Book 50+ of the best Humana Dual (Medicare & Medicaid) therapists in Massachusetts

My journey in helping others meet their mental health goals began at Westfield State College in 2004, graduating summa cum laude with a bachelor in social work. After raising 2 children I returned to what had become Westfield State University and completed my masters degree in one year with the goal of becoming a clinical therapist. Since that time I have worked with clients from 12-90 get the support they need.

As a licensed clinical social worker and certified substance abuse counselor, I specialize in supporting individuals navigating substance use and mental health challenges like anxiety, depression, and trauma. With over 10 years of experience in the field—and lived experience with addiction in my own family—I bring not only clinical knowledge but deep empathy and understanding to the work I do. I’m passionate about helping people break free from painful cycles, reconnect with their strengths, and move forward with greater clarity and self-compassion. Whether you're just starting to explore change or returning to this work after setbacks, I offer a supportive, judgment-free space to help you heal and grow at your own pace.

Hi there, I'm Andrea. Are you feeling overwhelmed with life? Does the never-ending ticker tape of to-do's running through your head leave you feeling physically exhausted and emotionally depleted? Do you feel pulled in a million directions, unable to fit it all in? Are you struggling to keep up with your relationships, work and health? Is it hard to be kind to yourself? Are you struggling as a parent, trying to get it all right but not sure what to do? I help people just like you manage anxiety and avoid burnout. Together, we can identify what's not working and get you back to balance. We'll use a whole self approach, addressing the needs of your mind, body and spirit. Whether you're dealing with overwhelm, relationship issues, parenting struggles, challenging symptoms of ADHD, or cycles of anxiety and depression, I'm here to help. Seeking therapy can feel scary but you're making the right choice. You deserve a safe space to heal and grow. In our sessions together, I'll meet you with compassion and evidence-based techniques so you can overcome the hangups and habits holding you back. Let's work together!

Hello! My name is Ms. Tammy Carson and I am a board-certified Psychotherapist. I am originally from Boston Massachusetts. In my younger years I traveled and worked in many states in a corporate yet still helping role as a business analyst and functioned as a project manager too in South Africa Johannesburg. I am licensed in the state of Massachusetts and Florida. I attended a Christian college for my undergraduate degree at Eastern Nazarene a college affiliated through the church of the Nazarene. The social work department at the college mirrored and was taught social work through a Christian perspective and philosophies taken from the stories of the bible. I completed my graduate degree at Simmons School of Social Work in Boston Massachusetts, getting an MSW, and an Urban Leadership certificate. I have been licensed and doing psychotherapy since 2013. My last job before doing psychotherapy full time was working in an emergency room alongside psychiatric residents doing crisis evaluations, advocating for all populations to get them the proper level of care needed. I like to think in psychotherapy session’s that, “I meet people where they are at in life”, and take it from there. I am an empath and proud of it. I genuinely like helping people understand, identify and better manage their daily lives and relationships. I enjoy helping people to take control and get the best out of life for themselves.

I'm Stephanie, an LICSW with 20 years of post Master's experience with all populations! I am a licensed School Adjustment Counselor for all levels as well. I have worked with children and adults, in medical, school, home and crisis settings. I thrive on helping clients to address their own challenges head on and find sustainable solutions! We all need a little help sometimes so let's work together to figure out how to move you toward the life you want to live.

Hello, my name is Nichole Gardner and I am a LCSW in NYS. As a social worker, my main priority is to work collaboratively with my clients to overcome the different challenges in their lives. I seek to empower all my clients, so they can implement positive and healthy change. For the past four years, I've worked as a psychiatric social worker at a mental health clinic. During this time, I've work with a wide range of populations addressing several different concerns. Some of these concerns addressing symptom management (wide range of diagnoses), implementation of healthy coping, relationship dynamics, finding life balance, and communication skills. One this past year, I've been dedicated to doing my part in assisting others manage the many of concerns of the COVID 19 pandemic. My social work values are integrated into every session, which will create a safe, open, nonjudgemental environment for each client. I believe deeply that mindfulness practice open our hearts, minds, and bodies and that use of cognitive behavioral techniques will build a clear understanding of who we are inside and out. I look forward to joining you on your journey to a happier and healthier you!

