Hello! My name is Pai and I am a Licensed Clinical Social Worker (LCSW) in the State of California and have been practicing for 7 years. As a first-generation Thai-American with working class background, I bring a deep understanding of overcoming hardships and trauma. I have worked in community mental health providing culturally responsive therapeutic services including harm reduction and crisis counseling. Rooted in social justice, my work as a therapist is an extension of my passion in helping others empower themselves and assist in their healing journey.
I am a Licensed Marriage and Family Therapist (LMFT) based in California. I provide a warm, supportive space where you can feel safe to explore what's on your mind, process challenges, and move toward growth and healing. I believe therapy should be a collaborative experience - guided by your needs, your voice, and your goals. Reaching out for support takes courage, and I'm honored to walk alongside you in this process.
Hello and welcome! I'm Allison, a Licensed Marriage Family Therapist with over 14 years experience providing therapy.
I earned my Masters in Counseling from The University of San Francisco's Sacramento satellite campus in 2012.
My approach to therapy begins with establishing a genuine connection with each client and how their challenges are impacting them. I establish this by providing a warm, open, and authentic environment.
I enjoy working with people facing a variety of challenges. This includes those experiencing anxiety, depression, those going through life stressors/transitions, and those feeling "stuck" in their lives.
Hello, I am Dion Smotherman.
Are you discovering that your plans for making tomorrow better seem to fade shortly after your day get going? Maybe you feel your creativity and enthusiasm have taken a vacation. Have you noticed your relationships are becoming harder to maintain and you long for the return of your creative self.
I enjoy working with families, couples, young adults and adolescents.
I specialize in working with you through marital conflict, grief, loss. anxiety, depression and trauma.
There are a few art materials you will need to purchase. I will provide a list. A beginning investment of $50 of supplies should work fine.
Let’s creatively work together towards making positive changes using Art Therapy and CBT.
I am an LPCC in California and an LPC in Texas. My educational background consists of earning my Bachelor of Arts in Psychology, a Master's in clinical counseling, and a Master's in Addictions. I am a National Certified Counselor and am a certified addictions counselor.
My past clinical experience includes working for a crisis center where the majority of clients experienced issues related to suicide, homicide, domestic violence, and child and elder abuse. These issues impact people of all ages, races, and ethnic groups. I have also worked for a county-based permanent assisted housing development where all of the clients have experienced episodes of homelessness, and have been significantly impacted by issues of trauma, depression, addictions, domestic violence, and child abuse.
Hello, my name is Christina and I am passionate about serving those who have been suffering and are looking for real solutions to their problems. I look forward to helping you meet your long and short term goals through our collaborative and therapeutic work together. I have 8+ years of post grad experience treating children, adults, families, former foster youth and incarcerated adults in a variety of mental health settings.
Hi! My name is Yomaira Suazo and I am a licensed Marriage Family Therapist in California. I identify as a Latina and am bilingual. My experiences include young adults and adults. My main focus is proving a client-centered approach along with other approaches that help to create a non-judgment space for clients to feel safe and unpack, learn, and begin the healing process.
VirtualOffers in-person in Fresno, CA - Accepting clients in CAAvailable
I am a California Indigenous (Ohlone) and third generation Mexican- and Sicilian-American Psychotherapist in the San Francisco Bay Area, currently providing therapeutic services online. I specialize in supporting teens and adults that are struggling with issues of anxiety and depression, grief, low self-esteem, negative thinking, self criticism, difficulties with life transitions and postpartum and women's issues. I work with individuals who may be struggling with depression, anxiety or grief.
Hello, I am a licensed Psychologist and have been working in the field for approximately 20 years. As a psychologist, I find fulfillment in helping individuals navigate, not only mental health challenges, but daily challenges in life by providing a supportive and compassionate environment. By utilizing an eclectic and collaborative approach we can find solutions together to overcome life's difficulties. Let me assist you in becoming the best version of yourself.
Are you feeling anxious, depressed, or just not ok. Are you overwhelmed trying to manage life's ebbs and flows? Do you have repetitious thoughts despite efforts to push them aside? Living with uncertainty while experiencing so many different feelings can be exhausting. I offer culturally sensitive services to clients of all socioeconomic backgrounds and abilities in a respectful, safe, supportive space.
