Therapists in Arizona
Dr. Christine Bielinski
Licensed Professional Counselor, PhD, LPC
Verified Verified
1 Endorsed
Scottsdale, AZ 85260
Hello. I welcome the opportunity to work with you. I believe change is always possible. Working together as a team, I am committed to YOU and your success in emerging as a braver, more joyful, and fulfilled person. I want you to THRIVE, not just survive in life. People come to me because they oftentimes feel stuck in their lives. I help them identify where they want to go and help them get there. I choose strategies depending upon your specific needs. I am trained in effective modalities including CBT, DBT, EFT, including Emotionally Focused Couples Therapy, EMDR, Mindfulness, Performance Interventions, and Christian Counseling.
Hello. I welcome the opportunity to work with you. I believe change is always possible. Working together as a team, I am committed to YOU and your success in emerging as a braver, more joyful, and fulfilled person. I want you to THRIVE, not just survive in life. People come to me because they oftentimes feel stuck in their lives. I help them identify where they want to go and help them get there. I choose strategies depending upon your specific needs. I am trained in effective modalities including CBT, DBT, EFT, including Emotionally Focused Couples Therapy, EMDR, Mindfulness, Performance Interventions, and Christian Counseling.
Mamta Bhargava
Counselor, MSc, LPC, NCC, CCH
Verified Verified
4 Endorsed
Scottsdale, AZ 85255 (Online Only)
I believe in the innate power in us to evolve and resolve. Sometimes when we are faced with challenging situations, our perspectives become hazy and we are unable to connect with our selves. I use eclectic and holistic modes of therapy to help people connect with their inner selves to move on in their lives and reach their full potential. I am trained in DBT, CBT, ACT and am also a Certified EMDR provider. I also completed an externship in Emotionally focussed Therapy for Couples as positive relationships are imperative for our emotional, mental health.
I believe in the innate power in us to evolve and resolve. Sometimes when we are faced with challenging situations, our perspectives become hazy and we are unable to connect with our selves. I use eclectic and holistic modes of therapy to help people connect with their inner selves to move on in their lives and reach their full potential. I am trained in DBT, CBT, ACT and am also a Certified EMDR provider. I also completed an externship in Emotionally focussed Therapy for Couples as positive relationships are imperative for our emotional, mental health.
Silver Lining Psychotherapy
Licensed Professional Counselor, MA, LPC, NCC, BHP
Verified Verified
4 Endorsed
Litchfield Park, AZ 85340
Angela utilizes a multi-modal theoretical approach that is tailored to each individual client, which may include CBT, DBT, Motivational interviewing, Person Centered, Therapeutic Play techniques, EMDR, and Attachment Based Trauma therapy.
Have you ever considered the root causes behind your life difficulties? Many of these may have originated from past traumatic events. If you are a person experiencing these types of difficulties please call so we can talk. At Silver Lining Psychotherapy, Angela is a Licensed Professional Counselor and enjoys providing treatment, assessment, counseling, and consulting services to a diverse population of individuals in the community.
Angela utilizes a multi-modal theoretical approach that is tailored to each individual client, which may include CBT, DBT, Motivational interviewing, Person Centered, Therapeutic Play techniques, EMDR, and Attachment Based Trauma therapy.
Have you ever considered the root causes behind your life difficulties? Many of these may have originated from past traumatic events. If you are a person experiencing these types of difficulties please call so we can talk. At Silver Lining Psychotherapy, Angela is a Licensed Professional Counselor and enjoys providing treatment, assessment, counseling, and consulting services to a diverse population of individuals in the community.
Heidi Hill
Licensed Professional Counselor, MSc, LPC, NCC
Verified Verified
4 Endorsed
Chandler, AZ 85226 (Online Only)
I also offer Reiki Energy Healing, DBT and Mindfulness Therapy & Skill Training.
Hello there, I am so glad you are here! My name is Heidi Hill, I am a Licensed Professional Counselor (LPC), Certified Trauma Specialist, and Holistic Mind-Body-Spirit (Integrative) Therapist, serving you through telehealth. I would be honored to partner with you in your wellness journey and believe we have connected for a reason. If you have found my page, you are likely someone who is very insightful, empathic to others, interested in learning and personal growth, and ready to take the next steps in your healing journey towards your best authentic self.
