Eating Disorders Therapists in Charlotte, NC
Judy Scheel, Ph.D., LCSW, CEDS
Clinical Social Work/Therapist, PhD, LCSW, CEDS
Verified Verified
Charlotte, NC 28202
Treating eating disorders or sexuality issues require understanding psychological & interpersonal issues underlying conditions while addressing symptoms & behaviors via Cognitive-Behavioral Therapy.
With years of training & personal analysis, I am solidly qualified to treat individuals/couples/families for mental health issues like anxiety & depression & interpersonal issues. I am certified as an EATING DISORDER expert (CEDS) & provide treatment for SEXUAL ISSUES with training from NYU Langone Medical. I am an Associate Member of SSTAR (Society for Sex Therapy & Research.) My approaches are fueled by many years of training in psychological theories. I am licensed in NC, NY & CA with offices in Charlotte, NC, New York, NY & offer video sessions for CA residents. I write two Blogs for psychologytoday.com on Sex & Eating Issues
Treating eating disorders or sexuality issues require understanding psychological & interpersonal issues underlying conditions while addressing symptoms & behaviors via Cognitive-Behavioral Therapy.
With years of training & personal analysis, I am solidly qualified to treat individuals/couples/families for mental health issues like anxiety & depression & interpersonal issues. I am certified as an EATING DISORDER expert (CEDS) & provide treatment for SEXUAL ISSUES with training from NYU Langone Medical. I am an Associate Member of SSTAR (Society for Sex Therapy & Research.) My approaches are fueled by many years of training in psychological theories. I am licensed in NC, NY & CA with offices in Charlotte, NC, New York, NY & offer video sessions for CA residents. I write two Blogs for psychologytoday.com on Sex & Eating Issues
New South Counseling Group: Rachel Dunning
Licensed Clinical Mental Health Counselor, MA, NCC, LCMHC
Verified Verified
Charlotte, NC 28226
I specialize in helping women who feel disconnected from themselves and their bodies find safe, healthy reconnection. My clients specifically experience this disconnection in the forms of eating issues, eating disorders, body image pain, low self-esteem and frequent (or even constant) mental obsession with how bad they think their bodies and selves are. They want something new and different, but often don't see 'new and different' as possible, sustainable or corrective to what they perceive are their flaws. Have you felt this way before? Do you feel this way now?
I specialize in helping women who feel disconnected from themselves and their bodies find safe, healthy reconnection. My clients specifically experience this disconnection in the forms of eating issues, eating disorders, body image pain, low self-esteem and frequent (or even constant) mental obsession with how bad they think their bodies and selves are. They want something new and different, but often don't see 'new and different' as possible, sustainable or corrective to what they perceive are their flaws. Have you felt this way before? Do you feel this way now?
Ashley Burke
Counselor, MA, LCMHCA, NCC
Verified Verified
1 Endorsed
Charlotte, NC 28210
I currently work with adolescents, adults, and couples struggling with eating disorders, trauma, depression, anxiety, BPD, PTSD, relational issues, and OCD.
Does life feel overwhelming right now? Anxiety, depression, and trauma have a way of dictating our thoughts and taking control. In other words, emotions are hard! It’s incredible how long the human body can hold in all the chaos that life brings. I want to help you let go of all of the distress you’ve been holding on to and take back that control. Life will always be unpredictable, however, together we can find ways to navigate through the storms.
I currently work with adolescents, adults, and couples struggling with eating disorders, trauma, depression, anxiety, BPD, PTSD, relational issues, and OCD.
Does life feel overwhelming right now? Anxiety, depression, and trauma have a way of dictating our thoughts and taking control. In other words, emotions are hard! It’s incredible how long the human body can hold in all the chaos that life brings. I want to help you let go of all of the distress you’ve been holding on to and take back that control. Life will always be unpredictable, however, together we can find ways to navigate through the storms.
Lindsey M McIntyre
Licensed Professional Counselor, MA, LPC
Verified Verified
Charlotte, NC 28210 (Online Only)
I spent the first part of my career in non-profit and private practice settings in a rural area. These experiences provided a wide range of clinical growth and led to specializations in complex trauma, anxiety, depression, and eating disorders. I quickly build rapport with clients and am particularly passionate about working with those who are apprehensive about the therapeutic process. In addition, I have an extensive background working with the LGBTQ+ community, from individual and group counseling to training clinicians in LGBTQ+ inclusivity.
