Dialectical Behavior (DBT) Therapists in Monticello, MN

Photo of Ana Spence-Baker, EdS, MEd, LPCC, NCC
Ana Spence-Baker
Licensed Professional Clinical Counselor, EdS, MEd, LPCC, NCC
Verified Verified
3 Endorsed
Monticello, MN 55365
I am a Licensed Professional Clinical Counselor (LPCC) and a national certified Trauma-Focused Cognitive Behavior Therapist (CFCBT). I have sixteen years of experience working with adults, families, children, and teens on different issues. I am trained in to work with individuals facing struggles related to parenting skills, developmental and learning disabilities, trauma, abuse, grief, depression and anxiety. I am also a certified meditation instructor who uses mind, body and spirit techniques. If you are going through stormy moments and struggles that prevent you from living your fulfilling life, I am here to help you.
I am a Licensed Professional Clinical Counselor (LPCC) and a national certified Trauma-Focused Cognitive Behavior Therapist (CFCBT). I have sixteen years of experience working with adults, families, children, and teens on different issues. I am trained in to work with individuals facing struggles related to parenting skills, developmental and learning disabilities, trauma, abuse, grief, depression and anxiety. I am also a certified meditation instructor who uses mind, body and spirit techniques. If you are going through stormy moments and struggles that prevent you from living your fulfilling life, I am here to help you.
(320) 373-9052 View (320) 373-9052
Photo of Michelle Clark, MA, LMFT, Marriage & Family Therapist
Michelle Clark
Marriage & Family Therapist, MA, LMFT
Verified Verified
1 Endorsed
Monticello, MN 55362
Are you wanting to live a more fulfilled life? Are you engaged in an unhealthy relationship or experiencing marital conflicts? Do you feel overwhelmed with depression, anxiety or suffer from PTSD? If you answered yes to any of these questions, then call me, Michelle Clark MA, LMFT, where help & healing begins. I am devoted to helping you live the life you have always wanted and committed to providing the highest quality care in a fun, safe, professional environment focusing on practical strategies to help you live the life you have always wanted but struggled to achieve.
Are you wanting to live a more fulfilled life? Are you engaged in an unhealthy relationship or experiencing marital conflicts? Do you feel overwhelmed with depression, anxiety or suffer from PTSD? If you answered yes to any of these questions, then call me, Michelle Clark MA, LMFT, where help & healing begins. I am devoted to helping you live the life you have always wanted and committed to providing the highest quality care in a fun, safe, professional environment focusing on practical strategies to help you live the life you have always wanted but struggled to achieve.
(763) 363-6238 View (763) 363-6238
Photo of Dan Schmoyer, MEd, MA, LSC, LPCC, Counselor
Dan Schmoyer
Counselor, MEd, MA, LSC, LPCC
Verified Verified
8 Endorsed
Monticello, MN 55362
*** We offer online/telehealth counseling sessions! If you are looking for someone who is compassionate yet honest enough to provide direction, advice, and guidance than give us a call. We also specialize in working with teenagers/young adults as they navigate life. Women's issues are an area of passion for some of our staff too. We base our counsel on a Christian worldview and have helped people from all walks of life find meaning, hope, and restoration through their struggle. Check out our website for more information and to watch a short video about our clinic.
*** We offer online/telehealth counseling sessions! If you are looking for someone who is compassionate yet honest enough to provide direction, advice, and guidance than give us a call. We also specialize in working with teenagers/young adults as they navigate life. Women's issues are an area of passion for some of our staff too. We base our counsel on a Christian worldview and have helped people from all walks of life find meaning, hope, and restoration through their struggle. Check out our website for more information and to watch a short video about our clinic.
(763) 280-7963 View (763) 280-7963
Photo of Sarah Sumner, MSW, LICSW, Clinical Social Work/Therapist
Sarah Sumner
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
1 Endorsed
Monticello, MN 55362
You are doing your best to just keep it together. You feel disconnected and lonely even in a room filled with people. You’re stressed out and irritated by stupidity every day. Most days you are exhausted because sleeping isn’t an option while anxious and self-defeating thoughts run circles in your mind. You never feel good enough and you try to get through each day without telling someone to “f” off, but once in a while you can’t hold it back and some unfortunate bystander (an idiot driver, of course) gets the brunt of your frustrations with life. This isn’t how it has to be anymore. It’s time for things to change.