I also offer Reiki Energy Healing, DBT and Mindfulness Therapy & Skill Training.
Hello there, I am so glad you are here! My name is Heidi Hill, I am a Licensed Professional Counselor (LPC), Certified Trauma Specialist, and Holistic Mind-Body-Spirit (Integrative) Therapist, serving you through telehealth. I would be honored to partner with you in your wellness journey and believe we have connected for a reason. If you have found my page, you are likely someone who is very insightful, empathic to others, interested in learning and personal growth, and ready to take the next steps in your healing journey towards your best authentic self.
Lilliana Magali Hoy-Nielsen
Clinical Social Work/Therapist, LCSW, MSW
Verified Verified
3 Endorsed
Oro Valley, AZ 85737
In addition, Magali uses Cognitive behavioral therapy, Family Systems, Dialectical Behavioral Informed Technique, Trauma Informed Care, as tools to address other mental and behavioral health conditions.
Magali Hoy-Nielsen has been working with clients who have extensive trauma experiences, sexual, physical abuse, domestic violence, and parent/child attachment disorder. Magali focuses on the specific trauma that has impacted the client's life and guides that client in finding clarity, self healing, and a path towards self control. Magali has been working in the area of trauma and attachment for 19 years, helping mend broken and damaged parent/child relationships, which is the core of healthy connections in the future.
In addition, Magali uses Cognitive behavioral therapy, Family Systems, Dialectical Behavioral Informed Technique, Trauma Informed Care, as tools to address other mental and behavioral health conditions.
Magali Hoy-Nielsen has been working with clients who have extensive trauma experiences, sexual, physical abuse, domestic violence, and parent/child attachment disorder. Magali focuses on the specific trauma that has impacted the client's life and guides that client in finding clarity, self healing, and a path towards self control. Magali has been working in the area of trauma and attachment for 19 years, helping mend broken and damaged parent/child relationships, which is the core of healthy connections in the future.
Perspectives Therapy
Clinical Social Work/Therapist, L, C, S, W
Verified Verified
2 Endorsed
Tucson, AZ 85712
My models of change are CBT, DBT and solution focused therapy.
I am a Latina with a master’s degree from Arizona State University, licensed through the BBHE in Arizona. I am the owner/ founder of Perspectives Therapy located in Tucson. I started in this field 23 years ago & my areas of expertise are vast. I treat patients of all ages & empower the latino community by providing a safe place to heal emotionally & talk openly. I treat men, women of all ages and adolescent girls who are having difficulties with confidence, self-esteem, trauma, relationships, emotional control & communication issues. I am also certified through state of Arizona to provide Domestic Violence offender treatment.
My models of change are CBT, DBT and solution focused therapy.
I am a Latina with a master’s degree from Arizona State University, licensed through the BBHE in Arizona. I am the owner/ founder of Perspectives Therapy located in Tucson. I started in this field 23 years ago & my areas of expertise are vast. I treat patients of all ages & empower the latino community by providing a safe place to heal emotionally & talk openly. I treat men, women of all ages and adolescent girls who are having difficulties with confidence, self-esteem, trauma, relationships, emotional control & communication issues. I am also certified through state of Arizona to provide Domestic Violence offender treatment.
Julie Espinoza
Licensed Professional Counselor, MA, LPC
Verified Verified
3 Endorsed
Phoenix, AZ 85016
Since practicing for 22+ years, I am trained in many best practice modalities: IFS, EMDR, DBT, ACT, EFT, Gottman Method, Sex therapy, Psychedelic Assisted Psychotherapy & others.
Your ability to seek out resources amidst the pain is a magnificent part of you, and I want to speak to that part. It is important that you remember that growth and healing is not about fixing what is “wrong” with you because you are not broken. Instead of fixing, our time together will be an exploration of all parts of you, one of curiosity and compassion, designed to unearth and liberate the wisdom that already exists inside of you. Going to therapy doesn’t mean that you can’t handle life’s challenges on our own. Rather, it’s a gift that you give yourself to stay mentally and emotionally fit.
Since practicing for 22+ years, I am trained in many best practice modalities: IFS, EMDR, DBT, ACT, EFT, Gottman Method, Sex therapy, Psychedelic Assisted Psychotherapy & others.
