Internal Family Systems (IFS) Therapists in La Mesa, CA

Photo of Debbie Lee, Marriage & Family Therapist Associate, MA, AMFT
Debbie Lee
Marriage & Family Therapist Associate, MA, AMFT
1 Endorsed
La Mesa, CA 91942
I prefer a holistic healing approach, which includes techniques like CBT and IFS to address thoughts, emotions, and behaviors alongside Somatic Therapy to tackle underlying physical tension.
Life, given to us without choice, often delivers challenging experiences. Sometimes, these experiences cripple us by making us feel helpless. However, each of us is created with a remarkable design for renewal. If seeking change, regardless of circumstances, anyone can hope for a better tomorrow. This is my belief, and it guides my approach to every client I meet.
I prefer a holistic healing approach, which includes techniques like CBT and IFS to address thoughts, emotions, and behaviors alongside Somatic Therapy to tackle underlying physical tension.
Life, given to us without choice, often delivers challenging experiences. Sometimes, these experiences cripple us by making us feel helpless. However, each of us is created with a remarkable design for renewal. If seeking change, regardless of circumstances, anyone can hope for a better tomorrow. This is my belief, and it guides my approach to every client I meet.
(619) 202-8116 View (619) 202-8116
Photo of Cara Silva - Silva Family Therapy, Inc, Marriage & Family Therapist, LMFT, LPCC, APCC, AMFT
Silva Family Therapy, Inc
Marriage & Family Therapist, LMFT, LPCC, APCC, AMFT
1 Endorsed
La Mesa, CA 91942
Each therapist has their own specialties, including IFS, EMDR, Play therapy, addiction, exposure therapy, and military culture.
SFTi is all about helping others find their potential. Uncertainty might not have ever felt so strong but these last few years has created so much self doubt, instability, mistrust, and chaos. Sadly, for many this is what their whole life has felt like. When dealing with trauma, addiction, Identity, or abuse this is your life. Who can I trust? Where will I go? What can I do? SFTi staffs experienced trauma informed therapists specializing in EMDR, Addiction, LGBTQIA, Body Positive, Domestic Violence, and PTSD.
Each therapist has their own specialties, including IFS, EMDR, Play therapy, addiction, exposure therapy, and military culture.
SFTi is all about helping others find their potential. Uncertainty might not have ever felt so strong but these last few years has created so much self doubt, instability, mistrust, and chaos. Sadly, for many this is what their whole life has felt like. When dealing with trauma, addiction, Identity, or abuse this is your life. Who can I trust? Where will I go? What can I do? SFTi staffs experienced trauma informed therapists specializing in EMDR, Addiction, LGBTQIA, Body Positive, Domestic Violence, and PTSD.
(619) 648-4656 View (619) 648-4656
Photo of Amber Michelle Monroe - Healing Balance Therapy Inc. , Marriage & Family Therapist, LMFT
Healing Balance Therapy Inc.
Marriage & Family Therapist, LMFT
La Mesa, CA 91942
All of our licensed therapists are trained in several evidenced based treatments such as EMDR & IFS.
Our clients typically struggle with people pleasing, perfectionist patterns, over thinking, increased worry or irritation and excessively caretaking. Others suffer with self worth, feeling like an imposture, avoidance of conflict and using their voice. Often clients have painful childhoods or adult traumas that can present with upsetting thoughts or images. These symptoms can often result in destructive coping strategies such as eating disorders, codependency, isolation or outbursts. Our clients are looking to learn, heal and grow into their most authentic selves. They need to be seen, known, taught and supported.
All of our licensed therapists are trained in several evidenced based treatments such as EMDR & IFS.
Our clients typically struggle with people pleasing, perfectionist patterns, over thinking, increased worry or irritation and excessively caretaking. Others suffer with self worth, feeling like an imposture, avoidance of conflict and using their voice. Often clients have painful childhoods or adult traumas that can present with upsetting thoughts or images. These symptoms can often result in destructive coping strategies such as eating disorders, codependency, isolation or outbursts. Our clients are looking to learn, heal and grow into their most authentic selves. They need to be seen, known, taught and supported.
