Obsessive-Compulsive (OCD) Therapists in Devon, PA

Photo of Lauren Merclean, MA, LCSW, Clinical Social Work/Therapist
Lauren Merclean
Clinical Social Work/Therapist, MA, LCSW
Verified Verified
3 Endorsed
Devon, PA 19333
I am a LCSW who specializes in treatment of mood and anxiety disorders for adults. I have a special interest and expertise in the treatment of Obsessive Compulsive Disorder and have significant experience with Exposure and Response Prevention and Dialectal Behavior Therapy Skills Training. I have worked with individuals who struggle with a variety of behavioral health issues to include but not limited to OCD, Anxiety Disorders, and Depressive Disorders. I have completed the Behavior Therapy Training Institute (BTTI) by the International OCD Foundation, an advanced training in the treatment of OCD.
I am a LCSW who specializes in treatment of mood and anxiety disorders for adults. I have a special interest and expertise in the treatment of Obsessive Compulsive Disorder and have significant experience with Exposure and Response Prevention and Dialectal Behavior Therapy Skills Training. I have worked with individuals who struggle with a variety of behavioral health issues to include but not limited to OCD, Anxiety Disorders, and Depressive Disorders. I have completed the Behavior Therapy Training Institute (BTTI) by the International OCD Foundation, an advanced training in the treatment of OCD.
(484) 321-6277 View (484) 321-6277
Photo of Dr. Ayesha Ludhani, PsyD, Psychologist
Dr. Ayesha Ludhani
Psychologist, PsyD
Verified Verified
Devon, PA 19333
As a parenting, anxiety and OCD expert, I'm here to help you find real relief.
Some days are so overwhelming it feels like you’re barely keeping it together. Balancing it all—work, family, and relationships—just feels too much to handle. You’re feeling directionless & defeated with no solution in sight. You keep telling yourself it shouldn’t be this hard, but thoughts like “Am I good enough?” or “This shouldn’t be happening to me” keep playing on a loop in your head. Life changes have only made things harder. You could be returning to work after maternity leave, starting a new job, or your kids are going to a new school—these transitions bring a whole new level of stress.
As a parenting, anxiety and OCD expert, I'm here to help you find real relief.
Some days are so overwhelming it feels like you’re barely keeping it together. Balancing it all—work, family, and relationships—just feels too much to handle. You’re feeling directionless & defeated with no solution in sight. You keep telling yourself it shouldn’t be this hard, but thoughts like “Am I good enough?” or “This shouldn’t be happening to me” keep playing on a loop in your head. Life changes have only made things harder. You could be returning to work after maternity leave, starting a new job, or your kids are going to a new school—these transitions bring a whole new level of stress.
(484) 623-5501 View (484) 623-5501
Photo of Michele Dietrich, LPC, Licensed Professional Counselor
Michele Dietrich
Licensed Professional Counselor, LPC
Verified Verified
Devon, PA 19333
Michele was raised in eastern Pennsylvania where she received both her Bachelor’s and Master’s degrees in psychology. She has held a Pennsylvania counseling license since 2002 and Michele is an Advanced ART Practitioner. She is the founder of Heart of the Matter LLC. Michele focuses on a broad range of treatment issues including PTSD, Trauma, Depression, Anxiety, OCD from preschool through adult clients. Also, Michele works with families to improve family dynamics and relationships.
Michele was raised in eastern Pennsylvania where she received both her Bachelor’s and Master’s degrees in psychology. She has held a Pennsylvania counseling license since 2002 and Michele is an Advanced ART Practitioner. She is the founder of Heart of the Matter LLC. Michele focuses on a broad range of treatment issues including PTSD, Trauma, Depression, Anxiety, OCD from preschool through adult clients. Also, Michele works with families to improve family dynamics and relationships.
(484) 427-2936 View (484) 427-2936
Photo of Nicole Watts, MA, LPC, NCC, Licensed Professional Counselor
Nicole Watts
Licensed Professional Counselor, MA, LPC, NCC
Verified Verified
Devon, PA 19333  (Online Only)
Hi! I’m so happy you are here. I know how hard it can be to ask for help and begin the process of discovering the root issues that are affecting your wellbeing and mental health. We will work together to create lasting change, as well as healing, and growth. Let 2024 be the year you prioritize your mental health, and start living the life you want!
Hi! I’m so happy you are here. I know how hard it can be to ask for help and begin the process of discovering the root issues that are affecting your wellbeing and mental health. We will work together to create lasting change, as well as healing, and growth. Let 2024 be the year you prioritize your mental health, and start living the life you want!
(610) 839-8968 View (610) 839-8968
Photo of Jesse Weiss-Zandfard, LCSW , BC-TMH, CCTP, CCATP, CSAM, Clinical Social Work/Therapist
Jesse Weiss-Zandfard
Clinical Social Work/Therapist, LCSW , BC-TMH, CCTP, CCATP, CSAM
Verified Verified
Devon, PA 19333  (Online Only)
