Q: I am concerned about privacy and confidentiality. Will people know I am receiving professional counseling when I go to your office?
KA: My office is located in a professional office building in Morristown with many different businesses. I maintain a very high level of discrete, private care affording patients the comfort and confidence to address whatever issue brings them to my practice.
Q: How often will I see you for counseling?
KA: The type and frequency of your counseling will be recommended to you at the conclusion of the first, diagnostic session. Most patients see me once per week, however specific circumstances could suggest that we need to meet more or less frequently.
Q: I was hoping that you could help my family member. They are resistant to coming to therapy. Can you work with them?
KA: Many of the patients I work with have some form of resistance. Resistance is a normal condition in therapy, especially in the beginning. In order for me to work with them, the patient has to be motivated enough to come under their own power, be verbal and attempt to dialogue about the issue(s) in question.
Q: I would like to begin a course of counseling with you. I am under the care of other professionals, including a psychiatrist. Will you coordinate with them?
KA: Yes, I will (with your permission and signed release forms) coordinate the treatment you receive through my office with the other professionals you receive services from.
Q: I have been recommended to attend a Substance Abuse Intensive Outpatient Program (IOP). I am willing to receive help for my drug and alcohol problem but I am concerned about the overall time commitment of the program and I am not interested in large group sessions. Do you offer an alternative?
KA: Yes, I offer an "Alternative to IOP" program. Not everyone responds to the traditional IOP group approach. Whether it is because of the heavy time commitments, uncomfortability in large groups, concerns about privacy and confidentiality or the financial burdens of an intensive program, the traditional IOP group program does not work for everyone. I offer a unique alternative for patients who require intensive services and who are looking for an alternative to the IOP group model. The "Alternative to IOP" program is a custom, individually tailored program of individual sessions, couple/family sessions and urinalysis screens that meets 2 to 4 times per week.
Q: I am concerned I may be developing a drinking problem. Are there any websites I can go to that would help me understand if I have a drinking problem?
KA: Yes, you can try
Q: My family member has been acting very differently lately. I am concerned they may be suffering from some form of mental illness. Do you have suggestions on where I can get information about what these signs and symptoms might mean?
KA: Yes, try the following websites:
Q: Where can I find a directory of local Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meetings?
KA: You can find meeting locations and times on the following websites:
Q: I am in the process of a divorce and my spouse has alleged I have a Drug and Alcohol problem. I need to undergo an evaluation so that I will be permitted to have custody or visitation of my children. How does the process work?
KA: Generally, formal, forensic style substance abuse evaluations are requested, or mandated, by third parties such as judges, attorneys, agencies, etc. The nature, purpose and scope of your evaluation will be reviewed and explained to you at the outset of the evaluation process. Evaluations usually consist of several components including interviews with the subject, collateral contacts and interviews, written testing and screening measures, review of past treatment records and/or other documents and urinalysis (or other) testing. Evaluations can occur over 3 to 25 hours (or more), inclusive of the interview time and are usually conducted over several separate meetings. The overall timeframe of the evaluation is dependent on a variety of factors, including the complexity of your particular circumstances and the overall matter at hand.
Q: I am interested in addressing my substance abuse issue but I am not interested in a 12 Step approach. Can you work with me?
KA: Alcoholics Anonymous, Narcotics Anonymous and other 12 Step based programs have proven to be effective for a large number of people who struggle with chemical dependency problems. Unfortunately, these fellowships are not a fit for everyone. Some folks struggle with the ideological principles or the 'spiritual' basis of 12 Step programs. I believe there are a number of different ways that individuals can get and stay sober. There are a number of different self help and professionally based approaches that can be utilized to address your substance abuse concern. During the first visit we will review if a self help program would be helpful to you and explore the various options that exist.
Q: I am concerned that I am drinking too much and I want to address this in counseling, but I do not believe things are so bad that I need to stop drinking completely at this point. Do you offer substance abuse services that are not abstinence oriented?
KA: Yes, but it will depend on a number of factors. In the first session we will review your history in detail. Dependant upon the signs and symptoms you are presenting with as well as the frequency and amount of your substance intake, non-abstinence based approaches may be an option. I will advise you at the conclusion of our first visit if control, containment and management approaches can be safely explored in your particular situation.
Q: I have seen the television program 'Intervention'. Do you perform Interventions and how do they work?
