Self-Harming Therapists in East Berlin, CT

Photo of Julie K Jones - Well Life Therapy, LLC, PhD, LPC, Licensed Professional Counselor
Well Life Therapy, LLC
Licensed Professional Counselor, PhD, LPC
Verified Verified
4 Endorsed
East Berlin, CT 06023
Are you or a loved one feeling afraid, anxious and/or overwhelmed? Are you trying to get through a challenging time or perhaps you have felt this way for a long time and just don't know why? Are you in a difficult relationship or having a family crisis? The counselors at Well Life Therapy, LLC are here to listen, guide and empower you to move through what you are struggling with. We will help you create strategies for healthy coping, problem solve with you, assist with communication skills and uncover ineffective and negative thinking patterns and ideas.
Are you or a loved one feeling afraid, anxious and/or overwhelmed? Are you trying to get through a challenging time or perhaps you have felt this way for a long time and just don't know why? Are you in a difficult relationship or having a family crisis? The counselors at Well Life Therapy, LLC are here to listen, guide and empower you to move through what you are struggling with. We will help you create strategies for healthy coping, problem solve with you, assist with communication skills and uncover ineffective and negative thinking patterns and ideas.
(860) 615-4014 View (860) 615-4014
Photo of Cassie Manger - Meraki Counseling LLC, LCSW, Clinical Social Work/Therapist
Meraki Counseling LLC
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
East Berlin, CT 06023
Cassie Manger, LCSW, the compassionate owner of Meraki Counseling LLC has a specialization in children and families from the University of Saint Joseph, Cassie brings over a decade of unique and invaluable experience to her work. Her passion lies in assisting clients experiencing challenges related to anxiety, depression, trauma, and spiritual beliefs. Cassie's expertise extends from Autism Spectrum Disorder, to Mood Disorders, Substance Use Disorders, psychosis, paranoia & co-occurring conditions. She excels in guiding individuals through life transitions & challenges connected with cultural diversity, & immigration-related issues.
Cassie Manger, LCSW, the compassionate owner of Meraki Counseling LLC has a specialization in children and families from the University of Saint Joseph, Cassie brings over a decade of unique and invaluable experience to her work. Her passion lies in assisting clients experiencing challenges related to anxiety, depression, trauma, and spiritual beliefs. Cassie's expertise extends from Autism Spectrum Disorder, to Mood Disorders, Substance Use Disorders, psychosis, paranoia & co-occurring conditions. She excels in guiding individuals through life transitions & challenges connected with cultural diversity, & immigration-related issues.
(203) 433-6815 View (203) 433-6815
Photo of Sarah Steingiser, LCSW, Clinical Social Work/Therapist
Sarah Steingiser
Clinical Social Work/Therapist, LCSW
Verified Verified
East Berlin, CT 06023  (Online Only)
My counseling style is warm and interactive. I believe in treating everyone with respect, sensitivity, and compassion, and I do not believe in stigmatizing labels. My approach combines client centered, cognitive-behavioral, humanistic, psychodynamic and solution focused counseling,
My counseling style is warm and interactive. I believe in treating everyone with respect, sensitivity, and compassion, and I do not believe in stigmatizing labels. My approach combines client centered, cognitive-behavioral, humanistic, psychodynamic and solution focused counseling,
(860) 813-3803 View (860) 813-3803
Photo of Kayla Reid, LCSW, Clinical Social Work/Therapist
Kayla Reid
Clinical Social Work/Therapist, LCSW
Verified Verified
East Berlin, CT 06023  (Online Only)
Hi! I am a Licensed Clinical Social Worker. I have have been in the social worker field for the past 8 years I completed her Bachelors degree in Social Work at Central Connecticut State University followed by a Masters in Social Work at Fordham University’s Graduate School of Social Work in 2016. I am a New Haven, CT native and Hopkins School alumna. My background is in therapy with adolescents, families and young adults. I currently work full time as a clinician within Yale University’s Mental Health and Counseling Center.
Hi! I am a Licensed Clinical Social Worker. I have have been in the social worker field for the past 8 years I completed her Bachelors degree in Social Work at Central Connecticut State University followed by a Masters in Social Work at Fordham University’s Graduate School of Social Work in 2016. I am a New Haven, CT native and Hopkins School alumna. My background is in therapy with adolescents, families and young adults. I currently work full time as a clinician within Yale University’s Mental Health and Counseling Center.
(203) 318-9133 View (203) 318-9133