Everyone possesses innate abilities and strengths that shape personal growth. Taking the first step to heal is courageous - striving for balance through self-discovery is the ultimate act of self-compassion. The heart of my practice is centered on how our experiences shape our brain, body and stress responses – how these emotional templates impact how we learn to cope with difficult emotions and their effect on our capacity to connect and realize our potential. I am passionate about helping adults, couples and adolescents develop skills that empower them to overcome obstacles, navigate life transitions and live a fulfilling life.
Everyone possesses innate abilities and strengths that shape personal growth. Taking the first step to heal is courageous - striving for balance through self-discovery is the ultimate act of self-compassion. The heart of my practice is centered on how our experiences shape our brain, body and stress responses – how these emotional templates impact how we learn to cope with difficult emotions and their effect on our capacity to connect and realize our potential. I am passionate about helping adults, couples and adolescents develop skills that empower them to overcome obstacles, navigate life transitions and live a fulfilling life.
(484) 214-2290 View (484) 214-2290
Photo of Paul Kesselman - Kesselman Clinical Associates, PsyD, Psychologist
Kesselman Clinical Associates
Psychologist, PsyD
Verified Verified
1 Endorsed
Devon, PA 19333
At Kesselman Clinical Associates, we are creating a community where you and your family can find understanding and support. We have clinicians who specialize in an array of areas, from anxiety, depression, and personality disorders to parenting and family issues, addiction, trauma, ADD/ADHD, ASD, and impulse control disorders. We provide individual treatment for children, teens, and adults, as well as group, couples, and family therapy, and we offer in-person or telehealth sessions.
At Kesselman Clinical Associates, we are creating a community where you and your family can find understanding and support. We have clinicians who specialize in an array of areas, from anxiety, depression, and personality disorders to parenting and family issues, addiction, trauma, ADD/ADHD, ASD, and impulse control disorders. We provide individual treatment for children, teens, and adults, as well as group, couples, and family therapy, and we offer in-person or telehealth sessions.
(610) 285-7366 View (610) 285-7366
Photo of Dr. Monica Buklan, PsyD, Psychologist
Dr. Monica Buklan
Psychologist, PsyD
Verified Verified
Devon, PA 19333
Adversity is a shared human experience. Sometimes even with your greatest efforts and supports, it feels that no matter what you do, you cannot seem to pass this roadblock in life. As a Licensed Psychologist, I help children, teens, and adults move past this impasse. My aim is to help you develop skills and strategies that you can carry with you throughout your journey. Whether you’re seeking help for you or your child, know that change is possible. While we do not get to choose our problems, we can choose how to respond to them.
Adversity is a shared human experience. Sometimes even with your greatest efforts and supports, it feels that no matter what you do, you cannot seem to pass this roadblock in life. As a Licensed Psychologist, I help children, teens, and adults move past this impasse. My aim is to help you develop skills and strategies that you can carry with you throughout your journey. Whether you’re seeking help for you or your child, know that change is possible. While we do not get to choose our problems, we can choose how to respond to them.
(267) 578-3440 View (267) 578-3440
Photo of Tracy Sciulli, MS, LPC, Licensed Professional Counselor
Tracy Sciulli
Licensed Professional Counselor, MS, LPC
Verified Verified
1 Endorsed
Devon, PA 19333
I encourage personal growth and support my clients through the joys and challenges of life. My expertise is in helping adolescents, adults, and parents build strategies that support their goals toward a more fulfilling life. I am a Licensed Professional Counselor specializing in anxiety, stress, and significant life transitions. I focus on the values of my clients to help them create a balance in our work together including educational tools, therapeutic skills, processing, and celebrating progress. Therapy takes courage and compassion to talk about the challenges and celebrate meaningful, positive changes.
I encourage personal growth and support my clients through the joys and challenges of life. My expertise is in helping adolescents, adults, and parents build strategies that support their goals toward a more fulfilling life. I am a Licensed Professional Counselor specializing in anxiety, stress, and significant life transitions. I focus on the values of my clients to help them create a balance in our work together including educational tools, therapeutic skills, processing, and celebrating progress. Therapy takes courage and compassion to talk about the challenges and celebrate meaningful, positive changes.
(610) 580-2747 View (610) 580-2747
Photo of John J. Novielli, MS, Psychologist
John J. Novielli
Psychologist, MS
Verified Verified
Devon, PA 19333
Have the life you want, not the one you live. Develop with your partner the relationship you always desired and stop living the one that keeps you stuck. I am a Clinical Psychologist with over thirty years of experience specializing in marital and family relationships and in dismantling the black holes that minimize our lives. Whatever your marital or family situation, my experience allows me to help you develop a plan of change (one or two sessions), and then implement this plan. I serve as your Psychologist and Coaching guide from the start.
