Attachment-based Therapists in Ladue, MO
![Photo of Laila Merz, PhD, Psychologist](https://photos.psychologytoday.com/437e11ce-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
I went into the field of psychology because I love helping people transform to the best version of themselves. We all need a safe place to understand ourselves and how we relate to others/self. I often say "We need to be Mindful of our Total-Well Being and that our minds and our bodies are an inter-connected systems. Where the mind goes, so does the man or woman in their actions and body states. We go to the physician for our physical health, so how much healthier would we be if we went to our psychologist for our mental health?" At heart, I am a holistic practitioner and love seeing my clients Thrive.
I went into the field of psychology because I love helping people transform to the best version of themselves. We all need a safe place to understand ourselves and how we relate to others/self. I often say "We need to be Mindful of our Total-Well Being and that our minds and our bodies are an inter-connected systems. Where the mind goes, so does the man or woman in their actions and body states. We go to the physician for our physical health, so how much healthier would we be if we went to our psychologist for our mental health?" At heart, I am a holistic practitioner and love seeing my clients Thrive.
![Photo of Karissa Curtis, MA, LPC, CST, Licensed Professional Counselor](https://photos.psychologytoday.com/0421cef0-d284-4feb-8218-23f5cf62f77c/4/320x400.jpeg)
Karissa Curtis
Licensed Professional Counselor, MA, LPC, CST
Verified Verified
1 Endorsed
Ladue, MO 63124
Waitlist for new clients
I use an integrative therapeutic approach often including attachment-based therapies, parts work, Voice of the Heart, and the Enneagram.
I believe people's pain is holy and sacred ground and that every individual's story has value. I work with individuals and couples, and I'm passionate about understanding my clients' struggles and giving them hope for healing and redemption. In coming to counseling, my clients can be assured that I'll provide a safe, non-judgmental space for them to grow and find healing. Of particular interest to me is helping people who struggle with relationship difficulties, sexual intimacy issues, vaginismus, sexual shame, religious and sexual identity conflicts, spirituality, and conflict and boundary issues.
I use an integrative therapeutic approach often including attachment-based therapies, parts work, Voice of the Heart, and the Enneagram.
I believe people's pain is holy and sacred ground and that every individual's story has value. I work with individuals and couples, and I'm passionate about understanding my clients' struggles and giving them hope for healing and redemption. In coming to counseling, my clients can be assured that I'll provide a safe, non-judgmental space for them to grow and find healing. Of particular interest to me is helping people who struggle with relationship difficulties, sexual intimacy issues, vaginismus, sexual shame, religious and sexual identity conflicts, spirituality, and conflict and boundary issues.
![Photo of Jane N Rubin, MEd, LPC, NCC, Licensed Professional Counselor](https://photos.psychologytoday.com/3cb49992-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Jane N Rubin
Licensed Professional Counselor, MEd, LPC, NCC
Verified Verified
1 Endorsed
Ladue, MO 63124
I believe "the right" therapeutic relationship is the key to successful therapy. My approach focuses on creating a safe and empathetic space that is both collaborative and client-centered. I provide specialized therapy to individuals, couples, and families seeking to improve their emotional and mental health, relationships, and overall life experience. I utilize Cognitive Behavioral Therapy (CBT) to help identify and change negative thought patterns, Solution-Focused Therapy (SFBT) to help identify practical strategies to achieve goals, and Mindfulness Therapy.
I believe "the right" therapeutic relationship is the key to successful therapy. My approach focuses on creating a safe and empathetic space that is both collaborative and client-centered. I provide specialized therapy to individuals, couples, and families seeking to improve their emotional and mental health, relationships, and overall life experience. I utilize Cognitive Behavioral Therapy (CBT) to help identify and change negative thought patterns, Solution-Focused Therapy (SFBT) to help identify practical strategies to achieve goals, and Mindfulness Therapy.
