Dialectical Behavior (DBT) Therapists in Columbus, OH
Hold Space Counseling
Clinical Social Work/Therapist, LISW-S, LPCC-S
Verified Verified
6 Endorsed
Columbus, OH 43235 (Online Only)
Our therapists are trained in different modalities including CBT, ACT, DBT, EMDR, and more.
We enjoy working with clients who are open to understanding how adverse life experiences negatively impact thoughts, feelings, and behaviors and are ready to do the work of exploring these connections in therapy. We strive to build relationships with our clients based on the foundations of curiosity and empathy in a collaborative setting that is goal-oriented and relaxed, where their true self can be seen and feel accepted. Our overarching hope for clients is that through therapy they would believe they have inherent worth and value as human beings, apart from what they do, have, or what other people think and say about them.
Our therapists are trained in different modalities including CBT, ACT, DBT, EMDR, and more.
We enjoy working with clients who are open to understanding how adverse life experiences negatively impact thoughts, feelings, and behaviors and are ready to do the work of exploring these connections in therapy. We strive to build relationships with our clients based on the foundations of curiosity and empathy in a collaborative setting that is goal-oriented and relaxed, where their true self can be seen and feel accepted. Our overarching hope for clients is that through therapy they would believe they have inherent worth and value as human beings, apart from what they do, have, or what other people think and say about them.
It all starts with a therapeutic connection, but I have been trained and will use CBT, DBT and EMDR.
Are you having a hard time coping with life? Are you overwhelmed? Do you want to have inner peace? I can help you. I come into session as your equal who's only goal is helping you become your best self. I begin by establishing a trusting, honest, sincere and genuine therapeutic relationship. I will destruct the issues that you are experiencing by using integrative theoretical techniques that are personalized for your individual needs. I am constantly analyzing your puzzle pieces so that connections can be made to establish awareness that will ultimately lead to healing. I will help you recognize that you are worth the fight!
It all starts with a therapeutic connection, but I have been trained and will use CBT, DBT and EMDR.
Are you having a hard time coping with life? Are you overwhelmed? Do you want to have inner peace? I can help you. I come into session as your equal who's only goal is helping you become your best self. I begin by establishing a trusting, honest, sincere and genuine therapeutic relationship. I will destruct the issues that you are experiencing by using integrative theoretical techniques that are personalized for your individual needs. I am constantly analyzing your puzzle pieces so that connections can be made to establish awareness that will ultimately lead to healing. I will help you recognize that you are worth the fight!
Tiffany D Hayes
Clinical Social Work/Therapist, MSW, LISW-S
Verified Verified
1 Endorsed
Columbus, OH 43235
Waitlist for new clients
I consider myself an eclectic therapist who uses a multitude of therapies to create the best fit for each client. Including but not limited to EMDR, IFS informed EMDR, DBT, CBT, solution focused and somatic therapy. I am trauma focused and I believe that no trauma is too small. My goal is to help each of my clients work through their traumas, embrace their strengths and become an empowered and confident person. I do have a therapy dog in training named Mollie.
I consider myself an eclectic therapist who uses a multitude of therapies to create the best fit for each client. Including but not limited to EMDR, IFS informed EMDR, DBT, CBT, solution focused and somatic therapy. I am trauma focused and I believe that no trauma is too small. My goal is to help each of my clients work through their traumas, embrace their strengths and become an empowered and confident person. I do have a therapy dog in training named Mollie.
I.M. Legacy Counseling & Consultation Services
Clinical Social Work/Therapist, LISW-S, LCSW
Verified Verified
Columbus, OH 43215 (Online Only)
Vaya has expertise in EMDR and DBT to recover from traumatic memories and manage intense emotions.
Are you haunted by your past? Experiencing feelings of anxiety, too many sleepless nights, or torturing yourself with guilt? Stop suffering in silence. It's time to heal! I am Vaya Fraley, aka "The Well-Abled Therapist", Co-founder of I.M. Legacy Counseling & Consultation Services, and Licensed Independent Social Worker Supervisor (LISW-S) in Ohio and Licensed Clinical Social Worker (LCSW) in Georgia. I specialize in serving Black women with visible disabilities/chronic illness who struggle with emotional trauma, depression, and anxiety.
