Photo of Nadya Kosanovskaya, Marriage & Family Therapist in Port Orchard, WA
Nadya Kosanovskaya
Marriage & Family Therapist, MA LMFT, SUDP, CMHS
Verified Verified
4 Endorsed
Port Orchard, WA 98366
I specialize in skills-building, trauma, life transitions, re-adjustments, anxiety, depression and stress mgnt.
I am a Master’s level Licensed Marriage and Family Therapy (LMFT) and co-occurring disorders therapist, who is trained in Family Systems and Substance Use/Dependency (SUDP) with the background in Human Biochemistry. I practice with a Holistic view and will focus on your overall well-being and not only emotional and mental health. My specialties are anxiety, depression, low self-esteem, insecurities and stress management. I support my clients and families on a level that is approachable, sensitive & humane, working with employees from; Google, Microsoft, FaceBook, AMZ, Boeing, Starbucks + others. Video sessions or in person meetings.
I specialize in skills-building, trauma, life transitions, re-adjustments, anxiety, depression and stress mgnt.
I am a Master’s level Licensed Marriage and Family Therapy (LMFT) and co-occurring disorders therapist, who is trained in Family Systems and Substance Use/Dependency (SUDP) with the background in Human Biochemistry. I practice with a Holistic view and will focus on your overall well-being and not only emotional and mental health. My specialties are anxiety, depression, low self-esteem, insecurities and stress management. I support my clients and families on a level that is approachable, sensitive & humane, working with employees from; Google, Microsoft, FaceBook, AMZ, Boeing, Starbucks + others. Video sessions or in person meetings.
(253) 300-2889 View (253) 300-2889
Photo of Northwest Therapy Group, PLLC - Kathleen Sharp, Counselor in Port Orchard, WA
Northwest Therapy Group, PLLC - Kathleen Sharp
Counselor, LMHCA
Verified Verified
Port Orchard, WA 98366  (Online Only)
Waitlist for new clients
I help with the process of healing depression, anxiety, substance abuse, and low self-esteem.
***Serving all of Washington state via Telehealth*** Much of adolescence and adulthood is reprogramming systems that have been put in place since childhood. I help individuals adapt to challenging life transitions as well as those wanting to understand and reconnect with themselves to find their sense of meaning in the world. My main purpose is to help others reach their potential in living a happy, healthy, and satisfying life.
I help with the process of healing depression, anxiety, substance abuse, and low self-esteem.
***Serving all of Washington state via Telehealth*** Much of adolescence and adulthood is reprogramming systems that have been put in place since childhood. I help individuals adapt to challenging life transitions as well as those wanting to understand and reconnect with themselves to find their sense of meaning in the world. My main purpose is to help others reach their potential in living a happy, healthy, and satisfying life.
(360) 230-5888 View (360) 230-5888
Photo of Tamara Axtell, Counselor in Port Orchard, WA
Tamara Axtell
Counselor, MS, LMHC, NCC
Verified Verified
1 Endorsed
Port Orchard, WA 98367
Providing caring and evidence-based treatments for anxiety, bipolar disorder, trauma, and co-occurring addictions is one of my passions.
Where are you trying to go? Is your past or fear for the future like a ball and chain, shackling you from the freedom you crave? Can you imagine your ideal life? I love to help my clients find a way toward living the life they envision. We all need a little help sometimes when life gets complicated. I always commit to working as hard as my clients in the time we spend together in sessions. I help clients gain practical skills and confidence for whatever challenges they are facing. Call me today and we will work together to break through to your best life!
Providing caring and evidence-based treatments for anxiety, bipolar disorder, trauma, and co-occurring addictions is one of my passions.
Where are you trying to go? Is your past or fear for the future like a ball and chain, shackling you from the freedom you crave? Can you imagine your ideal life? I love to help my clients find a way toward living the life they envision. We all need a little help sometimes when life gets complicated. I always commit to working as hard as my clients in the time we spend together in sessions. I help clients gain practical skills and confidence for whatever challenges they are facing. Call me today and we will work together to break through to your best life!
(253) 649-2370 View (253) 649-2370
Photo of Kassandrea E Manuele, Counselor in Port Orchard, WA
Kassandrea E Manuele
Counselor, LMHC
Verified Verified
Port Orchard, WA 98366
In a world that can often feel heavy with forces pushing and pulling us downward in so many directions it can feel all too easy to lose track of your true self. Feeling confused and asking how did I get here? Or why me? Or, I just want to get back to myself, but I don’t even know who I am anymore. You are not alone and there is a way. I work with individuals who struggle with these same questions. Questions that arise from the struggles with trauma, anxiety, depression, attention, autism, and others. My counseling services focus on addressing the integrated person.
