Obsessive-Compulsive (OCD) Therapists in Los Angeles, CA

Photo of Jesse Spiegel, Psychologist, PsyD
Jesse Spiegel
Psychologist, PsyD
1 Endorsed
Los Angeles, CA 90025
I specialize in the treatment of OCD, anxiety-based disorders and sleep related difficulties.
Life is filled with challenges and uncertainty, which often makes it difficult to move forward. Both children and adults’ experiences of the unknown can result in them feeling anxious, worried, and/or frustrated. I have focused my professional work in helping people gradually face their fears and problematic behaviors while integrating coping strategies along the way. I strive to help each client recognize their resilience and ability to grow.
I specialize in the treatment of OCD, anxiety-based disorders and sleep related difficulties.
Life is filled with challenges and uncertainty, which often makes it difficult to move forward. Both children and adults’ experiences of the unknown can result in them feeling anxious, worried, and/or frustrated. I have focused my professional work in helping people gradually face their fears and problematic behaviors while integrating coping strategies along the way. I strive to help each client recognize their resilience and ability to grow.
(424) 373-4493 View (424) 373-4493
Photo of Ally Zhou, Marriage & Family Therapist, MS, LMFT
Ally Zhou
Marriage & Family Therapist, MS, LMFT
3 Endorsed
Los Angeles, CA 90025
My areas of specialty include trauma, OCD, addiction, marginalized identities and cultural issues.
Welcome! I enjoy helping clients explore their identities and experiences in more depth in order to integrate more adaptive ways to heal from past wounds and live a more intentional and fulfilling life. In our work together, my goal is to help you cultivate greater awareness, identify and discard unhelpful patterns and create new avenues of change. Therapy with me is a dynamic, collaborative and slowed down process that acts as a container to safely explore and metabolize pain in a new way. I operate from a trauma-informed and culturally sensitive lens, with an emphasis in upholding anti-racist and LGBTQIA+ affirming practices.
My areas of specialty include trauma, OCD, addiction, marginalized identities and cultural issues.
Welcome! I enjoy helping clients explore their identities and experiences in more depth in order to integrate more adaptive ways to heal from past wounds and live a more intentional and fulfilling life. In our work together, my goal is to help you cultivate greater awareness, identify and discard unhelpful patterns and create new avenues of change. Therapy with me is a dynamic, collaborative and slowed down process that acts as a container to safely explore and metabolize pain in a new way. I operate from a trauma-informed and culturally sensitive lens, with an emphasis in upholding anti-racist and LGBTQIA+ affirming practices.
(424) 396-1467 View (424) 396-1467
Photo of Dr. Melanie R. Hudson, Psychologist, PsyD
Dr. Melanie R. Hudson
Psychologist, PsyD
3 Endorsed
Los Angeles, CA 90025
I am a licensed clinical psychologist specializing in the practice of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for adults and young adults experiencing OCD, and related anxiety spectrum disorders.
My goal is to build a strong therapeutic alliance & provide a collaborative setting for clients to learn & implement appropriate cognitive, behavioral & emotion-regulation skills. Through our active work together, clients learn to make sustainable changes and begin to live more fulfilling lives.
I am a licensed clinical psychologist specializing in the practice of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for adults and young adults experiencing OCD, and related anxiety spectrum disorders.
My goal is to build a strong therapeutic alliance & provide a collaborative setting for clients to learn & implement appropriate cognitive, behavioral & emotion-regulation skills. Through our active work together, clients learn to make sustainable changes and begin to live more fulfilling lives.
(310) 701-5103 View (310) 701-5103
Photo of Stephanie Joan Nelson, Marriage & Family Therapist Associate, MA, AMFT
Stephanie Joan Nelson
Marriage & Family Therapist Associate, MA, AMFT
Los Angeles, CA 90027
You crave connection, meaning, and a sense of purpose—but something feels misaligned. Maybe you’re struggling with relationship conflicts, feeling disconnected from yourself or others, or questioning the deeper meaning of your life. Relationship difficulties hinder intimacy, vulnerability, and true connections. These challenges can feel overwhelming and lead to anxiety, self-doubt, and loneliness. You don't need to navigate these challenges alone. Together, we can cultivate deeper relationships, embrace uncertainty with courage, and create a life that feels authentic and fulfilling.
