Photo of Chanelle Henderson, Licensed Professional Counselor in Roanoke City County, VA
Chanelle Henderson
Licensed Professional Counselor, LPC
Verified Verified
Roanoke, VA 24016
Waitlist for new clients
​In my practice I use evidence-based methods such as CBT, DBT, EMDR, and Somatic methods.
Welcome! I'm Chanelle Henderson, a licensed professional counselor specializing in compassionate support for all those along life's journey. When you step into my office, I see that you are letting me into sacred ground. ​ As a counselor, my role is to provide a place so you can be brave enough to heal and grow. I will support you with cultural humility and LGBTQIA+ affirming practices so you can strengthen a deeper relationship with yourself and those closest to you. I specialize in working with those affected by traumatic experiences such as the immigration process, childhood abuse, and perinatal recovery.
​In my practice I use evidence-based methods such as CBT, DBT, EMDR, and Somatic methods.
Welcome! I'm Chanelle Henderson, a licensed professional counselor specializing in compassionate support for all those along life's journey. When you step into my office, I see that you are letting me into sacred ground. ​ As a counselor, my role is to provide a place so you can be brave enough to heal and grow. I will support you with cultural humility and LGBTQIA+ affirming practices so you can strengthen a deeper relationship with yourself and those closest to you. I specialize in working with those affected by traumatic experiences such as the immigration process, childhood abuse, and perinatal recovery.
(540) 253-4779 View (540) 253-4779
Photo of Andrea S Reynolds, Clinical Social Work/Therapist in Roanoke City County, VA
Andrea S Reynolds
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Roanoke, VA 24014
I earned my Master of Social Work from Radford University and I am trained in Eye Movement Desensitization and Reprocessing (EMDR) and several therapeutic approaches including but not limited to Somatic Therapy; Cognitive Behavioral Therapy (CBT); Dialectical Behavior Therapy (DBT); Acceptance and Commitment Therapy (ACT).
Hi, my name is Andrea Reynolds (LCSW) and I practice from a Trauma-Informed perspective. I am licensed in the states of Virginia and North Carolina. I currently reside in southwest Virginia, I own and operate my private practice, Journey thru Counseling & Wellness, LLC, where I offer in-person and remote clinical services for individuals, couples, and groups in both states. In my free time, I love spending time with my family and on my yoga mat. I am a Registered Yoga Instructor (RYT-200) with Yoga Alliance and enjoy sharing the benefits of mindfulness in both my personal and professional communities.
I earned my Master of Social Work from Radford University and I am trained in Eye Movement Desensitization and Reprocessing (EMDR) and several therapeutic approaches including but not limited to Somatic Therapy; Cognitive Behavioral Therapy (CBT); Dialectical Behavior Therapy (DBT); Acceptance and Commitment Therapy (ACT).
Hi, my name is Andrea Reynolds (LCSW) and I practice from a Trauma-Informed perspective. I am licensed in the states of Virginia and North Carolina. I currently reside in southwest Virginia, I own and operate my private practice, Journey thru Counseling & Wellness, LLC, where I offer in-person and remote clinical services for individuals, couples, and groups in both states. In my free time, I love spending time with my family and on my yoga mat. I am a Registered Yoga Instructor (RYT-200) with Yoga Alliance and enjoy sharing the benefits of mindfulness in both my personal and professional communities.
(540) 701-5092 View (540) 701-5092
Photo of James Dayton Olsen, Licensed Professional Counselor in Roanoke City County, VA
James Dayton Olsen
Licensed Professional Counselor, LPC, MS
Verified Verified
1 Endorsed
Roanoke, VA 24016
I am a young therapist, and I am very passionate about my profession and the lives of my patients. I hail from Fredericksburg, VA, but am proud to call the Southwestern portion of the state my home. I have a diverse background, having worked in substance abuse, community clinics, and a private practice. I perform most forms of traditional talk therapy, though I am not very concerned with theories of counseling (they don't matter much anyways :) ). I strive to develop close, meaningful connections with my patients, and these relationships are the driving force in my work.
