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Addiction Counseling in Washington DC and Bethesda
We work with people at every stage of recovery, from someone who has not told anyone yet to someone who has relapsed after years of sobriety. Sessions are 50 minutes, $250 to $450, at our Dupont Circle and Bethesda offices or online, seven days a week including evenings until 9pm.
Why shame keeps addiction going
Some treatment makes it harder to stop, because it never addresses the shame underneath. If the message is that you are weak, broken or a disappointment, the most reliable way to escape that feeling is the behavior you came in to change. The treatment feeds the problem.
We start somewhere else. The compulsion is doing a job — usually numbing something, or making an unbearable feeling briefly bearable. Until you know what that job is, stopping is a matter of willpower alone, and willpower runs out.
Relapse is information, not failure
Most people arrive expecting relapse to be the thing we all dread and avoid discussing. We treat it differently. A relapse tells you exactly what the behavior is protecting you from, and when it happens, which is usually the most useful clinical information available.
That distinction decides whether a setback restarts the work or ends it, and it is why people who have failed in other programs sometimes do well here.
How we work
Internal Family Systems
IFS fits addiction unusually well. It treats the compulsion as a part of you doing a protective job rather than a defect to be defeated, which takes the fight out of the room. Keith Miller is a Certified Level III IFS therapist. Read more about IFS.
Understanding the cycle
Whether the substance is alcohol, drugs, food, sex or a screen, the pattern runs through emotion rather than around it. We map your particular sequence — the trigger, the relief, the aftermath — so you can interrupt it somewhere other than the last moment.
Mindfulness and craving
A craving feels permanent while it is happening and rarely lasts as long as it seems to. Learning to notice one without acting on it is a trainable skill, and it gives you somewhere to stand that is not white-knuckling.
Working alongside medical care
We are a counseling practice, not a detox facility. If you need medically supervised withdrawal we will say so and help you find it. Anna Richards provides psychiatric care from our Bethesda office where medication has a role.
Pornography and sex addiction
This is a large part of the addiction work we do, and it is the hardest for most people to raise. Compulsive pornography use, sexual behavior that has outrun what you intended, and the secrecy that grows around both.
Two things worth saying plainly. First, we do not treat it as a moral failure, because that framing is what keeps people silent for years. Second, if you are in a relationship, the disclosure is often as difficult as the behavior, and we work with couples as well as individuals — see sex and intimacy counseling and counseling after an affair.
You can ask for a counselor experienced in this specifically when you call. You do not have to explain it to a receptionist.
What we work with
Alcohol
From drinking that has quietly become daily to long histories with several attempts at stopping behind them.
Drugs
Prescription and recreational, including the stretch after detox when the substance is gone and the reasons for it are not.
Pornography
Compulsive use, escalation, and the gap it creates in a relationship.
Sex and love addiction
Behavior that has outrun intention, and patterns of pursuit that leave you emptier each time.
Gambling
Including online and sports betting, where the losses stay hidden longer than they used to.
Food and eating
Bingeing, restriction and the use of food to manage feeling. We also offer eating disorder treatment.
Shopping and spending
Compulsive buying, and debt accumulated in a way that is difficult to explain to anyone.
Gaming and screens
Mobile and online gaming that has taken over time you meant to spend elsewhere.
Who you would see
Dr. Mark Jacobsen, PhD, LICSW has more than 24 years in practice and works specifically with recovery from alcohol and addiction, alongside depression in men and anxiety disorders. He sees clients at Dupont Circle and online. Read his full profile.
You do not have to work out who fits. Call the referral coordinator on extension 0 and describe what is happening; we will match you. You can also see the full team.
When to consider addiction counseling
- You have tried to stop a behavior and found you could not
- Someone else — a doctor, a partner, another clinician — has raised concerns about your drinking, drug use or eating
- The behavior is interfering with your work or your relationships
- Hiding it takes real time and energy
- You have stopped before and started again
- A court has ordered you to attend counseling
You do not need to have hit a crisis to come. Most people who contact us are still functioning, and would rather not wait until they are not.
Where we are
We see clients at 1320 19th Street NW in Dupont Circle, opposite the Metro, and at 4300 Montgomery Avenue in Bethesda. Both offer evening appointments until 9pm and weekend slots, and video sessions are available with the same counselors if being seen walking into a counseling office is itself a concern.
Fees and insurance
Sessions are $250 to $450 for 50 minutes depending on the counselor. There is a free phone consultation first. We do not bill insurance directly, though clients who submit their own out-of-network claims commonly recover 40–60% of the cost. See our full policies and fees.
Frequently asked questions
Do I have to be abstinent to start?
No. Most people are still using when they first come in. Requiring abstinence before the first session would rule out nearly everyone who needs the help.
Do you run a detox or inpatient program?
No. We are an outpatient counseling practice. If you need medically supervised withdrawal we will tell you and help you find it, then work with you afterwards, which is often when the harder part starts.
Will you tell my partner or my employer?
No. What you say is confidential, with the narrow legal exceptions every therapist has around immediate danger. If you want your partner involved, that is your decision and we can help you plan it.
Can I talk about pornography or sex addiction without being judged?
Yes, and you can ask for a counselor experienced in it when you call rather than explaining on the phone. Shame is the reason most people wait years, and it is the first thing we work on.
What if I have relapsed before?
Then you know something useful about what the behavior is protecting you from. Bring them up rather than leaving them out.
Getting started
Call or text
Reach us on 202-629-1949 and ask for the referral coordinator on extension 0, or use the enquiry form.
Free phone consultation
Say as much or as little as you want to. No cost and no commitment at this stage.
Matched to a counselor
We match you to whoever suits your situation, then book your first 50-minute session.