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Online Therapists

Photo of Courtney Hicks, Marriage & Family Therapist in Waxahachie, TX
Courtney Hicks
Marriage & Family Therapist, LMFT-S, DBT-LBC
Verified Verified
Dallas, TX 75209
DBT is effective in treating personality disorders, treatment-resistant depression and anxiety, suicidal ideation, nonsuicidal self-injury, posttraumatic stress disorder (PTSD), substance use disorders, disordered eating, obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), bipolar disorder and severe emotion dysregulation.
Courtney is one of just three DBT-Linehan Board Certified Clinicians in north Texas. She works with adolescents and adults using Dialectical Behavior Therapy to help clients build a life that they believe to be truly worth living! She offers telehealth across the state of Texas. Courtney and her team at North Texas DBT Associates provide comprehensive DBT, which is comprised of highly structured weekly individual sessions, weekly group skills classes, and access to 24/7 phone coaching support. Courtney also offers DBT Prolonged Exposure Protocol for PTSD. For more information, visit our website, ntxdbt.com.
DBT is effective in treating personality disorders, treatment-resistant depression and anxiety, suicidal ideation, nonsuicidal self-injury, posttraumatic stress disorder (PTSD), substance use disorders, disordered eating, obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), bipolar disorder and severe emotion dysregulation.
Courtney is one of just three DBT-Linehan Board Certified Clinicians in north Texas. She works with adolescents and adults using Dialectical Behavior Therapy to help clients build a life that they believe to be truly worth living! She offers telehealth across the state of Texas. Courtney and her team at North Texas DBT Associates provide comprehensive DBT, which is comprised of highly structured weekly individual sessions, weekly group skills classes, and access to 24/7 phone coaching support. Courtney also offers DBT Prolonged Exposure Protocol for PTSD. For more information, visit our website, ntxdbt.com.
(214) 974-3036 View (214) 974-3036
Photo of Kiva Harper, Clinical Social Work/Therapist in Waxahachie, TX
Kiva Harper
Clinical Social Work/Therapist, LCSW-S
Verified Verified
1 Endorsed
Arlington, TX 76006  (Online Only)
If you're looking to heal from combat trauma, intimate partner violence, sexual assault or the suicide/murder of a loved one, I can help you. If you have a need for extra support and guidance through a challenging situation or you're just ready to move in a new direction in your life, I look forward to working with you to achieve your goals.
If you're looking to heal from combat trauma, intimate partner violence, sexual assault or the suicide/murder of a loved one, I can help you. If you have a need for extra support and guidance through a challenging situation or you're just ready to move in a new direction in your life, I look forward to working with you to achieve your goals.
(214) 382-0722 View (214) 382-0722
Photo of Benjamin Brockman, Licensed Professional Counselor in Waxahachie, TX
Benjamin Brockman
Licensed Professional Counselor, LPC-S, NCC, MA, DBT-LBC
Verified Verified
7 Endorsed
Frisco, TX 75035
Waitlist for new clients
I have extensive training and board certification in DBT and we offer comprehensive DBT treatment at our practice for individuals with Borderline Personality Disorder, emotional regulation difficulties, or at risk of suicide.
I understand that the difficulties of life can cause us to feel overwhelmed, stuck, or hopeless about the future. Honest and direct communication is the most effective way to assist others in overcoming the barriers that keep them from being who they want to be. I believe we are capable of creating significant change in our lives and relationships when we have the right support and counsel. I will help you gain insight into the patterns in your life that cause suffering, and to develop and execute a plan to address these issues to create your version of a “life worth living”.
I have extensive training and board certification in DBT and we offer comprehensive DBT treatment at our practice for individuals with Borderline Personality Disorder, emotional regulation difficulties, or at risk of suicide.
I understand that the difficulties of life can cause us to feel overwhelmed, stuck, or hopeless about the future. Honest and direct communication is the most effective way to assist others in overcoming the barriers that keep them from being who they want to be. I believe we are capable of creating significant change in our lives and relationships when we have the right support and counsel. I will help you gain insight into the patterns in your life that cause suffering, and to develop and execute a plan to address these issues to create your version of a “life worth living”.
