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More Therapists Nearby

Photo of Donald A Simpson, Licensed Professional Counselor in Labadie, MO
Donald A Simpson
Licensed Professional Counselor, MDiv, MA, LPC
Verified Verified
Washington, MO 63090
What to do with a difficult child, or with a teen whose behaviors pose real problems. How to keep a job, change one, or stay in school. What to do when identity is unclear, hope is lost, or in a crisis of faith. How to see with a partner a way of love and care. How to act in wisdom. When in need of relief from anxieties or pressures feeling too much to bear, one takes a brave and important step reaching out for qualified help. Working with a mental health professional, one can find integrity and meaning in the midst of pain. One can find healing and hopefulness for facing challenges. One can better understand their life.
What to do with a difficult child, or with a teen whose behaviors pose real problems. How to keep a job, change one, or stay in school. What to do when identity is unclear, hope is lost, or in a crisis of faith. How to see with a partner a way of love and care. How to act in wisdom. When in need of relief from anxieties or pressures feeling too much to bear, one takes a brave and important step reaching out for qualified help. Working with a mental health professional, one can find integrity and meaning in the midst of pain. One can find healing and hopefulness for facing challenges. One can better understand their life.
(636) 466-8280 View (636) 466-8280

Online Therapists

Photo of Blooming Oasis Therapy Services, Licensed Professional Counselor in Labadie, MO
Blooming Oasis Therapy Services
Licensed Professional Counselor, MA, LPC
Verified Verified
1 Endorsed
Affton, MO 63123  (Online Only)
LPC trained in EMDR, SIP and attachment-based therapy.
Are you struggling to feel accepted & comfortable in your own skin? Blooming Oasis is a private practice that focuses on individual, couples, and LGBTQ+. We are located in Affton and Saint Louis area as well as telehealth therapy. We help by actively listening to your story and fostering a calm environment by providing a healthy model for boundaries and relationships. We help clients navigate through change and life events. We will take a person-centered integrated approach to help you gain healthy, effective coping skills and balance in your daily life.
LPC trained in EMDR, SIP and attachment-based therapy.
Are you struggling to feel accepted & comfortable in your own skin? Blooming Oasis is a private practice that focuses on individual, couples, and LGBTQ+. We are located in Affton and Saint Louis area as well as telehealth therapy. We help by actively listening to your story and fostering a calm environment by providing a healthy model for boundaries and relationships. We help clients navigate through change and life events. We will take a person-centered integrated approach to help you gain healthy, effective coping skills and balance in your daily life.
(636) 259-4904 View (636) 259-4904
Photo of Allie Lehr, Marriage & Family Therapist in Labadie, MO
Allie Lehr
Marriage & Family Therapist, MA, LMFT
Verified Verified
Webster Groves, MO 63119
I draw on attachment-based and emotionally focused interventions to support my clients in gaining self-awareness and addressing the root causes of their concerns.
Are you struggling with a relationship or relationships in your life, or maybe even struggling with the relationship with yourself? Do you feel disconnected, scared, and unsure of where to begin? Relationships are hard AND they are what make us human. I am passionate about helping my clients, whether they are individuals, families, or romantic partners, improve communication, increase connection, and overcome painful experiences that are preventing them from having and maintaining healthy relationships.
I draw on attachment-based and emotionally focused interventions to support my clients in gaining self-awareness and addressing the root causes of their concerns.
Are you struggling with a relationship or relationships in your life, or maybe even struggling with the relationship with yourself? Do you feel disconnected, scared, and unsure of where to begin? Relationships are hard AND they are what make us human. I am passionate about helping my clients, whether they are individuals, families, or romantic partners, improve communication, increase connection, and overcome painful experiences that are preventing them from having and maintaining healthy relationships.
(803) 879-4781 View (803) 879-4781
Photo of Nigel Cook, Clinical Social Work/Therapist in Labadie, MO
Nigel Cook
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
2 Endorsed
Saint Louis, MO 63130
Sexuality should be celebrated! Society often makes it difficult for people to express themselves in this way, and therefore I try to offer a space for clients to freely explore all aspects of their sexuality without judgement. In my practice, I work collaboratively with clients to develop sexual communication skills, process shame associated with sexuality, and learn how to practice safer (more pleasurable) sex. I have experience with many types of clients, including LGBTQ+ people, femme-people, sex workers, and people discovering themselves later in life.
