Dialectical Behavior (DBT) Therapists in Crestwood, KY

Photo of Derek Stegner, LPCC
Derek Stegner
Licensed Professional Clinical Counselor, LPCC
Verified Verified
Crestwood, KY 40014  (Online Only)
I have many years of experience working with early childhood trauma and severe, persistent mental illness, varying from ages of 5 years to 70+. My goal is to empower and advocate for positive change within you, as the individual, and the system as a whole. The place that we will create together is a safe and judgement free space. I work through an Existential foundation, to help those I work with seek meaning and purpose, with skills built from experience with Dialectical Behavior Therapy, Solution-Focused Brief Therapy, and Cognitive Behavior Therapy, all within the context of a trauma-informed approach.
I have many years of experience working with early childhood trauma and severe, persistent mental illness, varying from ages of 5 years to 70+. My goal is to empower and advocate for positive change within you, as the individual, and the system as a whole. The place that we will create together is a safe and judgement free space. I work through an Existential foundation, to help those I work with seek meaning and purpose, with skills built from experience with Dialectical Behavior Therapy, Solution-Focused Brief Therapy, and Cognitive Behavior Therapy, all within the context of a trauma-informed approach.
(502) 829-7564 View (502) 829-7564
Photo of Heather Chafin, LPCC, Counselor
Heather Chafin
Counselor, LPCC
Verified Verified
1 Endorsed
Crestwood, KY 40014
Additionally, through a person-centered approach, I utilize CBT and DBT skills, motivational interviewing, and TF-CBT skills to address trauma, PTSD, depression, anxiety and relationship issues.
I enjoy working with couples, teens and adults. Using a gentle, yet direct approach, I work collaboratively with you to empower you to make positive changes in your life. Whether you are struggling with relationships, communication, depression or anxiety, I can help you identify barriers and provide you with the tools needed to successfully progress towards living a more rewarding life. Through a collaborative therapeutic process, I provide support as you work to develop coping and communication skills that lead to establishing healthier relationships and improvement of symptoms of anxiety and depression.
Additionally, through a person-centered approach, I utilize CBT and DBT skills, motivational interviewing, and TF-CBT skills to address trauma, PTSD, depression, anxiety and relationship issues.
I enjoy working with couples, teens and adults. Using a gentle, yet direct approach, I work collaboratively with you to empower you to make positive changes in your life. Whether you are struggling with relationships, communication, depression or anxiety, I can help you identify barriers and provide you with the tools needed to successfully progress towards living a more rewarding life. Through a collaborative therapeutic process, I provide support as you work to develop coping and communication skills that lead to establishing healthier relationships and improvement of symptoms of anxiety and depression.
(502) 289-0927 View (502) 289-0927
Photo of Kimberly Rachel Millanti, LPCC, Counselor
Kimberly Rachel Millanti
Counselor, LPCC
Verified Verified
Crestwood, KY 40014  (Online Only)
Life can be challenging! Whether you are struggling with a minor issue or affected drastically by feelings of sadness, stress, hopelessness, or just feeling stuck, I’m here to help. I realize that starting therapy can be difficult or nerve wracking, so my goal is to provide you with a safe space to express yourself and help you feel as comfortable as possible.
Life can be challenging! Whether you are struggling with a minor issue or affected drastically by feelings of sadness, stress, hopelessness, or just feeling stuck, I’m here to help. I realize that starting therapy can be difficult or nerve wracking, so my goal is to provide you with a safe space to express yourself and help you feel as comfortable as possible.
(502) 406-8659 View (502) 406-8659
Photo of Taylor Wallace- Yocom, LPCA, Counselor
Taylor Wallace- Yocom
Counselor, LPCA
Verified Verified
Crestwood, KY 40014
I love being able to work with individuals and families to help determine the best ways to engage and support them. I am a licensed Professional Clinical Counselor, providing individual, and family therapy to children, adolescents, and adults. My approach is client-centered. Building a strong therapeutic relationship based on trust is an important part of my practice. With my professional experience, education, and personal life insights, I aim to be a compassionate and effective therapist. My dedication is to guide you in achieving the transformation you want for yourself, your relationships, and your family.