Together, we will work to identify your presenting concerns and the internalized belief systems impacting how you address your them. Approaches designed to meet your specific needs, will be drawn from psychodynamic, art, mindfulness and somatic modalities.
I hope my supportive, non-judgemental, and warm approach will support your work in clarifying goals and gaining insights and skills to reach them.
Hello,
I'm Tasfia, I'm a Licensed Marriage Family Therapist with a passion to help individuals reach their personal goals. I have over 10 years experience providing individual therapy, family work and case management for children, adolescents and adults. My approach to therapy is cohesive and client-centered. I assist individuals identify their strengths and barriers through individual therapy, behavioral rehabilitation, and collateral support within a multicultural community.
Marjorie is a Spanish language Bilingual Psychotherapist from South America and has been practicing in the USA since 2008 as a MSW provider and since 2012 as a LCSW therapist.
Marjorie graduated with both a bachelor's degree in social work and a master's degree in clinical social work from California State University Los Angeles.
Marjorie works both in her own private practice -focusing on women’s issues and minority populations - and as a Psychiatric Social Worker for a large managed health care organization, helping clients with diverse psychosocial stressors or chronic mood disorders.
Marjorie has extensive experience in social work, advocacy, case management and mental health services for over 18 years.
Marjorie has provided psychotherapy services for adults and children from various cultural backgrounds, she’s sensitive to the linguistic needs of the clients served (Spanish/English).
Areas of focus: Assessment and diagnosis formulation, treatment planning, counseling (short term specific or situational issues), psychotherapy (long term broader range for mental illness) and crisis intervention.
Hi! My name is Junise Dorestin and I am a License Marriage and Family Therapist. Prior to becoming a therapist, I worked as a children social service worker with Child Protective Services. I have been working in the field of mental health for over 10 years. I obtained my Masters of Art in Psychology emphasis Marriage and Family Therapy from Alliant International University in 2008. I have experienced in working with incarcerated individuals, families, children and young adult. I use a broad range of treatment method to assist individuals and families in the process of reaching their goals. As a LMFT, I am passionate about helping others work through their struggles and built insight. I work those who are struggling with a variety of issues including depression, anxiety, bipolar, PTSD and stress. I have work with those with psychotic disorders and dual diagnoses.
Hi! I am a Licensed Marriage and Family Therapist providing services in Florida and California. I graduated from Pace University and have been practicing clinician for 25 years. I am a strengths-based clinician with extensive training and experience in cognitive behavioral therapy. The decision to seek therapy can be hard and intimidating. My goal is to provide a space for exploration, reflection and change.
I am a Licensed Clinical Social Worker (LCSW) based in Orange County, CA. For almost 10 years, I have worked in various settings with teens and adults to help them build resilience, healthy coping mechanisms, and learn to process emotions. I create a non-judgmental environment to support each client in their exploration of what led them to seek therapy. Through insight and awareness, clients can feel more empowered and find a deeper sense of self.
Hello, and welcome. I am Dr. Diari Banigo, Ph.D, LCSW, a Christian, doctoral‑trained clinician, and adjunct professor. I am dedicated to providing compassionate, evidence‑informed therapy that honors the whole person. My approach emphasizes emotional resilience, meaningful connection, and healing from life’s stressors. I believe therapy is most effective as a collaborative process, and I encourage patients to actively engage in their care with me and with other providers who support their overall wellbeing.
Important Notice:
Dr. Banigo provides psychotherapeutic services. Requests for administrative documentation—such as disability certification, FMLA, or emotional support animal letters—will be referred to another mental health provider. This policy ensures that therapy sessions remain focused on clinical care and your healing process.
Hello, I’m a Licensed Clinical Social Worker in California. I’m a California native who graduated from the University of Southern California in 2019 with a Masters in Social Work degree and have been working in the mental health field for 7 years. My passion is for normalizing mental health in order to reduce the stigma often associated with it. We need to get comfortable talking about our mental health.
Are you looking for a new direction or searching how to live your best life? Life is challenging however there are opportunities to gain new insights and learn new skills in order to enjoy life and all that it has to offer. I enjoy incorporating active things into therapy, a sense of humor, and mindfulness.
If you are trying to manage anxiety, depression, stress, work challenges, relationship problems, we will work together to find the solution that works best for you. Counseling offers a safe space to explore, learn new skills, and gain the ability to truly enjoy your life.