Vaya has expertise in EMDR and DBT to recover from traumatic memories and manage intense emotions.
Are you haunted by your past? Experiencing feelings of anxiety, too many sleepless nights, or torturing yourself with guilt? Stop suffering in silence. It's time to heal! I am Vaya Fraley, aka "The Well-Abled Therapist", Co-founder of I.M. Legacy Counseling & Consultation Services, and Licensed Independent Social Worker Supervisor (LISW-S) in Ohio and Licensed Clinical Social Worker (LCSW) in Georgia. I specialize in serving Black women with visible disabilities/chronic illness who struggle with emotional trauma, depression, and anxiety.
I take an eclectic, client-focused approach to therapy and use CBT, DBT, mindfulness, and acceptance and commitment strategies, as well trauma-focused therapy such as EMDR.
I help clients learn to effectively manage life challenges and build emotional resilience through improved coping, communication and relationship skills. I am also a certified food and eating wellness coach, and can help clients address some of the nutritional underpinnings of mood issues, including anger, anxiety and depression. I work with clients who experience anxiety, depression, OCD, PTSD, bipolar disorder, substance abuse, behavioral addiction, and disordered eating, as well those who have experienced grief, co-dependency, low self-esteem, physical/ emotional abuse and family of origin dysfunction.
I take an eclectic, client-focused approach to therapy and use CBT, DBT, mindfulness, and acceptance and commitment strategies, as well trauma-focused therapy such as EMDR.
I help clients learn to effectively manage life challenges and build emotional resilience through improved coping, communication and relationship skills. I am also a certified food and eating wellness coach, and can help clients address some of the nutritional underpinnings of mood issues, including anger, anxiety and depression. I work with clients who experience anxiety, depression, OCD, PTSD, bipolar disorder, substance abuse, behavioral addiction, and disordered eating, as well those who have experienced grief, co-dependency, low self-esteem, physical/ emotional abuse and family of origin dysfunction.
Emily King
Licensed Professional Clinical Counselor, MSEd, LPCC
Verified Verified
Columbus, OH 43219
I draw heavily from Cognitive Behavior Therapy (CBT), Dialectical Behavior Therapy ( DBT), Narrative Therapy and Feminist Therapy; however, I also believe that the therapeutic relationship we develop will likely be the most healing aspect of counseling.
"There is no greater agony than bearing an untold story inside you." --Maya Angelou. Suffering is often silent. We hold back our sadness, loneliness, resentment & shame. We think that pushing these feelings aside will allow us to live the life we desire. Yet, if you find yourself unable to move forward, I would be honored to sit alongside you as you process your story. Your pain. Your joy. Your sorrow, self-doubt and hatred. It is my goal that through my nonjudgmental ear you feel seen, heard, accepted & cared for. It is in this space that we can overcome the hardships of your past or future, & embrace the light that is within you.
I draw heavily from Cognitive Behavior Therapy (CBT), Dialectical Behavior Therapy ( DBT), Narrative Therapy and Feminist Therapy; however, I also believe that the therapeutic relationship we develop will likely be the most healing aspect of counseling.
"There is no greater agony than bearing an untold story inside you." --Maya Angelou. Suffering is often silent. We hold back our sadness, loneliness, resentment & shame. We think that pushing these feelings aside will allow us to live the life we desire. Yet, if you find yourself unable to move forward, I would be honored to sit alongside you as you process your story. Your pain. Your joy. Your sorrow, self-doubt and hatred. It is my goal that through my nonjudgmental ear you feel seen, heard, accepted & cared for. It is in this space that we can overcome the hardships of your past or future, & embrace the light that is within you.
Olivia utilizes a trauma-informed framework with her clients as well as Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Internal Family System's, and Motivational Interviewing.