![Photo of Katherine Fezzi, MSW, LMSW, JD, Pre-Licensed Professional](https://photos.psychologytoday.com/e2209b21-8a23-4963-805d-4a8c421dbbd8/1/320x400.jpeg)
At Plan Your Recovery, Katherine performs psychotherapy and facilitates group therapy. Concentrating her practice on addiction treatment, she also has experience working with depression, anxiety, social anxiety, trauma, PTSD, disordered eating, attachment disorders, body dysmorphia, codependent relationships, etc. Additionally, she holds a Juris Doctorate, as well as a Bachelor of Science in Business Administration, with a concentration in Human Resources and a minor Economics.
At Plan Your Recovery, Katherine performs psychotherapy and facilitates group therapy. Concentrating her practice on addiction treatment, she also has experience working with depression, anxiety, social anxiety, trauma, PTSD, disordered eating, attachment disorders, body dysmorphia, codependent relationships, etc. Additionally, she holds a Juris Doctorate, as well as a Bachelor of Science in Business Administration, with a concentration in Human Resources and a minor Economics.
![Photo of Ashley Bell - Footsteps Counseling, LLC, MA, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/86255d60-ca8b-4425-a31a-d5b7e2c4f981/1/320x400.jpeg)
Footsteps Counseling, LLC
Licensed Professional Counselor, MA, LPC
Verified Verified
2 Endorsed
Ladue, MO 63124
Are you just f-ing exhausted? A car accident left you emotionally paralyzed. An assault shook up your life. A recent medical diagnosis or crisis has you questioning what's next. All the "why" questions are flying through your head and the constant noise is driving you nuts. You want things to make sense. You want to feel like yourself again. Most of all, you want to go back in time to the thing that changed your body or your life and do everything in your power to prevent it from happening. The problem is that no one prepared you for this or understands how to help.
Are you just f-ing exhausted? A car accident left you emotionally paralyzed. An assault shook up your life. A recent medical diagnosis or crisis has you questioning what's next. All the "why" questions are flying through your head and the constant noise is driving you nuts. You want things to make sense. You want to feel like yourself again. Most of all, you want to go back in time to the thing that changed your body or your life and do everything in your power to prevent it from happening. The problem is that no one prepared you for this or understands how to help.
![Photo of Karen A Geren, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3d0eda07-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Karen utilizes non-judgmental and empowering approaches that focus on helping individuals access internal strengths to cope with life's difficulties. She offers unconditional support for improved wellbeing while actively challenging behaviors that may hinder progress. She has regularly facilitated growth and healing for adolescents and adults with issues such as eating disorders, trauma, anxiety, depression, relationship issues, addictions, self-injury, self-esteem, and OCD. Interventions specific to clients' needs are regularly reviewed in order to provide tools to be used between therapy sessions.
Karen utilizes non-judgmental and empowering approaches that focus on helping individuals access internal strengths to cope with life's difficulties. She offers unconditional support for improved wellbeing while actively challenging behaviors that may hinder progress. She has regularly facilitated growth and healing for adolescents and adults with issues such as eating disorders, trauma, anxiety, depression, relationship issues, addictions, self-injury, self-esteem, and OCD. Interventions specific to clients' needs are regularly reviewed in order to provide tools to be used between therapy sessions.
![Photo of Danica Byler, MA, LPC, NCC, Licensed Professional Counselor](https://photos.psychologytoday.com/5062dea4-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Danica Byler
Licensed Professional Counselor, MA, LPC, NCC
Verified Verified
Ladue, MO 63124 (Online Only)
The Gottman Method is an integrative approach to couple therapy based on over 40 years of research. As a Certified Gottman therapist, I work with couples experiencing communication issues, trouble dealing with conflict and personality differences, infidelity, differing parenting styles, intimacy and closeness. After a thorough assessment of your relationship, we will establish goals, and begin to develop a plan to gain skills that will help begin to heal the issues that can sometimes feel difficult to navigate on your own.
The Gottman Method is an integrative approach to couple therapy based on over 40 years of research. As a Certified Gottman therapist, I work with couples experiencing communication issues, trouble dealing with conflict and personality differences, infidelity, differing parenting styles, intimacy and closeness. After a thorough assessment of your relationship, we will establish goals, and begin to develop a plan to gain skills that will help begin to heal the issues that can sometimes feel difficult to navigate on your own.
