Dialectical Behavior (DBT) Therapists in Freeport, TX
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Tammy S Fountain
Licensed Professional Counselor, LPC-S, CGP
Verified Verified
Lake Jackson, TX 77566
Tammy practiced Cognitive Behavioral Therapy and Dialectical Behavior Therapy while at The Menninger Clinic, and continues to utilize evidenced based treatments.
"Tell me, what is it you plan to do With Your one wild and precious life? " - from Mary Oliver's The Summer Day Tammy S. Fountain, M.A., LPC-S is a Licensed Professional Counselor-Supervisor who has provided services to people of all ages in the Galveston-Houston area for over decades. She has worked with children, adolescents and adults with emotional, physical and spiritual struggles inpatient and outpatient facilities, including Shriners' Burns Hospital, UTMB Children's Hospital, The Menninger Clinic's Professionals in Crisis Program, Teen and Family Services (addictions), Art Bridge Houston and in a private practice.
Tammy practiced Cognitive Behavioral Therapy and Dialectical Behavior Therapy while at The Menninger Clinic, and continues to utilize evidenced based treatments.
"Tell me, what is it you plan to do With Your one wild and precious life? " - from Mary Oliver's The Summer Day Tammy S. Fountain, M.A., LPC-S is a Licensed Professional Counselor-Supervisor who has provided services to people of all ages in the Galveston-Houston area for over decades. She has worked with children, adolescents and adults with emotional, physical and spiritual struggles inpatient and outpatient facilities, including Shriners' Burns Hospital, UTMB Children's Hospital, The Menninger Clinic's Professionals in Crisis Program, Teen and Family Services (addictions), Art Bridge Houston and in a private practice.
Are you in a committed relationship but want to handle conflict better or deepen your emotional intimacy? I teach Gottman Couple Therapy Interventions that work for emotionally healthy partners. Are you living or working with someone who prefers conflict over understanding, who reacts to your reasonable expectations, explanations, and suggestions with rage, gaslighting, and blame, who leaves you in a fog and feeling crazy? I will help you learn to trust your own mind again, to deal with difficult people, and to heal. I will help you develop confidence in your worth, good communication skills, and to set appropriate boundaries.
Are you in a committed relationship but want to handle conflict better or deepen your emotional intimacy? I teach Gottman Couple Therapy Interventions that work for emotionally healthy partners. Are you living or working with someone who prefers conflict over understanding, who reacts to your reasonable expectations, explanations, and suggestions with rage, gaslighting, and blame, who leaves you in a fog and feeling crazy? I will help you learn to trust your own mind again, to deal with difficult people, and to heal. I will help you develop confidence in your worth, good communication skills, and to set appropriate boundaries.
Letriece Johnson w/ COCOA Cup Therapy, Inc.
Pre-Licensed Professional, MSW, ACSW
Verified Verified
1 Endorsed
Lake Jackson, TX 77566 (Online Only)
Are you ready for a change? Are you feeling stuck, bothered, feeling some way, overwhelmed, or just not feeling like yourself? My name is Letriece Johnson, and I am an Associate Clinical Licensed Social Worker, providing access, building resilience and support to the BIPOC community. I am here to help get you to a LYFE REimagined. I have a deep understanding of the disparities, challenges, and barriers associated with marginalized communities, especially our youth. I specialize in trauma, depression, anxiety, life transitions, and self-esteem.
Are you ready for a change? Are you feeling stuck, bothered, feeling some way, overwhelmed, or just not feeling like yourself? My name is Letriece Johnson, and I am an Associate Clinical Licensed Social Worker, providing access, building resilience and support to the BIPOC community. I am here to help get you to a LYFE REimagined. I have a deep understanding of the disparities, challenges, and barriers associated with marginalized communities, especially our youth. I specialize in trauma, depression, anxiety, life transitions, and self-esteem.
