Dialectical Behavior (DBT) Psychiatrists in Westport, MA

Photo of Carol Smith, PA-C, Physician Assistant
Carol Smith
Physician Assistant, PA-C
Verified Verified
Westport, MA 02790
Self-discovery and implementation of new habits and skills can be uncomfortable. My ideal client is someone who is ready to be uncomfortable and one who is dedicated to making an investment in their mental health. Having someone who is consistent with their care and transparent about their feelings and symptoms will lead to an efficient resolution of concerns and achieving goals.
Self-discovery and implementation of new habits and skills can be uncomfortable. My ideal client is someone who is ready to be uncomfortable and one who is dedicated to making an investment in their mental health. Having someone who is consistent with their care and transparent about their feelings and symptoms will lead to an efficient resolution of concerns and achieving goals.
(508) 590-9521 View (508) 590-9521
Photo of Dr. Allen Masry, MD, Psychiatrist
Dr. Allen Masry
Psychiatrist, MD
Verified Verified
Westport, MA 02790
I am Board Certified in Adult Psychiatry and have been practicing since 2005. I completed my residency from Tufts University in Boston, Massachusetts and my Fellowship in Addictions from the Robert Johnson Wood Foundation. In 2014, I was featured in SJ Magazine as one of New Jersey’s top psychiatrists. I have experience working with adults as well as adolescents suffering from both psychiatric diagnosis and substance use disorders and have extensive experience working in both out-patient and in-patient settings.
I am Board Certified in Adult Psychiatry and have been practicing since 2005. I completed my residency from Tufts University in Boston, Massachusetts and my Fellowship in Addictions from the Robert Johnson Wood Foundation. In 2014, I was featured in SJ Magazine as one of New Jersey’s top psychiatrists. I have experience working with adults as well as adolescents suffering from both psychiatric diagnosis and substance use disorders and have extensive experience working in both out-patient and in-patient settings.
(508) 691-8476 View (508) 691-8476
Photo of Dr. Andrea Papa-Molter, MD, Psychiatrist
Dr. Andrea Papa-Molter
Psychiatrist, MD
Verified Verified
Westport, MA 02790
I am double board-certified in Psychiatry and Addiction Medicine. I believe in using both medication when indicated as well as therapy. I was trained in CBT and was given the Excellence in Cognitive Behavioral Therapy during my residency program. I use supportive therapy with each client I see. During my residency I served as Chief Resident and was awarded the Overall Excellence in Psychiatry Award as well as the Clinical Excellence Award.
I am double board-certified in Psychiatry and Addiction Medicine. I believe in using both medication when indicated as well as therapy. I was trained in CBT and was given the Excellence in Cognitive Behavioral Therapy during my residency program. I use supportive therapy with each client I see. During my residency I served as Chief Resident and was awarded the Overall Excellence in Psychiatry Award as well as the Clinical Excellence Award.
(508) 374-9699 View (508) 374-9699
DLH Consulting & Psychiatric Services
Psychiatric Nurse Practitioner, LMHC, LICSW, LCSW, PMH-NP, MD
Verified Verified
Westport, MA 02790
Today you are one step closer to a new you where you feel empowered and on a positive path to growth and well-being. As a solution-focused therapist, my goal is to help you uncover your true potential and lead a life that is worth celebrating.
Today you are one step closer to a new you where you feel empowered and on a positive path to growth and well-being. As a solution-focused therapist, my goal is to help you uncover your true potential and lead a life that is worth celebrating.
(508) 306-8336 View (508) 306-8336

More Psychiatrists Nearby

Photo of Emily Daniell, MSN, PMHNP, CARN-AP, Psychiatric Nurse Practitioner
Emily Daniell
Psychiatric Nurse Practitioner, MSN, PMHNP, CARN-AP
Verified Verified
Fall River, MA 02720
I am a board-certified Psychiatric Nurse Practitioner who believes strongly in the collaborative relationship between practitioner and client. I believe in offering non-stigmatized care in a comfortable setting where a trusting rapport can be built. I have experience treating anxiety, depression, ADHD, bipolar disorder, insomnia, etc. I am a certified Addiction specialist and have a decade of experience treating Substance Use Disorders. I offer treatment with Suboxone, Sublocade, Brixadi, or Vivitrol as well as general psychiatric med management. If you are looking for MAT, psych med mgmt, or both, I would love to work with you.
