Substance Use and Anxiety Counseling with Madeline Seim Leitner at Collective Wellness LLC

Substance Use/Abuse/Dependency and anxiety often go hand in hand.

Sometimes, teens and adults with anxiety try to self-medicate with substances. Other times, your substance dependency can lead to significant stress and anxiety. Whether anxiety has led to your abuse or vice versa, it’s crucial to work with a therapist trained in substance use. This is where Maddie Leitner, MSW, LCSW comes in.

Similar to my passion for working with anxiety and perfectionism for kids, teens, and college students, Maddie focuses her work on two areas she’s passionate about: substance use and anxiety, and the link between the two. It was a pleasure to interview her, and i’m so excited for you to learn more about her work!

Maddie Leitner, MSW, LCSW substance use and anxiety therapist at Collective Wellness, LLC in St. Louis

Maddie Leitner, MSW, LCSW substance use and anxiety therapist at Collective Wellness, LLC in St. Louis

Why did you choose to become a Licensed Clinical Social Worker in St. Louis?

I chose to become a LCSWin St. Louis for a number of reasons. I was first motivated to pursue this career while in college. I saw a therapist during my undergraduate education who had an incredibly positive impact on me and my growth as a young woman. As a psychology major, I was already interested in mental health, but this therapeutic experience lead me to want to explore mental health treatment as a career path.

What kind of treatment do you provide for substance use and anxiety?

I use a mix of Cognitive Behavioral Therapy and Motivational Interviewing to treat individuals suffering from substance use disorders and co-occurring anxiety disorders. These methods focus on assessing the individuals readiness for change and their level of motivation, as well as identifying maladaptive and recurring behaviors and beliefs that are no longer serving the individual.

What ages do you work with in your private practice?

I work with individuals age 18 and older.

Talk about the link you see between substance use, substance dependency, and self-medicating with anxiety:

I utilize the disease model of addiction, meaning I treat it as a mental health disorder instead of a behavioral issue.

There is a strong link between symptoms of anxiety and the abuse of mood and mind altering substances. It is common for individuals to use substances as a coping mechanism for their anxiety, which reinforces the behavior. If substances decrease anxiety, why stop? As the addiction progresses, the individual often presents with more severe symptoms of chemical dependency such as tolerance, withdrawal, and inability to stop despite negative consequences. Anxiety is one of the main symptoms of withdrawal, which often leads to continued use to counteract withdrawal symptoms. The vicious cycle continues until the individual seeks intervention.

What can people expect to leave with after working with you?

After working with me, individuals can expect to have greater insight into their addictive behaviors and understand how their addiction has progressed and impacted their lives. Individuals will have explored how past experiences, trauma, and anxiety have impacted their using behaviors. Individuals can also expect to challenge unhelpful core beliefs, therefore creating lasting change in those behaviors that are no longer functional.

How long have you been working with anxiety, and how long have you been in St. Louis?

I graduated from George Warren Brown School of Social work in 2016. For the past 3 years, I have been working with chemical dependency and anxiety in multiple settings. I started my career in the residential substance abuse treatment setting, and currently treat substance use disorders and anxiety in the outpatient setting through my private practice.

Who are your favorite types of clients to work with?

My favorite client population to work with is young adults (age 18-30) struggling with substance abuse and/or anxiety disorders. I enjoy working with newly sober individuals who are looking for support in the maintenance of their sobriety. I also enjoy working with individuals who are concerned about their level of use, but are unsure about the severity of their problem. Finally, I love working with individuals who have a chemically dependent loved one who need assistance in coping and setting boundaries.

What happens during a first appointment with you?

During the first appointment, we will get to know one another and start building the therapeutic alliance. My goal is to help you feel comfortable in opening up about your reasons for seeking counseling. During the session I will gather information and learn about you and your experiences with chemical dependency and/or anxiety.

What do you wish people knew about getting treatment for anxiety disorders?

I wish people knew that it is ok to be ambivalent about your readiness to change. Even if you are unsure about your desire to stop using or make other behavioral changes, counseling can be a great place to gain insight and better understand your options moving forward. I also wish people knew that addiction is a disease, and therefore requires treatment as such. This means we will utilize the disease model of addiction to help understand how chemicals impact the brain and make it difficult to stop using.

How can people learn more and contact you?

You can learn more about me and the services I provide on my website or on my Psychology Today profile.

I can be reached via phone or email: 314-884-1511 or

Social Media links: Facebook and Instagram

One fun fact about me:

I have been playing on a kickball team for the past 3 years, which is where I met my husband!

Curious to learn more about anxiety, anger management, and perfectionism in St. Louis? Kelsey Torgerson Dunn at Compassionate Counseling St. Louis works with kids, teens, and families - and when she’s not the best fit, or when there’s co-occurring substance use, she helps connect you with other awesome St. Louis area resources, just like Maddie! You can reach Compassionate Counseling St. Louis via email at, or set up your free 15 minute phone consultation on our consultation page!