Art Therapy in Nashville, TN

Photo of Deborah E Doineau, EdD, Psychologist
Deborah E Doineau
Psychologist, EdD
Verified Verified
Nashville, TN 37212
With younger children, I use play and art therapy and behavior modification for behavior disorders.
My clientele consists of children, adolescents, and adults. I use a variety of approaches in working with my clients in an attempt to find the most efficacious approach to meet the particular client's needs. As a psychologist, I also perform psychological evaluations for diagnostic purposes. For example, I evaluate cognitive ability, learning disorders, ADHD, autism spectrum disorders, and many other issues. Finding oneself can be a daunting task in our complex society. I aspire to help my clients achieve self understanding, a sense of efficacy, and develop tools to assist them in navigating life's challenges on their own.
With younger children, I use play and art therapy and behavior modification for behavior disorders.
My clientele consists of children, adolescents, and adults. I use a variety of approaches in working with my clients in an attempt to find the most efficacious approach to meet the particular client's needs. As a psychologist, I also perform psychological evaluations for diagnostic purposes. For example, I evaluate cognitive ability, learning disorders, ADHD, autism spectrum disorders, and many other issues. Finding oneself can be a daunting task in our complex society. I aspire to help my clients achieve self understanding, a sense of efficacy, and develop tools to assist them in navigating life's challenges on their own.
(615) 745-1058 View (615) 745-1058
Photo of Samantha Hymes, LPCMHSP, ATR, Licensed Professional Counselor
Samantha Hymes
Licensed Professional Counselor, LPCMHSP, ATR
Verified Verified
2 Endorsed
Nashville, TN 37206
As a registered art therapist, I am trained to safely incorporate art making into our work together, as the need or interest arises.
Do you find yourself ruminating over the past and feeling embarrassed, anxious, or depressed for “not being over it"? Perhaps you learned to compartmentalize your emotions to cope. I work with my clients to hone their emotional awareness and create space to meet, understand, and process parts of their lives that have been put aside to survive.
As a registered art therapist, I am trained to safely incorporate art making into our work together, as the need or interest arises.
Do you find yourself ruminating over the past and feeling embarrassed, anxious, or depressed for “not being over it"? Perhaps you learned to compartmentalize your emotions to cope. I work with my clients to hone their emotional awareness and create space to meet, understand, and process parts of their lives that have been put aside to survive.
(615) 258-6249 View (615) 258-6249
Photo of Carolyn Kutsko, PhD, LMFT, Marriage & Family Therapist
Carolyn Kutsko
Marriage & Family Therapist, PhD, LMFT
Verified Verified
2 Endorsed
Nashville, TN 37204
I am a Holistic Therapist meaning I treat mental health through the lens of the whole person: emotional, relational, physical, and spiritual. I offer experiences treating depression, trauma, anxiety, eating disorders and other mental health issues aiming to bring clients into their bodies and out of the mode of traditional talk therapy. These include psychodrama, sand tray, art, and yoga therapy. Wounding happens through living, relational, body-felt experiences and require similar experiences to heal. I create a safe container and relationship for the natural process of healing to occur. Expect to move, breath, and feel... we will not just sit and talk.
I am a Holistic Therapist meaning I treat mental health through the lens of the whole person: emotional, relational, physical, and spiritual. I offer experiences treating depression, trauma, anxiety, eating disorders and other mental health issues aiming to bring clients into their bodies and out of the mode of traditional talk therapy. These include psychodrama, sand tray, art, and yoga therapy. Wounding happens through living, relational, body-felt experiences and require similar experiences to heal. I create a safe container and relationship for the natural process of healing to occur. Expect to move, breath, and feel... we will not just sit and talk.
(615) 800-7078 View (615) 800-7078
Photo of Payton Lindner, MMFT
Payton Lindner
MMFT
Verified Verified
4 Endorsed
Nashville, TN 37204
Yo! I’m Payton, I’m an openly queer + nonbinary human and my pronoun are they/she! I think that humans are the coolest. My philosophy as an Identity Doula + Healing Practitioner takes into consideration that every human and every situation is different, thus unique tools and approaches are required for unique people and things. Sessions with me will go beyond standard talk therapy, as it is my personal and professional opinion that humans often heal with art, movement, visuals, embodiment, activities, and music better than they do with standard talk therapy alone. (Try to think of this as fun and exciting, not scary or awkward!)
