Browse · Mental Health Treatment
About this program
One program for the substance use and the condition underneath it
Dual diagnosis, or co-occurring disorder, means a substance use disorder and a mental health condition at the same time. It is common, not unusual: in 2023, 20.4 million adults in the United States had both a substance use disorder and a mental illness in the past year, according to the 2023 National Survey on Drug Use and Health. Treating one and ignoring the other is the most common reason a first attempt at recovery does not hold. Our New Hampshire program at 1D Commons Dr, Units 21 & 22 in Londonderry is built to treat both at once, with one clinical team and one care plan.
The program runs under the clinical oversight of our Medical Director, Dr. Richard Marasa, MD, who is board certified in Addiction Medicine, Emergency Medicine and Internal Medicine, holds a New Hampshire medical license, and brings 46 years of clinical practice and 23 years of personal recovery to it. He is responsible for medical evaluation at intake, for prescribing and supervising medication-assisted treatment, and for the co-occurring medical conditions that so often travel with addiction. Psychiatric support and medication management for the mental health side are built into the program, and master's-level clinicians deliver the therapy. You will find the team on our staff page and read more in Dr. Marasa's bio.
Anxiety and depression
Anxiety and depression with substance use
Most of the adults we see did not start drinking or using for fun. Alcohol quiets anxiety for an hour, then makes the next morning worse. Stimulants lift a low mood, then drop it further. Benzodiazepines and opioids blunt panic and pain, then take over. By the time someone calls us, it is usually impossible to tell from the outside which came first, and it does not matter for treatment. Both get treated, together, from the first week.
In practice that means an assessment that screens for depression, anxiety and trauma alongside the substance use, psychiatric support when it is indicated, medication for the mood or anxiety disorder when it helps, and therapy that teaches skills for both. The program can help with:
- Anxiety disorders and panic
- Depression and mood disorders
- Trauma-related conditions and PTSD
- Sleep problems tied to substance use
- Anger and difficulty managing emotions
- Grief, stress and life transitions
Therapies we use
Cognitive Behavioral Therapy (CBT) for the thinking patterns that keep anxiety, depression and cravings going. Dialectical Behavior Therapy (DBT) for emotion regulation, distress tolerance and relationships, which is why it is used for substance use disorder, anxiety, depression and post-traumatic stress disorder. Group therapy, psychoeducation and individual counseling, plus the holistic and experiential therapies our New Hampshire program offers alongside clinical care: sound bowl therapy, meditation and breathwork, yoga, Reiki, music therapy and art therapy. Our Health Realization track, offered in Londonderry, is a non-12-step approach many clients with anxiety find useful.
Medication, when it helps
Medication for depression or anxiety, and medication-assisted treatment for alcohol or opioid use disorder with naltrexone, Vivitrol, buprenorphine or Suboxone, are managed inside the same program rather than by a separate prescriber across town. Every MAT prescription is written and overseen by Dr. Marasa. We do not prescribe methadone and we are not an opioid treatment program.
PTSD and veterans
PTSD, veterans and trauma-exposed professionals in New Hampshire
About 7 out of every 100 veterans will have PTSD at some point in life, and among veterans of Iraq and Afghanistan the lifetime figure is 29 out of 100, according to the VA National Center for PTSD. First responders, nurses, corrections officers and others whose work exposes them to trauma carry a similar weight, and for many of them alcohol or drugs became the way to sleep. Clear Steps Recovery is an approved VA Community Care provider, and our program for veterans and trauma-exposed professionals treats the addiction and the underlying trauma together rather than sending you to two programs.
In Londonderry that looks like trauma-informed groups, individual therapy with clinicians who understand the connection between high-exposure work and substance use, DBT skills for the moments when the past intrudes, and medication management when it is indicated. Confidentiality matters to people whose careers depend on their reputation, and our center sits in a commercial park off I-93, not on a main street. If you are a veteran, ask us about VA Community Care authorization when you call. If you are not, TRICARE and most private plans are accepted.
Schedules in Londonderry
Day, intensive and evening schedules, including Evening IOP
Dual diagnosis care in New Hampshire is delivered inside our regular levels of care, so the schedule follows the level a clinician recommends at your assessment, and you step down as you stabilize:
- 01
Day Treatment (PHP): Full clinical days on weekdays with no overnight stays, for people who need the most structure and daily contact with the clinical team. Your insurer may call it partial hospitalization. See <a href="/recovery-programs/php-new-hampshire">PHP in New Hampshire</a>.
- 02
Intensive Outpatient Program (IOP): Structured group and individual treatment several days a week during business hours, usually three-hour sessions, for people stepping down from Day Treatment or who need more than weekly therapy. See <a href="/recovery-programs/intensive-outpatient-program">IOP in New Hampshire</a>.