I spent the first part of my career in non-profit and private practice settings in a rural area. These experiences provided a wide range of clinical growth and led to specializations in complex trauma, anxiety, depression, and eating disorders. I quickly build rapport with clients and am particularly passionate about working with those who are apprehensive about the therapeutic process. In addition, I have an extensive background working with the LGBTQ+ community, from individual and group counseling to training clinicians in LGBTQ+ inclusivity.
Grayson Montgomery Patton
Clinical Social Work/Therapist, LCSW
Verified Verified
Charlotte, NC 28203
Waitlist for new clients
I have worked with individuals struggling with eating disorders, body image concerns, life transitions, anxiety, depression, relationship issues, trauma, and more.
I strongly believe that empathy, trust, and respect are the foundation of a therapeutic relationship. If you are considering making changes, now is the time and I'm here to walk beside you through it. As a therapist, I hope to provide a space for you to share openly, discover new perspectives, and feel heard. You are not defined by what you are struggling with. I use a person-centered, strengths-based approach, in which therapy is a collaborative process. My goal is to help you align with your values and become the best version of yourself.
I have worked with individuals struggling with eating disorders, body image concerns, life transitions, anxiety, depression, relationship issues, trauma, and more.
I strongly believe that empathy, trust, and respect are the foundation of a therapeutic relationship. If you are considering making changes, now is the time and I'm here to walk beside you through it. As a therapist, I hope to provide a space for you to share openly, discover new perspectives, and feel heard. You are not defined by what you are struggling with. I use a person-centered, strengths-based approach, in which therapy is a collaborative process. My goal is to help you align with your values and become the best version of yourself.
Zara Steinhart
Marriage & Family Therapist, LMFT
Verified Verified
Charlotte, NC 28203
I am a Licensed Marriage and Family Therapist who specializes in working with young folks and their families as they move toward recovery from their eating disorders. I am originally from sunny San Diego, California, and currently work at the Charlotte, North Carolina office of Veritas Collaborative. I most frequently provide individual, couples, and family therapy utilizing Internal Family Systems, Emotion-Focused and Narrative styles of therapy. Additionally, I provide group therapy and therapeutic meals with patients and their families.
I am a Licensed Marriage and Family Therapist who specializes in working with young folks and their families as they move toward recovery from their eating disorders. I am originally from sunny San Diego, California, and currently work at the Charlotte, North Carolina office of Veritas Collaborative. I most frequently provide individual, couples, and family therapy utilizing Internal Family Systems, Emotion-Focused and Narrative styles of therapy. Additionally, I provide group therapy and therapeutic meals with patients and their families.
Deborah Walsh
Licensed Clinical Mental Health Counselor, LCMHC
Verified Verified
1 Endorsed
Charlotte, NC 28210 (Online Only)
I am an experienced clinical mental health counselor with a specialization in disordered eating, trauma, body image and anxiety. For over ten years, I have provided therapy, led teams, and supervised clinicians in the treatment of eating disorders, trauma and emotional disorders. I am excited to bring my extensive experience, passion and empathic style into private practice with Next Steps Counseling and Consulting.
I am an experienced clinical mental health counselor with a specialization in disordered eating, trauma, body image and anxiety. For over ten years, I have provided therapy, led teams, and supervised clinicians in the treatment of eating disorders, trauma and emotional disorders. I am excited to bring my extensive experience, passion and empathic style into private practice with Next Steps Counseling and Consulting.
OneCore Counseling
Clinical Social Work/Therapist, MSW, LCSW, ACSW
Verified Verified
3 Endorsed
Charlotte, NC 28226
I specialize in working with eating disorders and bariatric issues in both adolescents and adults, co - occurring disorders, and breaking strongholds of addictive behavioral patterns in individual, couples, & family therapy.
Most have been taught to monitor behavior, but few have mastered monitoring their heart. I am passionate about helping clients gain understanding and instill hope for change. By starting where the client is at, I aim to facilitate change as it relates to the mind, body, & soul. Creating a safe environment for a strong therapeutic alliance, each client is treated wholistically to discover one's true potential for conflict resolution. Building on individual client's strengths, the C.O.R.E. issue to the presenting problem is revealed.