More Therapists Nearby

Photo of Marissa Maple, LCSW, Clinical Social Work/Therapist
Marissa Maple
Clinical Social Work/Therapist, LCSW
Verified Verified
Southington, CT 06489  (Online Only)
Additionally, I am trained in utilizing Dialectical Behavioral Therapy (DBT) as an intervention for individuals suffering with self-harming behaviors and suicidal ideations.
I am a gender-affirming Licensed Clinical Social Worker with a passion for working with the LGBTQ+ community. I have experience working with individuals in both clinical, school, and in-home settings, as well as providing comprehensive evaluations, conducting treatment planning, and completing crisis interventions.
Additionally, I am trained in utilizing Dialectical Behavioral Therapy (DBT) as an intervention for individuals suffering with self-harming behaviors and suicidal ideations.
I am a gender-affirming Licensed Clinical Social Worker with a passion for working with the LGBTQ+ community. I have experience working with individuals in both clinical, school, and in-home settings, as well as providing comprehensive evaluations, conducting treatment planning, and completing crisis interventions.
(860) 957-8246 View (860) 957-8246
Photo of Ashley DaCosta, MSW, LCSW, Clinical Social Work/Therapist
Ashley DaCosta
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
2 Endorsed
Plantsville, CT 06479
I have treated a variety of clients who suffer from traumatic experiences including sexual and physical abuse, domestic violence, and neglect as well as depression, anxiety, and self-harming behaviors.
NOT CURRENTLY TAKING CLIENTS. The first step towards getting somewhere is to decide that you are not going to stay where you are. Allow yourself to take that first step towards improvement and wellness. I have been practicing clinical social work for 7+ years and primarily work with children adolescents, and young adults aged 6-25. I believe that building trust is an essential step to creating a strong therapeutic relationship. It is essential in my practice to personally engage each client to tailor treatment to address specific client needs. I am compassionate and patient, yet direct and offer support in any way that I can.
I have treated a variety of clients who suffer from traumatic experiences including sexual and physical abuse, domestic violence, and neglect as well as depression, anxiety, and self-harming behaviors.
NOT CURRENTLY TAKING CLIENTS. The first step towards getting somewhere is to decide that you are not going to stay where you are. Allow yourself to take that first step towards improvement and wellness. I have been practicing clinical social work for 7+ years and primarily work with children adolescents, and young adults aged 6-25. I believe that building trust is an essential step to creating a strong therapeutic relationship. It is essential in my practice to personally engage each client to tailor treatment to address specific client needs. I am compassionate and patient, yet direct and offer support in any way that I can.
(959) 666-6435 View (959) 666-6435
Photo of Kristen Helin - Synergy Psychology Group, LLC, PsyD, Psychologist
Synergy Psychology Group, LLC
Psychologist, PsyD
Verified Verified
Glastonbury, CT 06033
SOME OF OUR SPECIALITIES INCLUDE: Mood Disorders (depression/anxiety,) Adolescent Problems, Women's Issues (pregnancy-related difficulties, PPD, Body image,) Personal Growth (introspective, spiritual, and emotional exploration,) Trauma and Loss, Interpersonal Issues, Self-Injurious Behaviors (cutting, disordered eating,) Transitional Concerns.
Synergy Psychology Group is a small private practice located in Glastonbury, Connecticut offering individualized and creative approaches to understanding problems and their solutions. Synergy provides diverse services to meet the needs of clients including psychotherapy for individuals and couples. Synergy additionally conducts psychological evaluations, consultations, and workshops. Our Team: Clinical Psychologist and owner Kristen Helin, Psy.D. and associate Courtney Chan, Licensed Clinical Social Worker
SOME OF OUR SPECIALITIES INCLUDE: Mood Disorders (depression/anxiety,) Adolescent Problems, Women's Issues (pregnancy-related difficulties, PPD, Body image,) Personal Growth (introspective, spiritual, and emotional exploration,) Trauma and Loss, Interpersonal Issues, Self-Injurious Behaviors (cutting, disordered eating,) Transitional Concerns.
Synergy Psychology Group is a small private practice located in Glastonbury, Connecticut offering individualized and creative approaches to understanding problems and their solutions. Synergy provides diverse services to meet the needs of clients including psychotherapy for individuals and couples. Synergy additionally conducts psychological evaluations, consultations, and workshops. Our Team: Clinical Psychologist and owner Kristen Helin, Psy.D. and associate Courtney Chan, Licensed Clinical Social Worker
(860) 384-6691 View (860) 384-6691
Photo of JoAnna Rudewicz, LCSW, Clinical Social Work/Therapist
JoAnna Rudewicz
Clinical Social Work/Therapist, LCSW
Verified Verified
Southington, CT 06489
Waitlist for new clients
Many children, adolescents and young adults are struggling with the pressure and stress of everyday life. Imagine having someone to help them cope with their difficulties, decrease negative feelings or self harming behaviors and increase feelings of self worth, hope and happiness. My goal is to give clients a safe and trusted space where they are comfortable to express their feelings in a calm and nurturing environment and are ready to challenge their thoughts, problem solve or just decompress. When you are ready, I am here and happy to work with you as part of your team!