Yo! I’m Payton, I’m an openly queer + nonbinary human and my pronoun are they/she! I think that humans are the coolest. My philosophy as an Identity Doula + Healing Practitioner takes into consideration that every human and every situation is different, thus unique tools and approaches are required for unique people and things. Sessions with me will go beyond standard talk therapy, as it is my personal and professional opinion that humans often heal with art, movement, visuals, embodiment, activities, and music better than they do with standard talk therapy alone. (Try to think of this as fun and exciting, not scary or awkward!)
(629) 230-3151 View (629) 230-3151
Photo of Anne McKenzie McEntire, LCSW, Clinical Social Work/Therapist
Anne McKenzie McEntire
Clinical Social Work/Therapist, LCSW
Verified Verified
Nashville, TN 37216
I use a variety of therapeutic models including CBT, DBT, and experiential art making to help you achieve your goals.
I love to work with clients who struggle with anxiety, depression, work life balance, codependency, and phase of life stressors. I especially enjoy working with clients who identify as high achieving, perfectionistic, creatives and professionals. I want to help clients identify their needs and start achieving their goals. I believe in therapy, and its benefits. Let's get you feeling better and living well!
I use a variety of therapeutic models including CBT, DBT, and experiential art making to help you achieve your goals.
I love to work with clients who struggle with anxiety, depression, work life balance, codependency, and phase of life stressors. I especially enjoy working with clients who identify as high achieving, perfectionistic, creatives and professionals. I want to help clients identify their needs and start achieving their goals. I believe in therapy, and its benefits. Let's get you feeling better and living well!
(615) 903-0148 View (615) 903-0148
Photo of Ashley Elaine Dantzler, MA, LPC, MHSP, Licensed Professional Counselor
Ashley Elaine Dantzler
Licensed Professional Counselor, MA, LPC, MHSP
Verified Verified
3 Endorsed
Nashville, TN 37203
Waitlist for new clients
Through mindfulness, thought and behavior modification, art, play, and more, I work with my clients to help them create growth.
The world we live in is full of opportunities to disconnect, avoid emotions, and escape reality. I believe that healing is often found through connection to people around us, connection to nature, and the ability to sit with both comfortable and uncomfortable emotions. In therapy, I work to create an authentic, non- judgmental, welcoming, and trustworthy environment through which healing and growth may occur. I believe that the therapeutic relationship is crucial to the success of counseling, and place great importance on it.
Through mindfulness, thought and behavior modification, art, play, and more, I work with my clients to help them create growth.
The world we live in is full of opportunities to disconnect, avoid emotions, and escape reality. I believe that healing is often found through connection to people around us, connection to nature, and the ability to sit with both comfortable and uncomfortable emotions. In therapy, I work to create an authentic, non- judgmental, welcoming, and trustworthy environment through which healing and growth may occur. I believe that the therapeutic relationship is crucial to the success of counseling, and place great importance on it.
(615) 471-7165 View (615) 471-7165
Photo of Karissa Melchior, LPCMHSP, ATR-BC, Licensed Professional Counselor
Karissa Melchior
Licensed Professional Counselor, LPCMHSP, ATR-BC
Verified Verified
1 Endorsed
Nashville, TN 37216
I use a holistic approach that incorporates mindfulness, art and self-expression into my practice.
What's standing in the way of you finding your best path? I believe you have everything you need to reach your full potential, sometimes it’s just hard knowing where to start. Let me help you sort though everything and get back on track. People seek counseling for a variety of reasons. Whatever the reason that brings you through the door, I commit to walking with you throughout the healing process to achieve inner growth and peace. I believe that therapy should be individualized for each client. After an initial intake appointment, counseling services will be formulated to meet your specific needs.
I use a holistic approach that incorporates mindfulness, art and self-expression into my practice.
What's standing in the way of you finding your best path? I believe you have everything you need to reach your full potential, sometimes it’s just hard knowing where to start. Let me help you sort though everything and get back on track. People seek counseling for a variety of reasons. Whatever the reason that brings you through the door, I commit to walking with you throughout the healing process to achieve inner growth and peace. I believe that therapy should be individualized for each client. After an initial intake appointment, counseling services will be formulated to meet your specific needs.
