Therapy for Addiction in Thunder Bay
When something that once helped you cope begins to take more from your life than you want to give.
Perhaps you tell yourself you’ll only have a couple of drinks. You decide this will be the last time you use. You promise yourself you’ll cut back next week.
Then a stressful day arrives. The urge feels different from the decision you made earlier, and you find yourself repeating something you genuinely wanted to change.
At BelMind Therapeia, we offer compassionate, evidence-informed counselling for addiction and substance use concerns in Thunder Bay and virtually across Ontario. You don’t have to know whether your experience meets the definition of addiction before reaching out.
You can be uncertain and still begin.
Sometimes, the question isn’t simply why you use.
It’s what happens just before you feel that you need to.
Maybe drinking helps you feel more comfortable with people. Cannabis seems to quiet your thoughts. A substance helps you get through a difficult shift, avoid painful memories, or feel something when you’ve been emotionally numb.
Perhaps the experience is different. You aren’t sure why you keep returning to it, and the explanations people offer don’t seem to fit.
We can explore what substance use does for you, what it costs you, and what you would like your relationship with it to become. Understanding a behaviour is not the same as excusing its consequences. It gives us more useful information about how to change it.
Addiction can involve biological, psychological, and social factors. Effective care considers the person and their circumstances rather than treating every substance use problem as identical. [1]
What is addiction?
Addiction is commonly associated with difficulty controlling substance use, strong urges or cravings, and continued use despite harmful consequences.
A substance use disorder is a clinical diagnosis made by assessing a pattern of symptoms and the difficulties it causes. Substance use problems can range in severity, and not everyone who is concerned about their drinking or drug use meets the criteria for a disorder. [1]
Physical dependence and addiction are not the same thing. Someone taking a prescribed medication may develop physical dependence without compulsive use or the other features of addiction. A thoughtful assessment makes that distinction. [2]
You do not need a diagnosis to discuss concerns about your substance use with a therapist.
When might substance use be becoming a problem?
The warning signs are not always dramatic. Sometimes they appear as small compromises that gradually become difficult to ignore.
Your limits keep changing.
You intend to have less, stop earlier, or take a break. But you repeatedly find yourself using more or continuing longer than you planned.
It occupies more of your day.
You spend increasing time thinking about using, obtaining substances, recovering afterward, or planning when you can use again.
Parts of life are paying the price.
Your health, work, finances, sleep, relationships, or responsibilities are affected, yet changing the pattern remains difficult.
Wanting to stop and wanting to use coexist.
You may genuinely want things to change while experiencing intense cravings or feeling drawn back to familiar patterns.
You do not need to reach a crisis before deciding that your relationship with alcohol or drugs deserves attention.
Why does the same pattern keep returning?
The following is one possible pattern, not an explanation that fits everyone. In therapy, we explore what happens in your particular circumstances.
Something happens.
Stress, loneliness, discomfort, a memory, or a familiar situation changes how you feel.
An urge develops.
Using begins to seem like the quickest way to change the experience.
Relief arrives.
The substance may briefly reduce distress, create pleasure, or make things feel manageable.
The cost appears.
A difficult consequence or another uncomfortable feeling can make the next urge harder to manage.
We can examine this process without assuming that every episode of substance use follows it. Your therapy may involve identifying situations, emotions, thoughts, habits, and practical circumstances that influence your decisions.
The aim is to develop more options at the moments when you currently feel you have very few.
What does research say about addiction therapy?
Psychological treatment can help people understand substance use patterns and develop strategies for change. The approach should reflect the substance involved, the severity of the problem, your goals, and whether medical care is needed.
Health Canada identifies cognitive behavioural therapy, motivational interviewing, counselling, and other interventions among the treatment options for substance use concerns. [3]
Canada’s 2023 alcohol use disorder guideline recommends offering psychosocial treatments and, for appropriate patients, evidence-based medications. The guideline reports small-to-medium benefits for approaches including CBT and family-based treatment on alcohol outcomes. [4]
Cognitive Behavioural Therapy
CBT can help identify relationships among thoughts, emotions, situations, and substance use. Work may include recognizing triggers, developing coping strategies, planning for difficult situations, and changing patterns that maintain the problem.
