Depression Therapists in Pasadena, CA

Photo of Sarah Appleton, LMFT, Counselor
Sarah Appleton
Counselor, LMFT
Verified Verified
Pasadena, CA 91105
She has experience with individuals suffering from a range of concerns including anxiety and depression.
Sarah Appleton is a Licensed Marriage and Family Therapist & Professional Clinical Counselor in California with more than 15 years of experience. She has a Bachelor’s Degree in Psychology from California State University Bakersfield, a Master’s Degree in Counseling Psychology from California State University Bakersfield, and a Doctorate in Clinical Psychology from Alliant International University Fresno. Sarah believes that a therapeutic relationship can offer a supportive and encouraging environment to explore current struggles, understand how one’s history impacts the present.
She has experience with individuals suffering from a range of concerns including anxiety and depression.
Sarah Appleton is a Licensed Marriage and Family Therapist & Professional Clinical Counselor in California with more than 15 years of experience. She has a Bachelor’s Degree in Psychology from California State University Bakersfield, a Master’s Degree in Counseling Psychology from California State University Bakersfield, and a Doctorate in Clinical Psychology from Alliant International University Fresno. Sarah believes that a therapeutic relationship can offer a supportive and encouraging environment to explore current struggles, understand how one’s history impacts the present.
(818) 960-1280 View (818) 960-1280
Photo of Erick Santos, LCSW, EMDR
Erick Santos
LCSW, EMDR
Verified Verified
Pasadena, CA 91101
Has trauma, anxiety, or depression interfered with the potential to become the best version of yourself? We often feel defined by traumatic or emotionally difficult experiences then often leave us feeling stuck in place rather than moving forward towards our goals. I’m here to provide a safe, affirming space for you to develop an understanding of yourself to overcome past experiences or fears that define you. Our work together will be met with unconditional acceptance, creative approaches, and the utmost compassion.
Has trauma, anxiety, or depression interfered with the potential to become the best version of yourself? We often feel defined by traumatic or emotionally difficult experiences then often leave us feeling stuck in place rather than moving forward towards our goals. I’m here to provide a safe, affirming space for you to develop an understanding of yourself to overcome past experiences or fears that define you. Our work together will be met with unconditional acceptance, creative approaches, and the utmost compassion.
(626) 322-2881 View (626) 322-2881
Photo of Brigid Gorski Rosebraugh, MA, LMFT, Marriage & Family Therapist
Brigid Gorski Rosebraugh
Marriage & Family Therapist, MA, LMFT
Verified Verified
Pasadena, CA 91101
I've been in private practice for several years and in the field for over 20 years, working with adults, adolescents and children who have had relational issues, depression, anxiety and a number of other mental health issues. I believe most of us go through periods in our lives when things get to be too much and our functioning is affected. I help my clients to determine what the root issues are and to address them as effectively as possible by working with their strengths in order to increase insight and make behavioral changes that will alleviate the problems.
I've been in private practice for several years and in the field for over 20 years, working with adults, adolescents and children who have had relational issues, depression, anxiety and a number of other mental health issues. I believe most of us go through periods in our lives when things get to be too much and our functioning is affected. I help my clients to determine what the root issues are and to address them as effectively as possible by working with their strengths in order to increase insight and make behavioral changes that will alleviate the problems.
(626) 322-2850 View (626) 322-2850
Photo of Stacy Scates, MA, LMFT, Marriage & Family Therapist
Stacy Scates
Marriage & Family Therapist, MA, LMFT
Verified Verified
1 Endorsed
Pasadena, CA 91101
Are you a couple, individual or family in need of new coping skills? Through somatic, body-centered awareness, our work together can help you to explore and understand your sensations, emotions, thoughts and actions so that you can have more authentic experiences of connection, intimacy, and joy. I work with individuals, couples and families with the following issues: Anxiety, depression, grief, loss, and intimacy. In my practice, I prioritize play and pleasure over perfection and precision.
Are you a couple, individual or family in need of new coping skills? Through somatic, body-centered awareness, our work together can help you to explore and understand your sensations, emotions, thoughts and actions so that you can have more authentic experiences of connection, intimacy, and joy. I work with individuals, couples and families with the following issues: Anxiety, depression, grief, loss, and intimacy. In my practice, I prioritize play and pleasure over perfection and precision.
(323) 375-2872 View (323) 375-2872
Photo of Ernesto Cruz, LMFT, Marriage & Family Therapist
Ernesto Cruz
Marriage & Family Therapist, LMFT
Verified Verified
Pasadena, CA 91105