I am a board-certified Psychiatric Nurse Practitioner who believes strongly in the collaborative relationship between practitioner and client. I believe in offering non-stigmatized care in a comfortable setting where a trusting rapport can be built. I have experience treating anxiety, depression, ADHD, bipolar disorder, insomnia, etc. I am a certified Addiction specialist and have a decade of experience treating Substance Use Disorders. I offer treatment with Suboxone, Sublocade, Brixadi, or Vivitrol as well as general psychiatric med management. If you are looking for MAT, psych med mgmt, or both, I would love to work with you.
(401) 343-7562 View (401) 343-7562
Photo of Dr. Valerie Seney, PhD,  MA, LMHC, PMHNP, BC, Psychiatric Nurse Practitioner
Dr. Valerie Seney
Psychiatric Nurse Practitioner, PhD, MA, LMHC, PMHNP, BC
Verified Verified
1 Endorsed
Fall River, MA 02720
Waitlist for new clients
As a dedicated & board-certified Psychiatric Nurse Practitioner, I am committed to fostering a therapeutic partnership with each client. I believe in creating a safe & non-stigmatized environment where trust can flourish, forming the foundation for effective & personalized treatment. I specialize in addressing a spectrum of mental health concerns, including anxiety, depression, ADHD, bipolar disorder, and insomnia. My practice extends beyond conventional psychiatric care, to include treating Substance Use Disorder. Additionally, my services encompass psychotherapy & medication management to ensure holistic & effective treatment.
As a dedicated & board-certified Psychiatric Nurse Practitioner, I am committed to fostering a therapeutic partnership with each client. I believe in creating a safe & non-stigmatized environment where trust can flourish, forming the foundation for effective & personalized treatment. I specialize in addressing a spectrum of mental health concerns, including anxiety, depression, ADHD, bipolar disorder, and insomnia. My practice extends beyond conventional psychiatric care, to include treating Substance Use Disorder. Additionally, my services encompass psychotherapy & medication management to ensure holistic & effective treatment.
(774) 458-9613 x1 View (774) 458-9613 x1
Photo of Renee Marie Garbitt, MSN, C-NP, PMHNP, Psychiatric Nurse Practitioner
Renee Marie Garbitt
Psychiatric Nurse Practitioner, MSN, C-NP, PMHNP
Verified Verified
New Bedford, MA 02740  (Online Only)
Now accepting new referrals.- At Grounded Interventions Psychiatric Services we offer treatment grounded in empirically supported strategies to address a dynamic set of behavioral health needs. Our approach is compassionate, individually tailored and aimed at reducing distressing symptoms while improving overall quality of life.​
Now accepting new referrals.- At Grounded Interventions Psychiatric Services we offer treatment grounded in empirically supported strategies to address a dynamic set of behavioral health needs. Our approach is compassionate, individually tailored and aimed at reducing distressing symptoms while improving overall quality of life.​
(508) 886-3921 View (508) 886-3921

Online Psychiatrists

Photo of Christoforos Iraklis Giakoumatos, MD, Psychiatrist
Christoforos Iraklis Giakoumatos
Psychiatrist, MD
Verified Verified
Boston, MA 02116
I treat adults with mental health disorders, such as depression, bipolar disorder, anxiety, ADHD and PTSD. I also treat adults with substance use disorders and behavioral addictions. I believe in individualizing treatment based on each person's needs. I offer medication management visits, complemented with elements of Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Acceptance and Commitment Therapy (ACT) and psychodymanic psychotherapy. I also offer psychotherapy visits without medication management, if someone is not in need of medications.