Heather Melass
Licensed Professional Counselor, MA, LPC
Verified Verified
1 Endorsed
Lake Jackson, TX 77566
As someone with a Clinical Mental Health background and Family Systems Orientation, I understand that when one person in the family is struggling, it can be a struggle for everyone. I approach mental health and healing from a biological, psychological, social, environmental, and spiritual approach. Healing looks different for each person.
As someone with a Clinical Mental Health background and Family Systems Orientation, I understand that when one person in the family is struggling, it can be a struggle for everyone. I approach mental health and healing from a biological, psychological, social, environmental, and spiritual approach. Healing looks different for each person.
I am a Nationally certified counselor and an LPC in the state of TX. My clients describe me as empathetic, kind, and patient. My primary focus is to provide a safe space to unravel emotions, trauma, or experiences without the fear of being judged. My primary area of specialty is Cognitive behavioral therapy. My experience includes working with children, adolescents and individuals of diverse cultures. I am a strong believer in the statement. "Progress is progress no matter how small it is".
I am a Nationally certified counselor and an LPC in the state of TX. My clients describe me as empathetic, kind, and patient. My primary focus is to provide a safe space to unravel emotions, trauma, or experiences without the fear of being judged. My primary area of specialty is Cognitive behavioral therapy. My experience includes working with children, adolescents and individuals of diverse cultures. I am a strong believer in the statement. "Progress is progress no matter how small it is".
Online Therapists
Clearhope Counseling & Wellness Center, Pasadena
Licensed Professional Counselor, LPC, LCSW, LMFT, LMT
Verified Verified
7 Endorsed
Pasadena, TX 77505
We have therapists who specialize in trauma, EMDR, DBT, couples, depression, anxiety, OCD, eating disorders, relationship issues, parenting, school behavioral challenges, underperformance, anger management and many other unique needs concerning individuals and their relationships.
Clearhope Counseling & Wellness Center Pasadena exists to remove access barriers to high-quality mental health services. We are a team of experts eager to partner with clients from all backgrounds, needs, and experiences in their journey to hope and healing.
We have therapists who specialize in trauma, EMDR, DBT, couples, depression, anxiety, OCD, eating disorders, relationship issues, parenting, school behavioral challenges, underperformance, anger management and many other unique needs concerning individuals and their relationships.
Clearhope Counseling & Wellness Center Pasadena exists to remove access barriers to high-quality mental health services. We are a team of experts eager to partner with clients from all backgrounds, needs, and experiences in their journey to hope and healing.
Theodor Napp
Licensed Professional Counselor Associate , LPC-A, MS
Verified Verified
1 Endorsed
Houston, TX 77065
I primarily practice person-centered talk therapy, integrating in Acceptance and Commitment Therapy (ACT), Dialectical Behavioral Therapy ( DBT), and Cognitive Behavioral Therapy (CBT).
I am a Licensed Professional Counselor - Associate (LPC-A) under the supervision of Stephanie Michelle Taylor (LPC-S), working at Ellie Mental Health-Copperfield. I am passionate about working with individuals 16 and up. My areas of focus include helping clients work through Trauma, Anxiety, Stress, Depression, Low Self-Esteem, Grief, Neurodivergent Issues, and Life Situations. I hope to guide and support you on the path to achieving your goals and helping to create a healthy lifestyle through understanding and accepting your life experiences. I want my clients to take comfort in the fact that I will provide a safe space for them.
I primarily practice person-centered talk therapy, integrating in Acceptance and Commitment Therapy (ACT), Dialectical Behavioral Therapy ( DBT), and Cognitive Behavioral Therapy (CBT).
I am a Licensed Professional Counselor - Associate (LPC-A) under the supervision of Stephanie Michelle Taylor (LPC-S), working at Ellie Mental Health-Copperfield. I am passionate about working with individuals 16 and up. My areas of focus include helping clients work through Trauma, Anxiety, Stress, Depression, Low Self-Esteem, Grief, Neurodivergent Issues, and Life Situations. I hope to guide and support you on the path to achieving your goals and helping to create a healthy lifestyle through understanding and accepting your life experiences. I want my clients to take comfort in the fact that I will provide a safe space for them.
