Dialectical Behavior (DBT) Therapists in Seguin, TX

Photo of Ashlee N Albart, MS, LPC-S, NCC, Licensed Professional Counselor
Ashlee N Albart
Licensed Professional Counselor, MS, LPC-S, NCC
Verified Verified
Seguin, TX 78156
Ashlee utilizes a version of Cognitive Behavioral Therapy called Dialectical Behavior Therapy which focuses on problem-solving and acceptance.
Do you need help in achieving greater self-acceptance, changing negative thinking, and improving your self-esteem? Do you struggle in managing your emotions more effectively? Every person's world view is unique to them, and Ashlee utilizes a variety of treatment methods to encourage clients to become a more active participant in their own well-being.
Ashlee utilizes a version of Cognitive Behavioral Therapy called Dialectical Behavior Therapy which focuses on problem-solving and acceptance.
Do you need help in achieving greater self-acceptance, changing negative thinking, and improving your self-esteem? Do you struggle in managing your emotions more effectively? Every person's world view is unique to them, and Ashlee utilizes a variety of treatment methods to encourage clients to become a more active participant in their own well-being.
(830) 261-3248 View (830) 261-3248
Photo of Randall Harvey, MS, LPCC, Licensed Professional Counselor
Randall Harvey
Licensed Professional Counselor, MS, LPCC
Verified Verified
Seguin, TX 78155  (Online Only)
I know finding a good fit for a therapist is hard. And finding a good fit is critical to finding relief and healing. Feeling alone in the trauma, the grief and loss, the overwhelm, and just feeling stuck. It's exhausting, lonely, and I know you're sick of it by now. You get to have some guidance, laughs, and expertise as you go to your sessions, work on YOU outside of sessions, and start feeling more whole again. As for working with me and what it's like? I've been told I'm warm and humorous (usually at my own expense). I see you as the expert and me as the guide, and I will put you at ease right off the bat.
I know finding a good fit for a therapist is hard. And finding a good fit is critical to finding relief and healing. Feeling alone in the trauma, the grief and loss, the overwhelm, and just feeling stuck. It's exhausting, lonely, and I know you're sick of it by now. You get to have some guidance, laughs, and expertise as you go to your sessions, work on YOU outside of sessions, and start feeling more whole again. As for working with me and what it's like? I've been told I'm warm and humorous (usually at my own expense). I see you as the expert and me as the guide, and I will put you at ease right off the bat.
(210) 741-8533 View (210) 741-8533
Photo of Eb McKnight - The Agape Center-Faith Based | Trauma | Addiction
The Agape Center-Faith Based | Trauma | Addiction
Verified Verified
Seguin, TX 78155
Our Mental Health Pastoral Counselor are certified, trained in providing, trauma informed biblical counseling for Adults, Youth, Teen, Couples, Marriage, and Family that are struggling with, Anxiety, Depression, Trauma, Sex Trafficking, PTSD, Family/Domestic Violence, Addictions such as alcohol/drug abuse, pornography, behavioral issues, Divorce, and social/relational concerns. All counseling sessions, Day Intensives, Aftercare and Intensive Outpatient Programs (IOP), are all 1 on 1. Court ordered Family Violence, DWI, and DUI programs are available.
Our Mental Health Pastoral Counselor are certified, trained in providing, trauma informed biblical counseling for Adults, Youth, Teen, Couples, Marriage, and Family that are struggling with, Anxiety, Depression, Trauma, Sex Trafficking, PTSD, Family/Domestic Violence, Addictions such as alcohol/drug abuse, pornography, behavioral issues, Divorce, and social/relational concerns. All counseling sessions, Day Intensives, Aftercare and Intensive Outpatient Programs (IOP), are all 1 on 1. Court ordered Family Violence, DWI, and DUI programs are available.
