Photo of Pathway to Change Counseling Services, Marriage & Family Therapist in Puyallup, WA
Pathway to Change Counseling Services
Marriage & Family Therapist, MA, LMFT
Verified Verified
3 Endorsed
Puyallup, WA 98371
We provide individual, couples, group, and family counseling specializing in treatment for: depression, anxiety, trauma and PTSD, sexual abuse, ADHD/ADD, anger, mood disorder, behavioral problems, conflict resolution, OCD, grief counseling, parenting support, LGBTQ, gender identity, stress management and more.
We have immediate openings for new clients! Today is your first step on the pathway to change and together we will make the transformation you are seeking in your life. Pathway to Change is unique in that we offer several therapists to choose from who can work collaboratively with you to accomplish the change you want to see. With over 40 years of combined therapy experience each therapist offers a different approach within the therapeutic relationship. We are excited to now offer Life Coaching through our partnership with Simply You LLC. To schedule life coaching sessions please visit the following website: www.simply-you-llc.com.
We provide individual, couples, group, and family counseling specializing in treatment for: depression, anxiety, trauma and PTSD, sexual abuse, ADHD/ADD, anger, mood disorder, behavioral problems, conflict resolution, OCD, grief counseling, parenting support, LGBTQ, gender identity, stress management and more.
We have immediate openings for new clients! Today is your first step on the pathway to change and together we will make the transformation you are seeking in your life. Pathway to Change is unique in that we offer several therapists to choose from who can work collaboratively with you to accomplish the change you want to see. With over 40 years of combined therapy experience each therapist offers a different approach within the therapeutic relationship. We are excited to now offer Life Coaching through our partnership with Simply You LLC. To schedule life coaching sessions please visit the following website: www.simply-you-llc.com.
(253) 218-4176 View (253) 218-4176
Photo of Kristin Sweet Fischer, Marriage & Family Therapist in Puyallup, WA
Kristin Sweet Fischer
Marriage & Family Therapist, MA, LMFT
Verified Verified
2 Endorsed
Puyallup, WA 98371
I provide a supportive environment for individuals and couples to practice skills designed to enhance personal, relational, and professional satisfaction. My office is a safe confidential place to process life. I help individuals manage mental health and reduce need for prescriptions by incorporating research based practices. Learning tools to reduce anxiety, depression and PTSD due to trauma. Additionally, I am familiar with the challenges of military families and first responders. The unique cultural challenges of these groups and how therapy can help normalize and reduce mental distress for families and individuals.
I provide a supportive environment for individuals and couples to practice skills designed to enhance personal, relational, and professional satisfaction. My office is a safe confidential place to process life. I help individuals manage mental health and reduce need for prescriptions by incorporating research based practices. Learning tools to reduce anxiety, depression and PTSD due to trauma. Additionally, I am familiar with the challenges of military families and first responders. The unique cultural challenges of these groups and how therapy can help normalize and reduce mental distress for families and individuals.
(253) 218-4467 View (253) 218-4467
Photo of Code of Resilience Counseling, Clinical Social Work/Therapist in Puyallup, WA
Code of Resilience Counseling
Clinical Social Work/Therapist, LICSW
Verified Verified
Puyallup, WA 98375
We all need a safe space to unburden our fear, anxiety and sadness. Therapy is a place where you can do that freely. There are as many “kinds” of therapy as there are therapists. As a seasoned therapist I tend to have a more eclectic blend of therapy modalities. I can change and offer different approaches depending on what you need. One of the most important things a therapist does is meet you where you are and walk with you forward, out of the place of pain that brought you in. I like to think of it as meeting people where they are, sitting down and drawing a map together to get you back to being you!
We all need a safe space to unburden our fear, anxiety and sadness. Therapy is a place where you can do that freely. There are as many “kinds” of therapy as there are therapists. As a seasoned therapist I tend to have a more eclectic blend of therapy modalities. I can change and offer different approaches depending on what you need. One of the most important things a therapist does is meet you where you are and walk with you forward, out of the place of pain that brought you in. I like to think of it as meeting people where they are, sitting down and drawing a map together to get you back to being you!