You crave connection, meaning, and a sense of purpose—but something feels misaligned. Maybe you’re struggling with relationship conflicts, feeling disconnected from yourself or others, or questioning the deeper meaning of your life. Relationship difficulties hinder intimacy, vulnerability, and true connections. These challenges can feel overwhelming and lead to anxiety, self-doubt, and loneliness. You don't need to navigate these challenges alone. Together, we can cultivate deeper relationships, embrace uncertainty with courage, and create a life that feels authentic and fulfilling.
(213) 583-2148 View (213) 583-2148
Photo of Dr. Amy Wiseman, Psychologist, PsyD
Dr. Amy Wiseman
Psychologist, PsyD
2 Endorsed
Online Only
We take a varied approach with our patients, assessing if symptoms need immediate attention like with OCD/trauma/etc, but make time for the deep interpersonal processing and integration that leads to true healing.
My ideal client is the one who comes to my office with the genuine desire to grow and change. You have heard of depression and anxiety but you are unsure if you have a mental disorder. It is clear to you that something is not working but you don’t really know what it is, or maybe you know exactly what is going on but cannot seem to get a handle on how to change it. If you want to live as your highest and most authentic self, or if you just want to see a shift in unwelcome and uncomfortable behaviors, thoughts or feelings, my staff and I can help you begin that journey so long as you are ready to put in the work. 30 min FREE consult!
We take a varied approach with our patients, assessing if symptoms need immediate attention like with OCD/trauma/etc, but make time for the deep interpersonal processing and integration that leads to true healing.
My ideal client is the one who comes to my office with the genuine desire to grow and change. You have heard of depression and anxiety but you are unsure if you have a mental disorder. It is clear to you that something is not working but you don’t really know what it is, or maybe you know exactly what is going on but cannot seem to get a handle on how to change it. If you want to live as your highest and most authentic self, or if you just want to see a shift in unwelcome and uncomfortable behaviors, thoughts or feelings, my staff and I can help you begin that journey so long as you are ready to put in the work. 30 min FREE consult!
(323) 648-3093 View (323) 648-3093
Photo of Annie Zadori, Psychologist, PsyD
Annie Zadori
Psychologist, PsyD
Online Only
OCD, Body Dysmorphic disorder, Panic, and Phobias are my specialty.
I use a combination of evidence-based approaches such as, Exposure Response Prevention, Behavioral Therapy, Cognitive Therapy, and Coaching to treat Anxiety and mood related disorders, including OCD, BDD, Panic, and Phobias. The majority of my training in these areas was conducted with UCLA supervisors_ the highest-ranked in the country.
OCD, Body Dysmorphic disorder, Panic, and Phobias are my specialty.
I use a combination of evidence-based approaches such as, Exposure Response Prevention, Behavioral Therapy, Cognitive Therapy, and Coaching to treat Anxiety and mood related disorders, including OCD, BDD, Panic, and Phobias. The majority of my training in these areas was conducted with UCLA supervisors_ the highest-ranked in the country.
(747) 850-9603 View (747) 850-9603
Photo of Hannah Bystritsky Johnson, Clinical Social Work/Therapist, LCSW
Hannah Bystritsky Johnson
Clinical Social Work/Therapist, LCSW
5 Endorsed
Los Angeles, CA 90024
My focus is treating individuals with chronic pain/illness, anxiety, OCD, and mood disorders.
Life is filled with challenges that can sometimes feel like too much for one person to manage on their own. Just making it through the day can be a struggle that sometimes feels like carrying around an invisible weight. If you’re feeling stuck and overwhelmed, I’m here to walk along side you and help you rediscover strengths that allow for growth and change. With a compassionate and evidence-based approach, I provide an individualized treatment plan designed to address each person's unique symptoms and needs. My practice focuses on creating a safe and non-judgemental space to help you work towards reaching your goals.
My focus is treating individuals with chronic pain/illness, anxiety, OCD, and mood disorders.
