Women's Issues, Clinical Treatment for Women

The clinical issues women bring into a private psychology practice rarely arrive in single-condition form. Anxiety presents alongside drinking. Depression overlaps with disordered eating. Trauma surfaces alongside relationship strain. Perimenopausal mood shifts are mistaken for marital problems. The work of clinical treatment for women, in my practice, is treating the picture as it actually is, not isolating one condition while pretending the others are not there.

This page outlines the conditions I most commonly treat in women, what assessment looks like, and what the work of treatment involves. The starting point is always a confidential consultation, not a treatment plan.

For a working definition of what specialization in women's clinical issues actually covers, see our reference: Therapist Specializing in Women's Issues, What That Actually Covers.

Clinical Conditions Treated

Alcohol Use Disorder

Mild to moderate AUD presents differently in women than in men. The pattern is often private, the off switch fails episodically rather than continuously, and the consequences accumulate quietly over years. Treatment is matched to severity and to the co-occurring conditions usually present.

Read the clinical guide →

Anxiety Disorders

Generalized anxiety, social anxiety, and panic disorder are among the most common conditions I see in women, and frequently they precede the substance use that brings the patient into treatment. Cognitive-behavioral therapy and motivational work are evidence-based approaches; medication coordination with a psychiatrist is part of the work when appropriate.

Depression

Depression in women often carries features that complicate the standard treatment picture: rumination patterns, fatigue indistinguishable from postpartum or perimenopausal change, and self-medication with alcohol that obscures the underlying mood symptoms. Accurate assessment is the first part of treatment.

Trauma and PTSD

Many women presenting with substance use have a history of trauma, often unresolved, sometimes only recognized retrospectively. Trauma-informed treatment paces the work to what the patient is ready to handle. The substance use is treated alongside the trauma, not as a precondition to addressing it.

Perimenopausal and Hormonal Mood Changes

Mood, anxiety, sleep, and cravings shift across the menstrual cycle, through pregnancy and postpartum, and through perimenopause. Women in their forties and fifties often describe a noticeable change in their relationship with alcohol that maps onto hormonal change. The clinical assessment accounts for this.

Disordered Eating Patterns

Eating disorder patterns and substance use frequently co-occur in women, and the two conditions reinforce each other. Treatment addresses both; coordination with eating-disorder-specialty care is arranged when the severity requires it.

Relationship and Family Strain

When the substance use or mental health condition is affecting a marriage, partnership, or parenting relationship, family work is offered when it fits the case. Some women want a partner involved; some do not. The patient defines this.

Co-Occurring Substance Use and Mental Health Conditions

The combination of a mood or anxiety disorder with substance use is the most common presentation in my practice. Treating both simultaneously, rather than sequentially, is the evidence-based approach for most cases.

How the Work Is Structured

Initial consultation

A confidential 60-90 minute conversation that establishes the clinical picture, identifies the most pressing conditions, and determines what realistic treatment options look like. Most consultations are conducted via secure video.

Ongoing therapy

If treatment is appropriate, weekly individual sessions are the typical structure. Frequency adjusts as the situation stabilizes. Modalities include cognitive-behavioral therapy, motivational interviewing, psychodynamic work, and trauma-informed approaches, matched to the case.

Medication coordination

When medication is appropriate, for the underlying condition, for substance use cravings, or for both, coordination with a psychiatrist familiar with this clinical population is part of the work.

Privacy and access

All care is delivered as private, self-pay psychology. Records stay within the practice. There are no insurance claims, no employer notifications. PSYPACT authorization allows for telehealth in over 30 states.

Dr. Lori Washton

Clinical Psychologist · Women & Adolescents

Dr. Lori Washton is a clinical psychologist with over 25 years of experience treating women and adolescents whose substance use occurs alongside anxiety, depression, trauma, or other co-occurring conditions. Her clinical orientation is harm-reduction-first, family-systems-aware, and evidence-based. She does not require abstinence as a precondition for treatment.

Licensed in NY and NJ; PSYPACT-authorized for telehealth in over 30 additional states. Self-pay private practice. Initial consultations conducted via secure video.

Women's Clinical Issues