I am a young therapist, and I am very passionate about my profession and the lives of my patients. I hail from Fredericksburg, VA, but am proud to call the Southwestern portion of the state my home. I have a diverse background, having worked in substance abuse, community clinics, and a private practice. I perform most forms of traditional talk therapy, though I am not very concerned with theories of counseling (they don't matter much anyways :) ). I strive to develop close, meaningful connections with my patients, and these relationships are the driving force in my work.
(540) 516-4730 View (540) 516-4730
Photo of Christie McIntosh-Svirsky, Clinical Social Work/Therapist in Roanoke City County, VA
Christie McIntosh-Svirsky
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Roanoke, VA 24012
Christie McIntosh-Svirsky is a Licensed Clinical Social Worker and a Certified Clinical Trauma Professional by the International Association of Trauma Professionals, with a variety of clinical experience in community mental health and private practice settings. Christie approaches counseling from a person-centered & strength-based perspective, believing that everyone is unique and has core strengths which can be harnessed to assist them in dealing with life's challenges. Christie will work with you to develop a personalized course of treatment uniquely tailored to your needs, preferences and personality, and where you set the pace.
Christie McIntosh-Svirsky is a Licensed Clinical Social Worker and a Certified Clinical Trauma Professional by the International Association of Trauma Professionals, with a variety of clinical experience in community mental health and private practice settings. Christie approaches counseling from a person-centered & strength-based perspective, believing that everyone is unique and has core strengths which can be harnessed to assist them in dealing with life's challenges. Christie will work with you to develop a personalized course of treatment uniquely tailored to your needs, preferences and personality, and where you set the pace.
(540) 491-0251 View (540) 491-0251
Photo of Regina Rivera, Licensed Professional Counselor in Roanoke City County, VA
Regina Rivera
Licensed Professional Counselor, MS, LPC
Verified Verified
1 Endorsed
Roanoke, VA 24012  (Online Only)
You deserve a safe, supportive, and encouraging environment to share, explore and make progress. As your counselor, I will work diligently to meet you exactly where you are, help you feel comfortable and have a non-judgmental counseling space. You should feel validated, supported and empowered during your journey in counseling and I want to provide you with individualized treatment and care. Our collaborative relationship is of the utmost importance to me, and it is at the very foundation of our work together. I am committed to helping you feel empowered to work toward meeting your individual goals and increasing happiness.
You deserve a safe, supportive, and encouraging environment to share, explore and make progress. As your counselor, I will work diligently to meet you exactly where you are, help you feel comfortable and have a non-judgmental counseling space. You should feel validated, supported and empowered during your journey in counseling and I want to provide you with individualized treatment and care. Our collaborative relationship is of the utmost importance to me, and it is at the very foundation of our work together. I am committed to helping you feel empowered to work toward meeting your individual goals and increasing happiness.
(540) 583-3744 View (540) 583-3744
Photo of Yasmin Ramadan, Pre-Licensed Professional in Roanoke City County, VA
Yasmin Ramadan
Pre-Licensed Professional
Verified Verified
1 Endorsed
Roanoke, VA 24016  (Online Only)
Hi there! I truly believe creating healthier relationships is connected to your overall well being and quality of life. I focus on building healthy relationships. If you experience relationships that cause anxiety or depression and/or you feel like you can't be your authentic self in your relationships, I can help. I specialize in relationships and understand that relationships can be very fulfilling to your mental health. I offer services to both individuals and couples. If you are interested in creating healthier relationships let's work together!
Hi there! I truly believe creating healthier relationships is connected to your overall well being and quality of life. I focus on building healthy relationships. If you experience relationships that cause anxiety or depression and/or you feel like you can't be your authentic self in your relationships, I can help. I specialize in relationships and understand that relationships can be very fulfilling to your mental health. I offer services to both individuals and couples. If you are interested in creating healthier relationships let's work together!