Self-Awareness & Discovery
Clinical Social Work/Therapist, LCSW
Verified Verified
Houston, TX 77077
Waitlist for new clients
I use several different therapeutic approaches including cognitive behavioral therapy, dialectical behavior therapy, emotionally focused therapy, emotionally focused family therapy, and mentalization based therapy.
If you have come to this profile, I dare say it is not a chance encounter. So, with that said, I want to extend an open invitation for us to discuss what challenges are getting in the way of your peace and contentment. I know what it is like to try and work through issues on your own and not be successful. Let's explore the root of your negative feelings.
I use several different therapeutic approaches including cognitive behavioral therapy, dialectical behavior therapy, emotionally focused therapy, emotionally focused family therapy, and mentalization based therapy.
If you have come to this profile, I dare say it is not a chance encounter. So, with that said, I want to extend an open invitation for us to discuss what challenges are getting in the way of your peace and contentment. I know what it is like to try and work through issues on your own and not be successful. Let's explore the root of your negative feelings.
I have extensive training and experience with addiction/recovery, grief/loss and Dialectical Behavior Therapy.
Taking that first step is huge and finding the right therapist fit is important. I am passionate about helping adult clients navigate life’s stressors. Many of my clients struggle with identifying and validating their emotional experiences, which impacts all areas of their lives. I work collaboratively with my clients as they learn to cope with life changes, relationship struggles, grief and loss, and complex family relationships. As you learn to better understand yourself and your current coping style, we will work together to develop new strategies to support the struggles that brought you to therapy.
I have extensive training and experience with addiction/recovery, grief/loss and Dialectical Behavior Therapy.
Taking that first step is huge and finding the right therapist fit is important. I am passionate about helping adult clients navigate life’s stressors. Many of my clients struggle with identifying and validating their emotional experiences, which impacts all areas of their lives. I work collaboratively with my clients as they learn to cope with life changes, relationship struggles, grief and loss, and complex family relationships. As you learn to better understand yourself and your current coping style, we will work together to develop new strategies to support the struggles that brought you to therapy.
Chelsea Chang
Clinical Social Work/Therapist, LCSW, LCADC, ICADC
Verified Verified
Houston, TX 77074 (Online Only)
Waitlist for new clients
The types of therapy I offer include Attachment-Based, Coaching, Cognitive-Behavioral Therapy, Culturally Sensitive, Dialectical Behavioral Therapy, Feminist, Grief Support Therapy, Motivational Interviewing, Multicultural, and Solution-Focused Therapy.
I have been a Licensed Clinical Social Worker since 2019, and I have experience supporting young adults and adults with concerns such as addictions, substance use disorders, depression, anxiety, life transitions, relationship/ family issues, and anger management. My ideal client would like to resolve these issues by empowering themselves to learn how to counter negative thoughts, regulate emotions, tolerate moments of distress, communicate effectively, and mindfully stay within the present moment. My ideal client would like to learn these skills in order to manifest their ideal life and be the best version of themselves.
The types of therapy I offer include Attachment-Based, Coaching, Cognitive-Behavioral Therapy, Culturally Sensitive, Dialectical Behavioral Therapy, Feminist, Grief Support Therapy, Motivational Interviewing, Multicultural, and Solution-Focused Therapy.
I have been a Licensed Clinical Social Worker since 2019, and I have experience supporting young adults and adults with concerns such as addictions, substance use disorders, depression, anxiety, life transitions, relationship/ family issues, and anger management. My ideal client would like to resolve these issues by empowering themselves to learn how to counter negative thoughts, regulate emotions, tolerate moments of distress, communicate effectively, and mindfully stay within the present moment. My ideal client would like to learn these skills in order to manifest their ideal life and be the best version of themselves.
A Therapeutic Approach, Penny Lane, LPC, MS
Licensed Professional Counselor, LPC, MS
Verified Verified
Alvin, TX 77511
Meeting your needs are essential to me. I have a variety of tool kits: cognitive behavior therapy, dialectical behavior therapy, and personality disorders training. I enjoy helping parents find solutions to difficult situations. I enjoy helping those with Attention Deficit Hyperactivity Disorder, Mood Disorder, Anxiety Disorder, and Depression. I can provide psycho-diagnostic assessments for children and adults. I use strategies such as applied behavior management, using self monitoring skills, and coping skills.