I am available on Tuesdays and Wednesdays in person, most other days are via telehealth.
Offers in-person in Sacramento, CA - Accepting clients in CAAvailable
I am the kind of clinician who will utilize real-life references and examples of how the interventions work, I am transparent, and nonjudgmental and will share with you the exact intent of my interventions.
I have been working with children, adults couples and families throughout my career, I've been practicing for 26 years.
I tailor my interventions to clients' expressed needs and goals collaboratively as I believe the client is the expert of their own lives, and my job is to help reframe and redirect self-awareness to ones existing strengths and to build upon them.
Hello, my name is Yesenia Segovia, with an LCSW based in California. I really value listening, being a warm presence, bringing a sense of calm, understanding where you're coming from, validating your experiences, and empowering you to make changes. Seriously, this is a judgment-free zone! Feeling safe and comfortable in therapy is super important to me. We'll team up and work through whatever you're facing together, and I'm here to support you in reaching your well-being goals. Over the years, I've helped many people just like you find healing and achieve what they're aiming for.
Hello! My name is Mackenzie Maurer and I am a Licensed Clinical Social Worker. I've been working as a clinical therapist since 2017. I graduated with my MSW from Cal State University, Los Angeles and became licensed in 2021. I became a social worker because it aligned well with my belief in social justice and working as a therapist has only strengthened this belief. I am lucky to really love what I do and I feel honored to get to witness my clients' growth in the therapeutic process.
My name is Wendy Bertram and I am a Licensed Clinical Social Worker (LCSW/LISW) based out of Arizona with a Masters in Social Work from ASU. Currently I'm licensed in both Arizona and California, providing both in-person and teleheatlh services. I use a client centered approach and multiple therapy models, depending on your needs. I am here to partner with you to work through the issues causing disruptions in your life and to help you meet your goals. Everyone’s experience is unique, and the therapeutic experience should reflect this.
My expertise spans various areas, including life transitions, anxiety, depression, trauma, relationship issues, grief and loss, self-esteem struggles, stress and worry, caregiver stress, and those struggling with the impacts of medical diagnoses. By employing a client-centered approach, I work to foster a safe and non-judgmental space for individuals to explore their emotions, thoughts, and experiences. I employ evidence-based interventions such as cognitive-behavioral therapy (CBT), mindfulness techniques, and solution-focused therapy to promote personal insight, resilience, and coping skills for positive change.
Hello, I am a Licensed Marriage and Family therapist (LMFT) in the state of California. University of California, Berkeley (UCB) for the AB in English and University of San Francisco (USF) in Counseling. Because of my personal experiences with having seizures when I was younger, I now concentrate on addressing the emotions and hopes and dreams of people who are dealing with the multiple, and often times consuming, issues of having a seizure disorder as well as any combination of realities and histories that equal the seizure experience. Please let me know if I can bring a more balanced picture to your life and those who you value and love in your life as well.
I’m a Licensed Marriage and Family Therapist with a Master’s degree in Counseling Psychology and over 15 years of experience in the mental health field. I specialize in working with adults navigating anxiety, depression, trauma, life transitions, and dual diagnoses. My approach is compassionate, culturally sensitive, and focused on treating the whole person—I utilize evidence-based and self-empowering modalities to help clients gain insight, heal from within, and move forward with greater clarity and confidence.
I am a Licensed Marriage and Family Therapist located in the state of California. I received my Master's Degree from Antioch University Los Angeles and have been practicing for 18 years. Working together, I help adults work to find solutions to ongoing issues causing anxiety, sadness and loneliness in their lives so they may become the best version of themselves.
I am a licensed professional clinical counselor dedicated to promoting healing and growth through a personalized, multidisciplinary approach. Understanding that each individual is unique, I integrate a variety of therapeutic modalities to meet the specific needs of my clients, recognizing that what works for one may not apply to all. I place a strong emphasis on building a trusting rapport and establishing a collaborative therapeutic alliance, where we work together to create lasting change. I firmly believe that every person has the potential to shape and develop the life they envision, and my role is to guide and support them in this process.
