Exposure Response Prevention (ERP) Therapists in Dupont Circle, Washington, DC

Photo of Allison Shuff, Licensed Social Worker, MSW, LMSW, LGSW
Allison Shuff
Licensed Social Worker, MSW, LMSW, LGSW
1 Endorsed
Dupont Circle, Washington, DC 20036
I utilize tools from acceptance and commitment therapy (ACT), mindfulness-based therapy, dialectical behavioral therapy (DBT), and exposure and response prevention ( ERP) for OCD.
Being a human can be heavy, but you don’t have to carry the load alone. I have immediate availability to assist teens, adults, and couples at any stage of their healing journey. In my practice, I strive to create a safe and supportive space for all identities and cultures. Using a sex-positive and anti-oppressive approach, I work with those looking to address longstanding or newly discovered issues. My specialties areas include ADHD/Autism, gender and sexuality/LGBTQIA+ experiences, OCD, BPD, trauma, anxiety, depression, attachment, and simply existing amidst the turmoil. I see clients in person in DC or virtually for MD and VA.
I utilize tools from acceptance and commitment therapy (ACT), mindfulness-based therapy, dialectical behavioral therapy (DBT), and exposure and response prevention ( ERP) for OCD.
Being a human can be heavy, but you don’t have to carry the load alone. I have immediate availability to assist teens, adults, and couples at any stage of their healing journey. In my practice, I strive to create a safe and supportive space for all identities and cultures. Using a sex-positive and anti-oppressive approach, I work with those looking to address longstanding or newly discovered issues. My specialties areas include ADHD/Autism, gender and sexuality/LGBTQIA+ experiences, OCD, BPD, trauma, anxiety, depression, attachment, and simply existing amidst the turmoil. I see clients in person in DC or virtually for MD and VA.
(202) 929-5643 View (202) 929-5643
Photo of Sarah Holland, Clinical Social Work/Therapist, LICSW, LCSW
Sarah Holland
Clinical Social Work/Therapist, LICSW, LCSW
3 Endorsed
Dupont Circle, Washington, DC 20036
I utilize principles of Internal Family Systems (or "parts work"), psychodynamic, somatic, and mindfulness-based therapies, as well as ERP and Brainspotting.
My clients would describe me as easy to talk to, genuine, warm, inquisitive, and validating. While I take therapy seriously, I also think laughter is a powerful medicine. If you're tired of "just talking" in therapy, my interactive style might work well for you. If you're an "overthinker", I can help you get out of your head and into your emotions and body.
I utilize principles of Internal Family Systems (or "parts work"), psychodynamic, somatic, and mindfulness-based therapies, as well as ERP and Brainspotting.
My clients would describe me as easy to talk to, genuine, warm, inquisitive, and validating. While I take therapy seriously, I also think laughter is a powerful medicine. If you're tired of "just talking" in therapy, my interactive style might work well for you. If you're an "overthinker", I can help you get out of your head and into your emotions and body.
(202) 890-1828 View (202) 890-1828
Photo of Jessica Nemeth, Psychologist, PsyD
Jessica Nemeth
Psychologist, PsyD
1 Endorsed
Dupont Circle, Washington, DC 20036
I am grounded in CBT (cognitive behavioral therapy), and integrate other evidence-based treatments, such as ERP (exposure and response prevention), DBT and CPT for trauma.
Welcome to my practice. I help people make meaningful changes in their lives, with a warm and empathic style, using evidence-based treatments that work. My clients gain a more compassionate and realistic understanding of themselves as well as solid skills and strategies for improving their moods, their functioning, their relationships, and their sense of purpose. I work collaboratively with clients to set goals for their therapy, and I view myself as their partner. I strive to create a non-judgmental, caring and connected therapeutic relationship, where we can work with good humor and deep respect for your values and goals.
I am grounded in CBT (cognitive behavioral therapy), and integrate other evidence-based treatments, such as ERP (exposure and response prevention), DBT and CPT for trauma.
Welcome to my practice. I help people make meaningful changes in their lives, with a warm and empathic style, using evidence-based treatments that work. My clients gain a more compassionate and realistic understanding of themselves as well as solid skills and strategies for improving their moods, their functioning, their relationships, and their sense of purpose. I work collaboratively with clients to set goals for their therapy, and I view myself as their partner. I strive to create a non-judgmental, caring and connected therapeutic relationship, where we can work with good humor and deep respect for your values and goals.
