Dialectical Behavior (DBT) Treatment Centers in Concord, MA

Photo of Molly Ruiz - DBT Works, Treatment Center
DBT Works
Treatment Center
Verified Verified
Concord, MA 01742
At DBT Works, we’re passionate about dialectical behavior therapy (DBT).
We treat all forms of emotion dysregulation, including: borderline personality disorder, depression, anxiety, and PTSD. We also treat a range of related emotional difficulties including suicidality, self-injury, impulsivity, relationship difficulties, problematic substance use, disordered eating, and unstable sense of self. Our clients are highly sensitive individuals (as are our staff!) who are interested in building skills to manage their sensitive emotions.
At DBT Works, we’re passionate about dialectical behavior therapy (DBT).
We treat all forms of emotion dysregulation, including: borderline personality disorder, depression, anxiety, and PTSD. We also treat a range of related emotional difficulties including suicidality, self-injury, impulsivity, relationship difficulties, problematic substance use, disordered eating, and unstable sense of self. Our clients are highly sensitive individuals (as are our staff!) who are interested in building skills to manage their sensitive emotions.
(857) 420-5097 View (857) 420-5097
Photo of Gillian Galen - Triad Adolescent Services, PsyD, Treatment Center
Triad Adolescent Services
Treatment Center
Verified Verified
Concord, MA 01742  (Online Only)
We offer didactic and process oriented Parent Skills and Support groups designed to work with parents and families who have children, adolescents and young adults who are struggling with depression and anxiety, self injury and self worth. Our expert-led parent skills and support groups to provide an understanding, compassionate place for parents to learn and practice parenting effectiveness and self care. Triad's group-based practice was founded upon the fundamental belief that family systems work best in a positive, strength-based approach. We utilize DBT and CBT principles and our clinicians share 50+ years of experience working directly with parents and famlies. All groups are virtual and co-led, providing group-specific curriculum treating no more than 12 parents in each group. Homework is provided to reinforce learning between sessions.
We offer didactic and process oriented Parent Skills and Support groups designed to work with parents and families who have children, adolescents and young adults who are struggling with depression and anxiety, self injury and self worth. Our expert-led parent skills and support groups to provide an understanding, compassionate place for parents to learn and practice parenting effectiveness and self care. Triad's group-based practice was founded upon the fundamental belief that family systems work best in a positive, strength-based approach. We utilize DBT and CBT principles and our clinicians share 50+ years of experience working directly with parents and famlies. All groups are virtual and co-led, providing group-specific curriculum treating no more than 12 parents in each group. Homework is provided to reinforce learning between sessions.
(781) 678-8244 View (781) 678-8244
Photo of David Perna - Copernican Clinical Services, Treatment Center
Copernican Clinical Services
Treatment Center
Verified Verified
Concord, MA 01742
At Copernican we utilize a combination of traditional therapy techniques and cutting-edge clinical interventions to help support your treatment experience. Our staff functions as an integrated, CLINICAL TEAM as we coordinate with other professionals in a seamless manner. Our approach to continuity of care that is packed with relevant clinical information. We believe that KNOWLEDGE IS POWER. The usual response we receive from other professionals is, "Thanks! You guys are always so helpful."
At Copernican we utilize a combination of traditional therapy techniques and cutting-edge clinical interventions to help support your treatment experience. Our staff functions as an integrated, CLINICAL TEAM as we coordinate with other professionals in a seamless manner. Our approach to continuity of care that is packed with relevant clinical information. We believe that KNOWLEDGE IS POWER. The usual response we receive from other professionals is, "Thanks! You guys are always so helpful."
(617) 405-3203 View (617) 405-3203
Photo of Admissions Line - Meta Addiction Treatment, Treatment Center
Meta Addiction Treatment
Treatment Center
Verified Verified
Concord, MA 01742
Clients choose Meta Addiction Treatment for a recovery experience that puts their needs first. We work closely with every client to personalize their treatment plan and ensure we're helping them meet their recovery goals. We also offer flexible schedules for each of our outpatient levels of care to work around work, school, or family commitments.