![Photo of Alisha Beseth, MA, LPC, Counselor](https://photos.psychologytoday.com/843e80cc-0311-4d7d-a9a9-817e6dc58e8b/3/320x400.jpeg)
Alisha Beseth
Counselor, MA, LPC
Verified Verified
1 Endorsed
Ladue, MO 63124
Waitlist for new clients
If you're hoping to get unstuck from the past, move out of survival mode, and figure out how to thrive, please reach out! I'll help assess what's stuck, work with you to get unstuck, and collaborate with you to change and grow. I also really enjoy working with people who are ready to try EMDR (either as a primary approach or in conjunction with talk therapy, depending on your needs).
If you're hoping to get unstuck from the past, move out of survival mode, and figure out how to thrive, please reach out! I'll help assess what's stuck, work with you to get unstuck, and collaborate with you to change and grow. I also really enjoy working with people who are ready to try EMDR (either as a primary approach or in conjunction with talk therapy, depending on your needs).
![Photo of Erika M. Ottolini, MEd, LPC, NCC, Licensed Professional Counselor](https://photos.psychologytoday.com/3db2da61-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Erika M. Ottolini
Licensed Professional Counselor, MEd, LPC, NCC
Verified Verified
1 Endorsed
Ladue, MO 63124
Whether you are a teen struggling with friendships and social media, a young person about to graduate from college and fraught with anxiety about your next transition, the parent of a young person wondering how best to help them grow or someone looking for change and not sure where to start, know that there is help available in a compassionate and understanding space. At Artemis Counseling, our goal is to empower teens, parents and families who often come to us during a time of transition, to move through life’s transitions and soar.
Whether you are a teen struggling with friendships and social media, a young person about to graduate from college and fraught with anxiety about your next transition, the parent of a young person wondering how best to help them grow or someone looking for change and not sure where to start, know that there is help available in a compassionate and understanding space. At Artemis Counseling, our goal is to empower teens, parents and families who often come to us during a time of transition, to move through life’s transitions and soar.
![Photo of Richard B Boswell - Richard B. Boswell, LCSW, L.L.C, LCSW, LLC, Clinical Social Work/Therapist](https://photos.psychologytoday.com/78ef9d9c-0b8e-4548-9515-123627e932e7/2/320x400.jpeg)
Richard B. Boswell, LCSW, L.L.C
Clinical Social Work/Therapist, LCSW, LLC
Verified Verified
Ladue, MO 63124 (Online Only)
Waitlist for new clients
My practice is highly specialized using evidence-based methods that help couples, families and individuals. I am certified by both the Gottman Institute and the International Center for Excellence in Emotionally Focused Therapy to help couples. I also work with individuals experiencing the challenge of depression, anxiety, trauma, bipolar disorder, parenting issues or those needing to improve their relationships with the important people in their lives.
My practice is highly specialized using evidence-based methods that help couples, families and individuals. I am certified by both the Gottman Institute and the International Center for Excellence in Emotionally Focused Therapy to help couples. I also work with individuals experiencing the challenge of depression, anxiety, trauma, bipolar disorder, parenting issues or those needing to improve their relationships with the important people in their lives.
![Photo of Francesca M Ferrentelli, PhD, LPC, BCC, Licensed Professional Counselor](https://photos.psychologytoday.com/c8949de6-1d80-474e-92df-98968693b26e/3/320x400.jpeg)
Francesca M Ferrentelli
Licensed Professional Counselor, PhD, LPC, BCC
Verified Verified
4 Endorsed
Ladue, MO 63124
My style is informed by EMDR therapy, psychodynamic therapy, Jungian and depth psychology, and positive psychology. I am a licensed professional counselor, a certified EMDR clinician, and a board certified coach. My training and experience has prepared me to help clients with trauma, anxiety, addictions, depression, disordered eating, body image dissatisfaction, life's additions, My approach helps people recognize and change counterproductive patterns in their lives. relationship issues, life transitions, anxiety, and depression. I want to assist people to develop newer, healthier patterns in their lives.