Exploring motivation and ambivalence
You might have compelling reasons both to change and to keep using. A collaborative conversation can help clarify those reasons without argument, pressure, or assumptions about what you should want.
ACT and values-based work
Acceptance and Commitment Therapy can help explore how you respond to cravings and difficult emotions, while reconnecting with choices that reflect what matters to you. It may be incorporated into an individualized plan rather than presented as a universal first-line addiction treatment.
EMDR for addictions: working with the memories and triggers behind an urge.
Sometimes, you know exactly why you want to stop using. What is harder to understand is why the urge can feel so powerful in a particular moment.
It might begin when you walk past a familiar place, finish a difficult shift, remember a painful experience, or find yourself alone at a certain time of day. The urge may arrive before you have had time to think through what you want to do.
Eye Movement Desensitization and Reprocessing (EMDR) is known primarily as an evidence-based treatment for PTSD. Therapists have also developed addiction-focused applications that address substance-related memories, triggers, cravings, and difficulties connected to change. [11]
BelMind Therapeia offers EMDR-informed addiction treatment in Thunder Bay. We consider whether this approach may be useful as part of your wider treatment plan, rather than assuming it is right for everyone.
When substance use and painful experiences intersect
Some people use substances partly to manage distress connected with traumatic experiences. Trauma-focused EMDR may help address those memories and their ongoing emotional effects. Having an addiction does not automatically mean trauma is its underlying cause.
When a trigger seems to take over
Addiction-focused EMDR protocols may target memories and cues associated with craving, the anticipated positive effects of using, and fears or beliefs that make change difficult. The aim is to explore whether these responses can become less disruptive.
Choosing an appropriate focus together
Treatment includes assessment, preparation, discussion of current substance use and safety, and selecting suitable targets. EMDR may be integrated with other counselling approaches and coordinated with medical addiction care when necessary.
What is an EMDR addiction protocol?
There is more than one addiction-focused EMDR protocol. For example, DeTUR stands for Desensitization of Triggers and Urge Reprocessing. It focuses on identifying and processing triggers associated with urges, while establishing a positive treatment goal.
Another approach, CravEx, focuses on addiction-related memories and craving. These protocols offer different ways of organizing treatment; the name of a protocol alone does not establish its effectiveness for every person. [11]
What does the research say?
A 2025 meta-analysis of 14 studies found that EMDR was associated with reductions in craving and several emotional symptoms among people with substance use disorders. However, the pooled effect on addiction severity was not statistically significant. The researchers also identified generally low study quality and limited evidence about long-term outcomes. [12]
What that means for your care: EMDR for addictions is a developing treatment approach. It may be considered alongside established addiction interventions, but it should not be presented as a guaranteed way to eliminate cravings, prevent a return to use, or replace indicated medication and medical treatment.
Do I have to commit to complete abstinence before starting therapy?
You can begin by having an honest conversation about where you are today.
Some people want to stop using entirely. Others are considering reducing their use, minimizing harm, or understanding whether they have a problem.
Treatment goals should be discussed collaboratively. The safest and most appropriate options can differ depending on the substance, medical risks, and your circumstances. [3]
You do not need to pretend you are ready for a goal you have not chosen.
Counselling matters. Sometimes medical treatment is essential, too.
Addiction treatment is not one single service. Counselling, medication, withdrawal management, and community support serve different purposes.
BelMind Therapeia provides counselling and psychotherapy. We are not a medical detoxification facility, emergency service, or opioid agonist treatment clinic. When medical assessment or another level of care is needed, we can discuss connecting with an appropriate healthcare service.
Alcohol use disorder
Canada’s clinical guideline recommends psychosocial interventions and identifies naltrexone and acamprosate as first-line medication options for adults with moderate-to-severe alcohol use disorder, when appropriate. Medication decisions belong with a qualified prescriber. [4]
Alcohol withdrawal can sometimes be dangerous. If you drink heavily or regularly and are considering stopping, seek medical advice about withdrawal risk rather than assuming it is safe to stop abruptly.