Life is filled with challenges that can sometimes feel like too much for one person to manage on their own. Just making it through the day can be a struggle that sometimes feels like carrying around an invisible weight. If you’re feeling stuck and overwhelmed, I’m here to walk along side you and help you rediscover strengths that allow for growth and change. With a compassionate and evidence-based approach, I provide an individualized treatment plan designed to address each person's unique symptoms and needs. My practice focuses on creating a safe and non-judgemental space to help you work towards reaching your goals.
(310) 929-6279 View (310) 929-6279
Photo of Sepideh Gidanian, Marriage & Family Therapist, MA, LMFT
Sepideh Gidanian
Marriage & Family Therapist, MA, LMFT
4 Endorsed
Los Angeles, CA 90025
I am passionate about helping my clients on their journey of self-discovery, who are experiencing life hardships or feeling stuck. I believe the therapeutic process is a collaboration and teamwork between the psychotherapist and the client, and self-awareness and growth are the natural results of effective psychotherapy. In my opinion, there are many reasons why we become who we are. Our genetics, biology, neurology, upbringing, relationships, life experiences, and the society we were raised in are all important in shaping who we have become.
I am passionate about helping my clients on their journey of self-discovery, who are experiencing life hardships or feeling stuck. I believe the therapeutic process is a collaboration and teamwork between the psychotherapist and the client, and self-awareness and growth are the natural results of effective psychotherapy. In my opinion, there are many reasons why we become who we are. Our genetics, biology, neurology, upbringing, relationships, life experiences, and the society we were raised in are all important in shaping who we have become.
(310) 634-1386 View (310) 634-1386
Photo of Michelle Gagnon, Marriage & Family Therapist Associate, AMFT
Michelle Gagnon
Marriage & Family Therapist Associate, AMFT
Online Only
Michelle specializes in the treatment of past trauma, panic disorder, obsessive compulsive disorder ( OCD), and specific phobias (fear of flying, blood injection injury, etc) via EMDR 2
Michelle is dedicated to supporting clients through a trauma-informed approach. She has extensive experience working with adolescents and adults in both individual and group therapy settings. At the LGBT Center, Michelle provided crisis intervention, counseling, and long-term support for LGBTQ+ youth experiencing homelessness and foster care. Michelle incorporates modalities such as EMDR, DBT, CBT, IFS, Solution-Focused Therapy, and holistic grief counseling into her practice. With a background in working with complex cases, including dual diagnoses and trauma, she strives to create a safe and affirming space for all clients.
Michelle specializes in the treatment of past trauma, panic disorder, obsessive compulsive disorder ( OCD), and specific phobias (fear of flying, blood injection injury, etc) via EMDR 2
Michelle is dedicated to supporting clients through a trauma-informed approach. She has extensive experience working with adolescents and adults in both individual and group therapy settings. At the LGBT Center, Michelle provided crisis intervention, counseling, and long-term support for LGBTQ+ youth experiencing homelessness and foster care. Michelle incorporates modalities such as EMDR, DBT, CBT, IFS, Solution-Focused Therapy, and holistic grief counseling into her practice. With a background in working with complex cases, including dual diagnoses and trauma, she strives to create a safe and affirming space for all clients.
(323) 538-6753 View (323) 538-6753
Photo of Christopher Mulligan - Cyber Addiction Recovery Center, Clinical Social Work/Therapist, LCSW
Cyber Addiction Recovery Center
Clinical Social Work/Therapist, LCSW
1 Endorsed
Los Angeles, CA 90034
I utilize cognitive-behavioral therapy and psycho-eductional techniques to treat individuals struggling with addiction, anxiety, mood, and impulse control disorders (with a sub-specialization in OCD).
I have 32 years of experience treating children, teens and young adults with anxiety, mood, and impulse control disorders. I specialize in internet and video game addiction, Including teen and adult online pornography addiction. I conduct groups for internet and video game addiction. I provide individual, couples, and family counseling focusing on addiction and the underlying problems that create addiction.
I utilize cognitive-behavioral therapy and psycho-eductional techniques to treat individuals struggling with addiction, anxiety, mood, and impulse control disorders (with a sub-specialization in OCD).
I have 32 years of experience treating children, teens and young adults with anxiety, mood, and impulse control disorders. I specialize in internet and video game addiction, Including teen and adult online pornography addiction. I conduct groups for internet and video game addiction. I provide individual, couples, and family counseling focusing on addiction and the underlying problems that create addiction.