(844) 405-6642 View (844) 405-6642
Photo of Frances Rekrut, Psychologist, MA, PhD
Frances Rekrut
Psychologist, MA, PhD
12 Endorsed
Dupont Circle, Washington, DC 20036
I employ an integrative approach using different therapeutic models including Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention ( ERP), & Acceptance Commitment Therapy (ACT).
Compassionate therapy has the power to help people reflect, grow, and change. Using a warm and engaging approach, I collaborate with clients to develop treatment strategies that work based on research-based techniques. I specialize in working with clients struggling with relationship issues, OCD, grief and loss, and difficult life transitions, including changes in roles or identity.
I employ an integrative approach using different therapeutic models including Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention ( ERP), & Acceptance Commitment Therapy (ACT).
Compassionate therapy has the power to help people reflect, grow, and change. Using a warm and engaging approach, I collaborate with clients to develop treatment strategies that work based on research-based techniques. I specialize in working with clients struggling with relationship issues, OCD, grief and loss, and difficult life transitions, including changes in roles or identity.
(202) 759-7878 View (202) 759-7878
Photo of Matthew Worhach, Psychologist, PhD
Matthew Worhach
Psychologist, PhD
9 Endorsed
Dupont Circle, Washington, DC 20036
Most people I work with are doing well on paper — but still feel stuck. You might be successful, driven, and capable, yet find yourself overthinking, doubting yourself, or feeling disconnected from your confidence and emotions. Maybe you’re tired of always being “the responsible one,” holding it together, or staying productive while something underneath feels unsettled. I’m a warm psychologist with 12 years of experience, and I specialize in working with professionals who want to feel more secure in themselves and break patterns that keep them from living the life they want.
Most people I work with are doing well on paper — but still feel stuck. You might be successful, driven, and capable, yet find yourself overthinking, doubting yourself, or feeling disconnected from your confidence and emotions. Maybe you’re tired of always being “the responsible one,” holding it together, or staying productive while something underneath feels unsettled. I’m a warm psychologist with 12 years of experience, and I specialize in working with professionals who want to feel more secure in themselves and break patterns that keep them from living the life they want.
(202) 499-4555 View (202) 499-4555
Photo of Aimee Caramico, Psychologist, PsyD
Aimee Caramico
Psychologist, PsyD
1 Endorsed
Dupont Circle, Washington, DC 20036
I specialize in Acceptance and Commitment Therapy (ACT), a mindfulness-based behavior therapy that focuses on helping clients live fulfilling and meaningful lives even with the struggles of everyday life. I offer a collaborative approach that helps to guide clients toward their goals through fostering insight and acceptance while also reducing avoidance behaviors. I believe that every person has a natural internal strength that I seek to foster through empowerment. My ultimate goal is to help clients drop the struggle and live a valued life so they can manage the inevitable ups and downs of the human experience on their own.
I specialize in Acceptance and Commitment Therapy (ACT), a mindfulness-based behavior therapy that focuses on helping clients live fulfilling and meaningful lives even with the struggles of everyday life. I offer a collaborative approach that helps to guide clients toward their goals through fostering insight and acceptance while also reducing avoidance behaviors. I believe that every person has a natural internal strength that I seek to foster through empowerment. My ultimate goal is to help clients drop the struggle and live a valued life so they can manage the inevitable ups and downs of the human experience on their own.
(202) 932-0587 View (202) 932-0587
Photo of Caroline Freedenberg, Clinical Social Work/Therapist, LICSW, LCSW
Caroline Freedenberg
Clinical Social Work/Therapist, LICSW, LCSW
1 Endorsed
Dupont Circle, Washington, DC 20036
I am a licensed clinical social worker with expertise in cognitive behavioral therapy (CBT), exposure and response prevention ( ERP), and dialectical behavioral therapy (DBT).
Many women and partners/fathers feel sad, anxious, stressed, and struggle to find joy or experience barriers connecting with their pregnancy or baby. You are not alone, and it is not your fault. Think of me as an ally in your corner, a mirror for your strengths, and a strategist walking alongside you during this time. I am passionate about working with women and parents experiencing perinatal anxiety, depression, post-traumatic stress, and obsessive-compulsive disorders during or following a pregnancy, and navigating parenthood.