(615) 258-6425 View (615) 258-6425
Photo of Meg Bearman, LPC, MHSP, ATR-P, Licensed Professional Counselor
Meg Bearman
Licensed Professional Counselor, LPC, MHSP, ATR-P
Verified Verified
6 Endorsed
Nashville, TN 37206
I offer Art Therapy and Brainspotting as two forms of dynamic trauma treatment beyond typical talk-therapy.
I have over a decade of experience specifically treating trauma, anxiety, depression, grief, life-transitions, and communication/relationship support. I offer weekly psychotherapy to clients using a strengths-based, integrative, and psychodynamic approach to help increase self-insight, self-esteem, and seIf-compassion. I view each client as a unique and individual being, and we work together to figure out your best course of treatment and healing. My goal is to help you live your most fulfilled life, all while being your most authentic self- my goal is for you is to thrive.
I offer Art Therapy and Brainspotting as two forms of dynamic trauma treatment beyond typical talk-therapy.
I have over a decade of experience specifically treating trauma, anxiety, depression, grief, life-transitions, and communication/relationship support. I offer weekly psychotherapy to clients using a strengths-based, integrative, and psychodynamic approach to help increase self-insight, self-esteem, and seIf-compassion. I view each client as a unique and individual being, and we work together to figure out your best course of treatment and healing. My goal is to help you live your most fulfilled life, all while being your most authentic self- my goal is for you is to thrive.
(615) 645-2803 View (615) 645-2803
Photo of Kevana S West, r-DMT, Pre-Licensed Professional
Kevana S West
Pre-Licensed Professional, r-DMT
Verified Verified
1 Endorsed
Nashville, TN 37207  (Online Only)
My work focuses on coping through creativity and the healing power of art making.
Our collective struggle is that we have inherited a world of imbalance and as such, imbalance lives within each of us. It is my belief that healing is done in community, and that true change can only occur in the space between individuals. Together, we will work to find equilibrium and healing amongst the madness. It is my goal to help clients develop and hone the best version of themselves according to their own vision. Through the integration of movement and the expressive arts, I seek to assist clients in rewriting their narratives in a way that embodies dignity and strength.
My work focuses on coping through creativity and the healing power of art making.
Our collective struggle is that we have inherited a world of imbalance and as such, imbalance lives within each of us. It is my belief that healing is done in community, and that true change can only occur in the space between individuals. Together, we will work to find equilibrium and healing amongst the madness. It is my goal to help clients develop and hone the best version of themselves according to their own vision. Through the integration of movement and the expressive arts, I seek to assist clients in rewriting their narratives in a way that embodies dignity and strength.
(615) 205-4386 View (615) 205-4386
Photo of Catherine Harris, MA, ATR-BC, RYT 200, Art Therapist
Catherine Harris
Art Therapist, MA, ATR-BC, RYT 200
Verified Verified
4 Endorsed
Nashville, TN 37206
I'm Catherine, Art Therapist with HeartSpace Wellness Studio.
Offering sessions in Art Therapy to support chronic illness, grief and loss, and burnout. Throughout our lives, loss can show up in many forms: the loss of a job, the loss of a relationship, the loss of health, the loss of fertility, and of course the loss of life. All of these experiences can have the same intense effects as the death of a loved one. They can leave us feeling shattered, lost, and alone. Our modern-day way of life does not provide us with the rituals or guides we need to properly care for ourselves, find relief and support, and effectively grieve these losses when they occur. I understand, and I’m here to help.
I'm Catherine, Art Therapist with HeartSpace Wellness Studio.
Offering sessions in Art Therapy to support chronic illness, grief and loss, and burnout. Throughout our lives, loss can show up in many forms: the loss of a job, the loss of a relationship, the loss of health, the loss of fertility, and of course the loss of life. All of these experiences can have the same intense effects as the death of a loved one. They can leave us feeling shattered, lost, and alone. Our modern-day way of life does not provide us with the rituals or guides we need to properly care for ourselves, find relief and support, and effectively grieve these losses when they occur. I understand, and I’m here to help.
