Dialectical Behavior (DBT) Therapists in Carefree, AZ

Photo of Helen Koester, Licensed Professional Counselor, MS, CCTP-II
Helen Koester
Licensed Professional Counselor, MS, CCTP-II
6 Endorsed
Carefree, AZ 85377
I also incorporate concepts from IFS and DBT when they are helpful in supporting my clients' growth and healing.
Helen is a compassionate client-centered Licensed Professional Counselor (LPC), and Certified Clinical Trauma Professional (CCTP-II). She is known for helping clients communicate more effectively, experience healing, growth, success, and freedom. Helen aspires to help clients adopt a more positive and empowered mindset, so they can tap into their existing strengths, skills, and resources to uncover solutions. She supports and guides clients in identifying what is not working, promoting their commitment to change what they can, and assisting them in accomplishing their goals.
I also incorporate concepts from IFS and DBT when they are helpful in supporting my clients' growth and healing.
Helen is a compassionate client-centered Licensed Professional Counselor (LPC), and Certified Clinical Trauma Professional (CCTP-II). She is known for helping clients communicate more effectively, experience healing, growth, success, and freedom. Helen aspires to help clients adopt a more positive and empowered mindset, so they can tap into their existing strengths, skills, and resources to uncover solutions. She supports and guides clients in identifying what is not working, promoting their commitment to change what they can, and assisting them in accomplishing their goals.
(480) 351-6095 View (480) 351-6095
Photo of Tina Coatta, Clinical Social Work/Therapist, MSW, LICSW, LCSW
Tina Coatta
Clinical Social Work/Therapist, MSW, LICSW, LCSW
Carefree, AZ 85377
Looking for help with difficult relationships or healing from trauma? I specialize in working with adults and teens who have experienced complex trauma or are navigating life transitions. I provide sliding scale fees to reduce financial barriers to accessing therapy. I incorporate somatosensory practices, expressive arts, EMDR and Flash to help you heal from trauma. You may be feeling ready for a change and need support moving forward. You may be struggling with attachment relationships. You may be feeling overwhelmed. You may be struggling with anxiety and navigating work or school. I’d be glad to set up a time to connect!
Looking for help with difficult relationships or healing from trauma? I specialize in working with adults and teens who have experienced complex trauma or are navigating life transitions. I provide sliding scale fees to reduce financial barriers to accessing therapy. I incorporate somatosensory practices, expressive arts, EMDR and Flash to help you heal from trauma. You may be feeling ready for a change and need support moving forward. You may be struggling with attachment relationships. You may be feeling overwhelmed. You may be struggling with anxiety and navigating work or school. I’d be glad to set up a time to connect!
(952) 230-0617 View (952) 230-0617
Photo of Jennifer Salas, Licensed Professional Counselor, MC, LPC
Jennifer Salas
Licensed Professional Counselor, MC, LPC
15 Endorsed
Serves Area
With extensive training in evidence based therapies, my therapeutic approach can include CBT (to address thought patterns), DBT (to enhance skills for managing emotions and relationships), EMDR (to improve self-worth and decrease sensitivity of traumatic memories), ERP (to decrease obsessions and compulsions), and IFS (to support our parts and dissociation).
Bilingual (English and Spanish). Serving mental health counseling and Immigration Evaluation clients in AZ via Telehealth. Healing is truly possible! Each person has immense strength and resilience. My passion involves walking alongside clients to build upon areas of hope for improved well-being. People do not need to go through these things alone. I strive to provide quality, trustworthy, and professional guidance to my clients in a collaborative manner. I have years of experience assisting those who have gone through trauma, sexuality-based issues, and those struggling to manage difficult emotions, thoughts, and relationships.
With extensive training in evidence based therapies, my therapeutic approach can include CBT (to address thought patterns), DBT (to enhance skills for managing emotions and relationships), EMDR (to improve self-worth and decrease sensitivity of traumatic memories), ERP (to decrease obsessions and compulsions), and IFS (to support our parts and dissociation).
Bilingual (English and Spanish). Serving mental health counseling and Immigration Evaluation clients in AZ via Telehealth. Healing is truly possible! Each person has immense strength and resilience. My passion involves walking alongside clients to build upon areas of hope for improved well-being. People do not need to go through these things alone. I strive to provide quality, trustworthy, and professional guidance to my clients in a collaborative manner. I have years of experience assisting those who have gone through trauma, sexuality-based issues, and those struggling to manage difficult emotions, thoughts, and relationships.