(619) 382-3154 View (619) 382-3154
Photo of Leah Anne Mitchell, Clinical Social Work/Therapist, LCSW
Leah Anne Mitchell
Clinical Social Work/Therapist, LCSW
La Mesa, CA 91941
We all struggle at times in life. Some are able to quickly move past these challenges. For others, our challenges become overwhelming, we feel stuck, and we feel a sense of suffering in our stuckness. Anxiety, trauma, and relationship issues are often factors that contribute to our suffering. Changing and growing can be scary, painful, and hard. If you recognize that the pain and challenges of where you are at are worth the risk of changing, you have already begun your courageous transformation journey.
We all struggle at times in life. Some are able to quickly move past these challenges. For others, our challenges become overwhelming, we feel stuck, and we feel a sense of suffering in our stuckness. Anxiety, trauma, and relationship issues are often factors that contribute to our suffering. Changing and growing can be scary, painful, and hard. If you recognize that the pain and challenges of where you are at are worth the risk of changing, you have already begun your courageous transformation journey.
(619) 382-2704 View (619) 382-2704
Photo of Taneesha Chambers, Licensed Professional Clinical Counselor, LPCC
Taneesha Chambers
Licensed Professional Clinical Counselor, LPCC
Online Only
Hello, I'm Taneesha! I am a Licensed Professional Counselor who is passionate about assisting people while on their journey toward healing and growth in the face of the challenges they may be currently experiencing and/or past traumas that may be causing distress. I have experience with ages 18-97 and have worked with clients with many different experiences and diagnoses including Anxiety, Depression, PTSD/Trauma, Substance Abuse, Bipolar Disorder, Suicidal Ideation, and more.
Hello, I'm Taneesha! I am a Licensed Professional Counselor who is passionate about assisting people while on their journey toward healing and growth in the face of the challenges they may be currently experiencing and/or past traumas that may be causing distress. I have experience with ages 18-97 and have worked with clients with many different experiences and diagnoses including Anxiety, Depression, PTSD/Trauma, Substance Abuse, Bipolar Disorder, Suicidal Ideation, and more.
(408) 763-4866 View (408) 763-4866
Photo of Faith Reeves-Austin, Licensed Professional Clinical Counselor, LPCC
Faith Reeves-Austin
Licensed Professional Clinical Counselor, LPCC
Online Only
In these unprecedented times, I am here to provide a safe and dependable space for you to decompress and navigate adversity. I support clients by empowering them to be their authentic selves, identifying tools to cope with everyday stressors, and addressing symptoms of systemic oppression contributing to the mental health epidemic in our country. As a black queer woman, I am passionate about supporting marginalized communities by providing culturally competent and LGBTQ+ affirming care to all ages and walks of life.
In these unprecedented times, I am here to provide a safe and dependable space for you to decompress and navigate adversity. I support clients by empowering them to be their authentic selves, identifying tools to cope with everyday stressors, and addressing symptoms of systemic oppression contributing to the mental health epidemic in our country. As a black queer woman, I am passionate about supporting marginalized communities by providing culturally competent and LGBTQ+ affirming care to all ages and walks of life.
(619) 492-4087 View (619) 492-4087
Photo of Alex Bailey, Counselor, LPCC, MA, CEAP
Alex Bailey
Counselor, LPCC, MA, CEAP
2 Endorsed
La Mesa, CA 91942
My specialties are in EMDR, IFS, Eastern Psychology, Mindfulness, and more commonly recognized modalities such as CBT, DBT, and ACT.
I believe in emphasizing one’s own unique spiritual journey as the primary source of knowing; that there is nothing needed to “fix,” but rather an opportunity to explore with newfound curiosity and connection. Collaborating with our natural environment and translating what is discussed during our time in into lived experiences is incredibly powerful and useful for sustained growth and learning. I am also licensed in CO as a certified psychedelic assisted therapy facilitator and offer psilocybin and ketamine facilitation as appropriate.
My specialties are in EMDR, IFS, Eastern Psychology, Mindfulness, and more commonly recognized modalities such as CBT, DBT, and ACT.
I believe in emphasizing one’s own unique spiritual journey as the primary source of knowing; that there is nothing needed to “fix,” but rather an opportunity to explore with newfound curiosity and connection. Collaborating with our natural environment and translating what is discussed during our time in into lived experiences is incredibly powerful and useful for sustained growth and learning. I am also licensed in CO as a certified psychedelic assisted therapy facilitator and offer psilocybin and ketamine facilitation as appropriate.
