Self-Harming Counselling in London

Photo of Carolyn Connor, Counsellor, MBACP
Carolyn Connor
Counsellor, MBACP
Verified Verified
Online Only
Born in the North of England, I emigrated to Australia with my family as a child, returning after a few years. I left for London in my late teens. My dyslexia, and not fitting in, had left me feeling as if I couldn’t learn and would have few job opportunities. In my town, I had two options: hairdressing or nuclear shipbuilding. I chose cutting hair and talking to human beings about their relationships. Working in West End salons, listening to clients’ stories, raising 4 children, and living with my husband with a terminal illness, gave me a deep understanding of human dynamics so I decided to retrain as a counsellor.
Born in the North of England, I emigrated to Australia with my family as a child, returning after a few years. I left for London in my late teens. My dyslexia, and not fitting in, had left me feeling as if I couldn’t learn and would have few job opportunities. In my town, I had two options: hairdressing or nuclear shipbuilding. I chose cutting hair and talking to human beings about their relationships. Working in West End salons, listening to clients’ stories, raising 4 children, and living with my husband with a terminal illness, gave me a deep understanding of human dynamics so I decided to retrain as a counsellor.
020 4572 5039 View 020 4572 5039
Photo of Alison Goolnik, Psychotherapist, MA, MBACP
Alison Goolnik
Psychotherapist, MA, MBACP
Verified Verified
London W10
Are you depressed or self-harming?
Through therapy, we can explore your feelings, help you gain a deeper understanding of yourself, develop effective coping strategies and help you overcome negative thoughts. My speciality is working with anxiety and self-esteem and my experience includes further education colleges, schools, hospitals, support services and helplines.
Are you depressed or self-harming?
Through therapy, we can explore your feelings, help you gain a deeper understanding of yourself, develop effective coping strategies and help you overcome negative thoughts. My speciality is working with anxiety and self-esteem and my experience includes further education colleges, schools, hospitals, support services and helplines.
View
Photo of Monika Gos, Psychologist, HCPC - Clin. Psych.
Monika Gos
Psychologist, HCPC - Clin. Psych.
Verified Verified
London W1U
I use cutting edge brain & body based experiential methods of therapy to help you and your brain to work at your best.
The fact that we are alive, proves we are resilient and creative enough in our attempts to face life’s challenges. At times our experience may become overwhelming or too painful to adapt to, or the adaptation may come with great consequences. The long-term effects of this may lead to anxiety, low mood or lack of confidence. When stress keeps us in its grip for too long, some health problems or physical pain / psychosomatic symptoms may develop as a consequence. You may be feeling that you cannot live fully or express yourself, as if there was a block or a barrier between you and life, you and others, or you and your core self.
I use cutting edge brain & body based experiential methods of therapy to help you and your brain to work at your best.
The fact that we are alive, proves we are resilient and creative enough in our attempts to face life’s challenges. At times our experience may become overwhelming or too painful to adapt to, or the adaptation may come with great consequences. The long-term effects of this may lead to anxiety, low mood or lack of confidence. When stress keeps us in its grip for too long, some health problems or physical pain / psychosomatic symptoms may develop as a consequence. You may be feeling that you cannot live fully or express yourself, as if there was a block or a barrier between you and life, you and others, or you and your core self.
0115 824 3741 View 0115 824 3741
Photo of Reema Patel, Counsellor, MBACP Accred
Reema Patel
Counsellor, MBACP Accred
Verified Verified
1 Endorsed
Online Only
I support clients who present with a wide range of interpersonal and relationship difficulties, emotion regulation disorders such as BPD, childhood abuse, bereavement and loss, eating disorders, depression and anxiety and suicidal and self-harming behaviours.
I am a BACP-registered accredited counsellor, MBT therapist, DBT therapist + supervisor. My core training was in psychodynamic counselling; following this I continued my professional development in cognitive, mentalisation + dialectical-based therapies. I have a particular expertise in personality disorders, such as BPD.
I support clients who present with a wide range of interpersonal and relationship difficulties, emotion regulation disorders such as BPD, childhood abuse, bereavement and loss, eating disorders, depression and anxiety and suicidal and self-harming behaviours.
I am a BACP-registered accredited counsellor, MBT therapist, DBT therapist + supervisor. My core training was in psychodynamic counselling; following this I continued my professional development in cognitive, mentalisation + dialectical-based therapies. I have a particular expertise in personality disorders, such as BPD.
020 3826 8325 View 020 3826 8325
Photo of Dr Danielle Baillieu, Psychologist, DCounsPsych, HCPC - Couns. Psych.
Dr Danielle Baillieu
Psychologist, DCounsPsych, HCPC - Couns. Psych.
Verified Verified
London N3
This includes special needs such as ASD, ADHD, Dyslexia, trauma, anxiety, self-harming and bereavement.