- 03
Evening IOP, Monday to Thursday, 6 to 9 pm: The same intensive program after work, four evenings a week in Londonderry, with the same clinicians and the same care plan. For the adult who is holding down a job while dealing with anxiety, depression and drinking, this is usually the level that makes treatment possible at all. See <a href="/recovery-programs/evening-iop-new-hampshire">Evening IOP</a>.
- 04
Outpatient Program (OP): Weekly individual and group sessions, with medication management continuing, for people maintaining recovery or stepping down from IOP. See <a href="/recovery-programs/outpatient-program-new-hampshire">outpatient care in New Hampshire</a>.
Offices are open Monday to Friday, 8 AM to 5 PM, evening groups run Monday through Thursday, and the admissions line is answered 24 hours a day. There is free on-site parking at 1D Commons Drive, just off Route 102 at I-93 Exit 4, about 15 minutes from Manchester, 10 from Derry and 20 from Nashua or Salem. A virtual option exists for adults who cannot attend in person. Ask admissions whether it fits the level of care you need.
Plain limits
What this program is not
We are an outpatient program. We do not have psychiatric inpatient beds, we do not run a crisis unit, and we do not provide detox on site. If you or someone you love is in immediate danger, call 911, or call or text 988 for the Suicide and Crisis Lifeline. If withdrawal from alcohol or benzodiazepines needs medical supervision first, we arrange it with a partner detox facility or through The Doorway NH (dial 211) and plan the step into our program for the day of discharge. When the assessment finds that someone needs a higher level of psychiatric care than we provide, we say so and help with the referral.
Insurance in New Hampshire
New Hampshire insurance for dual diagnosis treatment
Mental health and substance use treatment are covered under federal parity law on the same terms as other medical care. Our Londonderry program works with Ambetter Health, AmeriHealth, Anthem Blue Cross Blue Shield, Harvard Pilgrim, NH Healthy Families, Point32Health, TRICARE, Tufts Health Plan, VA Community Care and WellSense Health Plan, and with New Hampshire Medicaid through Granite Advantage plans. We are not in network with Medicare at this time. If Medicare is your primary insurance, FindTreatment.gov can point you to programs that accept it.
Coverage check in minutes
Call and admissions verifies your plan with the carrier at no cost, then explains any deductible or copay before anything is scheduled.
Same-day assessment
A confidential assessment with a licensed clinician is often available the same day at our Londonderry center. When your program starts depends on the level of care recommended.
In Massachusetts
Closer to Boston? Mental health treatment in Needham, MA
Our Needham, MA center runs a mental health treatment program alongside Day Treatment and Evening Treatment on Monday through Thursday evenings, at 392 Chestnut Street, Suite 200, about 30 minutes from downtown Boston. Same clinical leadership, Massachusetts program names. Learn more about our Needham center.
Frequently asked
FAQ about dual diagnosis treatment in New Hampshire
What is dual diagnosis treatment, and do you offer it in New Hampshire?
Dual diagnosis means a substance use disorder and a mental health condition such as anxiety, depression or PTSD at the same time. Yes. Our Londonderry, NH center treats both in one program, with one clinical team and one care plan, under the oversight of our Medical Director, Dr. Richard Marasa, MD. You do not need a diagnosis before you call. The assessment screens for both.
Which comes first, the mental health treatment or the addiction treatment?
Neither waits for the other. Anxiety, depression and trauma are treated in the same groups and individual sessions as the substance use, from the first week. Medication for a mood or anxiety disorder and medication-assisted treatment for alcohol or opioid use disorder are managed inside the same program.
Can I get treatment for anxiety or depression in New Hampshire if I keep working?
Yes. Our Evening IOP meets Monday through Thursday from 6 to 9 pm in Londonderry, with the same clinicians and care plan as the daytime program. Day Treatment (PHP), daytime IOP and weekly outpatient care are also available, and a clinician recommends the level at your assessment.
Do you treat PTSD for veterans in New Hampshire?
Yes. Clear Steps Recovery is an approved VA Community Care provider, and our program for veterans and trauma-exposed professionals treats PTSD and substance use together at our Londonderry center. Ask admissions about VA Community Care authorization when you call. TRICARE and most private plans are also accepted.
Is this an inpatient psychiatric program or a crisis service?
No. We are an outpatient program with no psychiatric beds and no crisis unit. If you or someone you love is in immediate danger, call 911, or call or text 988 for the Suicide and Crisis Lifeline. If the assessment shows someone needs a higher level of psychiatric care than we provide, we say so and help with the referral.
Does New Hampshire insurance cover dual diagnosis treatment?
Mental health and substance use treatment are covered under federal parity law on the same terms as other medical care. Our Londonderry program works with most private plans, TRICARE, VA Community Care and New Hampshire Medicaid through Granite Advantage plans. We are not in network with Medicare at this time. Call and admissions verifies your plan with the carrier at no cost before anything is scheduled.
