Is teen therapy available online or only in person?

Both. Most of our work with adolescents is done by Zoom, which fits how teens already live and removes friction for busy families. We can see your teen in person at our Princeton, NJ office by appointment. We are licensed in NY and NJ and authorized for telepsychology in PA, CT, and most PSYPACT states.

What ages do you treat?

Adolescents and young adults, roughly ages 13-25. We work with high school students, college students, and young adults navigating early career or graduate school.

How is your practice different from BetterHelp or Talkspace?

We are a private, doctorate-level psychology practice, not a platform. Your teen sees the same psychologist every session. We specialize in adolescents with substance use combined with anxiety, depression, ADHD, or family stress. We do not accept insurance, which gives us the time and clinical flexibility that platform-based therapy often cannot.

Do you involve parents in treatment?

Yes, when the young person consents, and at developmentally appropriate intervals. We see parents and family members on Zoom regularly, sometimes the entire family at once. The team approach (young person + family + clinician) is one of the strongest predictors of lasting change.

What if my teen will not agree to come?

Start by suggesting an evaluation, not 'treatment.' Frame it as: 'I just want you to get an evaluation. Let's just see what a professional has to say.' Most teens will agree to that. Once they meet with us and feel heard, they typically choose to continue.

Do you require abstinence as the only goal?

No. For alcohol and marijuana, moderation can be a clinically appropriate goal in some cases. For opioids, cocaine, methamphetamine, or benzodiazepines, abstinence is the goal because the medical risks are too high. We assess each young person individually.

Teen Therapy NYC, NJ, PA, CT | Dr. Lori Washton

Q: Does my teen have to stop using before they can come to therapy?

No. Demanding abstinence as a precondition for treatment is like telling someone who is depressed that they have to stop being depressed before they can see a therapist. We meet teens where they are and work from there. Most adolescents who come to us are still using when they start.

When Something Is Wrong

Most parents who reach out to us describe the same kind of moment. Something has happened. The school called. There was an arrest. A car accident. Or maybe nothing dramatic, but the picture has changed: grades slipping, friends changing, longer silences, the sense that something is off.

Whether it is marijuana, alcohol, cocaine, vaping, prescription pills, or Xanax, by the time a young person comes to our attention there has usually been a consequence. Some parents come earlier, they just do not like what they are seeing and want help before it escalates.

How you respond in the next few weeks will shape everything that comes next. The wrong move can shut down communication for years. The right kind of treatment, and the right clinician, can change the trajectory.

What We Treat

In adolescents, substance use almost never travels alone. The substance is usually a coping mechanism for an underlying emotional disorder. We treat both at the same time.

Substance Use

Marijuana, alcohol, cocaine, opioids, vaping, Xanax, prescription medications. We treat the use and the reason behind the use.

Anxiety & Depression

Co-occurring mental health conditions are the rule, not the exception. We treat both simultaneously rather than in sequence.

Academic Pressure

Achievement-oriented families often hide problems. Ivy League pressure, prep school environments, competitive grading, we know this world.

ADHD

Undiagnosed or inadequately treated ADHD frequently underlies adolescent substance use. We coordinate with psychiatrists when medication is appropriate.

Trauma & PTSD

Past trauma, whether recognized or not, often drives substance use as a way to shut down overwhelming feelings.

Family Conflict

Family dynamics affect and are affected by adolescent use. We work with the whole family, often on the same Zoom call.

A Different Kind of Treatment

No Abstinence Requirement to Start

Demanding that a teen stop using before treatment begins is like telling a depressed person to stop being depressed before they can see a therapist. It is not fair, it does not work, and it prevents people from coming into treatment in the first place.

Treat Both Problems at the Same Time

The emotional disorder and the substance use are treated together, not one before the other. This may mean coordinating with a psychiatrist for medication if there is depression, anxiety, bipolar disorder, or ADHD underneath.

Engage Through Listening, Not Pressure

Everybody wants to be heard, even when they are doing something they should not be doing. We start by hearing what the substance is doing for them, what they get out of it, and only then begin working on alternatives.

Pace Carefully, Pressure Backfires

Too much pressure too fast and they will relapse. They do not yet have the coping skills to handle the emotions they have been suppressing with substances. We move at the pace the young person can actually sustain.

Family as Essential Partners

Parents and siblings are part of the work. We provide guidance on how to be supportive without enabling, how to communicate without shutting things down, and how to manage the natural anxiety that comes with watching your child struggle.