While I work mainly in an existential and phenomenological way I also use a range of techniques, including CBT, EMDR, Mindfulness, FLASH and Brainspotting. I provide a safe, non-judgmental space for adults, children, couples and families where we can work on understanding the situation you are in and how to make changes in your life. Whether you're experiencing anxiety, depression or coping with bereavement, therapy will be tailor-made for your situation. I work with neurotypical and neurodiverse clients struggling with ADHD, autism, dyslexia, self-harm or bullying.
This includes special needs such as ASD, ADHD, Dyslexia, trauma, anxiety, self-harming and bereavement.
While I work mainly in an existential and phenomenological way I also use a range of techniques, including CBT, EMDR, Mindfulness, FLASH and Brainspotting. I provide a safe, non-judgmental space for adults, children, couples and families where we can work on understanding the situation you are in and how to make changes in your life. Whether you're experiencing anxiety, depression or coping with bereavement, therapy will be tailor-made for your situation. I work with neurotypical and neurodiverse clients struggling with ADHD, autism, dyslexia, self-harm or bullying.
07903 936379 View 07903 936379
Photo of Kira Montague, Psychotherapist, MA, HCPC-Art Therap.
Kira Montague
Psychotherapist, MA, HCPC-Art Therap.
Verified Verified
London SE19
I have supported adults facing a wide variety of experiences, including; depression, anxiety, frustration and feeling stuck, relationship challenges, loss and bereavement, work related stress, personality disorders, self-harming behaviour and suicidal thoughts, childhood sexual abuse, postnatal depression and people who want to deepen their relationship with themselves.
My way of working integrates humanistic and psychodynamic approaches, alongside the arts. Together we will work towards building a trusting relationship which offers the opportunity to explore and understand any of the feelings, thoughts and experiences that have brought you to therapy.
I have supported adults facing a wide variety of experiences, including; depression, anxiety, frustration and feeling stuck, relationship challenges, loss and bereavement, work related stress, personality disorders, self-harming behaviour and suicidal thoughts, childhood sexual abuse, postnatal depression and people who want to deepen their relationship with themselves.
My way of working integrates humanistic and psychodynamic approaches, alongside the arts. Together we will work towards building a trusting relationship which offers the opportunity to explore and understand any of the feelings, thoughts and experiences that have brought you to therapy.
020 4572 5107 View 020 4572 5107
Photo of Jack Reardon, Psychotherapist, BACP
Jack Reardon
Psychotherapist, BACP
Verified Verified
London SW4
I have experience with; addiction recovery, anxiety, depression, trauma, compulsive behaviour, relationship difficulties/or lack of relationship, low self-esteem, lacking direction/meaning in life, childhood abuse, dissociation, suicidal thoughts, anger, self-harming/destructive thoughts and behaviour, amongst others.
I am an Integrative Counselling Psychotherapist, with over 6 and a half years' experience throughout the field. I have facilitated the healing of a range of issues; ranging from chronic mental-illness to relationship issues. I also specialise in IFS (stepping stones level 1 with Derek Scott), psychodynamic and Jungian Psychotherapeutic approaches.
I have experience with; addiction recovery, anxiety, depression, trauma, compulsive behaviour, relationship difficulties/or lack of relationship, low self-esteem, lacking direction/meaning in life, childhood abuse, dissociation, suicidal thoughts, anger, self-harming/destructive thoughts and behaviour, amongst others.
I am an Integrative Counselling Psychotherapist, with over 6 and a half years' experience throughout the field. I have facilitated the healing of a range of issues; ranging from chronic mental-illness to relationship issues. I also specialise in IFS (stepping stones level 1 with Derek Scott), psychodynamic and Jungian Psychotherapeutic approaches.
01748 901307 View 01748 901307
Photo of Venise Adams-Sarfo - Chrystal Therapy (Autism Specialist), Psychotherapist, MBACP
Chrystal Therapy (Autism Specialist)
Psychotherapist, MBACP
Verified Verified
London WC2H
We have extensive experience working with children and young people (CYP) in schools, helping those who are struggling with: Self-Harming Behaviors, anxiey and low self esteem.
Are you, or someone you care for, navigating the challenges of ADHD or Autism Spectrum Disorder (ASD)? You’re not alone, at Chrystal Therapy, we are here to walk this journey with you. We understand how overwhelming these unique paths can feel. But we also know they can lead to incredible growth and uncover remarkable strengths. At Chrystal Therapy, our experienced team of therapists is dedicated to providing personalised care in a safe, supportive environment. We are proud to be registered members of the BACP.
We have extensive experience working with children and young people (CYP) in schools, helping those who are struggling with: Self-Harming Behaviors, anxiey and low self esteem.
Are you, or someone you care for, navigating the challenges of ADHD or Autism Spectrum Disorder (ASD)? You’re not alone, at Chrystal Therapy, we are here to walk this journey with you. We understand how overwhelming these unique paths can feel. But we also know they can lead to incredible growth and uncover remarkable strengths. At Chrystal Therapy, our experienced team of therapists is dedicated to providing personalised care in a safe, supportive environment. We are proud to be registered members of the BACP.
01905 975299 View 01905 975299