Additionally, I work with clients struggling with depression and mood disorders.
I was born and raised in Northeast LA. I traveled to the Midwest for my undergraduate education, before returning to the Valley to finish my graduate degree in Psychology. In my practice I work with adolescents, adults, couples and families. I provide services in English and Spanish. I serve a diverse clientele including members of minority communities like BIPOC and LGBTQ. I have worked with issues of acculturation and racial trauma. I also work with clients facing generalized anxiety. I have experience helping survivors of sexual and physical abuse.
Additionally, I work with clients struggling with depression and mood disorders.
I was born and raised in Northeast LA. I traveled to the Midwest for my undergraduate education, before returning to the Valley to finish my graduate degree in Psychology. In my practice I work with adolescents, adults, couples and families. I provide services in English and Spanish. I serve a diverse clientele including members of minority communities like BIPOC and LGBTQ. I have worked with issues of acculturation and racial trauma. I also work with clients facing generalized anxiety. I have experience helping survivors of sexual and physical abuse.
(323) 689-5588 View (323) 689-5588
Photo of Yolanda Batres-Espinoza, LMFT, Marriage & Family Therapist
Yolanda Batres-Espinoza
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Pasadena, CA 91105
I have helped many families break through the stigma of therapy, and I have experience in treating diverse individuals and families living with trauma, depression, anxiety, and many other issues.
Welcome! My name is Yolanda Batres-Espinoza, and I am a Licensed Marriage and Family Therapist. I received my Master of Science in Marriage and Family Therapy at Fuller Theological Seminary with an emphasis in Medical Family Therapy. I developed my passion for psychotherapy at the age of eight when I first had a therapist of my own. From then on, I was determined to become a Licensed Marriage and Family Therapist and help others as I was helped during my youth. I am an LGBTQIA+ affirmative therapist and a member of the community.
I have helped many families break through the stigma of therapy, and I have experience in treating diverse individuals and families living with trauma, depression, anxiety, and many other issues.
Welcome! My name is Yolanda Batres-Espinoza, and I am a Licensed Marriage and Family Therapist. I received my Master of Science in Marriage and Family Therapy at Fuller Theological Seminary with an emphasis in Medical Family Therapy. I developed my passion for psychotherapy at the age of eight when I first had a therapist of my own. From then on, I was determined to become a Licensed Marriage and Family Therapist and help others as I was helped during my youth. I am an LGBTQIA+ affirmative therapist and a member of the community.
(323) 843-5812 View (323) 843-5812
Photo of Vanessa Espinosa, LCSW, Clinical Social Work/Therapist
Vanessa Espinosa
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Pasadena, CA 91106
Specialties include, but are not limited to working with women, depression/anxiety, trauma, and loss.
Therapy is a unique opportunity for exploration and understanding of one's own story, and can facilitate healing and transformation during trying times. In my practice, I work collaboratively with clients to uncover and strengthen their inner wisdom, while teaching them skills needed to maneuver through life's challenges, changes and transitions. I provide a supportive and hope-filled environment that allows for a journey of self-discovery, and helps to foster self-love, self-compassion, and acceptance.
Specialties include, but are not limited to working with women, depression/anxiety, trauma, and loss.
Therapy is a unique opportunity for exploration and understanding of one's own story, and can facilitate healing and transformation during trying times. In my practice, I work collaboratively with clients to uncover and strengthen their inner wisdom, while teaching them skills needed to maneuver through life's challenges, changes and transitions. I provide a supportive and hope-filled environment that allows for a journey of self-discovery, and helps to foster self-love, self-compassion, and acceptance.
(562) 551-6164 View (562) 551-6164
Photo of Margaret (Meg) J. Bezucha, MEd, LMFT, Marriage & Family Therapist
Margaret (Meg) J. Bezucha
Marriage & Family Therapist, MEd, LMFT
Verified Verified
13 Endorsed
Pasadena, CA 91101
Many of my clients come in with anxiety, depression, learning, relationship, identity and self-esteem issues, as well as issues around addiction.
Are you concerned about a child or adolescent that is struggling? Are they shutting down and sad? Worried or mad? Are they having trouble functioning at school or with friends? How about at home and with their family? Has something in their life changed? Maybe they need a little more support at this particular time... Therapy can help. I work with individuals of all ages, couples, and families.
Many of my clients come in with anxiety, depression, learning, relationship, identity and self-esteem issues, as well as issues around addiction.
