Therapists in Panama City, FL
![Photo of Megan Dasbach, LMHC, NCC, MT-BC](https://photos.psychologytoday.com/b1c0509f-97e3-4373-8f5e-449c1a264d6c/1/320x400.png)
Megan Dasbach
Licensed Mental Health Counselor, LMHC, NCC, MT-BC
Verified Verified
1 Endorsed
Panama City, FL 32405
Waitlist for new clients
I specialize with neurodivergence, including Autism Spectrum and Attention Deficit Disorders.
My dear friends! Thank you for taking the time to see my profile. I believe very strongly in the egalitarian relationship - you are the expert in your experiences, and I am here to reflect, process, and help you on your personal journey through whatever you are hoping for support on. Whether you are looking for a therapist for yourself or your little one, I think therapy should be enjoyable, supportive, and our relationship is central to your comfort here.
I specialize with neurodivergence, including Autism Spectrum and Attention Deficit Disorders.
My dear friends! Thank you for taking the time to see my profile. I believe very strongly in the egalitarian relationship - you are the expert in your experiences, and I am here to reflect, process, and help you on your personal journey through whatever you are hoping for support on. Whether you are looking for a therapist for yourself or your little one, I think therapy should be enjoyable, supportive, and our relationship is central to your comfort here.
![Photo of Christy Carpenter, LMHC, Counselor](https://photos.psychologytoday.com/5df30a5f-bb02-4683-b2c6-b55331b465ad/2/320x400.jpeg)
I also offer educational consulting for students who struggle at school with learning disabilities, bullying, autism, and other educational barriers.
Feel like life's challenges are just too much sometimes? Or does your child struggle with ADHD, behavioral, or self-esteem issues? If you battle depression, anxiety, marital or family issues, behavioral concerns, grief, or other hurdles, I can support you through your journey. Besides my formal training, I've lived through many major life transitions, myself: military family life, the death of a child, marital issues, & job loss and change. I understand the complicated feelings involved. I've navigated these situations and I can help you find your way, too.
I also offer educational consulting for students who struggle at school with learning disabilities, bullying, autism, and other educational barriers.
Feel like life's challenges are just too much sometimes? Or does your child struggle with ADHD, behavioral, or self-esteem issues? If you battle depression, anxiety, marital or family issues, behavioral concerns, grief, or other hurdles, I can support you through your journey. Besides my formal training, I've lived through many major life transitions, myself: military family life, the death of a child, marital issues, & job loss and change. I understand the complicated feelings involved. I've navigated these situations and I can help you find your way, too.
![Photo of Dr. Shellyann M. H. Thomas, PhD, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/f946430b-9e94-4638-802d-c4071141bebd/3/320x400.jpeg)
Dr. Shellyann M. H. Thomas
Marriage & Family Therapist, PhD, LMFT
Verified Verified
Panama City, FL 32404 (Online Only)
I specialize in Behavior including but not limited to, Autism, ADHD, ODD, & Anxiety.
Are you having difficulty connecting and parenting your child? If your kiddo is managing ADHD, Autism, and Oppositional defiance symptoms (ODD), look no further, Reach out to Dr. Shelly for support:-) I am a Family Therapist & Behavior Analyst. I am aware of the issue at hand where parents who need help are unable to get that at this time. If you're waiting for ABA, but want a Dr to see what you're dealing with, email or text me at 754-400-1689. I will provide an Assessment as you wait for services with a treatment plan along with interventions. I will do this for a flat rate of $395. I will request videos as well for my Analysis.
I specialize in Behavior including but not limited to, Autism, ADHD, ODD, & Anxiety.
Are you having difficulty connecting and parenting your child? If your kiddo is managing ADHD, Autism, and Oppositional defiance symptoms (ODD), look no further, Reach out to Dr. Shelly for support:-) I am a Family Therapist & Behavior Analyst. I am aware of the issue at hand where parents who need help are unable to get that at this time. If you're waiting for ABA, but want a Dr to see what you're dealing with, email or text me at 754-400-1689. I will provide an Assessment as you wait for services with a treatment plan along with interventions. I will do this for a flat rate of $395. I will request videos as well for my Analysis.
