Therapists in Kent County, MI

Photo of Jennifer L Selent, MA LMFT, Marriage & Family Therapist
Jennifer L Selent
Marriage & Family Therapist, MA LMFT
Verified Verified
1 Endorsed
Grand Rapids, MI 49546
I am a Marriage and Family Therapist that has been working with Families, Couples, and Individuals with many diagnosis for over 15 years. I have a very wide array of experience, but do provide specialized training for the following populations: First Responders, individuals suffering from traumatic stress, eating disorders/disordered eating, addiction, and grief as well as their families. I also can support with performance issues related to competition, work, etc. I expect you would find me to be down to earth and practical, but clinically sophisticated in my approach. My goal is partnership and empowerment.
I am a Marriage and Family Therapist that has been working with Families, Couples, and Individuals with many diagnosis for over 15 years. I have a very wide array of experience, but do provide specialized training for the following populations: First Responders, individuals suffering from traumatic stress, eating disorders/disordered eating, addiction, and grief as well as their families. I also can support with performance issues related to competition, work, etc. I expect you would find me to be down to earth and practical, but clinically sophisticated in my approach. My goal is partnership and empowerment.
(616) 537-6729 View (616) 537-6729
Photo of Hope Welch, MA, LPC, Counselor
Hope Welch
Counselor, MA, LPC
Verified Verified
Grand Rapids, MI 49546
Besides a strong focus on client centered healing, I've received specific trainings in depression, anxiety, eating disorders and sport psychology.
Is life a little overwhelming right now? You deserve to be heard in a non-judgmental environment regardless of your life journey and the issues that you're currently facing. Despite what challenge it is that you're experiencing, there is a road map to improving your life satisfaction. Counseling can provide a space for each individual to self-navigate current life situations. You'll also learn coping skills for when future stressors arise. I offer Christian counseling as an option for those interested but I love working with people from all walks of life.
Besides a strong focus on client centered healing, I've received specific trainings in depression, anxiety, eating disorders and sport psychology.
Is life a little overwhelming right now? You deserve to be heard in a non-judgmental environment regardless of your life journey and the issues that you're currently facing. Despite what challenge it is that you're experiencing, there is a road map to improving your life satisfaction. Counseling can provide a space for each individual to self-navigate current life situations. You'll also learn coping skills for when future stressors arise. I offer Christian counseling as an option for those interested but I love working with people from all walks of life.
(616) 208-4096 View (616) 208-4096
Photo of Sarah Rodriguez, MA, LPC, CAADC, Counselor
Sarah Rodriguez
Counselor, MA, LPC, CAADC
Verified Verified
1 Endorsed
Grand Rapids, MI 49504
Waitlist for new clients
Building on over 10 years of experience, I have taken additional education courses in the treatment of eating disorders and the array of co-occurring concerns that often accompany them.
I believe therapy is most effective when there is an authentic connection within a non-judgmental environment. Through a collaborative understanding, my hope is to provide a safe space for clients to grow and enhance heir overall well-being while creating an individualized therapeutic experience. To provide this kind of therapy, I adopt a holistic approach and rely on empathy as a guiding principle. I incorporate elements of mindfulness, Acceptance and Commitment Therapy, Narrative therapy, and Internal Family Systems Therapy.
Building on over 10 years of experience, I have taken additional education courses in the treatment of eating disorders and the array of co-occurring concerns that often accompany them.
I believe therapy is most effective when there is an authentic connection within a non-judgmental environment. Through a collaborative understanding, my hope is to provide a safe space for clients to grow and enhance heir overall well-being while creating an individualized therapeutic experience. To provide this kind of therapy, I adopt a holistic approach and rely on empathy as a guiding principle. I incorporate elements of mindfulness, Acceptance and Commitment Therapy, Narrative therapy, and Internal Family Systems Therapy.
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Photo of Justyne Ortquist, MS, MEd, LPC, Licensed Professional Counselor
Justyne Ortquist
Licensed Professional Counselor, MS, MEd, LPC
Verified Verified
Justyne is a compassionate and dedicated therapist specializing in relational therapy and the treatment of eating disorders. With a wealth of experience and expertise, Justyne employs an integrative approach that combines somatic techniques, trauma-informed yoga, and emotion focused therapy to facilitate healing on multiple levels. Her deep understanding of the relationship between body and mind informs her approach to somatic-based healing, which goes beyond traditional talk therapy. This is the foundation of her work with clients to support them in healing trauma in the body and addressing maladaptive coping mechanisms.
