Skip to content
  • Mental Health Issues
    • Anxiety
    • ADHD
    • Bipolar Disorder
    • Depression
    • Grief
    • OCD
    • Personality Disorders
    • PTSD
  • Relationships
    • Dating
    • Marriage
    • Sex & Intimacy
    • Infidelity
    • Relationships 101
  • Wellness
    • Anger
    • Burnout
    • Stress
    • Sleep
    • Meditation
    • Mindfulness
    • Yoga
  • Therapy
    • Starting Therapy
    • Types of Therapy
    • Best Online Therapy Services
    • Online Couples Therapy
    • Online Therapy for Teens
  • Medication
    • Anxiety Medication
    • Depression Medication
    • ADHD Medication
    • Best Online Psychiatrist Options
  • My Mental Health
    • Men
    • Women
    • BIPOC
    • LGBTQIA+
    • Parents
    • Teens
  • About Us
    • Editorial Policy
    • Advertising Policy
    • About Us
    • Find a Local Therapist
    • Join Our Free Directory

Join our Newsletter

Get helpful tips and the latest information

Choosing Therapy on Facebook
Choosing Therapy on Instagram
Choosing Therapy on Twitter
Choosing Therapy on Linkedin
Choosing Therapy on Pinterest
Choosing Therapy on Tiktok
Choosing Therapy on Youtube
Choosing Therapy Logo

Newsletter

  • Mental Health Issues
    • Anxiety
    • ADHD
    • Bipolar Disorder
    • Depression
    • Grief
    • OCD
    • Personality Disorders
    • PTSD
  • Relationships
    • Dating
    • Marriage
    • Sex & Intimacy
    • Infidelity
    • Relationships 101
  • Wellness
    • Anger
    • Burnout
    • Stress
    • Sleep
    • Meditation
    • Mindfulness
    • Yoga
  • Therapy
    • Starting Therapy
    • Types of Therapy
    • Best Online Therapy Services
    • Online Couples Therapy
    • Online Therapy for Teens
  • Medication
    • Anxiety Medication
    • Depression Medication
    • ADHD Medication
    • Best Online Psychiatrist Options
  • My Mental Health
    • Men
    • Women
    • BIPOC
    • LGBTQIA+
    • Parents
    • Teens
  • About Us
    • Editorial Policy
    • Advertising Policy
    • About Us
    • Find a Local Therapist
    • Join Our Free Directory
  • What Is Schizophrenia?What Is Schizophrenia?
  • Schizophrenia & AlcoholSchizophrenia & Alcohol
  • Comorbidity With AUDComorbidity With AUD
  • Alcohol's Effects on SymptomsAlcohol's Effects on Symptoms
  • Can Alcohol Cause Symptoms?Can Alcohol Cause Symptoms?
  • Signs of Alcohol MisuseSigns of Alcohol Misuse
  • Treatment OptionsTreatment Options
  • ConclusionConclusion
  • ResourcesResources
  • InfographicsInfographics

Schizophrenia & Alcohol: Understanding the Connections

Headshot for John Cottone, PhD

Written by: John Cottone, PhD

Rajy Abulhosn, MD

Reviewed by: Rajy Abulhosn, MD

Published: December 19, 2022
John G. Cottone, PhD
Written by:

John Cottone 

PHD
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD

The connection between schizophrenia and alcohol is not completely understood. People with schizophrenia consume alcohol for many of the same reasons as unaffected individuals. However, there are a number of reasons why drinking alcohol may present unique risks for those with schizophrenia. Understanding the risks is important considering the high comorbidity between schizophrenia, alcohol use disorder and other substance-related

Schizophrenia Treatment, Covered by Insurance

Grow Therapy enables you to find a psychiatrist or psychiatric nurse practitioner who can diagnose your condition, prescribe appropriate medications, and monitor your reaction to medication. Find A Provider

Choosing Therapy is compensated for marketing by Grow Therapy.

Find A Provider

What Is Schizophrenia?

Schizophrenia is a mental disorder that includes chronic psychotic symptoms such as hallucinations and delusions. Though it occurs in under 1% of the population worldwide, its burden on family and society at large is far-reaching, with the illness being among the top 15 leading causes of disability.1

Usually schizophrenia is diagnosed between late adolescence and early adulthood (upper range of late 20s for males and early 30s for females) with the onset of psychotic symptoms. However, subtle signs and symptoms may emerge earlier in the form of negative and cognitive symptoms.