I treat adults with mental health disorders, such as depression, bipolar disorder, anxiety, ADHD and PTSD. I also treat adults with substance use disorders and behavioral addictions. I believe in individualizing treatment based on each person's needs. I offer medication management visits, complemented with elements of Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Acceptance and Commitment Therapy (ACT) and psychodymanic psychotherapy. I also offer psychotherapy visits without medication management, if someone is not in need of medications.
(857) 810-4123 View (857) 810-4123
Photo of Jacqueline Buchanan, MD, Psychiatrist
Jacqueline Buchanan
Psychiatrist, MD
Verified Verified
Cambridge, MA 02138
I offer integrated CBT and DBT, and medication management, if indicated.
Sometimes we have a sense of the ways in which we hope to grow with psychotherapy, and sometimes we learn things about ourselves along the way that are unexpected and turn out to be central issues. Psychotherapy has the capacity to help us identify these central issues in a way that liberates and empowers us. In our work together, I will use psychodynamic psychotherapy to explore the issues you are concerned about, as well as who you are, what has shaped you, and what might be holding you back from living your life to the fullest. I have experience working with patients with a broad array of issues and diagnoses.
I offer integrated CBT and DBT, and medication management, if indicated.
Sometimes we have a sense of the ways in which we hope to grow with psychotherapy, and sometimes we learn things about ourselves along the way that are unexpected and turn out to be central issues. Psychotherapy has the capacity to help us identify these central issues in a way that liberates and empowers us. In our work together, I will use psychodynamic psychotherapy to explore the issues you are concerned about, as well as who you are, what has shaped you, and what might be holding you back from living your life to the fullest. I have experience working with patients with a broad array of issues and diagnoses.
(617) 648-9622 View (617) 648-9622
Photo of Menekse Alpay, MD, Psychiatrist
Menekse Alpay
Psychiatrist, MD
Verified Verified
1 Endorsed
Cambridge, MA 02138
I am well-versed in different psychotherapies including psychoanalysis, psychodynamic therapy, dialectical-behavioral therapy, mindfulness-based therapy and interpersonal therapy.
I work with individuals who have anxiety, depression, mood disorders, insomnia, relationship problems, trauma history, medical illness, neurological illness, and/or individuals who are helping family members with these problems. My experience over the last 25 years in psychiatry has shown that medications are helpful but do not take care of all problems in life. I offer combined psychiatric treatment. I received my psychiatric residency training from Georgetown University Hospital and fellowship in Psychosomatic Medicine from Massachusetts General Hospital, Harvard Medical School.
I am well-versed in different psychotherapies including psychoanalysis, psychodynamic therapy, dialectical-behavioral therapy, mindfulness-based therapy and interpersonal therapy.
I work with individuals who have anxiety, depression, mood disorders, insomnia, relationship problems, trauma history, medical illness, neurological illness, and/or individuals who are helping family members with these problems. My experience over the last 25 years in psychiatry has shown that medications are helpful but do not take care of all problems in life. I offer combined psychiatric treatment. I received my psychiatric residency training from Georgetown University Hospital and fellowship in Psychosomatic Medicine from Massachusetts General Hospital, Harvard Medical School.
(617) 231-9618 View (617) 231-9618
Photo of Jessica Kolczewski, MSN, APRN, Psychiatric Nurse Practitioner
Jessica Kolczewski
Psychiatric Nurse Practitioner, MSN, APRN
Verified Verified
Randolph, MA 02368  (Online Only)
I completed the DBT foundational training in 2014 and incorporate DBT concepts into my work.
Are you looking for someone who can both prescribe medications and be present and listen to your experience? I value the importance of combining therapeutic techniques with medication management. I am a Psychiatric Nurse Practitioner, with 14 years of nursing experience. I treat a variety of patients, including those suffering from trauma, anxiety, depression, mood disorders, ADHD, borderline personality disorder and suicidal or self injurious behaviors. On a part time basis, I have a "co-therapist" named Bella. She is trained as a therapy dog for the purpose of providing animal assisted therapy.
