Vistula Solutions Independent clinical case management US & international · (805) 206-9477
Vistula Solutions

Case file · opened on first call

Two kinds of pressure. One way through.

Independent clinical case management for complex mental health and addiction. One assessment, one written plan across every provider — and one person accountable until it holds.

Families pay us. Treatment facilities never do — by policy and by federal law.

If a treatment program gave you our name: they chose us because we're independent — no program pays us, so the advice is only about your family.

01 · Case management

Multiple providers, no one in charge. We run the whole system — one plan, one accountable person, until it holds.

02 · Placement

The right program — residential, detox, or sober living — matched to the person. No facility pays us, so no facility sways the answer.

03 · Coaching

For the long stretch after treatment — and for executives carrying a company all day and a person in crisis all night.

Independence: absolute Scope: agreed before work begins Every engagement ends in writing
Entry 01

The pattern we see

A family has already spent six figures on treatment. There is a relapse anyway. A therapist, a psychiatrist, an attorney, a facility — and nobody in charge of the whole picture.

When someone you love is in a mental health or addiction crisis, the hardest part is not finding help. It is knowing which help is right — and who is accountable once treatment starts.

That is the job. We speak with every provider and with the client, assess where things actually stand, and bring everyone onto one plan. Then we stay on it until it holds.

Entry 02

What we do

Case management

The spine of the practice

For complex cases with multiple providers, we run the whole system so no one else has to. Much of our work is with high-net-worth individuals and families, where privacy is not a preference — it is a condition of care. We work quietly. What happens in the family stays in the family.

  • Clinical assessment, then one written plan across every provider
  • Discharge planned before it arrives — the highest-risk weeks covered by a real plan, not a printout
  • Wrap-around care with one thread through all of it: detox, treatment, and ongoing supervision after discharge
  • Access to leading professionals, exceptional facilities, and in-home treatment when that is the better fit
  • Weekly or more frequent meetings with all providers and facilities
  • Written updates to the family: what was promised, what was delivered
  • Medication and progress tracking, early warning signs, crisis response

The aim is simple to say and hard to do: an environment where healing, long-term recovery, and personal growth actually have room to happen.

Placement

Independent, always

Finding the right program — residential treatment, detox, or sober living — matched to diagnosis, history, and family, anywhere in the US or abroad. No facility pays us, so no facility influences the answer.

Coaching

For the long stretch

We guide clinically complex individuals and their families through crisis — steady, reachable, and honest about what comes next. After treatment, recovery coaching keeps the plan alive. Families learn a new role, and how to hold it without breaking.

And for executives: some of our clients carry a company all day and a person in crisis all night. That is its own clinical picture. We coach it the way we run everything else — discreet, scheduled, accountable.

Entry 03

The method

01 · First days

Listen

The whole story, from everyone — the client, the family, and every professional already involved.

02

Assess

A clinical assessment of where things actually stand: diagnosis, acuity, what has been tried, and what it will take.

03

Align

One written plan, organized around the client's own goal, shared with every provider — so everyone works from the same page.

04 · The long middle

Hold

Weekly or more frequent provider meetings. Coordinated care, watched closely, reported in writing.

05 · When stability comes

Step down

A planned transition, and a written record of what happened — not just what it cost.

Entry 04

What we take on

Complex psychiatric presentations — thought, mood, and personality disorders
Alcohol and drug addiction, including co-occurring disorders
Process addictions — eating disorders, sexual compulsivity, gaming and gambling
Trauma and related life challenges
Complexities of family and generational wealth, including work with fiduciaries and conservatees
Executives under extreme stress, where the pressure at work and the pressure at home are the same problem
For families & individuals

Someone you love needs help that holds

Whether nothing has been tried yet or everything has, the first step is the same: a 20-minute call, no obligation, and an honest read of the situation.

Book the call
For facilities & fiduciaries

An independent clinical partner

Crisis intervention, case consultation, discharge continuity, long-term case management, and documented oversight reporting for conservatees — dated, written records a fiduciary can file.

See the professional services
Entry 05

The practice

Vistula Solutions was founded by Aga Pedroso. She has sat at both tables: inside leading Malibu treatment facilities as a full-time case manager for high-acuity addiction and mental health clients — and beside families, as the person who finally got everyone on one page.

The practice is built around a partner network we know personally and have worked with directly: neuropsychologists, psychiatrists, physicians, therapists, nutritionists, and recovery coaches across the US and abroad. Clients are served anywhere in the country and internationally.

No testimonials appear on this site — in this field they are too easy to fake. References from past clients and professional partners are available on request.

Confidentiality, stated plainly

Who we work with — and that we work with them — is nobody's business but theirs. Nothing leaves the file without written permission. No mailing lists, ever.

On the record
Independent clinical oversight for complex mental health & addiction, since 2023
Years of full-time, high-acuity case management at a leading Malibu treatment facility
M.Sc. International Healthcare Management · doctoral research in progress
Board member, The Brain Injury Research Foundation
Entry 06 · The first step

A 20-minute call. An honest read.

Zoom or phone. Confidential, and no obligation. If we're not the right help, we will say so — and tell you what is.

Independence: absolute Scope: agreed before work begins Fee: agreed in writing