Justyne is a compassionate and dedicated therapist specializing in relational therapy and the treatment of eating disorders. With a wealth of experience and expertise, Justyne employs an integrative approach that combines somatic techniques, trauma-informed yoga, and emotion focused therapy to facilitate healing on multiple levels. Her deep understanding of the relationship between body and mind informs her approach to somatic-based healing, which goes beyond traditional talk therapy. This is the foundation of her work with clients to support them in healing trauma in the body and addressing maladaptive coping mechanisms.
(616) 277-7533 View (616) 277-7533
Photo of Rene Sobleski, MA, LLP, Limited Licensed Psychologist
Rene Sobleski
Limited Licensed Psychologist, MA, LLP
Verified Verified
Grand Rapids, MI 49502
I specialize in the treatment and assessment of eating disorders, over eaters, obesity, disordered eating, sex addictions, sexual abuse victims, on-line pornography, trauma recovery, grief and loss issues.
I am experienced in providing Marital Therapy, Dialectical Behavioral Therapy, Solution Focused Therapy, Cognitive Behavioral Therapy, Emotional Freedom Techniques and Internal Family Systems, among others. I provide therapy for individuals (children ages 4-12, adolescents and adults), groups, families and couples.
I specialize in the treatment and assessment of eating disorders, over eaters, obesity, disordered eating, sex addictions, sexual abuse victims, on-line pornography, trauma recovery, grief and loss issues.
I am experienced in providing Marital Therapy, Dialectical Behavioral Therapy, Solution Focused Therapy, Cognitive Behavioral Therapy, Emotional Freedom Techniques and Internal Family Systems, among others. I provide therapy for individuals (children ages 4-12, adolescents and adults), groups, families and couples.
(269) 749-1315 View (269) 749-1315
Photo of Deena Iris Cantu, LLP, LPC, Licensed Professional Counselor
Deena Iris Cantu
Licensed Professional Counselor, LLP, LPC
Verified Verified
3 Endorsed
Grand Rapids, MI 49504
I work well with clients seeking help for problems with anxiety and depression. Those referred to me with these issues find that symptomatically they are struggling with panic, sleep disturbances, worry thoughts, self-defeating thoughts/behaviors, eating disorders,addictions and unknowingly, at times, some of their difficulties have been attached to old trauma. Many people with these sorts of struggles find that this spills over into problems with relationships and/or functioning at work and school. Areas of intimacy, both emotional and sexual are important work also. I work with individuals, married couples,families, and groups.
I work well with clients seeking help for problems with anxiety and depression. Those referred to me with these issues find that symptomatically they are struggling with panic, sleep disturbances, worry thoughts, self-defeating thoughts/behaviors, eating disorders,addictions and unknowingly, at times, some of their difficulties have been attached to old trauma. Many people with these sorts of struggles find that this spills over into problems with relationships and/or functioning at work and school. Areas of intimacy, both emotional and sexual are important work also. I work with individuals, married couples,families, and groups.
(616) 965-2049 View (616) 965-2049
Photo of Michelle M Muenzenmeyer - Michelle Muenzenmeyer, MA, LLP, CMHC, Limited Licensed Psychologist
Michelle Muenzenmeyer
Limited Licensed Psychologist, MA, LLP, CMHC
Verified Verified
1 Endorsed
Grand Rapids, MI 49546
This process is helpful in the treatment of anxiety, depression, eating disorders, relationship problems, and making life changes.
Do you find yourself setting the same goals without achieving them? In the pain and suffering, there is opportunity for growth and change. You've taken a step forward by looking into treatment, congratulations! I offer a trusting and compassionate approach to allow my clients to feel vulnerable with their struggles. I have worked with clients who have suffered with depression, grief, relationship issues, anxiety, life stage changes, obesity, binge eating and more. At the end of treatment, some clients report feeling more resilient with painful emotions which leads to healthier relationships and a more fulfilling life.
This process is helpful in the treatment of anxiety, depression, eating disorders, relationship problems, and making life changes.
Do you find yourself setting the same goals without achieving them? In the pain and suffering, there is opportunity for growth and change. You've taken a step forward by looking into treatment, congratulations! I offer a trusting and compassionate approach to allow my clients to feel vulnerable with their struggles. I have worked with clients who have suffered with depression, grief, relationship issues, anxiety, life stage changes, obesity, binge eating and more. At the end of treatment, some clients report feeling more resilient with painful emotions which leads to healthier relationships and a more fulfilling life.
(616) 788-2795 View (616) 788-2795
Photo of Nicole Marganti, PsyD, ABPP, Psychologist
Nicole Marganti
Psychologist, PsyD, ABPP
Verified Verified
Grand Rapids, MI 49505
I specialize in treating depression, anxiety, trauma, relationships, life transitions, and eating disorders.