My style is informed by EMDR therapy, psychodynamic therapy, Jungian and depth psychology, and positive psychology. I am a licensed professional counselor, a certified EMDR clinician, and a board certified coach. My training and experience has prepared me to help clients with trauma, anxiety, addictions, depression, disordered eating, body image dissatisfaction, life's additions, My approach helps people recognize and change counterproductive patterns in their lives. relationship issues, life transitions, anxiety, and depression. I want to assist people to develop newer, healthier patterns in their lives.
![Photo of Alison Cannon Yawitz, MEd, LPC, NCC, Licensed Professional Counselor](https://photos.psychologytoday.com/3c9eb849-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Alison Cannon Yawitz
Licensed Professional Counselor, MEd, LPC, NCC
Verified Verified
Ladue, MO 63124
Waitlist for new clients
I provides comprehensive therapeutic services for individuals, teens and families who are faced with obstacles to healthy living. My practice is born from extensive experience with at-risk teens and families, and with individuals seeking to overcome challenges to fulfilling and healthy lives. Therapy is built upon the principle of partnership - with safety, compassion, acceptance and respect at the core. Clients rediscover their inborn strength, confidence, courage and resilience while being supported to develop new skills, shape healthy relationships, heal trauma and begin living the lives they've envisioned for themselves.
I provides comprehensive therapeutic services for individuals, teens and families who are faced with obstacles to healthy living. My practice is born from extensive experience with at-risk teens and families, and with individuals seeking to overcome challenges to fulfilling and healthy lives. Therapy is built upon the principle of partnership - with safety, compassion, acceptance and respect at the core. Clients rediscover their inborn strength, confidence, courage and resilience while being supported to develop new skills, shape healthy relationships, heal trauma and begin living the lives they've envisioned for themselves.
![Photo of Holly Pfisterer Strelow, LPC, NCC, MEd, Licensed Professional Counselor](https://photos.psychologytoday.com/3db55f92-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Holly Pfisterer Strelow
Licensed Professional Counselor, LPC, NCC, MEd
Verified Verified
2 Endorsed
Ladue, MO 63124
About a decade ago I attended a conference at the Omega Institute and was reawakened to the immense suffering in the world and I realized there was no more time to waste. I needed to change careers in order to be of service. All of my life I wanted to be a healer and pursued a Masters degree in Clinical Mental Health. My approach is mindful, practical, respectful and always hopeful. I believe each of us holds the key to our own healing within our highest sense of Self. My role is to help support that discovery process through thoughtful exploration, creativity and a little humor.
About a decade ago I attended a conference at the Omega Institute and was reawakened to the immense suffering in the world and I realized there was no more time to waste. I needed to change careers in order to be of service. All of my life I wanted to be a healer and pursued a Masters degree in Clinical Mental Health. My approach is mindful, practical, respectful and always hopeful. I believe each of us holds the key to our own healing within our highest sense of Self. My role is to help support that discovery process through thoughtful exploration, creativity and a little humor.
![Photo of Shannon Gartland, MA, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/0df650ef-353b-4d97-b547-819e465b103d/2/320x400.jpeg)
Shannon Gartland
Licensed Professional Counselor, MA, LPC
Verified Verified
2 Endorsed
Ladue, MO 63124
I am a licensed professional counselor who works from a client-centered approach. My goal is to provide a warm and compassionate environment where you can feel safe to share and process your experiences. I think of counseling as a place to gain greater insight and self-awareness around core beliefs. I will work with you to identify patterns of maladaptive coping and learn healthier ways to cope with life's challenges.
I am a licensed professional counselor who works from a client-centered approach. My goal is to provide a warm and compassionate environment where you can feel safe to share and process your experiences. I think of counseling as a place to gain greater insight and self-awareness around core beliefs. I will work with you to identify patterns of maladaptive coping and learn healthier ways to cope with life's challenges.
![Photo of Emily Hartman, MA, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/53e4cccc-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
I treat individuals, couples and families with a variety of struggles. Whether you are in need of help navigating present relationships, life transitions, or are struggling with lifelong issues, my education and experience can help you achieve your goals. I use a variety of approaches throughout the therapeutic process to meet the needs of the clients I see as they progress and work towards leading a happier, healthier life. My experience and training can help you grow and create the change for which you are looking.