Photo of Beverley Blackman, Psychotherapist, MA, MUKCP
Beverley Blackman
Psychotherapist, MA, MUKCP
Verified Verified
London W1K
My background encompasses both private mental health sectors and NHS Mental Health Trusts, working both 1:1 and in groups, and includes working in a cutting-edge therapeutic community.
I have many years of experience at working integratively, meaning that I am able to draw on many different psychotherapeutic techniques in order to tailor the therapy to each individual's needs. This way, the whole of my attention is on you as a person and what your needs may be at that particular moment; there are no pre-determined steps.
My background encompasses both private mental health sectors and NHS Mental Health Trusts, working both 1:1 and in groups, and includes working in a cutting-edge therapeutic community.
I have many years of experience at working integratively, meaning that I am able to draw on many different psychotherapeutic techniques in order to tailor the therapy to each individual's needs. This way, the whole of my attention is on you as a person and what your needs may be at that particular moment; there are no pre-determined steps.
020 3962 1159 View 020 3962 1159
Photo of Fran Mullins, Counsellor, MBACP Accred
Fran Mullins
Counsellor, MBACP Accred
Verified Verified
London N2
The kind of issues that I help clients with include; anxiety, panic attacks, low mood, depression, relationship problems, jealousy, stress, repeated unwanted patterns of behaviour, work problems, grief and loss, low self esteem, self-harming or suicidal thoughts, addictions, anger, and body image or eating issues.
By building a trusting relationship wiith my clients, and drawing on a range of therapeutic techniques, I am able to help explore and examine their current issues and difficulties, with the aim of providing renewed hope, understanding, empowerment and choices.
The kind of issues that I help clients with include; anxiety, panic attacks, low mood, depression, relationship problems, jealousy, stress, repeated unwanted patterns of behaviour, work problems, grief and loss, low self esteem, self-harming or suicidal thoughts, addictions, anger, and body image or eating issues.
By building a trusting relationship wiith my clients, and drawing on a range of therapeutic techniques, I am able to help explore and examine their current issues and difficulties, with the aim of providing renewed hope, understanding, empowerment and choices.
020 3987 4651 View 020 3987 4651
Photo of Dr Nicole Harvey, Psychologist, HCPC - Forensic Psych.
Dr Nicole Harvey
Psychologist, HCPC - Forensic Psych.
Verified Verified
Online Only
I have significant experience working with individuals with big emotions, suicidal/ self-harming thoughts, relational difficulties, mood swings, feelings of emptiness, fears of abandonment, impulsivity, low mood, and anxiety.
If you're reading this you're probably looking for some support to make important changes to your life. Maybe you’ve noticed unhealthy or unwanted patterns in your relationships. Maybe you’re struggling to make sense of your emotions and behaviours. I will help you to understand yourself and support you to make the changes you may have been struggling to make on your own. You've come to the right place.
I have significant experience working with individuals with big emotions, suicidal/ self-harming thoughts, relational difficulties, mood swings, feelings of emptiness, fears of abandonment, impulsivity, low mood, and anxiety.
If you're reading this you're probably looking for some support to make important changes to your life. Maybe you’ve noticed unhealthy or unwanted patterns in your relationships. Maybe you’re struggling to make sense of your emotions and behaviours. I will help you to understand yourself and support you to make the changes you may have been struggling to make on your own. You've come to the right place.
020 4572 0474 View 020 4572 0474
Photo of Diane Patricia Stewart - Compassion Counselling , Counsellor, MBACP
Compassion Counselling
Counsellor, MBACP
Verified Verified
Online Only
My name is Diane Stewart. I am qualified Counsellor, who has worked in various settings including school and charity counselling services. I offer a compassionate counselling service online and face to face to children and adults. I have experience helping individuals with trauma, stress, anxiety, depression, suicide ideation, self harming, trauma, relationship issues, sexual abuse, emotional distress, attachment issues & intimacy related issues. I have worked with clients with additions and drug misuse.
My name is Diane Stewart. I am qualified Counsellor, who has worked in various settings including school and charity counselling services. I offer a compassionate counselling service online and face to face to children and adults. I have experience helping individuals with trauma, stress, anxiety, depression, suicide ideation, self harming, trauma, relationship issues, sexual abuse, emotional distress, attachment issues & intimacy related issues. I have worked with clients with additions and drug misuse.
020 7046 0102 View 020 7046 0102
Photo of Shana Laffy - Shana Laffy - Relationship Therapist , Counsellor, MBACP
Shana Laffy - Relationship Therapist
Counsellor, MBACP
Verified Verified
4 Endorsed
London NW5
My therapeutic approach is trauma-informed & based on cutting-edge neuroscience.
Connecting and relating to others is often one of life's hardest and most painful parts. Many people face challenges with their relationships, whether that's with a partner, friends, siblings, parents, or even the most important relationship—with themselves. People may come to therapy to talk about their sexuality or sexual challenges, communication blocks or trust issues. Partners may want to explore difficult topics such as a lack of desire or intimacy, or people might be curious to change aspects of their life that are no longer serving them.
