Family Therapy Psychiatrists in Caroline County, MD

Photo of Belinda Okoruwa, Psychiatric Nurse Practitioner, MSN, CRNP, FNP-BC, FNP-C, PMHNP
Belinda Okoruwa
Psychiatric Nurse Practitioner, MSN, CRNP, FNP-BC, FNP-C, PMHNP
Online Only
I am a dual-certified Nurse Practitioner with over 16 years of diverse experience working in the health care area both in the field of Family Medicine, leadership as well as Mental Health.
With extensive training in psychopharmacology, addiction medicine, and supportive therapy, I provide evidence-based treatment choices including medication management, non-pharmacological approaches, nutritional supplements, and addiction treatments including counseling and supportive therapy.
I am a dual-certified Nurse Practitioner with over 16 years of diverse experience working in the health care area both in the field of Family Medicine, leadership as well as Mental Health.
With extensive training in psychopharmacology, addiction medicine, and supportive therapy, I provide evidence-based treatment choices including medication management, non-pharmacological approaches, nutritional supplements, and addiction treatments including counseling and supportive therapy.
(443) 390-5838 View (443) 390-5838
Photo of Genia Grimes, Psychiatric Nurse Practitioner, PMHNNP
Genia Grimes
Psychiatric Nurse Practitioner, PMHNNP
1 Endorsed
Serves Area
Genia is a dedicated and patient-focused Psychiatric Nurse Practitioner. known for exceptional interpersonal and communication skills, the ability to manage competing priorities, and maintaining accurate and efficient documentation. She has a deep commitment to providing compassionate and comprehensive care to individuals struggling with mental health and substance use disorders. She believes that telehealth has the capacity to effectively reach a wider patient population, breaking down barriers and ensuring that quality care is accessible to all, regardless of geographical location or mobility constraints.
Genia is a dedicated and patient-focused Psychiatric Nurse Practitioner. known for exceptional interpersonal and communication skills, the ability to manage competing priorities, and maintaining accurate and efficient documentation. She has a deep commitment to providing compassionate and comprehensive care to individuals struggling with mental health and substance use disorders. She believes that telehealth has the capacity to effectively reach a wider patient population, breaking down barriers and ensuring that quality care is accessible to all, regardless of geographical location or mobility constraints.
(240) 655-8311 View (240) 655-8311
Photo of Alicia Medina - Greater Chesapeake, Psychiatric Nurse Practitioner, CRNP, LCSW-C, LCPC, RN, MD
Greater Chesapeake
Psychiatric Nurse Practitioner, CRNP, LCSW-C, LCPC, RN, MD
Serves Area
Now accepting adults and children in office or via telehealth. We offer medication management, therapy, and case management services. We treat a variety of mental health disorders including psychotic disorders, mood disorders, anxiety disorders, ADHD, and substance use disorders. We also offer Suboxone/Buprenorphine, Naltrexone, and other medications to treat addictions. We partner with other agencies such as Mental Health Court, IOPs, PRPs, and hospitals. We accept Medicaid, Medicare, and can help patients with no insurance. Contact us: 443-438-6893 or email via the link on this page.
Now accepting adults and children in office or via telehealth. We offer medication management, therapy, and case management services. We treat a variety of mental health disorders including psychotic disorders, mood disorders, anxiety disorders, ADHD, and substance use disorders. We also offer Suboxone/Buprenorphine, Naltrexone, and other medications to treat addictions. We partner with other agencies such as Mental Health Court, IOPs, PRPs, and hospitals. We accept Medicaid, Medicare, and can help patients with no insurance. Contact us: 443-438-6893 or email via the link on this page.
(410) 862-2975 View (410) 862-2975
Photo of Raymond S Hoffman, Psychiatrist, MD, FIPA
Raymond S Hoffman
Psychiatrist, MD, FIPA
Serves Area
I am a psychiatrist and psychoanalyst in practice in the Cape St. Clair area of Annapolis, MD, downtown Easton, MD, and in northern Caroline County, MD. My experience spans many years in the medication management of major and minor psychiatric disorders, but also in in-depth psychotherapeutic treatment of depression, anxiety, inhibitions, trauma, dissociation, attachment issues, relational challenges, and addiction. I am also experienced in the supervision of therapists expanding their psychodynamic and psychoanalytic knowledge base and in providing personal psychotherapy and control analysis for students in these disciplines.
I am a psychiatrist and psychoanalyst in practice in the Cape St. Clair area of Annapolis, MD, downtown Easton, MD, and in northern Caroline County, MD. My experience spans many years in the medication management of major and minor psychiatric disorders, but also in in-depth psychotherapeutic treatment of depression, anxiety, inhibitions, trauma, dissociation, attachment issues, relational challenges, and addiction. I am also experienced in the supervision of therapists expanding their psychodynamic and psychoanalytic knowledge base and in providing personal psychotherapy and control analysis for students in these disciplines.
(443) 233-0341 View (443) 233-0341