Olivia Scirocco (she/her) is a Licensed Social Worker. She graduated from The Ohio State University with an undergraduate degree in psychology and a master’s degree in social work. Olivia has experience working with children, adolescents, and young adults in outpatient, inpatient, and community-based settings.
Olivia utilizes a trauma-informed framework with her clients as well as Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Internal Family System's, and Motivational Interviewing.
Olivia Scirocco (she/her) is a Licensed Social Worker. She graduated from The Ohio State University with an undergraduate degree in psychology and a master’s degree in social work. Olivia has experience working with children, adolescents, and young adults in outpatient, inpatient, and community-based settings.
Emily Getschman
Clinical Social Work/Therapist, MSW, LISW-S
Verified Verified
Columbus, OH 43220
Waitlist for new clients
I am trained in several evidence based treatments including Dialectical Behavioral Therapy, Cognitive Behavioral Therapy, Trauma Focused CBT and Motivational Interviewing.
I am a Licensed Independent Social Worker Supervisor through the State of Ohio Counselor and Social Work Board. I have over 10+ years of experience working with children, adolescents and families in a variety of settings (including the school setting and psychiatric hospital setting). I work with children and adolescents ages 10-21 and treat a range of concerns including: anxiety, depression, behavioral concerns, parenting challenges, school concerns and mood disorders. Whatever the presenting problem, I place a strong emphasis on family focused treatment and use a collaborative approach to every client.
I am trained in several evidence based treatments including Dialectical Behavioral Therapy, Cognitive Behavioral Therapy, Trauma Focused CBT and Motivational Interviewing.
I am a Licensed Independent Social Worker Supervisor through the State of Ohio Counselor and Social Work Board. I have over 10+ years of experience working with children, adolescents and families in a variety of settings (including the school setting and psychiatric hospital setting). I work with children and adolescents ages 10-21 and treat a range of concerns including: anxiety, depression, behavioral concerns, parenting challenges, school concerns and mood disorders. Whatever the presenting problem, I place a strong emphasis on family focused treatment and use a collaborative approach to every client.
I received intensive training in comprehensive Dialectical Behavior Therapy ( DBT) through Behavioral Tech and specialized in working with adolescents, young adults, and adults with emotion dysregulation, trauma, depression, anxiety, and eating disorders.
I work with adults using Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy ( DBT) to treat a wide range of eating-related concerns, as well as anxiety, depression, and associated conditions. I also provide Cognitive Processing Therapy (CPT) for adults seeking trauma therapy, and I provide couples therapy using Integrative Behavioral Couple Therapy (IBCT).
I received intensive training in comprehensive Dialectical Behavior Therapy ( DBT) through Behavioral Tech and specialized in working with adolescents, young adults, and adults with emotion dysregulation, trauma, depression, anxiety, and eating disorders.
I work with adults using Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy ( DBT) to treat a wide range of eating-related concerns, as well as anxiety, depression, and associated conditions. I also provide Cognitive Processing Therapy (CPT) for adults seeking trauma therapy, and I provide couples therapy using Integrative Behavioral Couple Therapy (IBCT).
Charity Harrison
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Columbus, OH 43215
Waitlist for new clients
She works from a collaborative, trauma and culture-informed approach, integrating a variety of theories and techniques such as: cognitive-processing, dialectical-behavioral, somatic therapy, acceptance & commitment therapy, and more.
Charity is passionately committed to assisting individuals, couples, and families on their journey towards greater self-awareness, restorative care, and holistic wellness. Her goal is to help clients better understand their everyday lived experiences, how they have shaped their health, well-being, and relationship with self and others. Additionally, live a life that aligns with their truest self, values, and goals. It is her hope, together with clients, therapy can become a safe space where you can share your story, heal, and feel empowered as you make positive changes.
She works from a collaborative, trauma and culture-informed approach, integrating a variety of theories and techniques such as: cognitive-processing, dialectical-behavioral, somatic therapy, acceptance & commitment therapy, and more.