According to the DSM 5, a person with schizophrenia will exhibit at least two of the first five symptoms (with at least one being a positive symptom) for a period of one month or more:

  • Delusions: Distorted beliefs that, despite possibly having a kernel of truth, are not supported by the overwhelming evidence accessible to most other objective, non-psychotic observers.
  • Hallucinations: Sensory illusions that can take the form of seeing, hearing or tasting things that aren’t really there.
  • Disorganized speech: Speech that does not make logical sense or is incoherent. Speech disturbances may also manifest as a reduction in speech (alogia) or an increase in speech (pressured speech).
  • Disorganized behavior: Behavior that does not fit a given situation.
  • Negative symptoms: Absence of typical, common or normal features that most individuals regularly exhibit, such as blunted affect (reduced emotional expression), avolition (reduced motivation), and asociality (reduced desire to interact with others).
  • Cognitive symptoms: Expert clinicians may use cognitive symptoms (such as verbal fluency and memory impairment) to distinguish schizophrenia from other disorders.

Can Someone With Schizophrenia Drink Alcohol?

It is risky for someone with schizophrenia to drink alcohol for a number of reasons. First, some of the same brain circuits that are dysfunctional in schizophrenia are what put an individual at greater risk for substance dependence and misuse. In fact, rates of heavy alcohol use are three times higher for those with a psychotic disorder than the general population.2

Even though people with schizophrenia report using alcohol for many of the same reasons as neurotypical individuals (e.g., stress relief, to relax, to feel “buzzed”), the risk for misuse is higher. This is due to impairments in decision-making, impulse control, and related executive functioning. Accordingly, it is likely harder for individuals with schizophrenia to inhibit themselves after one or two drinks than a neurotypical person.

Second, alcohol can interact with antipsychotic medications, which can render them ineffective, or even lead to overdose, toxicity, or death.3 Medication compliance is notably difficult with schizophrenia, even without alcohol misuse. Once therapeutic levels of antipsychotics become unstable as a result of excessive alcohol consumption, an acute episode of psychosis can arise that may lead to exacerbation of symptoms and further medication noncompliance. As such, people with schizophrenia who misuse alcohol are more likely to skip their medication than those who do not.4

Schizophrenia & Alcohol Abuse

Schizophrenia has a very high comorbidity rate with substance use disorders (47%). Furthermore, alcohol use disorder (AUD) is experienced by 24.3% – 33.7% of individuals with schizophrenia.4, 5 The combined toll of these two disorders can be incredibly detrimental to the person, their family, and community.

Alcohol is legal, readily available, and relatively inexpensive, which makes it particularly easy to access and use in excess. Unfortunately, individuals with schizophrenia who also misuse alcohol typically have poor medication compliance and tend to live in stressful circumstances that lack support. They are also more likely to be depressed, misuse other substances, become homeless, engage in disruptive behavior, go to jail, or be hospitalized.4

The neurobiology of schizophrenia increases vulnerability to addiction in general. Impairments in impulse control, inhibition, and decision-making are common to schizophrenia. In turn, drinking alcohol in moderation proves more difficult, especially considering that alcohol further exacerbates these deficits. It’s like a double punch to the same area.

Individuals with schizophrenia are safest when practicing alcohol (and drug) abstinence in order to avoid developing dependence or relapsing to alcohol misuse. Those who are diagnosed with both schizophrenia and alcohol use disorder (but can remain abstinent from alcohol use) show fewer psychiatric symptoms, reduced hospitalizations, improved psychosocial stability, and improved quality of life, relative to those who do not remain abstinent.4

Does Alcohol Make Schizophrenia Symptoms Worse?

The relationship between alcohol misuse and exacerbation of schizophrenia symptoms has not been as widely studied as schizophrenia and cannabis and other drugs. If a relationship does exist between the two, it is likely indirect and mediated by other factors.