Your ability to seek out resources amidst the pain is a magnificent part of you, and I want to speak to that part. It is important that you remember that growth and healing is not about fixing what is “wrong” with you because you are not broken. Instead of fixing, our time together will be an exploration of all parts of you, one of curiosity and compassion, designed to unearth and liberate the wisdom that already exists inside of you. Going to therapy doesn’t mean that you can’t handle life’s challenges on our own. Rather, it’s a gift that you give yourself to stay mentally and emotionally fit.
I implement evidence-based therapy techniques including, but not limited to, mindfulness-based interventions, IBCT, CBT, ACT, and DBT to address symptoms of PTSD, depression, anxiety, low self-esteem, relational problems, and/or other life stressors.
Facing difficult emotional and interpersonal challenges in our lives can be frightening but can also be a time for growth and healing. Talking with someone who listens without judgment, understands your concerns, and helps you clarify issues can be invaluable. I am a culturally competent therapist with experience working with various populations including, the LGBTQ community, adolescents, adults, couples, veterans, and those suffering from chronic illness. My therapeutic approach is solution-focused and strength-based, faith/spirituality can be incorporated into treatment as well.
I implement evidence-based therapy techniques including, but not limited to, mindfulness-based interventions, IBCT, CBT, ACT, and DBT to address symptoms of PTSD, depression, anxiety, low self-esteem, relational problems, and/or other life stressors.
Facing difficult emotional and interpersonal challenges in our lives can be frightening but can also be a time for growth and healing. Talking with someone who listens without judgment, understands your concerns, and helps you clarify issues can be invaluable. I am a culturally competent therapist with experience working with various populations including, the LGBTQ community, adolescents, adults, couples, veterans, and those suffering from chronic illness. My therapeutic approach is solution-focused and strength-based, faith/spirituality can be incorporated into treatment as well.
Cognitive-Behavioral Therapy (CBT), Motivational Interviewing, Schema Therapy, Adlerian Therapy, and Dialectical Behavioral Therapy ( DBT).
Hi There. Nice to meet you. I'm a LMFT. I have been practicing therapy in the Southern Arizona region since 2011. I have received specialized training focusing on relationships, family, and children. I have 17 years of community mental health experience, 10 of which includes providing individual, couples, family, and group therapy. I have had the privilege of learning from and working with a diverse range of populations; from the underserved to commercially insured individuals.
Cognitive-Behavioral Therapy (CBT), Motivational Interviewing, Schema Therapy, Adlerian Therapy, and Dialectical Behavioral Therapy ( DBT).
Hi There. Nice to meet you. I'm a LMFT. I have been practicing therapy in the Southern Arizona region since 2011. I have received specialized training focusing on relationships, family, and children. I have 17 years of community mental health experience, 10 of which includes providing individual, couples, family, and group therapy. I have had the privilege of learning from and working with a diverse range of populations; from the underserved to commercially insured individuals.
Marlys L Reardon - Emdr - Postpartum Mood Disorders
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
3 Endorsed
Gilbert, AZ 85296 (Online Only)
I'm trained in CBT, Perinatal Mood & Anxiety Disorders, EMDR, Motivational Interviewing, DBT Skills, Hypnotherapy, Ego States Therapy & Addictions Treatment.
Accepting NEW Clients! Let's work together to discover the truest version of yourself! The decision to seek therapy is a courageous, personal one that honors your life experiences and journey. My objective when working with clients is to provide a safe, comfortable space where they can share freely and without judgement. Your therapeutic journey will be aimed at addressing the behaviors that block you, preventing you from living your most authentic, joyful life. My approach is holistic; centering on assessing emotional and mental health concerns, as well as physical health, familial interactions, community, and spiritual needs.
I'm trained in CBT, Perinatal Mood & Anxiety Disorders, EMDR, Motivational Interviewing, DBT Skills, Hypnotherapy, Ego States Therapy & Addictions Treatment.
Accepting NEW Clients! Let's work together to discover the truest version of yourself! The decision to seek therapy is a courageous, personal one that honors your life experiences and journey. My objective when working with clients is to provide a safe, comfortable space where they can share freely and without judgement. Your therapeutic journey will be aimed at addressing the behaviors that block you, preventing you from living your most authentic, joyful life. My approach is holistic; centering on assessing emotional and mental health concerns, as well as physical health, familial interactions, community, and spiritual needs.