In a world that can often feel heavy with forces pushing and pulling us downward in so many directions it can feel all too easy to lose track of your true self. Feeling confused and asking how did I get here? Or why me? Or, I just want to get back to myself, but I don’t even know who I am anymore. You are not alone and there is a way. I work with individuals who struggle with these same questions. Questions that arise from the struggles with trauma, anxiety, depression, attention, autism, and others. My counseling services focus on addressing the integrated person.
(253) 900-2430 View (253) 900-2430
Photo of Sarah Pence, Counselor in Port Orchard, WA
Sarah Pence
Counselor, LMHCA, SUDP
Verified Verified
Port Orchard, WA 98367
I specialize in trauma, anxiety, depression, and substance use disorders.
Everyone no matter who they are are able to move past the darkness and trauma of their past, I am here to help rebuild and reshape thoughts and behaviors that have kept you in the dark. I enjoy collaborating with my clients to achieve their best version of themselves. Reaching out for help is the hardest step in therapy a person can take. By having an open mind and free space to help clients feel safe to express past traumas is essential to build a foundation to become the version each person has the right to show the world.
I specialize in trauma, anxiety, depression, and substance use disorders.
Everyone no matter who they are are able to move past the darkness and trauma of their past, I am here to help rebuild and reshape thoughts and behaviors that have kept you in the dark. I enjoy collaborating with my clients to achieve their best version of themselves. Reaching out for help is the hardest step in therapy a person can take. By having an open mind and free space to help clients feel safe to express past traumas is essential to build a foundation to become the version each person has the right to show the world.
(253) 880-1529 View (253) 880-1529
Photo of Catherine McMonigle, Marriage & Family Therapist in Port Orchard, WA
Catherine McMonigle
Marriage & Family Therapist, MS, LMFT
Verified Verified
Port Orchard, WA 98366
I specialize in helping clients address a variety of issues such as the effects of childhood traumas, relationship distress, divorce, grief and loss, disordered eating patterns, family conflict, substance abuse, depression, anxiety, and life transitions.
My style of therapy is warm, accepting, and compassionate. After having trained extensively and been witness to countless stories of transformation, I can say with certainty that healing is absolutely possible. This is an invitation to break free from painful experiences, beliefs, and thought patterns that keep you from living the life you want, and leave you feeling hopeless or weary. I am guided by the belief that what you need to heal is already within you. Together, we will discover your internal source of strength and wisdom.
I specialize in helping clients address a variety of issues such as the effects of childhood traumas, relationship distress, divorce, grief and loss, disordered eating patterns, family conflict, substance abuse, depression, anxiety, and life transitions.
My style of therapy is warm, accepting, and compassionate. After having trained extensively and been witness to countless stories of transformation, I can say with certainty that healing is absolutely possible. This is an invitation to break free from painful experiences, beliefs, and thought patterns that keep you from living the life you want, and leave you feeling hopeless or weary. I am guided by the belief that what you need to heal is already within you. Together, we will discover your internal source of strength and wisdom.
(253) 367-2967 View (253) 367-2967
Photo of Jennifer Tynna Irwin, Counselor in Port Orchard, WA
Jennifer Tynna Irwin
Counselor, MS, LMHC, NCC
Verified Verified
Port Orchard, WA 98367
Have you been impacted by problematic relationships, infidelity, or sex addiction? You might feel lost, betrayed, and alone. Do you ask yourself, "How do I keep ending up in these relationships?". Are you afraid to be alone even when your partner is clearly unhealthy? Core beliefs are the foundation of our being but when they cause us pain, embarrassment, and shame we can become depressed, anxious, fake, and withdrawn. Do you compare yourself to others (I call this Comparanoia)? Do you tell yourself “I am stupid”, “I am worthless”, or “I am not good enough”? If so, then your core beliefs may be contributing to your pain today.
Have you been impacted by problematic relationships, infidelity, or sex addiction? You might feel lost, betrayed, and alone. Do you ask yourself, "How do I keep ending up in these relationships?". Are you afraid to be alone even when your partner is clearly unhealthy? Core beliefs are the foundation of our being but when they cause us pain, embarrassment, and shame we can become depressed, anxious, fake, and withdrawn. Do you compare yourself to others (I call this Comparanoia)? Do you tell yourself “I am stupid”, “I am worthless”, or “I am not good enough”? If so, then your core beliefs may be contributing to your pain today.
(253) 358-8564 View (253) 358-8564
Photo of Sunny Jansma-Simon, Mental Health Counselor in Port Orchard, WA
Sunny Jansma-Simon
Mental Health Counselor, MA, LMHC, CCTPII
Verified Verified
1 Endorsed
Port Orchard, WA 98366