I am a licensed clinical social worker with expertise in cognitive behavioral therapy (CBT), exposure and response prevention ( ERP), and dialectical behavioral therapy (DBT).
Many women and partners/fathers feel sad, anxious, stressed, and struggle to find joy or experience barriers connecting with their pregnancy or baby. You are not alone, and it is not your fault. Think of me as an ally in your corner, a mirror for your strengths, and a strategist walking alongside you during this time. I am passionate about working with women and parents experiencing perinatal anxiety, depression, post-traumatic stress, and obsessive-compulsive disorders during or following a pregnancy, and navigating parenthood.
(202) 759-5869 View (202) 759-5869
Photo of Corinne Kacmarek, Psychologist, PhD
Corinne Kacmarek
Psychologist, PhD
Dupont Circle, Washington, DC 20036
I have expertise in trauma, substance use, and health-related behavior change. I specialize in delivering gold-standard treatments such as cognitive processing therapy for post-traumatic stress disorder; cognitive behavioral therapy for insomnia, nightmares, chronic pain, substance use, and binge eating disorder; and motivational interviewing for behavior change. I draw on therapeutic techniques from humanistic, dialectical, acceptance-based, and problem solving approaches to help each individual's mental health journey feel practical and meaningful.
I have expertise in trauma, substance use, and health-related behavior change. I specialize in delivering gold-standard treatments such as cognitive processing therapy for post-traumatic stress disorder; cognitive behavioral therapy for insomnia, nightmares, chronic pain, substance use, and binge eating disorder; and motivational interviewing for behavior change. I draw on therapeutic techniques from humanistic, dialectical, acceptance-based, and problem solving approaches to help each individual's mental health journey feel practical and meaningful.
(855) 744-0197 View (855) 744-0197
Photo of Erin Abbott, Clinical Social Work/Therapist, LCSW-C
Erin Abbott
Clinical Social Work/Therapist, LCSW-C
2 Endorsed
Dupont Circle, Washington, DC 20036
  With training in Dialectical Behavior Therapy (DBT), Eye Movement Desensitization and Reprocessing (EMDR), and Exposure Response Prevention ( ERP).
My journey in this field began with a deep-rooted desire to make a positive impact, leading me to earn my undergraduate degree in Social Work from Catholic University in 2013. I continued my education and completed my Masters in Social Work through the advanced standing program in 2014. My professional path has taken me through various roles, starting with the DC Child and Family Services, where I completed my clinical licensure requirements. For the past nine years, I’ve had the privilege of working in private practice, helping clients from diverse backgrounds find fulfillment and resilience.
  With training in Dialectical Behavior Therapy (DBT), Eye Movement Desensitization and Reprocessing (EMDR), and Exposure Response Prevention ( ERP).
My journey in this field began with a deep-rooted desire to make a positive impact, leading me to earn my undergraduate degree in Social Work from Catholic University in 2013. I continued my education and completed my Masters in Social Work through the advanced standing program in 2014. My professional path has taken me through various roles, starting with the DC Child and Family Services, where I completed my clinical licensure requirements. For the past nine years, I’ve had the privilege of working in private practice, helping clients from diverse backgrounds find fulfillment and resilience.
(240) 852-1916 View (240) 852-1916
Photo of Ryoichi Noguchi, Psychologist, PhD
Ryoichi Noguchi
Psychologist, PhD
Dupont Circle, Washington, DC 20036
Lasting change is possible with effective interventions and proper support. I specialize in evidence-based treatments to help people overcome anxiety, depression, OCD, and a range of other mental health concerns. Whether you struggle with social anxiety, depression, or difficult life circumstances, my role is to help you improve your quality of life and create real, measurable changes.
Lasting change is possible with effective interventions and proper support. I specialize in evidence-based treatments to help people overcome anxiety, depression, OCD, and a range of other mental health concerns. Whether you struggle with social anxiety, depression, or difficult life circumstances, my role is to help you improve your quality of life and create real, measurable changes.
(855) 699-3488 View (855) 699-3488
Photo of Diane Lameira, Psychologist, PhD
Diane Lameira
Psychologist, PhD
1 Endorsed
Dupont Circle, Washington, DC 20036
I have advanced training in Exposure and Response Prevention ( ERP), the gold-standard treatment for OCD, and help clients face intrusive thoughts with less fear and more freedom.