Vivian E Watters
Licensed Master Social Worker, LMSW
Verified Verified
Scottsdale, AZ 85258 (Online Only)
In practice, I use several modalities including CBT, DBT, Gestalt Therapy, Brief, Solution Focused Therapies, mindfulness and coaching.
Hello, my name is Vivian Watters, LMSW and I am honored to have the opportunity to work with you on your mental health journey. My goal is to bring healing and comfort to many aspects of your life. I understand that there is no ‘one size fits all” when it comes to unravelling life’s stressful challenges, so allow me to be on this journey with you.
In practice, I use several modalities including CBT, DBT, Gestalt Therapy, Brief, Solution Focused Therapies, mindfulness and coaching.
Hello, my name is Vivian Watters, LMSW and I am honored to have the opportunity to work with you on your mental health journey. My goal is to bring healing and comfort to many aspects of your life. I understand that there is no ‘one size fits all” when it comes to unravelling life’s stressful challenges, so allow me to be on this journey with you.
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Licensed Professional Counselor, MS, LPC, CHT
Verified Verified
3 Endorsed
Mesa, AZ 85206
Using CBT, DBT, and solution-focused therapy, my goal is to build a partnership with each client to help my client identify what change is necessary for them to move in the right direction.
New to the practice, Carrie Peters is accepting new patients for in person or virtual sessions. Private, secure office in Mesa! Let's work together to build a partnership that fosters healing. Theresa Cloyd: I approach every patient with an open mind and no judgement. Counseling sessions are personalized because every client is different! My treatment approach is person centered. I believe the approach must be tailored to each individual and for this reason, various treatment modalities are used including strengths-based, spiritual centered, and evidenced-based.
Using CBT, DBT, and solution-focused therapy, my goal is to build a partnership with each client to help my client identify what change is necessary for them to move in the right direction.
New to the practice, Carrie Peters is accepting new patients for in person or virtual sessions. Private, secure office in Mesa! Let's work together to build a partnership that fosters healing. Theresa Cloyd: I approach every patient with an open mind and no judgement. Counseling sessions are personalized because every client is different! My treatment approach is person centered. I believe the approach must be tailored to each individual and for this reason, various treatment modalities are used including strengths-based, spiritual centered, and evidenced-based.
Hello, my name is Rosemary Martinez and I'm a licensed professional counselor in Arizona. I specialize in helping people work through and heal from past trauma that has impacted their daily lives. I use modalities such as CBT, EMDR, and DBT to reprocess and heal the entire person. I hope to have the opportunity to help you. I try to get the whole picture of the person I'm working with. I don't just want to know the trauma I want to understand how it is impacting your daily living and how we can work together to improve that. I use modalities such as CBT, EMDR, and DBT among others, to treat the person, not the diagnosis.
Hello, my name is Rosemary Martinez and I'm a licensed professional counselor in Arizona. I specialize in helping people work through and heal from past trauma that has impacted their daily lives. I use modalities such as CBT, EMDR, and DBT to reprocess and heal the entire person. I hope to have the opportunity to help you. I try to get the whole picture of the person I'm working with. I don't just want to know the trauma I want to understand how it is impacting your daily living and how we can work together to improve that. I use modalities such as CBT, EMDR, and DBT among others, to treat the person, not the diagnosis.
Ryan Shelby Butler
Licensed Professional Counselor, MS, LPC
Verified Verified
2 Endorsed
Peoria, AZ 85383
Utilizing realistic solution-focused techniques from CBT, DBT, Family Systems, Narrative and Existential therapies.
I am a Licensed Professional Counselor (LPC), working under the private agency: Becoming Transformed, LLC. I come from a demonstrated history of working in the higher education industry, where I was able to apply my unique counseling skills in a diverse community of teaching, accounting/finance, analytics, and guidance for students and school leadership. I spend much of my spare time with family, serving in church leadership, reading/writing, and enjoying the great outdoors.
Utilizing realistic solution-focused techniques from CBT, DBT, Family Systems, Narrative and Existential therapies.
I am a Licensed Professional Counselor (LPC), working under the private agency: Becoming Transformed, LLC. I come from a demonstrated history of working in the higher education industry, where I was able to apply my unique counseling skills in a diverse community of teaching, accounting/finance, analytics, and guidance for students and school leadership. I spend much of my spare time with family, serving in church leadership, reading/writing, and enjoying the great outdoors.