Are you concerned about a child or adolescent that is struggling? Are they shutting down and sad? Worried or mad? Are they having trouble functioning at school or with friends? How about at home and with their family? Has something in their life changed? Maybe they need a little more support at this particular time... Therapy can help. I work with individuals of all ages, couples, and families.
(213) 481-5178 View (213) 481-5178
Photo of Natalia I Melancon, LCSW, Clinical Social Work/Therapist
Natalia I Melancon
Clinical Social Work/Therapist, LCSW
Verified Verified
Pasadena, CA 91101  (Online Only)
If you are looking for a therapist who will help you feel accepted, supported and free to process your feelings and thoughts in a safe judgment-free space, you will find me a good fit for your needs. I will not tell you what to do but will gently guide you through your journey toward your goals and your own decisions. I love working with adults (18+) and helping them navigate challenges with depression, anxiety, trauma, grief and loss, LGBTQIA+ and life transitions issues in a warm and compassionate environment.
If you are looking for a therapist who will help you feel accepted, supported and free to process your feelings and thoughts in a safe judgment-free space, you will find me a good fit for your needs. I will not tell you what to do but will gently guide you through your journey toward your goals and your own decisions. I love working with adults (18+) and helping them navigate challenges with depression, anxiety, trauma, grief and loss, LGBTQIA+ and life transitions issues in a warm and compassionate environment.
(951) 904-2682 View (951) 904-2682
Photo of Elizabeth Shon, PhD, Psychologist
Elizabeth Shon
Psychologist, PhD
Verified Verified
Pasadena, CA 91106
Waitlist for new clients
I have had the privilege of working with adults and couples for over 37 years, helping with a wide range of issues including: depression, anxiety, self esteem, relationships, stress, ageing, family of origin issues, cross cultural issues, identity, grief/loss and mild addictions.
I have had the privilege of working with adults and couples for over 37 years, helping with a wide range of issues including: depression, anxiety, self esteem, relationships, stress, ageing, family of origin issues, cross cultural issues, identity, grief/loss and mild addictions.
(626) 671-4930 View (626) 671-4930
Photo of Andriette Pieron, MA, LMFT, Marriage & Family Therapist
Andriette Pieron
Marriage & Family Therapist, MA, LMFT
Verified Verified
Pasadena, CA 91101  (Online Only)
I will support you in obtaining clarity and forward momentum around life transitions, depression, identity issues, relationships, addictions, trauma, anxiety and health challenges.
Do you need a place to be yourself? To be seen and fully accepted for who you are and encouraged to take leaps and risks to craft who you want to be? The fear of failure and judgments, our own and others, often holds us back from exploring the edge of our possibilities. I am passionate about creating a nurturing relationship where you can begin to practice and embody the changes you want to create in your own life. I work with individuals, couples, children, adolescents and families. I specialize in women who are reinventing themselves and family members of individuals with mental illness.
I will support you in obtaining clarity and forward momentum around life transitions, depression, identity issues, relationships, addictions, trauma, anxiety and health challenges.
Do you need a place to be yourself? To be seen and fully accepted for who you are and encouraged to take leaps and risks to craft who you want to be? The fear of failure and judgments, our own and others, often holds us back from exploring the edge of our possibilities. I am passionate about creating a nurturing relationship where you can begin to practice and embody the changes you want to create in your own life. I work with individuals, couples, children, adolescents and families. I specialize in women who are reinventing themselves and family members of individuals with mental illness.
(415) 712-2667 View (415) 712-2667
Photo of Shana Pallotta, MBA, LMFT, Marriage & Family Therapist
Shana Pallotta
Marriage & Family Therapist, MBA, LMFT
Verified Verified
9 Endorsed
Pasadena, CA 91101
I work with individuals who would like to address anxiety, depression, grief, trauma, LGBTQIA issues, relationship struggles, or personal growth.
I'm a holistic therapist who is passionate about helping you experience a more meaningful and fulfilling life. Change can be daunting. Feeling overwhelmed or stuck can prevent you from living in greater alignment with your purpose. This can impact your relationships, career, and general sense of well-being. My goal is to create a safe space and help empower you to connect with your own authenticity and meaning so that you can break free from the patterns that are limiting you.
I work with individuals who would like to address anxiety, depression, grief, trauma, LGBTQIA issues, relationship struggles, or personal growth.
I'm a holistic therapist who is passionate about helping you experience a more meaningful and fulfilling life. Change can be daunting. Feeling overwhelmed or stuck can prevent you from living in greater alignment with your purpose. This can impact your relationships, career, and general sense of well-being. My goal is to create a safe space and help empower you to connect with your own authenticity and meaning so that you can break free from the patterns that are limiting you.