Many children, adolescents and young adults are struggling with the pressure and stress of everyday life. Imagine having someone to help them cope with their difficulties, decrease negative feelings or self harming behaviors and increase feelings of self worth, hope and happiness. My goal is to give clients a safe and trusted space where they are comfortable to express their feelings in a calm and nurturing environment and are ready to challenge their thoughts, problem solve or just decompress. When you are ready, I am here and happy to work with you as part of your team!
(203) 463-5331 View (203) 463-5331
Photo of Dr. Yacihuilca Moní, Psychologist
Dr. Yacihuilca Moní
Psychologist
Verified Verified
Newington, CT 06111  (Online Only)
My name is Yacihuilca Moní, a licensed clinical psychologist in MA and CT, dedicated to supporting individuals across their lifespan. With a passion for providing compassionate care, I have worked extensively with diverse populations, including children, adolescents, adults, and seniors. My therapeutic toolkit includes Cognitive-Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and Acceptance and Commitment Therapy (ACT), tailored to meet each client's unique needs. Additionally, I am trained in Eye Movement Desensitization and Reprocessing (EMDR).
My name is Yacihuilca Moní, a licensed clinical psychologist in MA and CT, dedicated to supporting individuals across their lifespan. With a passion for providing compassionate care, I have worked extensively with diverse populations, including children, adolescents, adults, and seniors. My therapeutic toolkit includes Cognitive-Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and Acceptance and Commitment Therapy (ACT), tailored to meet each client's unique needs. Additionally, I am trained in Eye Movement Desensitization and Reprocessing (EMDR).
(860) 431-2738 View (860) 431-2738
Photo of Soribel Martinez - SMPsychotherapay & Counseling Services , LCSW, Clinical Social Work/Therapist
SMPsychotherapay & Counseling Services
Clinical Social Work/Therapist, LCSW
Verified Verified
Farmington, CT 06030
Are you exhausted from carrying around the weight of anxiety? Does the struggle to get through your day with depression make you want to stay in bed? Are you overwhelmed by society's pressure to stay positive and try harder? Mental health issues can make even the most minor tasks seem impossible. You can’t get away from the swirling negative thoughts in your mind long enough to accomplish your goals. You want to engage with life and be present with your loved ones, but it all seems like too much effort. You need someone to guide you out of the dark and help you find your path to wellness.
Are you exhausted from carrying around the weight of anxiety? Does the struggle to get through your day with depression make you want to stay in bed? Are you overwhelmed by society's pressure to stay positive and try harder? Mental health issues can make even the most minor tasks seem impossible. You can’t get away from the swirling negative thoughts in your mind long enough to accomplish your goals. You want to engage with life and be present with your loved ones, but it all seems like too much effort. You need someone to guide you out of the dark and help you find your path to wellness.
(203) 587-8083 View (203) 587-8083
Photo of Stephanie Watkins, LPC, Licensed Professional Counselor
Stephanie Watkins
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Newington, CT 06111
Our mind is a battlefield. Individuals often fight thoughts and feelings of guilt, shame, worthlessness, and regret throughout their lifetime and often engage in maladaptive behaviors to medicate the pain they are dealing with. Many times mental health problems stem from spiritual issues and deep rooted, distorted core beliefs. When life gets rough, these core beliefs often rise to the surface and cause us to go in a downward spiral of depression and negative harmful behaviors. Therapy is a powerful ally to help conquer the negative and often debilitating thoughts that try to take over every aspect of our lives.
Our mind is a battlefield. Individuals often fight thoughts and feelings of guilt, shame, worthlessness, and regret throughout their lifetime and often engage in maladaptive behaviors to medicate the pain they are dealing with. Many times mental health problems stem from spiritual issues and deep rooted, distorted core beliefs. When life gets rough, these core beliefs often rise to the surface and cause us to go in a downward spiral of depression and negative harmful behaviors. Therapy is a powerful ally to help conquer the negative and often debilitating thoughts that try to take over every aspect of our lives.
(860) 485-7733 View (860) 485-7733
Photo of Danielle Stone - The Life Workshop, MSW, LICSW, PMH-C, Clinical Social Work/Therapist
The Life Workshop
Clinical Social Work/Therapist, MSW, LICSW, PMH-C
Verified Verified
1 Endorsed
Middletown, CT 06457  (Online Only)
Do you find yourself navigating the complexities of reproduction or parenthood? Perhaps you're a new parent wondering if what you're feeling is normal or grappling with feeling guilt and shame for not experiencing the joy you expected. You may be struggling with perinatal complications, feeling isolated and overwhelmed by the emotional rollercoaster. Your needs are multifaceted – deserving understanding, validation, and compassionate support from someone who truly "gets it." We want you to emerge from this experience feeling the best version of yourself and fully equipped to embrace the joys and challenges of this journey.