Do intrusive thoughts get stuck in your mind and feel impossible to shake? Thoughts like, “What if I’m a terrible person?”, “What if I don’t actually love my spouse?”, or “What if I get a deadly disease?” These thoughts can feel so threatening that you may end up checking things repeatedly, replaying conversations, or seeking reassurance, but the relief never lasts. It can be exhausting, confusing, and scary to live this way. You’re not alone, and effective treatment is available.
I have advanced training in Exposure and Response Prevention ( ERP), the gold-standard treatment for OCD, and help clients face intrusive thoughts with less fear and more freedom.
Do intrusive thoughts get stuck in your mind and feel impossible to shake? Thoughts like, “What if I’m a terrible person?”, “What if I don’t actually love my spouse?”, or “What if I get a deadly disease?” These thoughts can feel so threatening that you may end up checking things repeatedly, replaying conversations, or seeking reassurance, but the relief never lasts. It can be exhausting, confusing, and scary to live this way. You’re not alone, and effective treatment is available.
(202) 759-3410 View (202) 759-3410
Photo of Sara Battista - Greenhouse Psychotherapy, Licensed Professional Counselor, LCPC, LPC
Greenhouse Psychotherapy
Licensed Professional Counselor, LCPC, LPC
7 Endorsed
Dupont Circle, Washington, DC 20036
I'm Sara, the founder of this cozy little mental health practice! Greenhouse is home to a passionate team of providers who deliver high-quality, personalized mental health care to adults and teens of all genders. Whether you're tackling a specific challenge or just feeling like it's time to grow, we’re here to support you every step of the way. At Greenhouse, we believe mental healthcare isn’t a luxury, it’s a right. That’s why we lead with compassion, meet you with zero judgment, and celebrate the unique human you are. Our therapy isn’t one-size-fits-all — it’s personal, thoughtful, and rooted in real connection.
I'm Sara, the founder of this cozy little mental health practice! Greenhouse is home to a passionate team of providers who deliver high-quality, personalized mental health care to adults and teens of all genders. Whether you're tackling a specific challenge or just feeling like it's time to grow, we’re here to support you every step of the way. At Greenhouse, we believe mental healthcare isn’t a luxury, it’s a right. That’s why we lead with compassion, meet you with zero judgment, and celebrate the unique human you are. Our therapy isn’t one-size-fits-all — it’s personal, thoughtful, and rooted in real connection.
(202) 851-2990 View (202) 851-2990
Photo of Jennifer Spatzer, Psychologist, PsyD, LCP
Jennifer Spatzer
Psychologist, PsyD, LCP
Dupont Circle, Washington, DC 20036
I have 10+ years of experience working with clients who are in an acute to mild phase of a mental health issue, major life stressor, or life transition. I have specialized experience working with psychosis, depersonalization/derealization, dissociation, delusions, Bipolar Disorder, Schizoaffective, Delusional Disorder. I offer an active, collaborative approach to therapy and provide an environment of acceptance, warmth and respect that allows my clients to gain insight, self-efficacy, and empowerment while working toward an ultimate goal of taking control of their mental health and achieving sustained well-being and stability.
I have 10+ years of experience working with clients who are in an acute to mild phase of a mental health issue, major life stressor, or life transition. I have specialized experience working with psychosis, depersonalization/derealization, dissociation, delusions, Bipolar Disorder, Schizoaffective, Delusional Disorder. I offer an active, collaborative approach to therapy and provide an environment of acceptance, warmth and respect that allows my clients to gain insight, self-efficacy, and empowerment while working toward an ultimate goal of taking control of their mental health and achieving sustained well-being and stability.
(202) 851-2776 View (202) 851-2776
Photo of Tracy l Thomas, Psychologist, PsyD
Tracy l Thomas
Psychologist, PsyD
3 Endorsed
Dupont Circle, Washington, DC 20036
My therapeutic style is warm, authentic, and interactive. I create a comfortable and non-judgmental working environment for my clients, using empathy, honesty, and a sense of humor. I approach each individual treatment collaboratively - establishing treatment goals that are tailored specifically to the individual client's needs. My clients gain understanding and insight that help alleviate symptoms and create positive life changes. Because the way we think affects the way we feel, I help my clients learn how to identify and challenge negative thinking. These practical skills enable them to maintain the level of progress they make during therapy.