I completed the DBT foundational training in 2014 and incorporate DBT concepts into my work.
Are you looking for someone who can both prescribe medications and be present and listen to your experience? I value the importance of combining therapeutic techniques with medication management. I am a Psychiatric Nurse Practitioner, with 14 years of nursing experience. I treat a variety of patients, including those suffering from trauma, anxiety, depression, mood disorders, ADHD, borderline personality disorder and suicidal or self injurious behaviors. On a part time basis, I have a "co-therapist" named Bella. She is trained as a therapy dog for the purpose of providing animal assisted therapy.
(617) 208-4410 View (617) 208-4410
Photo of Dr. Adam Henderson, MD, Psychiatrist
Dr. Adam Henderson
Psychiatrist, MD
Verified Verified
2 Endorsed
Newton, MA 02459
Waitlist for new clients
I have expertise in Mentalization Based Therapy (MBT) and DBT for depression, anxiety and BPD treatment.
Welcome! I'm a board-certified psychiatrist offering psychotherapy and thoughtful medication management. I'm on faculty at Harvard Medical School and work as a staff psychiatrist at McLean hospital, in addition to my time in my confidential private practice. I'm specialized in trauma recovery, addiction counseling, and BPD treatment. I also help with depression, anxiety, and ADHD. I work with clients new to therapy as well as clients who have tried numerous therapies and/or medications and haven't gotten the results they wanted. I listen and work collaboratively with you.
I have expertise in Mentalization Based Therapy (MBT) and DBT for depression, anxiety and BPD treatment.
Welcome! I'm a board-certified psychiatrist offering psychotherapy and thoughtful medication management. I'm on faculty at Harvard Medical School and work as a staff psychiatrist at McLean hospital, in addition to my time in my confidential private practice. I'm specialized in trauma recovery, addiction counseling, and BPD treatment. I also help with depression, anxiety, and ADHD. I work with clients new to therapy as well as clients who have tried numerous therapies and/or medications and haven't gotten the results they wanted. I listen and work collaboratively with you.
(617) 284-0729 View (617) 284-0729
Photo of Christina Gormly - Vista Family Psychiatry, LLC, PMHNPBC, Psychiatric Nurse Practitioner
Vista Family Psychiatry, LLC
Psychiatric Nurse Practitioner, PMHNPBC
Verified Verified
Boston, MA 02109  (Online Only)
My name is Christina Gormly and I am currently scheduling new clients for telehealth sessions. I specialize in caring for children, adolescents, and young adults. I take a warm and holistic approach, utilizing CBT and DBT methods to assist you in meeting your goals. I enjoy working with families with complex needs. I am certified by the ANCC to treat mental health conditions across the lifespan. I have extensive experience in treating eating disorders, as well as depressive disorders, anxiety disorders, obsessive-compulsive disorders, trauma, attention deficit, and mood dysregulation.
My name is Christina Gormly and I am currently scheduling new clients for telehealth sessions. I specialize in caring for children, adolescents, and young adults. I take a warm and holistic approach, utilizing CBT and DBT methods to assist you in meeting your goals. I enjoy working with families with complex needs. I am certified by the ANCC to treat mental health conditions across the lifespan. I have extensive experience in treating eating disorders, as well as depressive disorders, anxiety disorders, obsessive-compulsive disorders, trauma, attention deficit, and mood dysregulation.
(603) 420-2529 View (603) 420-2529
Shoshana Marchand
Psychiatric Nurse, MA, MSN, PMHNPBC
Verified Verified
1 Endorsed
Northampton, MA 01060  (Online Only)
I'm a psychiatric nurse practitioner, offering consultation, medication management and therapy in downtown Northampton. I care about what makes us unique, as well as what we have in common. My interests include anxiety disorders like panic and OCD, as well as people on the autism spectrum or with social or learning differences. I'm delighted to work with LGBTQ clients or those in gender transition. I'm a believer in trauma -sensitive care, trained in DBT and in mindfulness. Clients say I'm both communicative and collaborative. Please note that my practice is currently limited to people aged 16 and older.