KA: Yes, I assist families in constructing Interventions on loved ones who are resistant to pursuing substance abuse services on their own. Interventions begin by assembling a "team" of people (usually 4 to 6 individuals who have close, meaningful relationships with the substance abuser). The initial meeting with the "team" is a 2 hour session where history is gathered and the viability of conducting an intervention is explored. The preparation required to implement an Intervention ranges from a single session to numerous sessions spread over several weeks or months. There are several models and styles of Interventions that can be constructed and each will be reviewed with the "team".
Q: I have a family member who has a chemical dependency problem. They have been in a number of different treatment centers, outpatient programs and have seen private therapists. They cannot seem to stay sober despite all of these efforts and I am feeling discouraged that treatment can help them. Do you have any insights?
KA: Most treatment programs/providers tend to have a one dimensional focus. They have a particular model and philosophy and try to ‘force’ the round peg into the square hole (to coin a phrase). Substance Abuse and Chemical Dependency disorders are highly complex conditions that are influenced by a variety of factors including the person’s social and environmental dynamics, psychological/psychiatric condition(s) and personality/character style, to name a few. Just as with medical disorders and conditions, there are a variety of factors that will influence how the patient will respond. Take diabetes, for example. There are several different types of diabetes (Type 1, Type 2, Gestational), as well as different levels of acuity within those sub-types. Do doctors treat a newly diagnosed Type 2 diabetic the same way they would treat a brittle Type 1 diabetic? They obviously do not. But, many substance abuse treatment programs/providers do not view things this way. In many traditional substance abuse treatment programs patients with wildly varying histories of substance use, drugs of choice, number of attempts at care, existence of co-occurring disorders, differing motivational levels and levels of functioning are all ‘co-mingled’ into the same groups sessions, lectures and other program activities. There is an old saying, “when the only tool you have is a hammer, everything looks like a nail”. I believe that in order to successfully treat patients who have substance abuse/dependency issues; a highly individualized and tailored program must be established. This requires working with a clinician, or program, that has the capacity to properly access both the sub-type of substance abuse condition that the patient has as well as assess the internal and external factors that influence the patient and their care. Only then can the 'whole' patient be properly treated and truly positive outcomes be attained.
Q: What is a “High Functioning Alcoholic”?
KA: Most people think of the ‘skid row’ bum when they think of someone who is “Alcoholic”. In fact, most people who are Alcoholic or otherwise chemically dependent, are functional individuals. They are students, housewives, businessmen/women, professionals, active community members, and so on. It is estimated that 75% of Alcoholics are actually functional. High Functioning Alcoholics/Addicts are people who are, in fact, chemically dependent but who are able to maintain their external life and in some cases at a very high level. They go to work, maintain their obligations with school, community, family etc. Many High Functioning Alcoholics/Addicts are often not viewed by themselves, healthcare professionals and loved ones are being chemically dependent because they are maintaining a (sometimes high) level of success and achievement in their life. They are often suffering silently with the thought in the back of their head that ‘something is wrong with the way I drink or use drugs’. The denial process of the High Functioning Alcoholic/Addict is often compounded by the ‘secondary denial' of the loved ones and family who falsely confirm for the Addict/Alcoholic that “everything is OK”. High Functioning Alcoholics/Addicts often blame their excessive use on external situations and circumstances and spend a great deal of time attempting to resolve those issues only to find that they continue to experience problems in their life attributed to drug and/or alcohol use. High Functioning Alcoholics/Addicts can maintain functionality for fairly lengthy periods of time and will make tremendous sacrifices to maintain the ‘image of functionality’ at all costs. Alcoholism and Drug Addiction are progressive conditions, so as the High Functioning Alcoholic/Addict continues to use, there is an eventually downturn into impaired functionality. Research has shown that individuals who arrest their Alcohol/Drug abuse at an earlier age, at a higher level of functionality and with fewer devastating life consequences have better outcomes for maintaining longstanding sobriety, have higher quality of lives in recovery and make quicker accents out of the ‘active addictive process’ when compared to their counterparts.
Q: How do ‘Recovery Management Services’ work?