(562) 250-5109 View (562) 250-5109
Photo of Dr. Kendall Kohnle - Dr. Kendall Kohnle, Los Angeles CBT Anxiety Expert, Psychologist, PhD
I am a licensed psychologist and Assistant Director at CBT Los Angeles specializing in evidence-based therapy for anxiety disorders (i.e., obsessive-compulsive disorder, post-traumatic stress disorder, specific phobia, panic disorder, social anxiety, and generalized anxiety).
I am extensively trained in Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), Cognitive Processing Therapy (CPT), and Prolonged Exposure (PE). I also am trained in Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Integrative Behavioral Couple Therapy (IBCT). I see adolescents, adults, and couples.
I am a licensed psychologist and Assistant Director at CBT Los Angeles specializing in evidence-based therapy for anxiety disorders (i.e., obsessive-compulsive disorder, post-traumatic stress disorder, specific phobia, panic disorder, social anxiety, and generalized anxiety).
I am extensively trained in Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), Cognitive Processing Therapy (CPT), and Prolonged Exposure (PE). I also am trained in Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Integrative Behavioral Couple Therapy (IBCT). I see adolescents, adults, and couples.
(424) 487-6252 View (424) 487-6252
Photo of Ariana Howell, Marriage & Family Therapist Associate, MS, AMFT, EMDR
Ariana Howell
Marriage & Family Therapist Associate, MS, AMFT, EMDR
4 Endorsed
Online Only
Do you experience sudden waves of panic or feel stuck in a constant state of “what if?” You might find yourself on edge, struggling to trust your own mind, or doubting your ability to "handle it." If this sounds familiar, you’re not alone—and you don’t have to navigate it by yourself. As a therapist who understands the lived experience of anxiety firsthand, I offer a warm, compassionate space where you can make sense of what’s happening, rebuild a sense of safety, and begin to trust yourself again.
Do you experience sudden waves of panic or feel stuck in a constant state of “what if?” You might find yourself on edge, struggling to trust your own mind, or doubting your ability to "handle it." If this sounds familiar, you’re not alone—and you don’t have to navigate it by yourself. As a therapist who understands the lived experience of anxiety firsthand, I offer a warm, compassionate space where you can make sense of what’s happening, rebuild a sense of safety, and begin to trust yourself again.
(310) 504-2713 View (310) 504-2713
Photo of Claudia Miles, Marriage & Family Therapist, MA, LMFT
Claudia Miles
Marriage & Family Therapist, MA, LMFT
1 Endorsed
Los Angeles, CA 90035
I work with clients on issues ranging from depression, anxiety, OCD, addiction to relationship, career and identity issues and I work with couples.
I spent a decade in the music and film industry working with musicians and artists prior to becoming a therapist and am a musician myself. I have a deep understanding of the particular struggles artists deal with and have supported many in removing the blocks to doing their best work.
I work with clients on issues ranging from depression, anxiety, OCD, addiction to relationship, career and identity issues and I work with couples.
I spent a decade in the music and film industry working with musicians and artists prior to becoming a therapist and am a musician myself. I have a deep understanding of the particular struggles artists deal with and have supported many in removing the blocks to doing their best work.
(628) 500-8235 View (628) 500-8235
Photo of Madison Blair, Clinical Social Work/Therapist, LCSW
Madison Blair
Clinical Social Work/Therapist, LCSW
5 Endorsed
Los Angeles, CA 90048
I also specialize in OCD.
I commend you for beginning your search for a therapist. I am a Licensed Clinical Social Worker practicing in California. I serve individuals ages 5+, couples, and families.
I also specialize in OCD.
I commend you for beginning your search for a therapist. I am a Licensed Clinical Social Worker practicing in California. I serve individuals ages 5+, couples, and families.
(424) 447-8601 View (424) 447-8601
Photo of Megan L. Wagner, Psychologist, PhD, BCB
Megan L. Wagner
Psychologist, PhD, BCB
7 Endorsed
Online Only
Wagner has an extensive background working with individuals with chronic pain and other health problems, anxiety, OCD, trichotillomania, ADHD, perfectionism, depression, and career concerns, as well as with students, artists, professionals, and veterans.