![Photo of Miles Haas, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/2ad6a623-2fd1-4881-9f7d-37a477a57e7b/2/320x400.jpeg)
Miles Haas
Clinical Social Work/Therapist, LCSW
Verified Verified
Panama City, FL 32405
Waitlist for new clients
Comprehensive behavioral evaluation services for autism, attention deficit hyperactivity disorder, and other childhood challenges are available for children. School accommodation support. Miles Haas is a social worker and counselor with 10+ years of experience helping people from all walks of life. He specializes in relationship issues, treating depression, anxiety, trauma, substance abuse, autism, attention-deficit hyperactivity disorder, and other mental health issues. Our family-owned business offer clients a haven where they can have a unique relationship with their clinician and themselves!
Comprehensive behavioral evaluation services for autism, attention deficit hyperactivity disorder, and other childhood challenges are available for children. School accommodation support. Miles Haas is a social worker and counselor with 10+ years of experience helping people from all walks of life. He specializes in relationship issues, treating depression, anxiety, trauma, substance abuse, autism, attention-deficit hyperactivity disorder, and other mental health issues. Our family-owned business offer clients a haven where they can have a unique relationship with their clinician and themselves!
![Photo of Sarah Stubins, LMHC, MS, Counselor](https://photos.psychologytoday.com/559f184f-6f2d-4e4c-852f-c5af56df5aee/3/320x400.jpeg)
My primary work is with children, adolescents, and their families, but I also work with adults individually. Primary areas of specialty include social skills training (I develop curriculum for social groups), and mood regulation within the youth population. I am a staunch advocate of focusing on communication; both verbal and nonverbal, as I help my clients improve their “emotional vocabulary”. My ideal client is someone is ready to make a positive change in his or her life, working through self-improvement. These clients wish to develop skills they are having difficulty with and/or are not able to develop on their own.
My primary work is with children, adolescents, and their families, but I also work with adults individually. Primary areas of specialty include social skills training (I develop curriculum for social groups), and mood regulation within the youth population. I am a staunch advocate of focusing on communication; both verbal and nonverbal, as I help my clients improve their “emotional vocabulary”. My ideal client is someone is ready to make a positive change in his or her life, working through self-improvement. These clients wish to develop skills they are having difficulty with and/or are not able to develop on their own.
![Photo of Maura Lee Pratt, MS, LMHC, LPC, NCC, Counselor](https://photos.psychologytoday.com/54cdf97b-4246-46ad-9b4e-240462ad26a8/2/320x400.jpeg)
Have you thought about what it would be like to stop “getting by” every day & start living a more valued & meaningful life? Are you having issues in managing life? No matter what you are going through, I am here to help. I believe therapy is a process, formed by the bond between therapist & client, working side-by-side. I meet you where you are, go at your pace, & assist you in achieving your goals. With my life experiences, education & training, I have lots of skills/tools at my disposal to find the right ones for you to begin living a healthier & happier life. I look forward to exploring this journey with you.
Have you thought about what it would be like to stop “getting by” every day & start living a more valued & meaningful life? Are you having issues in managing life? No matter what you are going through, I am here to help. I believe therapy is a process, formed by the bond between therapist & client, working side-by-side. I meet you where you are, go at your pace, & assist you in achieving your goals. With my life experiences, education & training, I have lots of skills/tools at my disposal to find the right ones for you to begin living a healthier & happier life. I look forward to exploring this journey with you.
![Photo of Dr. Andrea McCrary, PhD, LMHC, MS, MEd, Counselor](https://photos.psychologytoday.com/4595f848-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
I am a licensed psychotherapist and have extensive experience in working with depression, anxiety, relational issues, trauma, schizophrenia, Bipolar I and II, ADHD, gender issues, sexual issues, parental conflicts, blended family issues, compulsive disorders, grief, eating disorders, incest survivors, infidelity, inheritance disputes, chronic illness, divorce, sexual orientation issues, gender issues, borderline personality disorder, anger management, substance abuse, self-esteem, agoraphobia, sleep discomfort, and suicidal ideation.
