Joshua Cary

Counseling | Addiction (Substance Use Disorder)

2445 W Whites Bridge Ave Fresno CA, 93706 Show map

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About

Joshua S. Cary SUDRC is a dedicated and compassionate professional in the field of social work and addiction counseling, bringing years of hands-on experience and extensive academic knowledge to his role. Currently pursuing advanced studies in Social Work, Joshua has honed a deep understanding of substance use disorders (SUD) and the complexities of addiction treatment. His skill set includes proficiency in Motivational Interviewing, ASAM assessment, and creating effective treatment plans that address both immediate needs and long-term recovery goals. As a registered counselor with CADTP, he is well-versed in evidence-based practices and is adept at tailoring interventions to each individual’s stage of change and unique circumstances. Joshua’s approach is rooted in empathy, cultural competency, and a commitment to dismantling the social stigma around addiction, making him an impactful advocate and a trusted ally for those on the path to recovery.

Education and Training

Fresno City College AA, AS, AA 2025

Provider Details

Male English

Joshua Cary

Joshua Cary's Expert Contributions

My Answers

Can social anxiety disorder be fixed?
The duration of alcohol addiction treatment can vary widely depending on individual needs, the severity of the addiction, and the type of treatment chosen. Here’s an overview of the typical stages and timelines: 1. Detox (5-7 days) For people with moderate to severe alcohol dependence, medical detox is often the first step. Detox typically lasts 5-7 days, but some may need more or less time. During this time, symptoms of withdrawal are managed under medical supervision. 2. Inpatient Treatment (28-90 days) Inpatient or residential treatment usually lasts between 28 and 90 days. In these programs, patients receive intensive therapy, counseling, and support in a structured environment. Shorter stays of around 28 days are common, but some people benefit from longer programs of 60 or 90 days if the addiction is severe or if there are co-occurring mental health issues. 3. Outpatient Treatment (3 months to a year or more) Outpatient treatment, which allows individuals to live at home and attend treatment sessions, can last from several months to a year or more. Outpatient care often follows inpatient treatment but can also be a standalone approach, particularly if the addiction is less severe. Sessions can include individual therapy, group therapy, family counseling, and support groups like AA (Alcoholics Anonymous). 4. Aftercare and Ongoing Support (Indefinite) Recovery from alcohol addiction is often considered a lifelong journey. Aftercare, which can include regular counseling, 12-step meetings, and peer support groups, may continue indefinitely to help prevent relapse. Many people attend support meetings or therapy for years as a way to maintain sobriety and build a support network. Encouraging your friend to discuss treatment options with a medical provider or addiction specialist can help tailor a program to their specific needs. They may also benefit from trying different treatments to see what works best for them. READ MORE
Alcohol withdrawal
If you have been drinking only one alcoholic beverage every night, it is generally unlikely that you will experience significant withdrawal symptoms if you quit. Alcohol withdrawal symptoms usually occur in individuals who drink larger amounts or drink more frequently over extended periods. However, everyone's body is different, and withdrawal can vary depending on individual factors like metabolism, genetics, and overall health. Typical alcohol withdrawal symptoms can include anxiety, restlessness, mild tremors, and difficulty sleeping, but these are more common in people with a higher level of alcohol dependency. Since you’re not on any medications or have underlying conditions, the risk should be lower for severe withdrawal symptoms. If you do notice mild symptoms or feel concerned, it can be helpful to consult a healthcare provider for guidance on the safest way to stop drinking. READ MORE
What treatments work for drug addiction?
There are several evidence-based treatments for drug addiction, each addressing different aspects of the condition. Effective treatment plans often combine multiple approaches, as addiction is a complex disease that affects both the brain and behavior. Here’s an overview of treatments that work well for drug addiction: 1. Behavioral Therapies Cognitive Behavioral Therapy (CBT): CBT helps individuals recognize and change patterns of thinking and behavior related to drug use. It’s effective in helping people cope with triggers, avoid situations that lead to drug use, and build healthier habits. Motivational Interviewing (MI): MI enhances motivation to quit by helping individuals explore their reasons for change and resolve ambivalence. It’s especially helpful for those who may not feel ready for treatment. Contingency Management: This approach uses rewards to encourage sobriety. For instance, individuals receive incentives for each drug-free urine test, reinforcing positive behaviors. Effectiveness: Behavioral therapies are highly effective because they address underlying thought patterns and provide tools for long-term recovery. 