(615) 265-6116 View (615) 265-6116
Photo of Amanda Marshall - Family Care Center, LCSW, Clinical Social Work/Therapist
Family Care Center
Clinical Social Work/Therapist, LCSW
Verified Verified
Nashville, TN 37209
I use a variety of approaches including mindfulness, CBT, play therapy, ARC, TBRI, narrative, and expressive and art interventions.
I specialize in trauma, attachment losses such as foster care and adoption, and working with children and preteens. I also enjoy working with people of all ages to address anxiety, depression, grief, trauma, self-image, and family changes.
I use a variety of approaches including mindfulness, CBT, play therapy, ARC, TBRI, narrative, and expressive and art interventions.
I specialize in trauma, attachment losses such as foster care and adoption, and working with children and preteens. I also enjoy working with people of all ages to address anxiety, depression, grief, trauma, self-image, and family changes.
(629) 276-6100 View (629) 276-6100
Photo of Hannah Reed, LPC, Licensed Professional Counselor
Hannah Reed
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Nashville, TN 37203
I use a variety of experiential therapeutic modalities such as EMDR, psychodrama, internal family systems (IFS), writing, and art, and I lead with creativity, curiosity, and an open heart.
There's nothing more gratifying to me than witnessing people courageously say the things they thought they couldn't say, do the things they thought they couldn't do, and move through feelings they thought would surely take them under. All of which leads to the life experience they have been yearning for. Shame, addiction, anxiety, trauma, grief, disordered eating, depression, etc. are all factors that impact a person's ability to move forward, and many who struggle may even feel a sense of hopelessness after having tried countless methods to get "unstuck." With the right help and tools, life can and does get better.
I use a variety of experiential therapeutic modalities such as EMDR, psychodrama, internal family systems (IFS), writing, and art, and I lead with creativity, curiosity, and an open heart.
There's nothing more gratifying to me than witnessing people courageously say the things they thought they couldn't say, do the things they thought they couldn't do, and move through feelings they thought would surely take them under. All of which leads to the life experience they have been yearning for. Shame, addiction, anxiety, trauma, grief, disordered eating, depression, etc. are all factors that impact a person's ability to move forward, and many who struggle may even feel a sense of hopelessness after having tried countless methods to get "unstuck." With the right help and tools, life can and does get better.
(629) 260-4832 View (629) 260-4832
Photo of Kara Cross, LPCMHSP, ATR, Licensed Professional Counselor
Kara Cross
Licensed Professional Counselor, LPCMHSP, ATR
Verified Verified
1 Endorsed
Nashville, TN 37212
I am a licensed psychotherapist, registered art therapist, artist, former art teacher, and of course, I love using art in my sessions. I can provide a safe, non judgemental space for you to work through whatever life issues you are processing. I believe in empowering my clients to find their voice and foster the potential they already have through realizing self worth, building confidence, and embracing our whole selves. I am excited to hear from you.
I am a licensed psychotherapist, registered art therapist, artist, former art teacher, and of course, I love using art in my sessions. I can provide a safe, non judgemental space for you to work through whatever life issues you are processing. I believe in empowering my clients to find their voice and foster the potential they already have through realizing self worth, building confidence, and embracing our whole selves. I am excited to hear from you.
(615) 908-6681 View (615) 908-6681
Photo of Kaitlyn King, LMFT, ATR, Marriage & Family Therapist
Kaitlyn King
Marriage & Family Therapist, LMFT, ATR
Verified Verified
Nashville, TN 37205
I take a person-centered & strengths-based approach, integrating art therapy, mindfulness, narrative therapy, IFS, and EMDR.
We all experience some combination of painful experiences and traumas just by making our way through life, and these experiences can lead you to construct a story of yourself that is anything but empowering. My goal is to mirror your strengths and your worth back to you— to remind you of the truth, despite what your parents, partners, friends, church, and society have told you. Through a creative, holistic blend of art and talk therapy, I support my clients (individuals, families and couples) to integrate mind, body and spirit in service of deeper healing, connection, and personal + collective growth.
I take a person-centered & strengths-based approach, integrating art therapy, mindfulness, narrative therapy, IFS, and EMDR.