I am a licensed psychotherapist and have extensive experience in working with depression, anxiety, relational issues, trauma, schizophrenia, Bipolar I and II, ADHD, gender issues, sexual issues, parental conflicts, blended family issues, compulsive disorders, grief, eating disorders, incest survivors, infidelity, inheritance disputes, chronic illness, divorce, sexual orientation issues, gender issues, borderline personality disorder, anger management, substance abuse, self-esteem, agoraphobia, sleep discomfort, and suicidal ideation.
![Photo of La'Shawn C Peterson, Pastoral Counselor](https://photos.psychologytoday.com/77c54bb0-01aa-4767-b743-10c31b5b2488/3/320x400.jpeg)
Life happens. We cannot always control the things that take place in our lives. The issues seem to control us in ways that can sometimes cause us to drift away from who we use to be. I want to help you get that life back by coming alongside you and helping you to be the person you loved before the issue or issues of life took place and took you down a road you never intended to end up on.
Life happens. We cannot always control the things that take place in our lives. The issues seem to control us in ways that can sometimes cause us to drift away from who we use to be. I want to help you get that life back by coming alongside you and helping you to be the person you loved before the issue or issues of life took place and took you down a road you never intended to end up on.
![Photo of Melissa Sosa-Miracolo, MS, LMHC, BCaBA, Counselor](https://photos.psychologytoday.com/40d604fb-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Melissa Sosa-Miracolo
Counselor, MS, LMHC, BCaBA
Verified Verified
Panama City, FL 32404 (Online Only)
Melissa has learned the importance of making people feel safe, heard, and understood. With Melissa, you can expect to feel at ease with her approachable, relatable, and down-to-earth attitude. She has an innate understanding of the pain life can cause and how chronic pain can sometimes cause you to suffer enough to struggle to function. There is no judgment when you walk through her door. Melissa is honest and direct, and you can expect to receive authentic feedback. Her goal is always to help you uncover truths about yourself so that you can be the realest version of who you are.
Melissa has learned the importance of making people feel safe, heard, and understood. With Melissa, you can expect to feel at ease with her approachable, relatable, and down-to-earth attitude. She has an innate understanding of the pain life can cause and how chronic pain can sometimes cause you to suffer enough to struggle to function. There is no judgment when you walk through her door. Melissa is honest and direct, and you can expect to receive authentic feedback. Her goal is always to help you uncover truths about yourself so that you can be the realest version of who you are.
![Photo of Denisha Smith, MS, LMHC, Counselor](https://photos.psychologytoday.com/0fe39b5f-f343-4522-82b6-2e4373b0db67/2/320x400.jpeg)
There is no ideal client, just an ideal concept, the belief in self. We work to build that through conversations about your past present and future, and conquering trauma as a means of living in the now.
There is no ideal client, just an ideal concept, the belief in self. We work to build that through conversations about your past present and future, and conquering trauma as a means of living in the now.
![Photo of Danielle Shelton - Better Living Solutions, MM, MT-BC, CEDCAT](https://photos.psychologytoday.com/4d13df25-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Are you, or someone you know, struggling with an eating disorder, negative body image, poor self esteem, lack of confidence, and/or unhealthy relationships/struggles with food and exercise? Better Living Solutions provides collaborative care by licensed mental health professionals, registered dietitians, and certified eating disorder specialists. We can provide you with a full assessment, create a treatment team based on your individual needs, and provide activity guidelines/recommendations and meal support. We also have several group therapy options and will educate you and your support team on tools that are recovery focused.
Are you, or someone you know, struggling with an eating disorder, negative body image, poor self esteem, lack of confidence, and/or unhealthy relationships/struggles with food and exercise? Better Living Solutions provides collaborative care by licensed mental health professionals, registered dietitians, and certified eating disorder specialists. We can provide you with a full assessment, create a treatment team based on your individual needs, and provide activity guidelines/recommendations and meal support. We also have several group therapy options and will educate you and your support team on tools that are recovery focused.