(619) 404-4533 View (619) 404-4533
Photo of Trish Franzblau, Clinical Social Work/Therapist, LCSW
Trish Franzblau
Clinical Social Work/Therapist, LCSW
La Mesa, CA 91941
A favorite quote of mine is, "It's never too late to have a happy childhood." As a nurturing therapist, I believe my role is to provide support, guidance, and a SAFE place to share, vent, scream, cry, laugh or just sit quietly. I also believe it's not what happens to people that's most important, but what they do about it. Our background and circumstances may have influenced who we are, but we are responsible for who we become. Though daunting, this realization can be extremely EmPOWERing as you are in charge of your life and your future happiness! With this knowledge, change can unfold.
A favorite quote of mine is, "It's never too late to have a happy childhood." As a nurturing therapist, I believe my role is to provide support, guidance, and a SAFE place to share, vent, scream, cry, laugh or just sit quietly. I also believe it's not what happens to people that's most important, but what they do about it. Our background and circumstances may have influenced who we are, but we are responsible for who we become. Though daunting, this realization can be extremely EmPOWERing as you are in charge of your life and your future happiness! With this knowledge, change can unfold.
(805) 214-8832 View (805) 214-8832
Photo of Tienna Jackson, Clinical Social Work/Therapist, LCSW
Tienna Jackson
Clinical Social Work/Therapist, LCSW
Online Only
Hello and welcome! My name is Tienna Jackson, a licensed clinical social worker (LCSW) and psychotherapist dedicated to guiding individuals on their journey to emotional well-being. My therapeutic style is rooted in evidence-based practices, drawing from my training and experience in providing culturally sensitive cognitive-behavioral therapy, psychodynamic therapy, and trauma-informed care. As a member of the BIPOC (Black, Indigenous, and People of Color) community, I bring a unique perspective and a deep understanding of the cultural nuances that may impact mental health.
Hello and welcome! My name is Tienna Jackson, a licensed clinical social worker (LCSW) and psychotherapist dedicated to guiding individuals on their journey to emotional well-being. My therapeutic style is rooted in evidence-based practices, drawing from my training and experience in providing culturally sensitive cognitive-behavioral therapy, psychodynamic therapy, and trauma-informed care. As a member of the BIPOC (Black, Indigenous, and People of Color) community, I bring a unique perspective and a deep understanding of the cultural nuances that may impact mental health.
(925) 794-8202 View (925) 794-8202
Photo of Arthur Bilbrey, Marriage & Family Therapist, LMFT, CCTP-II, ART-M
Arthur Bilbrey
Marriage & Family Therapist, LMFT, CCTP-II, ART-M
Online Only
If you're struggling with anxiety, PTSD, or trauma—and talk therapy hasn’t brought lasting relief—you’re not alone. Many of my clients come to me feeling stuck in survival mode. They’ve tried coping skills but want something deeper. I’m a Master Certified Accelerated Resolution Therapy (ART) provider and Certified Clinical Trauma Professional (CCTP-II), with advanced training in Brainspotting, ART, EMDR, and ACT. I use trauma-informed approaches that help the mind and body heal.
If you're struggling with anxiety, PTSD, or trauma—and talk therapy hasn’t brought lasting relief—you’re not alone. Many of my clients come to me feeling stuck in survival mode. They’ve tried coping skills but want something deeper. I’m a Master Certified Accelerated Resolution Therapy (ART) provider and Certified Clinical Trauma Professional (CCTP-II), with advanced training in Brainspotting, ART, EMDR, and ACT. I use trauma-informed approaches that help the mind and body heal.
(510) 721-3425 View (510) 721-3425
Photo of Grace Berke Montgomery, Marriage & Family Therapist, LMFT
Grace Berke Montgomery
Marriage & Family Therapist, LMFT
Online Only
I draw from a range of evidence-based modalities, including Cognitive Behavioral Therapy (CBT), EMDR, and Family Systems.
I have 30 years of clinical experience in a multitude of settings, including all phases of patient care, from an initial assessment to developing a course of treatment and altering the course as indicated with input from the patient. I earned a Bachelor of Arts in Behavioral Sciences, pursued a graduate degree, and earned a Masters's Degree in Counseling Psychology at National University, San Diego, CA. My experience is expansive developmentally with regard to age as well as the condition for which the person is seeking care.