Do you find yourself navigating the complexities of reproduction or parenthood? Perhaps you're a new parent wondering if what you're feeling is normal or grappling with feeling guilt and shame for not experiencing the joy you expected. You may be struggling with perinatal complications, feeling isolated and overwhelmed by the emotional rollercoaster. Your needs are multifaceted – deserving understanding, validation, and compassionate support from someone who truly "gets it." We want you to emerge from this experience feeling the best version of yourself and fully equipped to embrace the joys and challenges of this journey.
(413) 259-0361 View (413) 259-0361
Photo of Rebeca Carrasquillo, LCSW, Clinical Social Work/Therapist
Rebeca Carrasquillo
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Hartford, CT 06114  (Online Only)
Unable to take new clients at this time. They say life isn't about waiting for the storm to pass, it's about learning how to dance in the rain", but sometimes we just don' t know how to get out of the storm, or have the right moves to dance, or maybe the moves you have just don't cut it. Let me be the one to help you address the changes you want to make in yourself, your relationships, your coping abilities, and overall wellbeing.
Unable to take new clients at this time. They say life isn't about waiting for the storm to pass, it's about learning how to dance in the rain", but sometimes we just don' t know how to get out of the storm, or have the right moves to dance, or maybe the moves you have just don't cut it. Let me be the one to help you address the changes you want to make in yourself, your relationships, your coping abilities, and overall wellbeing.
(413) 485-7216 View (413) 485-7216
Photo of Danielle Urciullo, LCSW, Clinical Social Work/Therapist
Danielle Urciullo
Clinical Social Work/Therapist, LCSW
Verified Verified
3 Endorsed
Berlin, CT 06037
Embrace your lived experiences is definitely my motto! I am also a strong advocate that there is enormous strength that emerges from having empowering relationships in your life. We can work to analyze, navigate, and find these relationships. This will allow you to live a life with increased connection and vibrance. I approach sessions from holistic, psychodynamic, and harm-reduction perspectives. I aim to be anti-racist, feminist, trans-accepting, sober questioning, and understanding of those who are voice hearers. In sum, all are welcome here!
Embrace your lived experiences is definitely my motto! I am also a strong advocate that there is enormous strength that emerges from having empowering relationships in your life. We can work to analyze, navigate, and find these relationships. This will allow you to live a life with increased connection and vibrance. I approach sessions from holistic, psychodynamic, and harm-reduction perspectives. I aim to be anti-racist, feminist, trans-accepting, sober questioning, and understanding of those who are voice hearers. In sum, all are welcome here!
(857) 997-9180 View (857) 997-9180
Photo of Ethan Horowitz, LMFT, Marriage & Family Therapist
Ethan Horowitz
Marriage & Family Therapist, LMFT
Verified Verified
Farmington, CT 06032  (Online Only)
I am a licensed marriage and family therapist with experience working in outpatient, hospital, and school settings. I believe that the client/therapist relationship is especially important in creating positive change, and I have worked to empower clients experiencing a wide variety of challenges to move toward their goals. I strive to provide a supportive and nonjudgmental environment for clients to feel heard and understood, and tailor treatment to meet each individual's needs.
I am a licensed marriage and family therapist with experience working in outpatient, hospital, and school settings. I believe that the client/therapist relationship is especially important in creating positive change, and I have worked to empower clients experiencing a wide variety of challenges to move toward their goals. I strive to provide a supportive and nonjudgmental environment for clients to feel heard and understood, and tailor treatment to meet each individual's needs.
(860) 419-0705 View (860) 419-0705
Photo of Stephanie Morelli, LCSW, Clinical Social Work/Therapist
Stephanie Morelli
Clinical Social Work/Therapist, LCSW
Verified Verified
3 Endorsed
Southington, CT 06489
If you’re a parent seeking counseling for your child or teen or if you’re a young adult wanting an empathic therapist to help you navigate your healing journey, you’ve come to the right place. Stephanie specializes in working with children ages 7+ through young adulthood (college aged). Stephanie treats those with depression, anxiety, poor self-esteem, trauma, attention deficits, autism, peer issues, school problems and barriers to self-expression utilizing expressive therapies and a play-based approach.
If you’re a parent seeking counseling for your child or teen or if you’re a young adult wanting an empathic therapist to help you navigate your healing journey, you’ve come to the right place. Stephanie specializes in working with children ages 7+ through young adulthood (college aged). Stephanie treats those with depression, anxiety, poor self-esteem, trauma, attention deficits, autism, peer issues, school problems and barriers to self-expression utilizing expressive therapies and a play-based approach.