(323) 800-5247 View (323) 800-5247
Photo of Judy Baldwin, MA, LMFT, Marriage & Family Therapist
Judy Baldwin
Marriage & Family Therapist, MA, LMFT
Verified Verified
Pasadena, CA 91101
Areas of clinical focus include relationships, anxiety, depression, parenting, cross cultural issues, creativity and the search for meaning.
As a warm and curious therapist, I work with you to explore the inner dynamics of your personal story and to instill a renewed sense of hope. We look closely at self limiting patterns of belief and behavior which are often routed in culture and family- of- origin relationships, and we focus in on your strengths and resiliency. In a compassionate environment we address your specific goals and help you rediscover your authentic and vibrant self so that you may connect more deeply with the loved ones in your life, and with the work and activities that give you your sense of life's meaning.
Areas of clinical focus include relationships, anxiety, depression, parenting, cross cultural issues, creativity and the search for meaning.
As a warm and curious therapist, I work with you to explore the inner dynamics of your personal story and to instill a renewed sense of hope. We look closely at self limiting patterns of belief and behavior which are often routed in culture and family- of- origin relationships, and we focus in on your strengths and resiliency. In a compassionate environment we address your specific goals and help you rediscover your authentic and vibrant self so that you may connect more deeply with the loved ones in your life, and with the work and activities that give you your sense of life's meaning.
(626) 427-3596 View (626) 427-3596
Photo of Corey Hooper, MA, MFT, Marriage & Family Therapist
Corey Hooper
Marriage & Family Therapist, MA, MFT
Verified Verified
Pasadena, CA 91101
As a psychotherapist and Jungian analyst, I will help you tap inner resources to better understand & deal with life challenges. We will explore who the 'you' is under anxiety, depression, fears, difficult relationships, and low self-esteem. As a Marriage and Family Therapist and analyst, I am flexible in providing the type of treatment best suited for each client, whether it is supportive when navigating difficult life transitions or analytic when exploring the inner dynamics of psyche and Self. During our work together we can explore how dreams, art, journaling, sandtray, & creative imagination play an active part in healing.
As a psychotherapist and Jungian analyst, I will help you tap inner resources to better understand & deal with life challenges. We will explore who the 'you' is under anxiety, depression, fears, difficult relationships, and low self-esteem. As a Marriage and Family Therapist and analyst, I am flexible in providing the type of treatment best suited for each client, whether it is supportive when navigating difficult life transitions or analytic when exploring the inner dynamics of psyche and Self. During our work together we can explore how dreams, art, journaling, sandtray, & creative imagination play an active part in healing.
(424) 321-6493 View (424) 321-6493
Photo of Jacky Lau, LMFT, Marriage & Family Therapist
Jacky Lau
Marriage & Family Therapist, LMFT
Verified Verified
Pasadena, CA 91101  (Online Only)
You might feel stuck or like your life is spiraling out of control. Perhaps you're struggling with anxiety or depression, and you've lost your spark. It might seem like you’re trapped in a monotonous routine—just going to work and coming home, living day to day with no joy in between. If this resonates with you, know that things can get better. You’re ready for change and you deserve to find happiness again
You might feel stuck or like your life is spiraling out of control. Perhaps you're struggling with anxiety or depression, and you've lost your spark. It might seem like you’re trapped in a monotonous routine—just going to work and coming home, living day to day with no joy in between. If this resonates with you, know that things can get better. You’re ready for change and you deserve to find happiness again
(626) 663-2099 View (626) 663-2099
Photo of Kellett Tighe - Kellett Tighe Therapy, MFA, MAP, LMFT, Marriage & Family Therapist
Kellett Tighe Therapy
Marriage & Family Therapist, MFA, MAP, LMFT
Verified Verified
1 Endorsed
Pasadena, CA 91101  (Online Only)
Are you experiencing relationship concerns, interpersonal challenges, or employment issues? Struggling with addiction, depression, self-esteem, anxiety, or the aftermath of trauma? As a therapist, I am here to support and guide you. I am empathetic, genuine, connected and collaborative. My role is to facilitate your understanding of what is preventing and blocking you from achieving your goals, harmony of mind and repose. Prior to becoming a therapist, I have worked for over 16 years in the entertainment industry. A process of introspection led me to discover my true passion lies in connecting with people.
Are you experiencing relationship concerns, interpersonal challenges, or employment issues? Struggling with addiction, depression, self-esteem, anxiety, or the aftermath of trauma? As a therapist, I am here to support and guide you. I am empathetic, genuine, connected and collaborative. My role is to facilitate your understanding of what is preventing and blocking you from achieving your goals, harmony of mind and repose. Prior to becoming a therapist, I have worked for over 16 years in the entertainment industry. A process of introspection led me to discover my true passion lies in connecting with people.
