Ellen Case

I've been doing this work for 30+ years, and the thing that hasn't changed is this: I'm genuinely interested in what's happening beneath the surface of your life — not just the symptoms, but the patterns, the history, the stories you've been telling yourself for a long time. My background as a writer shapes how I work. Language matters. The words we use — or avoid — say something real. I'll help you find language for what's been hard to articulate. I'm queer-affirming, harm-reduction oriented, and comfortable with the full range of human experience: grief, addiction, trauma, identity, end-of-life. If you've felt like you don't fit neatly into someone else's treatment model, you'll fit here. I don't do shame, and I don't do ultimatums.

I draw on relational, psychodynamic, and narrative frameworks — which is a technical way of saying I pay attention to what's happening between us, to the past that lives in the present, and to the stories you're carrying. I integrate CBT and mindfulness where they're actually useful, not as a formula. For substance use and addiction, I work from a harm-reduction model. That means meeting you where you are — no required abstinence, no judgment — and building from there. I work with adults and older adults, individually. I see California clients via telehealth, which means serious work doesn't require you to leave home. My style is warm and direct. I ask real questions and I tell you what I notice.

You'll do most of the talking. I'll listen carefully — not to categorize you, but to understand what's actually going on and what you're hoping for. I won't hand you a diagnosis or a homework assignment in the first hour. I'll probably ask about what's brought you here now, not just the history. And I'll be honest with you about what I'm noticing. My goal in a first session is to make sure you leave feeling understood, and to give you a clear sense of whether we're a good fit for ongoing work together. We can also schedule a free 15-minute consultation before booking so you can ask questions and get a feel for how I work.