I'm a psychiatric nurse practitioner, offering consultation, medication management and therapy in downtown Northampton. I care about what makes us unique, as well as what we have in common. My interests include anxiety disorders like panic and OCD, as well as people on the autism spectrum or with social or learning differences. I'm delighted to work with LGBTQ clients or those in gender transition. I'm a believer in trauma -sensitive care, trained in DBT and in mindfulness. Clients say I'm both communicative and collaborative. Please note that my practice is currently limited to people aged 16 and older.
(413) 650-1402 View (413) 650-1402
Photo of Dr. Andrew Wu, MD, Psychiatrist
Dr. Andrew Wu
Psychiatrist, MD
Verified Verified
7 Endorsed
Brookline, MA 02446
Waitlist for new clients
I have broad experience with management of mood and anxiety disorders, and applying multimodal therapeutic techniques like DBT and ACT to best suit my patients needs.
Hi! It can be hard to find a good psychiatrist. Good mental healthcare requires a flexible and creative approach. To ensure high-quality psychiatric services, I operate a boutique practice, where patients have access to sooner appointments and can speak to me outside of appointments, if needed. If we work together, I strive to individualize your treatment to what works best for you. I have an active therapeutic style to make sure your sessions are engaging, helpful, and sometimes even fun! Whether it's your first time seeking out help, or you've seen previous doctors before, I'm happy to talk to you more.
I have broad experience with management of mood and anxiety disorders, and applying multimodal therapeutic techniques like DBT and ACT to best suit my patients needs.
Hi! It can be hard to find a good psychiatrist. Good mental healthcare requires a flexible and creative approach. To ensure high-quality psychiatric services, I operate a boutique practice, where patients have access to sooner appointments and can speak to me outside of appointments, if needed. If we work together, I strive to individualize your treatment to what works best for you. I have an active therapeutic style to make sure your sessions are engaging, helpful, and sometimes even fun! Whether it's your first time seeking out help, or you've seen previous doctors before, I'm happy to talk to you more.
(857) 226-4143 View (857) 226-4143
Photo of Carlos Covarrubias, MSN, PMHNP, Psychiatric Nurse Practitioner
Carlos Covarrubias
Psychiatric Nurse Practitioner, MSN, PMHNP
Verified Verified
Boston, MA 02130
I provide personalized treatment and services for a wide range of mental health issues, including psychotherapy using ACT, CBT, DBT, and MI techniques and evidence-based psychopharmacology.
I'm a psychiatric nurse practitioner in Boston, offering online psychotherapy to clients throughout Massachusetts, in-person therapy and medication management in Jamaica Plain, and online classes and workshops at www.ThreeTreesMentalHealth.com
I provide personalized treatment and services for a wide range of mental health issues, including psychotherapy using ACT, CBT, DBT, and MI techniques and evidence-based psychopharmacology.
I'm a psychiatric nurse practitioner in Boston, offering online psychotherapy to clients throughout Massachusetts, in-person therapy and medication management in Jamaica Plain, and online classes and workshops at www.ThreeTreesMentalHealth.com
(857) 475-7631 View (857) 475-7631
Photo of Shula Waldoks, PMHNP, Psychiatric Nurse Practitioner
Shula Waldoks
Psychiatric Nurse Practitioner, PMHNP
Verified Verified
Newton, MA 02464
I incorporate patient education, collaborative decision making, CBT, DBT, Internal Family Systems and trauma informed care into my medication management sessions.
I really enjoy working with people who are struggling with their mental health and know it's time to get help. Perhaps it is their first time reaching out or maybe their current medication and therapy regimen isn't working at well as it could be. I love to work with patients collaboratively, so that we can make decisions together and work as a team. I am particularly skilled at working with older adolescents and young adults in their 20s and early 30s as they navigate their way into healthy adulthood.
I incorporate patient education, collaborative decision making, CBT, DBT, Internal Family Systems and trauma informed care into my medication management sessions.