My therapeutic style is warm, authentic, and interactive. I create a comfortable and non-judgmental working environment for my clients, using empathy, honesty, and a sense of humor. I approach each individual treatment collaboratively - establishing treatment goals that are tailored specifically to the individual client's needs. My clients gain understanding and insight that help alleviate symptoms and create positive life changes. Because the way we think affects the way we feel, I help my clients learn how to identify and challenge negative thinking. These practical skills enable them to maintain the level of progress they make during therapy.
(202) 552-0511 View (202) 552-0511
Photo of Dickson Tang, Psychological Associate, PhD
Dickson Tang
Psychological Associate, PhD
1 Endorsed
Dupont Circle, Washington, DC 20036
I specialize in treating adults with anxiety, OCD, phobias (ex. fear of flying), sleep or insomnia, trauma, and career concerns. I work well with those needing support around major career transitions, as I shifted from a 16-year career at the World Bank to the mental health field. As a Chinese-American immigrant from Hong Kong, I also have a strong interest in helping clients navigate issues related to their cultural identities or adjusting to different cultural environments.
I specialize in treating adults with anxiety, OCD, phobias (ex. fear of flying), sleep or insomnia, trauma, and career concerns. I work well with those needing support around major career transitions, as I shifted from a 16-year career at the World Bank to the mental health field. As a Chinese-American immigrant from Hong Kong, I also have a strong interest in helping clients navigate issues related to their cultural identities or adjusting to different cultural environments.
(833) 283-9006 View (833) 283-9006
Photo of Emma Reed, Counselor, LGPC
Emma Reed
Counselor, LGPC
2 Endorsed
Dupont Circle, Washington, DC 20036
Hi there, I'm Emma! I specialize in working with adults of all ages that are facing eating disorders, depression, anxiety, OCD, trauma, and body image issues. I also work with clients seeking to explore their gender, sexuality, and relationships to sex and sexuality. I am passionate about helping individuals live authentically in their values, their relationships, and in the present moment. I believe that therapeutic approaches should be tailored to each individual client in a collaborative, nonjudgmental way. CBT, DBT, mindfulness therapies, and person-centered theories are some of my go-tos.
Hi there, I'm Emma! I specialize in working with adults of all ages that are facing eating disorders, depression, anxiety, OCD, trauma, and body image issues. I also work with clients seeking to explore their gender, sexuality, and relationships to sex and sexuality. I am passionate about helping individuals live authentically in their values, their relationships, and in the present moment. I believe that therapeutic approaches should be tailored to each individual client in a collaborative, nonjudgmental way. CBT, DBT, mindfulness therapies, and person-centered theories are some of my go-tos.
(202) 932-9330 View (202) 932-9330
Photo of John Michael Della Porta, Psychologist, PsyD
John Michael Della Porta
Psychologist, PsyD
Dupont Circle, Washington, DC 20036
I work with patients who have been diagnosed with OCD, anxiety disorders, and mood disorders, as well as those who are struggling with issues such as avoidance/procrastination, perfectionism, self-criticism, or feeling generally overwhelmed. I provide a structured treatment approach to modify thoughts and behavior patterns with an emphasis on learning to tolerate uncomfortable emotions. I help patients increase their awareness for why they are struggling with the issues they encounter, and identify specific tools that will allow them to live their lives more aligned with their values.
I work with patients who have been diagnosed with OCD, anxiety disorders, and mood disorders, as well as those who are struggling with issues such as avoidance/procrastination, perfectionism, self-criticism, or feeling generally overwhelmed. I provide a structured treatment approach to modify thoughts and behavior patterns with an emphasis on learning to tolerate uncomfortable emotions. I help patients increase their awareness for why they are struggling with the issues they encounter, and identify specific tools that will allow them to live their lives more aligned with their values.
(202) 335-6707 View (202) 335-6707
Photo of Catherine Coogan, Psychologist, PhD
Catherine Coogan
Psychologist, PhD
3 Endorsed
Dupont Circle, Washington, DC 20036
Therapy is an opportunity to better understand who you are and gain skills to address challenges. I most often work with people who are experiencing mood or anxiety concerns, obsessive-compulsive disorder (OCD) symptoms, life transitions, and relationship issues.