(360) 564-5484 View (360) 564-5484
Photo of Kailee Akers, Marriage & Family Therapist Associate in Puyallup, WA
Kailee Akers
Marriage & Family Therapist Associate, LMFTA
Verified Verified
6 Endorsed
Puyallup, WA 98375
My ideal client is anyone that is ready to work on themselves or their relationships. I am willing to help anyone who needs help with depression, anxiety, relationship issues, behavioral issues, among many others.
My ideal client is anyone that is ready to work on themselves or their relationships. I am willing to help anyone who needs help with depression, anxiety, relationship issues, behavioral issues, among many others.
(253) 352-4554 View (253) 352-4554
Photo of Affordable Counseling Center, Marriage & Family Therapist in Puyallup, WA
Affordable Counseling Center
Marriage & Family Therapist, PhD, LMFT
Verified Verified
1 Endorsed
Puyallup, WA 98373
In today's society families encounter daily stressors which can lead to depression, anxiety, poor communication and so much more.
NEW Clients Welcome! The Affordable Counseling Center is designed to meet the counseling needs of all families, with affordable services at $25/session. Services are provided by Masters Level graduate students from local colleges who work under the direction of highly experienced and qualify supervisors.
In today's society families encounter daily stressors which can lead to depression, anxiety, poor communication and so much more.
NEW Clients Welcome! The Affordable Counseling Center is designed to meet the counseling needs of all families, with affordable services at $25/session. Services are provided by Masters Level graduate students from local colleges who work under the direction of highly experienced and qualify supervisors.
(253) 285-1618 x2 View (253) 285-1618 x2
Photo of Annie Sturtewagen, Counselor in Puyallup, WA
Annie Sturtewagen
Counselor, MA, LMHCA
Verified Verified
1 Endorsed
Puyallup, WA 98372
They have experience treating a variety of diagnoses and problems including mood disorders, anxiety disorders, suicidal thoughts, psychotic disorders, trauma, substance use, ADHD, autism, coping with chronic pain, grief, adjustment disorders, and emotional regulation difficulties.
Accepting New Patients In Person and Telehealth children, teens, and couples. She received their master’s degree in clinical mental health counseling at Northwestern University in June of 2023. Annie's past clinical experience includes working with a variety of clients at a community mental health agency dedicated to reaching underserved populations. Prior to becoming a licensed mental health counselor associate.Annie worked as a board-certified music therapist at a state psychiatric hospital for six years. Annie utilized a variety of expressive arts and therapeutic activities in both individual and group therapy settings.
They have experience treating a variety of diagnoses and problems including mood disorders, anxiety disorders, suicidal thoughts, psychotic disorders, trauma, substance use, ADHD, autism, coping with chronic pain, grief, adjustment disorders, and emotional regulation difficulties.
Accepting New Patients In Person and Telehealth children, teens, and couples. She received their master’s degree in clinical mental health counseling at Northwestern University in June of 2023. Annie's past clinical experience includes working with a variety of clients at a community mental health agency dedicated to reaching underserved populations. Prior to becoming a licensed mental health counselor associate.Annie worked as a board-certified music therapist at a state psychiatric hospital for six years. Annie utilized a variety of expressive arts and therapeutic activities in both individual and group therapy settings.
(253) 262-0586 View (253) 262-0586
Photo of Kellee Franks, Marriage & Family Therapist in Puyallup, WA
Kellee Franks
Marriage & Family Therapist, LMFT
Verified Verified
Puyallup, WA 98373  (Online Only)
Do you or your teen struggle in your relationships, with stress/anxiety, or your sense of self? Do you feel exhausted, overwhelmed, and lost by having to meet everyone's expectations, getting through everyday life, and feeling the weight of your stresses? Do you wonder or hope that your life, emotional health, and relationships could be better, or your teen could have better relationships, improved emotional regulation, and higher self-esteem? Now more than ever, adolescents, young adults, and women are feeling anxious, overwhelmed and uncertain about themselves, finding their place in life, and developing their sense of self.