(214) 516-7117 x300 View (214) 516-7117 x300
Photo of Johanna Wender, Counselor in Waxahachie, TX
Johanna Wender
Counselor, MA, LMHC, CMHS
Verified Verified
Dallas, TX 75254
Welcome to Bravura Counseling. I proudly specialize in mental health wellness for active duty and retired first responders, as well as military members and veterans, and their family members, throughout Washington State. I focus on providing counseling that addresses some of the most urgent mental health conditions affecting our first responder and military communities, including: PTSD, critical incident trauma, anxiety, depression, suicide prevention, burnout/workplace stress, substance abuse, and work/life balance.
Welcome to Bravura Counseling. I proudly specialize in mental health wellness for active duty and retired first responders, as well as military members and veterans, and their family members, throughout Washington State. I focus on providing counseling that addresses some of the most urgent mental health conditions affecting our first responder and military communities, including: PTSD, critical incident trauma, anxiety, depression, suicide prevention, burnout/workplace stress, substance abuse, and work/life balance.
(206) 594-5736 View (206) 594-5736
Photo of Megan Rasmussen, Licensed Professional Counselor in Waxahachie, TX
Megan Rasmussen
Licensed Professional Counselor, LPC-S
Verified Verified
Frisco, TX 75034
Amongst Megan’s areas of expertise are the treatment of Anxiety, Depression, Adjustment Disorder, Alcohol/ Chemical Dependency, Anger Management, Attachment Disorders, ADHD, Behavior Modification, Bipolar Disorder, Codependency, Domestic Violence, Disordered Eating, Gender Identity/ Sexuality, LGBTQIA+, Impulse Disorder, Mood Disorders, Obsessive Compulsive Disorder (OCD), Panic Disorder, Post-traumatic Stress Disorder (PTSD), Psychotic Disorder, Self-harm, Suicide Ideation, Sleep Disorders, Stress Management, Trauma, and Women’s Issues. She enjoys working with teenagers, adults, couples, and families.
Amongst Megan’s areas of expertise are the treatment of Anxiety, Depression, Adjustment Disorder, Alcohol/ Chemical Dependency, Anger Management, Attachment Disorders, ADHD, Behavior Modification, Bipolar Disorder, Codependency, Domestic Violence, Disordered Eating, Gender Identity/ Sexuality, LGBTQIA+, Impulse Disorder, Mood Disorders, Obsessive Compulsive Disorder (OCD), Panic Disorder, Post-traumatic Stress Disorder (PTSD), Psychotic Disorder, Self-harm, Suicide Ideation, Sleep Disorders, Stress Management, Trauma, and Women’s Issues. She enjoys working with teenagers, adults, couples, and families.
(214) 307-6252 View (214) 307-6252
Photo of Dr. Michael Contreras, Licensed Professional Counselor in Waxahachie, TX
Dr. Michael Contreras
Licensed Professional Counselor, LPC-S, LCDC, ADC, ICADC, DOT-SAP
Verified Verified
1 Endorsed
Bedford, TX 76021  (Online Only)
Waitlist for new clients
My client population includes children, adolescents and adults. I work with individuals as well as families. I facilitate numerous groups and skills training curriculum in various topics including adolescent first offenders, anger management, divorce and separation, parenting, and teen issues.
My client population includes children, adolescents and adults. I work with individuals as well as families. I facilitate numerous groups and skills training curriculum in various topics including adolescent first offenders, anger management, divorce and separation, parenting, and teen issues.
(817) 849-6835 View (817) 849-6835
Photo of Michelle Deal, Clinical Social Work/Therapist in Waxahachie, TX
Michelle Deal
Clinical Social Work/Therapist, LCSW
Verified Verified
Dallas, TX 75231
Do you often find it difficult to find the words to describe your feelings? Or to open up to people and feel a connection with them? Or are you a parent who struggles with a challenging & strained relationship with your child? The individual clients I typically work with say they feel like they don't fit in, feel misunderstood, have a lot of chaos in their lives, have trouble relating to and trusting others, & struggle with feelings of emptiness, yet feel intense emotions that they are afraid to express.
Do you often find it difficult to find the words to describe your feelings? Or to open up to people and feel a connection with them? Or are you a parent who struggles with a challenging & strained relationship with your child? The individual clients I typically work with say they feel like they don't fit in, feel misunderstood, have a lot of chaos in their lives, have trouble relating to and trusting others, & struggle with feelings of emptiness, yet feel intense emotions that they are afraid to express.