(602) 786-8961 View (602) 786-8961
Photo of Brittany Bolden, Marriage & Family Therapist, LMFT, CST, LCAS
Brittany Bolden
Marriage & Family Therapist, LMFT, CST, LCAS
Serves Area
Many couples and individuals reach a point where the relationship they want feels out of reach. Trust may have been damaged, communication feels strained, or intimacy has become complicated by past hurts, addiction, or emotional disconnection. I work with clients who are ready to better understand their patterns, rebuild safety in their relationships, and develop healthier ways to connect—with themselves and with their partners. My work focuses on relationships, recovery, and sexual wellness. I specialize in supporting individuals and couples navigating the intersection of addiction recovery, intimacy, and relational healing.
Many couples and individuals reach a point where the relationship they want feels out of reach. Trust may have been damaged, communication feels strained, or intimacy has become complicated by past hurts, addiction, or emotional disconnection. I work with clients who are ready to better understand their patterns, rebuild safety in their relationships, and develop healthier ways to connect—with themselves and with their partners. My work focuses on relationships, recovery, and sexual wellness. I specialize in supporting individuals and couples navigating the intersection of addiction recovery, intimacy, and relational healing.
(980) 462-8505 View (980) 462-8505

More Therapists Nearby

Photo of Sophia Salazar, Counselor, MS, PhDc, LAC CST, ABS
Sophia Salazar
Counselor, MS, PhDc, LAC CST, ABS
Phoenix, AZ 85028
Sexual performance is about much more than physical function—it’s deeply connected to the mind. Stress, anxiety, self-confidence, relationship dynamics, past experiences, and emotional well-being all play a significant role in a man’s ability to experience satisfying intimacy. Many men struggle silently with concerns such as performance anxiety, erectile difficulties, low desire, premature ejaculation, body image concerns, or feelings of inadequacy. These challenges can create a cycle of worry and self-doubt that further impacts sexual confidence and connection.
Sexual performance is about much more than physical function—it’s deeply connected to the mind. Stress, anxiety, self-confidence, relationship dynamics, past experiences, and emotional well-being all play a significant role in a man’s ability to experience satisfying intimacy. Many men struggle silently with concerns such as performance anxiety, erectile difficulties, low desire, premature ejaculation, body image concerns, or feelings of inadequacy. These challenges can create a cycle of worry and self-doubt that further impacts sexual confidence and connection.
(520) 564-2162 View (520) 564-2162
Photo of Christine Hoffman, Clinical Social Work/Therapist, LCSW
Christine Hoffman
Clinical Social Work/Therapist, LCSW
Serves Area
I have over 17 years of experience in hospice care, grief and loss, and psychotherapy; using DBT, CBT, ACT, and EMDR, as well as the understanding of neurophysiology.
Have you been struggling with anxiety or depression from unresolved incidents that have happened in your life? I believe that the way to healing is through connection; to yourself, others, nature, and a higher power (if this is important to you), and building skills to deepen these connections. If you would like to feel more at peace within yourself, and be an active participant in your healing journey, I can help you find the peace that you are longing to have and your ability to move your dreams forward.
I have over 17 years of experience in hospice care, grief and loss, and psychotherapy; using DBT, CBT, ACT, and EMDR, as well as the understanding of neurophysiology.
Have you been struggling with anxiety or depression from unresolved incidents that have happened in your life? I believe that the way to healing is through connection; to yourself, others, nature, and a higher power (if this is important to you), and building skills to deepen these connections. If you would like to feel more at peace within yourself, and be an active participant in your healing journey, I can help you find the peace that you are longing to have and your ability to move your dreams forward.
(480) 613-8841 View (480) 613-8841
Photo of Gina Benevento, Clinical Social Work/Therapist, LMSW, CCTS-I
Gina Benevento
Clinical Social Work/Therapist, LMSW, CCTS-I
1 Endorsed
Online Only
I utilize a holistic, affirming, and empathetic approach to therapy that includes evidence-based practices such as trauma-informed care, DBT, CBT, Mindfulness, Client-centered therapy, and Motivational Interviewing.