Clients choose Meta Addiction Treatment for a recovery experience that puts their needs first. We work closely with every client to personalize their treatment plan and ensure we're helping them meet their recovery goals. We also offer flexible schedules for each of our outpatient levels of care to work around work, school, or family commitments.
(351) 300-7380 View (351) 300-7380
Evoke Wellness at Waltham
Treatment Center
Verified Verified
Concord, MA 01742
At Evoke Wellness, our mission is to empower individuals on their journey to recover from addiction and mental health challenges. We provide compassionate, evidence-based care that fosters personal growth, resilience, and lasting positive change. Through comprehensive treatment and unwavering support, we aim to help individuals rediscover their inherent worth and lead fulfilling lives.
At Evoke Wellness, our mission is to empower individuals on their journey to recover from addiction and mental health challenges. We provide compassionate, evidence-based care that fosters personal growth, resilience, and lasting positive change. Through comprehensive treatment and unwavering support, we aim to help individuals rediscover their inherent worth and lead fulfilling lives.
(781) 546-5491 View (781) 546-5491

More Treatment Centers Nearby

Photo of Our Admissions Team - Evolve Teen Dual Diagnosis Treatment, Treatment Center
Evolve Teen Dual Diagnosis Treatment
Treatment Center
Verified Verified
Waltham, MA 02453
At Evolve, we provide the highest caliber of evidence-based treatment for teens aged 12-17 struggling with dual diagnosis, depression, anxiety, trauma, substance use, ADHD, self-harming or high-risk behaviors, suicidality, and other mental health/behavioral issues. Our emphasis on safety and individualized attention are reasons why so many families from all over the country choose Evolve. Our primary therapeutic modalities include Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy. Teens participate in individual and family therapy at least 5 times a week, weekly psychiatry sessions, and daily groups (on DBT Skills Training, Anger Management, Seeking Safety, and Relapse Prevention), as well as learning coping skills and participating in daily academics. For families from out-of-state, we conduct family therapy remotely. We offer daily experiential activities proven to support recovery (e.g. equine therapy, surf, art, drama, music, yoga, etc.) and 12-Step/SMART Recovery programs for those struggling with dual diagnoses. We offer gender-affirming care for LGBTQ+ and transgender teens.
At Evolve, we provide the highest caliber of evidence-based treatment for teens aged 12-17 struggling with dual diagnosis, depression, anxiety, trauma, substance use, ADHD, self-harming or high-risk behaviors, suicidality, and other mental health/behavioral issues. Our emphasis on safety and individualized attention are reasons why so many families from all over the country choose Evolve. Our primary therapeutic modalities include Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy. Teens participate in individual and family therapy at least 5 times a week, weekly psychiatry sessions, and daily groups (on DBT Skills Training, Anger Management, Seeking Safety, and Relapse Prevention), as well as learning coping skills and participating in daily academics. For families from out-of-state, we conduct family therapy remotely. We offer daily experiential activities proven to support recovery (e.g. equine therapy, surf, art, drama, music, yoga, etc.) and 12-Step/SMART Recovery programs for those struggling with dual diagnoses. We offer gender-affirming care for LGBTQ+ and transgender teens.
(858) 683-1268 View (858) 683-1268
Photo of Jimmy Castrucci - Clearhaven Recovery Center, Treatment Center
Clearhaven Recovery Center
Treatment Center
Verified Verified
Waltham, MA 02451
Offering CBT, DBT, motivational interviewing and many more clinical modalities our goal is that every client recovers from their addictions .
Our specialty at CRC is treating individuals who suffer from substance use disorder, with first hand experience we focus on the internal issues that cause addiction and alcoholism. All of our staff are in long term recovery and all know the struggle of asking for help, when that point is reached the healing process can’t start to begin. Partaking in our family focused groups is highly encouraged to all our clients loved ones as we all realize that the family component plays an integral role in an individual getting well.
Offering CBT, DBT, motivational interviewing and many more clinical modalities our goal is that every client recovers from their addictions .