2. Medication-Assisted Treatment (MAT) For Opioid Addiction: Medications like methadone, buprenorphine, and naltrexone reduce cravings and withdrawal symptoms, helping individuals maintain sobriety. For Alcohol Addiction (if applicable): Medications like naltrexone and acamprosate can help reduce cravings and manage symptoms. For Nicotine Addiction: Nicotine replacement therapies (patches, gum) and medications like varenicline (Chantix) or bupropion (Zyban) can help with cravings. Effectiveness: MAT is especially effective for opioid addiction and is often combined with counseling and behavioral therapies. Medications help stabilize the individual and reduce the risk of relapse, particularly in the early stages of recovery. 3. Support Groups and Peer Support Programs 12-Step Programs (e.g., Narcotics Anonymous): A structured program offering community support and a set of principles to guide recovery. 12-step groups provide a supportive environment and a sense of accountability. SMART Recovery: A non-12-step program focused on self-management, cognitive skills, and self-empowerment, useful for individuals who prefer a science-based approach. Effectiveness: Support groups are effective for providing long-term support, building a sense of community, and preventing relapse. They offer a non-judgmental space to share experiences, find encouragement, and connect with others facing similar challenges. 4. Inpatient and Outpatient Rehabilitation Programs Inpatient Rehab: Typically involves staying at a treatment facility for 28 to 90 days, providing intensive, structured support. Inpatient programs often include medical supervision, counseling, group therapy, and activities to support sobriety. Outpatient Rehab: Allows individuals to attend treatment sessions while living at home. Outpatient programs can be intensive or scheduled less frequently, depending on the person’s needs. Effectiveness: Inpatient rehab is especially beneficial for those with severe addictions or those who need a stable environment away from triggers. Outpatient rehab can also be highly effective, particularly if the person has a strong support network. 5. Aftercare and Relapse Prevention Ongoing Counseling or Therapy: Continued therapy helps individuals address life stressors, manage triggers, and work through challenges that arise after treatment. Sober Living Homes: Transitional housing that offers a sober environment for people who have completed rehab. These homes provide structure, peer support, and accountability. Relapse Prevention Programs: These programs teach individuals how to recognize and manage triggers, build coping strategies, and develop a plan for maintaining sobriety. Effectiveness: Aftercare is essential for maintaining sobriety and preventing relapse, as it reinforces skills learned in treatment and provides ongoing support. 6. Holistic and Complementary Therapies Exercise and Nutrition Programs: Physical health can greatly impact mental well-being and recovery, making exercise and healthy eating an important part of treatment. Mindfulness and Meditation Practices: Techniques like mindfulness, yoga, and meditation can help manage stress, improve emotional regulation, and reduce cravings. Effectiveness: These therapies can enhance traditional treatments, supporting overall wellness and resilience. They can help individuals build new, healthy habits and reduce stress. Summary Combining these approaches tends to be the most effective strategy for long-term recovery. Treatment plans should be tailored to the individual, addressing their specific needs, circumstances, and preferences. For many people, a combination of behavioral therapy, medication-assisted treatment (if applicable), and ongoing support can provide the best results. READ MORE
Can cannabis addiction be fixed?
Yes, recovery from cannabis addiction is absolutely possible, and many people successfully address their cannabis dependence with the right strategies and support. Here’s what recovery typically involves: 1. Recognizing the Addiction Acknowledging that cannabis use has become problematic is the first step. Addiction is often marked by cravings, increased tolerance, difficulty controlling use, and negative effects on daily life, so recognizing these patterns can help build motivation to make changes. 2. Developing a Treatment Plan Recovery from cannabis addiction can look different for everyone, so finding a personalized approach is important. Common treatment options include therapy (such as cognitive behavioral therapy), counseling, and support groups. Some people find outpatient counseling helpful, while others may benefit from a more structured program if they need additional support. 3. Therapy and Behavioral Interventions Therapy can be extremely effective in managing cannabis addiction. Cognitive Behavioral Therapy (CBT), Motivational Enhancement Therapy (MET), and contingency management are common approaches that help individuals develop healthier coping skills, change thought patterns, and reinforce positive behaviors. Therapy also helps address underlying issues like anxiety or stress that might drive cannabis use. 4. Building a Support System Support from friends, family, or support groups can be essential in recovery. Groups like Marijuana Anonymous (MA) provide a nonjudgmental space to share experiences, gain encouragement, and develop healthy routines. Having people around who understand your journey can make a big difference, especially during times of temptation or stress. 5. Setting Goals and Tracking Progress Setting small, realistic goals, such as reducing use gradually or tracking sober days, can help maintain motivation and provide a sense of accomplishment. A journal, app, or calendar can help you track progress, which often reveals how far you’ve come and encourages you to keep going. 