For instance, those who drink alcohol are more likely not to take their medications, resulting in exacerbated symptoms. Furthermore, due to the presence of hallucinations or delusions, those with schizophrenia already have a difficult time separating reality from their false perceptions. Therefore, if one’s brain is under the effect of alcohol, the ability to determine fact from fiction can be further impacted.

In those with schizophrenia, alcohol misuse increases the risk of heightened:

  • Suicidal ideation
  • Depression
  • Disruptive behavior
  • Aggression/violence
  • Medication nonadherence
  • Misuse of other substances
  • Chronic medical problems
  • Incarceration
  • Legal problems
  • Family problems
  • Homelessness
  • High rates of hospitalization

Alcohol-Related Psychosis

Excessive use of alcohol over an extended period of time can induce psychosis in individuals who do not have schizophrenia. This is called alcohol-related psychosis (aka alcohol-induced psychotic disorder, alcohol hallucinosis). Although it may share certain symptoms with schizophrenia or other primary psychotic disorders, it is different.

Schizophrenia is a chronic, long-term disorder, while alcohol-related psychosis is much briefer, usually resolving within weeks. Sometimes alcohol-induced psychosis can result from alcohol withdrawal as well, and symptoms can include hallucinations (usually auditory but sometimes visual) and delusions (usually persecutory).6 Delirium tremens is another alcohol-related psychotic state specific to acute withdrawal from an alcohol-dependent condition, and this is also distinct from both schizophrenia and alcohol-induced psychotic disorder.

Help For Addiction

Ria Health: Effective, Evidence-Based Alcohol Treatment 100% Online Quickly change your relationship to alcohol with our at-home program. On average, Ria Health members reduce their BAC levels by 50% in 3 months in the program. Services are covered by many major health plans. Visit Ria Health


Telehealth Treatment For Opioid Use Disorder Bicycle Health offers therapy, support, and medication for addiction treatment (MAT).  MAT offers the lowest relapse rates for opioid use disorder, helping people to stop using opioids with minimal physical discomfort. Covered by most major insurance. Visit Bicycle Health.

Choosing Therapy partners with leading mental health companies and is compensated for marketing by Ria Health and  Bicycle Health.

Can Alcohol Abuse Cause Schizophrenia?

While a direct causal link between alcoholism and schizophrenia is lacking, about ⅓ of individuals with schizophrenia or schizophreniform disorder also meet criteria for an alcohol-use disorder (AUD).4 As such, it seems that both schizophrenia and AUDs may be have similar causal influences, including genetic predispositions to neurological vulnerabilities, and environmental factors like drug use, poverty, physical/sexual abuse, and trauma. However, it is important to note that alcohol misuse cannot directly lead to the onset of clinical schizophrenia. Alcohol use exacerbates dysfunction of certain brain regions and contributes to a vicious cycle of schizophrenia symptoms and alcohol misuse.

Schizophrenia and an alcohol use disorder share similar possible causations including:

Genetics

There seems to be a heritability factor underlying the co-occurring nature of schizophrenia and substance use disorders in general, including AUD.2, 7 Schizophrenia (80-85%) and AUD (40-60%) are highly heritable, and genes that predispose one to impaired functioning of the brain’s dopamine ‘reward circuit’ (mesocorticolimbic system) may underlie both of these conditions.8

Neurological impairments

Impairments in the mesocorticolimbic system, also referred to as the brain’s “reward circuit,” underlie problems with inhibition and impulsivity, motivation, emotion, learning, and memory. Dysfunction of this circuitry (including brain regions such as the prefrontal cortex, hippocampus, amygdala, nucleus accumbens, and ventral tegmentum) and related neurotransmitters (e.g., dopamine, glutamate, serotonin) can lead to many shared symptoms of these disorders.  (this sentence is actually what the author should have said above in the “does alcohol use make schizophrenia symptoms worse” section. This sentence is a perfect summary)

Environment

Individuals with schizophrenia and AUD often live in an environment with many stressors (e.g., financial, familial, abuse, etc.), instability, and a poor support network. An individual may recover from alcohol use, but as with many addictions, if the substance is readily available in the home and stressors remain present, the likelihood of relapse is high. While these disorders can affect anyone in any socioeconomic class, the lack of means of financial support can limit support options for the individual.