We don't have to travel the path of change alone. Choosing a therapist is the first step. My goal is to build trust and safety so that you can sink into the work. Whatever is drawing you to therapy, you deserve an active and supportive therapist. My role: to provide witness and guideposts as you put words to your experience. Anxiety, depression and other symptoms may feel like they are keeping you from your life. Our work can help you discover what will serve you moving forward and let go of what does not.
We don't have to travel the path of change alone. Choosing a therapist is the first step. My goal is to build trust and safety so that you can sink into the work. Whatever is drawing you to therapy, you deserve an active and supportive therapist. My role: to provide witness and guideposts as you put words to your experience. Anxiety, depression and other symptoms may feel like they are keeping you from your life. Our work can help you discover what will serve you moving forward and let go of what does not.
(206) 737-0611 View (206) 737-0611
Photo of Sierra Osmers, Marriage & Family Therapist Associate in Port Orchard, WA
Sierra Osmers
Marriage & Family Therapist Associate, MA
Verified Verified
Port Orchard, WA 98367
My purpose is to help individuals, couples, and families overcome adversity in their lives and relationships. I use a solution-focused approach to understand each person’s unique set of values, and direction. Together, we will strengthen and heal your relationships with yourself, and the people important to you. We will find meaning out of your past experiences, and use this to create a change for your future. To identify what is truly important to you.
My purpose is to help individuals, couples, and families overcome adversity in their lives and relationships. I use a solution-focused approach to understand each person’s unique set of values, and direction. Together, we will strengthen and heal your relationships with yourself, and the people important to you. We will find meaning out of your past experiences, and use this to create a change for your future. To identify what is truly important to you.
View
Photo of James McCormack, Marriage & Family Therapist in Port Orchard, WA
James McCormack
Marriage & Family Therapist, LMFT, CCht, Rht
Verified Verified
1 Endorsed
Port Orchard, WA 98366
Couples/Families: Close relationships can be difficult. Top issues that bring couples into counseling include: Money, In-Laws, Parenting, Housework, Sex, and Emotional Intimacy. Relational issues left untreated often cause couples to live in "quiet desperation" or all-out warfare. Couple and familial relationships don't have to be a series of endless arguments or giving up and feeling alone. With awareness, skills, and practice relationships can change for the better. I would be honored to help in this journey so that you and your loved ones can recover the joy, fun, and deep connection that first drew you together.
Couples/Families: Close relationships can be difficult. Top issues that bring couples into counseling include: Money, In-Laws, Parenting, Housework, Sex, and Emotional Intimacy. Relational issues left untreated often cause couples to live in "quiet desperation" or all-out warfare. Couple and familial relationships don't have to be a series of endless arguments or giving up and feeling alone. With awareness, skills, and practice relationships can change for the better. I would be honored to help in this journey so that you and your loved ones can recover the joy, fun, and deep connection that first drew you together.
(360) 813-6594 View (360) 813-6594
Photo of Sheri A Lane, Marriage & Family Therapist in Port Orchard, WA
Sheri A Lane
Marriage & Family Therapist, MA, LMFT
Verified Verified
Port Orchard, WA 98367
Not accepting new clients
My Treatment Specialization includes: Premarital and Marital; Couples and Families; Working with First Responders; Parenting and Blended Family Issues; Adolescents; Life Transitions; Depression and Anxiety; Family of Origin Issues; Self Esteem; Stress Management; and Grief and Loss.
Are you struggling to communicate effectively with your spouse, partner, children or co-workers? Are you confused by the current circumstances you find yourself in? Life isn't easy, but finding someone to talk to about life's challenges should be. As a licensed Marriage and Family therapist, I am passionate about relationships and I am committed to helping individuals, couples and families reach their greatest potential. Using a collaborative approach, I offer my clients a safe environment to learn practical skills to help improve communication and decrease negativity in their relationships.
My Treatment Specialization includes: Premarital and Marital; Couples and Families; Working with First Responders; Parenting and Blended Family Issues; Adolescents; Life Transitions; Depression and Anxiety; Family of Origin Issues; Self Esteem; Stress Management; and Grief and Loss.
Are you struggling to communicate effectively with your spouse, partner, children or co-workers? Are you confused by the current circumstances you find yourself in? Life isn't easy, but finding someone to talk to about life's challenges should be. As a licensed Marriage and Family therapist, I am passionate about relationships and I am committed to helping individuals, couples and families reach their greatest potential. Using a collaborative approach, I offer my clients a safe environment to learn practical skills to help improve communication and decrease negativity in their relationships.
(253) 271-4671 View (253) 271-4671