Meeting your needs are essential to me. I have a variety of tool kits: cognitive behavior therapy, dialectical behavior therapy, and personality disorders training. I enjoy helping parents find solutions to difficult situations. I enjoy helping those with Attention Deficit Hyperactivity Disorder, Mood Disorder, Anxiety Disorder, and Depression. I can provide psycho-diagnostic assessments for children and adults. I use strategies such as applied behavior management, using self monitoring skills, and coping skills.
Katie Ewell - Eating Disorders
Licensed Professional Counselor, MA, NCC, LPC
Verified Verified
2 Endorsed
Houston, TX 77019 (Online Only)
I tend to draw from CBT, ACT, and DBT approaches depending on your unique needs.
The first step to changing unwanted thoughts or behaviors is to uncover what is driving them. Everyone has a unique story, and through our work, we will discover what is currently keeping you feeling "stuck." My clients have described my approach to therapy as "firm yet gentle" in terms of helping them reaching their goals. I offer free 15 minute phone consultations. Let's chat and figure out if we can work together!
I tend to draw from CBT, ACT, and DBT approaches depending on your unique needs.
The first step to changing unwanted thoughts or behaviors is to uncover what is driving them. Everyone has a unique story, and through our work, we will discover what is currently keeping you feeling "stuck." My clients have described my approach to therapy as "firm yet gentle" in terms of helping them reaching their goals. I offer free 15 minute phone consultations. Let's chat and figure out if we can work together!
I use elements of Person-Centered Approach, as well as CBT, DBT, Attachment-Based, Motivational Interviewing, Family Systems, Experiential, Strengths-Based, & Mindfulness-Based therapies and frameworks, with an emphasis on Trauma-Informed Care and culture awareness.
Hello and welcome! It is my greatest honor to join you and empower you as you navigate your wellness journey. As we develop our therapeutic relationship, it is my priority is to create a safe space, develop a genuine connection, & build mutual trust. My approach to your goals & re-imagining a purpose and balance in life that is functional and healthy for you will be unique to you. Whether you are struggling with interpersonal relationships, mood/depression/anxiety, or general functioning- I am here to support you. My own mental health and academic journey have been my greatest testimony to the power of connection & change.
I use elements of Person-Centered Approach, as well as CBT, DBT, Attachment-Based, Motivational Interviewing, Family Systems, Experiential, Strengths-Based, & Mindfulness-Based therapies and frameworks, with an emphasis on Trauma-Informed Care and culture awareness.
Hello and welcome! It is my greatest honor to join you and empower you as you navigate your wellness journey. As we develop our therapeutic relationship, it is my priority is to create a safe space, develop a genuine connection, & build mutual trust. My approach to your goals & re-imagining a purpose and balance in life that is functional and healthy for you will be unique to you. Whether you are struggling with interpersonal relationships, mood/depression/anxiety, or general functioning- I am here to support you. My own mental health and academic journey have been my greatest testimony to the power of connection & change.
Donna Marie Henscheid
Licensed Professional Counselor, MEd, LPC
Verified Verified
Spring, TX 77379
Waitlist for new clients
I enjoy working with young people and adults as they move along their paths of self-discovery and become the best version of themselves. Throughout the life journey, challenges are presented which offer each us to opportunity to grow. In the process of growth, we contend with uncertainty and often experience discomfort. A variety of therapeutic tools such as eye movement desensitization reprocessing (EMDR), dialectical behavioral therapy ( DBT) and action methods can be utilized in order that adults and adolescents, can be supported as they navigate the unknown paths related to past events, current challenges and future desires.