I really enjoy working with people who are struggling with their mental health and know it's time to get help. Perhaps it is their first time reaching out or maybe their current medication and therapy regimen isn't working at well as it could be. I love to work with patients collaboratively, so that we can make decisions together and work as a team. I am particularly skilled at working with older adolescents and young adults in their 20s and early 30s as they navigate their way into healthy adulthood.
(617) 644-4834 View (617) 644-4834
Photo of Arthi Kumaravel, Psychiatrist
Arthi Kumaravel
Psychiatrist
Verified Verified
4 Endorsed
Brookline, MA 02446  (Online Only)
I am a Harvard trained psychiatrist with a background in psychopharmacological (medication) approaches as well as a variety of therapy modalities, including psychodynamic psychotherapy, CBT, DBT, ACT, couples and group therapy.
Reaching out for help is one of the hardest yet crucial steps in improving your psychological well-being, and one which I commend you for doing. It can be difficult to find a psychiatrist that feels right for you. But once a strong connection is formed, that relationship can be a life changing experience for you. You deserve a safe space to explore the psychological, social, cultural, relationship and biological contributors to your mental health. I aim to provide you with this safe space using both therapy and medications tailored to address your specific mental health needs.
I am a Harvard trained psychiatrist with a background in psychopharmacological (medication) approaches as well as a variety of therapy modalities, including psychodynamic psychotherapy, CBT, DBT, ACT, couples and group therapy.
Reaching out for help is one of the hardest yet crucial steps in improving your psychological well-being, and one which I commend you for doing. It can be difficult to find a psychiatrist that feels right for you. But once a strong connection is formed, that relationship can be a life changing experience for you. You deserve a safe space to explore the psychological, social, cultural, relationship and biological contributors to your mental health. I aim to provide you with this safe space using both therapy and medications tailored to address your specific mental health needs.
(617) 812-7464 View (617) 812-7464
Photo of Anne Turley, NP, Psychiatric Nurse Practitioner
Anne Turley
Psychiatric Nurse Practitioner, NP
Verified Verified
Cambridge, MA 02139  (Online Only)
Anne integrates principles of motivational interviewing, cognitive behavioral therapy (CBT), and dialectical behavioral therapy (DBT) into her psychopharmacological treatment sessions.
Anne Turley is a Psychiatric Mental Health Nurse Practitioner in practice since 2014. She is well-versed in treating a wide range of diagnoses in patients aged 6-65. Anne is comfortable reaching outside traditional practice settings to care for patients and has embraced telemedicine as the key access to care advancement of the decade. Anne’s specialty areas include teenagers, autism spectrum disorder, mood disorders, obsessive-compulsive disorder, treatment-resistant anxiety disorders, and multi-diagnosis cases.
Anne integrates principles of motivational interviewing, cognitive behavioral therapy (CBT), and dialectical behavioral therapy (DBT) into her psychopharmacological treatment sessions.
Anne Turley is a Psychiatric Mental Health Nurse Practitioner in practice since 2014. She is well-versed in treating a wide range of diagnoses in patients aged 6-65. Anne is comfortable reaching outside traditional practice settings to care for patients and has embraced telemedicine as the key access to care advancement of the decade. Anne’s specialty areas include teenagers, autism spectrum disorder, mood disorders, obsessive-compulsive disorder, treatment-resistant anxiety disorders, and multi-diagnosis cases.
(339) 329-8545 View (339) 329-8545
Photo of Brian Boyle, MD, Psychiatrist
Brian Boyle
Psychiatrist, MD
Verified Verified
Brookline, MA 02446  (Online Only)
I provide psychiatric consultation, medication management, and therapy. I also have a background in therapeutic approaches including psychoanalysis, mentalization based treatment, dialectical behavioral therapy, and family therapy.
I provide psychiatric consultation, medication management, and therapy. I also have a background in therapeutic approaches including psychoanalysis, mentalization based treatment, dialectical behavioral therapy, and family therapy.
(857) 227-9205 View (857) 227-9205

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Dialectical Behavior (DBT) Psychiatrists

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.