6. Managing Cravings and Withdrawal Symptoms Some people experience withdrawal symptoms like irritability, insomnia, or anxiety when they quit. These are temporary and usually subside within a couple of weeks, but having a plan for managing these symptoms (such as relaxation techniques or a healthy routine) can make the process smoother. A healthcare provider can also provide guidance on handling withdrawal symptoms if they are significant. 7. Building New Habits Recovery is often about replacing old habits with new, fulfilling activities. Many people find that exercise, hobbies, mindfulness practices, or other activities help manage stress and reduce the urge to use cannabis. Finding meaning and enjoyment in new activities can reinforce the decision to stay substance-free. 8. Commitment to Long-Term Recovery Like other addictions, recovery from cannabis use disorder is a journey, and it’s important to continue building on positive changes and staying connected to support. Relapses can happen, and if they do, it’s helpful to view them as a learning opportunity rather than a setback. With ongoing support and the right strategies, you can move forward and strengthen your recovery. Summary Cannabis addiction can absolutely be addressed with the right support and approach. Recovery is possible, and with a personalized plan, commitment, and support network, you can successfully overcome cannabis dependence. It’s a process, but every small step forward helps reinforce the positive changes in your life. READ MORE
Can alcohol addiction be cured?
Alcoholism, often referred to as alcohol use disorder (AUD), is typically considered a chronic, manageable condition rather than something that can be "cured" in the traditional sense. However, many people successfully recover and lead fulfilling, sober lives. Here’s a breakdown of what recovery from alcoholism looks like: 1. Long-Term Recovery, Not a Cure Like other chronic conditions (such as diabetes or hypertension), alcohol addiction can be managed effectively, but it requires ongoing care and lifestyle adjustments. Recovery focuses on managing the condition, preventing relapse, and building a life where alcohol no longer plays a central role. 2. Achieving Sobriety and Maintaining It With the right treatment and support, many people stop drinking and maintain sobriety indefinitely. This process often involves therapy, peer support groups (like AA), medical treatment, or a combination of approaches tailored to the individual's needs. 3. Relapse as a Part of Recovery Relapses can happen and are often considered a part of the recovery process, not a failure. Many people experience setbacks but go on to achieve long-term sobriety. The focus in recovery is on building skills and support systems that make it easier to recover from setbacks and maintain progress. 4. Tools for Lasting Recovery Treatment often includes therapy (such as CBT or Motivational Interviewing), lifestyle changes, support groups, and sometimes medication to help reduce cravings or manage withdrawal symptoms. Recovery tools help people develop new ways of coping with stress, building healthy habits, and finding purpose outside of alcohol. 5. A Lifelong Commitment to Health and Well-being Because AUD is a chronic condition, most people in recovery find that ongoing support (whether through counseling, support groups, or peer connections) is essential to maintaining sobriety. Many people in recovery consider themselves to be "in recovery" indefinitely, recognizing the importance of staying connected to support and maintaining their sobriety-focused lifestyle. Summary While there’s no definitive “cure” for alcoholism, recovery is entirely possible, and millions of people maintain sobriety through a variety of treatments and ongoing support. Encouraging your friend to seek professional guidance and connect with support resources can be a powerful step in their journey toward a sober and fulfilling life. READ MORE
Can alcoholism be cured?
Alcoholism, often referred to as alcohol use disorder (AUD), is typically considered a chronic, manageable condition rather than something that can be "cured" in the traditional sense. However, many people successfully recover and lead fulfilling, sober lives. Here’s a breakdown of what recovery from alcoholism looks like: 1. Long-Term Recovery, Not a Cure Like other chronic conditions (such as diabetes or hypertension), alcohol addiction can be managed effectively, but it requires ongoing care and lifestyle adjustments. Recovery focuses on managing the condition, preventing relapse, and building a life where alcohol no longer plays a central role. 2. Achieving Sobriety and Maintaining It With the right treatment and support, many people stop drinking and maintain sobriety indefinitely. This process often involves therapy, peer support groups (like AA), medical treatment, or a combination of approaches tailored to the individual's needs. 3. Relapse as a Part of Recovery Relapses can happen and are often considered a part of the recovery process, not a failure. Many people experience setbacks but go on to achieve long-term sobriety. The focus in recovery is on building skills and support systems that make it easier to recover from setbacks and maintain progress. 4. Tools for Lasting Recovery Treatment often includes therapy (such as CBT or Motivational Interviewing), lifestyle changes, support groups, and sometimes medication to help reduce cravings or manage withdrawal symptoms. Recovery tools help people develop new ways of coping with stress, building healthy habits, and finding purpose outside of alcohol. 5. A Lifelong Commitment to Health and Well-being Because AUD is a chronic condition, most people in recovery find that ongoing support (whether through counseling, support groups, or peer connections) is essential to maintaining sobriety. Many people in recovery consider themselves to be "in recovery" indefinitely, recognizing the importance of staying connected to support and maintaining their sobriety-focused lifestyle. Summary While there’s no definitive “cure” for alcoholism, recovery is entirely possible, and millions of people maintain sobriety through a variety of treatments and ongoing support. Encouraging your friend to seek professional guidance and connect with support resources can be a powerful step in their journey toward a sober and fulfilling life. READ MORE
