Most therapists will tell you they treat addiction.
That's technically true for a lot of them. Addiction shows up in almost every practice — in the drinking that escalated after the divorce, the Adderall that became necessary, the weed that stopped being occasional. Therapists see it constantly.
But seeing it and being licensed specifically for it are different things.
What LCAS Actually Is
LCAS stands for Licensed Clinical Addictions Specialist. In North Carolina it's a separate licensure from the standard mental health counseling credential — meaning it requires additional supervised clinical hours, specific addiction-focused training, and a separate board examination.
I hold both an LCMHC — Licensed Clinical Mental Health Counselor — and an LCAS. That combination is less common than it sounds. Most therapists in this area have one or the other. Having both means I'm equipped to work with the full picture when mental health and substance use are showing up together — which they almost always are.
Why the Credential Gap Matters
Here's what happens when someone with an alcohol problem goes to a therapist who isn't specifically trained in addiction:
The therapist treats the anxiety. Or the depression. Or the relationship problems. All of which are real. All of which need attention.
But the substance use often gets addressed as a symptom — something to manage or reduce while working on the "real" issue underneath. The problem is that addiction doesn't work that way. It has its own clinical logic, its own neurobiological dynamics, its own stages of change. Treating it as a side effect of something else usually means you're working at the wrong level.
An addiction-trained clinician doesn't just treat the anxiety and hope the drinking follows. We track the substance use as its own clinical entity — how it's functioning, what it's protecting, what stage of readiness the person is actually in — alongside everything else that's going on.
The Dual Diagnosis Reality
Most people who come in with substance use concerns aren't just struggling with substances. They're dealing with anxiety that became unmanageable. Or depression that stripped away every other coping mechanism. Or trauma that never got addressed and found a chemical solution.
This is called dual diagnosis — co-occurring mental health and substance use disorders. It's more common than not. And it requires someone who can hold both tracks simultaneously rather than referring out to a separate addiction specialist and hoping the two treatments coordinate.
That's what the LCAS credential makes possible. I don't have to choose which problem to treat. I work with the whole thing.
More on what that looks like in practice at addiction counseling in Cornelius, NC.
What This Looks Like in Practice
The clients I work with in this space usually don't identify as addicts. That word doesn't fit their self-image and often isn't clinically accurate.
What they know is that something has shifted. The drinking that used to be social has become structural — built into the evening in a way that feels less like a choice and more like a requirement. The substance that used to take the edge off now barely does, but stopping feels impossible to imagine. The behavior that started as a reward has become the thing they're organizing their life around.
They're functioning. Often well. Nobody at work knows. Their family is starting to notice but hasn't said anything directly yet.
That's exactly the right time to come in. Before it's a crisis. Before the consequences have compounded. When the window for real intervention is still open.
You Don't Need a Diagnosis
You don't need to have hit a bottom. You don't need to be ready to quit entirely. You don't need to have a clear label for what's happening.
What I'm looking for is honesty — about what the pattern actually is, what it's doing for you, and whether something about it has stopped working. That's enough to start.
I see clients in person in Cornelius, NC — near Lake Norman — and via telehealth anywhere in North Carolina.
Ready to talk? Free 15-minute consultation.