I treat individuals, couples and families with a variety of struggles. Whether you are in need of help navigating present relationships, life transitions, or are struggling with lifelong issues, my education and experience can help you achieve your goals. I use a variety of approaches throughout the therapeutic process to meet the needs of the clients I see as they progress and work towards leading a happier, healthier life. My experience and training can help you grow and create the change for which you are looking.
![Photo of Danielle Endejan, MA, NCC, PLPC, CRAADC, Licensed Professional Counselor](https://photos.psychologytoday.com/fccf1998-cb3a-4d7a-afd3-de26d72e8087/2/320x400.jpeg)
Danielle Endejan
Licensed Professional Counselor, MA, NCC, PLPC, CRAADC
Verified Verified
1 Endorsed
Ladue, MO 63124
I look forward to meeting you! I was born and raised in St. Louis, & obtained my undergraduate degree with honors in Counseling and Education followed by a Master of Arts in Counseling for Licensure in Professional Counseling from MBU. I utilize empirically proven interventions (such as Motivational Interviewing, CBT, DBT) interwoven with compassionate wisdom for the therapeutic goal of coming alongside you in your unique journey and extending the opportunity and hope for healing & growth through the situation you find yourself in. My desire is to provide an authentic and compassionate environment that fosters continuous healing.
I look forward to meeting you! I was born and raised in St. Louis, & obtained my undergraduate degree with honors in Counseling and Education followed by a Master of Arts in Counseling for Licensure in Professional Counseling from MBU. I utilize empirically proven interventions (such as Motivational Interviewing, CBT, DBT) interwoven with compassionate wisdom for the therapeutic goal of coming alongside you in your unique journey and extending the opportunity and hope for healing & growth through the situation you find yourself in. My desire is to provide an authentic and compassionate environment that fosters continuous healing.
![Photo of Angie Casey, MA, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/5cfd7157-0971-4f29-af36-ad4531fee465/1/320x400.jpeg)
Welcome! I offer counseling services for children and adolescents who are struggling with emotional regulation, anxious thoughts, peer relationships, depression, school related issues, and/or self-esteem in a compassionate and safe environment. Working with kiddos is my specialty and passion! I am a former teacher with a Bachelors degree in Early Childhood Education (birth-3rd grade) and now a counselor with a Masters in Counseling.
Welcome! I offer counseling services for children and adolescents who are struggling with emotional regulation, anxious thoughts, peer relationships, depression, school related issues, and/or self-esteem in a compassionate and safe environment. Working with kiddos is my specialty and passion! I am a former teacher with a Bachelors degree in Early Childhood Education (birth-3rd grade) and now a counselor with a Masters in Counseling.
![Photo of Patricia Ann Heiser - Heiser Counseling and Healing Arts, ATR, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/41c9b62d-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
Heiser Counseling and Healing Arts
Licensed Professional Counselor, ATR, LPC
Verified Verified
1 Endorsed
Ladue, MO 63124
I enjoy helping people increase self-awareness, heal and improve their life and relationships. I use a variety of approaches, including client centered, strength based, focused on goals set by each client. I work with Individuals, Couples using EMDR, Intimacy from the Inside-Out, dealing with PTSD, trauma, anxiety, attachments issues, relationships, addictions, and mortality. I enjoy working with individuals, partners, couples and families. I believe in the power of focused healing, increased awareness, compassion, hope and love.
I enjoy helping people increase self-awareness, heal and improve their life and relationships. I use a variety of approaches, including client centered, strength based, focused on goals set by each client. I work with Individuals, Couples using EMDR, Intimacy from the Inside-Out, dealing with PTSD, trauma, anxiety, attachments issues, relationships, addictions, and mortality. I enjoy working with individuals, partners, couples and families. I believe in the power of focused healing, increased awareness, compassion, hope and love.
