Outpatient Services

At CMC, we know that one size does not fit all!

Our expert psychologists are deeply trained in evidence-based approaches to address a range of issues, and we will work with you to come up with treatment options that best suit your needs. Along with substance use, our clinicians have decades of experience treating trauma, anxiety and other mood disorders, attention issues, and relationship problems.

At CMC, you can participate in individual therapy, couples therapy, or therapy with a group that targets your specific goals; or a combination of any of these. If you have a therapist outside of CMC and would like to continue working with them, that’s OK! We collaborate closely with outside therapists and tailor our work to complement your work with them. If you don’t have a therapist, you will be paired with a clinician at CMC who is trained in the approaches that best address your goals.

We provide individual and group telehealth sessions when appropriate. We also work closely with trusted colleagues who can provide expert psychiatric consultation/medication, nutritional consultation, and other types of wellness support.

Throughout your treatment, we will work with you to identify the family and peer relationships that need to be addressed in order for you to maintain long-term change. Family members are almost always doing the best they can when it comes to offering support, but many lack crucial understanding, skills, and strategies. On top of that, there may be a significant amount of anger, resentment, and hopelessness in a family by the time a person decides to seek help. We will help you constructively engage the people close to you so they can learn how to play a motivating and supportive role in your life moving forward.

Initial Consultation

Taking the first step toward making a change is a very important moment. While it can feel inspiring to finally ask for help, this step is often accompanied by questions, concerns, and uncertainties. The initial consultation process at CMC is designed to be collaborative, encouraging, informative, and meaningful. An effective plan for change begins with a clear and in-depth understanding of you and the circumstances that have brought you to the point of considering additional support.

As clinicians devoted to providing science-based care of the highest quality, we believe in the importance of accurate assessment to guide and individually tailor your therapy. Your consultation will include a variety of standardized questionnaires as well as a comprehensive interview with a psychologist. This allows us to understand you in a more complete way, including your life circumstances and experiences, relationships, strengths, vulnerabilities, and goals.

The initial consultation will conclude with a collaborative discussion, where we will make recommendations to help you understand all of your options, including individual therapy, group therapy, and/or couples or family therapy—in addition to other resources outside of CMC, if appropriate. We can collaborate with other treatment providers working with you and will invite their input in developing a plan. If together we decide an outside referral is the best option for you, we will work to help you identify and connect with the best possible outside support to meet your needs.

We know how crucial this step can be. We welcome the chance to collaborate with you and offer you our best thinking and experience in developing a way forward that leads to success.

Individual Therapy

CMC clinicians are trained in a variety of cutting-edge approaches, and we work hard to match you with the person on our team who is trained in the clinical methods best suited to your needs. We will help you clarify the patterns in your life you wish to change and expose you to strategies that can help you implement those changes. 

Therapy at CMC is not a passive process; it is active, engaging, and collaborative. Individual therapy is supplemented by our unique behavioral tracking system that gives ongoing feedback on our work together and your progress.

Treatment at CMC is individualized to meet your needs. No matter your motivation level—whether you are reluctant to change or eager for the tools to reach your goals—we will work to design a program that meets you where you are.

Group Therapy

There are a wide range of groups available at CMC, and we do our best to help you find a group that best fits your needs. Aside from some specialty groups, groups are no larger than eight people, and they are all run by at least one doctoral-level clinician (usually two).

Our structured groups can be especially useful when you are trying to learn strategies for coping with cravings, regulating emotions, or trying to make new life choices. Our process groups are more open-ended in content and focus on maintenance issues such as relationships, professional life, and life goals. All of our groups incorporate relaxed, non-threatening exposure to mindfulness practices to increase mind-body awareness, an essential skill for beginning and maintaining positive change. 

Please reach out to us for current offerings!

Groups include:

Edit

Our Day Programs (similar in intensity to IOP, intensive outpatient program, level of care) include two 80-minute, skills-focused groups per day, including Dialectical Behavior Therapy (DBT) skills, DBT consultation, Positive Communication Skills Training, Weekend Planning, Weekend Outcome, Moving Forward, and CBT-Relapse Prevention. We ask that clients at this level of care have the goal of abstinence for the period of time they are in the group, since the objective is to practice these skills instead of turning to a substance to cope. Twice-weekly drug testing and breathalyzing are also part of the day program structure.

Clients in intensive services also meet individually with a CMC clinician to help deepen and support the skills learned in groups. Those participating in ongoing psychotherapy with outside providers are welcome and encouraged to continue treatment while receiving services at CMC.

Edit

Tools for Change (CBT)
This group exposes participants to a variety of cognitive-behavioral skills to help achieve behavior change. We ask that clients in this group have the goal of abstinence for the period of time they are in the group, since the objective is to practice new skills. Participants learn skills that promote behavior change and learn to continually cultivate internal motivation. Sessions also target underlying problems such as depression or anxiety and encourage the development of healthy life habits.

Harm Reduction/Moderation
A skills-based group focusing on motivation and goal setting for clients who seek moderation or would like to reduce the negative consequences associated with their substance use and other risky behaviors.

