Therapy for Adult Children of Alcoholics (ACoAs) in Philadelphia, PA
Start Healing From Parental Addiction Today
Therapy can be helpful if you grew up with a parent who struggled with alcohol or other substances and find yourself repeating interpersonal patterns that leave you anxious, exhausted, or overly responsible for other adults. You may appear highly capable, successful, and independent on the outside, but inside, feel lonely, tense, and even unsure of who you are. Therapy can give you space to normalize and explore these patterns, get validation, and learn ways to build relationships that finally feel peaceful, balanced, and authentic.
Sometimes, it feels like the parent-child roles are reversed…
You are tired of having to “parent” your parents…
Many adult children of alcoholics develop incredible strengths: responsibility, attentiveness, and an ability to manage difficult situations. But those strengths often come at a cost. You may feel responsible for other people’s emotions, afraid of conflict or abandonment, drawn to relationships where you are the helper or fixer, and guilty for asserting your needs or boundaries.
Healing is Possible
Therapy for Adult Children of Alcoholics (ACOAs) in Philadelphia Can Help.
Even when you’ve achieved independence or success, close relationships may leave you feeling anxious, drained, or overwhelmed. Friends, partners, and coworkers might see only your competence and reliability, not the exhaustion or loneliness that comes from constantly holding everything together. Understanding these patterns is the first step toward changing them—and building connections that finally feel safe and fulfilling.
What is Therapy for Adult Children of Alcoholics (ACOAs)?
Therapy work with me is grounded in family systems and trauma-informed therapy, which helps you see how childhood experiences with addiction shaped your beliefs, emotions, and relational habits. Growing up in a household affected by alcoholism or other addiction often means you learned to manage chaos, absorb stress, and prioritize others’ needs above your own.
ACoA therapy helps you identify the invisible rules, roles, and patterns that guided your behavior as a child, and gives you tools to develop a stronger sense of self outside your caretakers’ illness/es. By understanding these patterns, you can start making conscious choices about your relationships instead of reacting out of old habits.
This type of therapy doesn’t focus on blaming parents—it focuses on healing your responses, reclaiming your voice, and building healthier, more grounded ways of interacting with the world.
Multiple bodies of research suggest that loved ones doing their own healing will be one of the most effective ways to increase the chances that your loved one will recover, too.
What to Expect from Therapy for Adult Children of Alcoholics (ACoAs)
Recognizing and Understanding Patterns
You’ll gain clarity about the ways your upbringing shaped your relationships, coping skills, and self-perception. Many ACoAs discover that behaviors like over-functioning, anxiety about others’ approval, or chronic caretaking are not personal flaws—they are survival strategies from childhood.
Learning to Protect Your Emotional Wellbeing
Therapy provides strategies to maintain your emotional safety. You’ll practice setting boundaries, saying “no” without guilt, and noticing when you’re taking on responsibilities that aren’t yours. This helps reduce anxiety and exhaustion while improving the quality of your connections and helping others take responsibility for their own actions (“natural consequences”) so they are potentially able to gain confidence and life skills.
Building Balanced, Authentic Relationships
As you strengthen your sense of self and practice new ways of relating, you may experience relationships that feel calmer, more balanced, and more fulfilling. You’ll learn to engage without over-extending yourself, express your needs clearly, and feel more confident trusting your own feelings in connection with others. In turn, this may also help you gain resilience to continue to support your loved one in their recovery and/or use healthy distancing as needed to support both of your mental health (break out of enabling, guilting, or shaming patterns).
Starting Therapy is easy
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Get in touch by filling out this quick form here.
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We’ll schedule a time to chat and make sure we’re a great fit.
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Start therapy and begin your journey to healing!
Hi, I’m Ayla Fleming, LCSW
You deserve respect and peace.
I believe the answers are already within you. I provide evidence-based research, practical skills, and warm support to help you make the changes you want in your life. I believe everyone has a unique story. I look forward to hearing yours and helping you make the best decisions for yourself.
★★★★★
“Where to start with Ayla?
There is truly no one better in the field. She is hard working, dedicated, & genuine. Ayla goes above & beyond & listens without judgement. I trust her wholeheartedly & she is extremely knowledgeable. I HIGHLY recommend Ayla.”
- Ashley Severino, LCSW
★★★★★
“Working with Ayla Fleming LLC was a privilege.
She has a natural ability to make people feel understood, valued, and supported. Her warmth and professionalism set her apart, and I’ve seen firsthand how deeply she cares about her clients and her team. I can’t recommend her practice highly enough—anyone who works with her will be in excellent hands!”
- Mike Teti, LCSW
★★★★★
“Ayla has a rare gift
for helping women reconnect with themselves after years of self-sacrifice, codependency, or chronic self-doubt. Through her thoughtful, strategic work, clients begin to set healthy boundaries, trust their inner voice, and create more authentic, fulfilling relationships. Her work doesn’t just offer support—it sparks real, lasting change. If you’re ready to heal from the past, reclaim your self-worth, and live more boldly and freely, Ayla is the kind of therapist who will walk beside you with both empathy and precision. Her boutique practice model means you get the kind of personalized, high-touch care that can truly shift the trajectory of your life—and it’s absolutely worth it.”
- Brianna Dawson, NP
Frequently asked questions
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Sessions are virtual through a secure, HIPAA-compliant platform. I also expect to have an office in Center City, Philadelphia within the next year.
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Individual Sessions:
50 min session- $250
Couples/Family Sessions:
50 min session- $300
Longer sessions or “intensives” (short term therapy for longer sessions) may be designed if you wish, per your schedule or request, and prorated accordingly.
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I do not accept insurance or communicate directly with insurance companies. However, I am happy to provide a receipt you can submit to your insurance for possible reimbursement. Some of my clients have out-of-network benefits so they are able to get reimbursed for sessions. If that’s important to you, please check with your insurance company directly. Reimbursement rates can vary a lot.
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Submit a form via my Contact page. I review each form myself. You can also text or call me directly at 267-217-3017 or email me at ayla@aylaflemingllc.com
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I work with women, men, couples, and families who are struggling with anxiety, depression, and loss of self in their relationships or life roles.
If you want to learn healthy communication regardless of what other adults are doing, we will be a good fit. This includes family or relationship dysfunction, codependency, addiction, family drama, chronically choosing unhealthy partners, or the desire to grow after trauma.