Addiction Therapy

What is Substance Abuse Counseling? by Stella Kimbrough

Addiction Counseling


The aim of substance abuse counseling is to help make your life better, rather than just suppressing substance use. Through substance abuse counseling, you and your therapist can explore ways in which your life without substances can become better than your life with substances. You and your therapist will come up with mutually agreed-upon goals, and a plan to reach them. (It is understood in substance abuse counseling that when people get what they want out of treatment, they have better outcomes!) A substance abuse counselor believes in you and knows that you have within yourself everything you need to succeed, and that together you and your counselor will find it. The key elements in substance abuse counseling are safety, collaboration, empathy, respect, acceptance, hope, and cultural awareness. Substance abuse counseling recognizes a person’s innate strengths and abilities, and that people make the best possible choices they can at any given time. Change is not a straight line; ups and downs are part of the process! One major factor in substance abuse counseling is YOU! As in: how motivated are you to change? Through substance abuse counseling, we will explore your reasons for seeking change, your needs, your commitment, your ability, and your desire to change. We will look at obstacles and will problem-solve together. At the end of the day, the most important factor that has been shown to predict substance use abstinence is COMMITMENT – i.e. “I will go to that meeting today.”

If you or someone you love is struggling with addiction, we are here to help.

Stella Kimbrough, MSW, LSW

Stella Kimbrough, MSW, LSW


4 Things to Consider When Wondering If You Struggle With Addiction

4 things to consider when wondering if you struggle

with addiction:

contributed by Stella Kimbrough, MSW, LSW

(Adapted from the CAGE substance abuse screening tool)

1) Have you ever felt the need to cut down on your drinking or substance use?


2) Have you felt annoyed by someone telling you to cut back or criticizing you for your

drinking or substance use?

3) Have you ever felt guilty about your drinking or substance use?

4) Have you ever felt the need to drink or use substances to steady your nerves or get rid

of a hangover?

*If you have answered yes to two or more, you may have an alcohol or substance use problem

If you’d like more information on addiction counseling, or to schedule your appointment in our Philadelphia, West Chester or Bryn Mawr location, click here:

What is Substance Addiction? By Stella Kimbrough


Sometimes when people think of substance addiction, they imagine extreme compulsive and habitual use of substances that results in severe negative consequences. Substance addiction, however, can look different from person to person. Substance addiction, or substance use disorder as it’s classified in the Diagnostic and Statistical Manual of Mental Disorders, 5 th edition, refers to certain patterns of behavior related to using substances that lie on a continuum from mild to severe. People with a substance use disorder experience significant impairment or distress as a result of their substance use. There are specific symptoms associated with substance use disorder, which may include varying degrees of the following:

Addiction Symptoms

  •  The individual may take the substance in larger amounts or over a longer period than was originally intended

  •  The individual may want to cut down or stop the substance use and may have multiple unsuccessful attempts to decrease or discontinue use

  •  The individual may spend a great deal of time obtaining the substance, using the substance, or recovering from its effects

  •  The individual may plan daily activities around the substance use

  •  The individual may experience craving for the substance, which means an intense desire or urge for the drug

  •  The individual may have difficulty fulfilling obligations at work, school, or home

  •  The individual may continue substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance

  •  The individual may stop or become less involved in important social, occupational, or recreational activities because of the substance use

  •  The individual may withdraw from family activities and hobbies in order to use the substance

  •  The individual may use substances in risky or dangerous situations

  •  The individual may continue substance use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance

  •  The individual may be unable to stop using the substance despite negative consequences

  •  The individual may experience tolerance, which means that they need to use more of the substance over time to get the same effect

  •  The individual may experience withdrawal when they suddenly stop taking the substance, which may result in continued substance use to avoid feeling the withdrawal symptoms

  • People with substance addiction may experience the symptoms above with one substance or many different substances to varying degrees.


Some people with substance addiction can have many or all of the above symptoms, and some people have just a couple. Each person with a substance addiction may have different circumstances that led them to use substances, and generally speaking, substance addiction can affect anyone (any gender, any race, any ethnicity, etc.). It is estimated that roughly 5-10% of the population of the United States suffers from substance addiction. Since substance addiction carries a large stigma and many people may never seek treatment, the prevalence rate of addiction may be even higher. It is also true that substance addiction is associated with certain brain changes that remain long after the individual has stopped taking the substance. For example, a person may experience an intense craving or urge to use the substance when they are around the substance or when they are reminded of the substance. Additionally, people with substance addiction problems are vulnerable to returning to substance use after a period of sobriety, or relapsing. Relapse rates for drug addiction (40%-60%) are similar to other chronic illnesses such as type 1 diabetes (30%-50%) and asthma (50%-70%).

Stella Kimbrough, MSW, LSW

Stella Kimbrough, MSW, LSW

Stella Kimbrough is a Licensed Social Worker who specializes in providing substance abuse counseling to individuals who struggle with addiction. She uses a strengths based perspective and utilizes concepts from CBT, DBT motivational interviewing and psychodynamic therapy. If you’re ready to schedule an appointment in Bryn Mawr or Philadelphia, contact her now, click here.