You are doing your best to just keep it together. You feel disconnected and lonely even in a room filled with people. You’re stressed out and irritated by stupidity every day. Most days you are exhausted because sleeping isn’t an option while anxious and self-defeating thoughts run circles in your mind. You never feel good enough and you try to get through each day without telling someone to “f” off, but once in a while you can’t hold it back and some unfortunate bystander (an idiot driver, of course) gets the brunt of your frustrations with life. This isn’t how it has to be anymore. It’s time for things to change.
(763) 402-9446 View (763) 402-9446
Photo of Sevilla Meyers, LADC, Pre-Licensed Professional
Sevilla Meyers
Pre-Licensed Professional, LADC
Verified Verified
Monticello, MN 55362  (Online Only)
I feel well-equipped and prepared to help you work through issues that may be getting in the way of you living your best life. It is a big step to reach out to a therapist and to begin talking about and working through issues that may seem overwhelming. I can help you identify goals for yourself and overcome obstacles. Together, we can develop a positive course moving forward to help you meet your purpose and positive vision for your life. I provide a safe environment with grounding and centering techniques, to explore emotions that may be difficult to talk about.
I feel well-equipped and prepared to help you work through issues that may be getting in the way of you living your best life. It is a big step to reach out to a therapist and to begin talking about and working through issues that may seem overwhelming. I can help you identify goals for yourself and overcome obstacles. Together, we can develop a positive course moving forward to help you meet your purpose and positive vision for your life. I provide a safe environment with grounding and centering techniques, to explore emotions that may be difficult to talk about.
(763) 299-8289 View (763) 299-8289
Photo of Kevin Smith - Northwinds Counseling Services, P.A., LMFT, LPCC, LGSW
Northwinds Counseling Services, P.A.
LMFT, LPCC, LGSW
Verified Verified
Monticello, MN 55362
At Northwinds, we consider it a privilege to help our clients as they go through life-changing experiences. With integrity, compassion, and a deep devotion to the worth of each individual we see, we are here to help you make positive adjustments to the stressful life challenges you are facing. We offer individual, couples, and family counseling. Our primary model of treatment is Cognitive-Behavioral therapy, though we frequently draw from other treatment models as needed. LMFT: Kevin Smith, Amy Halverson, John Torkelson, and Terri Jorstad; LPCC: Jordan Leuthold, Michelle Rhea, Raven Winter & Rindie Eagle; LGSW: Allison Brockway
At Northwinds, we consider it a privilege to help our clients as they go through life-changing experiences. With integrity, compassion, and a deep devotion to the worth of each individual we see, we are here to help you make positive adjustments to the stressful life challenges you are facing. We offer individual, couples, and family counseling. Our primary model of treatment is Cognitive-Behavioral therapy, though we frequently draw from other treatment models as needed. LMFT: Kevin Smith, Amy Halverson, John Torkelson, and Terri Jorstad; LPCC: Jordan Leuthold, Michelle Rhea, Raven Winter & Rindie Eagle; LGSW: Allison Brockway
(763) 280-5780 View (763) 280-5780

More Therapists Nearby

Photo of Jacqui Theisen - Serenity Mental Health Services, MS, NCC, LPCC, Counselor
Serenity Mental Health Services
Counselor, MS, NCC, LPCC
Verified Verified
1 Endorsed
Buffalo, MN 55313
Our therapists offer many different treatment strategies, including, but not limited to: Dialectical Behavioral (DBT), Cognitive Behavioral (CBT), spirituality and holistic health approaches, Mindfulness, Emotion-Focused Therapy (EFT), Solutions Focused.