Signs of Alcohol Misuse in Those With Schizophrenia

If you are concerned that a loved one is experiencing symptoms of schizophrenia, alcohol misuse, or both, encourage them to contact a medical professional or treatment center. Individuals with this dual diagnosis can be less compliant with their psychiatric medications, leading them to be more actively symptomatic, and thus resistant to seeking treatment.  As such, a carousel of hospitalizations is common for those in this category.

Warning signs of alcohol misuse in a loved one with schizophrenia include:

  • Further decline in self-care
  • Reduced motivation
  • Inability to enjoy non-substance related things
  • Increased aggression and/or violence
  • Changes in appetite
  • Unusual mood changes
  • Medication not taken
  • Changes in sleep pattern
  • Speech disturbances (slurred, nonsensical, etc.)
  • Failure to show up to work or school
  • Problems with maintaining relationships
  • Disinhibition or disruptive behavior
  • Increased depression

Ria Health: Effective, Evidence-Based Alcohol Treatment 100% Online

Quickly change your relationship to alcohol with our at-home program. On average, Ria Health members reduce their BAC levels by 50% in 3 months in the program. Services are covered by many major health plans. Visit Ria Health

Choosing Therapy partners with leading mental health companies and is compensated for marketing by Ria Health.

Visit Ria Health

Treatment for Co-Occurring Schizophrenia & AUD

If you or someone you care about has schizophrenia and/or an AUD, the first step in treatment is acknowledgement that one could benefit from help. Each disorder comes with symptom clusters that can interfere with daily functioning. If you’re noticing symptoms of these disorders but are not sure how to proceed, you may want to find a therapist or psychiatrist who can help determine the best approach to treatment.

In cases of acute severity, hospitalization may be necessary to stabilize the person. Antipsychotic medication or detoxification may help with stabilization, after which a treatment plan can be established. An integrated approach with coordination among clinicians and family, if possible, is ideal in most situations.

Therapy

Treatment for the dual diagnosis of schizophrenia and AUD tends to be integrative and concrete. The plan usually involves equipping the individual (and family, if possible) with strategies to create structure, reduce anxiety, acquire accessible support, establish a relapse prevention plan, and avoid environments that may lead to alcohol use, while participating in positive, low-stress, supportive activities.

Therapeutic options for comorbid schizophrenia and AUD include:

  • Individual psychotherapy: Individual therapy, either from a behavioral therapy (BT) or cognitive-behavioral therapy (CBT) perspective may focus on setting concrete goals–like reality testing of hallucinations and delusions, verbal skills enhancement, maintenance of activities of daily living (ADLs), and medication compliance.  Insight-oriented therapy may foster a more abstract understanding of the factors contributing to the substance use that trigger one’s psychotic symptoms.
  • Family therapy: Family therapy often focuses on the ways an individual’s family system can better prevent the afflicted individual from undue anxiety, frustration or confusion. Additionally, having family members join for doctor and therapy appointments can make a big difference in the treatment outcome as coping strategies work best when relatives are involved.9
  • Intensive Outpatient Therapy:  Intensive outpatient therapy is an integrative approach that usually provides 9-20 hours of individual and group therapy, skills-training, and other related assistance to help the individual function in their daily life and community.
  • Motivational enhancement therapy: As a short-term (4-6 weeks) form of therapy that is particularly effective for treating substance misuse, this approach utilizes motivational interviewing techniques to help a person develop their own awareness, understanding, and intrinsic motivation needed for change and improvement.
  • Contingency management: This approach involves reinforcing positive behaviors like abstinence, treatment attendance, and medication adherence with “agreed on, immediate, tangible rewards.”10 It is particularly effective for individuals with a dual diagnosis of schizophrenia and AUD.
  • Assertive community treatment (ACT): ACT is a patient-centered treatment that integrates support from an interdisciplinary team including psychotherapists, nurses, doctors, occupational therapists, and peers to help the individuals function within their community.
  • Residential programs: For individuals with more severe dual diagnoses, have difficulty with medication adherence, are homeless, or come from poor home environments, a residential program may be beneficial for recovery and support.

Medications

With a dual diagnosis of schizophrenia and AUD, pharmaceutical options are somewhat slimmer than for either condition alone. AUD medications, such as naltrexone, have shown efficacy in reducing both alcohol use and psychotic symptoms11. Acamprosate, disulfiram, and varenicline are also possible treatments, though not many studies have investigated these in dual diagnoses.