More Therapists Nearby

Photo of Anita Bains in Port Orchard, WA
Anita Bains
MS, APRN, BC
Verified Verified
Bremerton, WA 98310  (Online Only)
As a therapist specializing in PTSD, trauma, stress, and anxiety I will help you navigate the path toward healing and growth. Together, we will heal the wounds of the past and uncover the resilience within you. and work towards reclaiming your life from the grip of past experiences. With my extensive experience and training, I have witnessed the profound impact that healing past can have on individuals. I understand that these challenges can manifest in various ways, affecting your emotions, relationships, and overall well-being.
As a therapist specializing in PTSD, trauma, stress, and anxiety I will help you navigate the path toward healing and growth. Together, we will heal the wounds of the past and uncover the resilience within you. and work towards reclaiming your life from the grip of past experiences. With my extensive experience and training, I have witnessed the profound impact that healing past can have on individuals. I understand that these challenges can manifest in various ways, affecting your emotions, relationships, and overall well-being.
(360) 529-3734 View (360) 529-3734
Photo of Dr. Colleen Rustad, Psychologist in Port Orchard, WA
Dr. Colleen Rustad
Psychologist, PhD, LCP
Verified Verified
3 Endorsed
Gig Harbor, WA 98332  (Online Only)
Waitlist for new clients
My specialties include working with adults dealing with stress, anxiety, depression, self-esteem issues or relationship problems, as well as academic /career/ or life transition.
I will work collaboratively with you in therapy so you can work through any challenges you may be facing and achieve your goals. Whether you are experiencing a new problem, or have been struggling with something for a while, together we will work to find your inner strengths, overcome past or present challenges, and improve the quality of your life. I am a warm and compassionate therapist who provides a safe, caring, and non-judgmental environment. My goal is for you to feel more hopeful and confident, and to live the life you desire.
My specialties include working with adults dealing with stress, anxiety, depression, self-esteem issues or relationship problems, as well as academic /career/ or life transition.
I will work collaboratively with you in therapy so you can work through any challenges you may be facing and achieve your goals. Whether you are experiencing a new problem, or have been struggling with something for a while, together we will work to find your inner strengths, overcome past or present challenges, and improve the quality of your life. I am a warm and compassionate therapist who provides a safe, caring, and non-judgmental environment. My goal is for you to feel more hopeful and confident, and to live the life you desire.
(253) 201-2154 View (253) 201-2154
Photo of Patricia Milligan, Counselor in Port Orchard, WA
Patricia Milligan
Counselor, MA, LMHC
Verified Verified
Bremerton, WA 98311
Have you ever been made to feel like you can do nothing right? Do you question your ability to make a decision? Are you anxious, on edge, depressed or even lonely? Authentic Thoughts is a counseling practice that helps you move from where you are to your true authentic self.
Have you ever been made to feel like you can do nothing right? Do you question your ability to make a decision? Are you anxious, on edge, depressed or even lonely? Authentic Thoughts is a counseling practice that helps you move from where you are to your true authentic self.
(253) 242-6674 View (253) 242-6674
Photo of Sarah L Boyd, Counselor in Port Orchard, WA
Sarah L Boyd
Counselor, LMHC
Verified Verified
Bremerton, WA 98310  (Online Only)
We need a place to process our experiences, resolve disruptive emotional responses, build healthy coping mechanisms, and face our deepest fears as we grow to become the best version of our true selves.
These days it seems everyone is dealing with trauma and overwhelming distress - whether childhood, complex, combat, generational, or just keeping up with the jones's, it is making our society sicker everyday as we forget how to care for one another and are forced into solitary corners of suffering. Those with the strongest natural supports and biological defenses will thrive, but more and more those natural supports and defenses are weakening, even for the most successful as the illness becomes pervasive.
We need a place to process our experiences, resolve disruptive emotional responses, build healthy coping mechanisms, and face our deepest fears as we grow to become the best version of our true selves.
These days it seems everyone is dealing with trauma and overwhelming distress - whether childhood, complex, combat, generational, or just keeping up with the jones's, it is making our society sicker everyday as we forget how to care for one another and are forced into solitary corners of suffering. Those with the strongest natural supports and biological defenses will thrive, but more and more those natural supports and defenses are weakening, even for the most successful as the illness becomes pervasive.
(425) 585-2658 View (425) 585-2658
Photo of Kristine Clay, Mental Health Counselor in Port Orchard, WA
Kristine Clay
Mental Health Counselor, PsyD, LMHC, CMHS
Verified Verified
Bremerton, WA 98311
Waitlist for new clients
Counseling to help navigate life's storms for families, children and adults. I work with clients post divorce both in co-parent counseling and reunification. Parent/co-parent coaching, counseling, and support to parents, children, and teens in family transitions. I enjoy working to restore relationships through Reunification Therapy for parent and child. I also provide Counseling for those with depression, anxiety, trauma, and other life stressors, family conflict, improve self concept and decision-making. We will reduce symptoms and increase joy and peace.