Sexuality should be celebrated! Society often makes it difficult for people to express themselves in this way, and therefore I try to offer a space for clients to freely explore all aspects of their sexuality without judgement. In my practice, I work collaboratively with clients to develop sexual communication skills, process shame associated with sexuality, and learn how to practice safer (more pleasurable) sex. I have experience with many types of clients, including LGBTQ+ people, femme-people, sex workers, and people discovering themselves later in life.
(539) 245-6060 View (539) 245-6060
Photo of Riott Kochman, Clinical Social Work/Therapist in Labadie, MO
Riott Kochman
Clinical Social Work/Therapist, LCSW
Verified Verified
Saint Louis, MO 63104
The systems we live within (capitalism, colonialism, anti-fatness, etc.) and our early attachment experiences can leave us feeling disconnected from others, our bodies, our values, and our authentic selves. I offer a compassionate space to explore the ways these systems have impacted you. Together, we’ll develop resources, skills, and insights to make your life and relationships more manageable and meaningful.
The systems we live within (capitalism, colonialism, anti-fatness, etc.) and our early attachment experiences can leave us feeling disconnected from others, our bodies, our values, and our authentic selves. I offer a compassionate space to explore the ways these systems have impacted you. Together, we’ll develop resources, skills, and insights to make your life and relationships more manageable and meaningful.
(314) 501-5645 View (314) 501-5645
Photo of Healing Exchange LLC, Clinical Social Work/Therapist in Labadie, MO
Healing Exchange LLC
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Saint Louis, MO 63108
Are you ready to set healthy boundaries in your relationships? Have you been wanting to explore your sexuality but didn't know where to start? Is your non-monogamous relationship experiencing friction? Maybe you are the survivor, strong friend, and problem solver who appears to have it all together. Yet on the inside you feel overwhelmed while also wondering, "Is this worth going to therapy for?" If your boundaries leave you questioning yourself, if you want to explore your sexuality, or if you and your partner(s) want support, it's worth going to therapy for. Our relationship, sexuality, and trauma experts are here for you.
Are you ready to set healthy boundaries in your relationships? Have you been wanting to explore your sexuality but didn't know where to start? Is your non-monogamous relationship experiencing friction? Maybe you are the survivor, strong friend, and problem solver who appears to have it all together. Yet on the inside you feel overwhelmed while also wondering, "Is this worth going to therapy for?" If your boundaries leave you questioning yourself, if you want to explore your sexuality, or if you and your partner(s) want support, it's worth going to therapy for. Our relationship, sexuality, and trauma experts are here for you.
(314) 593-2416 View (314) 593-2416
Photo of Grayson Rosen, Pre-Licensed Professional in Labadie, MO
Grayson Rosen
Pre-Licensed Professional, MA, PLPC
Verified Verified
Saint Louis, MO 63104
Are you feeling like things just can’t continue the way they’re going? Has your inner critic become too loud? Are you curious about building a more authentic life? Wherever you are in your journey of self-discovery, facing your inner tension and deciding to seek help is an act of courage. I am dedicated to creating a therapeutic space with clients that is firmly rooted in safety and characterized by deep listening, where you can begin to work towards the root of your struggles at your own pace.
Are you feeling like things just can’t continue the way they’re going? Has your inner critic become too loud? Are you curious about building a more authentic life? Wherever you are in your journey of self-discovery, facing your inner tension and deciding to seek help is an act of courage. I am dedicated to creating a therapeutic space with clients that is firmly rooted in safety and characterized by deep listening, where you can begin to work towards the root of your struggles at your own pace.
(314) 820-0553 View (314) 820-0553
Photo of Megan Kopriva, Clinical Social Work/Therapist in Labadie, MO
Megan Kopriva
Clinical Social Work/Therapist, RYT, MSW, LCSW
Verified Verified
Saint Louis, MO 63117  (Online Only)
*ACCEPTING CALIFORNIA, ILLINOIS, AND MISSOURI CLIENTS* Come be seen & be known in a relational space with me, so that you can finally arrive home in yourself. Are you curious if you have experienced trauma, or if trauma may still be affecting you? Have you worked with many healers & still feel stuck in certain places? Have you experienced a spiritual awakening & need to integrate the experience(s)? If you answered 'yes' to any of these questions, then you may be in the right place. Trauma can express itself in PTSD & Complex PTSD symptoms, various types of depression & anxiety, & many other symptoms. Lets get to the root.
*ACCEPTING CALIFORNIA, ILLINOIS, AND MISSOURI CLIENTS* Come be seen & be known in a relational space with me, so that you can finally arrive home in yourself. Are you curious if you have experienced trauma, or if trauma may still be affecting you? Have you worked with many healers & still feel stuck in certain places? Have you experienced a spiritual awakening & need to integrate the experience(s)? If you answered 'yes' to any of these questions, then you may be in the right place. Trauma can express itself in PTSD & Complex PTSD symptoms, various types of depression & anxiety, & many other symptoms. Lets get to the root.
(341) 444-3409 View (341) 444-3409
Photo of Rynn Wyrick, Licensed Professional Counselor in Labadie, MO