The choice to seek therapy is often complicated and forming a relationship with your therapist is an important part of the process. I create a collaborative space where you can discuss your concerns, identities and story. Together we can identify where you would like therapy to take you, build on day-to-day techniques and explore deeper patterns and experiences that may create barriers. My approach is integrative and incorporates skills, narrative processing, metaphor, and intentional decision making. I hope that through our work you will feel empowered to make changes and feel more secure, stable, and in sync with your values.
I specialize in treating depression, anxiety, trauma, relationships, life transitions, and eating disorders.
The choice to seek therapy is often complicated and forming a relationship with your therapist is an important part of the process. I create a collaborative space where you can discuss your concerns, identities and story. Together we can identify where you would like therapy to take you, build on day-to-day techniques and explore deeper patterns and experiences that may create barriers. My approach is integrative and incorporates skills, narrative processing, metaphor, and intentional decision making. I hope that through our work you will feel empowered to make changes and feel more secure, stable, and in sync with your values.
(616) 439-2050 View (616) 439-2050
Photo of Anu Allington, LMSW, Clinical Social Work/Therapist
Anu Allington
Clinical Social Work/Therapist, LMSW
Verified Verified
Grand Rapids, MI 49546
I specialize in Eating Disorders, Anxiety, Couples' Counseling, Family Therapy, ADHD, Depression, and those with chronic medical conditions.
Reaching out for counseling takes courage and strength. Whether you are seeking support for a life stressor, a recent loss, to explore who you are, to address mental health challenges, or to navigate relationship difficulties, I welcome your contact. My goal is to offer you a safe and collaborative space where you feel heard and validated. I bring warmth, compassion, skill, and caring attention to help you along your journey, and together, we will develop treatment goals, clarify your core values, strengthen coping strategies, and engage in self-exploration leading to lasting change and growth.
I specialize in Eating Disorders, Anxiety, Couples' Counseling, Family Therapy, ADHD, Depression, and those with chronic medical conditions.
Reaching out for counseling takes courage and strength. Whether you are seeking support for a life stressor, a recent loss, to explore who you are, to address mental health challenges, or to navigate relationship difficulties, I welcome your contact. My goal is to offer you a safe and collaborative space where you feel heard and validated. I bring warmth, compassion, skill, and caring attention to help you along your journey, and together, we will develop treatment goals, clarify your core values, strengthen coping strategies, and engage in self-exploration leading to lasting change and growth.
(616) 724-7299 View (616) 724-7299
Photo of Theresa Joan Anderson-Varney, PhD, Psychologist
Theresa Joan Anderson-Varney
Psychologist, PhD
Verified Verified
Grand Rapids, MI 49546
I specialize in DID, depression, anxiety, post-traumatic stress disorder, eating disorders, sexual abuse, physical abuse, and emotional abuse.
The trials of life sometimes bring sadness and fear. I offer a place for healing and help in a safe environment, for children, adolescents, and adults. I will help you to find the answers to your conflicts and concerns. Whatever the problem we will work together to find the way out. I offer hope for the hopeless.
I specialize in DID, depression, anxiety, post-traumatic stress disorder, eating disorders, sexual abuse, physical abuse, and emotional abuse.
The trials of life sometimes bring sadness and fear. I offer a place for healing and help in a safe environment, for children, adolescents, and adults. I will help you to find the answers to your conflicts and concerns. Whatever the problem we will work together to find the way out. I offer hope for the hopeless.
(616) 414-4569 View (616) 414-4569
Photo of Jennifer DiGennaro, MA, LPC, Licensed Professional Counselor
Jennifer DiGennaro
Licensed Professional Counselor, MA, LPC
Verified Verified
8 Endorsed
Grand Rapids, MI 49506
Being at war with yourself and your body is exhausting. Maybe it started with your first diet in your teens or maybe it didn't start until later in life dealing with chronic pain or illness, or something else. You are sick of suffering and feeling like your body is an endless problem to be solved. It is hard to feel hopeful. Psychotherapy with me can help you deepen self-trust, self-care and self-acceptance. I have specialized training in trauma-informed approaches, including EMDR and Body Trust® which inform my holistic approach. I can support you to work through your past, honor your present and envision your future.
Being at war with yourself and your body is exhausting. Maybe it started with your first diet in your teens or maybe it didn't start until later in life dealing with chronic pain or illness, or something else. You are sick of suffering and feeling like your body is an endless problem to be solved. It is hard to feel hopeful. Psychotherapy with me can help you deepen self-trust, self-care and self-acceptance. I have specialized training in trauma-informed approaches, including EMDR and Body Trust® which inform my holistic approach. I can support you to work through your past, honor your present and envision your future.
(616) 201-3324 View (616) 201-3324
Photo of Kristin Moriarty Fiore, LLMSW, TCTSY-F, Clinical Social Work/Therapist
Kristin Moriarty Fiore