Dr. Wagner utilizes therapy approaches that have been thoroughly studied through scientific research, including cognitive behavioral therapy (CBT), mindfulness-based methods (e.g., ACT), and biofeedback. She also takes into account each client's unique needs and preferences and will collaborate with you to reach your therapy goals. She is currently taking new clients for both short-term and long-term individual therapy, and has a variety of scheduling options including daytime and evenings. Dr. Wagner is social justice-oriented and welcomes those seeking support regarding the current political landscape in the US.
Wagner has an extensive background working with individuals with chronic pain and other health problems, anxiety, OCD, trichotillomania, ADHD, perfectionism, depression, and career concerns, as well as with students, artists, professionals, and veterans.
Dr. Wagner utilizes therapy approaches that have been thoroughly studied through scientific research, including cognitive behavioral therapy (CBT), mindfulness-based methods (e.g., ACT), and biofeedback. She also takes into account each client's unique needs and preferences and will collaborate with you to reach your therapy goals. She is currently taking new clients for both short-term and long-term individual therapy, and has a variety of scheduling options including daytime and evenings. Dr. Wagner is social justice-oriented and welcomes those seeking support regarding the current political landscape in the US.
(310) 879-5604 View (310) 879-5604
Photo of Savannah Hemmig, Marriage & Family Therapist, LMFT, MS
Savannah Hemmig
Marriage & Family Therapist, LMFT, MS
2 Endorsed
Los Angeles, CA 90035
I specialize in treating OCD and OCD-related disorders with Acceptance and Commitment Therapy (ACT) and Exposure Response Prevention (ERP).
I am a Licensed Marriage and Family Therapist (LMFT) who earned both my degrees from the University of Southern California. I am an integrative contextual therapist who uses a variety of interventions to best suit each client. I draw from my diverse background in Acceptance and Commitment Therapy (ACT), Exposure Response Prevention (ERP), mindfulness, radical acceptance, regulation skills, Seeking Safety, harm reduction, and always trauma oriented.
I specialize in treating OCD and OCD-related disorders with Acceptance and Commitment Therapy (ACT) and Exposure Response Prevention (ERP).
I am a Licensed Marriage and Family Therapist (LMFT) who earned both my degrees from the University of Southern California. I am an integrative contextual therapist who uses a variety of interventions to best suit each client. I draw from my diverse background in Acceptance and Commitment Therapy (ACT), Exposure Response Prevention (ERP), mindfulness, radical acceptance, regulation skills, Seeking Safety, harm reduction, and always trauma oriented.
(323) 927-1241 View (323) 927-1241
Photo of Dr. Yumi Terajima, Psychologist, PsyD
Dr. Yumi Terajima
Psychologist, PsyD
1 Endorsed
Online Only
I aim to treat adult individuals and couples who struggle with a variety of concerns including, but not limited to, anxiety disorders and OCD, depression, mood disorders, perinatal mental health struggles, identity development, minority group stressors, and life transitions.
I’m a multicultural and trauma-informed Licensed Clinical Psychologist in California and Illinois. My goal is to provide a safe, warm, non-judgmental space while utilizing mindfulness and evidence-based techniques. This will allow us to work towards learning more about you and what might be beneficial to begin living your life aligned with your values.
I aim to treat adult individuals and couples who struggle with a variety of concerns including, but not limited to, anxiety disorders and OCD, depression, mood disorders, perinatal mental health struggles, identity development, minority group stressors, and life transitions.
I’m a multicultural and trauma-informed Licensed Clinical Psychologist in California and Illinois. My goal is to provide a safe, warm, non-judgmental space while utilizing mindfulness and evidence-based techniques. This will allow us to work towards learning more about you and what might be beneficial to begin living your life aligned with your values.
(310) 620-1503 View (310) 620-1503
Photo of Jenny A Quiroa, Marriage & Family Therapist, LMFT
Jenny A Quiroa
Marriage & Family Therapist, LMFT
Online Only
I incorporate client-centered approach to begin where the client is most comfortable and offers a safe environment for the client. I utilized an eclectic approach as each client is different and has different needs during treatment. I implement the following modalities: CBT, strength-based, DBT, solution-focused, mindfulness, and other therapy techniques to assist clients to feel better and supported throughout treatment.