Welcome! I am genuinely glad that you are here. It isn’t always easy to put your trust and safe keeping of personal feelings and experiences into another, so I am honored to get to know your story. I have had the privilege of working with children, teens and adults from various cultural and socioeconomic backgrounds, who have various relational preferences, etc. What I want to convey is that everyone is welcome here! A little about me- I have spent many years working as a school based Mental Health Therapist, so I very familiar with the unique experiences of school educators, administrators, and other supporting staff. I have been involved in Special Education and IEP meetings, and have supported parents and students in this area. Additionally, I continue to dedicate myself to the research and understanding of complex relationships and various attachment styles, and enjoy supporting my clients in those areas. I am also well versed and comfortable in supporting my clients through anxiety, depression and the processing of grief/loss. I would like you to know that I genuinely care about the emotional well-being of my clients, and my hope is that you feel safe and comfortable in sharing with me.
Hi. I'm an old white lady with years of experience living on this earth. I want to share what I've learned with you and assist you to recover from trauma, abuse, and attachment dysregulation. I'm culturally competent and have specific experience working with people who are first-generation Americans who are walking the line between two cultures, learning how to integrate all their parts into a cohesive whole.
Congratulations for taking the step to seek counseling. The world we live in is increasingly complex, and we can find ourselves feeling disconnected, stressed, and uncertain about what direction to take. How do we identify solutions for our life’s challenges? How do we let go of stress and sleep at night? As a therapist, I have counseled with individuals and families for over ten years and have found that problem-solving does not have to be stressful, and that we can work through our toughest issues.
It is common to believe that people in our relationships, or circumstances in our lives cause us to feel the way we do. But it is our thinking, and the way we relate to people and circumstances, that create our feelings and emotions. Cognitive Behavioral Therapy helps us observe what we are feeling and identify the thoughts that create our feelings. With increased self-awareness, we determine which of our thoughts and perceptions are distorted and unhelpful. As our thinking becomes more realistic, we feel better.
There are several therapy methods that are effective in creating positive change, including Narrative Therapy, Goal Setting, Visioning for Personal Growth, and Mindfulness to promote focus and attention. Let’s engage in a conversation to explore your individual needs, and how best to meet them.
Jungian therapy will look at the relationship of your “self” to your experiences and look at problems as a symptom of something deeper.
Whether it be a thought or perception, dream, belief, value or current relationship that brings you to therapy, we'll look for what messages are coming to you from within. Tapping into your own creativity, we can use myth and metaphor, poetry, dreams, literature and art to explore your relationship to the problem.
My name is Jacob Lapides and I am a licensed Marriage and Family Therapist (LMFT) in California and I have been in this field for over 10 years now. I am a Holistic therapist who likes to focus on healing an individual from all aspects including mind-body wellness. I bring an eclectic skill set of many different therapeutic approaches and orientations so that I can use different techniques to find the best tools and interventions to help and support whoever I am working with.
VirtualOffers in-person in Sebastopol, CA - Accepting clients in CAAvailable
I have worked in the mental health field for over 10 years, providing various services to adults and families. My approach is psychodynamic, relational, and insight-oriented with a holistic focus on the mind-body continuum. My style, while rooted in empathy, is also very direct. I will act as your mirror in order to help you see yourself more clearly. I also utilize positive psychology and strength-based approaches to help clients identify ways to increase their quality of life. Clients often walk away from therapy feeling heard, hopeful, and willing to attempt homework to improve their lives.
I offer support-based services utilizing both faith-based and secular perspectives to help guide clients to determine their best short and long-term personalized goals and objectives. We will create a client plan to help you achieve your personal goals and objectives in the most advantageous time frame possible. I am non-judgmental and try to meet my clients where they are in their life journey and transition to desired future outcomes and refinements.
I work with mild, moderate and severe mental health clients who may be in a current crisis with their marriage, stage of life issues, or self-improvement. I work with adults of all ages, gender and sexual orientations.
I have experience in counseling in faith-based, as well as secular perspectives and believe that each person has gifts and passions to offer to themselves, their families and their communities. We often need empathy, support and feedback to fulfill our expectations and goals in life.
Hi, I am a LMFT based in California! I have my Master's degree from National University and have been in the behavioral health field for 17 years.
I have found a passion in helping those in crisis, struggling with self-esteem, relational challenges, athletic performance and mood/eating disorders.
I want to be able to make change and guide those to focus on thought patterns, feelings and emotions to challenging situations and improve their daily living.
