Thinking about reaching out for help with alcohol, drugs, or a behavioral addiction takes courage. If you’ve landed here, something in your life is telling you it’s time — and we want you to know that 2nd Story Counseling is a judgment-free space where that conversation can begin.
Our Chicago therapists have worked with addiction in all its forms for nearly two decades. We understand that addiction isn’t a moral failing or a lack of willpower — it’s a complex, layered condition shaped by biology, psychology, trauma, and environment. And it responds to treatment.
Are any of these showing up in your life?
- You’ve tried to cut back or stop — and couldn’t
- Substance use or a behavior is affecting your work, relationships, or health
- You find yourself hiding how much you drink, use, or engage in a behavior
- You need more of something to get the same effect you used to
- You feel anxious, irritable, or physically unwell when you try to stop
- You keep telling yourself “this is the last time” — and it never is
- Shame and guilt follow you, but don’t stop the cycle
- People close to you have expressed concern
If several of those resonate, you’re not alone — and you’re in the right place. Let’s talk about what’s going on and what recovery can look like for you specifically.
What is addiction?
At its core, addiction is what happens when a person becomes unable to stop using a substance or engaging in a behavior — even when they desperately want to, and even when the consequences are significant. The urge overrides intention. This isn’t weakness; it’s a neurobiological reality.
Substance use — particularly alcohol, opiates, stimulants, and benzodiazepines — affects the brain’s reward system in powerful ways. Over time the brain adapts, leading to tolerance and dependence. But addiction isn’t only physical. The psychological and social dimensions are equally important — and equally treatable.
Most addiction specialists today work within a bio-psychosocial model — meaning addiction is understood as the product of biological vulnerability, psychological patterns (often including trauma and mental health), and social and environmental factors. Effective treatment addresses all three layers, not just the substance or behavior itself.
Types of addiction we treat
💧 Substance Addictions
Substance addiction involves a chemical dependency on a substance that has created negative consequences in a person’s life. Common substance addictions we work with include:
- Alcohol — the most common substance issue we see; visit our dedicated alcohol counseling Chicago page for more
- Opiates and opioids — prescription painkillers, heroin, fentanyl
- Stimulants — cocaine, crystal meth, amphetamines
- Benzodiazepines — prescription anti-anxiety medications used beyond their intended scope
- Cannabis — particularly when use becomes daily and interferes with functioning
- Tobacco and nicotine
- Polysubstance use — using multiple substances simultaneously or in rotation
🧠 Behavioral Addictions
Behavioral addictions follow the same cycle as substance addictions — an activity produces pleasure or relief, the brain seeks more of it, and over time the behavior becomes compulsive despite growing negative consequences. Common behavioral addictions include:
- Gambling
- Internet and gaming addiction — see our post on 10 signs of internet addiction
- Compulsive spending and shopping
- Relationship and love addiction
- Food and eating-related compulsions
- Risky and adrenaline-seeking behaviors
- Sex addiction — see our dedicated sex addiction counseling Chicago page
It’s also common to have more than one addiction simultaneously — for example, alcohol and gambling, or multiple substances at once. Co-occurring addictions are something our therapists are experienced in addressing.
Addiction and mental health: the connection
Addiction rarely exists in isolation. Anxiety, depression, trauma, and PTSD frequently co-occur with substance use and behavioral addictions — sometimes driving them, sometimes developing as a result of them, and often both at once. This is sometimes called a dual diagnosis or co-occurring disorder.
Treating only the addiction without addressing the underlying mental health piece is one of the most common reasons recovery stalls. Our integrative approach is designed to work with both simultaneously — not one after the other.
Addiction counseling for LGBTQ+ and queer clients
Substance use and behavioral addictions are disproportionately common in LGBTQ+ communities — not because of identity, but because of what identity can cost in a world that isn’t always affirming. Minority stress, family rejection, discrimination, internalized shame, and the cultural role of alcohol in queer social spaces all contribute to elevated rates of problematic use.
For over 20 years, 2nd Story Counseling has provided affirming addiction counseling for gay, lesbian, bisexual, transgender, nonbinary, and queer clients in Chicago’s Lakeview neighborhood. Our therapists understand the specific pressures facing the queer community — and you won’t need to explain or justify your identity to get good care here. Learn more about our LGBTQ+ affirming therapy.