Are you looking for a safe, inclusive, and compassionate space to navigate life's daily challenges? Do you wonder why things seem to be harder for you than for the people around you? Have you noticed that you feel like you are just going through the motions of life and don't find joy in the things that you used to? Maybe you are feeling sad, anxious, or just not yourself. Do you want to feel more empowered in your ability to regulate your moods and gain self-acceptance? Have you ever struggled in relationships and didn't know why? Maybe the past keeps sneaking its ugly head into your present life. Stability is possible!
I utilize a holistic, affirming, and empathetic approach to therapy that includes evidence-based practices such as trauma-informed care, DBT, CBT, Mindfulness, Client-centered therapy, and Motivational Interviewing.
Are you looking for a safe, inclusive, and compassionate space to navigate life's daily challenges? Do you wonder why things seem to be harder for you than for the people around you? Have you noticed that you feel like you are just going through the motions of life and don't find joy in the things that you used to? Maybe you are feeling sad, anxious, or just not yourself. Do you want to feel more empowered in your ability to regulate your moods and gain self-acceptance? Have you ever struggled in relationships and didn't know why? Maybe the past keeps sneaking its ugly head into your present life. Stability is possible!
(623) 257-5983 View (623) 257-5983
Photo of Angela West, Licensed Professional Counselor, MC, NCC, LPC, CCTP
Angela West
Licensed Professional Counselor, MC, NCC, LPC, CCTP
Phoenix, AZ 85013
So, you’ve been stressing out and it’s finally time to get some help. I hear you! When family conflict, anxiety, marital issues, depression, grief, issues from childhood, or trauma are making you feel stressed, it may be time to seek help from a trusted, caring specialist. Using the safety and acceptance of our therapeutic relationship and my experience of over 19 years in the mental health field, we can create your vision of a happier, more peaceful life! I’m pleased to accompany both individuals and couples/families on their journey toward healing, personal growth, and lasting stress reduction.
So, you’ve been stressing out and it’s finally time to get some help. I hear you! When family conflict, anxiety, marital issues, depression, grief, issues from childhood, or trauma are making you feel stressed, it may be time to seek help from a trusted, caring specialist. Using the safety and acceptance of our therapeutic relationship and my experience of over 19 years in the mental health field, we can create your vision of a happier, more peaceful life! I’m pleased to accompany both individuals and couples/families on their journey toward healing, personal growth, and lasting stress reduction.
(602) 638-3517 View (602) 638-3517
Photo of Dollmarie Adorno Rondon, Licensed Professional Counselor, MS/MHC, LPC
Dollmarie Adorno Rondon
Licensed Professional Counselor, MS/MHC, LPC
1 Endorsed
Online Only
I often use DBT in my practice and include other approaches holistically.
I am a bilingual Licensed Professional Counselor with 14 years of experience supporting clients. I believe mental health is just as essential as physical health, and maintaining balance in both areas leads to greater harmony and fulfillment in life. I have worked in diverse mental health settings in Puerto Rico, Texas, Arizona, and provided individual, group, couples, and family counseling. My work has focused on adjustment disorders, trauma, interpersonal challenges, depression, anxiety, stress, substance use concerns, and anger management in adults.
I often use DBT in my practice and include other approaches holistically.
I am a bilingual Licensed Professional Counselor with 14 years of experience supporting clients. I believe mental health is just as essential as physical health, and maintaining balance in both areas leads to greater harmony and fulfillment in life. I have worked in diverse mental health settings in Puerto Rico, Texas, Arizona, and provided individual, group, couples, and family counseling. My work has focused on adjustment disorders, trauma, interpersonal challenges, depression, anxiety, stress, substance use concerns, and anger management in adults.
(928) 496-6691 View (928) 496-6691
Photo of Lyndsey Young, Counselor, MA, LPC, LCMHC, CEDS
Lyndsey Young
Counselor, MA, LPC, LCMHC, CEDS
5 Endorsed
Phoenix, AZ 85001
Accepting New Clients! Counseling is a space to be heard and get to work on the healing you deserve. Living your life wrapped up in anxiety, depression and stress is not the life you dreamed for yourself, and change is possible. I am committed to creating a space to facilitate healing, growth, and change. I believe people deserve an intentional space, non-judgmental guidance, and strategic treatment for their unique struggles. You are brave and worth the change you are seeking, and I would be honored to work with you.