Hi this is Carol. I am a licensed independent clinical social worker in eight states. My career started in Pennsylvania where I attended Chestnut Hill College and received my Master's in Counseling Psychology, Marriage and Family Therapy Option. It continued in upstate Pennsylvania and New York where I attended SUNY University of Buffalo and received my Master of Social Work Degree. I capped those off with a Psy.D. from Cal Southern University, Magnum Cum Laude 2012. I hold an LCSW in PA, VA, NC, TX, and LI. I hold an LISW-CP in South Carolina, and LICSW in RI and MA. I facilitate stress reduction meditations once weekly on an internet platform for Mindful Leaders. I am a certified AADC in South Carolina. I am trained in EMDR methods including their substance and pain control protocols. All licensures and certifications are current.

Hello! I'm a Licensed Clinical Social Worker (LICSW) in Massachusetts. I have been in the field for over 20 years, supporting people of all ages. I enjoy helping people to work on themselves to live a fulfilling life, and be prepared to deal with challenges as they arise. Working together with clients as they improve their quality of life is extremely rewarding.

I was born and raised in Puerto Rico and 20 years ago I moved to Florida where I currently reside. I graduated in 2005 from Florida International University with a Masters in Mental Health Counseling. At the present time, I hold 8 state licenses that allows me to to provide Tele-health counseling in other states besides Florida; Texas, South Carolina, Georgia, Arizona, Missouri, Utah and Michigan. I am also bilingual (English and Spanish) and I have more than 10 years of experience in the mental health and social services arena.

Hi there I am a Licensed Clinical Social Worker (LICSW) practicing in the field for past 14 years. I believe in providing care with respect, compassion, sensitivity and in a non judgmental way. Life is full of challenges however, in my experience I have realized that most of my clients are equally resourceful. Time and time again I have observed that my clients often resolve their issues with guidance and support. Many of my clients have said that they feel heard and not judged for the decisions they make day in and day out, I believe this is my strength. I meet my clients where they are at and try to understand what they are dealing with. I take the time to understand your struggles and craft a treatment plan based on your abilities and strengths. If you are ready to usher in the change in your life, I am here to help. To book an appointment please reach out to my intake team at +1 (786) 755-1863 OR reception+Charuta8742@growtherapy.com

Hi! I am a Licensed Clinical Social Worker in MA and NH . I have a master's degree from Boston University and have been working in the mental health field for 17 years. I have experience working in Homelessness/Transitional housing for Women and the unification of their children, Partial and Inpatient Psychiatric Hospitalization (individual and group therapy and case management ), Crisis Intervention, Palliative and Hospice Care, and providing individual and couples counseling with a virtual behavioral health organization as well as in private practice.

My name is Amanda, and I am a Licensed Clinical Social Worker licensed in Florida and Nevada. I graduated from the University of South Florida with a Bachelor of Arts in Psychology, with a concentration in Criminology. I completed my Masters in Social Work from the University of Central Florida. My training includes various modalities, but my approach is often person-centered, strength-based, and solution-focused. I am always seeking to learn more in all areas, in effort to provide the best support that I can to the individuals that I work with.

Espanol: Tómate un momento para reconocer que has dado el primer paso para volver a ti y trabajar en tu bienestar. Tomar la decisión de buscar ayuda es un acto de mucha valentia. A veces preferimos quedarnos en nuestra zona de comfort por temor a enfrentar aquello que nos esta afectando. Trabajar en nosotros es el acto de amor propio más importante que podemos hacer. Asi que te invito a que tomes este momento y te valides ya que has superado el primer obstáculo. Espero que podamos conectarnos pronto y que me permitas ir de tu lado en este viaje hacia la sanación interior y bienestar emocional. Eres importante y eres valioso, no lo olvides ;) English: Take a moment to acknowledge that you've taken the first step to come back to yourself and work on your well-being. Making the decision to seek help is an act of great courage. Sometimes we prefer to stay in our comfort zone for fear of facing what is affecting us. Working on ourselves is the most important act of self-love we can do. So I invite you to take this moment and validate yourself since you have overcome the first obstacle. I hope we can connect soon and that you will allow me to go on your side on this journey towards inner healing and emotional well-being. You're important and you're valuable, don't forget it ;)

Hi, I'm Paula, I'm an L.M.H.C. in MA, I've been in the field for 3 decades. I enjoy a reputation for making people feel comfortable in session and working effectively with them to resolve their presenting problems. I work with teens as well as adults to resolve issues from the past so people can enjoy life and meet their fullest potential.