(540) 583-4758 View (540) 583-4758
Photo of Megan Ellis, Licensed Professional Counselor in Roanoke City County, VA
Megan Ellis
Licensed Professional Counselor, LPC-S, LSATP
Verified Verified
Roanoke, VA 24014
Are you feeling overwhelmed with the problems in your life? Or dealing with an issue that is bigger than what you can handle on your own? You have made a great choice today in reaching out for help. Enduring the difficult times in life can be daunting unless we have the right people surrounding us. You may be experiencing a COVID related problem such as grief and loss, relationship issues, increased anxiety level, or changes in your mood and energy level. Whatever the issue or stress in your life right now, I want you to know that you don't have to go it alone. You are taking the right step in reaching out for help!
Are you feeling overwhelmed with the problems in your life? Or dealing with an issue that is bigger than what you can handle on your own? You have made a great choice today in reaching out for help. Enduring the difficult times in life can be daunting unless we have the right people surrounding us. You may be experiencing a COVID related problem such as grief and loss, relationship issues, increased anxiety level, or changes in your mood and energy level. Whatever the issue or stress in your life right now, I want you to know that you don't have to go it alone. You are taking the right step in reaching out for help!
(540) 258-4065 View (540) 258-4065
Photo of Muriel Vinson in Roanoke City County, VA
Muriel Vinson
MA, AMFT, QMHP
Verified Verified
Roanoke, VA 24016
Waitlist for new clients
We are constantly bombarded with messages that tell us we are not good enough, we are the problem, or we're not doing enough. This leads many feeling anxious, defeated, worthless and burnt out. I'm here to remind and show you that you are worthy of care, you are worthy of feeling seen and heard, and you are worthy of feeling understood. During therapy, I facilitate a deeper understanding of self, allowing you to identify behavioral and decision-making patterns that contribute to dis-ease and dis-function in your life. You can't hit a target you don't have. Let's identify opportunities for positive change for wellbeing and freedom.
We are constantly bombarded with messages that tell us we are not good enough, we are the problem, or we're not doing enough. This leads many feeling anxious, defeated, worthless and burnt out. I'm here to remind and show you that you are worthy of care, you are worthy of feeling seen and heard, and you are worthy of feeling understood. During therapy, I facilitate a deeper understanding of self, allowing you to identify behavioral and decision-making patterns that contribute to dis-ease and dis-function in your life. You can't hit a target you don't have. Let's identify opportunities for positive change for wellbeing and freedom.
(540) 502-3950 View (540) 502-3950
Photo of Adrienne Rogers, Clinical Social Work/Therapist in Roanoke City County, VA
Adrienne Rogers
Clinical Social Work/Therapist, LCSW
Verified Verified
Roanoke, VA 24011  (Online Only)
What if you could finally find some relief for the constant worry or sadness you feel? What if you could find a way toward the life you want? There might be a lot going on in your life right now. Maybe you're feeling uncertain of the future and just don't feel like yourself anymore. Maybe you want to work on increasing your self-worth and acceptance or maybe you're just struggling to figure out a way forward with so many challenging things happening in the world. You aren't alone in this.
What if you could finally find some relief for the constant worry or sadness you feel? What if you could find a way toward the life you want? There might be a lot going on in your life right now. Maybe you're feeling uncertain of the future and just don't feel like yourself anymore. Maybe you want to work on increasing your self-worth and acceptance or maybe you're just struggling to figure out a way forward with so many challenging things happening in the world. You aren't alone in this.