Dialectical Behavior Therapy (DBT) Skills Groups
Dialectical Behavior Therapy (DBT) is an established evidence-based treatment that helps people change their relationship with substances and other destructive behaviors. In this group, participants learn mindfulness skills, interpersonal effectiveness skills, emotion regulation skills (i.e., how to recognize and shift how you feel without engaging in harmful behaviors), and distress tolerance (how to bear pain effectively without making difficult situations worse). Participants practice these skills in the outside world and then consult about their experiences in group to solidify learning. We offer a variety of DBT groups based on substance goals, age of group members, and familiarity with DBT skills.

Edit

Social Anxiety Group
A skills-based group that incorporates Acceptance and Commitment Therapy (ACT), mindfulness, and exposure/CBT to help people understand and cope with anxiety more effectively. This group utilizes a significant number of experiential exercises, which are sometimes scary but can also be fun!

Skills Training in Affective and Interpersonal Regulation (STAIR) Group
STAIR is a manualized (15 – 20 sessions) treatment specifically designed for people who have had traumatic experiences. Participants of this group learn skills to become more aware of (and comfortable with) all emotions, as well as positive, healthy coping skills for distressing feelings. They also learn to identify unhealthy relationship patterns and improve current relationships by gaining an understanding of the impact traumatic experiences have had on them.

Yoga Group
Our eight-week yoga group is run by a doctoral-level psychologist who is also a yoga instructor. Each week, clients will be led in approximately one hour of yoga practice, with time to verbally process the experience after. A weekly theme (e.g., self-compassion, tolerating discomfort) informs the practice. Goals include increased wellness, exposure to yoga techniques (poses, breathing, relaxation, and meditation), as well as learning techniques for self-regulation, self-awareness, and stress reduction. The yoga practice is accessible to all levels and tailored to meet individual needs. Comfortable clothing required! 

Train Your Brain—Executive Functioning Skills Group
In this highly structured group, participants will acquire and practice concrete skills for stronger executive functioning (cognitive processes that are necessary for regulating and monitoring behavior towards chosen goals). The work is active and direct, as participants practice behaviors to improve organization, scheduling, and task management and manage distractibility. The group takes place over a four-week cycle. Participants are asked to commit to a full cycle and are welcome to continue practicing these life-enhancing behaviors with us once that cycle is complete.

Moving Forward Group
This structured, mixed-goals group uses accountability and SMART goal setting to help develop strategies for accomplishing tasks that have proven challenging in the past. (SMART stands for specific, measurable, attainable, relevant, and time-bound.) Participants identify areas of their life that they want improve and gain mastery over those areas by breaking down goals into smaller, more attainable pieces.

Edit

These groups are for clients who have had previous exposure to skills-based groups and are consistently in the maintenance stage of behavior change. They are designed to support ongoing maintenance while addressing other life stressors, such as work/school and intimate relationships. We have a number of process groups running at any given time based on the needs of our clients and typically include gender specific as well as mixed gender groups.

What People Really Want to Know (FAQ)

Edit

Treatment at CMC is evidence-based. We rely on treatment approaches that have been tested in controlled research studies over many years and found to be the most effective. We take our direction from science and do what works. We understand motivation and strive to help you figure out what changes you want to make and provide the skills you need to be successful in reaching your goals. 

Our treatment is practical, problem-focused, active, results-oriented, and very supportive and we work hard to address each client’s particular circumstances, preferences, and needs. We will help you monitor your progress by tracking your goals and readjusting your strategies and intentions as needed. Treatment at CMC is non-shaming and promotes positive self-esteem, hope, and empowerment. We do not endorse the notion that addiction is a disease that will never go away—a potentially demoralizing idea that is not supported by the evidence.

Co-founders Dr. Jeffrey Foote and Dr. Carrie Wilkens opened CMC in 2003 to address the profound lack of evidence-based treatment options for substance issues. Their program was the first in NYC that was not 12-step/abstinence-only and the first to use only highly trained clinicians to provide care. Thankfully, the treatment field as a whole has started to come around to evidence-based practices, but CMC has led the way since its inception.

The approaches we use are a) motivational, enabling you to figure out what changes are important to you—because your personal investment matters over the long run; and b) cognitive-behavioral, helping you identify real-world risks and stressors and target specific behavioral change while developing a more rewarding and fulfilling life.

Edit

The treatment approaches used at CMC are ones that have proven to be effective in federally-funded research projects. Evidence-based treatments (EBT’s) are therapies that are codified in some way (e.g., manuals for how to progress in therapy) so that they can be evaluated in studies for effectiveness.  This is in contrast to therapies that are based on a theory of what “should” work, but have not necessarily proved to work with the evidence of research.  In the mental health field at large, “evidence-based treatments” are gaining momentum as a focus of research attention and as a focus of clinical work. 

At CMC our treatment approaches include Motivational-Interviewing (MI), a variety of Cognitive-Behavioral (CBT) approaches, Dialectical-Behavior Therapy (DBT), and Acceptance and Commitment Therapy (ACT). We also use a variety of evidence-based treatments for trauma and Post-Traumatic Stress Disorder (PTSD): Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), Skills Training in Affective and Interpersonal Regulation (STAIR), DBT-PE, and Eye Movement Desensitization and Reprocessing (EMDR).

