Recovery and dual diagnosis
Substance Use Counseling in Miami and Online Across Florida
Maybe the second glass of wine has quietly become the fourth. Maybe you’ve been sober for a while and the urges are louder lately. Or you’ve just finished a treatment program in South Florida and aren’t sure how to hold on to what you learned once the daily structure ends.
I’m Isabel Wyss, a Licensed Mental Health Counselor based in Miami. Before private practice, I worked as a primary therapist and clinical supervisor in substance use and addiction treatment settings, and as a primary therapist in community mental health, supporting people with addiction alongside trauma, anxiety and grief. I now offer outpatient substance use counseling online to adults across Florida.
This is talk therapy. I don’t provide detox, medication or medical care, and I’ll tell you plainly if you need more support than weekly sessions can give.
Who substance use counseling can help
You don’t need a diagnosis or a rock-bottom moment to start. People come to me with:
- Drinking or drug use that has crept up and is harder to cut back than expected
- Using to sleep, to switch off after work or to get through social events
- Early or long-term recovery, and wanting support with cravings, relapse warning signs or what comes next
- Stepping down from residential, PHP or IOP treatment and needing ongoing therapy
- A partner, parent or sibling whose drinking or drug use has shaped their life
Some people know they want to stop completely. Others aren’t sure yet. We can start from where you are and get clear on what you want to change.
Dual diagnosis: when substance use and mental health overlap
Substance use rarely shows up alone. For a lot of people it began as a way to manage something else: anxiety that wouldn’t quiet, memories that kept intruding, grief, depression or a body that never felt at ease. When the substance is gone, those feelings often come back stronger.
Dual diagnosis care means looking at both at once. In sessions we work on the pattern of use and on what sits underneath it, such as trauma imprints, unmet emotional needs and a nervous system that has been on alert for years. My training in EMDR and somatic trauma work helps here, and we pace it so your recovery stays protected.
If you see a psychiatrist or doctor for medication, therapy with me can sit alongside that care.
Codependency patterns
Loving someone who drinks or uses can reshape your whole life. You may have learned to read their mood the moment they walk in, to cover for them, or to keep the peace at any cost. Over time, your own needs fade into the background. Codependency often looks like:
- Saying yes when you mean no, then feeling resentful
- Feeling responsible for other people’s feelings and choices
- Struggling to rest while someone else is in trouble
- Losing track of what you want or how you feel
- Staying in relationships that hurt because leaving feels impossible
These patterns usually began as ways of staying safe or holding a family together. In therapy we look at where they came from, how they show up now, and how to set boundaries without abandoning the people you care about. This is individual therapy for you. I don’t offer couples or family sessions.
When a higher level of care is needed
Online outpatient therapy is a good fit for a lot of people, and it isn’t enough for everyone. I’d rather say that early than have you struggle without the right support.
Stopping some substances suddenly, especially alcohol, benzodiazepines or opioids, can cause serious or dangerous withdrawal. Please talk with a doctor before you cut back or stop. A medical detox, residential program, partial hospitalization program (PHP) or intensive outpatient program (IOP) may be a better starting point if:
- You’ve had withdrawal symptoms such as shaking, sweating, seizures or hallucinations
- You’re using every day and can’t go a day without it
- You’ve tried to cut back several times and haven’t been able to
- Your use is putting your health, job, housing or safety at serious risk
- You need more daily structure and support than weekly sessions can give
If that sounds like you, we can talk through the options during your consultation. Once you’re stepping down from a program, weekly therapy with me may be a good next step. For urgent help at any hour, call or text 988 (the Suicide & Crisis Lifeline) or go to the closest emergency department.
How online substance use counseling works
- 01Free 15-minute consultationWe talk by phone or video about what’s going on and what kind of support you need. If a higher level of care would serve you better, I’ll tell you.
- 02An honest look at the patternIn early sessions we map out your use: what triggers it, what it does for you and what it costs you, without shame or lectures.
- 03Skills for urges and hard momentsWe practice ways to ride out cravings, settle your body and get through the evenings, weekends and anniversaries that tend to be hardest.
- 04Work on the rootsAs you feel steadier, we turn to what sits underneath, using EMDR, somatic therapy, IFS-informed parts work or ACT where they fit.
Sessions are 50–60 minute secure video sessions for adults who are physically in Florida. I’m based in Miami and see clients across the state, from Miami-Dade up through Broward and Palm Beach. Private pay is $175 per session. Insurance options depend on your plan, so ask during your free consultation. You can book a free consultation through my secure client portal.
At a glance
Working with Isabel
- Isabel Wyss, LMHC (Florida MH26669)
- Online only, by secure video, for adults located in Florida
- $175 per 50–60 minute session
- Free 15-minute consultation
- Sessions in English or Spanish
Questions about Substance Use Counseling
Do you offer detox or medication-assisted treatment?
No. I provide outpatient talk therapy by secure video only. I don’t provide detox, prescribe medication or offer medical care. If you need to stop drinking or using a substance that can cause withdrawal, please speak with a doctor first. Therapy with me can sit alongside medical care or follow a stay in a treatment program.
What is dual diagnosis?
Dual diagnosis, also called co-occurring disorders, means a person is dealing with substance use alongside a mental health condition such as anxiety, depression or trauma. The two tend to feed each other, so treating only one often leaves the other in place. In therapy we work on both, paying attention to what the substance has been helping you cope with.
Can I see you after leaving a treatment program?
Yes, if weekly outpatient therapy suits where you are in recovery. The weeks after leaving residential, PHP or IOP care can be some of the hardest, because the daily structure falls away. I have worked in treatment settings myself and understand what those programs involve, so we can build on what you learned there.
Can I get help for codependency if I’m not the one using?
Yes. Codependency counseling is for the partner, parent, adult child or sibling, and it focuses on your wellbeing. We look at patterns such as over-responsibility, people-pleasing and collapsing boundaries, and how to care about someone without losing yourself. I offer individual sessions only, not couples or family therapy.
Is online substance use counseling confidential?
Sessions take place on a secure, HIPAA-compliant video platform. What you share is kept confidential within the limits that apply to all therapy in Florida, which mainly involve serious risk of harm to yourself or others, or suspected abuse of a child or an older or dependent adult. I explain these limits at the start so you know exactly where they are.
Related
Other ways I can help
Free 15-minute consultation
Start with a free 15-minute call
Tell me a little about what’s going on, ask your questions, and see how it feels to talk. There’s no pressure to book. Sessions are $175 for 50–60 minutes, online for anyone located in Florida.
Based in Miami, FL · Online across Florida · English & Español