At Serenity Mental Health Services, we enjoy working with individuals from all walks of life. We are passionate about what we do, and feel great joy when we see individuals make positive changes towards their recovery goals. We have experience in treating many diagnoses, utilizing several different treatment modalities. We work with individuals, families, couples, and groups. We also offer ARMHS, and CTSS!
Our therapists offer many different treatment strategies, including, but not limited to: Dialectical Behavioral (DBT), Cognitive Behavioral (CBT), spirituality and holistic health approaches, Mindfulness, Emotion-Focused Therapy (EFT), Solutions Focused.
At Serenity Mental Health Services, we enjoy working with individuals from all walks of life. We are passionate about what we do, and feel great joy when we see individuals make positive changes towards their recovery goals. We have experience in treating many diagnoses, utilizing several different treatment modalities. We work with individuals, families, couples, and groups. We also offer ARMHS, and CTSS!
(320) 313-1384 View (320) 313-1384
Photo of Jennifer Knapp, MS, LMFT, Marriage & Family Therapist
Jennifer Knapp
Marriage & Family Therapist, MS, LMFT
Verified Verified
Saint Michael, MN 55376
I am also a trauma informed therapist, meaning I have extensive training, including EMDR, DBT and body based therapies, to come along side and support you in a way that works for you.
We are not meant to live in isolation. From the moment we are born, our identity and sense of self is tied in with those around us. Over time, it may shift from parents to peer groups to intimate partners, but how we interact with others is at the core of our emotional well-being. Parenting comes with a unique set of questions, self-doubt, and high stakes. For many of us, it may activate unresolved hurt or resentment from our own childhood or invite feelings of inadequacy and uncertainty. Our intimate relationships are another significant part of our lives. Clients can learn how to connect, improve understanding, and strengthen their intimate relationships by moving past the cycles that break down communication and build walls of hurt and defensiveness. Couples can re-establish that “spark,” share a vision of a connected future, and feel both valued and validated by their partners. Experiencing trauma impacts our ability to connect with and receive connection from others. Sometimes we get so stuck in that trauma that it shifts our view of the world and can permanently alter our perception. Therapy is a place to process through this experience, so you can move forward with life.
I am also a trauma informed therapist, meaning I have extensive training, including EMDR, DBT and body based therapies, to come along side and support you in a way that works for you.
We are not meant to live in isolation. From the moment we are born, our identity and sense of self is tied in with those around us. Over time, it may shift from parents to peer groups to intimate partners, but how we interact with others is at the core of our emotional well-being. Parenting comes with a unique set of questions, self-doubt, and high stakes. For many of us, it may activate unresolved hurt or resentment from our own childhood or invite feelings of inadequacy and uncertainty. Our intimate relationships are another significant part of our lives. Clients can learn how to connect, improve understanding, and strengthen their intimate relationships by moving past the cycles that break down communication and build walls of hurt and defensiveness. Couples can re-establish that “spark,” share a vision of a connected future, and feel both valued and validated by their partners. Experiencing trauma impacts our ability to connect with and receive connection from others. Sometimes we get so stuck in that trauma that it shifts our view of the world and can permanently alter our perception. Therapy is a place to process through this experience, so you can move forward with life.
(763) 334-6512 View (763) 334-6512
Photo of Ashley Smith, MA, LPCC, Counselor
Ashley Smith
Counselor, MA, LPCC
Verified Verified
1 Endorsed
Big Lake, MN 55309
I often incorporate the use of Dialectical Behavioral Therapy (DBT) skills, Cognitive Behavioral Therapy (CBT) skills, writing and art activities, and mindfulness strategies into session.
Your story is ever changing, and my goal as a therapist is to help build insight into the life you are currently living, while making sustainable changes to create the life you want to live. I specialize in working with adults and adolescents (12+) who are experiencing life adjustments, changes in mood, relationship conflicts, poor school or work performance, and exploring personal development. I am also a board approved supervisor with the BBHT and am licensed to supervise LPC/LPCC's.
I often incorporate the use of Dialectical Behavioral Therapy (DBT) skills, Cognitive Behavioral Therapy (CBT) skills, writing and art activities, and mindfulness strategies into session.