15 Second Videos
Megan Dasbach
Maura Lee Pratt
Andrea McCrary
Denisha Smith
![Photo of Sunshine Wilder, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/80b8e0b4-16a4-43ef-a17b-d116c2e2455d/1/320x400.jpeg)
Hello, my name is Sunshine Wilder and I am a Licensed Clinical Social Worker in Florida. In 2004, I graduated with a master’s degree in social work and have been working for the past 19 years with children, teens, and adults in various settings such as child welfare, specialized therapeutic foster care, and outpatient therapy. I have experience working with individuals with a wide range of needs such as stress and anxiety, trauma and abuse, anger management, depression, ADHD, post-traumatic stress disorder (PTSD), attachment issues, and bipolar disorder.
Hello, my name is Sunshine Wilder and I am a Licensed Clinical Social Worker in Florida. In 2004, I graduated with a master’s degree in social work and have been working for the past 19 years with children, teens, and adults in various settings such as child welfare, specialized therapeutic foster care, and outpatient therapy. I have experience working with individuals with a wide range of needs such as stress and anxiety, trauma and abuse, anger management, depression, ADHD, post-traumatic stress disorder (PTSD), attachment issues, and bipolar disorder.
![Photo of Katie Ann-Giordano Ray, FNP-BC](https://photos.psychologytoday.com/2a90b91a-f6ac-4a3d-b0c6-a3a6b4f40a50/2/320x400.jpeg)
Hi! My name is Katie. I am a board certified family nurse practitioner. I have a background working in the hospital with patients who have suffered traumatic brain injuries as well as other neurological events such as seizures and strokes. I also have a strong background working with the pediatric population after years of bedside experience at a children's hospital. My passion is to help individuals while utilizing a holistic approach alongside modern medicine and coming up with a treatment plan that suits individuals while working as a team.
Hi! My name is Katie. I am a board certified family nurse practitioner. I have a background working in the hospital with patients who have suffered traumatic brain injuries as well as other neurological events such as seizures and strokes. I also have a strong background working with the pediatric population after years of bedside experience at a children's hospital. My passion is to help individuals while utilizing a holistic approach alongside modern medicine and coming up with a treatment plan that suits individuals while working as a team.
![Photo of David Longton, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/d5459abc-96df-418c-919d-9698c04c2783/3/320x400.jpeg)
David Longton
Marriage & Family Therapist, LMFT
Verified Verified
Panama City, FL 32401 (Online Only)
Are you struggling with anxiety, depression stress, trauma, ADHD or other life transitions? Do you find it difficult to communicate with your partner, family members, or peers? Are you experiencing difficulty with your children at home or school? My goal is to provide my clients a safe, nurturing environment that allows them to explore and seek the help that they need or want and achieve their full potential while maintaining positive, healthy relationships. I enjoy working with children, teens, adults, couples, and families.
Are you struggling with anxiety, depression stress, trauma, ADHD or other life transitions? Do you find it difficult to communicate with your partner, family members, or peers? Are you experiencing difficulty with your children at home or school? My goal is to provide my clients a safe, nurturing environment that allows them to explore and seek the help that they need or want and achieve their full potential while maintaining positive, healthy relationships. I enjoy working with children, teens, adults, couples, and families.
![Photo of Dulal Alghuraibi, MS, LMHC, RMFTI, PhD, Counselor](https://photos.psychologytoday.com/a1ccfe53-ceff-415e-ad9c-4521da891152/2/320x400.jpeg)
Dulal Alghuraibi
Counselor, MS, LMHC, RMFTI, PhD
Verified Verified
1 Endorsed
Panama City, FL 32404 (Online Only)
“Addressing our emotional, mental and psychological wounds is best way of empowering life” Happiness is not ready-made; our actions determine whether or not to achieve it. Over the last few years, I have had several clients all with their own story to tell. The mind can sometimes be an unsafe neighborhood; however, you don't have to go there alone. As a therapist, I help all my clients navigate the dilemmas by tailoring each therapy session to match your needs and wants. My approach is interactive, warm, and accepting, ensuring that each client feels a sense of belongingness. It implies that I offer tasks, feedback, and tools.
“Addressing our emotional, mental and psychological wounds is best way of empowering life” Happiness is not ready-made; our actions determine whether or not to achieve it. Over the last few years, I have had several clients all with their own story to tell. The mind can sometimes be an unsafe neighborhood; however, you don't have to go there alone. As a therapist, I help all my clients navigate the dilemmas by tailoring each therapy session to match your needs and wants. My approach is interactive, warm, and accepting, ensuring that each client feels a sense of belongingness. It implies that I offer tasks, feedback, and tools.