Izabela Weber
Licensed Professional Counselor, MA, MS, LPC, NCC
Verified Verified
Fountain Hills, AZ 85268
I utilize several methods: cognitive-behavioral therapy, solution-oriented therapy, acceptance and commitment therapy, person-centered therapy, DBT, specialized training for treating anxiety and trauma, and mindfulness training.
A key question is: are you new to counseling or did previous therapy not fulfill your expectations? I am a seasoned counselor focused on achieving CONCRETE GOALS that we establish together at the beginning of the therapy process. I frequently assess whether you have been making significant progress. If not, we work together on applying alternative methods in order to get where you want and need to be. In my cozy private practice office, you will be receiving my complete attention. This is a place where you find acceptance, peace of mind, and solutions to questions that have been troubling you for a long time.
I utilize several methods: cognitive-behavioral therapy, solution-oriented therapy, acceptance and commitment therapy, person-centered therapy, DBT, specialized training for treating anxiety and trauma, and mindfulness training.
A key question is: are you new to counseling or did previous therapy not fulfill your expectations? I am a seasoned counselor focused on achieving CONCRETE GOALS that we establish together at the beginning of the therapy process. I frequently assess whether you have been making significant progress. If not, we work together on applying alternative methods in order to get where you want and need to be. In my cozy private practice office, you will be receiving my complete attention. This is a place where you find acceptance, peace of mind, and solutions to questions that have been troubling you for a long time.
Trauma informed care, cognitive behavioral therapy, dialectical behavioral therapy, emotion regulation, and play therapy.
Dawnmarie has worked with ages 3 all the way to geriatric clients. Dawnmarie is experienced in working with individuals, families, and couples. Dawnmarie is trained in play therapy, trauma informed care, Cognitive behavioral therapy, and Dialectical behavioral therapy. Dawnmarie focuses in the whole body and understanding how our brain are bodies connect with one another. Dawnmarie has worked in outpatient, inpatient, and residential settings. Dawnmarie has experince working with a variety of diagnoses, co-occuring disorders, and serious mental illness diagnoses.
Trauma informed care, cognitive behavioral therapy, dialectical behavioral therapy, emotion regulation, and play therapy.
Dawnmarie has worked with ages 3 all the way to geriatric clients. Dawnmarie is experienced in working with individuals, families, and couples. Dawnmarie is trained in play therapy, trauma informed care, Cognitive behavioral therapy, and Dialectical behavioral therapy. Dawnmarie focuses in the whole body and understanding how our brain are bodies connect with one another. Dawnmarie has worked in outpatient, inpatient, and residential settings. Dawnmarie has experince working with a variety of diagnoses, co-occuring disorders, and serious mental illness diagnoses.
Debra DelVecchio-Lee
Licensed Professional Counselor
Verified Verified
Scottsdale, AZ 85254 (Online Only)
I am a Licensed Professional Counselor with over 20 years of experience helping individual and families with a wide variety of issues. My specialties include treatment for depression, anxiety, stress management, trauma, divorce, life transitions, and relationship concerns. Additionally, I have extensive training and experience in conflict resolution, and I have provided mediation and evaluative services in Family Court for many years. I use a combination of therapeutic approaches and techniques, including person-centered, solution-focused, family systems, cognitive-behavioral (CBT), dialectical behavioral therapy ( DBT)
I am a Licensed Professional Counselor with over 20 years of experience helping individual and families with a wide variety of issues. My specialties include treatment for depression, anxiety, stress management, trauma, divorce, life transitions, and relationship concerns. Additionally, I have extensive training and experience in conflict resolution, and I have provided mediation and evaluative services in Family Court for many years. I use a combination of therapeutic approaches and techniques, including person-centered, solution-focused, family systems, cognitive-behavioral (CBT), dialectical behavioral therapy ( DBT)
My primary interventions include CBT, DBT, ERP, Client-Centered Therapy, Solution Oriented Approaches and Mindfulness Based Grounding.
Welcome! I approach therapy with compassion, empathy, and a solution-oriented mindset. My specialized interests and focus are in body image and disordered eating, self-esteem, OCD, life transitions, stress, anxiety, depression, and family issues. I have experience within community mental health agencies, traditional outpatient settings, integrated healthcare and on college campuses. I believe that by providing a safe and non-judgmental space I support clients in gaining the courage to build confidence in themselves and their abilities to succeed.