I enjoy working with young people and adults as they move along their paths of self-discovery and become the best version of themselves. Throughout the life journey, challenges are presented which offer each us to opportunity to grow. In the process of growth, we contend with uncertainty and often experience discomfort. A variety of therapeutic tools such as eye movement desensitization reprocessing (EMDR), dialectical behavioral therapy ( DBT) and action methods can be utilized in order that adults and adolescents, can be supported as they navigate the unknown paths related to past events, current challenges and future desires.
There are many therapeutic models to target symptoms, and I am trained in providing the most effective therapy models of CBT, DBT, and Motivational Interviewing.
Thank you for visiting this profile! I am a licensed clinical social worker currently accepting new patients for individual therapy. Starting treatment is challenging, but the process can often lead to positive change. I will provide a comprehensive and collaborative approach tailored to your needs. My passion is working with clients who struggle with trauma, anxiety, depression, low self-esteem, and addiction. There are a wide variety of therapeutic models to target symptoms, and I am trained in providing the most effective therapy models of Cognitive Behavioral, Dialectal Behavioral, and Motivational Interviewing.
There are many therapeutic models to target symptoms, and I am trained in providing the most effective therapy models of CBT, DBT, and Motivational Interviewing.
Thank you for visiting this profile! I am a licensed clinical social worker currently accepting new patients for individual therapy. Starting treatment is challenging, but the process can often lead to positive change. I will provide a comprehensive and collaborative approach tailored to your needs. My passion is working with clients who struggle with trauma, anxiety, depression, low self-esteem, and addiction. There are a wide variety of therapeutic models to target symptoms, and I am trained in providing the most effective therapy models of Cognitive Behavioral, Dialectal Behavioral, and Motivational Interviewing.
Alexis Hyde-Washmon (Able Thoughts Pllc)
Marriage & Family Therapist, MS, LPC, BCBA, LMFT, LBA
Verified Verified
Katy, TX 77450
, ABA, CBT, DBT).
I provide services for the following: Child/Adolescent - development, application, and evaluation of behavioral/cognitive-behavioral interventions for child/teen populations (e.g., under-served, children of divorce, juvenile victims of violent crimes, children with conduct and personality disorders, children with developmental disorders, and adolescents with chemical dependency and life challenges). Adults/Elderly - individual, couples and family psychotherapy (e.g., marital, parenting, aging, divorce issues, chemical dependency, mood disorders, depression and anxiety, personality disorders, post-traumatic stress, and LGBTQ).
, ABA, CBT, DBT).
I provide services for the following: Child/Adolescent - development, application, and evaluation of behavioral/cognitive-behavioral interventions for child/teen populations (e.g., under-served, children of divorce, juvenile victims of violent crimes, children with conduct and personality disorders, children with developmental disorders, and adolescents with chemical dependency and life challenges). Adults/Elderly - individual, couples and family psychotherapy (e.g., marital, parenting, aging, divorce issues, chemical dependency, mood disorders, depression and anxiety, personality disorders, post-traumatic stress, and LGBTQ).
Monica Marie Rivera-Pina
Licensed Professional Counselor, LPC, NBCC, LMHC
Verified Verified
Houston, TX 77030 (Online Only)
Welcome to my profile! Let me share a little about myself. I own a telehealth practice in TX, Pragmatic Solutions Therapy PLLC. I serve adults of any age and specialize helping those dealing with anxiety, grief, trauma, depression, mood disorders, adjustment issues, anxiety, life transitions and health-related challenges. I use specific modalities such as: Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Solutions Focused, Mindfulness-Based Cognitive, Biofeedback, Humanistic, Acceptance Commitment therapy and a telehealth version of EMDR. I welcome anyone searching for solutions to any issue impeding their life goals.
Welcome to my profile! Let me share a little about myself. I own a telehealth practice in TX, Pragmatic Solutions Therapy PLLC. I serve adults of any age and specialize helping those dealing with anxiety, grief, trauma, depression, mood disorders, adjustment issues, anxiety, life transitions and health-related challenges. I use specific modalities such as: Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Solutions Focused, Mindfulness-Based Cognitive, Biofeedback, Humanistic, Acceptance Commitment therapy and a telehealth version of EMDR. I welcome anyone searching for solutions to any issue impeding their life goals.