(830) 254-5067 View (830) 254-5067
Photo of David Bennett, MA, LPC, LCDC, Licensed Professional Counselor
David Bennett
Licensed Professional Counselor, MA, LPC, LCDC
Verified Verified
Seguin, TX 78155
Are you happy with the life that you're living? Would you like to be more confident while making a tough decision? The process of coming to understand yourself is an opportunity to recognize how individual strengths can be used to meet personal, professional, social or family goals. For those prepared to make changes, therapy can be the catalyst to personal growth and development. I'd like to work with individuals looking to better themselves. If you have questions or ideas that you would like to explore in therapy give me a call so we can schedule an appointment.
Are you happy with the life that you're living? Would you like to be more confident while making a tough decision? The process of coming to understand yourself is an opportunity to recognize how individual strengths can be used to meet personal, professional, social or family goals. For those prepared to make changes, therapy can be the catalyst to personal growth and development. I'd like to work with individuals looking to better themselves. If you have questions or ideas that you would like to explore in therapy give me a call so we can schedule an appointment.
(830) 433-5835 View (830) 433-5835
Photo of Audrey Futrell, PsyD, LPC-S, Licensed Professional Counselor
Audrey Futrell
Licensed Professional Counselor, PsyD, LPC-S
Verified Verified
2 Endorsed
Seguin, TX 78155
I have a passion to work with adults struggling with an addiction. Additionally, I find a strong connection in working with adolescents and helping them get through stages of their lives. Everyone struggles at times in their lives but getting through these challenges can largely depend on who is there with the person and I desire to be the person that walks through this journey with you.
I have a passion to work with adults struggling with an addiction. Additionally, I find a strong connection in working with adolescents and helping them get through stages of their lives. Everyone struggles at times in their lives but getting through these challenges can largely depend on who is there with the person and I desire to be the person that walks through this journey with you.
(469) 804-6127 View (469) 804-6127
Photo of Miranda Velasquez, MA, LMFT, LCDC, CCTP, Marriage & Family Therapist
Miranda Velasquez
Marriage & Family Therapist, MA, LMFT, LCDC, CCTP
Verified Verified
1 Endorsed
Seguin, TX 78155
Have you been looking for a therapist who is a bit “vintage era” crossed with a splash of thrill seeker and a huge dose of animal lover? If so, you’ve found me. While this introduction may be humorous, please know that I take mental health seriously and have a deep respect for the therapeutic process. Working together, we focus on your needs and the best way to get you where you want to be. Do you need to establish better boundaries, reduce your anxiety, develop your superhero persona or get your groove back? If you’re willing to go the distance, I’m willing to run alongside you, chanting your name until you hit that finish line.
Have you been looking for a therapist who is a bit “vintage era” crossed with a splash of thrill seeker and a huge dose of animal lover? If so, you’ve found me. While this introduction may be humorous, please know that I take mental health seriously and have a deep respect for the therapeutic process. Working together, we focus on your needs and the best way to get you where you want to be. Do you need to establish better boundaries, reduce your anxiety, develop your superhero persona or get your groove back? If you’re willing to go the distance, I’m willing to run alongside you, chanting your name until you hit that finish line.
(830) 400-4114 View (830) 400-4114
Photo of Celina R Andersen-King, LCSW, CFMSW, Clinical Social Work/Therapist
Celina R Andersen-King
Clinical Social Work/Therapist, LCSW, CFMSW
Verified Verified
Seguin, TX 78155
People come into therapy because they want change. The pain of doing what you're doing, is bigger than the fear of changing. A good therapist knows pain, fear and change. Their job is to be a part of your team because you know you are doing this FOR YOU. I know the feeling. Well. Trauma comes, and nobody invites it in. It happens to you. You do what you can with what you have and what you know. Until someone gives you a better way. I want to be your someone, part of your team. I specialize in Depression and Anxiety and Trauma. I know what you are feeling and I know it does get better.