How we approach addiction treatment
There is no cookie-cutter approach to addiction recovery. What works depends on the substance or behavior, your history, your mental health, and what you’re ready for. Our therapists draw from multiple evidence-based approaches and tailor treatment to you specifically.
🌱 Internal Family Systems (IFS)
IFS is one of our signature modalities for addiction work — and one of the most powerful. In the IFS framework, the part of you that reaches for a substance or behavior isn’t the enemy; it’s a protector. It developed as a way to manage pain, numb difficult emotions, or create a sense of control. Rather than fighting or shaming that part, IFS works to understand it — and to find healthier ways to meet the needs it’s trying to address. This approach is particularly effective for clients whose addiction is rooted in trauma or deep emotional pain. Learn more about Internal Family Systems therapy.
🧠 Cognitive Behavioral Therapy (CBT)
CBT for addiction focuses on identifying the thoughts, triggers, and situations that drive substance use or compulsive behavior — and building concrete skills to interrupt those patterns. It’s practical, structured, and has strong research support for addiction treatment. Learn more about our CBT treatment in Chicago.
🧘 Mindfulness and ACT
Mindfulness-based approaches help clients develop awareness of cravings without automatically acting on them — creating space between impulse and behavior. Acceptance and Commitment Therapy (ACT) builds on this by helping you clarify your values and make choices aligned with who you want to be, rather than what the addiction is pulling you toward. Browse our blog for holistic approaches to addiction treatment.
💬 Relational and Trauma-Informed Therapy
For many clients, addiction is inseparable from trauma, attachment wounds, or relational patterns. Our relational therapy and trauma-informed approaches address these roots directly — because sustainable recovery often requires healing what the addiction was covering up.
Levels of care and what we offer
2nd Story Counseling provides outpatient individual addiction counseling — which is appropriate for many clients, particularly those with mild to moderate addiction, strong social support, and stable living situations. Depending on your situation, we may recommend combining individual therapy with:
- Intensive outpatient programs (IOP)
- Support groups such as AA, NA, or SMART Recovery
- Psychiatric evaluation for medication-assisted treatment
- Inpatient or residential treatment for more severe presentations
We’ll give you an honest picture of what level of care makes sense for your situation — and if we think you need something more intensive, we’ll say so and help connect you with the right resources. Visit our Chicago addiction recovery resources page for a comprehensive list of local options.
Frequently asked questions about addiction counseling in Chicago
Is addiction counseling confidential?
Yes. Everything discussed in therapy is confidential under federal and state law. There are narrow legal exceptions — such as imminent risk of harm — but your addiction history, what substances you use, and what you share in sessions is protected. Many people delay getting help out of fear that someone will find out. We want to put that concern to rest.
Do I have to be sober before starting therapy?
No. You don’t need to be sober to begin counseling. Many clients start therapy while still actively using — and the therapeutic relationship itself becomes part of what supports recovery. That said, if your level of use requires medical detox first, we’ll discuss that openly and help connect you with appropriate resources.
What’s the difference between abstinence and sobriety?
Abstinence means not using a substance. Sobriety is broader — it refers to a sustained state of recovery that encompasses emotional health, lifestyle change, and ongoing growth. Browse our site for more in depth information on abstinence vs. sobriety.
Do you accept insurance for addiction counseling?
All of our therapists are in-network with Blue Cross Blue Shield PPO. For clients paying out of pocket or using an HSA, please visit our fees page for current rates. A sliding scale is available for clients who qualify.
Do you offer telehealth for addiction counseling?
Yes. We offer secure virtual therapy for clients throughout Illinois. Telehealth can be especially helpful for clients in early recovery who are managing schedules around support group attendance, work, or family commitments.
What if I’ve relapsed before — can therapy still help?
Absolutely. Relapse is a common part of the recovery process — not a sign of failure or proof that treatment doesn’t work. It’s information. Our therapists are experienced in working with clients who have relapsed, helping them understand what happened, what needs weren’t being met, and how to build a more sustainable path forward.
Or call us directly at 773.528.1777 — confidential, no obligation.