Family members are also engaged with evidence-based treatment including Community Reinforcement and Family Training (CRAFT) and our Invitation to Change Approach® (ITC).

Edit

No. AA and other abstinence-based self-help organizations are widely accessible and instrumental in helping many people make positive changes. Over half of our clients actively participate in AA or other self-help groups in addition to the work they do at CMC. When appropriate, we encourage people to try a variety of self-help groups, because they offer free and immediate support. Additionally, for people who want to sustain abstinence, research suggests that regularly attending self-help groups increases the rate of success over the long term. There is no denying that there is something quite profound about being part of a solid recovery-driven community of peers.

Therapy with CMC, however, is not based on a 12-step philosophy. While the 12-step approach helps some people, there is no evidence that it is the only way to make real and long-lasting changes. Some people find aspects of the 12-step approach unhelpful, especially the imperatives to declare yourself an “addict,” “surrender” and concede that “you are powerless,” to accept that “you have a disease for life,” or to call upon a “higher power.” At CMC, we don’t tell people to get with the program; we help them design a program that works for them.

Some of the clearest evidence we have concerning addictive behaviors is that people change in many, many different ways, along different paths, and that confining a person to only one option will most likely block them from making positive change. Providing options lets people choose the changes they want to make and how they want to make them, to personally endorse and thus fully buy in to change. One size does not fit all!

Edit

The U.S. treatment system (and the public), unlike that of many other countries, has traditionally held a black-and-white view of substance abuse as a “disease” for which abstinence is the only solution. The data about how people really behave and change contradict this view. For most people, use falls on a continuum somewhere between unproblematic, problematic in varying ways and degrees, and destructive; and for most people, change is a gradual process that involves weighing the costs and benefits and then deciding to try something different, usually incrementally, until the problem behavior is resolved. For some, this can result in successful moderation; for others, abstinence is the only way to eliminate the negative effects of their use. The bottom line? It’s different for different people. 

We will work with you to understand your patterns and goals and assess whether you feel moderation is a viable option, and if it is, we will help you learn skills to be successful.

Edit

Lapses and returns to old behaviors are part of the change process for most (though not all) people attempting to make difficult life changes. They can most helpfully be seen as sources of information rather than as failures: they point to where there’s more work to be done. In all learning, there are mistakes and setbacks, and when it comes to behavior change, ambivalence is normal. We will help you understand your patterns and what causes you to go back to behaviors you are trying to avoid; and we will teach you the skills you need to keep moving forward.

Edit

If this is you, bravo! It takes courage to try to make a change and perseverance to try again. You understand how difficult it can be to make long-lasting changes. You may need some guidance on how best to make these changes stick. If you haven’t attended any self-help meetings, such as AA, NA, SMART Recovery, Refuge Recovery, or Recovery Dharma, then you might want to start there. These great resources have helped countless people change their substance use behaviors. But if you’re on this website, you’re probably ready for a different kind of support. We are experts in helping people develop the skills they need to change, motivation to sustain them, and compassion for themselves while pursuing this difficult work.

Edit

Probably not! Most people are able to make changes at an outpatient level of care. The question is, do you think you can make the changes you want to make in your current environment? One major benefit of inpatient treatment is that it removes you from your surroundings so that you have space to change and time to start building the skills you will need to sustain those changes when you get home, all without the stress of dealing with your everyday environment. At the same time, most people cannot afford to step out of their lives completely in order to go to residential treatment, and it may not be the best idea for other reasons. We recommend that you start with a consultation with our intake team, who can help you think through your options. It is very likely that we will encourage you to let us try to help you make changes as an outpatient without putting the rest of your life on hold.

If you’re wondering if inpatient treatment is right for you, click here to learn more about our residential program, CMC:Berkshires.

Edit

Absolutely. Approximately 80% of our clients have outside providers with whom they continue to work as they participate in treatment at CMC. In fact, most people feel that by focusing on their compulsive behavior problems with us, they are able to make significant progress with their outside therapist, as they work with new clarity and freedom on issues they had been avoiding with substances or other compulsive behaviors.

Edit

Treatment length and intensity (how often you come in) vary. Some of our clients come once a week for individual sessions only; others come five days a week for group and individual treatment. Short-term options include evaluation only or a brief two-week assessment and plan. The type and intensity of treatment depends on a variety of factors, including the severity of substance use and associated problems, sources of outside support, presence of other emotional and psychiatric issues, and overall quality of life and functioning. After an initial two-hour comprehensive evaluation, we design with you a treatment plan that makes the most sense.

Both cognitive-behavioral and motivational treatments are relatively short-term, typically lasting between two weeks and six months. (Motivational Interviewing, the approach behind our motivational work, takes only two sessions!) For all of our clients, treatment is results-oriented; that is, we use objective and individualized measures to continually assess whether the treatment plan is working.

Often, people come to us for a period of time and then take a break to work on making changes using the skills they have learned. You can always come back for a tune-up or to address a new behavior you want to change. Our model is flexible and individualized. We are proud to say that every client at CMC is doing something different!

Speak with an intake specialist