We all experience some combination of painful experiences and traumas just by making our way through life, and these experiences can lead you to construct a story of yourself that is anything but empowering. My goal is to mirror your strengths and your worth back to you— to remind you of the truth, despite what your parents, partners, friends, church, and society have told you. Through a creative, holistic blend of art and talk therapy, I support my clients (individuals, families and couples) to integrate mind, body and spirit in service of deeper healing, connection, and personal + collective growth.
(615) 205-7485 View (615) 205-7485
Photo of Eleanor Smith Estes, LPCMHSP, (T), NCC, MA CMHC, Pre-Licensed Professional
Eleanor Smith Estes
Pre-Licensed Professional, LPCMHSP, (T), NCC, MA CMHC
Verified Verified
6 Endorsed
Nashville, TN 37207
I love to incorporate art and mindfulness in my sessions when appropriate.
My passion in this work is to help those who struggle to find their voice and authentic self due to obstacles like trauma, anxiety, grief, OCD, low self-esteem, etc. These obstacles I named often become blinders and part of the identity as one encounters life transitions and forming relationships with others. My job is to sit with, listen to, and help guide him/her back to their true self where they can feel safe and at home.
I love to incorporate art and mindfulness in my sessions when appropriate.
My passion in this work is to help those who struggle to find their voice and authentic self due to obstacles like trauma, anxiety, grief, OCD, low self-esteem, etc. These obstacles I named often become blinders and part of the identity as one encounters life transitions and forming relationships with others. My job is to sit with, listen to, and help guide him/her back to their true self where they can feel safe and at home.
(615) 576-8962 View (615) 576-8962
Photo of Gillian Pulley - Undivided Whole, MA, ATR, Art Therapist
Undivided Whole
Art Therapist, MA, ATR
Verified Verified
1 Endorsed
Nashville, TN 37209  (Online Only)
Waitlist for new clients
Art is the foundation of my approach.
We become the most invested in the products of our own creation. Often the time and space to appreciate and enjoy what we created is overrun by tasks and attention needed for other details in order to generate or maintain ongoing success. The hustle to succeed frequently mirrors the anxiety of failure. How can achieving rest positively impact your business, as well as your personal relationships? Art is a great tool for mindfulness and self-awareness that enables you the choice to act instead of react to people and situations that exist in your daily life.
Art is the foundation of my approach.
We become the most invested in the products of our own creation. Often the time and space to appreciate and enjoy what we created is overrun by tasks and attention needed for other details in order to generate or maintain ongoing success. The hustle to succeed frequently mirrors the anxiety of failure. How can achieving rest positively impact your business, as well as your personal relationships? Art is a great tool for mindfulness and self-awareness that enables you the choice to act instead of react to people and situations that exist in your daily life.
(615) 455-3761 View (615) 455-3761
Photo of Rebecca Bailey, MA, LPC-MHS, Counselor
Rebecca Bailey
Counselor, MA, LPC-MHS
Verified Verified
2 Endorsed
Nashville, TN 37206
I am a friendly, empathetic, and encouraging mental health professional who utilizes many skills and techniques to help clients achieve their goals. My clients are individuals (13+) and couples who are healing from their past, desiring something different in their current situation, or planning their future full of possibilities. I utilize some of the most effective therapy methods used today, including Brainspotting, Cognitive-Behavioral Therapy, Acceptance and Commitment Therapy, Gottman Method Couples Therapy, and Art Therapy. I also have specialized training in Anxiety, ADHD, Trauma, and Addiction/Recovery disorders.
I am a friendly, empathetic, and encouraging mental health professional who utilizes many skills and techniques to help clients achieve their goals. My clients are individuals (13+) and couples who are healing from their past, desiring something different in their current situation, or planning their future full of possibilities. I utilize some of the most effective therapy methods used today, including Brainspotting, Cognitive-Behavioral Therapy, Acceptance and Commitment Therapy, Gottman Method Couples Therapy, and Art Therapy. I also have specialized training in Anxiety, ADHD, Trauma, and Addiction/Recovery disorders.