Your story is ever changing, and my goal as a therapist is to help build insight into the life you are currently living, while making sustainable changes to create the life you want to live. I specialize in working with adults and adolescents (12+) who are experiencing life adjustments, changes in mood, relationship conflicts, poor school or work performance, and exploring personal development. I am also a board approved supervisor with the BBHT and am licensed to supervise LPC/LPCC's.
(763) 402-8583 View (763) 402-8583
Photo of Teresa Movick-Anderson, MSW, LICSW, SEP, Clinical Social Work/Therapist
Teresa Movick-Anderson
Clinical Social Work/Therapist, MSW, LICSW, SEP
Verified Verified
1 Endorsed
Saint Michael, MN 55376
Please note, I am not currently taking on any new clients and will likely not have openings until summer or fall 2024. Please email if you would like to be added to my waitlist. I enjoy working with individuals and families from all walks of life. I believe we all have a unique story and need a safe space in order to share and process that story. My passion is working with children, teens, and young adults, especially those who are often labeled as difficult, misguided, or troubled. I also love working with adults, especially those struggling with trauma backgrounds, attachment disruptions, and/or mental health challenges.
Please note, I am not currently taking on any new clients and will likely not have openings until summer or fall 2024. Please email if you would like to be added to my waitlist. I enjoy working with individuals and families from all walks of life. I believe we all have a unique story and need a safe space in order to share and process that story. My passion is working with children, teens, and young adults, especially those who are often labeled as difficult, misguided, or troubled. I also love working with adults, especially those struggling with trauma backgrounds, attachment disruptions, and/or mental health challenges.
(763) 284-3636 View (763) 284-3636
Photo of Nathan Hoffman, MA, LPCC, Counselor
Nathan Hoffman
Counselor, MA, LPCC
Verified Verified
Saint Michael, MN 55376
Waitlist for new clients
As a therapist, I take a person-centered approach to therapy and work with individuals to help them gain awareness and understanding of their mental health, while helping them identify their strengths and values. I work to meet individuals where they are and I believe that openness, honesty, trust, and respect are foundational in a therapeutic relationship. I am committed to helping individuals move towards improving their mental health and overall well-being by utilizing a holistic approach that focuses on physical, emotional, and spiritual health.
As a therapist, I take a person-centered approach to therapy and work with individuals to help them gain awareness and understanding of their mental health, while helping them identify their strengths and values. I work to meet individuals where they are and I believe that openness, honesty, trust, and respect are foundational in a therapeutic relationship. I am committed to helping individuals move towards improving their mental health and overall well-being by utilizing a holistic approach that focuses on physical, emotional, and spiritual health.
(763) 247-7937 View (763) 247-7937
Photo of Whitney McElhone, MS, LPCC, Counselor
Whitney McElhone
Counselor, MS, LPCC
Verified Verified
8 Endorsed
Saint Michael, MN 55376  (Online Only)
Waitlist for new clients
Are you ready to make a positive change for YOU? If you are experiencing anxiety, depression, trauma symptoms or overwhelmed by life's stressors then you have come to the right place! I specialize in empowering adults to conquer these challenges, drawing on my expertise as a devoted mental health therapist. Together, we'll navigate your journey to healing and happiness. I have been working in the field and helping individuals since 2016. Together, we can empower you to grow through healing wounds, reduce symptoms, gain insight and become the best version of yourself—all while staying true to who you are.
Are you ready to make a positive change for YOU? If you are experiencing anxiety, depression, trauma symptoms or overwhelmed by life's stressors then you have come to the right place! I specialize in empowering adults to conquer these challenges, drawing on my expertise as a devoted mental health therapist. Together, we'll navigate your journey to healing and happiness. I have been working in the field and helping individuals since 2016. Together, we can empower you to grow through healing wounds, reduce symptoms, gain insight and become the best version of yourself—all while staying true to who you are.