(214) 216-2485 View (214) 216-2485
Photo of Linda Spang O'Toole, Licensed Professional Counselor in Waxahachie, TX
Linda Spang O'Toole
Licensed Professional Counselor, LPC, MS, DBT-LBC
Verified Verified
1 Endorsed
Dallas, TX 75206
I am a Licensed Professional Counselor and a DBT-Linehan Behavioral Certified Clinician with DALLAS DBT. We specialize in treating Borderline Personality Disorder, Emotion Dysregulation, and Complex PTSD using Dialectical Behavior Therapy (DBT), Prolonged Exposure (PE), and Complex PE. Additionally, I treat clients suffering from depression, bipolar disorder, mood disorders, anxiety, and chronic pain. I work with Adults, Adolescents, Parents, and Families
I am a Licensed Professional Counselor and a DBT-Linehan Behavioral Certified Clinician with DALLAS DBT. We specialize in treating Borderline Personality Disorder, Emotion Dysregulation, and Complex PTSD using Dialectical Behavior Therapy (DBT), Prolonged Exposure (PE), and Complex PE. Additionally, I treat clients suffering from depression, bipolar disorder, mood disorders, anxiety, and chronic pain. I work with Adults, Adolescents, Parents, and Families
(972) 918-0170 x4 View (972) 918-0170 x4
Photo of America Cardona, Clinical Social Work/Therapist in Waxahachie, TX
America Cardona
Clinical Social Work/Therapist, MSSW, LCSW-S
Verified Verified
1 Endorsed
Desoto, TX 75115  (Online Only)
You do not have to walk alone, allow me to walk with you. Life is hard enough so why are we so hard on ourselves? I am a Licensed Clinical Social Worker with over 12 years in the field of Social Work/Mental Health and over a decade psychotherapy with teens and adolescents. Emphasis in Trauma/Assault and Childhood Trauma. I believe everyone has the ability and should be given a chance to heal: mind, body, and spirit. It’s important to find someone who is a good fit for your journey. Offer Immigration support for Visa. Willing to see Intern to reduce cost; let’s talk.
You do not have to walk alone, allow me to walk with you. Life is hard enough so why are we so hard on ourselves? I am a Licensed Clinical Social Worker with over 12 years in the field of Social Work/Mental Health and over a decade psychotherapy with teens and adolescents. Emphasis in Trauma/Assault and Childhood Trauma. I believe everyone has the ability and should be given a chance to heal: mind, body, and spirit. It’s important to find someone who is a good fit for your journey. Offer Immigration support for Visa. Willing to see Intern to reduce cost; let’s talk.
(469) 995-8650 View (469) 995-8650
Photo of Dr. Messina & Associates, Psychologist in Waxahachie, TX
Dr. Messina & Associates
Psychologist, PsyD
Verified Verified
Southlake, TX 76092
Dr. Messina & Associates provides cognitive behavioral therapy (CBT), psychiatry and telepsychiatry services, and psychological testing to children, adolescents, and adults in Flower Mound and Southlake, TX.
Dr. Messina & Associates provides cognitive behavioral therapy (CBT), psychiatry and telepsychiatry services, and psychological testing to children, adolescents, and adults in Flower Mound and Southlake, TX.
(817) 677-0449 View (817) 677-0449
Photo of Kurt W. Billups, Licensed Professional Counselor in Waxahachie, TX
Kurt W. Billups
Licensed Professional Counselor, MA, MPC, LPC, BCPC, LPHA
Verified Verified
1 Endorsed
Fort Worth, TX 76133  (Online Only)
People should live happier, healthier lives. That is what all people want and deserve. My focus is on helping people achieve ALL of their goals. Everyone goes through tough times. Some people go through them on their own, but sometimes it takes a professional, unbiased perspective to help. People are the result of both nature (inherited traits) and nurture (environment) which form lenses through which we perceive the world. Through life experience, lenses can become scratched or cloudy. Bring the drive to improve and I will provide the experience, empathy, and knowledge. Let's make them clear again, together, as a team!