I am a psychotherapist and a theologian. I understand that people are imperfect, but there is always room for improvement. Oftentimes, when we expand our knowledge and skills in managing interpersonal relationships, we can experience more joy in life. As a therapist, I help clients overcome psychological issues preventing them from thriving in and maintaining healthy and meaningful relationships. Empowering individuals and couples and obtaining skills to help them live harmonious, confident, happier lives is satisfying.
Hello! I am a Licensed Marriage & Family Therapist (LMFT) based in sunny southern California, living with my partner, of many years, John, and our three cats, three dogs, and tortoise, who by the way, is currently hibernating...and don't we all wish we could do that at times? I have many years of experience working with individuals, and with a varied range of issues including anxiety, depression, low self-esteem and relationship challenges. I have worked in a variety of clinical settings with many ethnic populations. My style is down-to-earth, relatable, at times, direct, and always with a touch of humor. I love what I do and consider it an honor to help you resolve whatever it might be that is holding you back. I look forward to working with you! By the way, a former client recently said: "I am so grateful to have worked with you, you are truly gifted, and I have learned so much!"
As a seasoned therapist with nearly 20 years of consecutive licensing across multiple states, I specialize in a diverse array of client issues, including men's issues, LGBTQ+ concerns, aging and chronic illness challenges, sexual addiction, trauma and PTSD, anger management, clinical depression, and anxiety. My approach is built on an affirming and caring nature, allowing clients to feel safe and understood in our collaborative work. I utilize various therapeutic modalities, including person-centered therapy, CBT, and ACT, alongside group therapy, to tailor my interventions to each individual’s unique needs. My strong listening and speaking skills facilitate deep connections with clients, empowering them to explore their struggles, find meaning, and ultimately create positive changes in their lives. The impact of my work is reflected in the growth and resilience of my clients, as they navigate their personal journeys toward healing and fulfillment.
Hi, I am a Licensed Clinical Social Worker Licensed in California with 18+ years of professional clinical experience. I have experience in helping clients with stress, anxiety, family conflicts, motivation, self esteem, confidence, & depression. I also have experience working with coping with life changes. I help adults who are struggling, become the best version of themselves at their own pace.
Welcome to therapy, I'm Rachel.
If you or your loved one are experiencing emotional distress due to family, work, relationships or the unknown then I am here to help. It takes courage to seek out a Therapist and I am glad you are ready to get started.
I empower high-functioning individuals to reduce feelings of being overwhelmed, nervousness, worry, sadness and other symptoms that are disrupting life.
I am a Licensed Marriage & Family Therapist and I have provided mental health counseling for individuals in small rural clinics, larger city clinics, and as a provider for short-term counseling grant programs.
I offer flexible appointments, evenings and weekends. I understand how difficult the work/school week can be and want to increase your opportunities for accessing uniquely tailored mental health treatment.
*Currently not accepting couples*
Hola, and welcome!
As a therapist, I am passionate about supporting children, adolescents, and young adults navigating stress, anxiety, and depression—especially during times of change that may feel beyond their control. I strive to help them build practical coping skills that foster resilience, strengthen self-understanding, and cultivate a sense of hope. I look forward to connecting with you and exploring how I can support you.
Hi, I’m Lisa, a Licensed Marriage and Family Therapist with experience working with adolescents, young adults, and families navigating anxiety, emotional dysregulation, substance use, family conflict, self-esteem challenges, and life transitions. My approach is compassionate, collaborative, and grounded in meeting clients where they are. I strive to create a supportive and nonjudgmental space where clients feel safe exploring challenges, building insight, and developing healthier coping strategies and relationships. I believe meaningful change happens through authentic connection, self-awareness, and feeling genuinely understood.
Jamula Taylor, LMFT, is a licensed Marriage and Family Therapist and Boundaries Coach with 5 years of experience helping adults break unhealthy patterns, strengthen boundaries, and build emotional resilience. She has worked with diverse populations, including individuals navigating homelessness, incarceration, and major life stressors.
Jamula specializes in helping adults navigate life transitions, emotional challenges, relationship patterns, and personal growth through a compassionate and solution-focused approach. She focuses on helping clients develop healthier coping strategies, strengthen self-awareness, build confidence, and create meaningful change in their lives.
Areas of specialty include:
**Boundaries & People-Pleasing Patterns**
Supporting clients who struggle with overgiving, difficulty saying no, guilt, resentment, or prioritizing others’ needs over their own. Helping clients develop healthy boundaries and more balanced relationships.