Have the life you want, not the one you live. Develop with your partner the relationship you always desired and stop living the one that keeps you stuck. I am a Clinical Psychologist with over thirty years of experience specializing in marital and family relationships and in dismantling the black holes that minimize our lives. Whatever your marital or family situation, my experience allows me to help you develop a plan of change (one or two sessions), and then implement this plan. I serve as your Psychologist and Coaching guide from the start.
(484) 962-0938 View (484) 962-0938
Photo of Matthew Weldon Gelber, MS
Matthew Weldon Gelber
MS
Verified Verified
Devon, PA 19333
As a certified Master’s Level psychotherapist with over 19 years experience and “face of therapy and counseling” 2024 Main Line Today Magazine, I’m able to offer experience and understanding that gets to the heart of the issue for my clients.Are you unhappy, stressed or depressed at home? At Work? At School? Do you find yourself yet again in another relationship doomed for failure? Is Intimacy or trust or sex lacking in your relationship? I am a compassionate therapist who helps individuals, couples and families achieve favorable outcomes in different areas of their lives. My focus is specific to your needs and your goals.
As a certified Master’s Level psychotherapist with over 19 years experience and “face of therapy and counseling” 2024 Main Line Today Magazine, I’m able to offer experience and understanding that gets to the heart of the issue for my clients.Are you unhappy, stressed or depressed at home? At Work? At School? Do you find yourself yet again in another relationship doomed for failure? Is Intimacy or trust or sex lacking in your relationship? I am a compassionate therapist who helps individuals, couples and families achieve favorable outcomes in different areas of their lives. My focus is specific to your needs and your goals.
(610) 915-8047 View (610) 915-8047
Photo of Kristen Ott, MA, LMFT, Marriage & Family Therapist
Kristen Ott
Marriage & Family Therapist, MA, LMFT
Verified Verified
Devon, PA 19333
Waitlist for new clients
Life difficulties can propel us forward or they can leave us feeling stuck, anxious, angry and depressed. They can also take a toll on our interpersonal relationships. They can make us feel like our entire life is out of balance. I invite you to a safe environment where you can openly process difficult life experiences so that you can live a more fulfilling life with more meaningful relationships. I work with individuals, couples and families who have experienced trauma. I work from a core belief that our minds and body are interconnected. Past traumatic experiences get stored in our bodies and physical symptoms can manifest.
Life difficulties can propel us forward or they can leave us feeling stuck, anxious, angry and depressed. They can also take a toll on our interpersonal relationships. They can make us feel like our entire life is out of balance. I invite you to a safe environment where you can openly process difficult life experiences so that you can live a more fulfilling life with more meaningful relationships. I work with individuals, couples and families who have experienced trauma. I work from a core belief that our minds and body are interconnected. Past traumatic experiences get stored in our bodies and physical symptoms can manifest.
(215) 544-2966 View (215) 544-2966
Photo of William Morgan - Paoli Psychological Associates, PsyD, Psychologist
Paoli Psychological Associates
Psychologist, PsyD
Verified Verified
Devon, PA 19333
Paoli Psychological Associates is a group of mental health professionals dedicated to helping people develop the skills they need for life's challenges. Our counseling services offer personalized attention and an individualized approach to helping individuals, couples, and families overcome life's challenges, grow, and develop greater satisfaction and success. Our services include psychotherapy, counseling, testing, and psychological evaluation. We specialize in Cognitive Behavioral Therapy. Dr. Bill Morgan, director of PPA, is a licensed psychologist with over 20 years experience. Within our group we have a number of highly trained professionals covering a variety of specialties. We are committed to providing high quality services.
Paoli Psychological Associates is a group of mental health professionals dedicated to helping people develop the skills they need for life's challenges. Our counseling services offer personalized attention and an individualized approach to helping individuals, couples, and families overcome life's challenges, grow, and develop greater satisfaction and success. Our services include psychotherapy, counseling, testing, and psychological evaluation. We specialize in Cognitive Behavioral Therapy. Dr. Bill Morgan, director of PPA, is a licensed psychologist with over 20 years experience. Within our group we have a number of highly trained professionals covering a variety of specialties. We are committed to providing high quality services.
(610) 644-8182 View (610) 644-8182
Photo of Dr. Bill Morgan, PsyD, Psychologist
