is more prevalent than many people realize. Research consistently reveals that approximately half of those with a substance use disorder also struggle with at least one mental health condition, and the reverse is equally true.
This connection is no coincidence. Mental health conditions and substance use are intricately linked, often stemming from shared neurological, psychological, and environmental factors.
Common combinations of dual diagnosis include:
- Anxiety disorder and alcohol use disorder
- Depression and cannabis or opioid use disorder
- PTSD and substance use
- Bipolar disorder with stimulant or alcohol use
- ADHD and substance misuse
- Borderline Personality Disorder (BPD) alongside substance use
- Chronic pain, depression, and opioid dependence
If you've ever turned to substances to manage emotional pain, quiet intrusive thoughts, navigate social situations, or simply to feel normal, it's important to recognize that this is not a moral failure. Such behaviors often have deep psychological roots, and they are exactly what integrated treatment for dual diagnosis aims to address. Online therapy can be a valuable resource in this journey toward recovery.
Why Treating Both Conditions Together Changes Everything
When mental health conditions and substance use disorder 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 integrated treatment approach is the clinical standard of care for co-occurring disorders — and it's the only approach I use, including options like online therapy.
A Rare Combination of Credentials for Complex Presentations
Most psychologists are not trained in substance use treatment, and most substance use counselors lack the level of training that doctoral mental health clinicians possess. I am both a dual-diagnosis specialist and a Credentialed Alcoholism and Substance Abuse Counselor (CASAC) in New York State.
I hold a Doctor of Psychology (PsyD) from California Southern University, where I graduated Summa Cum Laude. My clinical experience encompasses inpatient psychiatric units, outpatient mental health programs, and community-based substance use services. This diverse background provides me with a unique, ground-level understanding of how co-occurring disorders manifest across various severity levels.
When you engage in online therapy with me, you are not working with a generalist who occasionally addresses substance use disorder. Instead, you are collaborating with a professional who deeply understands the clinical complexity of mental health conditions and integrated treatment approaches, ensuring a comprehensive perspective on your experience.
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 to dual diagnosis draws from the most well-researched and effective modalities for integrated treatment of mental health conditions and substance use disorders.
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 the complexity found in co-occurring disorders.
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. This method can be particularly useful in online therapy settings where flexibility is essential.
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 communicate effectively — or who have previously tried treatment but found it didn't address the full complexity of their mental health conditions and substance use disorder.
My clients often express feeling out of place in traditional mental health spaces due to their history with substance use, or feel they don't belong in conventional recovery environments because of the severity of their mental health needs. This practice is specifically designed to cater to that unique experience.
I specialize in integrated treatment for adults navigating:
- Dual diagnosis involving alcohol use disorder and anxiety or depression
- Opioid use disorder alongside co-occurring mood disorders
- Cannabis use disorder linked with psychosis or anxiety
- Stimulant use in relation to ADHD or bipolar disorder
- Substance use connected to trauma or PTSD
- Early recovery while managing ongoing mental health needs
- High-functioning substance use that appears fine from the outside
- Co-occurring disorders in LGBTQ+ adults
- Professionals, executives, and high-achievers dealing with dual diagnosis in a private setting
Additionally, I offer online therapy options for those seeking flexible solutions for their mental health and substance use challenges.
Dual Diagnosis Treatment Online — Private, Flexible, and Accessible
Seeking treatment for co-occurring disorders, which often involve both mental health conditions and substance use disorder, takes significant courage. The last thing you need is logistical barriers in the way. All sessions for online therapy take place via secure, HIPAA-compliant video, from the privacy of your own space.
If you're searching for an online dual diagnosis therapist in New York, a co-occurring disorders psychologist in Texas, or integrated treatment for mental health and substance use disorder in Colorado, Virginia, Wisconsin, or Delaware — I'm licensed and ready to work with you.
Evening appointments are available, and confidentiality is strictly maintained.
Frequently Asked Questions About Co-Occurring Disorder Treatment
What's the difference between a CASAC and a psychologist for substance use disorder treatment? A CASAC is a credentialed substance use counselor specifically trained in addiction and recovery, while a psychologist is a doctoral-level mental health clinician skilled in assessing, diagnosing, and treating mental health conditions. I hold both credentials, which allows me to offer fully integrated treatment for both dimensions of co-occurring disorders without needing to refer 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, particularly for those with a dual diagnosis — and it's one we can navigate together.
Is online therapy appropriate for dual diagnosis treatment? Yes, research supports online therapy as an effective format for both mental health and substance use treatment. Remote sessions can actually reduce barriers to consistent engagement, which is a crucial predictor of positive outcomes in dual diagnosis work.
Will you work alongside my existing treatment team? Absolutely. If you're collaborating 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 — it’s not a sign that you've failed or that treatment can't be effective. It often indicates that something important wasn't addressed. That's exactly the kind of clinical complexity this practice is designed to handle.
You Don't Have to Choose Which Part of Yourself to Heal
Co-occurring disorders, often referred to as dual diagnosis, are complex but treatable. With integrated treatment that includes doctoral-level clinical support understanding both mental health conditions and substance use disorder, lasting change is not just possible; it's the goal.
Let's discuss 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.