My therapeutic approach is trauma-informed & based on cutting-edge neuroscience.
Connecting and relating to others is often one of life's hardest and most painful parts. Many people face challenges with their relationships, whether that's with a partner, friends, siblings, parents, or even the most important relationship—with themselves. People may come to therapy to talk about their sexuality or sexual challenges, communication blocks or trust issues. Partners may want to explore difficult topics such as a lack of desire or intimacy, or people might be curious to change aspects of their life that are no longer serving them.
020 3835 4910 View 020 3835 4910
Photo of Bukola James, Counsellor
Bukola James
Counsellor
Verified Verified
Online Only
I am experienced in dealing with adults, young people and teens on issues such as anxiety, depression, OCD, Self-harming, suicidal ideations, spirituality, family relationship difficulties, peer problems at school, Trauma related to sexual assaults/abuse, romantic relationship problems, self-esteem.
I offer a safe confidential space and compassionate listening ears for clients to explore any issue. I work collaboratively with clients of any or no faith to build hope and achieve desired outcomes, helping people on their journey to restoration. This has included a variety of issues ranging from anxiety, depression, trauma and other emotional distresses.
I am experienced in dealing with adults, young people and teens on issues such as anxiety, depression, OCD, Self-harming, suicidal ideations, spirituality, family relationship difficulties, peer problems at school, Trauma related to sexual assaults/abuse, romantic relationship problems, self-esteem.
I offer a safe confidential space and compassionate listening ears for clients to explore any issue. I work collaboratively with clients of any or no faith to build hope and achieve desired outcomes, helping people on their journey to restoration. This has included a variety of issues ranging from anxiety, depression, trauma and other emotional distresses.
020 3319 1372 View 020 3319 1372
Photo of Charlotte Harris, Psychotherapist, MBACP
Charlotte Harris
Psychotherapist, MBACP
Verified Verified
London SW10
My practice is informed by the most cutting edge neuroscience research from the trauma field which as redefined our understanding of the way we experience and process challenging events in our mind and body.
I am a highly skilled and effective psychotherapist and counsellor offering a meaningful and sensitive approach to the therapy process. I specialise in the area of trauma and it´s impact on your relationship with yourself and with others. It can be helpful to explore past experiences and how they may have impacted upon us but this doesn´t mean going over painful memories in a way that is retraumatising. Some people prefer not to remember what happened in the past, for others the story is very important. Our process follows what feels most helpful for you.
My practice is informed by the most cutting edge neuroscience research from the trauma field which as redefined our understanding of the way we experience and process challenging events in our mind and body.
I am a highly skilled and effective psychotherapist and counsellor offering a meaningful and sensitive approach to the therapy process. I specialise in the area of trauma and it´s impact on your relationship with yourself and with others. It can be helpful to explore past experiences and how they may have impacted upon us but this doesn´t mean going over painful memories in a way that is retraumatising. Some people prefer not to remember what happened in the past, for others the story is very important. Our process follows what feels most helpful for you.
01227 949768 View 01227 949768
Photo of Erica Eassom, Psychologist, PsychD, HCPC - Clin. Psych.
Erica Eassom
Psychologist, PsychD, HCPC - Clin. Psych.
Verified Verified
London WC1N
You might struggle with food and eating, self-harming or experience unstable emotions as well as substance abuse.
I have over a decade of experience working with people with complex emotional problems in academia, the NHS, and the third sector. I have a special interest in working with survivors of childhood abuse and domestic violence and work as an expert witness in the area of gender-based violence and complex trauma.
You might struggle with food and eating, self-harming or experience unstable emotions as well as substance abuse.
I have over a decade of experience working with people with complex emotional problems in academia, the NHS, and the third sector. I have a special interest in working with survivors of childhood abuse and domestic violence and work as an expert witness in the area of gender-based violence and complex trauma.
020 8051 7910 View 020 8051 7910
Photo of Joohyun Lee, Counsellor
Joohyun Lee
Counsellor
Verified Verified
London E14
I have over 10 years clinical experience in various settings, working with a wide range of issues including: • Addictive, Self-harming behaviours • Anxiety and Depression • Identity and Self-esteem • Loss and Trauma • Obsessive Compulsive Disorder (OCD) • Relationship difficulties • Sex or Sexuality related issues.
Thinking psychodynamically, I will help you to get in touch with lesser known parts of yourself that might have been the driving force behind the repetition of problematic behaviours or relationship patterns. Together we will work though the root causes of your difficulties and make lasting changes.