Online Psychiatrists

Photo of Joseph Griffin - Peace 4 Minds, Psychiatrist, M, D
Peace 4 Minds
Psychiatrist, M, D
2 Endorsed
Online Only
I focus on providing individual and family psychiatric treatment to obtain peace of mind from the worries, trials, and tribulations of life.
I specialize in treating patients with Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, Anxiety, Depression, Bipolar Disorders, and Schizophrenia Disorders
I focus on providing individual and family psychiatric treatment to obtain peace of mind from the worries, trials, and tribulations of life.
I specialize in treating patients with Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, Anxiety, Depression, Bipolar Disorders, and Schizophrenia Disorders
(443) 457-9429 View (443) 457-9429
Photo of Adeline Azong, Psychiatric Nurse Practitioner
Adeline Azong
Psychiatric Nurse Practitioner
Baltimore, MD 21227
We provide services such as individual, group and family therapy, we also have on our team experience psychiatry nurse practitioners that prescribe medication base on client needs
Mine Healthcare Services, LLC. (MHS) offers truly wraparound integrated care for people overcoming addiction and mental health challenges. We know that addiction is on the rise, despite the efforts of so many people for so long to help people find and hold on to recovery. Our approach is unique in that we treat the whole person in an all-under-one-roof approach. We provide a multi-tiered system of addiction treatment programs to match each patient to where they are and what they need right now. We have mental health and psychiatric care on site as well as community-based services in the community.
We provide services such as individual, group and family therapy, we also have on our team experience psychiatry nurse practitioners that prescribe medication base on client needs
Mine Healthcare Services, LLC. (MHS) offers truly wraparound integrated care for people overcoming addiction and mental health challenges. We know that addiction is on the rise, despite the efforts of so many people for so long to help people find and hold on to recovery. Our approach is unique in that we treat the whole person in an all-under-one-roof approach. We provide a multi-tiered system of addiction treatment programs to match each patient to where they are and what they need right now. We have mental health and psychiatric care on site as well as community-based services in the community.
(410) 709-7320 View (410) 709-7320
Photo of Vivian A Umeugo - Asten Behavioral Health, Psychiatric Nurse Practitioner, DNP, APRN, PMHNP, BC
Asten Behavioral Health
Psychiatric Nurse Practitioner, DNP, APRN, PMHNP, BC
1 Endorsed
Largo, MD 20774
I am a Board-Certified Family Psychiatric Nurse Practitioner licensed in the state of Maryland and Washington D
Dr. Umeugo will work collaboratively with each individual with various mental disorders using a holistic form and evidence-based treatment to develop a plan to achieve the best possible state of mental health. My practice philosophy is based on forging relationships with people to understand both their mental health needs.
I am a Board-Certified Family Psychiatric Nurse Practitioner licensed in the state of Maryland and Washington D
Dr. Umeugo will work collaboratively with each individual with various mental disorders using a holistic form and evidence-based treatment to develop a plan to achieve the best possible state of mental health. My practice philosophy is based on forging relationships with people to understand both their mental health needs.
(240) 221-5530 View (240) 221-5530
Photo of Christina Ekoko Abange, Psychiatric Nurse Practitioner, DNP, APRN, CRNP, PMHNP, BC
Christina Ekoko Abange
Psychiatric Nurse Practitioner, DNP, APRN, CRNP, PMHNP, BC
Greenbelt, MD 20770
Christina Ekoko Abange upbringing nurtured the core values that shaped her into who she is, loyal, compassionate, loving, caring, and honest, with a solid attachment to family and community.
Dr. Christina Ekoko Abange is an experienced and compassionate Pediatric, Geriatric, and Psychiatric Nurse with 13 years in the industry. Patient rights advocate with excellent communication and critical thinking skills. Track record for demonstrating strong leadership, team management, crisis management, and organizational skills. Patient-focused care provider dedicated to patient success. Dr. Christina Ekoko Abange is an Advanced Practice Registered Nurse (APRN), Certified Registered Nurse (CRN)
Christina Ekoko Abange upbringing nurtured the core values that shaped her into who she is, loyal, compassionate, loving, caring, and honest, with a solid attachment to family and community.