First generation or typical antipsychotics are not ideal in this case, as while they might help with the psychotic symptoms, research suggests that alcohol use either remains unchanged or worsens.12 Certain second-generation or atypical antipsychotics, such as Clozapine (Clozaril), have been more useful in treating individuals with schizophrenia and AUD.4

Adherence to a medication regimen is notably poor in both individuals with schizophrenia and substance misuse disorders. Injectable medications have shown to be more effective treatments for individuals with dual diagnoses as they overcome the limitation of adherence. The person’s doctors or support staff will also know if the person is not complying by failure to attend.

12-Step Programs

Twelve-step programs can be a helpful resource for individuals with dual diagnosis of schizophrenia and AUD. Individuals with severe schizophrenia may struggle in group settings focused solely on the single diagnosis of substance use, which is why dual focus groups (e.g., Dual Recovery Anonymous) that are geared towards individuals with both mental health and substance use issues may be more beneficial. Dual focus programs have shown greater success in terms of abstinence, medication adherence, and improved overall functioning than single-focus 12-step programs.

Final Thoughts

Alcohol use disorder (AUD) does not always accompany schizophrenia, but when it does, it can make an already difficult cluster of symptoms even more challenging to overcome. If you or someone you care about is experiencing symptoms of either or both of these disorders, consider seeking clinical support sooner, rather than later. To find resources in your area, ask your doctor or other community members, call a help hotline or use other online resources to find a therapist or treatment facility near you.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Alcohol Treatment – Cut Back or Quit Entirely

Ria Health – Quickly change your relationship to alcohol with our at-home program. On average, members reduce their BAC levels by 50% in 3 months in the program. Services are covered by many major health plans. Visit Ria Health

Telehealth Treatment For Opioid Use Disorder

Bicycle Health – offers therapy, support, and medication for addiction treatment (MAT).  MAT offers the lowest relapse rates for opioid use disorder, helping people to stop using opioids with minimal physical discomfort. Covered by most major insurance. Visit Bicycle Health

Online Drug & Alcohol Program Covered By Insurance

Lionrock – Want to get help for a drug or alcohol problem without checking into Rehab? Lionrock’s online recovery program fits into your way of life. You keep your work and family commitments while you get help in our accredited online recovery program. Most private insurance plans are accepted. Free Consultation

Drinking Moderation

Sunnyside – Want to drink less? Sunnyside helps you ease into mindful drinking at your own pace. Think lifestyle change, not a fad diet. Develop new daily routines, so you maintain your new habits for life. Take a 3 Minute Quiz

Treatment for Mental Health Conditions That Coexist With SUD

Talkiatry – Get help from a doctor who can treat the mental health conditions that commonly lead to or coexist with substance use disorders. Take our online assessment and have your first appointment in days. Take Assessment

Addiction Newsletter

A free newsletter for those impacted by addiction. Get helpful tips and the latest information. Sign Up

Choosing Therapy partners with leading mental health companies and is compensated for marketing by Ria Health, Lionrock, Sunnyside, Talkiatry, and Bicycle Health.

For Further Reading

  • Substance Abuse and Mental Health Services Administration (SAMHSA)
  • NIDA Treatment Resources
  • Double Trouble in Recovery (dual diagnosis)
  • SMART Recovery (non-faith-based addiction recovery)
  • Alcoholics Anonymous

Stories You Might Like 


OCD & Schizophrenia: Are They Related?

Though they are vastly different mental health conditions, obsessive-compulsive disorder (OCD) and schizophrenia are sometimes perceived as being very similar. In some cases, OCD is even mistaken for schizophrenia. Read More

This content is sponsored By NOCD.

Schizophrenia & Alcohol Infographics

Schizophreniand Alcohol Abuse   Does Alcohol Make Schizophrenia Symptoms worse   Treatment for Co-Occurring Schizophrenia and AUD

Sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Schizophrenia. (n.d.). National Institute of Mental Health (NIMH). Retrieved from https://www.nimh.nih.gov/health/topics/schizophrenia.

