Substance Use Psychiatry · Seattle · Statewide WA Telehealth
Talk it through with a provider who looks at the substance use and the mood underneath it, together.
If drinking or using has started to take more than it gives, you can talk it through with a psychiatric provider who looks at the whole picture. Same-week appointment availability. Most major insurance plans accepted. In person at three Seattle-area offices or by secure video anywhere in Washington.
Substance use psychiatry is outpatient psychiatric care for adults whose drinking or substance use has started to cause problems, often addressed alongside the depression or anxiety that comes with it. Counseling Services for Wellbeing provides it in Seattle and statewide by secure video. This is outpatient care, not detox or rehab. We accept most major insurance plans and book same-week.
It started as one, and somewhere along the line it stopped being that.
It started as one drink, or one way to take the edge off, and somewhere along the line it stopped being that. Now the drink is several, or the thing you reach for is how you get through the day or how you come down from it. You tell yourself you will cut back, and for a while you do, and then you do not.
The low mood or the anxiety underneath it makes the whole thing harder. The substance was supposed to quiet it, and instead the two have started to feed each other. You have tried to stop on your own and could not make it stick, and the part that keeps you from reaching out is not knowing whether you will be met with help or with judgment.
You should be able to talk it through without the conversation starting from shame. The next step is not a confession and it is not a lecture. It is a real conversation with a psychiatric provider who looks at the substance use and the mood underneath it together, and helps you figure out what would actually help.
Outpatient psychiatric care for adults whose drinking or using takes more than it gives.
The one that became several
Drinking or using has started to cause problems in your life. What was meant to take the edge off now takes more than it gives.
Using to quiet the mood
Reaching for a substance to manage depression or anxiety, where the two have started to feed each other rather than ease it.
Tried to stop, did not stick
You have tried to cut back or stop on your own, more than once, and it has not held the way you hoped it would.
Outpatient, not residential
You want psychiatric support and coordinated therapy you can fit around your life, not a residential program away from it.
Not sure what you need
You are not sure what level of help fits your situation, and you want someone to talk it through with before deciding anything.
Help that does not start with shame
You want a conversation that begins with understanding your situation, not a lecture and not a confession.
The entry points are different, but the work is the same. The page never tells you that you have a disorder, and the first step is a conversation, not a commitment.
How psychiatric care for substance use works here.
We look at substance use the way we look at everything else, as part of whole-person care rather than a moral failing or an isolated habit, alongside your sleep, your mood, your body and the life around it.
Reach out
A short form or a call. We hear what is going on, where the substance use is hitting hardest, and what you have already tried. The first step is a conversation, not a confession.
Get matched
We pair you with a psychiatric provider whose focus fits your situation, and you see the same provider across your care for continuity, so you are not re-explaining your history every visit.
Start this week
First appointment in person at one of three Seattle-area offices or by secure video anywhere in Washington. The first visit is a real conversation, not a rushed med check and not a lecture, and you have a real say in the plan that comes out of it.
Why we address both at once.
Substance use rarely arrives on its own. For many people the drinking or the using and the depression or anxiety are tangled together, each one making the other harder to shake. A substance used to quiet anxiety can deepen it over time, and a low mood can make the pull toward a substance stronger. When substance use and a mental health condition occur together, that pattern is often called a co-occurring disorder, which the Substance Abuse and Mental Health Services Administration describes alongside its national helpline.
The same provider can look at the substance use alongside the depression or anxiety, and the team includes a large therapy roster, so the substance-use work and the mood work can be coordinated rather than split across separate providers. Medication management is described generally here because prescribing is a clinical decision made after an evaluation, and therapy is available alongside when that fits the work. Psychiatric care here may help you address substance use and the mood underneath it. We will not promise sobriety, recovery or any particular outcome.
How we compare
Counseling Services for Wellbeing vs. typical Seattle substance-use options.