Accepting New Clients! Counseling is a space to be heard and get to work on the healing you deserve. Living your life wrapped up in anxiety, depression and stress is not the life you dreamed for yourself, and change is possible. I am committed to creating a space to facilitate healing, growth, and change. I believe people deserve an intentional space, non-judgmental guidance, and strategic treatment for their unique struggles. You are brave and worth the change you are seeking, and I would be honored to work with you.
(623) 321-0032 View (623) 321-0032
Photo of Samantha Contreras, Clinical Social Work/Therapist
Samantha Contreras
Clinical Social Work/Therapist
Online Only
Facing difficult emotional and interpersonal challenges in our lives can be frightening, but can also be a time for growth and healing. Talking with someone who listens without judgement, understands your concerns and helps you clarify issues can be invaluable. I am a culturally competent therapist working with various population having experience with serving adolescents, adults, couples, veterans, those suffering from chronic illness, and those struggling with concerns around sexuality.
Facing difficult emotional and interpersonal challenges in our lives can be frightening, but can also be a time for growth and healing. Talking with someone who listens without judgement, understands your concerns and helps you clarify issues can be invaluable. I am a culturally competent therapist working with various population having experience with serving adolescents, adults, couples, veterans, those suffering from chronic illness, and those struggling with concerns around sexuality.
(928) 569-8556 View (928) 569-8556
Photo of Chelsy Taylor, Pre-Licensed Professional, LMSW
Chelsy Taylor
Pre-Licensed Professional, LMSW
Online Only
Chelsy Taylor is a Licensed Master Social Worker who provides therapeutic support to children, teens, and adults navigating life transitions, anxiety, depression, trauma, and substance use. She earned her Master's in Social Work and is committed to a trauma-informed, culturally responsive approach that emphasizes genuine human connection. Chelsy fosters a safe, compassionate space where clients can explore their thoughts, build emotional resilience, and work toward meaningful healing. She offers virtual therapy throughout Arizona, honoring the whole person so each client feels seen, heard, and supported.
Chelsy Taylor is a Licensed Master Social Worker who provides therapeutic support to children, teens, and adults navigating life transitions, anxiety, depression, trauma, and substance use. She earned her Master's in Social Work and is committed to a trauma-informed, culturally responsive approach that emphasizes genuine human connection. Chelsy fosters a safe, compassionate space where clients can explore their thoughts, build emotional resilience, and work toward meaningful healing. She offers virtual therapy throughout Arizona, honoring the whole person so each client feels seen, heard, and supported.
(928) 569-8546 View (928) 569-8546
Photo of Melissa Korkes, Psychologist, PsyD
Melissa Korkes
Psychologist, PsyD
2 Endorsed
Phoenix, AZ 85018
Dr. Melissa Korkes (she/her) is a licensed psychologist who has experience working in forensic settings, community mental health, and private practice. I have had the honor of working with individuals who present with serious mental health, trauma, sex addiction, sexual offending behaviors, betrayal trauma, grief, and LGBTQIA+ individuals.
Dr. Melissa Korkes (she/her) is a licensed psychologist who has experience working in forensic settings, community mental health, and private practice. I have had the honor of working with individuals who present with serious mental health, trauma, sex addiction, sexual offending behaviors, betrayal trauma, grief, and LGBTQIA+ individuals.
(602) 206-1844 View (602) 206-1844
Photo of Jeremy Umhay, Licensed Addiction Counselor, LIAC
Jeremy Umhay
Licensed Addiction Counselor, LIAC
1 Endorsed
Online Only
Hello! Thank you for your interest in exploring improving your quality of life! A little bit about myself, I have been a practicing clinician for over 8 years, now. I have a great deal of experience and enjoy helping individuals face their addictions and other co-occurring issues. While I have many years of experience in working with addiction and mental health, I have personal experience as well. So, I am definitely able to empathize with many struggles, across the board, especially in the case of addiction and mental health challenges. I am passionate and truly love what I do. Look forward to the opportunity to work with you.
Hello! Thank you for your interest in exploring improving your quality of life! A little bit about myself, I have been a practicing clinician for over 8 years, now. I have a great deal of experience and enjoy helping individuals face their addictions and other co-occurring issues. While I have many years of experience in working with addiction and mental health, I have personal experience as well. So, I am definitely able to empathize with many struggles, across the board, especially in the case of addiction and mental health challenges. I am passionate and truly love what I do. Look forward to the opportunity to work with you.