I draw from a range of evidence-based modalities, including Cognitive Behavioral Therapy (CBT), EMDR, and Family Systems.
I have 30 years of clinical experience in a multitude of settings, including all phases of patient care, from an initial assessment to developing a course of treatment and altering the course as indicated with input from the patient. I earned a Bachelor of Arts in Behavioral Sciences, pursued a graduate degree, and earned a Masters's Degree in Counseling Psychology at National University, San Diego, CA. My experience is expansive developmentally with regard to age as well as the condition for which the person is seeking care.
(626) 669-3495 View (626) 669-3495
Photo of Amy White, Marriage & Family Therapist, LMFT
Amy White
Marriage & Family Therapist, LMFT
4 Endorsed
La Mesa, CA 91942
I support individuals, couples and families who feel stuck in old patterns and disconnected from what they truly want. If you are navigating loss, life transitions or the impacts of trauma, together we can walk towards greater confidence, connection, and life satisfaction.
I support individuals, couples and families who feel stuck in old patterns and disconnected from what they truly want. If you are navigating loss, life transitions or the impacts of trauma, together we can walk towards greater confidence, connection, and life satisfaction.
(619) 304-5517 View (619) 304-5517
Photo of Julie Ellen Williams, Marriage & Family Therapist, MA, LMFT
Julie Ellen Williams
Marriage & Family Therapist, MA, LMFT
La Mesa, CA 91942
Julie Williams (They/She) is a compassionate, authentic, and experienced Mental Health Clinician that guides clients in gaining greater self-awareness and self-acceptance using Holistic, Transpersonal, and Somatic approaches for individual adults, teens, children, &/or families. Holistic Psychotherapy with Julie is for you if you are looking to learn ways to reduce symptoms of anxiety, depression, and/or post traumatic stress through the use of mindfulness-based coping skills. Centered on each individual’s unique needs and preferences, Julie weaves together several different therapeutic approaches and psychological theories.
Julie Williams (They/She) is a compassionate, authentic, and experienced Mental Health Clinician that guides clients in gaining greater self-awareness and self-acceptance using Holistic, Transpersonal, and Somatic approaches for individual adults, teens, children, &/or families. Holistic Psychotherapy with Julie is for you if you are looking to learn ways to reduce symptoms of anxiety, depression, and/or post traumatic stress through the use of mindfulness-based coping skills. Centered on each individual’s unique needs and preferences, Julie weaves together several different therapeutic approaches and psychological theories.
(619) 598-0637 View (619) 598-0637
Photo of Marisse Matanza Almazan, Marriage & Family Therapist Associate, AMFT
Marisse Matanza Almazan
Marriage & Family Therapist Associate, AMFT
La Mesa, CA 91942
I am passionate about working with individuals who are seeking healing, restoration, and a deeper understanding of themselves. Many of my clients come to therapy after experiencing trauma, loss, relationship wounds, or seasons of feeling disconnected from who they are. With empathy, curiosity, and a trauma-informed approach, I walk alongside clients as they process their experiences, reconnect with their strengths, and rediscover hope. Healing is not about becoming someone new, it is about coming home to the person you have always been beneath the pain.
I am passionate about working with individuals who are seeking healing, restoration, and a deeper understanding of themselves. Many of my clients come to therapy after experiencing trauma, loss, relationship wounds, or seasons of feeling disconnected from who they are. With empathy, curiosity, and a trauma-informed approach, I walk alongside clients as they process their experiences, reconnect with their strengths, and rediscover hope. Healing is not about becoming someone new, it is about coming home to the person you have always been beneath the pain.
(619) 815-3716 View (619) 815-3716
Photo of Daniel C. Kim, Marriage & Family Therapist, DMFT
Daniel C. Kim
Marriage & Family Therapist, DMFT
3 Endorsed
Online Only
I work through an attachment-based and trauma-informed framework - specifically, through the clinical models of Internal Family Systems ( IFS) and EMDR (Eye Movement Desensitization Reprocessing).
I work with clients who struggle with: unresolved emotional injury, trauma, self-worth, relational connection, mood/emotional problems, compulsive behaviors, and spiritual issues. I also work with members of the clergy (pastors, priests, missionaries, ministry leaders) who struggle with deep personal issues but lack a safe, nurturing space in which they may experience support and healing. My clients all seek and deserve healing in their lives and relationships.