How can you help with my alcohol addiction?
While I can’t replace a therapist or addiction specialist, I can guide you in the right direction and be a source of information and support as you explore recovery. If you’re open to it, reaching out to a healthcare professional or counselor trained in addiction treatment can also be a powerful step in building a personalized, professional support system. READ MORE
Which treatment is the most effective for an alcohol addiction?
The most effective treatment for alcohol addiction often combines multiple approaches, tailored to your specific needs, lifestyle, and goals. Here’s an overview of some of the most effective treatments for alcohol addiction: 1. Behavioral Therapy Cognitive Behavioral Therapy (CBT): CBT helps you identify and change negative thought patterns and behaviors associated with alcohol use. It teaches practical skills to manage triggers and cope with cravings. Motivational Interviewing (MI): This approach helps increase motivation to quit by exploring and resolving ambivalence toward change. It’s collaborative and respects your goals and readiness to change. Contingency Management: This method involves rewarding positive behaviors (like maintaining sobriety), reinforcing healthy habits. Effectiveness: Therapy is highly effective because it addresses the mental and emotional factors of addiction and builds long-term coping skills. 2. Medications for Alcohol Use Disorder (AUD) Naltrexone: Reduces cravings by blocking the pleasurable effects of alcohol on the brain. Acamprosate: Helps maintain abstinence by reducing cravings and withdrawal symptoms. Disulfiram: Causes unpleasant reactions (e.g., nausea, headache) if you drink alcohol, discouraging use. Effectiveness: Medication can be very helpful when combined with counseling or therapy, particularly for those who experience strong cravings or have a high risk of relapse. It’s important to consult a doctor to see if medication is a good fit for you. 3. Support Groups and Peer Support Alcoholics Anonymous (AA): A 12-step program where individuals support each other in maintaining sobriety. AA also offers a structured framework and a sense of community. SMART Recovery: A science-based, self-help program that focuses on building self-management skills and self-empowerment. Group Therapy: Led by a therapist, group therapy offers peer support with professional guidance. Effectiveness: Support groups are particularly effective in providing long-term community support. They offer accountability, reduce isolation, and allow individuals to share their experiences with others on the same journey. 4. Inpatient and Outpatient Rehab Programs Inpatient Rehab: A highly structured environment that offers 24/7 support, typically lasting 28 to 90 days. It’s effective for those needing intense support or a break from daily triggers. Outpatient Rehab: Allows you to continue living at home while attending therapy sessions several times a week. It’s flexible and can be effective if you have a stable home environment. Effectiveness: Inpatient programs have high success rates, especially for individuals with severe addiction or co-occurring mental health issues. Outpatient rehab is also highly effective, particularly when supplemented with ongoing therapy or support groups. 5. Aftercare and Relapse Prevention Programs Continuing Care Programs: After initial treatment, continuing care like follow-up therapy or support groups helps reinforce sobriety. Relapse Prevention Counseling: Focuses on understanding triggers, building coping skills, and planning for potential high-risk situations. Effectiveness: Aftercare is crucial for long-term success, as it provides tools for managing challenges post-treatment and helps maintain positive momentum. Choosing the Right Treatment The best treatment often combines several approaches: therapy for emotional support, medication for managing cravings (if needed), and support groups for community and accountability. A healthcare provider or addiction specialist can help develop a plan that suits your specific needs. With dedication and the right resources, recovery is achievable, and each step brings you closer to lasting sobriety. READ MORE
What are the treatment methods for alcohol addiction?