I have over 10 years clinical experience in various settings, working with a wide range of issues including: • Addictive, Self-harming behaviours • Anxiety and Depression • Identity and Self-esteem • Loss and Trauma • Obsessive Compulsive Disorder (OCD) • Relationship difficulties • Sex or Sexuality related issues.
Thinking psychodynamically, I will help you to get in touch with lesser known parts of yourself that might have been the driving force behind the repetition of problematic behaviours or relationship patterns. Together we will work though the root causes of your difficulties and make lasting changes.
020 3540 7327 View 020 3540 7327
Photo of Dr Ally Tomlins, Psychologist, PsychD, HCPC - Clin. Psych.
Dr Ally Tomlins
Psychologist, PsychD, HCPC - Clin. Psych.
Verified Verified
London SW1W
Her approach combines warmth and empathy with cutting-edge psychological science to deliver meaningful, lasting results.
Dr Tomlins is a Consultant Clinical Psychologist with 20+ years’ experience leading psychology services in the NHS and private sectors. She runs a private practice in London, working with adults and families, and leads the psychological provision for an intergenerational charity. At UCL, she works on the Doctorate in Clinical Psychology and is Deputy Course Director for the MSc in Clinical Associate Psychology. Dual trained as an Organisational Psychologist, she also works with high-performing executives from FTSE 100 companies. She has won multiple national awards for innovative and evidence based mental health work.
Her approach combines warmth and empathy with cutting-edge psychological science to deliver meaningful, lasting results.
Dr Tomlins is a Consultant Clinical Psychologist with 20+ years’ experience leading psychology services in the NHS and private sectors. She runs a private practice in London, working with adults and families, and leads the psychological provision for an intergenerational charity. At UCL, she works on the Doctorate in Clinical Psychology and is Deputy Course Director for the MSc in Clinical Associate Psychology. Dual trained as an Organisational Psychologist, she also works with high-performing executives from FTSE 100 companies. She has won multiple national awards for innovative and evidence based mental health work.
020 3872 2711 View 020 3872 2711
Photo of Rosella Pizzi, Counsellor, MBACP
Rosella Pizzi
Counsellor, MBACP
Verified Verified
London SW4
My experience includes working with primary school children, teenagers and adults, on issues such as anxiety, depression, domestic abuse, stress, panic attacks, anger, relationship difficulties, low self-confidence, low self-esteem, self-harming.
Hello, I’m Rosella, a qualified Integrative Counsellor and registered member of the British Association for Counselling and Psychotherapy (BACP). I offer counselling for adults and young people, providing both short- and long-term support. Therapy can help address feelings of anxiety, confusion, loss, burnout, or inadequacy. Everyone has a unique story, and I would be honoured to hear yours. In a compassionate, judgment-free space, we explore your experiences at your own pace, fostering self-awareness and growth. With the right environment, you can thrive and reach your full potential.
My experience includes working with primary school children, teenagers and adults, on issues such as anxiety, depression, domestic abuse, stress, panic attacks, anger, relationship difficulties, low self-confidence, low self-esteem, self-harming.
Hello, I’m Rosella, a qualified Integrative Counsellor and registered member of the British Association for Counselling and Psychotherapy (BACP). I offer counselling for adults and young people, providing both short- and long-term support. Therapy can help address feelings of anxiety, confusion, loss, burnout, or inadequacy. Everyone has a unique story, and I would be honoured to hear yours. In a compassionate, judgment-free space, we explore your experiences at your own pace, fostering self-awareness and growth. With the right environment, you can thrive and reach your full potential.
020 3597 6719 View 020 3597 6719
Photo of Dr Satbinder Kaur Bhogal, Psychologist, PsychD, HCPC - Clin. Psych.
Dr Satbinder Kaur Bhogal
Psychologist, PsychD, HCPC - Clin. Psych.
Verified Verified
Online Only
I work with both children & adults and have a keen interest in working with those who have experienced complex/relational trauma with or without self harming/suicidal behaviour. I work with a variety of mental health problems, such as anxiety and depression. I also work with couples experiencing difficulties in their relationship and work towards understanding the emotional conflicts, that result in the relationship being strained or likely to end without support. There is no one size fits all therapeutic approach and so I place importance on developing a shared understanding of what the core emotional issues are that impact you.
I work with both children & adults and have a keen interest in working with those who have experienced complex/relational trauma with or without self harming/suicidal behaviour. I work with a variety of mental health problems, such as anxiety and depression. I also work with couples experiencing difficulties in their relationship and work towards understanding the emotional conflicts, that result in the relationship being strained or likely to end without support. There is no one size fits all therapeutic approach and so I place importance on developing a shared understanding of what the core emotional issues are that impact you.
01564 334869 View 01564 334869
1
...