I work through an attachment-based and trauma-informed framework - specifically, through the clinical models of Internal Family Systems ( IFS) and EMDR (Eye Movement Desensitization Reprocessing).
I work with clients who struggle with: unresolved emotional injury, trauma, self-worth, relational connection, mood/emotional problems, compulsive behaviors, and spiritual issues. I also work with members of the clergy (pastors, priests, missionaries, ministry leaders) who struggle with deep personal issues but lack a safe, nurturing space in which they may experience support and healing. My clients all seek and deserve healing in their lives and relationships.
(619) 304-5490 View (619) 304-5490
Photo of Adam Moore, Marriage & Family Therapist, LMFT
Adam Moore
Marriage & Family Therapist, LMFT
La Mesa, CA 91942
I am a Licensed Marriage and Family Therapist (LMFT) in San Diego, California who has been working in the field of psychology since 2013. I have experience working in residential, schools, outpatient, and crisis settings as well as work now in my own private practice with clients experiencing depression, anxiety, panic attacks, addiction, relationship issues, parenting problems, social concerns, life transitions, grief/loss, trauma, abuse, crisis situations, and general adjustment issues. I have diagnosed and helped clients work through most of the disorders listed in the DSM-5.
I am a Licensed Marriage and Family Therapist (LMFT) in San Diego, California who has been working in the field of psychology since 2013. I have experience working in residential, schools, outpatient, and crisis settings as well as work now in my own private practice with clients experiencing depression, anxiety, panic attacks, addiction, relationship issues, parenting problems, social concerns, life transitions, grief/loss, trauma, abuse, crisis situations, and general adjustment issues. I have diagnosed and helped clients work through most of the disorders listed in the DSM-5.
(619) 345-5939 View (619) 345-5939
Photo of Madeleine E Denison, Marriage & Family Therapist Associate, MA, AMFT, EMDR
Madeleine E Denison
Marriage & Family Therapist Associate, MA, AMFT, EMDR
1 Endorsed
Online Only
The "lie" of grief is that we are alone in our experience. There is a sincere inclination that we must draw into ourselves, into our archive of memories, and suffer in isolation. When my clients begin their therapeutic work, I recognize that they have already initiated the transformation that takes place in grief. It requires resilience, inertia, and rebellion to reject that initial thought that suffering has to be done in isolation. My clients enter grief counseling in a feat of reconciliation, not only to their lost loved ones, but to the people that remain, and, inexplicably, to themselves.
The "lie" of grief is that we are alone in our experience. There is a sincere inclination that we must draw into ourselves, into our archive of memories, and suffer in isolation. When my clients begin their therapeutic work, I recognize that they have already initiated the transformation that takes place in grief. It requires resilience, inertia, and rebellion to reject that initial thought that suffering has to be done in isolation. My clients enter grief counseling in a feat of reconciliation, not only to their lost loved ones, but to the people that remain, and, inexplicably, to themselves.
(619) 492-7498 View (619) 492-7498
Photo of Nora Katz, Clinical Social Work/Therapist, LCSW
Nora Katz
Clinical Social Work/Therapist, LCSW
3 Endorsed
Online Only
You’re tired of feeling ruled by this anxiety or uncertainty. From the outside, your life looks good—you have a lot to be proud of. But something still isn’t right: you might feel anxious, have trouble making decisions, or unfulfilled and disconnected in your relationships. You’re constantly criticizing yourself, second-guessing that text message you sent or what others are thinking of you. Somehow, it’s like life is happening to you, instead of you being the one in control. And although you’ve tried to address this on your own through things like journaling or mindfulness practices, you still just don’t feel like yourself.
You’re tired of feeling ruled by this anxiety or uncertainty. From the outside, your life looks good—you have a lot to be proud of. But something still isn’t right: you might feel anxious, have trouble making decisions, or unfulfilled and disconnected in your relationships. You’re constantly criticizing yourself, second-guessing that text message you sent or what others are thinking of you. Somehow, it’s like life is happening to you, instead of you being the one in control. And although you’ve tried to address this on your own through things like journaling or mindfulness practices, you still just don’t feel like yourself.