Do you or your teen struggle in your relationships, with stress/anxiety, or your sense of self? Do you feel exhausted, overwhelmed, and lost by having to meet everyone's expectations, getting through everyday life, and feeling the weight of your stresses? Do you wonder or hope that your life, emotional health, and relationships could be better, or your teen could have better relationships, improved emotional regulation, and higher self-esteem? Now more than ever, adolescents, young adults, and women are feeling anxious, overwhelmed and uncertain about themselves, finding their place in life, and developing their sense of self.
(253) 242-9814 View (253) 242-9814
Photo of The Salish Sea Collective, Marriage & Family Therapist in Puyallup, WA
The Salish Sea Collective
Marriage & Family Therapist, LMFT, MS
Verified Verified
2 Endorsed
Puyallup, WA 98372
Whether you are struggling with anxiety, depression, trauma, or strained relationships we're here to help.
Life isn’t always easy. Sometimes, we need a little bit of help to work through some of life’s more challenging problems. Everyone has hurdles to overcome at some point. Whether you or your child struggle with anxiety, depression, or unhelpful behaviors, you should know that there is hope for a better tomorrow. The Salish Sea Collective understands that our clients deserve care encompassing physical, mental, emotional, sexual and spiritual health. These human aspects are intrinsically intertwined and require a holistic approach. Our multidisciplinary team create a cohesive atmosphere where clinicians work together for our clients.
Whether you are struggling with anxiety, depression, trauma, or strained relationships we're here to help.
Life isn’t always easy. Sometimes, we need a little bit of help to work through some of life’s more challenging problems. Everyone has hurdles to overcome at some point. Whether you or your child struggle with anxiety, depression, or unhelpful behaviors, you should know that there is hope for a better tomorrow. The Salish Sea Collective understands that our clients deserve care encompassing physical, mental, emotional, sexual and spiritual health. These human aspects are intrinsically intertwined and require a holistic approach. Our multidisciplinary team create a cohesive atmosphere where clinicians work together for our clients.
(253) 655-2757 View (253) 655-2757
Dr. John X Allemand
Clinical Social Work/Therapist, PhD, LICSW, BCD, MPH
Verified Verified
Puyallup, WA 98373
My work is influenced by the thought of existentialist philosophers and psychologists who speak compassionately to a profound and uniquely human dilemma—the quest for meaning in the face of suffering. Psychotherapy provides a safe and intimate space in which we might expand our capacity to bear suffering and to find meaning within and through it. Depth psychology proposes that the psyche consists of both conscious and unconscious thoughts, impulses, fantasies, and ideas. Symptoms (of depression, anxiety, addictions, etc.) are more than painful indicators of psychopathology.
My work is influenced by the thought of existentialist philosophers and psychologists who speak compassionately to a profound and uniquely human dilemma—the quest for meaning in the face of suffering. Psychotherapy provides a safe and intimate space in which we might expand our capacity to bear suffering and to find meaning within and through it. Depth psychology proposes that the psyche consists of both conscious and unconscious thoughts, impulses, fantasies, and ideas. Symptoms (of depression, anxiety, addictions, etc.) are more than painful indicators of psychopathology.
(206) 558-0266 View (206) 558-0266
Photo of Santana Taylor, Counselor in Puyallup, WA
Santana Taylor
Counselor, LMHC, SUDP
Verified Verified
1 Endorsed
Puyallup, WA 98373  (Online Only)
Thank you for checking in to learn a little bit more about me. Have you found that you struggling with issues related to anxiety, trauma, life transitions, or other major changes that can come on a day to day basis? We have all been there where we have found that we may need additional support to help navigate and cope with those challenges. My name is Santana and I am a Licensed Mental Health Counselor and a Substance use Disorder Professional offering virtual services.
Thank you for checking in to learn a little bit more about me. Have you found that you struggling with issues related to anxiety, trauma, life transitions, or other major changes that can come on a day to day basis? We have all been there where we have found that we may need additional support to help navigate and cope with those challenges. My name is Santana and I am a Licensed Mental Health Counselor and a Substance use Disorder Professional offering virtual services.