Hi! I am a Licensed Independent Clinical Social Worker (LICSW) based in Massachusetts. I received my MSW from Boston College, and has 8 years of experience working in the mental health and substance use field. I help adults who struggle with fear, self-control, and substance use disorders to challenge their fears, manage their lives, and improve their mental well being.

I am a 44 year old black male certified as an LICSW in Massachusetts. I grew up in Fall River, MA, served in the Air Force, and earned a Master's Degree from Boston University. I have experience working with people of all age ranges, with focuses on anxiety, depression, conflict resolution, existentialism, and trauma. I primarily utilize Cognitive Behavioral and Dialectical Behavioral as therapeutic approaches, along with supportive counseling and family approaches.

Hello! I am a licensed independent clinical social worker. I received my Masters from the University of Denver and have been a therapist for six years. I use a compassionate and mindful approach to support clients in meaningfully processing past stressors and traumas and coping with significant life transitions. Creating authentic meaning and joy from my life experiences, even the traumatic ones, has been a source of abundance to me. I’m passionate about continuing to better myself, my practice, and the lives of the people I work with.

I’m a licensed therapist with over a decade of experience, specializing in anxiety, depression, and life transitions. I offer a supportive, non-judgmental space where clients can openly explore their challenges and work towards meaningful personal growth. My goal is to assist you in navigating life changes, overcoming obstacles, and achieving a more fulfilling and happier life. I am dedicated to providing compassionate and understanding support throughout your therapeutic journey.

I am a licensed clinical social worker, advocate, mother, runner, and yoga enthusiast. I believe that everyone would benefit from talk therapy because life is challenging, complicated, and busy. I fully understand that getting ourselves to therapy is, at times, not easy and sincerely appreciate every client that intentionally decides that they are ready to grow, heal, and evolve. I believe in the power of becoming comfortable with being uncomfortable so as to push ourselves to step outside of our comfort zones.

I am a Licensed Clinical Social Worker practicing in the state of NC, SC, GA, CT, MA and IN. I am the sole therapist of Empathic Hues Counseling and Consultation, PLLC. My practice was created to help adults dealing with depression, anxiety and needing guidance with adjusting to to a change in quality of life. I hope to help individuals find peace needed to have more control over their lives and confidently overcome challenges. My goal is to help you understand “you” as well as focus on developing your internal and external strengths.

I have worked in a variety of different roles over the years which include individual and family counselling, being a member of a mobile crisis intervention team, working in a hospital setting in the maternity unit, pediatric unit, and on site outpatient health clinic. I most recently was working in an all male correctional facility offering support to both the inmate's and their families. I consider myself to be a generalist and have supported people of all ages with a wide variety of situations.

I have been most fortunate to have worked in the field of psychology, human services and higher education for four decades. Initially, I worked in a college counseling center while maintaining a private practice. Later, I became a professor and chairperson of the human services department while continuing to see clients privately. Through these years, I was able to balance teaching students about psychological principles and techniques while practicing therapy. I have developed programs and courses in Substance Abuse Counseling, Health Psychology and Positive Psychology and have been able to use these methods in counseling. I have learned much over the years sitting and listening deeply and unconditionally to those in therapy. I can offer a safe and open place to explore personal issues, helping to uncover sources of conflict, find clarity, a sense of purpose and meaning, as well as discover individual talents and strengths. I use psychodynamic, humanistic, existential, and mindfulness practices. Personally, I have survived serious illness and assisted and supported family members with very serious illnesses and believe I can help others in similar situations. I take the motto ‘that which does not kill me, makes me stronger’ into my sessions as a a guiding principle. As a lifelong learner I have also moved from focusing on psychopathology to a strengths-based model, specifically positive psychology, highlighting one’s strengths and talents and striving towards meaning and purpose more that the condition or diagnosis of an individual.