(720) 571-9290 View (720) 571-9290
Photo of Darcy A Flierl, Clinical Social Work/Therapist in Roanoke City County, VA
Darcy A Flierl
Clinical Social Work/Therapist, LCSW, CAP
Verified Verified
1 Endorsed
Roanoke, VA 24015
A Licensed Clinical Social Worker since 2006 and a Certified Addictions Professional since 2008, Darcy has helped families and individuals achieve personal outcomes that result in happier, healthier more peaceful lives. She has experience in individual and group setting therapy on an outpatient basis both through private practice and as a clinician with Tykes & Teens. "I wish to inspire transformation for individuals and organizations by assisting them in identifying their own personal assets, and identifying solutions to barriers that are currently preventing them from fulfilling their personal and organizational mission statements." Darcy Flierl, LCSW, CAP
A Licensed Clinical Social Worker since 2006 and a Certified Addictions Professional since 2008, Darcy has helped families and individuals achieve personal outcomes that result in happier, healthier more peaceful lives. She has experience in individual and group setting therapy on an outpatient basis both through private practice and as a clinician with Tykes & Teens. "I wish to inspire transformation for individuals and organizations by assisting them in identifying their own personal assets, and identifying solutions to barriers that are currently preventing them from fulfilling their personal and organizational mission statements." Darcy Flierl, LCSW, CAP
(772) 617-6928 View (772) 617-6928
Photo of Shelby D Kasey, Clinical Social Work/Therapist in Roanoke City County, VA
Shelby D Kasey
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Roanoke, VA 24017  (Online Only)
I am a Licensed Clinical Social Worker, with over 15 years of experience, in the field of Social Work. I've been in private practice as a licensed professional since 2015. I have experience working with children and families with a range of mental health disorders. Throughout my career I have had experience with facilitating substance abuse groups with adolescents and adults as well as administering individual assessments and SASSI-A2.
I am a Licensed Clinical Social Worker, with over 15 years of experience, in the field of Social Work. I've been in private practice as a licensed professional since 2015. I have experience working with children and families with a range of mental health disorders. Throughout my career I have had experience with facilitating substance abuse groups with adolescents and adults as well as administering individual assessments and SASSI-A2.
(540) 692-1729 View (540) 692-1729
Photo of Mia Gina Anderson, Licensed Professional Counselor in Roanoke City County, VA
Mia Gina Anderson
Licensed Professional Counselor, LPC
Verified Verified
Roanoke, VA 24002  (Online Only)
Gina "Mia" Anderson is a Licensed Professional Counselor (LPC) in Virginia with over 7 years of experience. She specializes in working with younger populations, helping clients overcome a range of mental health issues, including depression, stress, anxiety, anger, ADHD, addictions, LGBTIAQ+-related issues, trauma, and abuse.
Gina "Mia" Anderson is a Licensed Professional Counselor (LPC) in Virginia with over 7 years of experience. She specializes in working with younger populations, helping clients overcome a range of mental health issues, including depression, stress, anxiety, anger, ADHD, addictions, LGBTIAQ+-related issues, trauma, and abuse.
(540) 340-5506 View (540) 340-5506
Photo of Patrick Knicely, Pre-Licensed Professional in Roanoke City County, VA
Patrick Knicely
Pre-Licensed Professional
Verified Verified
Roanoke, VA 24011
Patrick Knicely is a Resident in Counseling (RIC) who has pioneered personality psychology within the counseling field. He specializes in working with clients of all ages who are experiencing anger, stress, anxiety, depression, life transitions, relationship issues, self-esteem issues, behavioral issues, and much more. At the core of his practice, Patrick empowers clients to uncover the layers of their personalities.
Patrick Knicely is a Resident in Counseling (RIC) who has pioneered personality psychology within the counseling field. He specializes in working with clients of all ages who are experiencing anger, stress, anxiety, depression, life transitions, relationship issues, self-esteem issues, behavioral issues, and much more. At the core of his practice, Patrick empowers clients to uncover the layers of their personalities.
(540) 924-3302 View (540) 924-3302
Photo of Selina Kelly, Clinical Social Work/Therapist in Roanoke City County, VA
Selina Kelly
Clinical Social Work/Therapist, LCSW
Verified Verified
Roanoke, VA 24038
My therapeutic approach is strengths based and tailored for each client, situation, and goal to find what works best for that individual. I believe you are the expert in your life and embrace a person-centered philosophy to best meet my client's needs. I have experience providing therapy in outpatient, school based, and in-home settings working with ADD/ADHD, anxiety disorder, bipolar disorder, depression, personality disorders, dual diagnosis, anger management, substance use and abuse, parenting issues, and more. I am a Licensed Clinical Social Worker and further certified to provide Trauma Focused CBT in the state of VA.