(270) 655-1976 View (270) 655-1976
Photo of Holly Bonnardel, Marriage & Family Therapist Associate in Puyallup, WA
Holly Bonnardel
Marriage & Family Therapist Associate, LMFTA
Verified Verified
Puyallup, WA 98373
I practice from a non-pathologizing perspective and fuse my clients’ context, experiences, core values and goals with a solution-focused lens to encourage my clients to understand unhelpful thoughts and behaviors. I share what I am observing authentically with direct communication and work to help my clients express and integrate new perspectives and emotions in a healthy way in order to reach their goals. I value and integrate aspects of most theoretical modalities, but work mostly from a solution-focused perspective while also emphasizing and exploring emotions.
I practice from a non-pathologizing perspective and fuse my clients’ context, experiences, core values and goals with a solution-focused lens to encourage my clients to understand unhelpful thoughts and behaviors. I share what I am observing authentically with direct communication and work to help my clients express and integrate new perspectives and emotions in a healthy way in order to reach their goals. I value and integrate aspects of most theoretical modalities, but work mostly from a solution-focused perspective while also emphasizing and exploring emotions.
(253) 447-5879 View (253) 447-5879
Photo of Leia Shinsato, Marriage & Family Therapist in Puyallup, WA
Leia Shinsato
Marriage & Family Therapist, LMFT
Verified Verified
4 Endorsed
Puyallup, WA 98373
As we venture through life, sometimes we find that the expectations we set for ourselves, our partners, and the future are constantly changing. My hope is to ease you through life’s transitions while enriching the relationships you have. I believe therapy should be a safe, non-judgmental, and nurturing place to put down the weights and ease into meaningful conversations. I enjoy working together with clients to identify their strengths, explore ways to reconnect with themselves and others to move forward in ways that feel genuine.
As we venture through life, sometimes we find that the expectations we set for ourselves, our partners, and the future are constantly changing. My hope is to ease you through life’s transitions while enriching the relationships you have. I believe therapy should be a safe, non-judgmental, and nurturing place to put down the weights and ease into meaningful conversations. I enjoy working together with clients to identify their strengths, explore ways to reconnect with themselves and others to move forward in ways that feel genuine.
(253) 465-9537 View (253) 465-9537
Photo of Jitani Mosley, Marriage & Family Therapist Associate in Puyallup, WA
Jitani Mosley
Marriage & Family Therapist Associate, MS, LMFTA
Verified Verified
Puyallup, WA 98372  (Online Only)
Jitani is a Marriage and Family Therapist. She graduated from Belmont Abbey College, where she received a bachelor’s degree in applied psychology, and went on to obtain a graduate degree in Marriage and Family Therapy from Capella University. Her philosophy is built on the notion that everything is connected to everything and that it is essential to explore how one’s family, co-workers, and friends, impact an individual’s mental health and vice versa.
Jitani is a Marriage and Family Therapist. She graduated from Belmont Abbey College, where she received a bachelor’s degree in applied psychology, and went on to obtain a graduate degree in Marriage and Family Therapy from Capella University. Her philosophy is built on the notion that everything is connected to everything and that it is essential to explore how one’s family, co-workers, and friends, impact an individual’s mental health and vice versa.
(253) 400-2663 View (253) 400-2663
Photo of McKenzie Sienkiewich, Pre-Licensed Professional in Puyallup, WA
McKenzie Sienkiewich
Pre-Licensed Professional, MA, LICSWA
Verified Verified
1 Endorsed
Puyallup, WA 98372  (Online Only)
Accepting NEW Patients Now via In Person and Telehealth! McKenzie is getting her master’s degree in Social Work at the university of New Mexico. As a Social Worker, she is looking forward to working with women, children, adults, men, and families.
Accepting NEW Patients Now via In Person and Telehealth! McKenzie is getting her master’s degree in Social Work at the university of New Mexico. As a Social Worker, she is looking forward to working with women, children, adults, men, and families.