5 Things You need to know before you start counseling

So, you’ve decided to start counseling and you’re ready to go.  Perhaps you’ve never done therapy before or maybe you’re looking to take a new approach.  Here are some things you need to know before you start counseling.

1.  Finding a therapist that you feel safe with is most important. 

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You can line up a bunch of great therapists, but if they’re not the best fit for you, you’re not going to do the intense, deep work you’re looking to do.  The role of a therapist is to be a guide through your journey, reflect back to you what we see and help you to overcome obstacles towards meeting your goals.  If you don’t click with your therapist or don’t feel safe enough to trust them, reaching your goals with them is unlikely.  Your therapist should be someone you can relax around and speak freely without fear of being judged.  Trust and safety are of paramount importance when you’re looking to do deep work on things like eating disorders, trauma, PTSD, couples’ work or issues specific to the LGBTQIA community.

2.  Specialties mean that there’s been special training in a particular issue. 

Our training in graduate school and doctoral programs very rarely provides training for specific diagnoses like PTSD, eating disorders or addictions.  So when a therapist decides to have a particular specialty, we need to seek out training geared specifically towards these issues.  If you notice that a therapist you’re interested in has indicated that we specialize in a particular area, you might want to ask us what sorts of training we’ve done to qualify us as an expert.  This will give you a better idea of how equipped we are to help you with your specific struggle.

3.  When you hire a therapist, you are paying for a space that is yours, for you.

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I’ve heard people say that therapy is like paying someone to be your friend.  This is actually not true.  When you hire a therapist and you pay money, what you are paying for is a safe, neutral, objective space and time where you can do your work.  It is an energy exchange.  You are not paying your therapist to care about you, you are paying for an hour in a room that is completely and totally about you and no one else.  In friendships, there’s a give and take, there’s a social obligation to ask how they are and be a support to them.  In a relationship with your therapist, you are taking time for yourself only and receiving support that is not reciprocated emotionally, only financially.  This dynamic can be extremely healing and empowering and for many, it is the only time and space where healing can truly take place.

4.  The more consistently you go, the more effective therapy is.

Sometimes, in an attempt to save money or save time, people want to schedule therapy sessions every other week or once per month.  While there’s nothing particularly wrong with scheduling like this, you may want to rethink the frequency and consistency of your therapy schedule.  You don’t have to be in therapy forever.  You can establish and work towards specific measurable goals with your therapist and see regular progress.  However, progress is more difficult to measure when you attend therapy inconsistently.  You may be having symptoms of PTSD, for example, and when several weeks go by without working on those particular symptoms, it is more difficult to get traction.  If you’re struggling with binging and purging and you go every week, you can check in with your therapist about the particular triggers and behaviors that may have lead to your binge and purge.  Don’t take my word for it, check it out for yourself.  Set a goal with your counselor and try going weekly, write down your progress and notice the differences between your weekly sessions over a period of at least 3 months versus bi-weekly or monthly progress over a 3-month period.  You may be surprised with the results.

5.  Therapy happens in stages.

Sometimes we think that as soon as we set foot in the door of a therapy office, we will be “cured” immediately or within a few sessions.  The reality is that there’s a therapeutic process which happens in stages.  The first stage is joining with your therapist or learning to trust them.  When we meet a new friend, we don’t usually tell them our deepest darkest right off the bat, it takes time and trust building to get to a place where we know they are a good friend.  A similar concept is applied in therapy.  Depending on the client, the level and amount of trauma and defenses, this stage can take anywhere from about a month to sometimes a year or even more.  Safety, trust and a therapeutic bond, known as a therapeutic alliance, is formed in order for the therapist to really know and understand the client and for the client to feel safe enough to open up and do their work. 

The second stage is where the work is done.  Since there’s now an underlying foundation established between therapist and client, the second stage is about vulnerability.  There is an unpacking, uncovering, examining and exploring the process that happens with the client and their trauma or their history.  This stage is where people see their patterns and make shifts and changes in their thoughts, beliefs, and behaviors.  The second stage of the therapeutic process is where clients reach their goals.

The third stage may or may not be part of the therapeutic process, dependent upon the client’s preference.  This stage is for maintenance.  The client continues therapy but perhaps doesn’t come every week any longer.  They use their therapist to check in with, get help with issues as they arise and review the goals and behaviors they established during the second stage.  Some people choose to forego this step and skip to the fourth stage.

The fourth stage of counseling is a closure process.  After attaining goals in the second stage, and maintaining new behaviors and thought processes in the fourth stage, this last and final stage is a review of accomplishments, work together and closure of the therapeutic relationship.  If the client chooses to end counseling, this practice of review and closure can be especially healing for those who have experienced traumatic grief or loss.  Saying goodbye in a healthy way, honoring the relationship without suddenly cutting it off is a beneficial process to learn about emotional maturity and sophistication. 

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I hope these tips have been helpful.  Please feel free to comment below with any other tips or feedback you have on this topic.  If you’d like to speak further about starting counseling or have any other questions about some of the things I’ve mentioned, please contact me at or call 610-314-8402.  I wish you luck in your endeavors and look forward to hearing from you soon!!