Dr. Bill Morgan
Psychologist, PsyD
Verified Verified
Devon, PA 19333
As a psychologist, counselor, and evaluator, I look at sessions as a collaborative process. Together we work towards making the changes my clients desire so that they experience more contentment, peace, satisfaction and success. I specialize in Cognitive Behavioral Therapy, an evidence-based approach that helps people learn skills that last a lifetime. I am a licensed psychologist with over twenty years experience as a counselor, therapist, and diagnostician, and am active in training therapists.
As a psychologist, counselor, and evaluator, I look at sessions as a collaborative process. Together we work towards making the changes my clients desire so that they experience more contentment, peace, satisfaction and success. I specialize in Cognitive Behavioral Therapy, an evidence-based approach that helps people learn skills that last a lifetime. I am a licensed psychologist with over twenty years experience as a counselor, therapist, and diagnostician, and am active in training therapists.
(610) 644-8182 View (610) 644-8182
Photo of Addie Smith, PsyD, Psychologist
Addie Smith
Psychologist, PsyD
Verified Verified
Devon, PA 19333
When our children hurt, we hurt. Teaching young children, adolescents and young adults coping skills that they will use for a lifetime is a wonderful gift for the entire family. Adult women experience a tremendous amount of stress. Habitual behaviors or ways of thinking that served us as children are often of no use and even harmful during adulthood. Feeling better requires challenging these old habits and creating new pathways to suit our current goals.
When our children hurt, we hurt. Teaching young children, adolescents and young adults coping skills that they will use for a lifetime is a wonderful gift for the entire family. Adult women experience a tremendous amount of stress. Habitual behaviors or ways of thinking that served us as children are often of no use and even harmful during adulthood. Feeling better requires challenging these old habits and creating new pathways to suit our current goals.
(610) 995-6667 View (610) 995-6667
Photo of Julie Benzaquen, PhD, Psychologist
Julie Benzaquen
Psychologist, PhD
Verified Verified
Devon, PA 19333
Dr. Julie Benzaquen is a licensed clinical psychologist with expertise working with children, adolescents, and families. She works diligently with her clients to establish a strong therapeutic alliance with all members of the family, collaborating with them to develop new coping strategies and create positive changes in mood and behavior.
Dr. Julie Benzaquen is a licensed clinical psychologist with expertise working with children, adolescents, and families. She works diligently with her clients to establish a strong therapeutic alliance with all members of the family, collaborating with them to develop new coping strategies and create positive changes in mood and behavior.
(484) 559-7224 View (484) 559-7224
Photo of Kristin Page, LPC, MSEd, NCC, Licensed Professional Counselor
Kristin Page
Licensed Professional Counselor, LPC, MSEd, NCC
Verified Verified
2 Endorsed
Devon, PA 19333
Whatever you are dealing with, you don't have to face it alone. At some point, in all of our lives, it can be very helpful to talk to someone. I am dedicated to helping you gain insight and develop tools to cultivate personal growth and relief from symptoms. We will work together and we will work holistically, meaning I consider the mind, body, and spirit in a safe, compassionate, curious, and healing environment to understand yourself better and begin to feel connected, whole, and healthy. This type of work creates deep and lasting change.
Whatever you are dealing with, you don't have to face it alone. At some point, in all of our lives, it can be very helpful to talk to someone. I am dedicated to helping you gain insight and develop tools to cultivate personal growth and relief from symptoms. We will work together and we will work holistically, meaning I consider the mind, body, and spirit in a safe, compassionate, curious, and healing environment to understand yourself better and begin to feel connected, whole, and healthy. This type of work creates deep and lasting change.
(484) 207-5573 View (484) 207-5573
Photo of Neal Stolar, MD-PhD
Neal Stolar
MD-PhD
Verified Verified
Devon, PA 19333  (Online Only)
At nPSYGHT, we emphasize the use of psychotherapy, while supplementing it with medication as needed and at minimum effective doses. We incorporate neuropsychotherapeutic concepts whenever possible, meaning we recognize that advances in our understanding of how the brain works can inform how psychotherapy can be conducted. We stress the importance of general good health habits - diet, exercise, sleep, relaxation methods (meditation, yoga, tai chi) - in promoting mental and behavioral well-being.
At nPSYGHT, we emphasize the use of psychotherapy, while supplementing it with medication as needed and at minimum effective doses. We incorporate neuropsychotherapeutic concepts whenever possible, meaning we recognize that advances in our understanding of how the brain works can inform how psychotherapy can be conducted. We stress the importance of general good health habits - diet, exercise, sleep, relaxation methods (meditation, yoga, tai chi) - in promoting mental and behavioral well-being.
(267) 983-5528 View (267) 983-5528