Charity is passionately committed to assisting individuals, couples, and families on their journey towards greater self-awareness, restorative care, and holistic wellness. Her goal is to help clients better understand their everyday lived experiences, how they have shaped their health, well-being, and relationship with self and others. Additionally, live a life that aligns with their truest self, values, and goals. It is her hope, together with clients, therapy can become a safe space where you can share your story, heal, and feel empowered as you make positive changes.
Alexandra Gilbert
Clinical Social Work/Therapist, LISW-S, MSW
Verified Verified
1 Endorsed
Columbus, OH 43235
I use evidence-based treatments of Cognitive Behavioral Therapy (CBT) including Trauma-Focused (TF-CBT), Dialectical behavior therapy ( DBT) and Acceptance and Commitment Therapy (ACT).
Therapy can be a comfortable place to unpack life’s “uncomfortable” moments. I believe therapy is collaborative and that a relaxed, honest and, at times humorous, communication style is important to creating an authentic environment. Personal growth best happens in a compassionate and supportive atmosphere. I am a licensed independent social worker who specializes in treating children, adults and families who seek a greater understanding of how their behaviors and emotions are connected to their life experiences. I can help you discover how your own natural strengths can be used to foster resilience and independence.
I use evidence-based treatments of Cognitive Behavioral Therapy (CBT) including Trauma-Focused (TF-CBT), Dialectical behavior therapy ( DBT) and Acceptance and Commitment Therapy (ACT).
Therapy can be a comfortable place to unpack life’s “uncomfortable” moments. I believe therapy is collaborative and that a relaxed, honest and, at times humorous, communication style is important to creating an authentic environment. Personal growth best happens in a compassionate and supportive atmosphere. I am a licensed independent social worker who specializes in treating children, adults and families who seek a greater understanding of how their behaviors and emotions are connected to their life experiences. I can help you discover how your own natural strengths can be used to foster resilience and independence.
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We specialize in CBT, DBT skills, and CFT.
Charlie Health is a leading provider of virtual mental health treatment for people in need of more than once-weekly therapy. Whether you're struggling with anxiety, depression, trauma, self-harm, suicidal ideation, or any ongoing mental health issue, Charlie Health’s Clinical Team is ready to help you start your healing journey today. You don’t have to struggle alone – we’re here for you. To get started today, reach out at t.ly/ch-oh
We specialize in CBT, DBT skills, and CFT.
Charlie Health is a leading provider of virtual mental health treatment for people in need of more than once-weekly therapy. Whether you're struggling with anxiety, depression, trauma, self-harm, suicidal ideation, or any ongoing mental health issue, Charlie Health’s Clinical Team is ready to help you start your healing journey today. You don’t have to struggle alone – we’re here for you. To get started today, reach out at t.ly/ch-oh
Emily Hunter
Licensed Social Worker, MSW, LSW
Verified Verified
Columbus, OH 43212
Waitlist for new clients
My approach is informed by mindfulness, acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), dialectical behavior therapy ( DBT), motivational interviewing, attachment-focused therapy, schema-therapy, and internal family systems (IFS).
I work with clients of all ages, however, I have a special interest in working with teens and young adults. I support clients navigating a variety of needs including grief, PTSD, trauma, attachment wounds, relationship challenges, life transitions, women's issues, anxiety, and depression. I am dedicated to walking with my clients in their healing, and emphasize creating a non-judgmental, collaborative space.
My approach is informed by mindfulness, acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), dialectical behavior therapy ( DBT), motivational interviewing, attachment-focused therapy, schema-therapy, and internal family systems (IFS).
I work with clients of all ages, however, I have a special interest in working with teens and young adults. I support clients navigating a variety of needs including grief, PTSD, trauma, attachment wounds, relationship challenges, life transitions, women's issues, anxiety, and depression. I am dedicated to walking with my clients in their healing, and emphasize creating a non-judgmental, collaborative space.