Rynn Wyrick
Licensed Professional Counselor, LPC, NCC
Verified Verified
1 Endorsed
Saint Louis, MO 63101  (Online Only)
I specialize in offering trauma-informed therapy to LGBTQIA+ and neurodivergent adults residing in Missouri. As a queer and trans individual myself, my focus is on co-creating a safe and affirming environment for folks to thrive. I hold space for clients to explore and process their experiences of grief, complex trauma, and challenges stemming from the impacts of living in a traumatic and oppressive society. I particularly enjoy working with queer and neurodiverse individuals who are interested in taking a more deliberate approach to their personal growth and who wish to develop a deeper connection with themselves and their bodies.
I specialize in offering trauma-informed therapy to LGBTQIA+ and neurodivergent adults residing in Missouri. As a queer and trans individual myself, my focus is on co-creating a safe and affirming environment for folks to thrive. I hold space for clients to explore and process their experiences of grief, complex trauma, and challenges stemming from the impacts of living in a traumatic and oppressive society. I particularly enjoy working with queer and neurodiverse individuals who are interested in taking a more deliberate approach to their personal growth and who wish to develop a deeper connection with themselves and their bodies.
(314) 970-3579 View (314) 970-3579
Photo of Kat Seal, Pre-Licensed Professional in Labadie, MO
Kat Seal
Pre-Licensed Professional, LMSW
Verified Verified
1 Endorsed
Saint Louis, MO 63108
Feeling fractured from your once-strong sense of self can be confusing, isolating, and painful. Oftentimes these feelings can arise from societal pressures to conform, living in a sex-negative society, or relationship and systemic trauma. Sex & relationship therapy can be a good fit for improving the relational quality of your life and accessing desire as a tool for living well. I specialize in supporting individuals and relationships (of all styles) who struggle to access authenticity and wholeness in their daily lives. I work best with engaged clients who practice active self reflection.
Feeling fractured from your once-strong sense of self can be confusing, isolating, and painful. Oftentimes these feelings can arise from societal pressures to conform, living in a sex-negative society, or relationship and systemic trauma. Sex & relationship therapy can be a good fit for improving the relational quality of your life and accessing desire as a tool for living well. I specialize in supporting individuals and relationships (of all styles) who struggle to access authenticity and wholeness in their daily lives. I work best with engaged clients who practice active self reflection.
(314) 897-4049 View (314) 897-4049
Photo of Mason Alexander Kinghorn, Clinical Social Work/Therapist in Labadie, MO
Mason Alexander Kinghorn
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Saint Louis, MO 63116  (Online Only)
Available Appt. Hours: Monday-Friday 11am-5pm. Do you struggle with depression, anxiety, feeling disconnected from others, or the way your life has been impacted by trauma? Are you searching for happiness or meaning in your relationships, your work, or in life in general? If any of this resonates with you, I may have the type of professional experience that would be helpful to you. I work with adults (18+) providing virtual therapy. I have additional experience with anger management, life transitions, LGBTQIA+ related issues, and low self-esteem. I am proud to provide gender-affirming care.
Available Appt. Hours: Monday-Friday 11am-5pm. Do you struggle with depression, anxiety, feeling disconnected from others, or the way your life has been impacted by trauma? Are you searching for happiness or meaning in your relationships, your work, or in life in general? If any of this resonates with you, I may have the type of professional experience that would be helpful to you. I work with adults (18+) providing virtual therapy. I have additional experience with anger management, life transitions, LGBTQIA+ related issues, and low self-esteem. I am proud to provide gender-affirming care.
(314) 730-0097 View (314) 730-0097
Photo of Cindy Renee Aug, Clinical Social Work/Therapist in Labadie, MO
Cindy Renee Aug
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Saint Louis, MO 63128
In Psychotherapy, it is the relationship between the patient and the therapist that allows for the patient to search for understanding into the nature of their difficulties. It is within the safety, confidentiality and understanding acceptance that the patient is encouraged to reveal intimate parts of themselves that allow the therapist to identify characteristic problems and patterns of behavior. Seemingly unexplainable behavior, thought patterns and symptoms turn out to have identifiable meanings beyond the awareness of the patient. Psychodynamic psychotherapy is aimed at personality changing goals and symptom relieving efforts. The patient is always in control of the therapeutic process.
In Psychotherapy, it is the relationship between the patient and the therapist that allows for the patient to search for understanding into the nature of their difficulties. It is within the safety, confidentiality and understanding acceptance that the patient is encouraged to reveal intimate parts of themselves that allow the therapist to identify characteristic problems and patterns of behavior. Seemingly unexplainable behavior, thought patterns and symptoms turn out to have identifiable meanings beyond the awareness of the patient. Psychodynamic psychotherapy is aimed at personality changing goals and symptom relieving efforts. The patient is always in control of the therapeutic process.