(860) 579-6043 View (860) 579-6043
Photo of Laura Jakabauski, LPC, Licensed Professional Counselor
Laura Jakabauski
Licensed Professional Counselor, LPC
Verified Verified
Southington, CT 06489  (Online Only)
I have been a Licensed Professional Counselor for over fifteen years. In that time, I have worked with a wide variety of behavioral health issues including depression, anxiety, grief, PTSD, sexual abuse, domestic violence, marital problems and trauma.
I have been a Licensed Professional Counselor for over fifteen years. In that time, I have worked with a wide variety of behavioral health issues including depression, anxiety, grief, PTSD, sexual abuse, domestic violence, marital problems and trauma.
(860) 530-6045 View (860) 530-6045
Photo of Suzanne M Howard, Pastoral Counselor
Suzanne M Howard
Pastoral Counselor
Verified Verified
1 Endorsed
Hartford, CT 06114
Hello and welcome! I’m Suzanne M Howard a board-certified mental health life coach committed to guiding individuals towards achieving mental wellness and enriched personal fulfillment. With 18 years of Pastoral counseling experience, I specialize in combining therapeutic practices with actionable life coaching strategies to help clients overcome challenges. For those ready to embark on a transformative journey, I offer a supportive, confidential environment where you can feel safe to explore your thoughts and feelings. Whether you are seeking to manage specific mental health issues or aiming for personal growth, I am here to assist!
Hello and welcome! I’m Suzanne M Howard a board-certified mental health life coach committed to guiding individuals towards achieving mental wellness and enriched personal fulfillment. With 18 years of Pastoral counseling experience, I specialize in combining therapeutic practices with actionable life coaching strategies to help clients overcome challenges. For those ready to embark on a transformative journey, I offer a supportive, confidential environment where you can feel safe to explore your thoughts and feelings. Whether you are seeking to manage specific mental health issues or aiming for personal growth, I am here to assist!
(959) 265-0685 View (959) 265-0685
Photo of Angela Burgess-Powell, MA, LMFT, Marriage & Family Therapist
Angela Burgess-Powell
Marriage & Family Therapist, MA, LMFT
Verified Verified
1 Endorsed
Plainville, CT 06062
Are you feeling overwhelmed? Are you sad, angry, feeling anxious at the current crisis? We all get affected by the stresses of life but you don't have to face this alone. Life is full of challenges that leave us feeling lonely and stuck without knowing where to turn. I work with clients in a safe, validating, empathetic and non judgmental virtual space to support you in expressing your deepest feelings. Together we will work to create goals to help you feel a greater sense of hope, well being, and happiness. I am Trained in Eye Movement Desensitization and Reprocessing Therapy effective for processing traumatic and adverse memories.
Are you feeling overwhelmed? Are you sad, angry, feeling anxious at the current crisis? We all get affected by the stresses of life but you don't have to face this alone. Life is full of challenges that leave us feeling lonely and stuck without knowing where to turn. I work with clients in a safe, validating, empathetic and non judgmental virtual space to support you in expressing your deepest feelings. Together we will work to create goals to help you feel a greater sense of hope, well being, and happiness. I am Trained in Eye Movement Desensitization and Reprocessing Therapy effective for processing traumatic and adverse memories.
(860) 470-6366 View (860) 470-6366
Photo of Rohan St Lawrence Brown - Rohan Brown, MA, MDiv, LPC, MA, MDiv, LPC, Licensed Professional Counselor
Rohan Brown, MA, MDiv, LPC
Licensed Professional Counselor, MA, MDiv, LPC
Verified Verified
Wethersfield, CT 06109
I provide individual, couples and group psychotherapy to all ages in a nonjudgmental confidential environment using an eclectic therapeutic approach - treating a wide range of issues including mood disorders, addiction, marriage, trauma, grief, parenting/adolescent, spiritual and existential dilemmas. Through a compassionate collaborative process together we explore how thoughts and feelings provide opportunities to increase self-awareness, mindfulness, reduce anxieties, stabilize mood while increasing ability to effectively function. I work in close collaboration with APRN prescriber. Expect to be treated with respect and be challenged to live your best life. Welcome, thank you for investing in yourself you deserve it!
I provide individual, couples and group psychotherapy to all ages in a nonjudgmental confidential environment using an eclectic therapeutic approach - treating a wide range of issues including mood disorders, addiction, marriage, trauma, grief, parenting/adolescent, spiritual and existential dilemmas. Through a compassionate collaborative process together we explore how thoughts and feelings provide opportunities to increase self-awareness, mindfulness, reduce anxieties, stabilize mood while increasing ability to effectively function. I work in close collaboration with APRN prescriber. Expect to be treated with respect and be challenged to live your best life. Welcome, thank you for investing in yourself you deserve it!
(860) 357-6852 View (860) 357-6852