I have experience in using a variety of therapeutic interventions for individual and group counseling including Cognitive Behavioral Therapy, Trauma Focused Cognitive Behavioral Therapy, and Dialectical Behavior Therapy.
I am a licensed clinical counselor with a Bachelor's degree in Psychology and Sociology from Miami University and a Master’s degree from the University of Dayton. I have worked with children, adolescents, adults and families in a variety of mental health settings and levels of care. Generally, my clients have been working on behavioral and mental challenges related to anxiety, depression, eating disorders, complex trauma, grief and loss, interpersonal relationship concerns, and difficulty with functioning in everyday life.
I have experience in using a variety of therapeutic interventions for individual and group counseling including Cognitive Behavioral Therapy, Trauma Focused Cognitive Behavioral Therapy, and Dialectical Behavior Therapy.
I am a licensed clinical counselor with a Bachelor's degree in Psychology and Sociology from Miami University and a Master’s degree from the University of Dayton. I have worked with children, adolescents, adults and families in a variety of mental health settings and levels of care. Generally, my clients have been working on behavioral and mental challenges related to anxiety, depression, eating disorders, complex trauma, grief and loss, interpersonal relationship concerns, and difficulty with functioning in everyday life.
Starks Counseling & Consultation Services, LLC
Clinical Social Work/Therapist, LISW-S
Verified Verified
Columbus, OH 43215
She is a trained TF-CBT, CBT, and DBT therapist.
Stephanie K. Starks, LISW-S, is a therapist and owner of Starks Counseling & Consultation Services, LLC . She 20 years of experience providing trauma-focused therapy. The goal at Starks Counseling is to provide “hope and healing” in a calm, supportive, and non-judgmental therapeutic environment. She and her staff do this by empowering their clients with the knowledge, skills and confidence to be active participants in their own healing, as they believe that they are all simply vessels in which to help facilitate the healing process.
She is a trained TF-CBT, CBT, and DBT therapist.
Stephanie K. Starks, LISW-S, is a therapist and owner of Starks Counseling & Consultation Services, LLC . She 20 years of experience providing trauma-focused therapy. The goal at Starks Counseling is to provide “hope and healing” in a calm, supportive, and non-judgmental therapeutic environment. She and her staff do this by empowering their clients with the knowledge, skills and confidence to be active participants in their own healing, as they believe that they are all simply vessels in which to help facilitate the healing process.
The antidote is empathy and compassion for the struggle they are experiencing and learning strategies such as DBT and CBT to begin to make lasting changing in life.
I have been in practice for nearly 20 years. Many clients come to see me because they feel stuck. I hear "what's the point? why am I here? what's my purpose? " I create the conditions where clients can be seen, understood and reflect on how they want to show up in their life. We explore feelings of loneliness, interpersonal detachment and how to deepen the connections with ourselves and others. I specialize in providing confidential, safe and effective Individual and Group counseling services for a wide range of human struggles including grief and loss, depression, anxiety, life transitions, family of origin issues and addiction.
The antidote is empathy and compassion for the struggle they are experiencing and learning strategies such as DBT and CBT to begin to make lasting changing in life.
I have been in practice for nearly 20 years. Many clients come to see me because they feel stuck. I hear "what's the point? why am I here? what's my purpose? " I create the conditions where clients can be seen, understood and reflect on how they want to show up in their life. We explore feelings of loneliness, interpersonal detachment and how to deepen the connections with ourselves and others. I specialize in providing confidential, safe and effective Individual and Group counseling services for a wide range of human struggles including grief and loss, depression, anxiety, life transitions, family of origin issues and addiction.
Her core modalities include cognitive behavioral therapy, dialectical behavior therapy, strength-based therapy, and child-centered therapy.
