Mt. Washington, Pittsburgh Since 1999
Counseling that meets you where you are.
Step By Step Support is a Mt. Washington practice led by Susan Rua, LPC, specializing in substance use disorders since 1999. Addiction, anger management, domestic violence, and mental health counseling, in person or by telehealth.
Addiction, anger management, domestic violence, and mental health counseling with Susan Rua, LPC, in person or by telehealth.
- Court-referred welcome
- Licensed & DDAP certified
Licensed &
accredited
LPC CADC MSPC
Licensed in Pennsylvania
How we can help
Counseling built around where you are
Some people come on their own. Some are sent by a court or a family member. Either way, you are welcome here, and we start with a conversation, not a verdict.
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Since 1999, the heart of the practice Addiction & Substance Use Counseling for alcohol, opioids, and other substance use, from early concern through long-term recovery, without shame. About this work 
Intensive Outpatient Program
A structured group program for people who need more than weekly counseling but not residential treatment.
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Medication-Assisted Treatment
Medication support for opioid dependency, overseen by a doctor and paired with real counseling.
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Anger Management
Anger is usually a signal, not the whole story. We find what is underneath it and build calmer ways to respond.
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Domestic Violence Counseling
A safe, confidential, nonjudgmental space to process what happened and begin to heal at your own pace.
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Individual, Couples & Family
One-on-one, couples, marriage, and family counseling, including co-dependency and parenting support.
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Mental Health Counseling
Support for anxiety, depression, grief, trauma, and the ordinary weight of a hard stretch of life.
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Meet Susan
Meeting people where they are
I have specialized in substance use disorders since 1999, and the practice has grown to include anxiety, depression, grief, and trauma.
My approach is simple and human. We meet you where you are, draw on whatever techniques fit your situation, and help you build the coping and life skills that make the next step possible. You are treated as a capable adult the whole way through.
- Licensed in Pennsylvania: LPC, CADC, MSPC
- Specializing in substance use disorders since 1999
No pressure, no surprises
What reaching out actually looks like
The hardest part is usually the first message. Here is the whole path from there, so nothing about it has to feel like a mystery.
Reach out
Call or send a short message. You do not need a diagnosis, a written history, or the right words. A sentence is enough.
A first conversation
We talk about what is going on and what you hope will change. No judgment, no commitment, no pressure to share more than you want.
A plan that fits you
Together we decide what working together looks like, and at what pace. You stay in the driver’s seat the whole way.
We begin
We start the work, meeting you exactly where you are, one step at a time.
Step one
It starts with a conversation.
Send a short message and Susan will get back to you. A sentence is enough.
Mon to Fri, 9am to 5pm · Sat by appointment
How we work
What working together actually feels like
Often the drinking, the anger, or the conflict is the surface of something deeper. We make room to work on both.
We set short, achievable goals so progress feels real instead of overwhelming, and we build skills you can actually use. There is no script here and no judgment.
- Short, achievable goals you can actually use
- Court referred or self referred, the same respect
Why Step by Step
What you can count on here
However you get here, on your own or because someone sent you, you are treated as a capable adult and met without judgment, from the first phone call on.
Since 1999
Substance use disorder counseling has been the heart of the practice from the start.
Licensed and certified
LPC, CADC, and MSPC, licensed in Pennsylvania.
In person or telehealth
Meet in Mt. Washington or by secure video, whatever works for your week.
Court referred welcome
A normal starting point here, met with the same respect as anyone else.
Common questions
The things people usually want to know
If your question is not here, just ask. There is no wrong question and no judgment in it.
What does a first session look like?
A conversation, not an interrogation. We talk about what brought you in and what you want to change. You do not need to prepare anything or have it figured out first. Come as you are.
How much does counseling cost?
It depends on the service and the length of your sessions. We keep it straightforward and go over it before you begin, so there are no surprises. If cost is a worry, say so when you reach out and we will talk through your options.
Do you take insurance?
Reach out with your insurance details and we will let you know what is possible. Many clients also choose to pay privately. Either way, we sort it out before your first session.
Is what I share kept private?
Yes. What you bring to your sessions is confidential, within the limits the law and professional ethics require. Your privacy is something I take seriously.
I was referred by a court. Can you still help?
Yes. Court-referred and forensic clients are welcome here and treated with the same respect as anyone else. Anger management and domestic violence work in particular are often court-connected. That is a normal starting point, not a mark against you.
Do you offer telehealth?
Yes. When getting to the Mt. Washington office is hard, we can meet by secure video, so distance or a busy week does not stand between you and support.