Opioid use disorder
The updated 2024 Canadian guideline identifies buprenorphine and methadone as standard first-line opioid agonist treatment options. Counselling can be part of care, but it should not be presented as a substitute for indicated medication treatment. [6]
Withdrawal management alone is not a complete treatment plan for opioid use disorder. Ongoing evidence-based care and overdose prevention are important.
Important safety information
If you may be physically dependent on alcohol or benzodiazepines, speak with a healthcare professional before stopping suddenly. Withdrawal can sometimes cause serious complications, including seizures. [4] [7]
If an overdose is suspected, call 911 immediately. Give naloxone if an opioid overdose is possible and naloxone is available, and stay with the person until emergency help arrives. [8]
What if addiction is connected to anxiety, depression, or trauma?
Sometimes substance use and mental health difficulties influence one another.
You might use a substance to manage distress. Later, its effects may worsen your sleep, anxiety, mood, or ability to cope. Or a mental health difficulty may become clearer after substance use changes.
When substance use and mental health disorders occur together, clinicians may refer to them as concurrent disorders. CAMH emphasizes coordinated, integrated treatment that considers both concerns rather than treating them as unrelated problems. [9]
At BelMind Therapeia, we can explore relevant emotional, behavioural, and trauma-related difficulties within the scope of psychotherapy. Depending on your needs, medical treatment or coordination with another addiction service may also be appropriate.
If past experiences remain distressing, you can explore our trauma and PTSD page. Trauma therapy and EMDR may be relevant for certain co-occurring difficulties, but they are not substitutes for indicated addiction-specific medical treatment.
What happens in your first addiction counselling session?
You do not need to arrive with a perfect explanation, a diagnosis, or a promise that you will never use again.
We begin by discussing your concerns, current substance use patterns, relevant health and safety issues, previous attempts to change, and what you hope to achieve. We explain confidentiality and its limits and discuss whether counselling is appropriate on its own or alongside other care.
Explore your situation.
We look at what is happening, what affects your decisions, what concerns you, and what strengths or supports you already have.
Build a practical plan.
We discuss your goals and develop strategies suited to your needs, while considering whether medical or additional addiction services are required.
Adjust as life changes.
We review what is helping, what remains difficult, and whether your goals or treatment plan need to change.
What if you return to using after making progress?
A return to substance use is a reason to revisit the treatment plan, understand what happened, and assess whether more support is needed. It does not erase earlier progress.
This is especially important when returning to opioids after a period of not using: reduced tolerance can increase overdose risk. The next step should include attention to safety, not simply another promise to try harder. [8] [3]
A conversation with someone who sees more than the substance use.
We approach therapy with curiosity about your circumstances, your goals, and the changes you want to make.
Founder, Registered Social Worker and psychotherapist. Vimal works with addiction and substance use concerns, trauma, anxiety, depression, and related difficulties. His approach is collaborative, trauma-informed, and informed by cognitive and behavioural therapies and ACT.
Registered Social Worker and EMDR Certified Therapist with more than 15 years of experience. Miguelle works with trauma, emotional regulation, anxiety, depression, and other concerns that may intersect with a person’s substance use difficulties. Her approach is strengths-based and client-centred.
Addiction counselling in Thunder Bay, with virtual appointments across Ontario.
If you are seeking support for alcohol use, drug use, or addiction-related difficulties in Thunder Bay, you can meet with us in person at BelMind Therapeia.
Virtual psychotherapy is also available across Ontario, including for people living in northern and remote communities. Whether online counselling is suitable depends on your needs, current safety, and whether medical services are also required.
If you need help locating medical addiction treatment, withdrawal management, or other community services, ConnexOntario provides free, confidential information and referrals throughout Ontario, 24 hours a day. You can also call 1-866-531-2600 . [10]
Frequently asked questions about addiction counselling.
You can ask questions before deciding whether counselling is the right next step for you.
Do I need to be diagnosed with addiction before booking therapy?
No. You can seek counselling because you are concerned about your drinking or drug use, even if you do not have a diagnosis. We can begin by exploring your concerns and considering what kind of support would be appropriate.
Do I have to stop using before my first appointment?