More Therapists Nearby

Photo of Susanna Francies, PsyD, Psychologist
Susanna Francies
Psychologist, PsyD
Verified Verified
Wayne, PA 19080
It may be related to an anxiety disorder, such as OCD, or it could be a result of past trauma or current stress.
My approach to treatment is one of compassion and collaboration. My goal is to develop a positive working relationship with you and help create a space in which you can begin to better understand yourself, resolve problems, and heal the past. My approach is practical, down to earth, and individualized to your needs. Therapy doesn't have to be mysterious or scary. I enjoy working with those who are new to therapy and want to help you feel comfortable and in control.
It may be related to an anxiety disorder, such as OCD, or it could be a result of past trauma or current stress.
My approach to treatment is one of compassion and collaboration. My goal is to develop a positive working relationship with you and help create a space in which you can begin to better understand yourself, resolve problems, and heal the past. My approach is practical, down to earth, and individualized to your needs. Therapy doesn't have to be mysterious or scary. I enjoy working with those who are new to therapy and want to help you feel comfortable and in control.
(610) 215-2664 View (610) 215-2664
Photo of Amy B. Young - CBT Center for Anxiety & OCD, PsyD
CBT Center for Anxiety & OCD
PsyD
Verified Verified
2 Endorsed
Wayne, PA 19087
We understand that many people who have anxiety and OCD experience tremendous shame.
The CBT Center for Anxiety and OCD believes in providing the community with the most cutting-edge, expert Cognitive Behavioral Therapy for anxiety, OCD, OC Spectrum Disorders and related conditions. We successfully treat clients with generalized anxiety, separation anxiety, social anxiety, phobias and panic. The Center also treats all OC Spectrum conditions including Body Dysmorphic Disorder, hoarding, caretakers of people who hoard, Trichotillomania ( hair pulling), Excoriation ( skin picking) and tics. We treat ALL forms of OCD including many of the lesser known types: relationship, existential, just right, pedophile, harm/violence, sexual orientation, hit & run, magical thinking, postpartum, moral scrupulosity/religious, symmetry/equalizing, health anxiety/hypochondriasis, olfactory reference syndrome (fear of body odor), muscle dysmorphia ( obsessive focus on muscles), emotional contamination, PANS/PANDAS, orthorexia (obsession with healthy eating), sensorimotor/hyperawareness and hyper-responsibility. The Center also specializes in working with people who have anxiety co-occurring with introversion, giftedness, people-pleasing and perfectionism as well as Sensory Processing Disorder, Developmental Coordination Disorder, Dyslexia and medical conditions. We frequently treat individuals with comorbid depression, ADHD and Bipolar Disorder. Specializing in anxiety, OCD and related conditions allows us to stay on top of the latest scientific research and utilize the most effective strategies for you.
We understand that many people who have anxiety and OCD experience tremendous shame.
The CBT Center for Anxiety and OCD believes in providing the community with the most cutting-edge, expert Cognitive Behavioral Therapy for anxiety, OCD, OC Spectrum Disorders and related conditions. We successfully treat clients with generalized anxiety, separation anxiety, social anxiety, phobias and panic. The Center also treats all OC Spectrum conditions including Body Dysmorphic Disorder, hoarding, caretakers of people who hoard, Trichotillomania ( hair pulling), Excoriation ( skin picking) and tics. We treat ALL forms of OCD including many of the lesser known types: relationship, existential, just right, pedophile, harm/violence, sexual orientation, hit & run, magical thinking, postpartum, moral scrupulosity/religious, symmetry/equalizing, health anxiety/hypochondriasis, olfactory reference syndrome (fear of body odor), muscle dysmorphia ( obsessive