Hello, and welcome! I am a Licensed Professional Counselor (LPC) in the state of Texas, and I am here to support you on your journey towards healing, self-discovery, and personal growth. I am passionate about helping others reach their fullest potential, and I have consistently witnessed the profound changes that can occur through therapy. Together, we can create a safe space where you are provided with the tools to aid in achieving the goals most important to you. You can expect to be supported in your goals through a variety of evidence-based interventions, such as Cognitive Behavioral Therapy and Dialectical Behavioral Therapy.
Hello, and welcome! I am a Licensed Professional Counselor (LPC) in the state of Texas, and I am here to support you on your journey towards healing, self-discovery, and personal growth. I am passionate about helping others reach their fullest potential, and I have consistently witnessed the profound changes that can occur through therapy. Together, we can create a safe space where you are provided with the tools to aid in achieving the goals most important to you. You can expect to be supported in your goals through a variety of evidence-based interventions, such as Cognitive Behavioral Therapy and Dialectical Behavioral Therapy.
Ellen Scott
Licensed Professional Counselor Associate, MS, NCC, CTP
Verified Verified
1 Endorsed
Sugar Land, TX 77478
I am also a Certified Trauma Professional, trained in EMDR and DBT to treat trauma and improve coping skills, and use a Person-Centered, cognitive, strengths-based and culturally-inclusive approach.
When life becomes overwhelming, it may seem daunting to reach out for care. Maybe you are struggling with work or school, battling expectations from others or yourself, or struggling with long-held tendencies like perfectionism, people-pleasing, or avoidance. Often we struggle with ourselves - our inner critic, self-doubt, past wounds, and overwhelming emotions like fear, anger, and hopelessness. Often we believe that we just have to “figure it out” and shoulder our burdens alone, but that is not true. You are worthy of attention, care, and healing, and now you’ve come to the right place to find hope and grow into your best self.
I am also a Certified Trauma Professional, trained in EMDR and DBT to treat trauma and improve coping skills, and use a Person-Centered, cognitive, strengths-based and culturally-inclusive approach.
When life becomes overwhelming, it may seem daunting to reach out for care. Maybe you are struggling with work or school, battling expectations from others or yourself, or struggling with long-held tendencies like perfectionism, people-pleasing, or avoidance. Often we struggle with ourselves - our inner critic, self-doubt, past wounds, and overwhelming emotions like fear, anger, and hopelessness. Often we believe that we just have to “figure it out” and shoulder our burdens alone, but that is not true. You are worthy of attention, care, and healing, and now you’ve come to the right place to find hope and grow into your best self.
Melissa Ibanez
Licensed Professional Counselor Associate, MEd, LPC-A, LCDC
Verified Verified
1 Endorsed
Kingwood, TX 77339 (Online Only)
I am a compassionate and experienced Licensed Professional Counselor-Associate, specializing in addiction, trauma, and co-occurring mental health disorders. I hold an M.Ed. in Clinical Mental Health Counseling and a bachelor’s degree in psychology from the University of Houston, supplemented by an MBA from the University of Houston Downtown. With six years as a Licensed Chemical Dependency Counselor, I have developed expertise in Motivational Interviewing, CBT, ACT, and DBT, working with individuals affected by trauma, grief, legal issues, bipolar disorder, ADHD, low self-esteem, depression, and anxiety.
I am a compassionate and experienced Licensed Professional Counselor-Associate, specializing in addiction, trauma, and co-occurring mental health disorders. I hold an M.Ed. in Clinical Mental Health Counseling and a bachelor’s degree in psychology from the University of Houston, supplemented by an MBA from the University of Houston Downtown. With six years as a Licensed Chemical Dependency Counselor, I have developed expertise in Motivational Interviewing, CBT, ACT, and DBT, working with individuals affected by trauma, grief, legal issues, bipolar disorder, ADHD, low self-esteem, depression, and anxiety.
See more therapy options for Freeport
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.