Clinical Social Work/Therapist, LLMSW, TCTSY-F
Verified Verified
1 Endorsed
Grand Rapids, MI 49506
My work with adults and teens focuses on integrating the body and mind to help you reconnect with yourself, address symptoms and behavioral patterns, and make positive changes in your life. My office creates a beautiful, accepting environment where you can safely explore what arises as we work through the therapy process together.
My work with adults and teens focuses on integrating the body and mind to help you reconnect with yourself, address symptoms and behavioral patterns, and make positive changes in your life. My office creates a beautiful, accepting environment where you can safely explore what arises as we work through the therapy process together.
(269) 371-5293 View (269) 371-5293
Photo of Urminda Sue Firlan - Life Journey Psychological Services PLLC, PhD, LP, Psychologist
Life Journey Psychological Services PLLC
Psychologist, PhD, LP
Verified Verified
5 Endorsed
Grand Rapids, MI 49505
Each person is on a unique life journey. We look forward to learning where you are on your journey and how we can help you create the life you desire. It is not about dwelling on the past but about using life lessons to move forward in a positive way. Even our most difficult life experiences bring us wisdom, character and integrity.
Each person is on a unique life journey. We look forward to learning where you are on your journey and how we can help you create the life you desire. It is not about dwelling on the past but about using life lessons to move forward in a positive way. Even our most difficult life experiences bring us wisdom, character and integrity.
(616) 208-5881 View (616) 208-5881
Photo of Cynthia Cortez, MA, LLPC, Pre-Licensed Professional
Cynthia Cortez
Pre-Licensed Professional, MA, LLPC
Verified Verified
1 Endorsed
Grand Rapids, MI 49503
I believe that every person is unique and different. I strive to create a safe space where you will be treated with respect and kindness, feel validated, heard, and feel safe to be yourself regardless of age, gender, or race. I believe that counseling is a journey to better oneself at any point in life’s journey and not only during a crisis or through challenges. Whether it is shame, guilt, depression, anxiety, relationship issues, questioning your identity or trauma you are dealing with, know that change is possible.
I believe that every person is unique and different. I strive to create a safe space where you will be treated with respect and kindness, feel validated, heard, and feel safe to be yourself regardless of age, gender, or race. I believe that counseling is a journey to better oneself at any point in life’s journey and not only during a crisis or through challenges. Whether it is shame, guilt, depression, anxiety, relationship issues, questioning your identity or trauma you are dealing with, know that change is possible.
(616) 219-2043 View (616) 219-2043
Photo of Katie Papke, LMSW, CAADC, CCTP, CHTVSP, Clinical Social Work/Therapist
Katie Papke
Clinical Social Work/Therapist, LMSW, CAADC, CCTP, CHTVSP
Verified Verified
1 Endorsed
Grand Rapids, MI 49525
As a Social worker, Katie has over 15 years of experience in addictions, trauma, human trafficking, abuse, and other mental health concerns. Katie is a survivor and has a passion working with individuals of all gender and sexual identities who are current and former sex industry workers, including victims and survivors of human trafficking. Her specialty is working with teens and adults with behavioral, mental health, relationship, trauma and substance abuse concerns. Katie desires to provide a safe, private, and confidential environment where an individual is free to express their choices for counseling with unbiased consultation.
As a Social worker, Katie has over 15 years of experience in addictions, trauma, human trafficking, abuse, and other mental health concerns. Katie is a survivor and has a passion working with individuals of all gender and sexual identities who are current and former sex industry workers, including victims and survivors of human trafficking. Her specialty is working with teens and adults with behavioral, mental health, relationship, trauma and substance abuse concerns. Katie desires to provide a safe, private, and confidential environment where an individual is free to express their choices for counseling with unbiased consultation.
(616) 208-3538 View (616) 208-3538
Photo of Bridget Gottlieb, LMSW, Clinical Social Work/Therapist
Bridget Gottlieb
Clinical Social Work/Therapist, LMSW
Verified Verified
Grand Rapids, MI 49503
Even though transitions are a part of all of our lives, they sometimes stir up old pain or are just too overwhelming to navigate without some help. You deserve the time and support to work through it and counseling can provide that for you. I believe in a person centered, interpersonal, cognitive behavioral and strengths based counseling approach. I have over 18 years of experience using these approaches working with individuals of all ages dealing with anxiety, depression, grief and loss, relationship issues, chronic illnesses and transitions at all stages of life.
Even though transitions are a part of all of our lives, they sometimes stir up old pain or are just too overwhelming to navigate without some help. You deserve the time and support to work through it and counseling can provide that for you. I believe in a person centered, interpersonal, cognitive behavioral and strengths based counseling approach. I have over 18 years of experience using these approaches working with individuals of all ages dealing with anxiety, depression, grief and loss, relationship issues, chronic illnesses and transitions at all stages of life.
