Cassandra Scull, LMHC

In order to create a therapeutic environment that facilitates positive, sustainable change, I utilize a diverse, integrative, evidence-based counseling approach. I draw techniques from trauma-informed cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), dialectical behavioral therapy (DBT), narrative therapy, and shadow work in order to develop insight, make changes, and heal. My incorporation of multiple modalities adds depth and introspection to my sessions, enabling folks to explore their inner narratives and uncover meaningful insights. I offer virtual individual therapy and I am LGBTQ+ affirming. I have a deep understanding of substance use, religious trauma, family dynamics, and existential anxiety and depression, making me a well-rounded therapist able to support my clients in various aspects of their lives.

You can schedule a consult with me here.

Resources for Active Addiction

Recommended Stages of Care for Active Addiction:

Clinical recommendations include a continuum of care that can provide substance use and mental health treatment up to 5 months to a year of treatment with the latter part of the time being supportive outpatient therapy, the plan below has had higher statistical success for sustained recovery from addiction which is why it is recommended. The full continuum of care process is as follows: 

Detox- 7 days (Sometimes people go straight into residential if medical clears them.) 

  • informative group therapy provided as well as access to an individual therapist/social workers to help build a care plan.
  • medical support for the detox phase. 

Residential (CSS- Clinical Stabilization Stage) – 28-30 days 

  • Group therapy focused 
  • Relapse prevention focused 
  • Developing an understanding around trauma therapy and practicing grounding skills.
  • Individual therapy weekly/biweekly depending on needs.  
  • Medical support, medication management.

PHP Partial Hospitalization Program 6 days a week for 6 hours 4-6 weeks

  • Live on site in house with other people practicing sober living. 
  • Transport to and from groups and clinical buildings. Life often feels like living on a small college campus. 
  • Group and individual therapy. 
  • Medical support, more time for more accurate medication management.
  • Support groups are often available here and within the local community such as AA/NA meetings and recovery oriented community functions to help connect folks with the local recovery community. 
  • Each PHP setting is a little different. Some PHPs offer assistance with getting job training/placement and support for continued education. Feel free to ask for specifics because programs vary on structure and access to community sober networks. 

IOP Intensive Outpatient Program- 3 or 5 days intensive outpatient. Length varies.

  • Individual and family therapy. 
  • Processing groups.
    • Trauma processing gets more intensive. As trauma is processed insight is developed about changing the internal narrative of the self in relation to the trauma. This has a high success rate in group therapy combined with individual therapy. 
  • Support groups incorporated within the local community such as AA/NA meetings and recovery oriented community functions. 
  • Medical support, continued medication management.

OP Outpatient – continued insight development/trauma work and maintenance. 

  • Individual therapy 
  • Family/marriage counseling 
  • Psychiatrist med management if needed. 

Why is this process group therapy focused? 

Human beings are social and no person has ever had success with  recovery or mental health alone. Group therapy models the family/community unit. While in group therapy the group goes through stages where they collectively process and work through issues, develop diverse coping strategies and learn conflict management.

Within individual therapy people are able to explore their past adverse experiences and trauma at a deeper, more intimate level and develop more personalized tools and strategies for positive and sustained change.

Why detox and/or 30 days and going home to an individual therapist or AA/NA is usually not enough:

It takes a year to build new habits and that is not taking into account a brain rewired for addiction. It can take the brain anywhere from 8-14 months to get back to its “normative chemistry” after a person becomes sober, a large chunk of the healing happens in the first 90 days. Individual therapy is weekly and certain coping skills and community support is often required to maintain sobriety while working through difficult issues in individual therapy. Continuum of care throughout the stages of treatment previously outlined provides the best outcomes for sustainable sobriety and mental health. 

Family Member Support: 

  • Al-Anon is a great resource that provides education and support for family members with loved ones that struggle with addiction. https://al-anon.org/
    • Al-Anon does resentment work. 
    • Helps families set appropriate boundaries and develops communication skills. 
  • Good reading materials can be found here: https://www.hazelden.org/store/welcome;jsessionid=E3DA4C7672E943BF9F128A3134314583
  • Individual/family therapy support is also recommended. This space can help you process and develop and cultivate healthy boundaries for yourself and your loved ones as well as develop better communication styles. 

A few good book titles for developing a strong sense of self and tackling addiction: 

  • Daring Greatly and The Gifts Of Imperfection, Atlas of the Heart all by Brane Brown- in all three books understanding the underpinnings of shame, self worth and vulnerability. Daring greatly specifically deals with shame reactions and how we can practice moving towards progress in the face of shame. 
  • Mindfulness and the 12 steps- integrating mindfulness into the practice of step work. 
  • 12 stupid things that mess up recovery and 12 more stupid things that mess up recover both by Allen Berger. 24 things all together between the two books that outline the pitfalls of recovery.  
  • Attached by Dr. Levine and Rachel S. F. Heller- this book is on attachment and how it affects our personalities, relationships and mental health. This is important because active addiction can significantly disrupt attachment styles.