(507) 821-3151 View (507) 821-3151
Photo of Christine Junod, MA, LMFT, Marriage & Family Therapist
Christine Junod
Marriage & Family Therapist, MA, LMFT
Verified Verified
Buffalo, MN 55313
My clients have experienced Big T or little t traumas, or they're anxious and overthinking. My clients have been harmed by past relationships or experiences and often don't feel "heard" by the significant people in their lives. Some clients need help identifying and processing long-held feelings, some need someone to come alongside and help them navigate a tough time in life. My clients don't want to feel alone anymore. They want to move ahead and replace their burdens with hope.
My clients have experienced Big T or little t traumas, or they're anxious and overthinking. My clients have been harmed by past relationships or experiences and often don't feel "heard" by the significant people in their lives. Some clients need help identifying and processing long-held feelings, some need someone to come alongside and help them navigate a tough time in life. My clients don't want to feel alone anymore. They want to move ahead and replace their burdens with hope.
(320) 337-1394 View (320) 337-1394
Photo of Stephanie M Van Beek, Pre-Licensed Professional
Stephanie M Van Beek
Pre-Licensed Professional
Verified Verified
2 Endorsed
Buffalo, MN 55313
I believe that everyone has the power within themselves to experience well-being. In the therapeutic relationship, I like to think of myself as your GPS; I provide directions and different routes to help get you where you want to go, and you get to decide whether to follow these directions or take your own route. Either way, I’ll still be there supporting your journey.
I believe that everyone has the power within themselves to experience well-being. In the therapeutic relationship, I like to think of myself as your GPS; I provide directions and different routes to help get you where you want to go, and you get to decide whether to follow these directions or take your own route. Either way, I’ll still be there supporting your journey.
(763) 373-7540 View (763) 373-7540
Photo of Rindie Eagle, MA, LPCC
Rindie Eagle
Licensed Professional Clinical Counselor, MA, LPCC
Verified Verified
4 Endorsed
Saint Michael, MN 55376
Waitlist for new clients
Currently full. If you find yourself struggling to keep the "perfect" mask on, I can help you become empowered to make the changes you want in your life to feel better and become recharged. We will use a strengths-based approach to identify the strengths you already have, and then you will learn how to use them in your favor to make the changes you want in your life in order to reduce the anxiety or depression that is draining your system. Go to this link to get on the waitlist: jotform.com/rindie/appointments
Currently full. If you find yourself struggling to keep the "perfect" mask on, I can help you become empowered to make the changes you want in your life to feel better and become recharged. We will use a strengths-based approach to identify the strengths you already have, and then you will learn how to use them in your favor to make the changes you want in your life in order to reduce the anxiety or depression that is draining your system. Go to this link to get on the waitlist: jotform.com/rindie/appointments
(763) 634-5444 View (763) 634-5444
Photo of Jodi Sims, LMFT, MS, Marriage & Family Therapist
Jodi Sims
Marriage & Family Therapist, LMFT, MS
Verified Verified
Big Lake, MN 55309
Are you not feeling like your usual self or are you feeling unsatisfied with things? Perhaps your mood is bothering you or relationships are stressful? If so, you are not alone and you are at the right place to address those concerns. I am an individual, marriage and family therapist with over 20 years of experience helping improve the lives of individuals, couples, families, and teens. Change can occur and lives can improve, but sometimes extra support and guidance is necessary in that process. I truly enjoy serving that role and would be honored to help.
Are you not feeling like your usual self or are you feeling unsatisfied with things? Perhaps your mood is bothering you or relationships are stressful? If so, you are not alone and you are at the right place to address those concerns. I am an individual, marriage and family therapist with over 20 years of experience helping improve the lives of individuals, couples, families, and teens. Change can occur and lives can improve, but sometimes extra support and guidance is necessary in that process. I truly enjoy serving that role and would be honored to help.