![Photo of Robert Kuchta, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3d7a2765-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Robert Kuchta
Clinical Social Work/Therapist, LCSW
Verified Verified
Panama City, FL 32402
Not accepting new clients
My goal is to help you improve the quality of your life and the lives of those you care about. I am a guide, supporter, educator, facilitator, mediator, and advocate. I will help you develop increased insight and self acceptance, nurture your strengths, learn to make better choices, and come to trust yourself more. You deserve to live in hope, have self respect, and trust yourself.
My goal is to help you improve the quality of your life and the lives of those you care about. I am a guide, supporter, educator, facilitator, mediator, and advocate. I will help you develop increased insight and self acceptance, nurture your strengths, learn to make better choices, and come to trust yourself more. You deserve to live in hope, have self respect, and trust yourself.
More Therapists Nearby
![Photo of Amy Pico, LMHC, LPC, LCPC, NCC](https://photos.psychologytoday.com/3c8e2b98-dfc4-49ca-b6d2-609d99f774aa/1/320x400.jpeg)
Amy Pico
Mental Health Counselor, LMHC, LPC, LCPC, NCC
Verified Verified
3 Endorsed
Panama City Beach, FL 32407 (Online Only)
HAVE YOU BEEN FEELING...LOST? Not in the traditional sense, perhaps, but numb, nervous, or detached. Disconnected from who you are, or where you’re going. Stuck in a fog of unnecessary pain or in the ruts of everyday life, struggling with the same issues, over and over again. No longer will you have to piece together the differing advice of multiple practitioners; together we’ll employ a wide array of supports. Using the best of modern psychotherapeutic practices and ancient healing we’ll reach a holistic solution. As a psychotherapist, I’ve learned pain can be released, trauma can be resolved and healing is your birthright.
HAVE YOU BEEN FEELING...LOST? Not in the traditional sense, perhaps, but numb, nervous, or detached. Disconnected from who you are, or where you’re going. Stuck in a fog of unnecessary pain or in the ruts of everyday life, struggling with the same issues, over and over again. No longer will you have to piece together the differing advice of multiple practitioners; together we’ll employ a wide array of supports. Using the best of modern psychotherapeutic practices and ancient healing we’ll reach a holistic solution. As a psychotherapist, I’ve learned pain can be released, trauma can be resolved and healing is your birthright.
![Photo of Rebecca L Clayton, MS, LPC, LMHC, NCC, Counselor](https://photos.psychologytoday.com/016fe64d-d97b-4a6e-b5b1-56b62c80d70b/1/320x400.png)
Rebecca L Clayton
Counselor, MS, LPC, LMHC, NCC
Verified Verified
2 Endorsed
Panama City Beach, FL 32407
I enjoy working with adults, children and adolescents. I believe that the central healing factor of effective therapy is a strong therapeutic connection or relationship between the client and the therapist. My goal in therapy is to offer a safe, warm haven to the client where they feel accepted and free to express the issues that brought them to therapy. I use an eclectic approach to therapy using a variety of theories and methods to approach the needs of the individual client.
I enjoy working with adults, children and adolescents. I believe that the central healing factor of effective therapy is a strong therapeutic connection or relationship between the client and the therapist. My goal in therapy is to offer a safe, warm haven to the client where they feel accepted and free to express the issues that brought them to therapy. I use an eclectic approach to therapy using a variety of theories and methods to approach the needs of the individual client.
![Photo of Sunshine Wilder, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/a4064de0-d6b5-4f11-83f7-26f83617551f/1/320x400.jpeg)
Hello, my name is Sunshine Wilder and I am a Licensed Clinical Social Worker in Florida. In 2004, I graduated with a master’s degree in social work and have been working for the past 19 years with children, teens, and adults in various settings such as child welfare, specialized therapeutic foster care, and outpatient therapy. I have experience working with individuals with a wide range of needs such as stress and anxiety, trauma and abuse, anger management, depression, ADHD, post-traumatic stress disorder (PTSD), attachment issues, and bipolar disorder.