People come into therapy because they want change. The pain of doing what you're doing, is bigger than the fear of changing. A good therapist knows pain, fear and change. Their job is to be a part of your team because you know you are doing this FOR YOU. I know the feeling. Well. Trauma comes, and nobody invites it in. It happens to you. You do what you can with what you have and what you know. Until someone gives you a better way. I want to be your someone, part of your team. I specialize in Depression and Anxiety and Trauma. I know what you are feeling and I know it does get better.
(830) 268-9077 View (830) 268-9077
Photo of Sandra Alvarez, LPC-A
Sandra Alvarez
LPC-Associate, LPC-A
Verified Verified
Seguin, TX 78155
Ever feel so bogged down and alone? Feeling stuck? Work, school, family, friends or just life in general making you feel frustrated and stressed out? Is past trauma weighing you down? Life can become overwhelming and sometimes we just need a little help to untangle ourselves. Contact me today and let’s work together in helping you down a better path.
Ever feel so bogged down and alone? Feeling stuck? Work, school, family, friends or just life in general making you feel frustrated and stressed out? Is past trauma weighing you down? Life can become overwhelming and sometimes we just need a little help to untangle ourselves. Contact me today and let’s work together in helping you down a better path.
(830) 396-4933 View (830) 396-4933
Photo of Irene Perales, LCSW, Clinical Social Work/Therapist
Irene Perales
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Seguin, TX 78155  (Online Only)
With a passion for helping individuals navigate life’s challenges and a dedication to fostering mental wellness, I am excited to offer a range of therapeutic services tailored to your unique needs. Whether you’re dealing with anxiety, depression, relationship issues, or simply need someone to talk to, I am here to provide compassionate and professional support. I strive to impart that it’s not about what’s wrong with you. Rather, it’s about understanding behaviors, thought patterns, and the protective tendencies that behaviors and thought patterns may serve.
With a passion for helping individuals navigate life’s challenges and a dedication to fostering mental wellness, I am excited to offer a range of therapeutic services tailored to your unique needs. Whether you’re dealing with anxiety, depression, relationship issues, or simply need someone to talk to, I am here to provide compassionate and professional support. I strive to impart that it’s not about what’s wrong with you. Rather, it’s about understanding behaviors, thought patterns, and the protective tendencies that behaviors and thought patterns may serve.
(210) 392-7960 View (210) 392-7960

Online Therapists

Photo of Gloria Mann, LPC-S, Licensed Professional Counselor
Gloria Mann
Licensed Professional Counselor, LPC-S
Verified Verified
Austin, TX 78731
I draw on a variety of techniques including Strengths Based Counseling, Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Mindfulness, and Eye Movement Desensitization and Reprocessing (EMDR).
I am honored to have the opportunity to walk with you in your journey. Trusting others can be hard, and I am committed to cultivating a safe place where you can share your story. My goal is for you to feel empowered to explore and share your fears and joy. Every person has faced challenges, and and I hope to create a safe place for you to be fully seen and celebrated. As you navigate the terrain of your life, I look forward to providing you with a listening ear and self-advocacy tools and strategies. Together, we will pursue healing and help you discover the courage and resiliency you have to meet life's challenges.
I draw on a variety of techniques including Strengths Based Counseling, Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Mindfulness, and Eye Movement Desensitization and Reprocessing (EMDR).
I am honored to have the opportunity to walk with you in your journey. Trusting others can be hard, and I am committed to cultivating a safe place where you can share your story. My goal is for you to feel empowered to explore and share your fears and joy. Every person has faced challenges, and and I hope to create a safe place for you to be fully seen and celebrated. As you navigate the terrain of your life, I look forward to providing you with a listening ear and self-advocacy tools and strategies. Together, we will pursue healing and help you discover the courage and resiliency you have to meet life's challenges.
(512) 969-2155 View (512) 969-2155
Photo of Madison Hamm, LCSW, Clinical Social Work/Therapist
Madison Hamm
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Austin, TX 78701
I gravitate most towards DBT, ACT, Motivational Interviewing, Strengths Based and Social Rhythm Theory.