There are several evidence-based treatments for drug addiction, each addressing different aspects of the condition. Effective treatment plans often combine multiple approaches, as addiction is a complex disease that affects both the brain and behavior. Here’s an overview of treatments that work well for drug addiction: 1. Behavioral Therapies Cognitive Behavioral Therapy (CBT): CBT helps individuals recognize and change patterns of thinking and behavior related to drug use. It’s effective in helping people cope with triggers, avoid situations that lead to drug use, and build healthier habits. Motivational Interviewing (MI): MI enhances motivation to quit by helping individuals explore their reasons for change and resolve ambivalence. It’s especially helpful for those who may not feel ready for treatment. Contingency Management: This approach uses rewards to encourage sobriety. For instance, individuals receive incentives for each drug-free urine test, reinforcing positive behaviors. Effectiveness: Behavioral therapies are highly effective because they address underlying thought patterns and provide tools for long-term recovery. 2. Medication-Assisted Treatment (MAT) For Opioid Addiction: Medications like methadone, buprenorphine, and naltrexone reduce cravings and withdrawal symptoms, helping individuals maintain sobriety. For Alcohol Addiction (if applicable): Medications like naltrexone and acamprosate can help reduce cravings and manage symptoms. For Nicotine Addiction: Nicotine replacement therapies (patches, gum) and medications like varenicline (Chantix) or bupropion (Zyban) can help with cravings. Effectiveness: MAT is especially effective for opioid addiction and is often combined with counseling and behavioral therapies. Medications help stabilize the individual and reduce the risk of relapse, particularly in the early stages of recovery. 3. Support Groups and Peer Support Programs 12-Step Programs (e.g., Narcotics Anonymous): A structured program offering community support and a set of principles to guide recovery. 12-step groups provide a supportive environment and a sense of accountability. SMART Recovery: A non-12-step program focused on self-management, cognitive skills, and self-empowerment, useful for individuals who prefer a science-based approach. Effectiveness: Support groups are effective for providing long-term support, building a sense of community, and preventing relapse. They offer a non-judgmental space to share experiences, find encouragement, and connect with others facing similar challenges. 4. Inpatient and Outpatient Rehabilitation Programs Inpatient Rehab: Typically involves staying at a treatment facility for 28 to 90 days, providing intensive, structured support. Inpatient programs often include medical supervision, counseling, group therapy, and activities to support sobriety. Outpatient Rehab: Allows individuals to attend treatment sessions while living at home. Outpatient programs can be intensive or scheduled less frequently, depending on the person’s needs. Effectiveness: Inpatient rehab is especially beneficial for those with severe addictions or those who need a stable environment away from triggers. Outpatient rehab can also be highly effective, particularly if the person has a strong support network. 5. Aftercare and Relapse Prevention Ongoing Counseling or Therapy: Continued therapy helps individuals address life stressors, manage triggers, and work through challenges that arise after treatment. Sober Living Homes: Transitional housing that offers a sober environment for people who have completed rehab. These homes provide structure, peer support, and accountability. Relapse Prevention Programs: These programs teach individuals how to recognize and manage triggers, build coping strategies, and develop a plan for maintaining sobriety. Effectiveness: Aftercare is essential for maintaining sobriety and preventing relapse, as it reinforces skills learned in treatment and provides ongoing support. 6. Holistic and Complementary Therapies Exercise and Nutrition Programs: Physical health can greatly impact mental well-being and recovery, making exercise and healthy eating an important part of treatment. Mindfulness and Meditation Practices: Techniques like mindfulness, yoga, and meditation can help manage stress, improve emotional regulation, and reduce cravings. Effectiveness: These therapies can enhance traditional treatments, supporting overall wellness and resilience. They can help individuals build new, healthy habits and reduce stress. Summary Combining these approaches tends to be the most effective strategy for long-term recovery. Treatment plans should be tailored to the individual, addressing their specific needs, circumstances, and preferences. For many people, a combination of behavioral therapy, medication-assisted treatment (if applicable), and ongoing support can provide the best results. READ MORE

Areas of expertise and specialization

Motivational InterviewingTrauma Informed CareDBT, CBT evidenced based practices.ASAM criteria

Professional Memberships

CADTP. https://cadtpcounselors.org/

Areas of research

My education and research spans several vital areas within social work, addiction counseling, and community health. His work in Substance Use Disorder (SUD) Treatment focuses on evidence-based interventions, such as Motivational Interviewing, and examines the role of social stigma in recovery efforts. Additionally, Joshua explores Health Disparities and Access to Care, advocating for equitable treatment for marginalized groups in addiction recovery. His research extends into Ethnic Studies and Social Justice, where he investigates the impact of historical trauma and cultural identity on substance use, with a particular emphasis on Indigenous and minority communities. Rooted in a strong commitment to community service, Joshua also examines Environmental and Urban Studies related to sustainability and health in Central California. Together, these areas reflect his dedication to enhancing recovery support systems, addressing social inequities, and advancing culturally responsive care.