(C)ultivate, (O)vercome, (R)enew, &
(E)mpower
I specialize in working with eating disorders and bariatric issues in both adolescents and adults, co - occurring disorders, and breaking strongholds of addictive behavioral patterns in individual, couples, & family therapy.
Most have been taught to monitor behavior, but few have mastered monitoring their heart. I am passionate about helping clients gain understanding and instill hope for change. By starting where the client is at, I aim to facilitate change as it relates to the mind, body, & soul. Creating a safe environment for a strong therapeutic alliance, each client is treated wholistically to discover one's true potential for conflict resolution. Building on individual client's strengths, the C.O.R.E. issue to the presenting problem is revealed.
(C)ultivate, (O)vercome, (R)enew, &
(E)mpower
Dr. Jessica Ribeiro
Psychologist, PhD
Verified Verified
Charlotte, NC 28277
Hi there! My name is Dr. Jess Ribeiro. I’m a clinical psychologist and university professor with over 15 years of clinical, research, and teaching experience licensed in NC, FL, and NJ. I specialize in the treatment of depression, eating disorders, and anxiety. In my practice, I use leading evidence-based therapies, which are treatments that are backed by decades of scientific research and shown to work. Primarily, these are cognitive-behavioral approaches (e.g., CBT) that are highly collaborative, active, and goal-oriented treatments that help people achieve desired symptom changes quickly and build more fulfilling lives.
Hi there! My name is Dr. Jess Ribeiro. I’m a clinical psychologist and university professor with over 15 years of clinical, research, and teaching experience licensed in NC, FL, and NJ. I specialize in the treatment of depression, eating disorders, and anxiety. In my practice, I use leading evidence-based therapies, which are treatments that are backed by decades of scientific research and shown to work. Primarily, these are cognitive-behavioral approaches (e.g., CBT) that are highly collaborative, active, and goal-oriented treatments that help people achieve desired symptom changes quickly and build more fulfilling lives.
Bilal M Ghandour
Psychologist, PhD
Verified Verified
1 Endorsed
Charlotte, NC 28210
This includes eating disorders, body image, self-harm tendencies, borderline personality disorder, conversion disorder, obsessive tendencies - such as OCD, trichotillomania (repeated hair pulling) and body dysmorphic disorder.
I am a psychologist with many years of experience working with teens and adults with emotional difficulties. I believe the key to successful treatment is a good client-therapist match and your motivation to getting help. In terms of therapy style, I use an interactive, collaborative approach - a genuine and warm dialogue between two persons who work together to understand/resolve issues. Also, I view myself as someone who asks questions that motivate you to gain further insight about issues of concern and, when you are ready to make changes, I will give you tools and skills to implement them.
This includes eating disorders, body image, self-harm tendencies, borderline personality disorder, conversion disorder, obsessive tendencies - such as OCD, trichotillomania (repeated hair pulling) and body dysmorphic disorder.
I am a psychologist with many years of experience working with teens and adults with emotional difficulties. I believe the key to successful treatment is a good client-therapist match and your motivation to getting help. In terms of therapy style, I use an interactive, collaborative approach - a genuine and warm dialogue between two persons who work together to understand/resolve issues. Also, I view myself as someone who asks questions that motivate you to gain further insight about issues of concern and, when you are ready to make changes, I will give you tools and skills to implement them.
Allison Gregory
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Charlotte, NC 28205
I enjoy working with individuals who are experiencing challenges within eating disorders, anxiety, depression, negative body image, low self-esteem and life transitions. I have over 2 years of experience specializing in eating disorders of all types in individual and group settings in PHP and IOP levels of care and had a special passion for running an art therapy group. I appreciate someone who is motivated and willing to lean into the hard things that may come with therapy. I believe vulnerability is key and my hope is to provide a space that you can use how you need, no matter your capacity each day.
I enjoy working with individuals who are experiencing challenges within eating disorders, anxiety, depression, negative body image, low self-esteem and life transitions. I have over 2 years of experience specializing in eating disorders of all types in individual and group settings in PHP and IOP levels of care and had a special passion for running an art therapy group. I appreciate someone who is motivated and willing to lean into the hard things that may come with therapy. I believe vulnerability is key and my hope is to provide a space that you can use how you need, no matter your capacity each day.