focus on muscles), emotional contamination, PANS/PANDAS, orthorexia (obsession with healthy eating), sensorimotor/hyperawareness and hyper-responsibility. The Center also specializes in working with people who have anxiety co-occurring with introversion, giftedness, people-pleasing and perfectionism as well as Sensory Processing Disorder, Developmental Coordination Disorder, Dyslexia and medical conditions. We frequently treat individuals with comorbid depression, ADHD and Bipolar Disorder. Specializing in anxiety, OCD and related conditions allows us to stay on top of the latest scientific research and utilize the most effective strategies for you.
(610) 756-1601 View (610) 756-1601
Photo of Melissa Mininno, MA, LPC, Licensed Professional Counselor
Melissa Mininno
Licensed Professional Counselor, MA, LPC
Verified Verified
Wayne, PA 19087
Thank you for checking out my profile! I am a licensed professional counselor practicing in Wayne, PA. I work primarily with adolescents, young adults, and adults struggling with anxiety, OCD, ADHD, depression, stress, and relationship challenges. I have experience working as a school counselor, as well as a direct ABA therapist for children and adolescents with ASD and other diagnoses. I use a client centered approach in effort to empower individuals to be leaders in their own healing. Additionally, I collaborate with psychiatrists, school, home, and other professionals to ensure the best treatment.
Thank you for checking out my profile! I am a licensed professional counselor practicing in Wayne, PA. I work primarily with adolescents, young adults, and adults struggling with anxiety, OCD, ADHD, depression, stress, and relationship challenges. I have experience working as a school counselor, as well as a direct ABA therapist for children and adolescents with ASD and other diagnoses. I use a client centered approach in effort to empower individuals to be leaders in their own healing. Additionally, I collaborate with psychiatrists, school, home, and other professionals to ensure the best treatment.
(610) 998-3804 View (610) 998-3804
Obsessive-Compulsive (OCD) Therapists

How long does OCD treatment take?

Obsessive-Compulsive Disorder (OCD) is often treated on a weekly or twice-weekly schedule, depending on symptom severity and the client’s preferences. Some clients may start to see a noticeable improvement in symptoms in as little as six weeks, but it’s also possible, especially in more severe cases, for treatment to take several months to a year before significant progress is made.

What happens if OCD is not treated?

Some people with OCD, especially those with mild symptoms, may find that they are able to adapt reasonably well to life with the condition, even if their symptoms never resolve completely. However, many people, particularly those whose symptoms are severe at the outset, find that their obsessions and compulsions grow more intrusive with time, making it harder to maintain relationships, hold down a job, or navigate the world successfully.

Are there medications for OCD?

Medication can be used to treat OCD. The class of drugs most often prescribed are selective serotonin reuptake inhibitors, or SSRIs, which include fluvoxamine (under the brand name Luvox), fluoxetine (Prozac), and sertraline (Zoloft), among others. In cases of treatment-resistant OCD, other classes of medication, such as tricyclic antidepressants or atypical antipsychotics, may be prescribed. Medication is frequently used in conjunction with therapy.

Can OCD come back after treatment?

Yes. Major life transitions, periods of stress, or other factors can cause symptoms to return or, if they were never fully eradicated, to ramp back up in intensity. For some, these relapses are brief and do not require additional treatment; identifying specific triggers and practicing the skills learned in therapy can help speed their course. For others, returning to therapy for a brief period can help address the underlying stress and strengthen coping mechanisms.