(253) 352-4774 View (253) 352-4774
Photo of Ivy Turner, Marriage & Family Therapist Associate in Puyallup, WA
Ivy Turner
Marriage & Family Therapist Associate, LMFTA
Verified Verified
1 Endorsed
Puyallup, WA 98373
As a therapist, I see my clients as the experts in their own lives. My role is akin to that of a guest—here to build upon the tools you already possess while introducing new ones that align with your life goals. I enjoy guiding clients through challenging life changes and helping them break patterns that no longer serve them. My experience primarily lies in working with teens and adults, including LGBTQIA+ youth and individuals with BIPOC identities.
As a therapist, I see my clients as the experts in their own lives. My role is akin to that of a guest—here to build upon the tools you already possess while introducing new ones that align with your life goals. I enjoy guiding clients through challenging life changes and helping them break patterns that no longer serve them. My experience primarily lies in working with teens and adults, including LGBTQIA+ youth and individuals with BIPOC identities.
(253) 785-9733 View (253) 785-9733
Photo of Bryght Coaching & Counseling Services, Counselor in Puyallup, WA
Bryght Coaching & Counseling Services
Counselor, MA, LMHC
Verified Verified
1 Endorsed
Puyallup, WA 98373
I work with individuals, couples & groups as a psychotherapist, business coach, and energy intuitive since 1995. My work tends to the deep needs of the soul and addresses the most basic ego scripts so that you can shift cellular memories, rediscover your true voice, reconnect with your healthiest sense of self and remember your deepest callings--and then find the freedom to seek and find your best and highest self. I facilitate both Family Constellations and Organizational (business) Constellations on-line and in workshops that open you to engage with your deepest creativity and free you from repeating negative patterns.
I work with individuals, couples & groups as a psychotherapist, business coach, and energy intuitive since 1995. My work tends to the deep needs of the soul and addresses the most basic ego scripts so that you can shift cellular memories, rediscover your true voice, reconnect with your healthiest sense of self and remember your deepest callings--and then find the freedom to seek and find your best and highest self. I facilitate both Family Constellations and Organizational (business) Constellations on-line and in workshops that open you to engage with your deepest creativity and free you from repeating negative patterns.
(253) 200-6709 View (253) 200-6709
Photo of Patty Swanson, Marriage & Family Therapist in Puyallup, WA
Patty Swanson
Marriage & Family Therapist, MA, LMFT, LMHC, NCC
Verified Verified
1 Endorsed
Puyallup, WA 98371  (Online Only)
Waitlist for new clients
Telehealth/virtual counseling only. I am open: Monday, Tuesday all day. I make time for businesses needing a Critical Incident Stress Management specialist for a traumatic situation in the workplace. I supervise therapists seeking supervision hours for full licensure, and I am an AAMFT Approved Supervisor and Washington state approved supervisor. I help those with relationship issues or adjustments such as divorce, a move in career or home location, losses or kids growing up and leaving home, or struggling to navigate and adjust to chronic illness, and grief and loss, just to name a few topics.
Telehealth/virtual counseling only. I am open: Monday, Tuesday all day. I make time for businesses needing a Critical Incident Stress Management specialist for a traumatic situation in the workplace. I supervise therapists seeking supervision hours for full licensure, and I am an AAMFT Approved Supervisor and Washington state approved supervisor. I help those with relationship issues or adjustments such as divorce, a move in career or home location, losses or kids growing up and leaving home, or struggling to navigate and adjust to chronic illness, and grief and loss, just to name a few topics.
(253) 242-9728 View (253) 242-9728
Photo of Jessie Waiamau-Ariota, Counselor in Puyallup, WA
Jessie Waiamau-Ariota
Counselor, MA, LMHC
Verified Verified
Puyallup, WA 98373
Not accepting new clients
My specialty areas include Depression/Anxiety, Suicidal Ideation, Relationship Issues, and Coping Skills.