Hello, my name is Sunshine Wilder and I am a Licensed Clinical Social Worker in Florida. In 2004, I graduated with a master’s degree in social work and have been working for the past 19 years with children, teens, and adults in various settings such as child welfare, specialized therapeutic foster care, and outpatient therapy. I have experience working with individuals with a wide range of needs such as stress and anxiety, trauma and abuse, anger management, depression, ADHD, post-traumatic stress disorder (PTSD), attachment issues, and bipolar disorder.
Online Therapists
![Photo of Douglas B Shoumaker, PsySp, LSP, NCSP](https://photos.psychologytoday.com/8a596270-0b30-4944-8cb1-8430f7f939f7/1/320x400.jpeg)
Evaluations to diagnose learning difficulties, cognitive disabilities, behavioral problems, ADHD, and possible autism spectrum disorders are also conducted.
I’m a Licensed School Psychologist and owner of Child & Adolescent Psychological and Counseling Svcs of NW FL (CAPS) and have been providing psychological assessments and counseling services to children, adolescents, and young adults for 31 years. As a School Psychologist, I'm passionate about seeing children and young adults reach their maximum potential at home, school, and their social setting. My goal is to help children and teens learn to live happier, healthier lives. I think it's paramount to set children and adolescents up for success instead of failure. I can work with the student as well as the parents to make this happen.
Evaluations to diagnose learning difficulties, cognitive disabilities, behavioral problems, ADHD, and possible autism spectrum disorders are also conducted.
I’m a Licensed School Psychologist and owner of Child & Adolescent Psychological and Counseling Svcs of NW FL (CAPS) and have been providing psychological assessments and counseling services to children, adolescents, and young adults for 31 years. As a School Psychologist, I'm passionate about seeing children and young adults reach their maximum potential at home, school, and their social setting. My goal is to help children and teens learn to live happier, healthier lives. I think it's paramount to set children and adolescents up for success instead of failure. I can work with the student as well as the parents to make this happen.
See more therapy options for Panama City
Autism Therapists
What is the most effective treatment for autism?
Applied Behavior Analysis (ABA) has come to be considered the standard treatment for children with autism spectrum disorder, and research has confirmed its effectiveness for many children. Therapists trained in ABA techniques work with children (and their parents) on developing social skills, communication and learning abilities, and everyday habits of hygiene and grooming. The clinician will tailor their program to the child’s particular need but the overarching goal will be to help them advance as far as possible toward independence based on their level of symptoms and decrease the need for additional special services. Families should seek a mental health professional specifically trained in ABA, and holding special certification in the technique, who has extensive experience not only with the approach but in using it with children with the same level of symptoms as the child who needs care.
How does ABA work?
Applied Behavior Analysis (ABA) sessions, which typically focus on positive reinforcement, can be intensive, lasting two or more hours several times a week, and continuing for two years or more. Therapists can also be expected to ask parents to take an active role in reinforcing lessons. Research has found that the technique can lead to major improvements that decrease the need for additional special services.
How does treatment for autism work?
Therapy sessions based on Applied Behavior Analysis will likely be frequent, intensive, and highly structured. After a thorough assessment, a therapist will help a child understand and develop skills in a range of areas, including communication, motor skills, social skills, self-care, play, and academic skills, as well as routines of daily living like hygiene. Typically, the therapist will help a child break down the components of a behavior—often referred to as the antecedent (what prompts an action), the behavior, and the consequence(what immediately follows)—and then reward the child at every step, while also asking parents to reinforce the lessons, and the rewards, throughout the day. This core therapy may be supplemented by occupational or speech therapy, and antidepressants, antipsychotics, and anticonvulsants may be prescribed to address specific severe symptoms.
How long does therapy for autism take?
Some people with autism spectrum disorder may be engaged in some level of therapy for many years, but research shows that treatment will be most effective if it is begun early and delivered intensively. When therapy begins by age 3, children tend to be better able to grasp and adopt the skills needed to manage everyday life, including attending school and establishing social relationships. This type of early-intervention treatment regimen is highly structured, typically involving 20 to 40 hours of one-on-one therapy per week, along with additional hours of engagement managed by parents, for a period of two years or more, although the duration of treatment is dependent on the child’s level of symptoms and pace of progress.