I include many different therapy styles & modalities in my practice to ensure my clients feel that they are in a place where they fit and matter. I believe learning & getting curious about our emotions, patterns and what we’re drawn to, is integral to behavior change, growth and feeling connected to our core identity.
I gravitate most towards DBT, ACT, Motivational Interviewing, Strengths Based and Social Rhythm Theory.
I include many different therapy styles & modalities in my practice to ensure my clients feel that they are in a place where they fit and matter. I believe learning & getting curious about our emotions, patterns and what we’re drawn to, is integral to behavior change, growth and feeling connected to our core identity.
(737) 387-4727 x1006 View (737) 387-4727 x1006
Photo of Meletina Taerbaum, MA, NCC, LPC, Licensed Professional Counselor
Meletina Taerbaum
Licensed Professional Counselor, MA, NCC, LPC
Verified Verified
Round Rock, TX 78681
Due to how I conduct counseling I draw from several strategies including Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy ( DBT), Acceptance and Commitment Therapy (ACT), Collaborative Problem Solving, Motivational Interviewing, and EMDR.
I believe that we all deserve the right to a healthy and happy life, and that counseling is an avenue to reaching that life. I am a counselor who believes in working collaboratively in a calm and supportive environment. Together we can identify goals and work to meet them in ways that feel safe and comfortable to you.
Due to how I conduct counseling I draw from several strategies including Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy ( DBT), Acceptance and Commitment Therapy (ACT), Collaborative Problem Solving, Motivational Interviewing, and EMDR.
I believe that we all deserve the right to a healthy and happy life, and that counseling is an avenue to reaching that life. I am a counselor who believes in working collaboratively in a calm and supportive environment. Together we can identify goals and work to meet them in ways that feel safe and comfortable to you.
(737) 204-9518 View (737) 204-9518
Photo of Sarah Beddingfield, LCSW, Clinical Social Work/Therapist
Sarah Beddingfield
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Austin, TX 78746
My treatment approach utilizes several different forms of therapy such as, Ketamine Assisted Psychotherapy (in partnership with Hara Health Center), EMDR, DBT, and CBT.
I specialize in treating a diverse range of clients, focusing on those suffering from Post-Traumatic Stress Disorder (PTSD), Anxiety, Depression, and those struggling to work through difficult mental health challenges. I also particularly enjoy working with adolescents and members of the LGBTQ+ community. I offer a safe and supportive environment where individuals can explore their experiences, and work towards healing. I am dedicated to fostering resilience and well-being in each person I work with.
My treatment approach utilizes several different forms of therapy such as, Ketamine Assisted Psychotherapy (in partnership with Hara Health Center), EMDR, DBT, and CBT.
I specialize in treating a diverse range of clients, focusing on those suffering from Post-Traumatic Stress Disorder (PTSD), Anxiety, Depression, and those struggling to work through difficult mental health challenges. I also particularly enjoy working with adolescents and members of the LGBTQ+ community. I offer a safe and supportive environment where individuals can explore their experiences, and work towards healing. I am dedicated to fostering resilience and well-being in each person I work with.
(512) 572-9499 View (512) 572-9499
Photo of Lorraine Hellman Robertson, LPC, Licensed Professional Counselor
Lorraine Hellman Robertson
Licensed Professional Counselor, LPC
Verified Verified
Round Rock, TX 78665
Offered are Cognitive Behavior Therapy, Dialectical Behavior Therapy, Person-Centered, Solution-Focused, EMDR, and Psychoeducation.
Hello, my name is Lorraine Hellman Robertson but I go by Rainey. I am a licensed clinical professional counselor (LCPC) in Montana, Colorado (LPC), Texas (LPC), and Florida (telehealth only TPMC524). My therapeutic approach is integrated and tailored to the best needs of the client. Offered are Cognitive Behavior Therapy, Dialectical Behavior Therapy, Person-Centered, Solution-Focused, EMDR, and Psychoeducation.