Dr. Christina Ekoko Abange is an experienced and compassionate Pediatric, Geriatric, and Psychiatric Nurse with 13 years in the industry. Patient rights advocate with excellent communication and critical thinking skills. Track record for demonstrating strong leadership, team management, crisis management, and organizational skills. Patient-focused care provider dedicated to patient success. Dr. Christina Ekoko Abange is an Advanced Practice Registered Nurse (APRN), Certified Registered Nurse (CRN)
(240) 202-3319 View (240) 202-3319
Photo of Constantine Lewko, Psychiatric Nurse Practitioner, PMHNP
Constantine Lewko
Psychiatric Nurse Practitioner, PMHNP
2 Endorsed
Laurel, MD 20708
Mental Health illness is difficult for you as the patient, and it is as difficult for family and friends watching your loved one suffer.
I provide all my patients with upbeat, stigma-free, individualized care. I am dedicated in helping individuals return to their optimal level of health in a timely manner. Recovery is attainable. We are here to help you every step of the way.
Mental Health illness is difficult for you as the patient, and it is as difficult for family and friends watching your loved one suffer.
I provide all my patients with upbeat, stigma-free, individualized care. I am dedicated in helping individuals return to their optimal level of health in a timely manner. Recovery is attainable. We are here to help you every step of the way.
(240) 540-5704 View (240) 540-5704
Photo of Stella Okeke - Courage Behavioral Healthcare Services LLC, Psychiatric Nurse Practitioner, PMHNP
Courage Behavioral Healthcare Services LLC
Psychiatric Nurse Practitioner, PMHNP
Rockville, MD 20850
"We work with clients who may be struggling with depression or trauma related to their relationships or family.
Are you or someone you love feeling overwhelmed? Are you feeling stressed at school or work? Is your child having a hard time fitting in school? Are they having issues with concentration and motivation? Do you feel depressed? Are you losing interest in everyday activities and pleasures? Are you having suicidal thoughts, thoughts of self harm or harming others? Do you have anxiety? Panic attacks? Or overall life disrupting PTSD? If this is you, please call us at Courage Behavioral Healthcare Services! Please call us, we will love to hear from you.
"We work with clients who may be struggling with depression or trauma related to their relationships or family.
Are you or someone you love feeling overwhelmed? Are you feeling stressed at school or work? Is your child having a hard time fitting in school? Are they having issues with concentration and motivation? Do you feel depressed? Are you losing interest in everyday activities and pleasures? Are you having suicidal thoughts, thoughts of self harm or harming others? Do you have anxiety? Panic attacks? Or overall life disrupting PTSD? If this is you, please call us at Courage Behavioral Healthcare Services! Please call us, we will love to hear from you.
(202) 873-9165 View (202) 873-9165
Photo of Bashkim Kadriu, Psychiatrist, MD, FAPA
Bashkim Kadriu
Psychiatrist, MD, FAPA
Bethesda, MD 20814
My subspeciality is on mood disorders and my practice focuses in the evaluation and treatment of depression, bipolar disorder, general anxiety disorders, post-traumatic stress disorders (PTSD), ADHD, related adjustment and stress-related disorders etc I provide medication management, consultations, individual or couples and/or family psychotherapy.
I received my board certification by the American Board of Psychiatry and Neurology (ABPN). I completed my Psychiatry Residency training at the Albert Einstein College of Medicine in New York City and the National Institute of Mental Health, Bethesda. My treatment approach is individual-centered, uniquely and collaboratively created with the client via a thorough understanding of life experience, symptoms, needs, and goals. It aims to improve individual mental health and overall sense of well-being. Complex mind & brain requires integrated multi-modal approach and thorough clinical expertise to ensure the best care is provided.
My subspeciality is on mood disorders and my practice focuses in the evaluation and treatment of depression, bipolar disorder, general anxiety disorders, post-traumatic stress disorders (PTSD), ADHD, related adjustment and stress-related disorders etc I provide medication management, consultations, individual or couples and/or family psychotherapy.