(573) 260-1145 View (573) 260-1145
Photo of Megan MacKenzie, Clinical Social Work/Therapist in Labadie, MO
Megan MacKenzie
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Saint Louis, MO 63108
As a relationship, sex, and gender therapist, I help couples, relationships, and individuals explore identities, navigate non-monogamy, and experience greater pleasure and intimacy. I am passionate about supporting LGBTQ+ folks in exploring and healing from the negative impacts of internalized homophobia, transphobia, and racism as they often manifest in shame, guilt, and low self-esteem.
As a relationship, sex, and gender therapist, I help couples, relationships, and individuals explore identities, navigate non-monogamy, and experience greater pleasure and intimacy. I am passionate about supporting LGBTQ+ folks in exploring and healing from the negative impacts of internalized homophobia, transphobia, and racism as they often manifest in shame, guilt, and low self-esteem.
(314) 626-0543 View (314) 626-0543
Photo of Lenna Catrett, Pre-Licensed Professional in Labadie, MO
Lenna Catrett
Pre-Licensed Professional, MSW, LMSW
Verified Verified
Saint Louis, MO 63104
Many of us are grappling with the effects of disconnection – from our bodies, emotions, identities, relationships, communities, and the natural world. This disconnection often presents as shame, self-criticism, fear and anxiety, dissociation, depression, self-harm, suicidal ideation, and more. Folks who are seeking to interrogate those symptoms, process traumas (both interpersonal and from larger systems of oppression), nurture self-compassion, build healthy relationships and community, explore social and cultural identities, challenge expectations of how to live a life, and recenter your autonomy: I’d love to work with you.
Many of us are grappling with the effects of disconnection – from our bodies, emotions, identities, relationships, communities, and the natural world. This disconnection often presents as shame, self-criticism, fear and anxiety, dissociation, depression, self-harm, suicidal ideation, and more. Folks who are seeking to interrogate those symptoms, process traumas (both interpersonal and from larger systems of oppression), nurture self-compassion, build healthy relationships and community, explore social and cultural identities, challenge expectations of how to live a life, and recenter your autonomy: I’d love to work with you.
(314) 907-2474 View (314) 907-2474
Photo of Deborah Vail, Licensed Professional Counselor in Labadie, MO
Deborah Vail
Licensed Professional Counselor, MA, LPC, NCC
Verified Verified
4 Endorsed
Saint Peters, MO 63376
Waitlist for new clients
Everyday life isn’t supposed to feel quite this hard or overwhelming, right? Maybe you wish you could manage your emotions or stress better. Perhaps something awful or painful happened that has you wondering if you'll ever feel "normal" or well again. Hi, my name is Deborah and I have the honor of empowering people on their courageous journeys to find ease and joy in living again. Join me in a safe and affirming space to gain insight on the origins of your struggles and find lasting healing. I offer in-person sessions in my O'Fallon office, or online telehealth sessions.
Everyday life isn’t supposed to feel quite this hard or overwhelming, right? Maybe you wish you could manage your emotions or stress better. Perhaps something awful or painful happened that has you wondering if you'll ever feel "normal" or well again. Hi, my name is Deborah and I have the honor of empowering people on their courageous journeys to find ease and joy in living again. Join me in a safe and affirming space to gain insight on the origins of your struggles and find lasting healing. I offer in-person sessions in my O'Fallon office, or online telehealth sessions.
(636) 626-4300 View (636) 626-4300
Photo of Tristan Connor, Clinical Social Work/Therapist in Labadie, MO
Tristan Connor
Clinical Social Work/Therapist, LCSW, CADC, CCM
Verified Verified
Saint Louis, MO 63116  (Online Only)
As a transgender therapist, one of my passions is working with clients who identify as part of the LGBTQIA+ population. I enjoy collaborating with individuals who are exploring their gender and/or sexual identities and hope to offer guidance and compassion as they let go of any residual societal expectations. I have undergone the entire process of hormones, top surgery, and bottom surgeries, and I am open with my clients about my experiences as we work to decrease their gender dysphoria and move toward the eventual goal of gender euphoria.
As a transgender therapist, one of my passions is working with clients who identify as part of the LGBTQIA+ population. I enjoy collaborating with individuals who are exploring their gender and/or sexual identities and hope to offer guidance and compassion as they let go of any residual societal expectations. I have undergone the entire process of hormones, top surgery, and bottom surgeries, and I am open with my clients about my experiences as we work to decrease their gender dysphoria and move toward the eventual goal of gender euphoria.
(314) 501-6096 View (314) 501-6096
Photo of James P Ahearn, Licensed Professional Counselor in Labadie, MO
James P Ahearn
Licensed Professional Counselor, MEd, LPC, JD