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Dina Gambella
Marriage & Family Therapist, LMFT
Verified Verified
Charlotte, NC 28203
Specializing in couples therapy, eating disorders, and general mood disorders.
I believe that you are the expert of your own life & my role as your therapist is to be a fellow companion on your journey towards emotional growth. Your desired outcomes will be achieved by creating long term solutions that uniquely fit your needs within the safety and trust of our therapeutic relationship. By creating a safe and trusting environment, I welcome the opportunity to support your treatment needs.
Specializing in couples therapy, eating disorders, and general mood disorders.
I believe that you are the expert of your own life & my role as your therapist is to be a fellow companion on your journey towards emotional growth. Your desired outcomes will be achieved by creating long term solutions that uniquely fit your needs within the safety and trust of our therapeutic relationship. By creating a safe and trusting environment, I welcome the opportunity to support your treatment needs.
Chelsea Darida
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Charlotte, NC 28205
I enjoy working with individuals navigating a range of challenges including anxiety, eating disorders, trauma, low self-esteem and negative body image. With over seven years of experience working with survivors of trauma, I strive to provide a safe and non-judgmental space for individuals to process the impact of their life experiences on who they are today. No matter what your struggle may be, you don't have to face it alone. I am here to provide support to empower you on your journey to healing and freedom.
I enjoy working with individuals navigating a range of challenges including anxiety, eating disorders, trauma, low self-esteem and negative body image. With over seven years of experience working with survivors of trauma, I strive to provide a safe and non-judgmental space for individuals to process the impact of their life experiences on who they are today. No matter what your struggle may be, you don't have to face it alone. I am here to provide support to empower you on your journey to healing and freedom.
Karly Perkins
Licensed Clinical Mental Health Counselor, LCMHC, LCAS, NCC
Verified Verified
1 Endorsed
Charlotte, NC 28204
Waitlist for new clients
As a therapist, my hope is to create a space that feels welcoming to your authentic self. I aim to hold space for you to show up as you need to that day, and will honor what you need in each session whether that is a space to vent, explore new skills, be challenged, or create goals that will meet your needs. I specialize in working eating disorders and body image concerns, substance use, college students, and the LGBTQ+ community. I additionally support those experiencing anxiety, depression, impacts from trauma, identity development, life transitions, and safety concerns such as self -harm or suicidality.
As a therapist, my hope is to create a space that feels welcoming to your authentic self. I aim to hold space for you to show up as you need to that day, and will honor what you need in each session whether that is a space to vent, explore new skills, be challenged, or create goals that will meet your needs. I specialize in working eating disorders and body image concerns, substance use, college students, and the LGBTQ+ community. I additionally support those experiencing anxiety, depression, impacts from trauma, identity development, life transitions, and safety concerns such as self -harm or suicidality.
Sarah Mitrano
MA/EdS, LCMHC
Verified Verified
Charlotte, NC 28204
Waitlist for new clients
My background in eating disorders extends from experience working in all different levels of care, providing a unique view on the struggles faced day to day.
As a therapist, my aim is to help guide you to a place that you are struggling to reach. I will meet you where you are and tailor the therapy to your needs. By providing a welcoming presence, I work to create a space that is safe and comfortable. Life can take us to all types of challenging, exciting, and sometimes unknown places. Having a non-judgmental atmosphere to process it all can promote growth within the mind and body connection. If you are struggling with identifying/accepting emotions, negative thinking, self-esteem/self-confidence, relationships with others, or the relationship with yourself, I am here to help!
My background in eating disorders extends from experience working in all different levels of care, providing a unique view on the struggles faced day to day.
As a therapist, my aim is to help guide you to a place that you are struggling to reach. I will meet you where you are and tailor the therapy to your needs. By providing a welcoming presence, I work to create a space that is safe and comfortable. Life can take us to all types of challenging, exciting, and sometimes unknown places. Having a non-judgmental atmosphere to process it all can promote growth within the mind and body connection. If you are struggling with identifying/accepting emotions, negative thinking, self-esteem/self-confidence, relationships with others, or the relationship with yourself, I am here to help!
Ann Kreindler-Siegel
Clinical Social Work/Therapist, LCSW, BCC, PLLC
Verified Verified
Charlotte, NC 28209
My primary specialties are working with people with Eating Disorders and/or trauma.