See more therapy options for London

Self-Harming Counsellors

How does therapy for self-harm work?

A person may turn to self-injury so that they can distract themselves from their stress, depression, anxiety, or upsetting circumstances. Therapy can address the cause of an individual’s suffering. A therapist can help a person understand why they may want to self-harm and help the person learn new methods of coping. A person may have poor emotion regulation, and treatment such as cognitive behavioural therapy (CBT) is helpful for breaking this behaviour. In addition, treatment such as dialectical behaviour therapy can help a person manage their tolerance of distress.

Which therapies are best for self-harm?

Specific approaches used by professionals include cognitive behavioural, dialectical behaviour, psychodynamic, and mentalisation-based therapies, among others. Cognitive behavioural and dialectical behaviour therapies are common approaches for people who have painful thoughts and past traumas. These therapies help an individual cope with distress, regulate emotions, and manage impulsive urges.

Does the tendency to self-harm mean the person is suicidal?

Having this urge does not mean the individual suffers from suicidal ideation. People who want to self-injure look to distract or alleviate themselves from the pain they are experiencing. People with suicidal tendencies want to end life altogether. However, this does not mean a person with the intent to self-harm will not attempt suicide.

How often and how long are therapy sessions for self-harm?

As with any type of therapy, sessions depend on the individual. Clients may see improvement within 20 sessions, at an average of 50 minutes per session, while others may opt for 20 to 30 sessions over, maybe, a six-month period. People, especially those with co-occurring conditions like depression and anxiety, may need to continue therapy for up to 12 to 18 months.