Verified Verified
7 Endorsed
Clayton, MO 63105
The clients I serve are often at a crossroads in their life story and unsure of how to close one chapter and begin anew. Clients I enjoy working with recognize that counseling continues outside of the session in self reflection, exploring behavior change, and shifting how we think and relate to ourselves. I find that counseling helps meet goals and needs as diverse as the client, and sometimes goals arise throughout the course of the relationship. No one needs a "good reason" to come to counseling, for the desire to reach out and try will always be sufficient.
The clients I serve are often at a crossroads in their life story and unsure of how to close one chapter and begin anew. Clients I enjoy working with recognize that counseling continues outside of the session in self reflection, exploring behavior change, and shifting how we think and relate to ourselves. I find that counseling helps meet goals and needs as diverse as the client, and sometimes goals arise throughout the course of the relationship. No one needs a "good reason" to come to counseling, for the desire to reach out and try will always be sufficient.
(314) 325-1594 View (314) 325-1594
Photo of Katie Bridges McDaniel, Marriage & Family Therapist in Labadie, MO
Katie Bridges McDaniel
Marriage & Family Therapist, MS, LMFT
Verified Verified
Clayton, MO 63105  (Online Only)
I am a Marriage and Family Therapist who enjoys working with individuals and couples. I have experience working with a variety of clinical issues including anxiety, depression, grief and loss, family and life transitions, parenting, school and work stressors, relationships, self-esteem, and trauma. I take a systems approach by understanding that each person is a part of a whole emotional and relational unit. I use Emotionally Focused Couple Therapy, Collaborative Language Therapy, and psychoeducation to help clients improve communication, foster coping skills, and plan for a better future.
I am a Marriage and Family Therapist who enjoys working with individuals and couples. I have experience working with a variety of clinical issues including anxiety, depression, grief and loss, family and life transitions, parenting, school and work stressors, relationships, self-esteem, and trauma. I take a systems approach by understanding that each person is a part of a whole emotional and relational unit. I use Emotionally Focused Couple Therapy, Collaborative Language Therapy, and psychoeducation to help clients improve communication, foster coping skills, and plan for a better future.
(314) 804-2001 View (314) 804-2001
Photo of Danielle Endejan, Licensed Professional Counselor in Labadie, MO
Danielle Endejan
Licensed Professional Counselor, MA, NCC, PLPC, CRAADC
Verified Verified
1 Endorsed
Saint Louis, MO 63130
I look forward to meeting you! I was born and raised in St. Louis, & obtained my undergraduate degree with honors in Counseling and Education followed by a Master of Arts in Counseling for Licensure in Professional Counseling from MBU. I utilize empirically proven interventions (such as Motivational Interviewing, CBT, DBT) interwoven with compassionate wisdom for the therapeutic goal of coming alongside you in your unique journey and extending the opportunity and hope for healing & growth through the situation you find yourself in. My desire is to provide an authentic and compassionate environment that fosters continuous healing.
I look forward to meeting you! I was born and raised in St. Louis, & obtained my undergraduate degree with honors in Counseling and Education followed by a Master of Arts in Counseling for Licensure in Professional Counseling from MBU. I utilize empirically proven interventions (such as Motivational Interviewing, CBT, DBT) interwoven with compassionate wisdom for the therapeutic goal of coming alongside you in your unique journey and extending the opportunity and hope for healing & growth through the situation you find yourself in. My desire is to provide an authentic and compassionate environment that fosters continuous healing.
(314) 470-9169 View (314) 470-9169
Photo of Empowered Movement, Licensed Professional Counselor in Labadie, MO
Empowered Movement
Licensed Professional Counselor, LPC, NCC
Verified Verified
3 Endorsed
Clayton, MO 63105  (Online Only)
Life is beautiful but often/sometimes challenging. Some days we feel confident and happy while other days we may feel alone or overwhelmed. The clients I work with are seeking new tools, skills, techniques and interventions to help them feel better, more in control and empowered on a daily basis. I work with adolescents, young adults, adults and elders experiencing life transitions, anxiety, depression, trauma, relationship issues, low self-esteem and more. Everyone deserves to have a safe space, with unconditional support that allows them to be authentically themselves, always.
Life is beautiful but often/sometimes challenging. Some days we feel confident and happy while other days we may feel alone or overwhelmed. The clients I work with are seeking new tools, skills, techniques and interventions to help them feel better, more in control and empowered on a daily basis. I work with adolescents, young adults, adults and elders experiencing life transitions, anxiety, depression, trauma, relationship issues, low self-esteem and more. Everyone deserves to have a safe space, with unconditional support that allows them to be authentically themselves, always.
(314) 701-8184 View (314) 701-8184