(949) 844-6359 View (949) 844-6359
Photo of Karli Cirovski, Associate Professional Clinical Counselor, APCC
Karli Cirovski
Associate Professional Clinical Counselor, APCC
1 Endorsed
La Mesa, CA 91942
Hello, I'm Karli, a registered Associate Professional Clinical Counselor who is passionate about helping teens, adults, and couples navigate life’s ups and downs. I strive to create a warm, welcoming space where clients feel truly seen, supported, and safe to explore both challenges and growth. My goal is to help clients connect with their values, build insight, and move toward a more fulfilling life.
Hello, I'm Karli, a registered Associate Professional Clinical Counselor who is passionate about helping teens, adults, and couples navigate life’s ups and downs. I strive to create a warm, welcoming space where clients feel truly seen, supported, and safe to explore both challenges and growth. My goal is to help clients connect with their values, build insight, and move toward a more fulfilling life.
(619) 815-3968 View (619) 815-3968
Photo of Marissa Ayala, Marriage & Family Therapist Associate, AMFT
Marissa Ayala
Marriage & Family Therapist Associate, AMFT
La Mesa, CA 91942
I pull from a variety of therapeutic modalities, such as Narrative Therapy, Internal Family Systems ( IFS), depth-oriented approaches, somatic work, and holistic practices such as play-based, expressive arts, and eco-psychology interventions.
I work with children, teens, adults, and couples navigating a variety of different life transitions and challenges. Some of my areas of focus are: relationship growth (both to self and others), supporting you through the navigation of anxiety and depression, PTSD, CPTSD, & early attachment wounds, neurodivergent identities (Autism, ADHD, AuDHD, and related experiences), LGBTQIA+ identities, bicultural and multicultural identities, self-esteem, self-worth, & healthy boundaries, guilt, grief, loss, & abandonment. As well as giving space to explore your inner child & shadow parts of yourself.
I pull from a variety of therapeutic modalities, such as Narrative Therapy, Internal Family Systems ( IFS), depth-oriented approaches, somatic work, and holistic practices such as play-based, expressive arts, and eco-psychology interventions.
I work with children, teens, adults, and couples navigating a variety of different life transitions and challenges. Some of my areas of focus are: relationship growth (both to self and others), supporting you through the navigation of anxiety and depression, PTSD, CPTSD, & early attachment wounds, neurodivergent identities (Autism, ADHD, AuDHD, and related experiences), LGBTQIA+ identities, bicultural and multicultural identities, self-esteem, self-worth, & healthy boundaries, guilt, grief, loss, & abandonment. As well as giving space to explore your inner child & shadow parts of yourself.
(619) 848-5838 View (619) 848-5838

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Internal Family Systems (IFS) Therapists
What is Internal Family Systems therapy?
Internal Family Systems (IFS) is a type of talk therapy that focuses on sub-personalities, or “families,” within a person, which may be made up of wounded parts and unpleasant emotions like anger and shame. These sub-personalities can come into conflict with each other and with an individual’s core Self, leaving the person feeling detached from positive traits such as the “8 C’s” of confidence, calmness, creativity, clarity, curiosity, courage, compassion, and connectedness. By healing a patient’s wounded parts, a therapist aims to restore balance and bring on positive change.

How does Internal Family Systems therapy work?
An IFS therapist will work with a patient to identify their particular sub-personalities, recognize the emotions powering them, and release them. By doing so, the patient should become more able to address any underlying problems their sub-personalities may have been trying to protect them from. Ultimately, a patient discovers ways to manage internal and external conflicts on their own, through techniques such as relaxation exercises, journaling, and making charts depicting the relationships between their core Self and their distinct parts.

Does Internal Family Systems therapy work?
IFS therapy has been shown to help people address conditions such as depression, anxiety, panic, fears and phobias, trauma, and substance use disorders. Some research has also found that it can help individuals deal with symptoms of physical health conditions like rheumatoid arthritis, such as pain, everyday functioning, depressive feelings, and low self-compassion. There are some conditions for which IFS treatment, specifically discussions of one’s “parts,” may be less appropriate, such as schizophrenia or other states that involve psychosis or paranoia.

How long does Internal Family Systems therapy take?
As with most forms of talk therapy, there is no set duration or end point for IFS therapy. After becoming comfortable with a therapist and the core concepts of IFS, some patients quickly make progress. While experiences vary, most will find that it is a relatively longer-term therapy, involving months and sometimes years of sessions.