I received my board certification by the American Board of Psychiatry and Neurology (ABPN). I completed my Psychiatry Residency training at the Albert Einstein College of Medicine in New York City and the National Institute of Mental Health, Bethesda. My treatment approach is individual-centered, uniquely and collaboratively created with the client via a thorough understanding of life experience, symptoms, needs, and goals. It aims to improve individual mental health and overall sense of well-being. Complex mind & brain requires integrated multi-modal approach and thorough clinical expertise to ensure the best care is provided.
(240) 507-5579 View (240) 507-5579
Photo of Glory A Tataw - Glory Tataw, Psychiatric Nurse Practitioner, MSN, PMHNP, BC
Glory Tataw
Psychiatric Nurse Practitioner, MSN, PMHNP, BC
2 Endorsed
Ellicott City, MD 21042
Experienced and Enthusiastic is driven by a passion for motivating clients and family
“Let’s build the life you deserve.” “Accepting New Clients” Medication and Therapy services– Virtual and In-Person, No Waiting List! Taking the first step toward improving your mental health can feel overwhelming. Congratulations on reaching out – it’s a courageous and essential decision. At GBH, we’re here to walk with you on your journey to a happier, healthier life. Whether you’re dealing with focusing, concentration, bipolar, anxiety, depression, stress, or addiction, we’ll meet you where you are and help you achieve your goals. Same-day, evening, and weekend appointments . Book now at gloriousmentalclinic.com or CALL /TEXT
Experienced and Enthusiastic is driven by a passion for motivating clients and family
“Let’s build the life you deserve.” “Accepting New Clients” Medication and Therapy services– Virtual and In-Person, No Waiting List! Taking the first step toward improving your mental health can feel overwhelming. Congratulations on reaching out – it’s a courageous and essential decision. At GBH, we’re here to walk with you on your journey to a happier, healthier life. Whether you’re dealing with focusing, concentration, bipolar, anxiety, depression, stress, or addiction, we’ll meet you where you are and help you achieve your goals. Same-day, evening, and weekend appointments . Book now at gloriousmentalclinic.com or CALL /TEXT
(410) 883-9678 View (410) 883-9678
Photo of Sussan Ononaku, Psychiatric Nurse Practitioner, DNP, CRNP, PMHNP
Sussan Ononaku
Psychiatric Nurse Practitioner, DNP, CRNP, PMHNP
Laurel, MD 20707
My experience as a family nurse practitioner gave me added knowledge to manage your body, mind and spirit
As a board certified psychiatric nurse practitioner, I have the expertise in psychiatric evaluation, medication management, addiction treatment and psychotherapy. I treat patients from 6yrs and above. I accept people of different ethnic backgrounds and my care is focused on providing you with the best care, irrespective of your status.
My experience as a family nurse practitioner gave me added knowledge to manage your body, mind and spirit
As a board certified psychiatric nurse practitioner, I have the expertise in psychiatric evaluation, medication management, addiction treatment and psychotherapy. I treat patients from 6yrs and above. I accept people of different ethnic backgrounds and my care is focused on providing you with the best care, irrespective of your status.
(443) 457-9678 View (443) 457-9678
Photo of Michele Harrell - Amondi Behavioral Healthcare Services, Psychiatric Nurse Practitioner, PMHNP-C, FNP-BC, EdD, MSN
Amondi Behavioral Healthcare Services
Psychiatric Nurse Practitioner, PMHNP-C, FNP-BC, EdD, MSN
Germantown, MD 20876
I understand what it’s like to feel anxious, down, or emotionally exhausted while still trying to show up for work, family, or daily responsibilities.
As a dual-certified PMHNP-BC and FNP-BC, I offer a holistic approach to care that supports both mental and physical well-being. I specialize in treating anxiety, depression, trauma, and mood disorders through non judgmental personalized psychiatric care, including evaluations, medication management, and supportive therapy.
I understand what it’s like to feel anxious, down, or emotionally exhausted while still trying to show up for work, family, or daily responsibilities.
As a dual-certified PMHNP-BC and FNP-BC, I offer a holistic approach to care that supports both mental and physical well-being. I specialize in treating anxiety, depression, trauma, and mood disorders through non judgmental personalized psychiatric care, including evaluations, medication management, and supportive therapy.
(301) 640-5519 x20876 View (301) 640-5519 x20876
Photo of Dr. Letitia Bolds, Psychiatrist, MD
Dr. Letitia Bolds
Psychiatrist, MD
Bethesda, MD 20817