(763) 575-8086 x4 View (763) 575-8086 x4
Photo of Lexi McDonald, MS, LPCC, Counselor
Lexi McDonald
Counselor, MS, LPCC
Verified Verified
1 Endorsed
Big Lake, MN 55309
Immediate openings, no waitlist. We will do the work together, and you will heal. I help effectively strengthen self-worth while standing with you through times of life-transitions, grief and loss, trauma, resilience, depression and anxiety, personality disorders. Healing happens from the combination of a safe space to share, building on strengths, and positive action towards change. You've been the active, high-performer, but overtime you're coming to realize the high-expectations are keeping you from doing your most effective work, get started, or stay on task. I help the high-level leaders thrive in mental wellness.
Immediate openings, no waitlist. We will do the work together, and you will heal. I help effectively strengthen self-worth while standing with you through times of life-transitions, grief and loss, trauma, resilience, depression and anxiety, personality disorders. Healing happens from the combination of a safe space to share, building on strengths, and positive action towards change. You've been the active, high-performer, but overtime you're coming to realize the high-expectations are keeping you from doing your most effective work, get started, or stay on task. I help the high-level leaders thrive in mental wellness.
(763) 314-4736 View (763) 314-4736
Photo of Denae Kuenzel, PsyD, LP, Psychologist
Denae Kuenzel
Psychologist, PsyD, LP
Verified Verified
Elk River, MN 55330
Waitlist for new clients
I hold a Doctoral Degree in Counseling Psychology and have also been a Registered Dietitian since 2009. I enjoy working with adolescents, adults, and older adults. My clinical interests include anxiety, complex trauma, eating disorders/body image, grief/loss, relationship challenges, life transitions, self-growth, and nutrition/wellness.
I hold a Doctoral Degree in Counseling Psychology and have also been a Registered Dietitian since 2009. I enjoy working with adolescents, adults, and older adults. My clinical interests include anxiety, complex trauma, eating disorders/body image, grief/loss, relationship challenges, life transitions, self-growth, and nutrition/wellness.
(763) 878-8554 View (763) 878-8554
Photo of Brittany Renando - Turning Page Counseling, LLC, MS, LPCC, Counselor
Turning Page Counseling, LLC
Counselor, MS, LPCC
Verified Verified
1 Endorsed
Big Lake, MN 55309  (Online Only)
I believe in providing all of my clients with the best therapy possible by using an approach that fits who they are as a person. I want my clients to have a safe, open space to be themselves, ask for what they need, and feel comfortable every time they come in. Therapy is a place of vulnerability that only works if the client can fully engage in the process and feel confident in their therapist. I strive to help clients reach a space where real healing is achieved and to have them leave sessions feeling understood and closer to their goals.
I believe in providing all of my clients with the best therapy possible by using an approach that fits who they are as a person. I want my clients to have a safe, open space to be themselves, ask for what they need, and feel comfortable every time they come in. Therapy is a place of vulnerability that only works if the client can fully engage in the process and feel confident in their therapist. I strive to help clients reach a space where real healing is achieved and to have them leave sessions feeling understood and closer to their goals.
(320) 852-2407 View (320) 852-2407
Photo of Christina Muraski, LMFT, RPT, Marriage & Family Therapist
Christina Muraski
Marriage & Family Therapist, LMFT, RPT
Verified Verified
Buffalo, MN 55313
Not accepting new clients
Christina specializes in working in early childhood mental health and sees young children from birth and up to age 6 and works closely with their caregivers providing parenting skills and focusing on strengthening relationships. Christina is a Registered Play Therapist and sees children up to the age of 12. Christina believes that play therapy offers a way to empower children and provides a space for them to heal from traumatic experiences, express their emotions in productive ways, and feel encouraged to move beyond their difficult situations, and all through their natural language which is PLAY.
Christina specializes in working in early childhood mental health and sees young children from birth and up to age 6 and works closely with their caregivers providing parenting skills and focusing on strengthening relationships. Christina is a Registered Play Therapist and sees children up to the age of 12. Christina believes that play therapy offers a way to empower children and provides a space for them to heal from traumatic experiences, express their emotions in productive ways, and feel encouraged to move beyond their difficult situations, and all through their natural language which is PLAY.
(320) 347-3759 View (320) 347-3759

See more therapy options for Monticello

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.