KA: One of the phenomenon that occur in substance abuse treatment is that some patients do well while involved in structured professional care, but backslide once they are no longer under the treatment and monitoring of a substance abuse professional/program. Clinical Management and Monitoring models are widely used in medical healthcare settings with chronic illnesses such as Diabetes, Asthma, and Cystic Fibrosis, to name a few. Substance Abuse ‘Recovery Management Services’ provide continued structure and monitoring for recovering individuals once the formal treatment has ended. Recovery Management Services include a variety of helpful, motivational contacts with the recovering individual over an extended period of time. For certain individuals, Recovery Management Services can be of assistance for the first 1 - 3 three years of initial sobriety. Contact is maintained with the patient via telephone, email, e-session (Skype) or in person on a pre-determined frequency. When appropriate, contact is also maintained with the family members of the recovering person. Furthermore, motivational and inspirational materials are mailed/emailed to patients regularly as well as drug testing continues. The tone and style of the Recovery Management Services is always helpful, upbeat and motivational. In cases where patients have relapsed, the Recovery Management Service quickly intervenes, assesses the patients’ needs and arranges for the appropriate program/placement/service. Recovery Management Services have shown the greatly improve outcomes and promote healthier patterns of thinking and behaving in recovery.
Here are some other interesting and helpful web-links:
Patient Testimonials and Reviews:
Kieran Ayre helped our family tremendously. Our son had been in an out of several substance abuse treatment programs in the past. He was never able to achieve any lasting period of sobriety. Kieran worked with our whole family and gave us generous attention as we struggled to come to terms with our role, as parents, in our son’s addiction. Our son felt comfortable with Kieran to really open up (for the first time to a therapist) and began to see things from a different perspective and really work on himself. Our son is now clean and sober, working and living independently. We could not be happier and are eternally grateful to Kieran for helping us all get to this place!
Elaine and Tom D. Basking Ridge, NJ
As a medical professional, struggling with an Alcohol and marital problem, I was apprehensive to seek Alcohol counseling. I was concerned about my professional reputation and did not want to sit in group sessions where patients, neighbors or others might see me. In Kieran, I found comfort, hope and direction, but most importantly I found safety and security in a private office environment that afforded me complete privacy and confidentiality. Kieran was very helpful, very knowledgeable and professional. He’s top notch!
A.S. Morris County, New Jersey
I was court ordered to attend substance abuse treatment and attended counseling sessions with Kieran 10 years ago. I did not want to go, but I had to. Kieran was a good guy, but I didn’t want to really hear the things he had to say. He made me think about the way I was thinking and behaving and he was patient with me. Three years later I knew I needed help, sought Kieran out, and went back to him. This time I was a “voluntary” patient, I wanted to be there and I took it seriously. I am over 6 years sober today and an active member of Alcoholics Anonymous. I still check in with Kieran every now and then. He was a big part of the reason I was able to really invest in the process of recovery. Even though I wasn’t able to hear his message 10 years ago, I remembered his passion and enthusiasm. That’s what brought me back to him when I was ready to try to stop using. I said to myself, “That guy can help me!” He’s a really good counselor and a great guy.
Kieran helped our family plan and execute an Intervention on our sister. We had been working with another Interventionist and the process was going nowhere. Additionally, our situation was complicated because we are 4 siblings living in four locations; 2 being out of state. Kieran worked with us to plan, rehearse and execute a flawless intervention. He gave us homework, reading assignments and made us look at our own issues. I am happy to say: It worked like a charm and I am happy to say our sister is sober today!
The “G” familyRandolph, NJ
Our daughter, Laura, had a serious drug problem that was complicated by a long standing psychiatric condition. Kieran worked with us as a family to find the prefect inpatient program for Laura. He helped us through every twist and turn of getting her there. He found the perfect program for her. After Laura completed inpatient care, it was determined that she needed “extended care”. Kieran was there for us again, taking the time to coordinate with the inpatient program and find the prefect aftercare placement for her. He worked tirelessly to make sure that the program was right for her and that she was comfortable. The extended care program ended up being out of state and we were nervous about whether she would like it there. Kieran called and spoke with Laura and her counselor the day she got there. Kieran called us at 10:30pm that night to let us know she was safe and comfortable. He let us know he had spoken with both Laura and her counselor. That meant the world to my wife and I. In a world where so many professionals are simply focused on making money, Kieran really went out of his way to look out for all of us and displayed extraordinary compassion for our daughter and us. We feel very lucky to have had him in our lives during a very trying time.
Drs. John and Mary S. Chatham, NJ
I sought Kieran Ayre out a number of years ago at the recommendation of a dear friend. I was battling with my husband around his drinking. I went to Kieran with the hope that I could convince my husband to see him and get sober. Kieran worked with me on my issues and taught me to emotionally detach from my husband’s Alcoholism. My husband never agreed to see Kieran, but I stayed and worked with him over 2 years. It may sound weird to some people but even though my husband still drinks, I have learned to not have his Addiction to Alcohol impact my life negatively. I attend Al-Anon and I am a transformed person in my journey of wellness. I cannot thank Kieran enough for opening my eyes and giving me permission to place my needs in front of my husband’s Alcoholism. He is, unfortunately still addicted to Alcohol, but I can honestly say, I am not addicted to his Alcoholism! Thank you, Kieran.