(520) 523-6733 View (520) 523-6733
Photo of Jaime A. Dion, Counselor, LAC
Jaime A. Dion
Counselor, LAC
Phoenix, AZ 85012
With a focus on your individual goals, I provide client-centered, trauma-informed care, drawing from approaches such as Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy ( DBT), Acceptance and Commitment Therapy (ACT), and Eye Movement Desensitization and Reprocessing (EMDR).
I collaborate with clients to promote psychological, emotional, and social well-being. My therapeutic approach blends warmth, appropriate humor, and strong rapport-building to foster a supportive and individualized healing process. With a background in lifespan human development and counseling, together we build treatment plans tailored to your strengths, growth areas, and unique needs.
With a focus on your individual goals, I provide client-centered, trauma-informed care, drawing from approaches such as Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy ( DBT), Acceptance and Commitment Therapy (ACT), and Eye Movement Desensitization and Reprocessing (EMDR).
I collaborate with clients to promote psychological, emotional, and social well-being. My therapeutic approach blends warmth, appropriate humor, and strong rapport-building to foster a supportive and individualized healing process. With a background in lifespan human development and counseling, together we build treatment plans tailored to your strengths, growth areas, and unique needs.
(623) 777-7825 View (623) 777-7825
Photo of Jakki A Ling, Licensed Professional Counselor, LPC, NCC
Jakki A Ling
Licensed Professional Counselor, LPC, NCC
1 Endorsed
Online Only
Our sessions will draw from evidence-based approaches such as CBT, DBT, ACT, and EMDR to help clients better understand patterns, manage emotions, and process past experiences.
You may be coming to therapy feeling anxious, overwhelmed, or disconnected from yourself. Your thoughts may feel heavy, emotions hard to manage, or self-doubt more present than you’d like. You might know something needs to change but feel unsure where to begin. Therapy can be a space to slow down, feel understood, and start moving forward with clarity.
Our sessions will draw from evidence-based approaches such as CBT, DBT, ACT, and EMDR to help clients better understand patterns, manage emotions, and process past experiences.
You may be coming to therapy feeling anxious, overwhelmed, or disconnected from yourself. Your thoughts may feel heavy, emotions hard to manage, or self-doubt more present than you’d like. You might know something needs to change but feel unsure where to begin. Therapy can be a space to slow down, feel understood, and start moving forward with clarity.
(623) 300-2108 View (623) 300-2108
Photo of Marika Joubert, Counselor, LCPC
Marika Joubert
Counselor, LCPC
3 Endorsed
Online Only
I have benefited from advanced training in DBT, EMDR, Ego State Therapy and Clinical Hypnosis, but now exclusively work with the neuroscience of Coherence Therapy.
Do you keep finding yourself in the same damaging fight, or dark emotional place? Do you feel that you’re smart, but dismayed that you have not been able to figure this out? Have you been to therapy before, and now feel skeptical of coping tools, clever reframes and insight? Do you long for something, or someone, to finally help you get rid of this suffering? If this is you, I may be able to help.
I have benefited from advanced training in DBT, EMDR, Ego State Therapy and Clinical Hypnosis, but now exclusively work with the neuroscience of Coherence Therapy.
Do you keep finding yourself in the same damaging fight, or dark emotional place? Do you feel that you’re smart, but dismayed that you have not been able to figure this out? Have you been to therapy before, and now feel skeptical of coping tools, clever reframes and insight? Do you long for something, or someone, to finally help you get rid of this suffering? If this is you, I may be able to help.
(208) 225-6923 View (208) 225-6923
Photo of Nathan Goltsman, Licensed Professional Counselor
Nathan Goltsman
Licensed Professional Counselor
Online Only
I want you to know that I empathize deeply with your struggle with mental health, whether it is anxiety, depression, trauma and/or addiction. These symptoms can be an overwhelming and isolating experience.
I want you to know that I empathize deeply with your struggle with mental health, whether it is anxiety, depression, trauma and/or addiction. These symptoms can be an overwhelming and isolating experience.