![Photo of Cristina Marie Smugala, MA, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/bf466f05-3b04-46d8-99eb-72dd36ac744f/2/320x400.jpeg)
Cristina Marie Smugala
Licensed Professional Counselor, MA, LPC
Verified Verified
3 Endorsed
Ladue, MO 63124 (Online Only)
My passion is to empathetically guide and support transformation of traumatic experience. I will empower you to face your fears, unburden toxic shame, heal traumatic wounds and help you reclaim the courage that you know is inside of you. The ability to have love, compassion and acceptance for yourself are powerful healing forces that I strive to ignite, recover and unlock in my clients. Through EMDR and Somatic Experiencing I focus on restoring a sense of calm, centered connectedness within the brain and body. I work to inspire courage, promote healing so you can embody radical acceptance, release fear and embrace authenticity.
My passion is to empathetically guide and support transformation of traumatic experience. I will empower you to face your fears, unburden toxic shame, heal traumatic wounds and help you reclaim the courage that you know is inside of you. The ability to have love, compassion and acceptance for yourself are powerful healing forces that I strive to ignite, recover and unlock in my clients. Through EMDR and Somatic Experiencing I focus on restoring a sense of calm, centered connectedness within the brain and body. I work to inspire courage, promote healing so you can embody radical acceptance, release fear and embrace authenticity.
![Photo of Dr. Denise LaBarge, PhD, LMFT, LPC, NCC, RN, Marriage & Family Therapist](https://photos.psychologytoday.com/3fea0004-46cd-11ea-a6ad-06142c356176/1/320x400.jpeg)
Dr. Denise LaBarge
Marriage & Family Therapist, PhD, LMFT, LPC, NCC, RN
Verified Verified
1 Endorsed
Ladue, MO 63124
Do you need a safe place to talk about difficult issues? There are countless benefits of therapy, however most people do not realize it, even when struggling with difficult problems or decisions. They often go weeks, months, even years carrying their burden alone. Well you are NOT alone! I am a Licensed Marriage and Family Therapist, Professional Counselor, and Registered Nurse with certificates in Divorce and Family Mediation and Medical Family Therapy.
Do you need a safe place to talk about difficult issues? There are countless benefits of therapy, however most people do not realize it, even when struggling with difficult problems or decisions. They often go weeks, months, even years carrying their burden alone. Well you are NOT alone! I am a Licensed Marriage and Family Therapist, Professional Counselor, and Registered Nurse with certificates in Divorce and Family Mediation and Medical Family Therapy.
See more therapy options for Ladue
Nearby Attachment-based Therapists Searches for Ladue
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- Kirkwood
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- Maryland Heights
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Attachment-based Therapists
Is attachment-based therapy the same as attachment therapy?
Attachment-based therapy may be confused with what is called “attachment therapy” (sometimes called “holding therapy”), a discredited and dangerous approach to treating children with attachment disorders, autism, or other mental health concerns. Attachment therapy—not attachment-based therapy—may involve restraining a child, forcing eye contact, and other coercive or abusive techniques. None of these practices are used in attachment-based therapy and the two modalities are in no way related.
What should I expect from attachment-based therapy?
Attachment-based therapy is based on attachment theory, which posits that children’s early relationships with their caregivers strongly influence their ability to navigate the world later in life. Thus, adults who seek attachment-based therapy should expect to deeply explore their childhood, identifying the dynamics or experiences that disrupted their attachment and the steps necessary to overcome challenges that arose as a result. Parents and children should expect to explore the possible factors that disrupted the parent-child relationship and work toward restoring trust and connection.
How long does attachment-based therapy last?
Certain forms of attachment-based therapy, especially those designed for parents and children, last for a set number of sessions; for example, Attachment and Biobehavioral Catch-Up, a specific attachment-based approach for young children who have undergone early adversity, unfolds over 10 one-hour sessions. When attachment-based therapy is practiced on adults or combined with other modalities, it may not last a specific length of time; clients may wish to ask prospective therapists how long they expect treatment to take.
Does attachment-based therapy work?
Most of the research on attachment-based therapy focuses on children and adolescents. Some of this research shows a positive effect, especially for attachment-based family therapy (ABFT). Other studies, however, have found that attachment-based therapy is no more effective than other approaches to childhood depression, anxiety, or suicidality. Less is known about the therapy’s efficacy on adult populations.