I am a Licensed Clinical Social Worker with more than 15 years of clinical experience in mental health services. I currently have active licenses from Florida and Massachusetts States. The approach I use in sessions of Telehealth psychotherapy is eclectic, including cognitive behavioral system, solution focused, relational approach with a strength base foundation. My areas of clinical work are adolescents and adults, who are experiencing depression, anxiety, trauma related symptoms and struggles with life transitions including but not limited to divorce, retirement, parenting children with special needs, grief and loss, non-binary gender clients, complex medical conditions and women issues. Tengo mas de 15 annos de experiencia clinica con servicios de salud mental y un diploma de maestria en trabajo social con licencia profesional de sico- terapeuta en los estados de Florida y Massachusetts. El enfoque que uso en las sesiones es una combinacion de terapia cognitiva, enfoques de solucion, relaciones con bases de fortalezas y habilidades de cada persona. Mis areas de solida experincia clinica son atender a adolescentes y adultos que sufren cuadros de depresion, ansiedad, sintomas de trauma y desafios emocionals que se viven en distintas etapas dela vida; salud emocional de la mujer, divorcio, jubilarse, criar hijos con necesidades especiales, duelos, comunidad LGBT, problemas de salud cronicos .

Hello, I’m Crystal, a Licensed Clinical Social Worker (LCSW) with over 12 years of experience in the mental health field. I hold a Master’s degree in Social Work from the University of Georgia. I specialize in Cognitive Behavioral Therapy (CBT) and Mindfulness Therapy. My professional focus is on supporting women, teenagers, and young adults as they navigate life’s complexities. With a deep rooted passion for understanding the intricacies of the human mind, I am committed to walking alongside you on your journey toward healing and personal growth.

Hi! I am a LICSW in the state of Massachusetts that has been practicing in psychiatric social work for over 30 years. I have worked in both inpatient and outpatient settings providing consultation, assessment and ultimately treatment that is short term and specific to my client's needs. I am passionate about educating others and removing the stigma of mental health issues.

I have over 30 years of clinical management , regulatory compliance, and consulting experience in behavioral healthcare systems both public and private. Former owner/operator of Community Health Center .I also have a deep knowledge of clinical program development including policies and procedures, staff training, and agency operations. I'm an expert in Florida Medicaid, Medicare and other state and federal regulatory compliance requirements . However, my real passion is working directly with clients offering support and having a first hand view of their personal growth. I speak Spanish and Greek .

In today's world, mental health support is needed more than ever. Mental health IS health. It's time to end the stigma and realize it's okay to not be okay. Finding a therapist can be a daunting process but congratulations on taking the first step! As a therapist, I am to foster an environment that is warm, collaborative, supportive, and nonjudgmental. Born and raised in Massachusetts, I earned my Masters in Social Work from Boston College after receiving my Bachelors of Arts degree in history. In addition to Massachusetts, I am also licensed in the states of Connecticut, Maine, Vermont, New Hampshire, and Illinois. Over the course of my career, I have had the privilege to work with a vast array of individuals from all walks of life including children and adolescents, adults, seniors, and members of the LGBTQIA+ community. As a telehealth provider, I only treat adults over the age of 22.

Hello, I am Daphne Jakstis. I have been a licensed therapist for over 23 years. I keep up to date with the latest advances in evidence-based therapy practices and incorporate them into my work with clients. Evidence-based practices are skills and techniques that have been proven to be effective. I also believe that healing is a holistic approach so I combine evidence-based practices with complementary approaches to promote overall healing and wellness. I realize that no two people are the same, so I tailor my approaches to best fit the specific needs of my clients. Whether you are struggling with anxiety, depression, trauma, or any other issue, I will help you fully realize your strengths and provide you with skills to help you manage challenges in healthier ways.

Sherry Miller, M.S., LPC (OK, TX,WI), LCPC, (IL), LMHC (FL, MA), CSADC (IL), CSAC (WI), LADC (OK), M-CAP (FL), ICS (WI), BC-TMH. Hi there. My name is Sherry Miller. I have a Master of Science in Human Service Community Counseling from National Louis University at Chicago, IL. I pride myself in strict confidentiality; with a unique insight into my consumers. Because I have been in a program of Recovery from Alcohol, Drugs, and Codependency for the past 28 plus years I knows firsthand what it takes to find the truth of oneself and want assist you with your own unique and personal journey of self-awareness. I am dually licensed to treat mental health and substance abuse concerns. I am also licensed as an Independent Clinical Supervisor in the field of Addictions. My clinical interests include family dysfunction, addiction treatment, co-dependency, domestic violence, sexual abuse, and family, individual, or group counseling. I have over 28 years’ experience in the treatment of anger, anxiety, depression, grief and loss, behavioral issues, parent education, fearfulness, addiction issues, and co-occurring disorders. I am board certified to do telehealth (counseling over the internet) for clients that cannot make it to the office for their counseling appointment or prefer the comfort of having their counseling session in the privacy of their own home. I am experienced working with all ages, genders, and the LGBTQ community. In addition, I have experience working on a college campus with college age persons. In my free time you will find me spending time with my cats, and dogs, riding my horses, riding my bike or working out at the gym.