(520) 525-6151 View (520) 525-6151
Photo of Anya Greany, Clinical Social Work/Therapist, LCSW, C-DBT
Anya Greany
Clinical Social Work/Therapist, LCSW, C-DBT
2 Endorsed
Online Only
I integrate evidence-based therapies including ERP, DBT, ACT and EMDR, while always considering you as a whole person rather than a diagnosis.
You may look like you’re functioning on the outside while feeling exhausted internally. Maybe your mind gets stuck in loops of overthinking, doubt, intrusive thoughts, or “what ifs.” Maybe you’ve spent years trying to avoid certain feelings, memories, or parts of yourself just to get through the day. Therapy can be a space where you no longer have to do that alone. I specialize in working with OCD, trauma, and LGBTQ+ clients, and I approach therapy with warmth, and curiosity. I understand how isolating OCD can feel, especially when your thoughts don’t match who you are or what you value.
I integrate evidence-based therapies including ERP, DBT, ACT and EMDR, while always considering you as a whole person rather than a diagnosis.
You may look like you’re functioning on the outside while feeling exhausted internally. Maybe your mind gets stuck in loops of overthinking, doubt, intrusive thoughts, or “what ifs.” Maybe you’ve spent years trying to avoid certain feelings, memories, or parts of yourself just to get through the day. Therapy can be a space where you no longer have to do that alone. I specialize in working with OCD, trauma, and LGBTQ+ clients, and I approach therapy with warmth, and curiosity. I understand how isolating OCD can feel, especially when your thoughts don’t match who you are or what you value.
(602) 962-8824 View (602) 962-8824
Photo of Logan Sage Croft, Licensed Professional Counselor, LPC
Logan Sage Croft
Licensed Professional Counselor, LPC
Online Only
Hi there, I'm Logan Sage! I'm glad you're here. If you're ready to embark on a journey of personal growth and positive change, I’m here to support you every step of the way. Seeking the right therapist is an important first step, and I look forward to partnering with you as we address your unique challenges and goals together. The therapeutic relationship we build will be a safe space for you to express your thoughts and feelings openly. My goal is to empower you with the insights and tools necessary to navigate life's challenges and enhance your overall quality of life.
Hi there, I'm Logan Sage! I'm glad you're here. If you're ready to embark on a journey of personal growth and positive change, I’m here to support you every step of the way. Seeking the right therapist is an important first step, and I look forward to partnering with you as we address your unique challenges and goals together. The therapeutic relationship we build will be a safe space for you to express your thoughts and feelings openly. My goal is to empower you with the insights and tools necessary to navigate life's challenges and enhance your overall quality of life.
(520) 470-6845 View (520) 470-6845

See more therapy options for Carefree

Dialectical Behavior (DBT) Therapists
Who is DBT for?
Dialectical Behavior Therapy (DBT) is designed for people who experience extreme emotional suffering because they lack the skills of emotion regulation and distress tolerance. The basic affliction can underlie a wide range of conditions, from borderline and other personality disorders to PTSD and treatment-resistant anxiety and depression. The therapy is helpful to those whose emotional reactivity is so intense it is disruptive to everyday functioning and leads to frequent crises.

Why do people need DBT?
The ability to regulate emotions is a core psychological skill that enables people to function in life and pay attention to the world outside themselves; it is consistently associated with well-being. DBT is designed to help people learn how to manage and regulate their emotions. Originally developed to treat people with borderline personality disorder whose extreme emotional suffering led to self-harming behavior and suicide attempts, the therapy is now applied to other conditions involving emotion dysregulation, particularly when other treatments have failed.

What happens in DBT?
Individuals meet weekly with their therapist to discuss their experiences relating to moods, behavior, and skills. Using checklists they maintain, they review emotional experiences and positive practices they engage in. The diaries help individuals discern what led up to a specific problem encountered, this is followed by discussion of the consequences of their actions. In addition, individuals may meet in class-like small groups to learn skills such as mindfulness, emotion regulation and distress tolerance.

How long does DBT last?
Because it is intended to establish long-lasting behavioral change among those with persistent problems, DBT is designed to last six months to a year. DBT includes both weekly sessions of individual therapy and weekly skills-training sessions conducted in small groups. Studies of DBT have documented improvement within a year of treatment, particularly in controlling self-harmful behavior; nevertheless, individuals may require therapy for several years.