People should live happier, healthier lives. That is what all people want and deserve. My focus is on helping people achieve ALL of their goals. Everyone goes through tough times. Some people go through them on their own, but sometimes it takes a professional, unbiased perspective to help. People are the result of both nature (inherited traits) and nurture (environment) which form lenses through which we perceive the world. Through life experience, lenses can become scratched or cloudy. Bring the drive to improve and I will provide the experience, empathy, and knowledge. Let's make them clear again, together, as a team!
(682) 334-8634 View (682) 334-8634
Photo of Crystal Nicole Gayle, Psychologist in Waxahachie, TX
Crystal Nicole Gayle
Psychologist, PhD
Verified Verified
Dallas, TX 75214
I am a licensed psychologist who enjoys working with children, adolescents, and adults. I use a strength-based, collaborative, and multicultural approach when I work with my clients. I believe in creating an honest and warm therapeutic environment while developing a strong rapport with each client or family as we work towards meeting their treatment goals. I utilize evidence-based treatments such as Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) to help individuals become the best versions of themselves.
I am a licensed psychologist who enjoys working with children, adolescents, and adults. I use a strength-based, collaborative, and multicultural approach when I work with my clients. I believe in creating an honest and warm therapeutic environment while developing a strong rapport with each client or family as we work towards meeting their treatment goals. I utilize evidence-based treatments such as Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) to help individuals become the best versions of themselves.
(972) 458-5478 View (972) 458-5478
Photo of Rachel McCorry, Clinical Social Work/Therapist in Waxahachie, TX
Rachel McCorry
Clinical Social Work/Therapist, MSSW, LCSW, LICSW, LMSW-C
Verified Verified
Plano, TX 75024  (Online Only)
Therapy is hard work. Going to therapy for the first time or the hundredth time can be scary. Finding a therapist who fits with your needs and desires is crucial to a healthy and successful therapeutic experience. As an approachable, person-centered therapist, I support my clients in working on goals that YOU design. Through an integrative and holistic approach, my style is to guide you in navigating the roads of life challenges, mood concerns, medical conditions, relationships, severe mental illness, and other life issues.
Therapy is hard work. Going to therapy for the first time or the hundredth time can be scary. Finding a therapist who fits with your needs and desires is crucial to a healthy and successful therapeutic experience. As an approachable, person-centered therapist, I support my clients in working on goals that YOU design. Through an integrative and holistic approach, my style is to guide you in navigating the roads of life challenges, mood concerns, medical conditions, relationships, severe mental illness, and other life issues.
(936) 930-3675 View (936) 930-3675
Photo of Nikita Tate-Casanova, Marriage & Family Therapist in Waxahachie, TX
Nikita Tate-Casanova
Marriage & Family Therapist, PhD, LMFT
Verified Verified
Temple, TX 76502
Dr. Nikita Tate-Casanova is an LMFT practicing for over 10 years. She uses several therapeutic techniques dependent upon clients’ needs, including CBT, EMDR, Internal Family Systems, Positive Psychology. She has experience working with individuals, couples, and families across the life span. Nikita has worked in private practice, church settings, inpatient acute/residential treatment programs, intensive outpatient programs, and partial hospitalization programs. She believes in holistic wellness that focuses on clients’ mental health improvement, somatic relief, spiritual connectivity, and positive self-image.
Dr. Nikita Tate-Casanova is an LMFT practicing for over 10 years. She uses several therapeutic techniques dependent upon clients’ needs, including CBT, EMDR, Internal Family Systems, Positive Psychology. She has experience working with individuals, couples, and families across the life span. Nikita has worked in private practice, church settings, inpatient acute/residential treatment programs, intensive outpatient programs, and partial hospitalization programs. She believes in holistic wellness that focuses on clients’ mental health improvement, somatic relief, spiritual connectivity, and positive self-image.
(254) 277-6501 View (254) 277-6501
Photo of Ashley Cook-Rovira, PLLC , Marriage & Family Therapist in Waxahachie, TX
Ashley Cook-Rovira, PLLC
Marriage & Family Therapist, LMFT, LPC-S, LCDC
Verified Verified
Grapevine, TX 76051
Are you feeling stuck by some life circumstance or feel as though you need help getting through a particularly troubling season of life? I help my clients work on their individual goals by meeting the client where they are at and working with them to find solutions to whatever issues are holding them back. I primarily work with clients struggling with trauma, grief/loss, depression, anxiety, dual-diagnoses (substance abuse in combination with other mental health diagnoses/presentations) for the past 12 years.