Michael J. di Salvo, (He/Him/His), Psychotherapist, LICSW, LCSW-IC, LCSW-QS, C-DBT, CTTP, C-GIP, CCATP, EMDR, is a Nationally Board Certified Licensed Clinical Independent Social Worker with over thirty-year's experience. He is licensed and certified in multiple states and works with adults (18 Years +). He has several specialty care areas in mental health therapy, including but not limited to Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Dialectical Behavioral Therapy, Person-Centered, Trauma-Focused, Grief and Loss Therapy, Psychodynamic Therapy, Positive Psychology and EMDR. He works with various Life Transitions, Coming-Out, Sexual Orientation, Gender Issues, Transitioning, Men's Issues, Mood Disorders, Anxiety, Depression, Geriatrics, LGBTQ+, Bias, Race, Ethnicity, Discrimination, Trauma, Career, Vets/Emergency Responders and Co-Occurring Disorders. Mr. di Salvo works with many diverse populations and works with persons who have experienced trauma, discrimination, racism, defamation, prejudice, hate and bias in any form. He is also a long-time advocate and mental health treatment provider for persons within the LGBTQ+ Community and many other minority populations. Mr. di Salvo provides a safe, supportive, welcoming, affirming, and nonjudgmental space for all people. If you have any questions, please schedule a "FREE" 15-minute virtual consultation today! If you do not see an available slot, please contact customer care with your availability so that we may accommodate your needs. *Virtual Sessions are available to all patients at this time in the following states: DE, FL, GA, MA, MD, NJ, NY, NV, PA, SC, VA, & WA. Mr. di Salvo graduated with honors. He obtained his undergraduate and post-graduate studies, research and internships through The Catholic University of America in Washington, D.C.

Welcome! My name is Twana Curry. I am an LCSW in multiple states with over 20+ years experience. I'm glad you are here, this is the first step in a journey. Do you ever feel like something is missing. Are you looking to go deeper in your journey, wanting to find the calm and balance with your past, present and future? This is when we seek guidance, we may be experiencing chronic stress, pain, depression, anxiety, grief, or as of late feeling like this world is not something we recognize any longer. I believe we feel our best when we have balance in all aspects of our lives, When this balance is skewed we feel drained, fatigued and easily overwhelmed. My commitment to my clients is to walk beside you in your journey, finding your life balance. I have experience working with depression, anxiety, chronic pain, ADHD, trauma, multiple medical issues, chronic pain, and those that are struggling with everyday living, addressing the needs of your mind, body and spirit. I work with individuals, couples, and families. I specialize in Trauma, from bullying to combat PTSD, anxiety and depression. Issues that manifest when we don't process the emotional and physical pain we experience. I also work with couples who have experienced infidelity, sexual issues, infertility, or those that are going through divorce or loss of their relationship. I come from a holistic patient-centered approach, we work together on a multidimensional plan, using various therapeutic techniques such as CBT, DBT, EFT-Tapping and guided trauma work in books like " Safely Embodied", " Your a Bad Ass, and Codependency No More. I use many different techniques. I incorporate multiple approaches holistic medical and nutritional treatments. I stress to use each session as a springboard to process the new skills we discuss.

Greetings! Are you feeling overwhelmed by day- to day issues? Are you struggling in your relationships, or having difficulties communicating with others? Do you just need a safe space to vent? These are all normal daily occurrences. This may be where you'll begin in therapy. However, the goal is to increase coping skills and decrease adverse symptoms as time progresses. My goal is to connect with you and truly understand your needs and goals. Expect an environment free of judgment where you can speak freely and show up as your authentic self. My approach is person-centered while utilizing appropriate evidence-based methods such as Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, and Motivational Interviewing. I help support young adults, individuals, and couples that may be dealing with a range of challenges in their lives related to trauma, anxiety, and depression. Let's work together to identify solutions that can improve functioning and increase life satisfaction.