(616) 504-6856 View (616) 504-6856
Photo of Jeromy Krogman, LPC, Counselor
Jeromy Krogman
Counselor, LPC
Verified Verified
5 Endorsed
Grand Rapids, MI 49546
Do you struggle with intrusive thoughts? Is it hard to get moving in the mornings? Is your life not what you wanted it to be? Then you have come to the right place. I work with a wide range of clients but specialize helping those with OCD and anxiety. I am also certified in helping couples improve their communication and build trust back into the relationship. I have helped couples deal with marriage infidelity as well as financial hardship. I also specialize in working through men's struggles. I have a very relaxed personality, which helps most clients feel at ease in talking in session.
Do you struggle with intrusive thoughts? Is it hard to get moving in the mornings? Is your life not what you wanted it to be? Then you have come to the right place. I work with a wide range of clients but specialize helping those with OCD and anxiety. I am also certified in helping couples improve their communication and build trust back into the relationship. I have helped couples deal with marriage infidelity as well as financial hardship. I also specialize in working through men's struggles. I have a very relaxed personality, which helps most clients feel at ease in talking in session.
(616) 947-4103 View (616) 947-4103
Photo of Martha Doran Burkett, LPC, NCC, CAADC, ACS, ADS, Licensed Professional Counselor
Martha Doran Burkett
Licensed Professional Counselor, LPC, NCC, CAADC, ACS, ADS
Verified Verified
Grand Rapids, MI 49506  (Online Only)
I am skillful and adept at helping people identify what they want to work on, and assisting in the development of a plan that makes sense to them. I work with them to determine what is the proper balance of education, information, accountability, support, and guidance to assure positive results for them. I have extensive experience working with members of the legal profession, health care professionals, students, military personnel and their families, but I enjoy working with clients from all walks of life. I am trained and experienced at assisting employers and families to intervene on individuals with substance use disorders.
I am skillful and adept at helping people identify what they want to work on, and assisting in the development of a plan that makes sense to them. I work with them to determine what is the proper balance of education, information, accountability, support, and guidance to assure positive results for them. I have extensive experience working with members of the legal profession, health care professionals, students, military personnel and their families, but I enjoy working with clients from all walks of life. I am trained and experienced at assisting employers and families to intervene on individuals with substance use disorders.
(616) 303-4087 View (616) 303-4087
Photo of Courtney Albin - Harmony, LPC, Licensed Professional Counselor
Harmony
Licensed Professional Counselor, LPC
Verified Verified
Kentwood, MI 49512
From the moment you walk into a counseling office or hit the "Enter" button to join a video session, your subconscious starts assessing your environment. Is it safe? Welcoming? Professional? Then comes the direct interaction with your counselor. Does it feel like they understand you? Do your personalities click? After you leave the session, your conscious thought kicks in to evaluate your experience. Many factors go into how you feel about counseling, and by proxy, the kind of experience you'll have.
From the moment you walk into a counseling office or hit the "Enter" button to join a video session, your subconscious starts assessing your environment. Is it safe? Welcoming? Professional? Then comes the direct interaction with your counselor. Does it feel like they understand you? Do your personalities click? After you leave the session, your conscious thought kicks in to evaluate your experience. Many factors go into how you feel about counseling, and by proxy, the kind of experience you'll have.
(616) 441-4250 View (616) 441-4250
Photo of Alyssa Wesley, MA, LLPC, CCMHC, NCC, CNC, Counselor
Alyssa Wesley
Counselor, MA, LLPC, CCMHC, NCC, CNC
Verified Verified
Grand Rapids, MI 49506
Research shows that joy is the hardest human emotion to truly experience. Challenges with depression, anxiety, life transitions, trauma, low self-esteem, relationships or many other things, hold us back from fully experiencing these moments of joy in life. Whenever you may be at in your journey, your choice in seeking help is one of bravery. My goal is to partner with you to better understand your present circumstances, create meaningful goals and continue to provide support and hope to you along the way.
Research shows that joy is the hardest human emotion to truly experience. Challenges with depression, anxiety, life transitions, trauma, low self-esteem, relationships or many other things, hold us back from fully experiencing these moments of joy in life. Whenever you may be at in your journey, your choice in seeking help is one of bravery. My goal is to partner with you to better understand your present circumstances, create meaningful goals and continue to provide support and hope to you along the way.
(616) 585-0252 View (616) 585-0252
1