(323) 673-2541 View (323) 673-2541
Photo of Valerie Labanca, LCSW, Clinical Social Work/Therapist
Valerie Labanca
Clinical Social Work/Therapist, LCSW
Verified Verified
Pasadena, CA 91101  (Online Only)
I have extensive training in a variety of evidence-based practices, such as Cognitive Behavior Therapy, Dialectical Behavior Therapy, Motivational Interviewing, Mindfulness CBT, Acceptance and Commitment Therapy, Solution-Focused, Psychodynamic therapy, attachment-based therapy, and relational therapy. I have had many years of experience working with people struggling with depression, anxiety, PTSD, domestic violence, mood disorders, ADHD, postpartum depression/anxiety, issues related to infertility, interpersonal relational challenges, panic disorders, immigration challenges, parenting challenges, insomnia, trans-related challenges
I have extensive training in a variety of evidence-based practices, such as Cognitive Behavior Therapy, Dialectical Behavior Therapy, Motivational Interviewing, Mindfulness CBT, Acceptance and Commitment Therapy, Solution-Focused, Psychodynamic therapy, attachment-based therapy, and relational therapy. I have had many years of experience working with people struggling with depression, anxiety, PTSD, domestic violence, mood disorders, ADHD, postpartum depression/anxiety, issues related to infertility, interpersonal relational challenges, panic disorders, immigration challenges, parenting challenges, insomnia, trans-related challenges
(510) 726-1002 View (510) 726-1002
Photo of Isabella (Bella) Shirinyan, MA, LMFT, Marriage & Family Therapist
Isabella (Bella) Shirinyan
Marriage & Family Therapist, MA, LMFT
Verified Verified
2 Endorsed
Pasadena, CA 91101
Navigating personal struggles often leaves us feeling alone, anxious, and disconnected. This experience can become even more intense when dealing with issues such as eating disorders, trauma, depression, anxiety, life transitions, bipolar disorder, and co-occurring conditions. I specialize in helping individuals navigate these challenges. Collaborating with psychiatrists, doctors, and dietitians, we form a holistic support team, going beyond traditional methods for comprehensive healing. We aim to equip you with tools for emotional, physical, and mental wellness, enabling lasting growth and resilience.
Navigating personal struggles often leaves us feeling alone, anxious, and disconnected. This experience can become even more intense when dealing with issues such as eating disorders, trauma, depression, anxiety, life transitions, bipolar disorder, and co-occurring conditions. I specialize in helping individuals navigate these challenges. Collaborating with psychiatrists, doctors, and dietitians, we form a holistic support team, going beyond traditional methods for comprehensive healing. We aim to equip you with tools for emotional, physical, and mental wellness, enabling lasting growth and resilience.
(818) 918-2237 View (818) 918-2237
Photo of Melissa Contractor, LMFT, Marriage & Family Therapist
Melissa Contractor
Marriage & Family Therapist, LMFT
Verified Verified
Pasadena, CA 91107
I have over 30 years of experience helping individuals, couples and families who are suffering due to mental health issues. I have been successful in helping clients with depression, anxiety, bipolar disorder, PTSD and psychotic disorders. I am comfortable treating a wide range of presenting problems. My clients will feel that they recieve real tools they can use to help manage their emotions and improve their functioning and their relationships. Book with me now by clicking on my website
I have over 30 years of experience helping individuals, couples and families who are suffering due to mental health issues. I have been successful in helping clients with depression, anxiety, bipolar disorder, PTSD and psychotic disorders. I am comfortable treating a wide range of presenting problems. My clients will feel that they recieve real tools they can use to help manage their emotions and improve their functioning and their relationships. Book with me now by clicking on my website
(626) 726-6842 View (626) 726-6842
Photo of Elena Frances Bell, MSW, LCSW, Clinical Social Work/Therapist
Elena Frances Bell
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Pasadena, CA 91104
Today's world demands so much of us. The pressures to be everything, do everything, for everyone can cause stress, anxiety, and depression. We are human. And even the best of humans need support from time to time to bounce back from the challenges of life and live powerfully. It is time that you had a consistent partnership that focuses on your healing, growth, and emotional resilience.
Today's world demands so much of us. The pressures to be everything, do everything, for everyone can cause stress, anxiety, and depression. We are human. And even the best of humans need support from time to time to bounce back from the challenges of life and live powerfully. It is time that you had a consistent partnership that focuses on your healing, growth, and emotional resilience.
(626) 790-7115 View (626) 790-7115
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Depression Therapists