See more therapy options for East Berlin

Self-Harming Therapists

How does therapy for self-harm work?

A person may turn to self-injury so that they can distract themselves from their stress, depression, anxiety, or upsetting circumstances. Therapy can address the cause of an individual’s suffering. A therapist can help a person understand why they may want to self-harm and help the person learn new methods of coping. A person may have poor emotion regulation, and treatment such as cognitive behavioral therapy (CBT) is helpful for breaking this behaviour. In addition, treatment such as dialectical behavior therapy can help a person manage their tolerance of distress.

Which therapies are best for self-harm?

Specific approaches used by professionals include cognitive behavioral, dialectical behavior, psychodynamic, and mentalisation-based therapies, among others. Cognitive behavioral and dialectical behavior therapies are common approaches for people who have painful thoughts and past traumas. These therapies help an individual cope with distress, regulate emotions, and manage impulsive urges.

Does the tendency to self-harm mean the person is suicidal?

Having this urge does not mean the individual suffers from suicidal ideation. People who want to self-injure look to distract or alleviate themselves from the pain they are experiencing. People with suicidal tendencies want to end life altogether. However, this does not mean a person with the intent to self-harm will not attempt suicide.

How often and how long are therapy sessions for self-harm?

As with any type of therapy, sessions depend on the individual. Clients may see improvement within 20 sessions, at an average of 50 minutes per session, while others may opt for 20 to 30 sessions over, maybe, a six-month period. People, especially those with co-occurring conditions like depression and anxiety, may need to continue therapy for up to 12 to 18 months.