Our specialty at CRC is treating individuals who suffer from substance use disorder, with first hand experience we focus on the internal issues that cause addiction and alcoholism. All of our staff are in long term recovery and all know the struggle of asking for help, when that point is reached the healing process can’t start to begin. Partaking in our family focused groups is highly encouraged to all our clients loved ones as we all realize that the family component plays an integral role in an individual getting well.
(781) 242-5536 View (781) 242-5536
Photo of Intake Department - Brighton-Allston Mental Health Association , LICSW, LMHC, MA, Treatment Center
Brighton-Allston Mental Health Association
Treatment Center, LICSW, LMHC, MA
Verified Verified
Waltham, MA 02451
We currently offer a wide variety of telehealth therapeutic co-ed groups for teens and adults including: Teen Social Skills Group (ages 13-17), Dance and Movement Group (ages 13-17), Young Adult Transitions Group (ages 18-24), Dialectical Behavior Therapy- DBT (ages 18+) with several day/time options, Adult Social Skills Group (ages 25+), and Adult Psychotherapy Processing Group (ages 50+).
Brighton-Allston Mental Health Association (BAMHA), a program of Italian Home for Children (IHC) is a diverse community mental health agency that has been servicing the Brighton/Allston community and surrounding Metro Boston area since 1964. BAMHA also has an outpatient satellite office in Jamaica Plain. We offer individual and group therapy treatment, psychopharmacology, as well as family and couples counseling services. BAMHA services clients ages 4-80+. Our BAMHA clinicians are trained in various treatment modalities including: traditional psychotherapy, dialectical behavioral therapy, cognitive behavioral therapy, expressive therapy, and play therapy. We also offer In-Home Therapy, Therapeutic Mentoring, In-Home Behavioral, and ABA services for children ages 4-20 through our partner Community Based Programs (CBP) at Italian Home. Our clinicians speak over a dozen languages, including Spanish. We now have immediate openings in all of our CBP programs, and offer telehealth services for your convenience and safety.
We currently offer a wide variety of telehealth therapeutic co-ed groups for teens and adults including: Teen Social Skills Group (ages 13-17), Dance and Movement Group (ages 13-17), Young Adult Transitions Group (ages 18-24), Dialectical Behavior Therapy- DBT (ages 18+) with several day/time options, Adult Social Skills Group (ages 25+), and Adult Psychotherapy Processing Group (ages 50+).
Brighton-Allston Mental Health Association (BAMHA), a program of Italian Home for Children (IHC) is a diverse community mental health agency that has been servicing the Brighton/Allston community and surrounding Metro Boston area since 1964. BAMHA also has an outpatient satellite office in Jamaica Plain. We offer individual and group therapy treatment, psychopharmacology, as well as family and couples counseling services. BAMHA services clients ages 4-80+. Our BAMHA clinicians are trained in various treatment modalities including: traditional psychotherapy, dialectical behavioral therapy, cognitive behavioral therapy, expressive therapy, and play therapy. We also offer In-Home Therapy, Therapeutic Mentoring, In-Home Behavioral, and ABA services for children ages 4-20 through our partner Community Based Programs (CBP) at Italian Home. Our clinicians speak over a dozen languages, including Spanish. We now have immediate openings in all of our CBP programs, and offer telehealth services for your convenience and safety.
(617) 917-2782 View (617) 917-2782
Photo of Banyan Massachusetts - Banyan Massachusetts, LMHC, Treatment Center
Banyan Massachusetts
Treatment Center, LMHC
Verified Verified
1 Endorsed
Burlington, MA 01803
At Banyan Massachusetts, we offer a host of programs designed to help those struggling with addictions. All of our Massachusetts drug and alcohol treatment programs provide comprehensive care to address the unique needs of each patient in relation to physical, mental, and emotional health. Our certified team at Banyan is comprised of physicians, psychiatrists, registered nurses, clinicians, case managers, and other addiction professionals. Many of our staff have firsthand knowledge of the life-changing challenges and issues that men and women commonly face when beginning a recovery lifestyle.