See more therapy options for Labadie


Attachment-based Therapists

Is attachment-based therapy the same as attachment therapy?

Attachment-based therapy may be confused with what is called “attachment therapy” (sometimes called “holding therapy”), a discredited and dangerous approach to treating children with attachment disorders, autism, or other mental health concerns. Attachment therapy—not attachment-based therapy—may involve restraining a child, forcing eye contact, and other coercive or abusive techniques. None of these practices are used in attachment-based therapy and the two modalities are in no way related.

What should I expect from attachment-based therapy?

Attachment-based therapy is based on attachment theory, which posits that children’s early relationships with their caregivers strongly influence their ability to navigate the world later in life. Thus, adults who seek attachment-based therapy should expect to deeply explore their childhood, identifying the dynamics or experiences that disrupted their attachment and the steps necessary to overcome challenges that arose as a result. Parents and children should expect to explore the possible factors that disrupted the parent-child relationship and work toward restoring trust and connection.

How long does attachment-based therapy last?

Certain forms of attachment-based therapy, especially those designed for parents and children, last for a set number of sessions; for example, Attachment and Biobehavioral Catch-Up, a specific attachment-based approach for young children who have undergone early adversity, unfolds over 10 one-hour sessions. When attachment-based therapy is practiced on adults or combined with other modalities, it may not last a specific length of time; clients may wish to ask prospective therapists how long they expect treatment to take.

Does attachment-based therapy work?

Most of the research on attachment-based therapy focuses on children and adolescents. Some of this research shows a positive effect, especially for attachment-based family therapy (ABFT). Other studies, however, have found that attachment-based therapy is no more effective than other approaches to childhood depression, anxiety, or suicidality. Less is known about the therapy’s efficacy on adult populations.