I am a therapist who has a passion for helping others break free from burdens. I believe our deepest secrets can be blockages to moving forward in life. My mission with every client is to create a space where they feel safe to be authentic, while learning ways to regain control of their lives. I am honored to support you in this journey you are getting ready to embark on and I am rooting for your success in the healing process. I am sending you well wishes and a safe space to chat.

If you are reading this, you are taking the hardest step: Looking for the right therapist. A little about me: I am a Licensed Mental Health Counselor who has been practicing as a Clinician for 10 years. I received my Masters degree in Mental Health Counseling from Springfield College in Boston. Prior to this, I "temporarily" moved to Quincy, Massachusetts from a suburb outside of Philadelphia after my Father was diagnosed with pancreatic cancer that metastasized to his liver. I loved the city of Boston so much, I never went back. In 10 years, I have worked inpatient, outpatient, PHP, long term residential, you name it.

As a licensed Marriage and Family Therapist, I provide a supportive, confidential, and non-judgmental environment where individuals can resolve challenges and gain deeper insight into their thoughts, feelings, and experiences. My client-centered, collaborative approach is tailored to each person's unique needs, helping them engage in self-reflection, stay present, and move toward positive change. Taking the first step is often the hardest, but choosing yourself and striving for a healthier mindset is a rewarding journey.

I believe that every person on this earth has the ability and the right to find peace and happiness in their lives. As a therapist for 17 years, I have helped many individuals find that so that they are able to live a happy, peaceful life. I use a very holistic approach to therapy treating each client as a whole not just the psychological issues.

Are you in a situation where friends and family are not enough help right now? There are times when almost everyone needs to talk to an objective person. If this is your first time in counseling finding out a little about about your counselor is just one of the steps you have to take. Another is understanding what counseling/therapy is. It's a confidential meeting with an objective professional trained to sort things out and identify if you are at risk of harming yourself because life is too painful to bear. Suppose you are dealing with an unbearable situation such as being threatened of losing a job, a death in the family, a serious illness of your own, ongoing disability or addiction, a relationship going sour or breakup, loss of any kind, depression, and anxiety, I can help you get back on track. The reason is , I have lived a bit. I know life has its ups and downs. I was a New Yorker. Ifinally settled down in Massachusetts. Then I had a family later than most. Although I did work in human services with my bachelor's degree, I went back to school as an adult with a young child. I am so grateful to be this educated to help my clients. I ran an outpatient early recovery program, an inpatient program for long-term alcoholics, individual sessions at an outpatient community mental health clinic, and of course my private practice. This is who I am. I will be pleased to be your guide on your journey to a happier healthier life. ,

Experienced Clinical Social Worker Licensed in MA, Florida, or New Hampshire. In-person available in Boston area for cash pay @ $250/session. Masters in Human Development and Psychology from Harvard. Trained Executive Functioning Coach. Masters of Business Administration. Customized patient centered treatment and capacity building. Increase self-esteem, manifest goals and improve boundaries with care. I have great respect for self-compassion and gratitude. I offer evidence-based tools to increase freedom and reduce suffering.

Dr. Ayers has her Master's in Social Work from Fordham University, her MS in Pastoral Counseling from Loyola University in Maryland, and her PhD in Counselor Education and Supervision from Neumann University. Dr. Ayers is currently completing a second doctorate, a Doctor of Psychology (Psy.D.). Dr. Ayers utilizes an eclectic approach to her work, including Cognitive Behavioral, Existential - Meaning Centered, Solution Focused, Humanistic and Mindfulness based therapies. Dr. Ayers is a Licensed Clinical Social Worker and a Certified Clinical Trauma Professional and Complex Trauma Certified Professional (CCTPII). Dr. Ayers holds multiple certifications in trauma as well as the integration of mental health and spirituality. Throughout her career, she has worked in the medical field and in both community and private sectors. Dr. Ayers is affiliated with the American Red Cross as a Disaster Mental Health Manager and Instructor and has traveled throughout the United States assisting survivors of natural and human caused disasters, with a specialization in management/leadership roles in mass casualties.