Counseling to help navigate life's storms for families, children and adults. I work with clients post divorce both in co-parent counseling and reunification. Parent/co-parent coaching, counseling, and support to parents, children, and teens in family transitions. I enjoy working to restore relationships through Reunification Therapy for parent and child. I also provide Counseling for those with depression, anxiety, trauma, and other life stressors, family conflict, improve self concept and decision-making. We will reduce symptoms and increase joy and peace.
(360) 531-7458 View (360) 531-7458
Photo of Bill Reddy, Counselor in Port Orchard, WA
Bill Reddy
Counselor, MCIOB, MA, LMHCA
Verified Verified
1 Endorsed
Bainbridge Island, WA 98110
I work with career professionals, adults, couples and teenagers who are experiencing difficulty in the office, at home or at school. I work with clients whose life experience is impacted by: trauma, relationships issues, midlife, leaving home, relocating, job loss, grief, anxiety, depression, culture shock or other significant life events including simply feeling stuck or at a loss. I bring over 30 years of professional and personal development to my work with individuals, families, adolescents, and couples. I hold a safe, secure, non-judgmental space in which to explore emotions, behaviors, thoughts, and feelings.
I work with career professionals, adults, couples and teenagers who are experiencing difficulty in the office, at home or at school. I work with clients whose life experience is impacted by: trauma, relationships issues, midlife, leaving home, relocating, job loss, grief, anxiety, depression, culture shock or other significant life events including simply feeling stuck or at a loss. I bring over 30 years of professional and personal development to my work with individuals, families, adolescents, and couples. I hold a safe, secure, non-judgmental space in which to explore emotions, behaviors, thoughts, and feelings.
(206) 823-1241 View (206) 823-1241
Photo of Robynn Frey, Marriage & Family Therapist in Port Orchard, WA
Robynn Frey
Marriage & Family Therapist, MA, LMFT
Verified Verified
Bremerton, WA 98311
Life can be hard! Having someone who listens and cares during a difficult time can make all the difference. My commitment to you is to build a strong relationship while offering the tools needed to meet your individual or family goals. I offer a client-centered, solution-focused approach to help guide you and support your needs. With strategies and approaches appropriate for all ages, I offer a non judgmental and safe environment, to help you/or your family achieve your goals. It would be an honor to be a support on your way to a healthy and rewarding journey!
Life can be hard! Having someone who listens and cares during a difficult time can make all the difference. My commitment to you is to build a strong relationship while offering the tools needed to meet your individual or family goals. I offer a client-centered, solution-focused approach to help guide you and support your needs. With strategies and approaches appropriate for all ages, I offer a non judgmental and safe environment, to help you/or your family achieve your goals. It would be an honor to be a support on your way to a healthy and rewarding journey!
(360) 526-8377 View (360) 526-8377
Photo of Holly Taylor, Counselor in Port Orchard, WA
Holly Taylor
Counselor, MA, LMHC
Not Verified Not Verified
Vashon, WA 98070
Integration of traumatic memories will elicit profound change, and enable us to feel and act from the love that is inherent in all people. I believe we are best able to become more aware of ourselves through studying our relationships. I will work with you to discover how you relate to others; we will study how your brain functions to bring past experiences into the present moment, distorting your sense of self and creating conflict. Clearing trauma can enable you to differentiate between then and now, so you are more free to make conscious choices about how you relate today.
Integration of traumatic memories will elicit profound change, and enable us to feel and act from the love that is inherent in all people. I believe we are best able to become more aware of ourselves through studying our relationships. I will work with you to discover how you relate to others; we will study how your brain functions to bring past experiences into the present moment, distorting your sense of self and creating conflict. Clearing trauma can enable you to differentiate between then and now, so you are more free to make conscious choices about how you relate today.
(206) 504-2246 View (206) 504-2246
Photo of Dr. Bre | Evolution Engineered, Inc., Licensed Professional Counselor in Port Orchard, WA
Dr. Bre | Evolution Engineered, Inc.
Licensed Professional Counselor, PhD, LPC, LMHC
Verified Verified
2 Endorsed
Gig Harbor, WA 98332  (Online Only)
Wanna be your own #RelationshipGoals! I help folx evolve beyond the same old arguments, into an honest partnership that nourishes each of you individually + together! My approach is all about identifying the individual skills each of you need to co-create a loving partnership -- without trauma bonds or codependency. I work with all backgrounds + orientations + expressions that know how to Love in all different ways! We do the work that is right for YOUR partnership—not anyone else's. You'll also discover if it's time to release your relationship. AND if it is time... I'll help you do so in the most Loving way!
Wanna be your own #RelationshipGoals! I help folx evolve beyond the same old arguments, into an honest partnership that nourishes each of you individually + together! My approach is all about identifying the individual skills each of you need to co-create a loving partnership -- without trauma bonds or codependency. I work with all backgrounds + orientations + expressions that know how to Love in all different ways! We do the work that is right for YOUR partnership—not anyone else's. You'll also discover if it's time to release your relationship. AND if it is time... I'll help you do so in the most Loving way!
(360) 788-3035 View (360) 788-3035