Perhaps they struggle with stress, sadness, school, or family.
As a double board certified Child and Adolescent and General Psychiatrist, I understand the complex and unique needs of each patient. Your options are not limited to pharmacological intervention alone. My treatment plans include healthy lifestyle adjustments and an understanding of how to organize and simplify your life.
Perhaps they struggle with stress, sadness, school, or family.
As a double board certified Child and Adolescent and General Psychiatrist, I understand the complex and unique needs of each patient. Your options are not limited to pharmacological intervention alone. My treatment plans include healthy lifestyle adjustments and an understanding of how to organize and simplify your life.
(301) 507-0792 View (301) 507-0792
Photo of Onyeanwuna Patrick Okpah - FocusMind Healthcare, Psychiatric Nurse Practitioner, PMHNP, BSN, MSN
FocusMind Healthcare
Psychiatric Nurse Practitioner, PMHNP, BSN, MSN
10 Endorsed
Online Only
My desire to follow the path of psychiatric mental health, was necessitated by the life-changing, and compassionate care, provided by a psychiatric nurse practitioner, to a close family member.
My strong background in psychiatric mental health across lifespan, and my expertise in the management of symptoma of Depression, Mood swings, Anxiety, PTSD, ADHD, Insomnia, and OCD, has allow me to assist my patients to lead a fulfilling live. My mission also, is to provide attainable care that not only treat symptoms, but also foster long-term well-being.
My desire to follow the path of psychiatric mental health, was necessitated by the life-changing, and compassionate care, provided by a psychiatric nurse practitioner, to a close family member.
My strong background in psychiatric mental health across lifespan, and my expertise in the management of symptoma of Depression, Mood swings, Anxiety, PTSD, ADHD, Insomnia, and OCD, has allow me to assist my patients to lead a fulfilling live. My mission also, is to provide attainable care that not only treat symptoms, but also foster long-term well-being.
(443) 234-0411 View (443) 234-0411
Photo of Ngozi Amadi-Obi - Prudent Behavioral and Wellness Health LLC, Psychiatric Nurse Practitioner, MSN, FNP, PMHNP
Prudent Behavioral and Wellness Health LLC
Psychiatric Nurse Practitioner, MSN, FNP, PMHNP
Online Only
I know what it means for a child or family member to be sick.
My name is Ngozi Amadi-Obi, but you can call me Ngozi. I work at Prudent Behavioral and Wellness Health as a psychiatric mental health nurse practitioner. My responsibilities include helping individuals with mental health problems and their families find support and solutions to their mental health concerns. My practice is driven by empathy, value, trust and respect for person and culture. I encourage and empower my clients to participate in the decision-making process as we focus on the positive outcome.
I know what it means for a child or family member to be sick.
My name is Ngozi Amadi-Obi, but you can call me Ngozi. I work at Prudent Behavioral and Wellness Health as a psychiatric mental health nurse practitioner. My responsibilities include helping individuals with mental health problems and their families find support and solutions to their mental health concerns. My practice is driven by empathy, value, trust and respect for person and culture. I encourage and empower my clients to participate in the decision-making process as we focus on the positive outcome.
(301) 939-0351 View (301) 939-0351
Photo of Grace Chikezie, Psychiatric Nurse Practitioner, DNP, CRNP, PMHNP, FNP
Grace Chikezie
Psychiatric Nurse Practitioner, DNP, CRNP, PMHNP, FNP
Online Only
I am a licensed Psychiatric Mental Nurse Practitioner and a licensed Family Nurse Practitioner too, I have worked with persons from various populations with mental health issues.
My goal is to help advocate for my clients and offer them good and customized care because I believe that as a trained PMHNP, I can improve people's quality of life mentally and otherwise using a holistic approach. I can help with psychotherapy during visits, anxiety disorders, depression, attention deficit hyperactivity disorder, PTSD and more.....
I am a licensed Psychiatric Mental Nurse Practitioner and a licensed Family Nurse Practitioner too, I have worked with persons from various populations with mental health issues.
My goal is to help advocate for my clients and offer them good and customized care because I believe that as a trained PMHNP, I can improve people's quality of life mentally and otherwise using a holistic approach. I can help with psychotherapy during visits, anxiety disorders, depression, attention deficit hyperactivity disorder, PTSD and more.....