  • Hartz, S. M., et al. (2017). Association between substance use disorder and polygenic liability to schizophrenia. Biological Psychiatry, 82(10), 709-715.

  • Tanaka, E. (2003). Toxicological interactions involving psychiatric drugs and alcohol: an update. Journal of clinical pharmacy and therapeutics, 28(2), 81-95

  • Drake, R. E., & Mueser, K. T. (2002). Co-occurring alcohol use disorder and schizophrenia. Alcohol research & health, 26(2), 99.

  • Archibald, L., et al. (2019). Alcohol use disorder and schizophrenia or schizoaffective disorder. Alcohol research: current reviews, 40(1).

  • Kendler, K. S. (1985). A twin study of individuals with both schizophrenia and alcoholism. The British Journal of Psychiatry, 147(1), 48-53

  • Diagnostic and Statistical Manual of Mental Disorders, 5th, ed. (2013). American Psychiatric Publishing.

  • Mueser, K. T., Valentiner, D. P., & Agresta, J. (1997). Coping with negative symptoms of schizophrenia: Patient and family perspectives. Schizophrenia Bulletin, 23(2), 329-339.

  • Archibald, L., et al. (2019). Alcohol use disorder and schizophrenia or schizoaffective disorder. Alcohol research: current reviews, 40(1).

  • Batki, S. L., et al. (2007). Monitored naltrexone without counseling for alcohol abuse/dependence in schizophrenia-spectrum disorders. American Journal on Addictions, 16(4), 253-259.

  • Akerman, S. C., et al. (2014). Pharmacotherapy of co-occurring schizophrenia and substance use disorders. Current addiction reports, 1(4), 251-260.

Show more

Recent Articles

Caffeine Addiction
Caffeine Addiction: Signs, Symptoms & Treatments
Caffeine addiction may occur when individuals consume caffeine heavily and for prolonged periods. Generally, caffeine is not psychologically addictive,...
';
Cocaine Addiction Signs, Symptoms, & Treatments
Cocaine Addiction: Signs, Symptoms & Treatments
People struggling with addiction may become physically, mentally, emotionally, or socially reliant on cocaine. Cocaine addiction is treatable, often...
';
Motivational Interviewing for Substance Abuse How It Works & What to Expect
Motivational Interviewing for Substance Abuse: How It Works & What to Expect
Motivational interviewing is a therapeutic method that was developed to increase someone’s readiness to make a change by helping...
';
Marijuana Addiction
Marijuana Addiction: Signs, Symptoms & Treatments
Marijuana addiction is a pervasive medical condition in which one becomes reliant on marijuana. Individuals addicted to marijuana continue...
';
is suboxone addictive
Suboxone Addiction: Signs & Symptoms
Suboxone is an opioid partial agonist that contains both buprenorphine and naloxone. It is generally prescribed to treat opioid...
';
Sober October Benefits, Tips, & More
Sober October: Benefits, Tips, & More
People who celebrate Sober October abstain from drinking for the entire month. Everyone is welcome to try this challenge,...
';
  • What Is Schizophrenia?What Is Schizophrenia?
  • Schizophrenia & AlcoholSchizophrenia & Alcohol
  • Comorbidity With AUDComorbidity With AUD
  • Alcohol's Effects on SymptomsAlcohol's Effects on Symptoms
  • Can Alcohol Cause Symptoms?Can Alcohol Cause Symptoms?
  • Signs of Alcohol MisuseSigns of Alcohol Misuse
  • Treatment OptionsTreatment Options
  • ConclusionConclusion
  • ResourcesResources
  • InfographicsInfographics
Choosing Therapy Logo White
  • About Us
  • Contact Us
  • Write for Us
  • Careers
  • Editorial Policy
  • Advertising Policy
  • Privacy Policy
  • Terms of Service

FOR IMMEDIATE HELP CALL:

Medical Emergency: 911

Suicide Hotline: 988

View More Crisis Hotlines
Choosing Therapy on Facebook
Choosing Therapy on Instagram
Choosing Therapy on Twitter
Choosing Therapy on Linkedin
Choosing Therapy on Pinterest
Choosing Therapy on Tiktok
Choosing Therapy on Youtube

© 2023 Choosing Therapy, Inc. All rights reserved.