I love being able to work with individuals and families to help determine the best ways to engage and support them. I am a licensed Professional Clinical Counselor, providing individual, and family therapy to children, adolescents, and adults. My approach is client-centered. Building a strong therapeutic relationship based on trust is an important part of my practice. With my professional experience, education, and personal life insights, I aim to be a compassionate and effective therapist. My dedication is to guide you in achieving the transformation you want for yourself, your relationships, and your family.
(502) 461-1375 View (502) 461-1375
Photo of Natasha Janes Markwell - Creative Family Counseling, LMFT, Marriage & Family Therapist
Creative Family Counseling
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Crestwood, KY 40014
I have a collaborative and strengths-based approach to therapy. I specialize in working with children, adolescents, and their families. I am passionate about assisting families with emotional/behavioral issues and building stronger relationships, while also finding solutions and healing. It is my belief that therapy is meant to be a safe space conducive to growth for everyone- regardless of age, gender, sexual orientation, or ethnicity.
I have a collaborative and strengths-based approach to therapy. I specialize in working with children, adolescents, and their families. I am passionate about assisting families with emotional/behavioral issues and building stronger relationships, while also finding solutions and healing. It is my belief that therapy is meant to be a safe space conducive to growth for everyone- regardless of age, gender, sexual orientation, or ethnicity.
(502) 325-3567 View (502) 325-3567
Photo of Madison Malloy, LPCA, Counselor
Madison Malloy
Counselor, LPCA
Verified Verified
1 Endorsed
Crestwood, KY 40014
Are you looking for a fresh perspective and a deeper understanding in your therapeutic journey? With a strong commitment to guiding clients toward their best selves, I bring a blend of youthful energy and empathetic insight to therapy. My experience in residential and inpatient settings has equipped me to support individuals of all ages in navigating the complexities of mental health. Together, we can foster a supportive environment where healing and personal growth thrive, empowering you to face life’s challenges with resilience and clarity.
Are you looking for a fresh perspective and a deeper understanding in your therapeutic journey? With a strong commitment to guiding clients toward their best selves, I bring a blend of youthful energy and empathetic insight to therapy. My experience in residential and inpatient settings has equipped me to support individuals of all ages in navigating the complexities of mental health. Together, we can foster a supportive environment where healing and personal growth thrive, empowering you to face life’s challenges with resilience and clarity.
(502) 547-0277 View (502) 547-0277

More Therapists Nearby

Photo of Jodi Bessinger - Renew Counseling, LLC, Counselor
Renew Counseling, LLC
Counselor
Verified Verified
3 Endorsed
La Grange, KY 40031
Renew Counseling Services was established in 2014, and quickly grew to become a group practice with more than 30 therapists. Our therapists are not only trained in several therapeutic models but also come from different backgrounds and life experiences. ​ The practice was created with the belief that all people can make great strides towards personal growth when ready for change. We know trauma plays an important role in the difficulties many face. We are a practice of therapists trained extensively in EMDR, Expressive Therapy, Family Therapy, DBT and CBT. We have many years of experience, knowledge and practice.
Renew Counseling Services was established in 2014, and quickly grew to become a group practice with more than 30 therapists. Our therapists are not only trained in several therapeutic models but also come from different backgrounds and life experiences. ​ The practice was created with the belief that all people can make great strides towards personal growth when ready for change. We know trauma plays an important role in the difficulties many face. We are a practice of therapists trained extensively in EMDR, Expressive Therapy, Family Therapy, DBT and CBT. We have many years of experience, knowledge and practice.
(502) 804-5467 View (502) 804-5467
Photo of Stephanie Hurst, LCSW, Clinical Social Work/Therapist
Stephanie Hurst
Clinical Social Work/Therapist, LCSW
Verified Verified
Anchorage, KY 40223
I take a multi-modal approach, pulling from CBT, DBT, ACT, REBT, IFS, and Family Systems.