Are you feeling stuck by some life circumstance or feel as though you need help getting through a particularly troubling season of life? I help my clients work on their individual goals by meeting the client where they are at and working with them to find solutions to whatever issues are holding them back. I primarily work with clients struggling with trauma, grief/loss, depression, anxiety, dual-diagnoses (substance abuse in combination with other mental health diagnoses/presentations) for the past 12 years.
(817) 330-9730 View (817) 330-9730
Photo of Trinity Rising Counseling Center, Licensed Professional Counselor in Waxahachie, TX
Trinity Rising Counseling Center
Licensed Professional Counselor, MEd, LPC-S, NCC, DCC
Verified Verified
1 Endorsed
Dallas, TX 75201  (Online Only)
Online Scheduling Available. Are you searching for someone that you can connect with. Someone who is authentic, genuine, relatable, and easy to talk to. With over eight years in the mental health field, eleven years in the military, and visiting several countries I have developed a strong sense of awareness for people emotions and feelings. I have learned to hear the issues that aren't being talked about because they are too intense, shameful, embarrassing, or hurtful. I will try to help you restore your life and claim your future. Schedule your first appointment visit www.trinityrisingcounselingcenter.com
Online Scheduling Available. Are you searching for someone that you can connect with. Someone who is authentic, genuine, relatable, and easy to talk to. With over eight years in the mental health field, eleven years in the military, and visiting several countries I have developed a strong sense of awareness for people emotions and feelings. I have learned to hear the issues that aren't being talked about because they are too intense, shameful, embarrassing, or hurtful. I will try to help you restore your life and claim your future. Schedule your first appointment visit www.trinityrisingcounselingcenter.com
(469) 202-4834 View (469) 202-4834
Photo of Steven A Cohen Military Family Clinic @ Metrocare, Psychologist in Waxahachie, TX
Steven A Cohen Military Family Clinic @ Metrocare
Psychologist, PhD
Verified Verified
Addison, TX 75001
The Steven A. Cohen Military Family Clinic at Metrocare provides quality, accessible, and comprehensive mental health care to post-9/11 Veterans, service members, and families regardless of insurance or ability to pay. Services are available to any person who has served in the U.S. Armed Forces, including the National Guard and Reserves, regardless of role or discharge status. The Military Family Clinic uses targeted, evidenced-based practices with a holistic approach to improving the quality of life for our veterans and their families. Services are provided by trained and credentialed staff and can be provided via online therapy.
The Steven A. Cohen Military Family Clinic at Metrocare provides quality, accessible, and comprehensive mental health care to post-9/11 Veterans, service members, and families regardless of insurance or ability to pay. Services are available to any person who has served in the U.S. Armed Forces, including the National Guard and Reserves, regardless of role or discharge status. The Military Family Clinic uses targeted, evidenced-based practices with a holistic approach to improving the quality of life for our veterans and their families. Services are provided by trained and credentialed staff and can be provided via online therapy.
(469) 680-3500 View (469) 680-3500
Photo of Provision Assessment & Psychotherapy, PLLC, Psychologist in Waxahachie, TX
Provision Assessment & Psychotherapy, PLLC
Psychologist, PhD, LP
Verified Verified
3 Endorsed
Dallas, TX 75225
I guarantee you are not alone, no matter what you might be carrying. In both assessment and psychotherapy, I emphasize a relational, person-centered approach. In therapy, we will work together to heal from hardships and traumatic experiences. The goal is to empower you with the tools you need to regain hope and carry on, no matter how dark the experiences have colored your world. The wound is the place where the light enters you (Rumi). Objective information gathered from assessments helps bring the missing pieces together to complete the puzzle of mental/physical health complexities. I work with children, adolescents, and adults.
I guarantee you are not alone, no matter what you might be carrying. In both assessment and psychotherapy, I emphasize a relational, person-centered approach. In therapy, we will work together to heal from hardships and traumatic experiences. The goal is to empower you with the tools you need to regain hope and carry on, no matter how dark the experiences have colored your world. The wound is the place where the light enters you (Rumi). Objective information gathered from assessments helps bring the missing pieces together to complete the puzzle of mental/physical health complexities. I work with children, adolescents, and adults.