Offered are Cognitive Behavior Therapy, Dialectical Behavior Therapy, Person-Centered, Solution-Focused, EMDR, and Psychoeducation.
Hello, my name is Lorraine Hellman Robertson but I go by Rainey. I am a licensed clinical professional counselor (LCPC) in Montana, Colorado (LPC), Texas (LPC), and Florida (telehealth only TPMC524). My therapeutic approach is integrated and tailored to the best needs of the client. Offered are Cognitive Behavior Therapy, Dialectical Behavior Therapy, Person-Centered, Solution-Focused, EMDR, and Psychoeducation.
(281) 915-0181 View (281) 915-0181
Photo of Kristen Smith Williamson, LPC, Licensed Professional Counselor
Kristen Smith Williamson
Licensed Professional Counselor, LPC
Verified Verified
5 Endorsed
Austin, TX 78731  (Online Only)
I prefer Solution Focused, Positive Psychology, Mindfulness, CBT, DBT.
Adulting is hard. Stress sucks. Anxiety and Depression seem to be passengers in the trip through life. The plague, Covid, has made these even more amplified....and being asked to go back into the office?! Seriously?! Have you ever felt like an outsider? Like, there can be a group of people talking and you are not part of the conversation. Are you part of the Neurodiverse/neurospicy community? Do you align with the LGBTQIA? Do you ever go to parties and hang out with the Cat? Dog? Well, then we might get along.
I prefer Solution Focused, Positive Psychology, Mindfulness, CBT, DBT.
Adulting is hard. Stress sucks. Anxiety and Depression seem to be passengers in the trip through life. The plague, Covid, has made these even more amplified....and being asked to go back into the office?! Seriously?! Have you ever felt like an outsider? Like, there can be a group of people talking and you are not part of the conversation. Are you part of the Neurodiverse/neurospicy community? Do you align with the LGBTQIA? Do you ever go to parties and hang out with the Cat? Dog? Well, then we might get along.
(469) 535-7308 View (469) 535-7308
Photo of Denise Smith, LPC, Licensed Professional Counselor
Denise Smith
Licensed Professional Counselor, LPC
Verified Verified
Schertz, TX 78154  (Online Only)
I am an experienced therapist who has worked with those struggling with addiction, mood disorders (including bipolar disorder), personality disorders, and trauma. I enjoy working with adults, adolescents, and families/couples. I primarily use CBT/ DBT modalities but can adjust to the needs of the client.
I am an experienced therapist who has worked with those struggling with addiction, mood disorders (including bipolar disorder), personality disorders, and trauma. I enjoy working with adults, adolescents, and families/couples. I primarily use CBT/ DBT modalities but can adjust to the needs of the client.
(430) 216-1158 View (430) 216-1158
Photo of Abí Steinsiek, LMSW, Clinical Social Work/Therapist
Abí Steinsiek
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Austin, TX 78704
My holistic therapeutic approach, weaves Sensorimotor Psychotherapy, Ketamine Assisted Psychotherapy, Dialectical Behavioral Therapy, and Internal Family Systems techniques with musings inspired from art, music, mindfulness and movement.
Accepting New Clients. I'm a somatic, creative and trauma-informed therapist that supports young adults, adults and elders navigating; neurodiversity, anxiety, depression, stress, family and community dynamics, emotional regulation, grief and loss, life transitions, psychedelic spaces, and trauma. My containers are inclusive, drawing from my experience supporting non-monogamous and LGBTQIA+ communities, welcoming all identities.
My holistic therapeutic approach, weaves Sensorimotor Psychotherapy, Ketamine Assisted Psychotherapy, Dialectical Behavioral Therapy, and Internal Family Systems techniques with musings inspired from art, music, mindfulness and movement.