I incorporate client-centered approach to begin where the client is most comfortable and offers a safe environment for the client. I utilized an eclectic approach as each client is different and has different needs during treatment. I implement the following modalities: CBT, strength-based, DBT, solution-focused, mindfulness, and other therapy techniques to assist clients to feel better and supported throughout treatment.
(424) 319-1015 View (424) 319-1015
Photo of Adella Jaeger, Clinical Social Work/Therapist, MSW, LCSW
Adella Jaeger
Clinical Social Work/Therapist, MSW, LCSW
1 Endorsed
Los Angeles, CA 90064
Are you feeling "stuck," overwhelmed, or find yourself worrying about things beyond your control? You are looking for the right therapist, someone who will not only "get you," but will actually help you. I am not a stereotypical "so how does that make you feel" therapist. Yes, I'm empathetic, down to earth, caring, and intuitive.. And I am also practical. As a therapist with over a decade of experience, I am actively involved, goal oriented, and realistic. I am skilled at providing both traditional and cutting-edge therapies, using invaluable tools that can open the doors for the insight and clarity that you are searching for.
Are you feeling "stuck," overwhelmed, or find yourself worrying about things beyond your control? You are looking for the right therapist, someone who will not only "get you," but will actually help you. I am not a stereotypical "so how does that make you feel" therapist. Yes, I'm empathetic, down to earth, caring, and intuitive.. And I am also practical. As a therapist with over a decade of experience, I am actively involved, goal oriented, and realistic. I am skilled at providing both traditional and cutting-edge therapies, using invaluable tools that can open the doors for the insight and clarity that you are searching for.
(702) 710-0826 View (702) 710-0826
Photo of Dr. Todd Brown, Psychologist, PhD
Dr. Todd Brown
Psychologist, PhD
Los Angeles, CA 90025
Intrusive obsessive thoughts can lead to cycles of avoidance, reassurance, and compulsive actions that try (but fail) to make things better.
I offer an approach that is evidence-based while also empathetic and individualized. Intensive outpatient (IOP) services are also available to target significantly interfering issues. Our time together will not be controlled by robotic manuals nor will they simply be venting sessions that can feel good in the moment but leave you questioning "what now?"
Intrusive obsessive thoughts can lead to cycles of avoidance, reassurance, and compulsive actions that try (but fail) to make things better.
I offer an approach that is evidence-based while also empathetic and individualized. Intensive outpatient (IOP) services are also available to target significantly interfering issues. Our time together will not be controlled by robotic manuals nor will they simply be venting sessions that can feel good in the moment but leave you questioning "what now?"
(424) 667-4234 View (424) 667-4234

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Obsessive-Compulsive (OCD) Therapists

How long does OCD treatment take?

Obsessive-Compulsive Disorder (OCD) is often treated on a weekly or twice-weekly schedule, depending on symptom severity and the client’s preferences. Some clients may start to see a noticeable improvement in symptoms in as little as six weeks, but it’s also possible, especially in more severe cases, for treatment to take several months to a year before significant progress is made.

What happens if OCD is not treated?

Some people with OCD, especially those with mild symptoms, may find that they are able to adapt reasonably well to life with the condition, even if their symptoms never resolve completely. However, many people, particularly those whose symptoms are severe at the outset, find that their obsessions and compulsions grow more intrusive with time, making it harder to maintain relationships, hold down a job, or navigate the world successfully.

Are there medications for OCD?

Medication can be used to treat OCD. The class of drugs most often prescribed are selective serotonin reuptake inhibitors, or SSRIs, which include fluvoxamine (under the brand name Luvox), fluoxetine (Prozac), and sertraline (Zoloft), among others. In cases of treatment-resistant OCD, other classes of medication, such as tricyclic antidepressants or atypical antipsychotics, may be prescribed. Medication is frequently used in conjunction with therapy.

Can OCD come back after treatment?

Yes. Major life transitions, periods of stress, or other factors can cause symptoms to return or, if they were never fully eradicated, to ramp back up in intensity. For some, these relapses are brief and do not require additional treatment; identifying specific triggers and practicing the skills learned in therapy can help speed their course. For others, returning to therapy for a brief period can help address the underlying stress and strengthen coping mechanisms.