I am a well-rounded therapist that takes a person-centered approach. I have worked with all ages (4-75 years old), but believe that I work best with young adults to middle age. I enjoy helping individuals learn what it means to take care of themselves and build resiliency to fight through life's struggles. I aspire to help people reach their full potential and live happier, more fulfilled lives.
I take a multi-modal approach, pulling from CBT, DBT, ACT, REBT, IFS, and Family Systems.
I am a well-rounded therapist that takes a person-centered approach. I have worked with all ages (4-75 years old), but believe that I work best with young adults to middle age. I enjoy helping individuals learn what it means to take care of themselves and build resiliency to fight through life's struggles. I aspire to help people reach their full potential and live happier, more fulfilled lives.
(520) 337-1719 View (520) 337-1719
Photo of Teal Hewlett, LCSW, Clinical Social Work/Therapist
Teal Hewlett
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Louisville, KY 40223
I specialize in CBT, DBT, Motivational Interviewing and Mindfulness-Based Therapy.
My approach to therapy is founded on respect and compassion for my clients, meeting them wherever they may be in their journey. Life can be filled with so many challenging moments and uncertainties, and as a therapist it's my top priority to provide a safe, comfortable and judgement-free space for clients to express themselves.
I specialize in CBT, DBT, Motivational Interviewing and Mindfulness-Based Therapy.
My approach to therapy is founded on respect and compassion for my clients, meeting them wherever they may be in their journey. Life can be filled with so many challenging moments and uncertainties, and as a therapist it's my top priority to provide a safe, comfortable and judgement-free space for clients to express themselves.
(502) 469-1895 View (502) 469-1895
Photo of Laura Cassidy, MS, LPCC-S, C-DBT, Licensed Professional Counselor
Laura Cassidy
Licensed Professional Counselor, MS, LPCC-S, C-DBT
Verified Verified
6 Endorsed
Anchorage, KY 40223  (Online Only)
I am certified in both EMDR and Dialectical Behavioral Therapy ( DBT).
Now enrolling for Fall 2024 Adolescent DBT Groups - Navigating the ups and downs of life can be challenging. It helps to have genuine and nonjudgmental support along the way. If you encounter a fork in the road of life and feel unsure of which path to take, counseling may help you explore personal growth and positive change. In our busy lives, it can be difficult to slow down and truly connect with ourselves, our values, and our understanding of the world around us. I believe therapeutic change occurs when we let go of perceived pressures and expectations so that we may seek a better understanding of our authentic selves.
I am certified in both EMDR and Dialectical Behavioral Therapy ( DBT).
Now enrolling for Fall 2024 Adolescent DBT Groups - Navigating the ups and downs of life can be challenging. It helps to have genuine and nonjudgmental support along the way. If you encounter a fork in the road of life and feel unsure of which path to take, counseling may help you explore personal growth and positive change. In our busy lives, it can be difficult to slow down and truly connect with ourselves, our values, and our understanding of the world around us. I believe therapeutic change occurs when we let go of perceived pressures and expectations so that we may seek a better understanding of our authentic selves.
(502) 427-1877 View (502) 427-1877
Photo of Mendy Mason, LPCC, Counselor
Mendy Mason
Counselor, LPCC
Verified Verified
1 Endorsed
Louisville, KY 40243
In individual therapy, I utilize evidence-based me methods such as EMDR, CBT, and DBT.
I am a Licensed Professional Clinical Counselor and I specialize in couples counseling, trauma/PTSD, depression, anxiety, addiction, and women’s issues. For those who desire it, I can integrate Christian counseling into the sessions. My approach enables me to support you in a way that respects your values and beliefs while also making use of the best practices in mental health care. My goal is to create a safe, supportive, and non-judgmental space where clients can explore their thoughts, feelings, and behaviors while using evidence-based therapy.
In individual therapy, I utilize evidence-based me methods such as EMDR, CBT, and DBT.
