Laguna Beach · Now offering VirtualLaguna Beach · PHP / IOP · Now offering Virtual IOP
PHP, IOP, and virtual IOP in Laguna Beach for trauma, personality disorders, and substance use. The person first. Then the diagnosis.
Dr. Courtney Tracy · Founder and chief clinical officer
The clinic
Therapist-founded, expert-led. Courtney built Exist for people who need trauma, personality-disorder, and dual-diagnosis care — and refuse to be treated as a chart first.
She is USC-trained, C-PD and CCTP certified. The clinic is Joint Commission accredited PHP and IOP in Laguna Beach, not a hospital admission.
We now offer a virtual IOP when you cannot be in Laguna Beach. It runs half days with group and 1:1 on a secure video call, for adults in California.
Accreditation
Programs
A full day, a half day, a room in Laguna Canyon, or a virtual IOP — same clinic, different intensity.
Five days a week. Full day. Sleep at home or at Truth House.
The most structured option. You spend the day in treatment, then sleep at home or at Truth House.
See how PHP worksCensus
Eight in a group
1:1
Three or more a week
Founded
Therapist-led
Clinical model
Courtney's three-part model. Not a 12-step hallway. Therapy, the whole day.
How we use DBT, EMDR, and somatic therapy
Somatic care
Exist in it again.
Yoga, breath, nutrition, and pain — how the body and the mind move each other. The work starts here when the nervous system will not stand down.
Cognitive analysis
The thought that runs the day.
Automatic thoughts, decisions, the story you tell yourself. We change the reaction before we ask you to change the life.
Psychoanalytic
What sits under the pattern.
A safe room for the unconscious — why you feel and act the way you do. Trauma, personality, and use, read as one history.
What we treat
Treated together, in the same week.
Most people arrive with more than one of these. The plan holds all of it — not a referral out, not a later track.
Dual diagnosis treatment in Orange CountyTalk to admissions
Trauma
What happened, still in the body.
What happened, still in the body.
Safety first, then a timeline. Somatic work in the same groups as everyone else — CCTP in the room.
The pattern is a survival skill.
Distress skills, then relationships, then identity. Not a personality-disorder hallway down the clinic.
The day goes flat.
A full day or a half day when the bed won. Same PHP/IOP chair as trauma and use.
The nervous system will not stand down.
The body first — breath, cold, walking — then the thought that will not stop. Group and 1:1.
The ritual quiets the fear, but only for a while.
Exposure work sits in the same PHP or IOP week as any trauma or substance use underneath it.
Relief that started making the rules.
The use sits in the same week as the trauma under it. Not a handoff to detox and a later call.
Housing
Accredited housing in Laguna Canyon for people already in PHP or IOP. Insurance does not cover the house — not local? Come stay with us.
See the Truth House
The roomSingle or shared.
Our founder
Chief Clinical Officer
USC-trained licensed psychotherapist and certified trauma and personality-disorder expert.
Me and my team help you go from feeling out of control, deeply misunderstood, and isolated to feeling in control of a life worth living.
Education
University of Southern California Magna Cum Laude · Master of Social Work · 2014–2016
California Southern University Summa Cum Laude · Doctorate in Clinical Psychology · 2016–2019
Credentials
LCSW · PsyD · RPA · C-DBT · C-PD · CCTP
Featured in
The New York Times · Good Morning America · NBC · Business Insider · The Washington Post
The team
Dr. Courtney Tracy founded the clinic. Mikaela Karpinski is the executive director.
Founder and chief clinical officer
LCSW · PsyD · RPA · C-DBT · C-PD · CCTP
USC-trained licensed psychotherapist and certified trauma and personality-disorder expert.
Therapist-founded, expert-led. Courtney built Exist for people who need trauma, personality-disorder, and dual-diagnosis care — and refuse to be treated as a chart first.
About Courtney
Executive Director
LCSW · trauma and personality
I am the team’s executive director. I am deeply passionate about helping people find lasting personal care, meaningful reconnection, and a treatment program that makes sense. I help our program and client experience thrive by balancing humanistic care and clinical expertise. If you are reading this, please know that all the hard work it takes to find healing is worth it. You are worth it. Outside of work, I spend time with my cats Squidward and Jelly (yes, there is a SpongeBob theme going on) and with my husband.
Somatic practitioner
RADT · RYT-500 · yoga and breath
Medical director
DO · psychiatry
Medical director
Psychiatry · dual diagnosis
Nine truths
01Body
We will help you exist in your body again, and teach you how to befriend it.
From people who stayed
I never thought I'd actually find a treatment center that cares this much.
Warm, inviting, and they get substance use and BPD.
We are so incredibly grateful for all of the compassionate care and support provided here.
As seen in
Insurance & admissions
Call us, or send your insurance below. We check your PHP, IOP, and outpatient benefits and write back within one business day. If we are not the fit, we help with a referral.
Reach out
Call or send the form. You talk to the clinic — not a call center.
We verify your benefits
We contact your insurance and map what your plan covers at each intensity.
Pick a start date
We recommend a starting intensity — and a room at Truth House if you're coming from out of the area.
Benefits vary by plan. Verification is free and is not a guarantee of coverage.
Verify your insurance
In-network with