At Banyan Massachusetts, we offer a host of programs designed to help those struggling with addictions. All of our Massachusetts drug and alcohol treatment programs provide comprehensive care to address the unique needs of each patient in relation to physical, mental, and emotional health. Our certified team at Banyan is comprised of physicians, psychiatrists, registered nurses, clinicians, case managers, and other addiction professionals. Many of our staff have firsthand knowledge of the life-changing challenges and issues that men and women commonly face when beginning a recovery lifestyle.
(339) 217-7397 View (339) 217-7397
Photo of Our Admissions - Ridge Adolescent Residential Treatment NH, Treatment Center
Ridge Adolescent Residential Treatment NH
Treatment Center
Verified Verified
Weston, MA 02493
Your teen is struggling with their mental health and well-being, and in need of intervention, stabilization, and a change of environment. As a concerned parent of a 12-18-year old, you may be looking at options such as residential treatment centers or wilderness programs. Wouldn’t it be comforting if you knew your child could receive the intervention, therapy, structure and supervision they need to achieve stabilization, all within an unparalleled natural setting?
Your teen is struggling with their mental health and well-being, and in need of intervention, stabilization, and a change of environment. As a concerned parent of a 12-18-year old, you may be looking at options such as residential treatment centers or wilderness programs. Wouldn’t it be comforting if you knew your child could receive the intervention, therapy, structure and supervision they need to achieve stabilization, all within an unparalleled natural setting?
(603) 803-4350 View (603) 803-4350
Photo of Ryan Caulfield - Greater Boston Addiction Centers - GBAC, Treatment Center
Greater Boston Addiction Centers - GBAC
Treatment Center
Not Verified Not Verified
Weston, MA 02493
Anyone struggling with addiction to drugs or alcohol needs professional support to heal and recover. Greater Boston Addiction Centers is here to help. Our substance abuse rehab programs provide daytime outpatient and evening intensive outpatient drug treatment programs to help you or your loved one rebuild and restore hope.
Anyone struggling with addiction to drugs or alcohol needs professional support to heal and recover. Greater Boston Addiction Centers is here to help. Our substance abuse rehab programs provide daytime outpatient and evening intensive outpatient drug treatment programs to help you or your loved one rebuild and restore hope.
(508) 392-5279 View (508) 392-5279
Photo of Aaron Kaplan - Hope Ave Therapy, PsyD, LICSW, LMHC, Treatment Center
Hope Ave Therapy
Treatment Center, PsyD, LICSW, LMHC
Verified Verified
Waltham, MA 02453
Hope Ave Therapy is a group of warm, skilled, experienced and effective psychotherapists who practice in Waltham, MA and serve the Greater Boston community. We aim to cultivate an environment where individuals and groups can speak candidly, explore their feelings and better understand themselves. We prioritize trust and authenticity as key tenets of the relationship between a client and therapist and prefer to work collaboratively toward clients’ goals.
Hope Ave Therapy is a group of warm, skilled, experienced and effective psychotherapists who practice in Waltham, MA and serve the Greater Boston community. We aim to cultivate an environment where individuals and groups can speak candidly, explore their feelings and better understand themselves. We prioritize trust and authenticity as key tenets of the relationship between a client and therapist and prefer to work collaboratively toward clients’ goals.
(617) 992-7279 View (617) 992-7279
Photo of Our Office - Northeast Addictions Treatment Center, Treatment Center
Northeast Addictions Treatment Center
Treatment Center
Verified Verified
Lexington, MA 02420
With extensive experience working in the substance use disorder field, Northeast Addictions Treatment Center (NEATC) knows the difference between average treatment and excellence in treatment. While most addiction centers provide clinical therapy as well as medical assistance, the length of stay does not provide the time needed to uncover the underlying causes and conditions of substance use disorder. However, at NEATC, our team of therapists, medical doctors, and clinicians will help you unearth the underlying causes of your substance use. We then address them directly and assist you in understanding the crux of the problem that leads you back down the path of drinking and using drugs.