(214) 438-0226 View (214) 438-0226
Photo of WomenSPEAK Recovery Counseling & Therapy, Counselor in Waxahachie, TX
WomenSPEAK Recovery Counseling & Therapy
Counselor, PhD, , LPCC, LPC
Verified Verified
Little Elm, TX 75068
Perhaps you’re at a point where you are frustrated and tired of starting over with a new therapist. You’re tired of telling your story over and over again and not experiencing any relief. You’re tired of taking all these medications and being numb. And you’re tired of your past trauma disrupting your everyday life. Perhaps you’re wondering if you’re ever going to heal and feel better. You CAN heal. The therapist’s job is to help facilitate the healing process that lies within you. To heal from trauma, you don’t have to talk about the details of what has happened to you (unless you find it helpful).
Perhaps you’re at a point where you are frustrated and tired of starting over with a new therapist. You’re tired of telling your story over and over again and not experiencing any relief. You’re tired of taking all these medications and being numb. And you’re tired of your past trauma disrupting your everyday life. Perhaps you’re wondering if you’re ever going to heal and feel better. You CAN heal. The therapist’s job is to help facilitate the healing process that lies within you. To heal from trauma, you don’t have to talk about the details of what has happened to you (unless you find it helpful).
(469) 754-8256 View (469) 754-8256
Photo of Laura L Avila, Psychologist in Waxahachie, TX
Laura L Avila
Psychologist, PhD
Verified Verified
Arlington, TX 76015  (Online Only)
I am a clinical psychologist with a special interest in health and wellness, both physical and emotional. I have also completed specialized training in evidence-based therapies for treatment of PTSD. I have enjoyed working with medical populations as this has deepened my understanding of the mind-body connection, particularly how health conditions can contribute to emotional problems and vice versa. Although we may not always be able to choose or change our current circumstances, we are able to choose how we think about, manage, and cope with our circumstances which can lead to a change in our overall health.
I am a clinical psychologist with a special interest in health and wellness, both physical and emotional. I have also completed specialized training in evidence-based therapies for treatment of PTSD. I have enjoyed working with medical populations as this has deepened my understanding of the mind-body connection, particularly how health conditions can contribute to emotional problems and vice versa. Although we may not always be able to choose or change our current circumstances, we are able to choose how we think about, manage, and cope with our circumstances which can lead to a change in our overall health.
(817) 587-3962 View (817) 587-3962
Suicidal Ideation Therapists

How does therapy for suicidal ideation work?

Stress, depression, anxiety, or upsetting circumstances can give rise to suicidal thinking. Therapy can address the events at the core of an individual’s suffering. Understanding why a person may be suicidal can help the therapist and the patient discover alternative methods of coping. A person with suicidal ideation may be mired in catastrophic thinking, and treatment like cognitive behavioral therapy is a good choice for breaking such patterns. In addition, treatment such as acceptance and commitment therapy can help a person manage their distress through better emotion regulation.

Which therapies are best for suicidal ideation?

Specific approaches used by professionals include cognitive behavioral, dialectical behavior, psychodynamic, acceptance and commitment therapies, among others. Cognitive behavioral and dialectical behavior therapies are two widely used therapies that can help individuals with painful thoughts and past traumas. These therapies help an individual tolerate distress, regulate emotions, and not act on dangerous urges.

Are there specific medications to be combined with therapy?

The use of medication for suicidal thoughts must be aligned with the underlying cause; conditions such as depression, anxiety, and psychosis may be at the root of suicidal ideation. A psychiatrist may prescribe medications for symptoms, which may include antipsychotics such as aripiprazole or antidepressants such as selective serotonin reuptake inhibitors.

How often and how long are therapy sessions for suicidal ideation?

As with any type of therapy, sessions depend on the individual. Patients may see improvement within 15 to 20 sessions, at an average of 50 minutes per session, while others may opt for 20 to 30 sessions over, perhaps, a six-month period. Still other patients, especially those with co-occurring conditions like major depression and anxiety, may need to continue sessions for up to 12 to 18 months. In some cases, residential treatment may be recommended for an individual who is judged to be at high risk of self-harm.