My therapeutic approach is strengths based and tailored for each client, situation, and goal to find what works best for that individual. I believe you are the expert in your life and embrace a person-centered philosophy to best meet my client's needs. I have experience providing therapy in outpatient, school based, and in-home settings working with ADD/ADHD, anxiety disorder, bipolar disorder, depression, personality disorders, dual diagnosis, anger management, substance use and abuse, parenting issues, and more. I am a Licensed Clinical Social Worker and further certified to provide Trauma Focused CBT in the state of VA.
(540) 779-8826 View (540) 779-8826
Photo of Dan Martinson, Psychologist in Roanoke City County, VA
Dan Martinson
Psychologist, PsyD, LCP
Verified Verified
Roanoke, VA 24005
I am a Clinical Psychologist in the Christiansburg area. I use a variety of therapies to help each individual with their specific needs. My approach to therapy is warm, empathic, and caring. Whether there is pain from which you are seeking relief, or ways you just feel stuck, my job is to empower and equip you to grow into more of the person you want to be – and to respect and care for the person you already have become! I also offer objective testing for ADHD and other forms of psychological assessment.
I am a Clinical Psychologist in the Christiansburg area. I use a variety of therapies to help each individual with their specific needs. My approach to therapy is warm, empathic, and caring. Whether there is pain from which you are seeking relief, or ways you just feel stuck, my job is to empower and equip you to grow into more of the person you want to be – and to respect and care for the person you already have become! I also offer objective testing for ADHD and other forms of psychological assessment.
(540) 215-1034 View (540) 215-1034
Photo of Kathryn Braswell, Licensed Professional Counselor in Roanoke City County, VA
Kathryn Braswell
Licensed Professional Counselor, MA, LPC
Verified Verified
1 Endorsed
Roanoke, VA 24001
I have been fortunate to gain experience working with teens to older adults in both the home and outpatient setting. I believe that building trust with my clients is one of the most important parts of the therapeutic process, as it is an invaluable asset to gain as I champion them to reach their goals toward healing and thriving. I have worked with clients who have suffered from depression, anxiety, bipolar, PTSD, codependency issues, emotion dysregulation, panic disorder, and grief. I have also worked with children in the foster care system, caregivers of those in foster care, and individuals who have suffered from sexual abuse.
I have been fortunate to gain experience working with teens to older adults in both the home and outpatient setting. I believe that building trust with my clients is one of the most important parts of the therapeutic process, as it is an invaluable asset to gain as I champion them to reach their goals toward healing and thriving. I have worked with clients who have suffered from depression, anxiety, bipolar, PTSD, codependency issues, emotion dysregulation, panic disorder, and grief. I have also worked with children in the foster care system, caregivers of those in foster care, and individuals who have suffered from sexual abuse.
(434) 474-2903 View (434) 474-2903
Photo of Elizabeth Largent, Clinical Social Work/Therapist in Roanoke City County, VA
Elizabeth Largent
Clinical Social Work/Therapist, LCSW, CCM
Verified Verified
1 Endorsed
Roanoke, VA 24003  (Online Only)
I am a Licensed Clinical Social Worker originally from Southern California and moved to Virginia Beach 17 years ago. I strive to create a safe space for my clients to express and validate their emotions. I enjoy working through daily life stressors through creative problem solving, setting boundaries and strengthening relationships. I customize each treatment for the person and their unique goals. I have an eclectic approach and use a variety of treatment models. Coming to therapy is hard work, and i acknowledge the great first step you have taken!
I am a Licensed Clinical Social Worker originally from Southern California and moved to Virginia Beach 17 years ago. I strive to create a safe space for my clients to express and validate their emotions. I enjoy working through daily life stressors through creative problem solving, setting boundaries and strengthening relationships. I customize each treatment for the person and their unique goals. I have an eclectic approach and use a variety of treatment models. Coming to therapy is hard work, and i acknowledge the great first step you have taken!
