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Sheila Ciminera, LCSW-11.png
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My first experience in the social services field was at Prevention Point Pittsburgh, a needle exchange program. Over the years, I have done program development, case management, group and individual therapy for people dealing with substance use issues. I am passionate about providing trauma informed care to my clients that incorporates harm reduction. Harm reduction is a set of practical strategies that literally reduces the harm associated with different behaviors like drug use- this can include safer use, managed use, or abstinence. Harm reduction creates an environment where you can openly discuss substance use without fear of judgment; I won't tell you to use or not use, because that will always be your choice. Sometimes we use substances because it's enjoyable or fun, and it's not necessarily a serious problem. Yet you may not be fully comfortable with where things are at- we can work together to get you to where you'd like to be. Maybe using has become detrimental to your safety and wellbeing, and you are unsure of where to begin or how to make changes.

There is no “one right way” to do substance use treatment. 

A standardized approach implies that everyone has faced the same challenges and barriers, and that everyone has the same needs. Treatment should be individualized! My approach is not based on 12 step ideas and concepts; however, I fully support you in pursuing whatever works for you. There are many options in addition to individual therapy; intensive outpatient programs, inpatient treatment, long term programs, SMART Recovery meetings, Suboxone, methadone, Naltrexone, acudetox, and more! For healing and recovery to happen, I feel all the areas of a person's life must be addressed- such as physical and mental health, financial needs, relationships- not JUST substance use. For one person, "recovery" may mean stopping all use. For another person, recovery may mean decreasing use or changing behaviors. Which leads us to the fact that. . .

Changing behaviors takes time.
Someone starts using as a choice. But once an addiction develops, the use is compulsive and not a choice. For many reasons, using may be a survival technique. That is why a characteristic of addiction is continued use despite harm. It's not as simple as just quitting. There may be a physical dependence that could make it hazardous for you to just stop using or drinking. Even if you don't have an addiction, changing ANY kind of patterns takes time. Our awareness and observation of our patterns is a huge step in the change process, and so much can be learned along the way (no matter how long it takes). 

 

You don't have to hit rock bottom to change.
Part of my job is to help you look at the reasons why you use, and what purpose it has served. There may be many legitimate reasons for it! For example, if someone uses because of anxiety, we can figure out some additional ways to cope with anxiety. I don't believe you have to lose everything to change. I don't want you to lose everything! If the negatives outweigh the positive benefits of using, we can work on making some changes that will improve your life.

 

Motivation looks different for everyone.
It doesn't matter what your motivation is! As long as there is some kind of motivation, even if it is just external, there is an opportunity for growth to happen. It's ok if you don't like the idea of changing your substance use, but have some reasons you feel you need to. Maybe health issues or staying out of jail are motivations, or keeping a job.

If you relapse or make mistakes during or after treatment, you DO NOT have to “start over”.

You still possess tools and skills to deal with life, and you still have the progress you made. Recovery (of any kind) is hard. It can feel like one step forward, 2 steps back. It is realistic that people may backslide or struggle due to different stressors and triggers. It is NOT a failure if you have to do treatment multiple times; it's actually normal. I'm here to walk beside you on that path. 

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