I went to see Kieran Ayre for counseling while in my sophomore year at XXXXXXXX (a private academy). My parents were going through a divorce and it was very tough for me at home. My way of dealing with it was to drink, use drugs and engage in self-destructive behaviors. Looking back, I felt that if I could get my parents to pay attention to me, and focus on me, they would not fight; they would stay together and not get divorced. Kieran worked with me to help me understand the roots of my behavior and develop better ways of coping and managing my emotions. When I first started with Kieran, I was in jeopardy of being academically dismissed from school. As a write this, I am presently a 2nd year medical student at XXXXX University. I owe a great deal to Kieran, who helped me through a very difficult chapter of my life. I have made the decision to pursue pediatric oncology and hope to instill hope and encouragement in the patients I work with, as Kieran did for me. He believed in me when I didn’t believe in myself.
I am an executive for a large multinational conglomerate Fortune 500 Company. I was drinking too much and it was impacting my health, my moods and most importantly my marriage. My wife told me I needed to do something and I asked her to sign me up for a program. She signed me up at an IOP program that was referred to us by our primary care physician. I went to my first night of IOP and it wasn’t anything like the brochure or the website touted. The group was full of court mandated men and women who couldn’t have been less interested to be there. The counselor was rough and used a “street approach” to bully and shame the group members. I couldn’t relate to a single member of the group, most of who had been to jail and used street drugs. Discouraged and annoyed, I refused to go back. After some searching around, my wife found Kieran. I VERY RELUCTANTLY went to see him, expecting another AA hyping lecture and threats that I would “end up dead” if I continued to drink. I think Kieran could sense my ambivalence and distrust, but he won me over. His style and approach were great. He saw my abilities and strengths and adapted an approach that worked to address the specific problems I was having. I’m not a big AA fan, and Kieran worked with me in a way that I could both understand and tolerate. He is smart and uses a lot of logic and reasoning that creates clarity when looking at complicated issues. I learned that I am not an alcoholic but someone who has developed a pattern of drinking to relieve stress, boredom and several other things. I have now learned techniques to identify the triggers that make me want to drink as well as strategies to keep my drinking under control. My wife and I were so happy with how my counseling went that we began seeing Kieran for marital counseling. Kieran is smart. He is educated and he approaches patients with care, concern, compassion and respect. I would recommend him strongly.
Kevin N. Summit, NJ
Colleague and Peer Endorsements/Recommendations:
Kieran is the consummate professional in a wide range of roles. As an experienced clinician, addiction specialist and consultant in this area, Kieran brings great insight and knowledge to his work. His key role as an administrator for a large residential facility demonstrates his obvious intelligence and competence in the work he does. Kieran is a trusted colleague who I recommend enthusiastically.
Nancy M. Violette, PhD, LCSW, LCADC, CCS
Assistant Professor, Fordham University School of Social Service
Former Director of Professional Development, Rutgers University
Kieran is an excellent and fair forensic expert. He is experienced enough to get past the non-sense that trips up less experienced experts. He provides fair opinions and is seasoned enough to recognize true problems even with the most difficult clients. He will go to the next step and provide realistic treatment plans and service recommendations for people who suffer from addiction problems. Kieran's professionalism and integrity are beyond question.
Dina Mikulka, Esq.
Partner at Paris P. Eliades Law Firm LLC
Kieran is an excellent choice if you need a comprehensive and thorough forensic evaluation in a litigated custody/parenting time matter. Kieran is also a great psychotherapist.
John Clancy, Esq.
Partner, Divorce & Family Law Attorney & Mediator at Townsend, Tomaio & Newmark, L.L.C.
I have known Kieran Ayre for 20 years and have called upon him for his expertise in the field of substance abuse treatment many times. He is well-known and well-respected in his field and extremely knowledgeable of the subject matter. It is always a pleasure speaking with Kieran, as he is very professional and always willing to help.
Jackie Tillson, LPC, LCADC, SAC, NCC
High School Student Assistance Counselor/Guidance Counselor
Therapist in Private Practice
Former Federal Aviation Administration (FAA) Substance Abuse Consultant