With extensive experience working in the substance use disorder field, Northeast Addictions Treatment Center (NEATC) knows the difference between average treatment and excellence in treatment. While most addiction centers provide clinical therapy as well as medical assistance, the length of stay does not provide the time needed to uncover the underlying causes and conditions of substance use disorder. However, at NEATC, our team of therapists, medical doctors, and clinicians will help you unearth the underlying causes of your substance use. We then address them directly and assist you in understanding the crux of the problem that leads you back down the path of drinking and using drugs.
(857) 337-1881 View (857) 337-1881
Photo of Southcoast Behavioral Health Detox Program - Southcoast Behavioral Health - Detox Program, Treatment Center
Southcoast Behavioral Health - Detox Program
Treatment Center
Verified Verified
Lincoln, MA 01773
If a person tries to stop using an addictive substance without professional assistance, they can experience withdrawal symptoms that are often painful and dangerous. Withdrawal symptoms can interfere with someone’s determination to achieve recovery. At Southcoast Behavioral Health, we offer a detoxification program that can help patients safely rid their bodies of toxic substances. Our goal is to support each of our patients so that they can go through the withdrawal process as comfortably as possible. Detox services at Southcoast are available for adults age 18 and older who are suffering from substance use disorders and are ready to take the first steps toward recovery. Patients participate in our detox program for an average of five to seven days, receiving assistance from our care team, which includes physicians, registered nurses, and psychiatrists.
If a person tries to stop using an addictive substance without professional assistance, they can experience withdrawal symptoms that are often painful and dangerous. Withdrawal symptoms can interfere with someone’s determination to achieve recovery. At Southcoast Behavioral Health, we offer a detoxification program that can help patients safely rid their bodies of toxic substances. Our goal is to support each of our patients so that they can go through the withdrawal process as comfortably as possible. Detox services at Southcoast are available for adults age 18 and older who are suffering from substance use disorders and are ready to take the first steps toward recovery. Patients participate in our detox program for an average of five to seven days, receiving assistance from our care team, which includes physicians, registered nurses, and psychiatrists.
(855) 532-8831 View (855) 532-8831
Photo of Strattus Mental Health Clinic - Strattus, TILL's Mental Health Clinic, Treatment Center
Strattus, TILL's Mental Health Clinic
Treatment Center
Not Verified Not Verified
Waltham, MA 02451
Strattus is your local community mental health clinic, offering a variety of outpatient services. Our clinical team is experienced in working with children, adolescents, adults, couples, and families, with and without specialized needs. In addition to counseling, we also provide medication assessment, management and monitoring to adults ages 18 or older.
Strattus is your local community mental health clinic, offering a variety of outpatient services. Our clinical team is experienced in working with children, adolescents, adults, couples, and families, with and without specialized needs. In addition to counseling, we also provide medication assessment, management and monitoring to adults ages 18 or older.
(781) 329-9365 View (781) 329-9365
Photo of Northstar Recovery Center - Intensive Outpatient - Northstar Recovery Center - Intensive Outpatient , Treatment Center
Northstar Recovery Center - Intensive Outpatient
Treatment Center
Not Verified Not Verified
Sudbury, MA 01776
Northstar Recovery Center is the premier outpatient substance use therapy provider in Massachusetts' MetroWest region. Offering day and evening programming both in-person and virtually at our Southborough location, we’re able to be flexible with your scheduling needs. High quality of care in a clean, warm and inviting setting.
Northstar Recovery Center is the premier outpatient substance use therapy provider in Massachusetts' MetroWest region. Offering day and evening programming both in-person and virtually at our Southborough location, we’re able to be flexible with your scheduling needs. High quality of care in a clean, warm and inviting setting.