Accepting New Clients. I'm a somatic, creative and trauma-informed therapist that supports young adults, adults and elders navigating; neurodiversity, anxiety, depression, stress, family and community dynamics, emotional regulation, grief and loss, life transitions, psychedelic spaces, and trauma. My containers are inclusive, drawing from my experience supporting non-monogamous and LGBTQIA+ communities, welcoming all identities.
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Photo of Susannah Parkin, LMSW
Susannah Parkin
Licensed Master Social Worker, LMSW
Verified Verified
2 Endorsed
Round Rock, TX 78664
I incorporate interventions from Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy ( DBT), Radically Open Dialectical Behavior Therapy (RO DBT), Cognitive Behavior Therapy (CBT), and Motivational Interviewing (MI).
Updated Fall 2024 - Accepting New Clients <> Through a lens of compassion and non-judgment, I aim to create a supportive environment for us to explore what is important to you. Each person comes to therapy with different experiences and goals. Some people don’t yet know their goals and others might change them along the way. I have a special interest in helping people feel less stuck, adjust to changes and transitions, or who have hidden challenges. With a background in research, I approach therapy with a perspective that is evidence based and emphasizes empathy and curiosity.
I incorporate interventions from Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy ( DBT), Radically Open Dialectical Behavior Therapy (RO DBT), Cognitive Behavior Therapy (CBT), and Motivational Interviewing (MI).
Updated Fall 2024 - Accepting New Clients <> Through a lens of compassion and non-judgment, I aim to create a supportive environment for us to explore what is important to you. Each person comes to therapy with different experiences and goals. Some people don’t yet know their goals and others might change them along the way. I have a special interest in helping people feel less stuck, adjust to changes and transitions, or who have hidden challenges. With a background in research, I approach therapy with a perspective that is evidence based and emphasizes empathy and curiosity.
(737) 520-4549 View (737) 520-4549
Photo of Sonja Cousar, LPC-S, LMHC, NCC, NBCC, Licensed Professional Counselor
Sonja Cousar
Licensed Professional Counselor, LPC-S, LMHC, NCC, NBCC
Verified Verified
3 Endorsed
Georgetown, TX 78626
I have training in behavioral therapy, client-centered therapy, dialectical behavior therapy ( DBT), trust-based relational intervention (TBRI), and cognitive behavioral therapy (CBT).
Everyone is different and need to get some guidance, support and set new goals. I am here to provide support and encouragement from an non-judgemental position. I am here the help build meaningful social connections. When human beings experience trauma or severe life stressors, it is not uncommon for their lives to unravel. My great passion is bringing healing to people who have been through a trauma.
I have training in behavioral therapy, client-centered therapy, dialectical behavior therapy ( DBT), trust-based relational intervention (TBRI), and cognitive behavioral therapy (CBT).
Everyone is different and need to get some guidance, support and set new goals. I am here to provide support and encouragement from an non-judgemental position. I am here the help build meaningful social connections. When human beings experience trauma or severe life stressors, it is not uncommon for their lives to unravel. My great passion is bringing healing to people who have been through a trauma.
(512) 764-0228 View (512) 764-0228
Photo of Barbara Suarez Chenoweth, LCSW, MSSW, Clinical Social Work/Therapist
Barbara Suarez Chenoweth
Clinical Social Work/Therapist, LCSW, MSSW
Verified Verified
Austin, TX 78756
I enjoy working with adults of all ages, in different stages of life. My areas of focus are grief and loss, depression and anxiety, trauma, and relationship issues. I use different approaches in therapy, from CBT and DBT to mindfulness and self-compassion. I've worked in a variety of settings with different mental health professionals and with people at varying times of need.
I enjoy working with adults of all ages, in different stages of life. My areas of focus are grief and loss, depression and anxiety, trauma, and relationship issues. I use different approaches in therapy, from CBT and DBT to mindfulness and self-compassion. I've worked in a variety of settings with different mental health professionals and with people at varying times of need.
(512) 957-9834 View (512) 957-9834
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.