My primary interventions include CBT, DBT, ERP, Client-Centered Therapy, Solution Oriented Approaches and Mindfulness Based Grounding.
Welcome! I approach therapy with compassion, empathy, and a solution-oriented mindset. My specialized interests and focus are in body image and disordered eating, self-esteem, OCD, life transitions, stress, anxiety, depression, and family issues. I have experience within community mental health agencies, traditional outpatient settings, integrated healthcare and on college campuses. I believe that by providing a safe and non-judgmental space I support clients in gaining the courage to build confidence in themselves and their abilities to succeed.
I utilize CBT and DBT, as well as motivational interviewing, mindfulness, intuitive eating, and personal empowerment techniques to help my clients feel healthier and happier.
You deserve treatment that is evidence-based and solution-focused. I believe every client is unique and deserves individualized treatment that is empathetic, non-judgmental, and most importantly, helpful!
I utilize CBT and DBT, as well as motivational interviewing, mindfulness, intuitive eating, and personal empowerment techniques to help my clients feel healthier and happier.
You deserve treatment that is evidence-based and solution-focused. I believe every client is unique and deserves individualized treatment that is empathetic, non-judgmental, and most importantly, helpful!
I completed my PhD in Community Psychology and have my Master's degree I utilize a variety of therapeutic modalities including contextual family therapy, CBT, DBT, trauma-informed visualization, EMDR but, overall, create a unique treatment plan to incorporate what works best for my clien.
I have worked with people of all ages and have effectively helped clients find relief from issues such as depression, sexual issues, anxiety, PTSD and communication difficulties. As a relational therapist, I work with couples, triads, quads and relationships of all types, including those with ENM or "alternative" relationship practices. I also have a great deal of experience working with adolescents suffering from trauma and oftentimes I find it helpful to involve other family members to assist in providing support for one another.
I completed my PhD in Community Psychology and have my Master's degree I utilize a variety of therapeutic modalities including contextual family therapy, CBT, DBT, trauma-informed visualization, EMDR but, overall, create a unique treatment plan to incorporate what works best for my clien.
I have worked with people of all ages and have effectively helped clients find relief from issues such as depression, sexual issues, anxiety, PTSD and communication difficulties. As a relational therapist, I work with couples, triads, quads and relationships of all types, including those with ENM or "alternative" relationship practices. I also have a great deal of experience working with adolescents suffering from trauma and oftentimes I find it helpful to involve other family members to assist in providing support for one another.
See more therapy options for Arizona
Dialectical Behavior (DBT) Therapists
Who is DBT for?
Dialectical Behavior Therapy (DBT) is designed for people who experience extreme emotional suffering because they lack the skills of emotion regulation and distress tolerance. The basic affliction can underlie a wide range of conditions, from borderline and other personality disorders to PTSD and treatment-resistant anxiety and depression. The therapy is helpful to those whose emotional reactivity is so intense it is disruptive to everyday functioning and leads to frequent crises.
Why do people need DBT?
The ability to regulate emotions is a core psychological skill that enables people to function in life and pay attention to the world outside themselves; it is consistently associated with well-being. DBT is designed to help people learn how to manage and regulate their emotions. Originally developed to treat people with borderline personality disorder whose extreme emotional suffering led to self-harming behavior and suicide attempts, the therapy is now applied to other conditions involving emotion dysregulation, particularly when other treatments have failed.
What happens in DBT?
Individuals meet weekly with their therapist to discuss their experiences relating to moods, behavior, and skills. Using checklists they maintain, they review emotional experiences and positive practices they engage in. The diaries help individuals discern what led up to a specific problem encountered, this is followed by discussion of the consequences of their actions. In addition, individuals may meet in class-like small groups to learn skills such as mindfulness, emotion regulation and distress tolerance.
How long does DBT last?
Because it is intended to establish long-lasting behavioral change among those with persistent problems, DBT is designed to last six months to a year. DBT includes both weekly sessions of individual therapy and weekly skills-training sessions conducted in small groups. Studies of DBT have documented improvement within a year of treatment, particularly in controlling self-harmful behavior; nevertheless, individuals may require therapy for several years.