(757) 979-6759 View (757) 979-6759
Photo of Janelle Cook, Clinical Social Work/Therapist in Roanoke City County, VA
Janelle Cook
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Roanoke, VA 24013  (Online Only)
Same Week Appointments! Do you struggle with worry about stressful situations and need help? Is anxiety taking over parts of your life that you used to really enjoy? What would your life be like right now if you could live it without constant worry and anxiety? Would you be doing things differently on a day-by-day basis? Would you be having more fun? Would you be more confident and have higher self-esteem? Would you be more joyful with your family and friends and appreciate your experiences more? If this sounds like you, I'm here to help! I use a strengths-based, solution-focused approach to help you set and achieve your goals.
Same Week Appointments! Do you struggle with worry about stressful situations and need help? Is anxiety taking over parts of your life that you used to really enjoy? What would your life be like right now if you could live it without constant worry and anxiety? Would you be doing things differently on a day-by-day basis? Would you be having more fun? Would you be more confident and have higher self-esteem? Would you be more joyful with your family and friends and appreciate your experiences more? If this sounds like you, I'm here to help! I use a strengths-based, solution-focused approach to help you set and achieve your goals.
(757) 210-7428 View (757) 210-7428
Photo of Prell Gross, Licensed Professional Counselor in Roanoke City County, VA
Prell Gross
Licensed Professional Counselor, MS, LPC
Verified Verified
3 Endorsed
Roanoke, VA 24024  (Online Only)
You've been able to manage "it" by yourself for a while, but something still doesn't feel right, right? "Something's off". You might have asked yourself is this normal stress or anxiety? Am I just sad or depressed? Why am I so annoyed with things lately? I'm here to listen to you - the right way and help you gain some clarity and regain control. My goal is to help you identify what's needed in order to make things better & get it. I'm here to support your personal growth & awareness in ways that feel most genuine to YOU! Our sessions will be honest, informative, collaborative, productive, & thought-provoking. Let's get to work!
You've been able to manage "it" by yourself for a while, but something still doesn't feel right, right? "Something's off". You might have asked yourself is this normal stress or anxiety? Am I just sad or depressed? Why am I so annoyed with things lately? I'm here to listen to you - the right way and help you gain some clarity and regain control. My goal is to help you identify what's needed in order to make things better & get it. I'm here to support your personal growth & awareness in ways that feel most genuine to YOU! Our sessions will be honest, informative, collaborative, productive, & thought-provoking. Let's get to work!
(757) 690-1992 View (757) 690-1992
Photo of Angela N Mitchell, Clinical Social Work/Therapist in Roanoke City County, VA
Angela N Mitchell
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Roanoke, VA 24015
My private practice serves individuals from toddlers to adults. I specialize in Trauma & Attachment; provide services for issues such as: neglect, physical/sexual abuse, trauma, emotional, behavior and mood disorders. Also work with those experiencing school, home & child care problems. Adult specialties: individual, couples & family counseling; divorce, anger management, DV, substance abuse, and trauma solution. I have extensive experience working with those who are trying to cope within the Child Welfare system. I will work with the court system, provide expert testimony, attend IEPs and/or FPM's if needed at additional rates.
My private practice serves individuals from toddlers to adults. I specialize in Trauma & Attachment; provide services for issues such as: neglect, physical/sexual abuse, trauma, emotional, behavior and mood disorders. Also work with those experiencing school, home & child care problems. Adult specialties: individual, couples & family counseling; divorce, anger management, DV, substance abuse, and trauma solution. I have extensive experience working with those who are trying to cope within the Child Welfare system. I will work with the court system, provide expert testimony, attend IEPs and/or FPM's if needed at additional rates.
(540) 657-3153 View (540) 657-3153

See more therapy options for Roanoke City County


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.