See more therapy options for Port Orchard

Anxiety Therapists

What are the most common treatments for anxiety?

Talk therapy, particularly cognitive behavioral therapy, is the most common treatment for anxiety. Studies have shown it is equally effective as medication. Other popular forms of therapy are popular, depending on a patient’s experience. Exposure therapy, for instance, can be useful for people dealing with fears and phobias, or who have experienced traumatic events. Dialectical Behavioral Therapy may be useful for patients who need help with emotion regulation. Anxiolytic medications, like benzodiazepines, can also help with calming a person enough to focus on the skills they’ve learned, and physical exercise has been shown to help symptoms of anxiety across the board.

How long does therapy for anxiety take to work?

The amount of time needed to alleviate symptoms depends on the severity of a person’s condition. Some therapies may take 5-20 weekly sessions to show results. Anti-depressant medications typically take two to four weeks before a benefit is felt. Anti-anxiety medications are felt typically within 20-30 minutes. Medications are best used to offer a patient a better headspace in which to work on techniques learned in therapy. Exercise, improved sleep habits, and meditation are effective, but takes weeks or months to show results.

When should I seek treatment for anxiety?

Everyone feels anxious at times, but when anxiety causes disruption to your daily life, it may be time to seek help. Such disruption can be mental, physical, or both: having fear dominate your thoughts, avoiding situations or objects that bring on feelings of anxiety, or experiencing shortness of breath, sweating, dizziness, or panic attacks. When these symptoms are recurrent and distressing, it may be time to talk to someone.

How effective is treatment for anxiety?

Treatment for anxiety has been shown to be moderately to highly effective, according to a large body of psychology studies and analyses. For some people, treatment using CBT or exposure therapy alone is effective. Others respond best to a combination of medication and therapy.