I am a Licensed Professional Clinical Counselor and I specialize in couples counseling, trauma/PTSD, depression, anxiety, addiction, and women’s issues. For those who desire it, I can integrate Christian counseling into the sessions. My approach enables me to support you in a way that respects your values and beliefs while also making use of the best practices in mental health care. My goal is to create a safe, supportive, and non-judgmental space where clients can explore their thoughts, feelings, and behaviors while using evidence-based therapy.
(502) 503-5490 View (502) 503-5490
Photo of Latrenia Somone Moore, LPCC, Counselor
Latrenia Somone Moore
Counselor, LPCC
Verified Verified
1 Endorsed
Louisville, KY 40223  (Online Only)
I incorporate Cognitive Behavior and Dialectical Behavioral Therapy, as well as Mindfulness.
Congratulations! Seeking professional help is not always easy, but you did it! Life can be full of many challenges, resulting in increased levels of stress and anxiety. During our sessions clients are encouraged to be vulnerable in Identifying their stressors within a safe, non judgemental therapeutic environment in which being vulnerable is encouraged. I welcome the opportunity to work with you on your path towared healing. If you are ready to schedule an appointment I am credentialed with Sondermind. Please reach out to Sondermind Support to set up your account , so that we may schedule your first session .
I incorporate Cognitive Behavior and Dialectical Behavioral Therapy, as well as Mindfulness.
Congratulations! Seeking professional help is not always easy, but you did it! Life can be full of many challenges, resulting in increased levels of stress and anxiety. During our sessions clients are encouraged to be vulnerable in Identifying their stressors within a safe, non judgemental therapeutic environment in which being vulnerable is encouraged. I welcome the opportunity to work with you on your path towared healing. If you are ready to schedule an appointment I am credentialed with Sondermind. Please reach out to Sondermind Support to set up your account , so that we may schedule your first session .
(931) 342-4065 View (931) 342-4065
Photo of Adam Thompson Berry, LPCC
Adam Thompson Berry
LPCC
Verified Verified
Louisville, KY 40243
People are often held captive by their emotions and thoughts, which prevents them from reaching their full potential. My practice is informed by blending mindfulness with other modalities to alleviate this state of distraction and fully experience the present moment. To best treat my clients, I use an integrative approach that draws from many different modalities including Cognitive Behavioral Therapy, Mindfulness-Based Cognitive Therapy, Dialectical Behavioral Therapy, humanistic, and existential modalities. I am also trained and experienced in EMDR.
People are often held captive by their emotions and thoughts, which prevents them from reaching their full potential. My practice is informed by blending mindfulness with other modalities to alleviate this state of distraction and fully experience the present moment. To best treat my clients, I use an integrative approach that draws from many different modalities including Cognitive Behavioral Therapy, Mindfulness-Based Cognitive Therapy, Dialectical Behavioral Therapy, humanistic, and existential modalities. I am also trained and experienced in EMDR.
(502) 747-9149 View (502) 747-9149
Photo of Stephanie Barnes - Goldenrod Mental Health, LLC , MSSW, LCSW, Clinical Social Work/Therapist
Goldenrod Mental Health, LLC
Clinical Social Work/Therapist, MSSW, LCSW
Verified Verified
1 Endorsed
Louisville, KY 40243  (Online Only)
I use a variety of evidence-based practices that I have been trained in, including Dialectical Behavioral Therapy, Acceptance and Commitment Therapy, and Cognitive Behavioral Therapy, all from a trauma informed perspective, to address behavioral, cognitive, and emotional issues in a collaborative way to best meet each client's needs.
I am a strong believer that the quality of the therapeutic relationship is the biggest contributor to client success. Therefore I work very hard to create a safe, non-judgemental environment with unconditional positive regard for my clients. I really enjoy helping individuals and couples cope and process with many issues and diagnosis. Most of my experience post-graduate has been working with trauma and severe mental illness. I am LGBTQ+ allied, gender-affirming, and kink and poly-friendly.