Christian Morden, (intern) is seeing clients at reduced rates. $75 for individual $95 for family HOPE is the only thing stronger than fear. Are you looking for a therapist to hope with you? I will. At the heart of all of my work as a therapist is a passion and desire to support and connect with you on your life journey. I will meet you where you are and help you get to where you want to go. You're reading this because you are ready for CHANGE! Learn how to apply LASTING SOLUTIONS to the issues in your life. I'll help you envision, fall in love with, and then create your best future. Aim for change. Hope with me. Let's get started!
My specialty areas include Depression/Anxiety, Suicidal Ideation, Relationship Issues, and Coping Skills.
Christian Morden, (intern) is seeing clients at reduced rates. $75 for individual $95 for family HOPE is the only thing stronger than fear. Are you looking for a therapist to hope with you? I will. At the heart of all of my work as a therapist is a passion and desire to support and connect with you on your life journey. I will meet you where you are and help you get to where you want to go. You're reading this because you are ready for CHANGE! Learn how to apply LASTING SOLUTIONS to the issues in your life. I'll help you envision, fall in love with, and then create your best future. Aim for change. Hope with me. Let's get started!
(253) 256-3713 View (253) 256-3713
Photo of Leana West, Marriage & Family Therapist Associate in Puyallup, WA
Leana West
Marriage & Family Therapist Associate, MA
Verified Verified
1 Endorsed
Puyallup, WA 98373
Not accepting new clients
I specialize within the areas of: Depression/Anxiety PTSD Grief/Loss Domestic/Intimate partner Abuse Trauma (Emotional, Mental, Sexual) Single Parenting.
As a Marriage and Family Therapist, I am passionate about getting to the heart of the challenge(s) my clients face. I desire to work with my clients in discovering who they are by working through the issue(s) they face and achieve their desired goal(s). I believe wholeheartedly in finding the beauty within that makes one uniquely who they are. There is no absolute way to achieve that, however; my role is to offer a judgment free safe space for my clients that allows for transparency in all aspects of their life to allow for hope to eliminate the feelings of being stuck and overwhelmed. I work with individuals, couples, and families
I specialize within the areas of: Depression/Anxiety PTSD Grief/Loss Domestic/Intimate partner Abuse Trauma (Emotional, Mental, Sexual) Single Parenting.
As a Marriage and Family Therapist, I am passionate about getting to the heart of the challenge(s) my clients face. I desire to work with my clients in discovering who they are by working through the issue(s) they face and achieve their desired goal(s). I believe wholeheartedly in finding the beauty within that makes one uniquely who they are. There is no absolute way to achieve that, however; my role is to offer a judgment free safe space for my clients that allows for transparency in all aspects of their life to allow for hope to eliminate the feelings of being stuck and overwhelmed. I work with individuals, couples, and families
(253) 544-4418 View (253) 544-4418
Photo of Charnei Washington, Marriage & Family Therapist Associate in Puyallup, WA
Charnei Washington
Marriage & Family Therapist Associate
Verified Verified
Puyallup, WA 98373  (Online Only)
Not accepting new clients
I specialize in helping adults of all walks of life, navigate significant life changes, cope with mild mood challenges, & provide support in sex therapy. Yes, I'm a sex therapist! My goal is to create a welcoming online space where you can openly share your thoughts & feelings, gain valuable insights, & develop the skills to empower yourself, whether related to your sexual journey or not. My passion is breaking the stigma around sex and sexual expression, especially in the context of mental health, with a focus on supporting people of color (POC). I believe mental health and sexual well-being are vital for overall wellness.
I specialize in helping adults of all walks of life, navigate significant life changes, cope with mild mood challenges, & provide support in sex therapy. Yes, I'm a sex therapist! My goal is to create a welcoming online space where you can openly share your thoughts & feelings, gain valuable insights, & develop the skills to empower yourself, whether related to your sexual journey or not. My passion is breaking the stigma around sex and sexual expression, especially in the context of mental health, with a focus on supporting people of color (POC). I believe mental health and sexual well-being are vital for overall wellness.
(253) 263-1262 View (253) 263-1262
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.