--- title: "Do You Have to Be Sober to Start Therapy?" url: https://respondersherpa.com/resources/do-i-have-to-be-sober-to-start-therapy description: "No, you don't have to be sober to start therapy. Why honesty about use matters, what a first conversation covers, and when a higher level of care fits." lang: en --- Resources (https://respondersherpa.com/resources) · Addiction # Do you have to be sober to start therapy? No. You don't have to be sober to start therapy with me. You don't need a sober date, a chip, or a promise that you'll never drink again. You can start exactly where you are today. That answer surprises a lot of people. Here is why it works that way, what honesty about use actually does for you, and what happens when more support is needed than weekly therapy can give. ## Why sobriety isn't the entry fee Many people believe they have to get their drinking or using under control before they are allowed to get help for it. That idea keeps people stuck. If you could stop on your own, you probably would have already. Waiting until you are sober to start therapy can mean waiting a very long time, while things at home and at work keep getting harder. For first responders and healthcare workers, drinking often starts as a way to come down. The first drink after shift takes the edge off. Then it becomes the only way to sleep, the only way to stop replaying the call, the only way to feel off duty. The substance is doing a job. Therapy looks at what that job is and helps you find other ways to handle it. That work can begin before you stop. You can read more about how I approach this on the addiction counseling (https://respondersherpa.com/first-responder-addiction) page. ## Why honesty about use matters more What matters is not whether you are sober. What matters is whether you can be honest about what you are using, how much, and how often. That honesty is what lets us see the real picture and make good decisions together. If you tell me you have two beers a night when it is closer to eight, we will be working on the wrong problem. If you tell me the truth, even when it is embarrassing, we can see patterns: which shifts lead to the heaviest nights, what you are trying not to feel, what has worked before and what hasn't. You will not be judged for it. The job is hard, and the ways people cope make sense in context. Honesty also keeps you safe. Some patterns of use carry real medical risk, especially when it comes to stopping suddenly. Knowing the truth helps me tell you when something needs medical attention rather than therapy alone. ## What a first conversation covers It starts with a free 15-minute call. You tell me a little about what is going on, and I tell you honestly whether I think I can help. There is no pressure to book. If we decide to work together, the first full session is an intake. In that intake, we talk about what brought you in, what your use looks like, what you have tried before, and what you want to be different. We talk about the job, the calls or shifts that stay with you, sleep, relationships, and home life. We also go over confidentiality and its limits, so you know exactly what stays in the room. There is more on that in will my department find out I'm in therapy? (https://respondersherpa.com/resources/will-my-department-find-out) You don't have to have all the answers. You don't have to know whether you want to quit completely or cut back. Those are things we can figure out together, and your goals can change as we go. ## How trauma and use connect For people who carry weight for a living, drinking and trauma often feed each other. The calls that replay make it hard to sleep, so you drink. The drinking makes sleep worse and mood lower, so the calls hit harder. Working on only one side can leave the other pulling you back. That is why I often work on both at once. I use EMDR (https://respondersherpa.com/emdr-therapy-utah) and Accelerated Resolution Therapy (https://respondersherpa.com/art-therapy-utah) for specific memories, and solution-focused therapy for daily life, including new ways to come down after shift. You can read more about that side of the work on the PTSD and trauma therapy (https://respondersherpa.com/ptsd-trauma-therapy) page. ## When a higher level of care is the right call Weekly outpatient therapy is not the right fit for everyone at every moment. Sometimes more support is needed. That might mean medical detox, an intensive outpatient program (IOP), or residential treatment. I don't provide those services, and I don't give medical or detox advice. What I do is tell you honestly if I think you need more than I can offer, and help you find it. That is not a rejection. It is part of taking your safety seriously. Depending on the situation, we may be able to keep working together alongside that care, or pick back up after. If you are unsure whether stopping on your own is safe, talk to a medical provider before you try. Some substances can be dangerous to stop suddenly. ## Why this matters to me In 2019, addiction took someone I love. I don't bring that up to make this about me. I bring it up because it is part of why I don't believe anyone should have to get better on their own before they are allowed to ask for help. ## The practical part Sessions are $150 for 50 minutes, paid at the time of the appointment. I don't bill insurance directly, but I can provide an out-of-network superbill on request. I see people in person in Midvale and by telehealth