Amy Jacobs is a Licensed Independent Social Worker with 20 years of experience in mental health, largely working with children/teens who need a higher level of support as well as those with intellectual disabilities, communication differences, and neurotypical clients with emotional/mental health concerns. As a neurodivergent-affirming and trauma-informed clinician, Amy has a passion for working with neurodivergent individuals who are often underserved in the mental health system. Amy's specialties include symptom/behavior management, coping skills, social skills, depression, anxiety, emotion regulation, grief and loss, and trauma.
Her core modalities include cognitive behavioral therapy, dialectical behavior therapy, strength-based therapy, and child-centered therapy.
Amy Jacobs is a Licensed Independent Social Worker with 20 years of experience in mental health, largely working with children/teens who need a higher level of support as well as those with intellectual disabilities, communication differences, and neurotypical clients with emotional/mental health concerns. As a neurodivergent-affirming and trauma-informed clinician, Amy has a passion for working with neurodivergent individuals who are often underserved in the mental health system. Amy's specialties include symptom/behavior management, coping skills, social skills, depression, anxiety, emotion regulation, grief and loss, and trauma.
Jonathan Miller
Counselor, EdM, LPCC-S
Verified Verified
2 Endorsed
Columbus, OH 43219 (Online Only)
I'm trained in therapies backed by years of research, such as Cognitive-Behavioral Therapy, Dialectical Behavioral Therapy and EMDR.
Cheer up? Relax? Put the past in the past? If it's easier said than done, you don't have to do it alone. I welcome people whose emotions sometimes seem stronger than they are. With over twenty-five years of experience in private practice and community mental health, I've helped people face the hardest life has to offer.
I'm trained in therapies backed by years of research, such as Cognitive-Behavioral Therapy, Dialectical Behavioral Therapy and EMDR.
Cheer up? Relax? Put the past in the past? If it's easier said than done, you don't have to do it alone. I welcome people whose emotions sometimes seem stronger than they are. With over twenty-five years of experience in private practice and community mental health, I've helped people face the hardest life has to offer.
I use evidence-based approaches (CBT and DBT-informed) to help those who struggle with behavioral health concerns.
I work primarily with young adults and adults who struggle with eating disorders of all types, but I also have extensive training to treat and support the often co-occurring disorders that can accompany eating disorders, such as anxiety, depression, and past trauma. My clinical work and years of experience have shaped my therapeutic practice in a way that attends to the entire continuum of my patient’s care. From the initial meeting, to the celebration that successful termination brings, I work hard to foster trust and learning as we navigate eating disorder recovery together.
I use evidence-based approaches (CBT and DBT-informed) to help those who struggle with behavioral health concerns.
I work primarily with young adults and adults who struggle with eating disorders of all types, but I also have extensive training to treat and support the often co-occurring disorders that can accompany eating disorders, such as anxiety, depression, and past trauma. My clinical work and years of experience have shaped my therapeutic practice in a way that attends to the entire continuum of my patient’s care. From the initial meeting, to the celebration that successful termination brings, I work hard to foster trust and learning as we navigate eating disorder recovery together.
A licensed clinical counselor for 20+ years, I create an accepting welcoming safe environment for you to explore your needs and work through challenges related to life transition, loss, grief and trauma. LGBTIA+ affirming and culturally aware, I use Cognitive Behavioral, Humanistic and Psychodynamic approaches to therapy and have been trained in DBT and EMDR. I have assisted patients with all depressive and anxiety diagnoses and employ Exposure Response Prevention for those with OCD issues. You are the expert on yourself and your needs, so I join with you to create your individualized journey of self-discovery and healing.
A licensed clinical counselor for 20+ years, I create an accepting welcoming safe environment for you to explore your needs and work through challenges related to life transition, loss, grief and trauma. LGBTIA+ affirming and culturally aware, I use Cognitive Behavioral, Humanistic and Psychodynamic approaches to therapy and have been trained in DBT and EMDR. I have assisted patients with all depressive and anxiety diagnoses and employ Exposure Response Prevention for those with OCD issues. You are the expert on yourself and your needs, so I join with you to create your individualized journey of self-discovery and healing.
See more therapy options for Columbus
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- Bexley
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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.