I use a variety of evidence-based practices that I have been trained in, including Dialectical Behavioral Therapy, Acceptance and Commitment Therapy, and Cognitive Behavioral Therapy, all from a trauma informed perspective, to address behavioral, cognitive, and emotional issues in a collaborative way to best meet each client's needs.
I am a strong believer that the quality of the therapeutic relationship is the biggest contributor to client success. Therefore I work very hard to create a safe, non-judgemental environment with unconditional positive regard for my clients. I really enjoy helping individuals and couples cope and process with many issues and diagnosis. Most of my experience post-graduate has been working with trauma and severe mental illness. I am LGBTQ+ allied, gender-affirming, and kink and poly-friendly.
(502) 586-4464 View (502) 586-4464
Photo of Danna Leigh Delafield, MA, Psychological Associate
Danna Leigh Delafield
Psychological Associate, MA
Verified Verified
2 Endorsed
Louisville, KY 40241
Danna utilizes the evidence-based treatment approaches of Cognitive Behavioral Therapy (CBT), Dialectal Behavior Therapy ( DBT).
Danna Delafeld is a Licensed Psychological Associate with over two decades of experience providing mental health services to individuals struggling with anxiety and mood related disorders as well as to those who have experienced trauma. While working with a wide range of anxiety and mood related issues, Danna specializes in the treatment of eating disorders and body image issues, including the treatment of Body Dysmorphic Disorder. Danna also works with relationship concerns that arise out of these types of struggles.
Danna utilizes the evidence-based treatment approaches of Cognitive Behavioral Therapy (CBT), Dialectal Behavior Therapy ( DBT).
Danna Delafeld is a Licensed Psychological Associate with over two decades of experience providing mental health services to individuals struggling with anxiety and mood related disorders as well as to those who have experienced trauma. While working with a wide range of anxiety and mood related issues, Danna specializes in the treatment of eating disorders and body image issues, including the treatment of Body Dysmorphic Disorder. Danna also works with relationship concerns that arise out of these types of struggles.
(502) 237-7050 View (502) 237-7050
Photo of Matt Gilbert, PsyD, Psychologist
Matt Gilbert
Psychologist, PsyD
Verified Verified
2 Endorsed
Louisville, KY 40222
Gilbert provides psychotherapy from a integrated and primarily interpersonally-based framework and provides treatments such as Dialectical Behavior and Cognitive Behavioral therapies and EMDR.
Dr. Gilbert specializes in difficulties associated with the impact of post-traumatic stress disorder. He is also a specialist in the treatment of complex psychological trauma and its associated impulsive behaviors and actions including self-harm, chronic suicidality and suicidal actions, dyscontrolled anger, and the quickly shifting mood states and interpersonal chaos that often accompany these struggles.  Additional areas of interest include mindfulness-based approaches to health and wellness, cycling mood disorders, depression, men’s issues, relationship concerns, and most general mental health difficulties.
Gilbert provides psychotherapy from a integrated and primarily interpersonally-based framework and provides treatments such as Dialectical Behavior and Cognitive Behavioral therapies and EMDR.
Dr. Gilbert specializes in difficulties associated with the impact of post-traumatic stress disorder. He is also a specialist in the treatment of complex psychological trauma and its associated impulsive behaviors and actions including self-harm, chronic suicidality and suicidal actions, dyscontrolled anger, and the quickly shifting mood states and interpersonal chaos that often accompany these struggles.  Additional areas of interest include mindfulness-based approaches to health and wellness, cycling mood disorders, depression, men’s issues, relationship concerns, and most general mental health difficulties.
(502) 871-4660 View (502) 871-4660
Photo of Shannon W Reynolds, Marriage & Family Therapist Associate
Shannon W Reynolds
Marriage & Family Therapist Associate
Verified Verified
Louisville, KY 40223
I received my Master’s in Marriage and Family Therapy from Campbellsville University and have been trained in EMDR, Dialectical Behavioral Therapy, Emotionally Focused Couples Therapy and Gottman Couples Therapy.