I have been in practice for more than thirty years and love what I do. I really enjoy working with people and my primary specialties are working with people with Eating Disorders, couples, family issues, and life issues that arise for people. I am also trained as a Somatic Experiencing Professional and work with people with anxiety, OCD, and all types of trauma. Trauma is defined as any emotionally overwhelming life experience and therefore encompasses many issues we deal with in life. I am known for my work in the Eating Disorder and trauma field.
My primary specialties are working with people with Eating Disorders and/or trauma.
I have been in practice for more than thirty years and love what I do. I really enjoy working with people and my primary specialties are working with people with Eating Disorders, couples, family issues, and life issues that arise for people. I am also trained as a Somatic Experiencing Professional and work with people with anxiety, OCD, and all types of trauma. Trauma is defined as any emotionally overwhelming life experience and therefore encompasses many issues we deal with in life. I am known for my work in the Eating Disorder and trauma field.
Angela S Redlak-Olcese
Psychologist, PsyD, CEDS-S
Verified Verified
Charlotte, NC 28226
Waitlist for new clients
She is a Certified Eating Disorder Specialist Supervisor (CEDS-S) by International Association of Eating Disorders Professionals (IAEDP), expert in CBT-Enhanced, leading evidenced based treatment for eating disorders, trained by The Centre for Eating Disorder Research (CREDO) at Oxford.
Dr. Redlak-Olcese's therapeutic approach is collaborative, structured, and active and provided in person or tele-health. It goes beyond "talk-therapy." Specific techniques are taught during each session and next steps are identified to practice at home. She is dedicated to integrating evidence based research into clinical practice. She helps you identify current patterns of thinking, feeling, physiological reactions, and behaviors that keep you stuck and develop new ways of coping and responding that work. She provides education/guidance to loved ones. Treatment is self-empowering, time limited, has a beginning, middle, and end.
She is a Certified Eating Disorder Specialist Supervisor (CEDS-S) by International Association of Eating Disorders Professionals (IAEDP), expert in CBT-Enhanced, leading evidenced based treatment for eating disorders, trained by The Centre for Eating Disorder Research (CREDO) at Oxford.
Dr. Redlak-Olcese's therapeutic approach is collaborative, structured, and active and provided in person or tele-health. It goes beyond "talk-therapy." Specific techniques are taught during each session and next steps are identified to practice at home. She is dedicated to integrating evidence based research into clinical practice. She helps you identify current patterns of thinking, feeling, physiological reactions, and behaviors that keep you stuck and develop new ways of coping and responding that work. She provides education/guidance to loved ones. Treatment is self-empowering, time limited, has a beginning, middle, and end.
Marketa Winfield
Licensed Professional Counselor, LCMHC, NCC, LPC
Verified Verified
Charlotte, NC 28209
I have a passion for working with children and adolescents; ages 10 to 17 with feeding and eating disorders.
The decision to come to therapy can be scary. There are so many unknowns, especially if you have never done this before. I am here to stand and walk with you through every step of the process of change and healing- It gets better. My goal in my relationship with you is to make sure that you feel safe and comfortable enough to be yourself.
I have a passion for working with children and adolescents; ages 10 to 17 with feeding and eating disorders.
The decision to come to therapy can be scary. There are so many unknowns, especially if you have never done this before. I am here to stand and walk with you through every step of the process of change and healing- It gets better. My goal in my relationship with you is to make sure that you feel safe and comfortable enough to be yourself.
Serenity Psychotherapy LLC
Licensed Clinical Mental Health Counselor, PLC
Verified Verified
Charlotte, NC 28277
Samantha has specialized in areas such as anxiety, depression, eating disorders, relationship conflicts, life transitions, career change, college prep for students, confidence, and self-esteem.
Samantha Malfitano LPC: When people feel safe to express all of their feelings, true healing can begin. For many, they have repressed these emotions for years, creating a disconnect from the mind, body & soul, Which separates you from your true self. You may feel stuck, depleted, lacking purpose, motivation & direction. Searching externally within people, places & things to give you relief, only to find this is just a temporary solution. Resulting in symptoms & behaviors such as anxiety, depression, eating disorders, panic, self harm, suicidal ideation, substance use, and others, to cope with these old painful emotions & memories.