(508) 687-6269 View (508) 687-6269
Photo of Melody Stone - Acera Health - Mental Health Outpatient Programs, Treatment Center
Acera Health - Mental Health Outpatient Programs
Treatment Center
Verified Verified
Acton, MA 01720
At Acera Health, we believe that change is possible for everyone. No matter what challenges you're facing, we'll be there to support you. We offer a range of services to help restore your mind and transform your life. Whether you're struggling with anxiety, depression, or addiction, we'll be there to support you every step of the way. We know that change can be difficult, but we also know that it's possible. With our help, you can create the life you've always wanted. Contact us today to learn more about our services and how we can help you create lasting change in your life.
At Acera Health, we believe that change is possible for everyone. No matter what challenges you're facing, we'll be there to support you. We offer a range of services to help restore your mind and transform your life. Whether you're struggling with anxiety, depression, or addiction, we'll be there to support you every step of the way. We know that change can be difficult, but we also know that it's possible. With our help, you can create the life you've always wanted. Contact us today to learn more about our services and how we can help you create lasting change in your life.
(949) 997-1284 View (949) 997-1284
Photo of Lee Kinsey - Kinsey & Associates, PhD, LMHC, Treatment Center
Kinsey & Associates
Treatment Center, PhD, LMHC
Verified Verified
Weston, MA 02493
We are a group of therapists who can hold the complexity of your story and address its many challenges all in one place. We specialize in complexity, and we delight in helping our clients feel grounded, safe, understood, and deeply known. Our clients often report relief that they found us, and we take that privilege seriously, with good humor and great patience.
We are a group of therapists who can hold the complexity of your story and address its many challenges all in one place. We specialize in complexity, and we delight in helping our clients feel grounded, safe, understood, and deeply known. Our clients often report relief that they found us, and we take that privilege seriously, with good humor and great patience.
(857) 971-4518 View (857) 971-4518
Photo of Donna Whipple - Psychotherapy Associates of N. Reading & Amesbury, MA, LMHC, PsyD, Treatment Center
Psychotherapy Associates of N. Reading & Amesbury
Treatment Center, MA, LMHC, PsyD
Verified Verified
Burlington, MA 01803  (Online Only)
We have 19 therapists with many different approaches and specialties. We take almost all insurances including Mass Health. We have day, after school, evening and weekend appointments for the convenience of our clients. We have been providing mental health services in North Reading for 23 years. We specialize in child and adolescent issues but also have expertise in family issues and adult problems. To refer yourself or someone else, call our main number and ask for a referral coordinator. They will take some basic information about what you are looking for and match you with a therapist who has experience in your particular problem, has appointments when you need them, and can take your insurance. We are 100% telehealth at this time and don't anticipate in person sessions going forward.
We have 19 therapists with many different approaches and specialties. We take almost all insurances including Mass Health. We have day, after school, evening and weekend appointments for the convenience of our clients. We have been providing mental health services in North Reading for 23 years. We specialize in child and adolescent issues but also have expertise in family issues and adult problems. To refer yourself or someone else, call our main number and ask for a referral coordinator. They will take some basic information about what you are looking for and match you with a therapist who has experience in your particular problem, has appointments when you need them, and can take your insurance. We are 100% telehealth at this time and don't anticipate in person sessions going forward.
(978) 961-9412 View (978) 961-9412
Photo of Advocates Community Behavioral Health Center - Advocates Community Behavioral Health Center, Treatment Center
Advocates Community Behavioral Health Center
Treatment Center
Verified Verified
1 Endorsed
Waltham, MA 02452
We support adults, children, and families coping with life’s ups and downs. For more than 30 years, Advocates counseling services have served as a safety net for people experiencing difficulties in life. Whether it's support during a difficult time, help coping with the stresses of everyday life, or treatment for addiction and mental health issues, our counselors, clinical nurses, and psychiatrists are here for you.
We support adults, children, and families coping with life’s ups and downs. For more than 30 years, Advocates counseling services have served as a safety net for people experiencing difficulties in life. Whether it's support during a difficult time, help coping with the stresses of everyday life, or treatment for addiction and mental health issues, our counselors, clinical nurses, and psychiatrists are here for you.
(508) 978-3658 View (508) 978-3658

See more therapy options for Concord

Dialectical Behavior (DBT) Treatment Centers

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.