Eating Disorders Therapists

What happens in therapy for eating disorders?

In therapy for eating disorders, patients typically describe their eating and exercise behaviors, their patterns of eating in relation to stress, their beliefs about their body, the ways their eating behavior affects their relationships, and their desire (or lack of it) to change. Such information helps the therapist understand the origins of the disorder and the role it plays in the patient’s life, important for guiding treatment. Attitudes and feelings about food and eating, body weight, and physical appearance are common topics of discussion throughout treatment.

What therapy types help with eating disorders?

Once any acute medical or psychiatric emergency is resolved, psychoactive medication is often prescribed, requiring the supervision of a psychiatrist. In addition, patients receive some form of nutritional counseling along with one or more forms of psychotherapy. For adolescents, family-based treatment is empirically validated and considered the first line of treatment; parents and their children meet weekly with a clinician as the adults are coached on how to nourish and psychologically support the young patient. Adults typically receive some form of individual psychotherapy, intended to resolve the cognitive and behavioral disturbances that underlie the disorder and to relieve the mood disturbances that accompany it. In addition, patients may also be helped by group therapy.

What is the goal of therapy for eating disorders?

The most immediate goal of treatment for eating disorders is to save the life of people who are on a path of starving themselves to death or engaging in eating patterns that are doing irreparable physical harm to their body. Once the acute medical danger is past, therapy is required to understand the nature of the disordered eating and/or exercise patterns, establish healthy eating behavior, and to tackle the many erroneous beliefs and distorted self-perceptions that underlie eating disorders and continue to pose a threat to health and life. Therapy also addresses the impaired mood that not only accompanies eating disorders but intensifies the danger to health and life.

What are the limitations of therapy for eating disorders?

Therapy can be very helpful for eating disorders—but that can happen only after people recognize they have a condition that must be treated. Especially with anorexia, the distortions in self-image that accompany the disorder can keep people from acknowledging they have a problem. Individuals may in fact see their eating disorder as a badge of self-control. Those with binge-eating disorder may feel too ashamed to seek help. Therapy cannot help those who do not avail themselves of it.

How long does therapy last for eating disorders?

Because of their complexity, recovery from eating disorders is usually a long-term process—measured in months and years— often marked by setbacks and relapse. Some form of help, such as individual or group therapy, may be advisable for much of that time. It is a general rule of thumb that the longer the illness has endured and the dysregulated eating behavior has taken root, the longer treatment is likely to be needed.