Therapy is an opportunity to better understand who you are and gain skills to address challenges. I most often work with people who are experiencing mood or anxiety concerns, obsessive-compulsive disorder (OCD) symptoms, life transitions, and relationship issues.
(202) 519-0106 View (202) 519-0106
Photo of Chris Vara, Clinical Social Work/Therapist, LICSW, LCSW-C, MDiv
Chris Vara
Clinical Social Work/Therapist, LICSW, LCSW-C, MDiv
6 Endorsed
Dupont Circle, Washington, DC 20036
For OCD, we use Exposure and Response Prevention ( ERP) Therapy.
We get to know the whole person; Instead of seeing problems to fix, we see people in need of remembering they are already whole. Whether you are caught in cycles that leave you exhausted, want better relationships but find them splintering, and/or find yourself shutting down or shutting off – you don’t have to suffer in silence. Nor do you have to suffer alone. Our identities often intersect with our struggles and our strengths. We'll meet you where you're at, and help you get where you're going. No matter where you are on your journey of becoming – together healing is possible.
For OCD, we use Exposure and Response Prevention ( ERP) Therapy.
We get to know the whole person; Instead of seeing problems to fix, we see people in need of remembering they are already whole. Whether you are caught in cycles that leave you exhausted, want better relationships but find them splintering, and/or find yourself shutting down or shutting off – you don’t have to suffer in silence. Nor do you have to suffer alone. Our identities often intersect with our struggles and our strengths. We'll meet you where you're at, and help you get where you're going. No matter where you are on your journey of becoming – together healing is possible.
(240) 201-2713 View (240) 201-2713
Photo of Dr. Meghan Keely McMackin, Psychologist, PhD
Dr. Meghan Keely McMackin
Psychologist, PhD
1 Endorsed
Dupont Circle, Washington, DC 20036
I have substantial experience using evidence-based approaches (ACT, CBT, ERP) to treat these conditions, and I tailor treatment to each client’s needs and goals.
Every client is different, and I make sure therapy feels collaborative and practical for you. Together we’ll identify what matters most, break challenges into manageable steps, and find strategies that fit your life. I will help you feel supported, empowered, and equipped to make meaningful change.
I have substantial experience using evidence-based approaches (ACT, CBT, ERP) to treat these conditions, and I tailor treatment to each client’s needs and goals.
Every client is different, and I make sure therapy feels collaborative and practical for you. Together we’ll identify what matters most, break challenges into manageable steps, and find strategies that fit your life. I will help you feel supported, empowered, and equipped to make meaningful change.
(202) 925-8719 View (202) 925-8719

See more therapy options for Dupont Circle, Washington

Nearby Exposure Response Prevention (ERP) Therapists Searches for Dupont Circle, Washington

See More Exposure Response Prevention (ERP) Therapists
Exposure Response Prevention (ERP) Therapists
Do I need exposure and response prevention therapy?
Many clients decide to seek help for obsessive thoughts and compulsive behaviors when these symptoms are distressing enough to disrupt everyday life. Any thoughts or behaviors that cause friction in close relationships are also worth addressing. In addition, the client’s symptoms don’t have to be severe for them to benefit from ERP therapy.

Is exposure and response prevention therapy part of cognitive behavioral therapy?
Exposure and response prevention is one specific type of CBT that focuses on behavioral change in response to triggering stimuli. It is related to exposure therapy but adds an additional component of preventing compulsive and harmful responses.

How long does exposure and response prevention therapy take?
While every patient is different, exposure and response prevention therapy typically lasts around 12 sessions, although some treatments can take longer. A therapist will determine if the treatment is complete based on how the client faces their fears, particularly the strongest ones. When a client feels less anxiety about stimuli that once evoked terror or distress, that is generally an indication that they are nearing the end of ERP therapy.

What are the limitations of exposure and response prevention therapy?
The most common pitfalls of exposure and response prevention therapy include not addressing a client’s core fears, allowing the client to avoid their most distressing stimuli, and using imaginary exposure when the client requires real-life exposure (and vice versa). ERP therapy is most effective when the client commits to the full course of treatment; if the client stops early or doesn’t practice what they have learned outside of therapy sessions, they are less likely to have successful outcomes.