anywhere in Utah. When you're ready, book a free 15-minute consultation (https://respondersherpa.com/booking) or call (801) 554-6372. If you're in crisis, call or text 988, or call 911. FAQ ## Common questions. Do I need to be sober to start therapy with you? + No. Sobriety is not required to begin. We start where you are. What if I show up to a session after drinking? + We would talk about it honestly. We would decide together what makes sense for that session. Do you provide detox? + No. I don't provide medical detox or medical advice. If medical detox, IOP, or residential treatment is the right call, I will say so and help you find it. Do I have to commit to quitting completely? + Your goals are yours. We talk openly about what you want to change and what the risks are, and we adjust as things move. Related reading - Addiction Counseling → (https://respondersherpa.com/first-responder-addiction) Alcohol and drug use that started as a way to come down after shift. Sobriety is not required to begin. - First Responders → (https://respondersherpa.com/first-responder-therapy) Police, fire, EMS, and dispatch. Confidential care outside the department. - Will My Department Find Out I'm in Therapy? → (https://respondersherpa.com/resources/will-my-department-find-out) How private practice, self-pay, and HIPAA keep your care yours, and what to ask any therapist. - EMDR vs. ART: How They Differ → (https://respondersherpa.com/resources/emdr-vs-art) A plain-language comparison of their eye movements, structure, imagery, and what sessions may feel like. - What Your First Therapy Session Looks Like → (https://respondersherpa.com/resources/first-therapy-session) From the free consultation and intake through goals, privacy, treatment choices, cadence, and fees. - Therapy Costs and Superbills → (https://respondersherpa.com/resources/paying-for-therapy) The session fee, self-pay process, superbills, possible out-of-network benefits, and Good Faith Estimates. - Peer Support, EAP, or Private Therapy? → (https://respondersherpa.com/resources/peer-support-eap-or-therapy) How peer support, employee assistance programs, and independent private therapy differ in purpose, privacy, and access. - When a Call Won't Let Go → (https://respondersherpa.com/resources/when-a-call-wont-let-go) Common reactions after a hard call, what may help in the first days, and when therapy may be worth considering. - Therapy or Coaching: Which One Fits? → (https://respondersherpa.com/resources/therapy-or-coaching) How licensed counseling, non-clinical coaching, and consulting differ, who each is for, and how to choose. Still have questions? Ask them on a free 15-minute call. Book a free 15-minute call: https://respondersherpa.com/booking (801) 554-6372: +18015546372 Brian Lewis, LCMHC · Midvale, Utah · Telehealth across Utah · Utah LCMHC license #5497978-6009 ## Structured data ```json [ { "@context": "https://schema.org", "@type": "WebSite", "@id": "https://respondersherpa.com/#website", "name": "Brian Lewis, LCMHC", "url": "https://respondersherpa.com", "publisher": { "@id": "https://respondersherpa.com/#practice" }, "inLanguage": "en-US" }, { "@context": "https://schema.org", "@type": [ "MedicalBusiness", "ProfessionalService" ], "@id": "https://respondersherpa.com/#practice", "name": "Brian Lewis, LCMHC", "url": "https://respondersherpa.com", "image": "https://respondersherpa.com/__l5e/assets-v1/d03407aa-3688-433f-b886-6fea75aee05b/og-hero-ridge.jpg", "logo": "https://respondersherpa.com/__l5e/assets-v1/d03407aa-3688-433f-b886-6fea75aee05b/og-hero-ridge.jpg", "telephone": "+1-801-554-6372", "priceRange": "$150", "medicalSpecialty": "Psychiatric", "address": { "@type": "PostalAddress", "addressLocality": "Midvale", "addressRegion": "UT", "addressCountry": "US" }, "geo": { "@type": "GeoCoordinates", "latitude": 40.6111, "longitude": -111.8994 }, "areaServed": [ { "@type": "State", "name": "Utah" }, { "@type": "City", "name": "Midvale" } ], "knowsAbout": [ "EMDR therapy", "Accelerated Resolution Therapy", "Addiction treatment", "PTSD", "Complex trauma", "First responder mental health" ], "provider": { "@id": "https://respondersherpa.com/#brian" } }, { "@context": "https://schema.org", "@type": "Person", "@id": "https://respondersherpa.com/#brian", "name": "Brian Lewis", "honorificSuffix": "LCMHC", "jobTitle": "Licensed Clinical Mental Health Counselor", "image": "https://respondersherpa.com/__l5e/assets-v1/d03407aa-3688-433f-b886-6fea75aee05b/og-hero-ridge.jpg", "url": "https://respondersherpa.com/about", "telephone": "+1-801-554-6372", "worksFor": { "@id": "https://respondersherpa.com/#practice" }, "hasCredential": [ "MA, Health Systems Management & Counseling Psychology", "Utah LCMHC license #5497978-6009", "EMDR trained", "Accelerated Resolution Therapy (ART) trained" ], "knowsAbout": [ "EMDR", "Accelerated Resolution Therapy", "Addiction treatment", "PTSD", "Complex trauma", "Solution-focused therapy", "First responder mental health", "Healthcare worker mental health" ], "areaServed": { "@type": "State", "name": "Utah" } }, { "@context": "https://schema.org", "@type": "MedicalWebPage", "@id": "https://respondersherpa.com/resources/do-i-have-to-be-sober-to-start-therapy#webpage", "url": "https://respondersherpa.com/resources/do-i-have-to-be-sober-to-start-therapy", "name": "Do You Have to Be Sober to Start Therapy?", "description": "No, you don't have to be sober to start therapy. 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