What is the goal of therapy for depression?

Therapy for depression has several major goals. One is to relieve the mental pain of depression, which distorts feeling and thinking so that sufferers cannot see beyond their current state of mind or envision feeling better. Another is to give people the mental tools to recognize and correct the kinds of distorted thinking that turn a problem into a catastrophe and lead to despair. Therapy also teaches people how to process negative emotions in constructive ways, so they have more control over their own emotional reactivity. And it helps people regain the ability to see themselves positively, the motivation to do things, and the capacity for pleasure.

What happens in therapy for depression?

Perhaps most important, no matter the type of therapy, patients form an alliance with the therapist; that connection is therapeutic in itself, plus it becomes an instrument of change. Patients learn to identify and to challenge their own erroneous beliefs and thoughts that amplify the effects of negative experiences. They learn to identify situations in which they are especially vulnerable. And they learn new patterns of thinking and behaving. They may be given “homework” assignments in which they practice their developing skills. In addition, good therapists regularly monitor patients to assess whether and how much the condition is improving.

What therapy types help with depression?

Several types of short-term therapy have been found effective, each targeting one or more areas of dysfunction. Cognitive behavioral therapy (CBT) helps clients challenge their negative thoughts and beliefs, learn new behavioral strategies, and curb reactivity to distressing situations. Behavioral activation (BA) is a form of therapy often used in conjunction with CBT; it focuses on engagement in rewarding activity as a pathway to changing negative feelings and disturbed mood. Another widely used approach is interpersonal therapy (IPT), which targets the social difficulties that both give rise to and get exacerbated by depression. Therapists may combine approaches as needed.

Can therapy for depression be done online?

Studies have found that online therapy can be highly effective for treating depression, although it may be more challenging to build a good therapist-patient alliance on screen than in person—at least at first. However, online therapy can offer considerable advantages. Accessibility and convenience are tops among them. Some people actually find it easier to talk about problems online than in person. While online therapy typically limits visibility of facial expression and body gestures that give important nonverbal cues to a patient’s state of mind, it can give therapists a glimpse into a patient’s world and life, providing information that can be highly useful in guiding therapy.

How effective is therapy for depression?

Many studies show that therapy is highly effective provided that patients complete the prescribed course of therapy, commonly 16 to 20 sessions. Over the long term, it is more effective than medication and the effects are more enduring. As a result, psychotherapy has the power not just to relieve current suffering but to prevent future episodes of the disorder. Therapy reverses the dysfunction in neural circuitry that disposes individuals to a negative view of themselves, the world, and their future and they acquire coping techniques, problem-solving skills, and understanding of their own vulnerabilities that are useful over the course of a lifetime.