(240) 887-0508 View (240) 887-0508
Photo of Juliet Ugochi Nwokedi, Psychiatric Nurse Practitioner, MSN, CRNP, PMHNP-B
Juliet Ugochi Nwokedi
Psychiatric Nurse Practitioner, MSN, CRNP, PMHNP-B
Online Only
I Prescribe and manage medications and offer treatments such as psychotherapy for individuals, groups, and family psychotherapy, including talk therapy and cog
As a board-certified Psychiatric Mental Health Practitioner, I understand that mental health matters and should be prioritized at all times. An individual’s ability to maintain a sound mind is key to achieving happiness and stability. With the impact of societal stigma on mental health, I congratulate you on taking the bold step in seeking help! I believe in your ability to live your best life in good health and sound mind, and that is why I am here.
I Prescribe and manage medications and offer treatments such as psychotherapy for individuals, groups, and family psychotherapy, including talk therapy and cog
As a board-certified Psychiatric Mental Health Practitioner, I understand that mental health matters and should be prioritized at all times. An individual’s ability to maintain a sound mind is key to achieving happiness and stability. With the impact of societal stigma on mental health, I congratulate you on taking the bold step in seeking help! I believe in your ability to live your best life in good health and sound mind, and that is why I am here.
(443) 342-9586 View (443) 342-9586
Photo of Bosede Adeleye - Amazing Healthcare Clinic, Psychiatric Nurse Practitioner, CRNP, PMHNP-B, FNP-BC
Amazing Healthcare Clinic
Psychiatric Nurse Practitioner, CRNP, PMHNP-B, FNP-BC
Hyattsville, MD 20783
To end the stigma associated with mental illness, I believe that educating patients, their family, and the public that mental illness can take many forms just as physical illness, and that early treatment and medication adherence is very critical.
I treat client with diverse mental health concerns such as Depression, Anxiety, Bipolar Disorder, ADHD, Schizophrenia and Suboxone treatment. I provide physical and psychosocial assessment, medication management, psychotherapy, and emergency psychiatric care for age six and above
To end the stigma associated with mental illness, I believe that educating patients, their family, and the public that mental illness can take many forms just as physical illness, and that early treatment and medication adherence is very critical.
I treat client with diverse mental health concerns such as Depression, Anxiety, Bipolar Disorder, ADHD, Schizophrenia and Suboxone treatment. I provide physical and psychosocial assessment, medication management, psychotherapy, and emergency psychiatric care for age six and above
(240) 387-9585 View (240) 387-9585

See more therapy options for Caroline County

Family Therapy Psychiatrists

What do family therapists do?

A family therapist facilitates the process of understanding and improving how a family functions. The therapist will help family members develop empathy for one another. They’ll seek to understand existing patterns, misunderstandings, and conflicts that arise, in order to help the family arrive at a realistic, unified understanding and develop the coping skills they need to build stronger relationships.

How long does therapy for families take to work?

Therapy manifests differently in every family; a common time frame is 12 weekly sessions, but some families may see improvement after just a few weeks. Families should discuss their goals with the therapist at the beginning of the process and periodically revisit those goals to assess their progress together.

How can you encourage a family member to attend family therapy?

You can encourage family members to attend therapy by expressing with both love and concern the challenges you see and explaining how a therapist could help the family navigate those challenges together. An outside perspective can help everyone feel heard, get on the same page, and develop new skills. If family members are still hesitant, it may be helpful to emphasize that family therapy is short-term—it won’t last forever.

Is therapy for families effective?

Family therapy can significantly improve family dynamics and relationships. Research suggests that family therapy can help individuals understand their role in the family, communicate and solve problems together, reduce conflict and draw boundaries when necessary, and develop coping skills for stressors, major life changes, and mental or physical illnesses within the family.