Samantha has specialized in areas such as anxiety, depression, eating disorders, relationship conflicts, life transitions, career change, college prep for students, confidence, and self-esteem.
Samantha Malfitano LPC: When people feel safe to express all of their feelings, true healing can begin. For many, they have repressed these emotions for years, creating a disconnect from the mind, body & soul, Which separates you from your true self. You may feel stuck, depleted, lacking purpose, motivation & direction. Searching externally within people, places & things to give you relief, only to find this is just a temporary solution. Resulting in symptoms & behaviors such as anxiety, depression, eating disorders, panic, self harm, suicidal ideation, substance use, and others, to cope with these old painful emotions & memories.
Susan Elizabeth Gessner
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Charlotte, NC 28203
I have specialized expertise in treating eating disorders and trauma.
I am a licensed clinical psychotherapist with 34 years of clinical experience. I am the owner of Charlotte Center for Balanced Living where I maintain a private practice in the historic Southend area of Charlotte, I pride my practice on delivering exceptional personalized care in a confidential, supportive, and safe environment. My treatment philosophy is empathically informed and draws from a broad range of theoretical orientations. I incorporate a blend of conventional and alternative approaches drawing upon a variety of styles and techniques to
I have specialized expertise in treating eating disorders and trauma.
I am a licensed clinical psychotherapist with 34 years of clinical experience. I am the owner of Charlotte Center for Balanced Living where I maintain a private practice in the historic Southend area of Charlotte, I pride my practice on delivering exceptional personalized care in a confidential, supportive, and safe environment. My treatment philosophy is empathically informed and draws from a broad range of theoretical orientations. I incorporate a blend of conventional and alternative approaches drawing upon a variety of styles and techniques to
See more therapy options for Charlotte
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Eating Disorders Therapists
What happens in therapy for eating disorders?
In therapy for eating disorders, patients typically describe their eating and exercise behaviors, their patterns of eating in relation to stress, their beliefs about their body, the ways their eating behavior affects their relationships, and their desire (or lack of it) to change. Such information helps the therapist understand the origins of the disorder and the role it plays in the patient’s life, important for guiding treatment. Attitudes and feelings about food and eating, body weight, and physical appearance are common topics of discussion throughout treatment.
What therapy types help with eating disorders?
Once any acute medical or psychiatric emergency is resolved, psychoactive medication is often prescribed, requiring the supervision of a psychiatrist. In addition, patients receive some form of nutritional counseling along with one or more forms of psychotherapy. For adolescents, family-based treatment is empirically validated and considered the first line of treatment; parents and their children meet weekly with a clinician as the adults are coached on how to nourish and psychologically support the young patient. Adults typically receive some form of individual psychotherapy, intended to resolve the cognitive and behavioral disturbances that underlie the disorder and to relieve the mood disturbances that accompany it. In addition, patients may also be helped by group therapy.
What is the goal of therapy for eating disorders?
The most immediate goal of treatment for eating disorders is to save the life of people who are on a path of starving themselves to death or engaging in eating patterns that are doing irreparable physical harm to their body. Once the acute medical danger is past, therapy is required to understand the nature of the disordered eating and/or exercise patterns, establish healthy eating behavior, and to tackle the many erroneous beliefs and distorted self-perceptions that underlie eating disorders and continue to pose a threat to health and life. Therapy also addresses the impaired mood that not only accompanies eating disorders but intensifies the danger to health and life.
What are the limitations of therapy for eating disorders?
Therapy can be very helpful for eating disorders—but that can happen only after people recognize they have a condition that must be treated. Especially with anorexia, the distortions in self-image that accompany the disorder can keep people from acknowledging they have a problem. Individuals may in fact see their eating disorder as a badge of self-control. Those with binge-eating disorder may feel too ashamed to seek help. Therapy cannot help those who do not avail themselves of it.
How long does therapy last for eating disorders?
Because of their complexity, recovery from eating disorders is usually a long-term process—measured in months and years— often marked by setbacks and relapse. Some form of help, such as individual or group therapy, may be advisable for much of that time. It is a general rule of thumb that the longer the illness has endured and the dysregulated eating behavior has taken root, the longer treatment is likely to be needed.