| Abstinence-only programs | General psychiatry practices | Counseling Services for Wellbeing | |
|---|---|---|---|
| Substance use and mood addressed together |
Substance use only
|
Mood only, skips the substance use
|
Both, in one place
|
| Insurance accepted |
Often cash-pay or program fees
|
Varies by practice
|
Kaiser, Premera, Regence, Aetna, UnitedHealthcare, Cigna
|
| First appointment |
Intake and waitlist process
|
Often weeks out
|
Same-week scheduling
|
| Intensive structure and detox |
Yes, structured and intensive
|
Outpatient only
|
Outpatient, refers out for detox
|
| Same provider each visit |
Rotating program staff
|
Usually
|
Same provider, continuous care
|
| Non-judgmental, whole-person approach |
Abstinence-first, program rules
|
Symptom-focused med check
|
Meets you where you are
|
-
Substance use and mood addressed together
-
Abstinence-only programsSubstance use only
-
General psychiatry practicesMood only, skips the substance use
-
Counseling Services for WellbeingBoth, in one place
-
-
Insurance accepted
-
Abstinence-only programsOften cash-pay or program fees
-
General psychiatry practicesVaries by practice
-
Counseling Services for WellbeingKaiser, Premera, Regence, Aetna, UnitedHealthcare, Cigna
-
-
First appointment
-
Abstinence-only programsIntake and waitlist process
-
General psychiatry practicesOften weeks out
-
Counseling Services for WellbeingSame-week scheduling
-
-
Intensive structure and detox
-
Abstinence-only programsYes, structured and intensive
-
General psychiatry practicesOutpatient only
-
Counseling Services for WellbeingOutpatient, refers out for detox
-
-
Same provider each visit
-
Abstinence-only programsRotating program staff
-
General psychiatry practicesUsually
-
Counseling Services for WellbeingSame provider, continuous care
-
-
Non-judgmental, whole-person approach
-
Abstinence-only programsAbstinence-first, program rules
-
General psychiatry practicesSymptom-focused med check
-
Counseling Services for WellbeingMeets you where you are
-
We are not a rehab, a detox or a residential program, and we will not pretend to be. We are the outpatient option that takes your insurance, gets you in this week, and looks at the substance use alongside the depression or anxiety underneath it. If you need a higher level of care, we will help you understand that and point you toward the right support.
Most major insurance plans accepted
We recommend confirming your benefits with your insurer before your first appointment, so psychiatric care for substance use here does not have to be hospital-slow or cash-pay.
Meet some of our providers.
A deeper bench than the five here, across psychiatry and a large therapy team. We match you with a provider whose focus fits your situation.
Deeper bench than the five here. Tell us what is going on and we will match you with the right provider.
Three offices or secure video anywhere in Washington.
If getting to an office is hard, or the privacy of being at home with no waiting room lowers the barrier to reaching out, psychiatric care for substance use is also available by secure video with the same provider you would see in person.
What adults ask before starting substance use psychiatry.
Do you take my insurance for substance use care?
We accept Kaiser, Premera, Regence, Aetna, UnitedHealthcare and Cigna. Much of the substance-use market is either program-based or cash-pay, so taking these carriers is one of the bigger differences when you are looking around. We recommend confirming your specific benefits with your insurer before your first appointment.
Is this a rehab or detox program?
No. This is outpatient psychiatric care and coordinated therapy, not a detox, rehab or residential program. If someone needs a higher level of care, the team will help them understand that and point them toward the right support rather than keeping them somewhere that does not fit. Knowing what level of help matches your situation is itself a useful answer to come away with.
Do you treat substance use and depression or anxiety together?
Yes. Substance use and depression or anxiety often travel together, and we address both rather than treating one and ignoring the other. The same provider can look at the substance use and the mood underneath it, and therapy is available alongside when that fits.
How soon can I be seen?
First appointments are available the same week. You do not have to wait weeks for an opening. Reach out and we will find the first opening that works for you, in person or by secure video.
Do you offer this online or only in person?
Both. You can meet in person at our Green Lake, Burien or Smokey Point offices, or by secure video anywhere in Washington with psychiatry by secure video. For some people the privacy of being at home, with no waiting room, makes it easier to reach out.
Will I be judged?
No. The approach here is non-judgmental, and the conversation starts with understanding your situation rather than from shame. You can talk it through honestly, and the provider meets you where you are. If you would like more information or support outside of an appointment, the Substance Abuse and Mental Health Services Administration runs a free, confidential national helpline.
Where are your offices?
We have offices in Green Lake in Seattle, in Burien and in Smokey Point in Arlington, plus secure video sessions anywhere in Washington with the same provider either way.
You do not have to sort it out alone, or start the conversation from shame.
If drinking or using has started to take more than it gives, you can talk it through with a psychiatric provider this week. Counseling Services for Wellbeing accepts most major insurance plans, books first appointments the same week, and offers outpatient psychiatric care for substance use addressed alongside depression and anxiety, in person at our Green Lake, Burien and Smokey Point offices or by secure video across Washington.