**Relationship Challenges & Communication**
Supporting clients in understanding relationship patterns, improving communication, increasing emotional awareness, and creating healthier connections.
**Trauma-Informed Healing & Generational Patterns**
Providing trauma-informed support for clients who want to explore how past experiences impact current thoughts, emotions, behaviors, and relationships while focusing on empowerment and resilience.
**Women’s Issues & Empowerment**
Supporting women navigating identity, confidence, motherhood, self-prioritization, and personal transformation.
**Therapeutic Approach:**
My approach integrates evidence-based therapy, mindfulness, cognitive-behavioral strategies, solution-focused interventions, and strengths-based techniques to help clients gain insight, build skills, and create sustainable change.
**Ideal Clients:**
Adults seeking support with personal growth, emotional wellness, boundaries, relationships, confidence, stress management, and life transitions.
My name is Patricia Pasillas (LCSW) and I'm a first generation Latina located here in the heart of Southern California. Throughout the last 17 years of my career as a licensed clinical social worker I've build a solid reputation for not only breaking down the barriers within society but it's my eagerness to help open the doors for others that truly separates me from others in this line of work.
Hello, I am a licensed professional clinical counselor in the state of California, I live in the Palm Springs area of Southern Cal. My goal in life is to assist others with their mental health challenges and provide them with tools and education that will help them successfully manage these challenges. I look forward to seeing you in one of my sessions.
I’ve had the honor of working closely with children, families, and individuals healing from various forms of trauma and impacts of mental health from a cultural lens. Along the way, I’ve gained a deep understanding of the many different ways family life can shape us, sometimes in unexpected or challenging ways. I’ve worked in a variety of roles and settings, as a Director, Clinical Supervisor, across government agencies, to private and mental health centers, which has helped me see each person’s story from many angles.
My approach is compassionate yet direct, down-to-earth, and tailored to you. Whether you’re looking for support for yourself, your family, or your relationships, I’m here to walk alongside you with kindness and respect. Together, we’ll create a safe space to explore, heal, and grow at your own pace.
I am a Licensed Clinical Social Worker, licensed in California and Nevada. I am based in Henderson, NV. As a married mother of 3, I enjoy spending time with my family which also includes my bearded dragon, fish and rabbit. I enjoy being outdoors and more importantly helping individuals see what they are truly capable of when it comes to their overall well-being and mental health.
Hello! I am a licensed Marriage and Family Therapist (LMFT) who has been working with individuals, couples and families for twenty three years. I use interventions based on cognitive behavioral techniques to help you reach your goals and overcome patterns of behavior that are not working well for you. I believe you are the expert in your own life and strive to work with you to understand and move forward toward your goals.
I am a Licensed Marriage and Family Therapist who provides counseling to adults and couples using a trauma-informed approach. I am trained in EMDR, Brainspotting, and Accelerated Resolution Therapy (ART), and I help clients process and heal from complex life experiences.
I bring a unique depth of experience to my work, having served 25 years as a police officer and over 13 years supporting first responders through peer support programs. I am also a certified domestic violence counselor with experience working with both adults and children impacted by trauma, and a U.S. Army veteran with four years of active-duty service.
If you’re feeling anxious, down, stuck in old patterns, or overwhelmed by racing thoughts, you’re not alone—and things can get better. Therapy can help you feel calmer, clearer, and more like yourself again.
I’m a California-based LCSW supporting teens and adults with anxiety, depression, trauma responses, ADHD, OCD, and relationship challenges. My approach is warm, encouraging, and structured. We’ll identify what’s getting in the way, build a plan that fits you, and practice practical tools you can start using right away. We’ll also track your progress so you can see real momentum.
You deserve support that feels steady, hopeful, and useful. When you’re ready, I’m here to help.
Hi. I am the daughter of immigrants which motivated me to study Multicultural community based psychology. I have worked in many different settings from community mental health to private practice. Currently I am the director of a consultation unit for youth and young adults in the foster care system. I really enjoy working with people on how to maximize their potential to create happier lives; sometimes this is achieved through more traditional therapy while other times this may require life coaching. I do not believe that therapy needs to be a continuous life long process, but rather a process individuals move in and out of at different stages of their lives.