Outpatient and Voluntary

For most adolescents, outpatient is the right fit, they keep going to school, keep their friendships, and develop coping skills in the actual environment where they will need to use them. We are the least restrictive level of treatment.

Why Teens Use What They Use

Different substances do different jobs. The substance a teen gravitates toward is clinical information, it tells us what they are trying to manage.

Marijuana, slows things down. Often used by teens who feel overstimulated, anxious, or whose minds will not stop racing. The risk: today's marijuana is many times stronger than the bud of past generations, and cart-based products can be laced with fentanyl. We have had teen patients hospitalized from marijuana, including seizures.

Alcohol, shuts down rational thoughts. Often used by teens whose internal world is too loud, perfectionism, social anxiety, family criticism. The thinking stops; the relief is immediate.

Opioids, eliminate anger. Teens who use opiates are often carrying anger they cannot express. The opiate makes the anger go away. This is one reason opioid use is so persistent, the underlying emotion does not have anywhere else to go.

Xanax and Benzodiazepines, chase a calm that mimics sleep. The danger is severe: combined with alcohol, regular Xanax use is physically addictive, and stopping suddenly can cause seizures. We have had teen patients almost die from Xanax-alcohol withdrawal.

Cocaine, an upper for teens who feel flat, exhausted, or unable to perform. More common in high school environments than most parents realize.

When we know what the substance is doing for a young person, we can begin asking the real question: what would let them feel that way without the substance?

Where We Fit in the Treatment System

Adolescent substance use treatment ranges from once-a-week outpatient therapy all the way up to locked psychiatric units. Knowing which level your teen actually needs is the first decision, and most parents do not have a clear map. Here is how the system is structured, in order of restrictiveness:

Outpatient Therapy (this is us)

One to two hours per week of individual therapy, with parent or family sessions as needed. The least restrictive level of care. Voluntary. The young person keeps their normal life and learns coping skills in the environment where they will use them.

Intensive Outpatient (IOP)

One to five days per week, three to six hours per day. Group-based. For teens who need more structure than weekly therapy but can still live at home.

Day Treatment / Partial Hospitalization

At least six hours per day, varying days per week. A step down from residential or a step up from IOP.

Residential Treatment

24 hours per day, voluntary. Like inpatient but less medically intensive. For teens whose home environment is unsafe or whose use cannot be interrupted on an outpatient basis.

Inpatient & Locked Units

Hospital-based, the most restrictive. Reserved for situations involving acute medical risk, severe withdrawal, suicidal or homicidal ideation, drug-induced psychosis. We refer out when the level of risk requires it.

Most adolescents who come to our practice can be effectively treated at the outpatient level. We escalate when needed and refer up the chain quickly if behavior becomes risky.

Why Working With Adolescents Is Different

Young people's brains are still developing. They are still plastic. If you can engage them and help them think differently about their use and how to cope, they shift much more rapidly than many adults.

A teen who learns to manage anxiety without alcohol at 17 carries that skill into college, into early career, into the rest of their adult life. A teen who learns to handle anger without opiates at 16 builds neural pathways that the substance was preventing.

This is why we treat young people. The window is open in a way it will not be in ten years.

For Parents

Even before your teen agrees to start, there is real work you can do. Parent consultation is available for families who:

Are concerned about substance use but unsure how to raise it without shutting down communication
Need to know whether what they are seeing is normal experimentation or genuine cause for concern
Are looking for the right next step after a crisis, arrest, school discipline, hospitalization
Want guidance on how to be supportive without enabling, and how to manage their own anxiety

If your teen will not agree to come, the most effective opener is to suggest an evaluation rather than therapy: "I just want you to get an evaluation. Let's see what a professional has to say." Most teens will agree to that, and once they meet with us and feel heard, they typically choose to continue.

Useful reading: how to talk to your teen about drug use · help for an out-of-control teen · how online therapy actually works for teens.

Young people walking up outdoor stairs together, recovery and forward motion

Dr. Lori Washton

Clinical Psychologist · Adolescent & Young Adult Specialist

For 25 years, Dr. Washton has worked with adolescents and young adults navigating substance use, anxiety, depression, ADHD, and the pressures of academic achievement. She specializes in families where success is expected and problems are concealed, Ivy League students, prep school environments, and high-achieving New York and New Jersey families.

Her approach builds trust with resistant teens while keeping parents appropriately informed, addressing the whole person, not just the symptom that brought them in. She is licensed in NY and NJ and authorized for telepsychology under PSYPACT.

"What gives real hope is that young people's brains are still plastic. If you can engage them and help them think differently about their use and how to cope, they shift much more rapidly than many adults."

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