You do not need to promise complete abstinence before making an initial enquiry. We can discuss your goals, current substance use, and the kind of care you need. If you may be at risk of dangerous withdrawal, medical assessment is important before you attempt to stop.
Can therapy help if I only want to cut back?
Reducing use or harm may be a treatment goal for some people. The suitability of that goal depends on the substance, medical risks, and your circumstances. We can explore your preferences and discuss appropriate treatment options without promising that every goal is safe in every situation.
What if I have tried to quit before?
Previous attempts can help us understand what worked, what became difficult, and what may need to change in your plan. Returning to use does not mean earlier progress has no value. Safety and additional supports may need to be reassessed, particularly with opioids.
Does BelMind provide detox or addiction medication?
No. BelMind Therapeia provides counselling and psychotherapy, not medical detoxification or medication prescribing. Alcohol and opioid use disorders may require medical treatment. We can discuss seeking an appropriate medical assessment or connecting with another service when needed.
Can I discuss addiction and trauma in therapy?
Yes. Substance use concerns can coexist with trauma, anxiety, depression, or other mental health difficulties. We can explore these connections and consider a coordinated treatment plan when more than one service is appropriate. You can also learn about trauma therapy at BelMind.
Is addiction counselling available online in Ontario?
BelMind Therapeia offers virtual psychotherapy across Ontario. We would discuss whether online counselling is suitable for your circumstances, including safety, privacy, and whether you need medical or more intensive addiction care.
What if I am worried about someone else’s substance use?
You can seek information and support for yourself, even if the other person is not ready to seek treatment. ConnexOntario provides free information and referrals for family members and others concerned about someone’s substance use.
Research and clinical references.
This page draws on Canadian clinical guidelines, government health resources, addiction-treatment guidance, and peer-reviewed research. These links are provided so you can examine the information and its limitations directly.
- Centre for Addiction and Mental Health. Addiction. Overview of addiction, problematic substance use, symptoms, and treatment options.
- National Institute on Drug Abuse. Principles of Drug Addiction Treatment: A Research-Based Guide. Distinguishes physical dependence from addiction and explains individualized treatment principles.
- Health Canada. Substance use treatment. Overview of treatment options, counselling, medication, harm reduction, and individualized care.
- Wood et al. (2023). Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder. Canadian Medical Association Journal. Recommendations for screening, withdrawal management, psychosocial treatment, and pharmacotherapy.
- Schwenker et al. (2023). Motivational interviewing for substance use reduction. Cochrane systematic review of 93 studies involving 22,776 participants.
- Yakovenko et al. (2024). Management of opioid use disorder: 2024 update to the national clinical practice guideline. Canadian Medical Association Journal. Recommendations on opioid agonist treatment, withdrawal management, and harm reduction.
- Health Canada. Benzodiazepines: Health effects, risks and withdrawal. Information on physical dependence, withdrawal symptoms, and overdose risks.
- Health Canada. Opioid overdose. Overdose warning signs, emergency response, naloxone, and factors that increase risk.
- Centre for Addiction and Mental Health. Concurrent disorders. Explains co-occurring mental health and substance use difficulties and the role of integrated treatment.
- ConnexOntario. Contact and support services. Free, confidential, 24-hour information and referrals for addiction and mental health services in Ontario.
- EMDR International Association. EMDR and Addictions Acronyms. Overview of addiction-focused EMDR terminology and approaches, including DeTUR, CravEx, trauma-focused EMDR, and addiction-focused EMDR.
- Therapeutic effects of eye movement desensitization and reprocessing for substance use disorders: A meta-analysis of addiction-related and emotional symptoms. 2025. Review of 14 studies examining craving, addiction severity, and co-occurring symptoms. The authors identified limitations in study quality and long-term evidence.
You can want things to change without knowing how to begin.
Maybe you are concerned about how much you drink. Maybe you’re finding it difficult to stop using. Perhaps you’re not sure whether addiction is the right word for what is happening.
We can begin with an honest conversation about your concerns and what kind of support would be useful.
Book a free 15-minute initial consultation to ask questions and explore whether counselling at BelMind Therapeia is an appropriate next step.