I received my Master’s in Marriage and Family Therapy from Campbellsville University and have been trained in EMDR, Dialectical Behavioral Therapy, Emotionally Focused Couples Therapy and Gottman Couples Therapy.
(502) 405-9721 View (502) 405-9721
Photo of Maggie Sweeney, LPCC
Maggie Sweeney
Licensed Professional Clinical Counselor, LPCC
Verified Verified
Louisville, KY 40223  (Online Only)
I take a client-centered and strength-based approach, utilizing a variety of evidence-based practices, including CBT, DBT, EMDR, systems therapy, narrative, and attachment theory.
I am Maggie Sweeney. I grew up poor in Brooklyn, I spent 23 years in the Navy, I have lived all over the world and retired in 2014. I earned my bachelor’s degree in liberal arts in science in 2009 and my MS in Mental Health Counseling in March 2017. My ex was active-duty Army and in July 2017 we got stationed at Fort Knox, KY. I earned my PhD in May 2022 and today I live Elizabethtown, KY.
I take a client-centered and strength-based approach, utilizing a variety of evidence-based practices, including CBT, DBT, EMDR, systems therapy, narrative, and attachment theory.
I am Maggie Sweeney. I grew up poor in Brooklyn, I spent 23 years in the Navy, I have lived all over the world and retired in 2014. I earned my bachelor’s degree in liberal arts in science in 2009 and my MS in Mental Health Counseling in March 2017. My ex was active-duty Army and in July 2017 we got stationed at Fort Knox, KY. I earned my PhD in May 2022 and today I live Elizabethtown, KY.
(270) 606-7829 View (270) 606-7829
Photo of Callie Ernspiker, MEd, LPA, Psychologist
Callie Ernspiker
Psychologist, MEd, LPA
Verified Verified
1 Endorsed
Louisville, KY 40243
Callie has experience in various empirically supported interventions such as TF-CBT, DBT, and ACT.
Callie graduated from the University of Louisville in 2022 with a Master of Education in Counseling Psychology. During her graduate studies, she provided therapy for underserved teens and adults in both school and community-based settings. She also worked with individuals in the department of juvenile justice. In addition to her clinical training, Callie was involved in two different research labs where she presented research projects at local conferences. Her research interests included disordered eating among pregnant women, as well as social inequities in health.
Callie has experience in various empirically supported interventions such as TF-CBT, DBT, and ACT.
Callie graduated from the University of Louisville in 2022 with a Master of Education in Counseling Psychology. During her graduate studies, she provided therapy for underserved teens and adults in both school and community-based settings. She also worked with individuals in the department of juvenile justice. In addition to her clinical training, Callie was involved in two different research labs where she presented research projects at local conferences. Her research interests included disordered eating among pregnant women, as well as social inequities in health.
(502) 673-1418 View (502) 673-1418
Photo of Ashley Paxton-Watts, LCSW, Clinical Social Work/Therapist
Ashley Paxton-Watts
Clinical Social Work/Therapist, LCSW
Verified Verified
Lyndon, KY 40241  (Online Only)
A Licensed Clinical Social Worker in Kentucky, Georgia, and Florida I focus my practice on use of Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy ( DBT), Solution Focused Therapy, Reality Therapy, and Life Coaching. I also provide EAP counseling and help with workplace concerns and employment/employer issues. I provide family therapy and couples counseling. I help clients reach effective solutions to their varied challenges. I believe that each individual has the ability to overcome struggles and to learn ways to self-heal.
A Licensed Clinical Social Worker in Kentucky, Georgia, and Florida I focus my practice on use of Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy ( DBT), Solution Focused Therapy, Reality Therapy, and Life Coaching. I also provide EAP counseling and help with workplace concerns and employment/employer issues. I provide family therapy and couples counseling. I help clients reach effective solutions to their varied challenges. I believe that each individual has the ability to overcome struggles and to learn ways to self-heal.
(859) 648-2314 View (859) 648-2314

See more therapy options for Crestwood

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.