(615) 255-1289 x166 View (615) 255-1289 x166
Photo of Misha Laster, MS, NCC, Pre-Licensed Professional
Misha Laster
Pre-Licensed Professional, MS, NCC
Verified Verified
3 Endorsed
Nashville, TN 37221
Life can be difficult at times with so many life transitions and still having to complete everyday tasks without support and encouragement. You are not alone in feeling the weight of trying to carry it all while experiencing stress, anxiety, depression, and burnout. Most importantly losing who you are deep down. Therapy can serve as a safe space to begin exploring who you are and what your needs are through creative expressions such as art or music and utilizing evidence-based interventions to help relieve the weight of those everyday stressors.
Life can be difficult at times with so many life transitions and still having to complete everyday tasks without support and encouragement. You are not alone in feeling the weight of trying to carry it all while experiencing stress, anxiety, depression, and burnout. Most importantly losing who you are deep down. Therapy can serve as a safe space to begin exploring who you are and what your needs are through creative expressions such as art or music and utilizing evidence-based interventions to help relieve the weight of those everyday stressors.
(615) 560-7215 View (615) 560-7215
Photo of Beth Pamela Siller, LMFT, Marriage & Family Therapist
Beth Pamela Siller
Marriage & Family Therapist, LMFT
Verified Verified
Nashville, TN 37209
Through the creative mediums of drama, play, music and movement, story, and art, Drama Therapy can help them feel understood and foster their emotional and social well-being.
Arts and Hearts Therapy is a creative approach to your child's needs. Is your child currently struggling to manage their big feelings? Are they finding it overwhelming and challenging to navigate their relationships with family and friends, establish a positive self-image, or manage their academic responsibilities alongside extra-curricular activities? Would you like some guidance and support around boundary setting, positive discipline practices, and authentic communication with your child? I've worked with children in academic settings since 2006. Various components of Early Childhood Education play a big role in my practice.
Through the creative mediums of drama, play, music and movement, story, and art, Drama Therapy can help them feel understood and foster their emotional and social well-being.
Arts and Hearts Therapy is a creative approach to your child's needs. Is your child currently struggling to manage their big feelings? Are they finding it overwhelming and challenging to navigate their relationships with family and friends, establish a positive self-image, or manage their academic responsibilities alongside extra-curricular activities? Would you like some guidance and support around boundary setting, positive discipline practices, and authentic communication with your child? I've worked with children in academic settings since 2006. Various components of Early Childhood Education play a big role in my practice.
(561) 677-9632 View (561) 677-9632
Photo of Christa Riches, LPC, MHSP, Licensed Professional Counselor
Christa Riches
Licensed Professional Counselor, LPC, MHSP
Verified Verified
1 Endorsed
Nashville, TN 37214
I incorporate expressive art, play, and sand tray into sessions where applicable.
When challenges, uncertainty, and major changes occur in our lives, it can be hard to know how to move forward. I am here not to provide “the answer”, but to be the guide and companion on your healing journey – the one shining the light down the path as we navigate the unknown together and find your answers together. We will set goals, face challenges head-on, and explore what it looks like to apply new skills and practice healthy and sustainable care of self within a safe environment.
I incorporate expressive art, play, and sand tray into sessions where applicable.
When challenges, uncertainty, and major changes occur in our lives, it can be hard to know how to move forward. I am here not to provide “the answer”, but to be the guide and companion on your healing journey – the one shining the light down the path as we navigate the unknown together and find your answers together. We will set goals, face challenges head-on, and explore what it looks like to apply new skills and practice healthy and sustainable care of self within a safe environment.
(629) 500-2951 View (629) 500-2951
1
Art Therapy

How does art therapy work?

The process of making art allows people to express themselves. Art-making can take many forms, such as painting, collage, or sculpting. The therapist asks questions that the work elicits, such as how the person felt while creating their piece, or if any memories surfaced that they can discuss. The therapist will then work with the patient to process their experience, understand themselves better, and work toward change.

Does art therapy help with trauma?

Art therapy can be a valuable treatment option for those suffering from trauma. Traumatic experiences such as combat, rape, or childhood abuse can be so painful that articulating them can be too scary or painful; creating art allows people to express themselves without words, and tell their story in a different way. The physical nature of creating art can also help people feel rooted in the body, which may benefit those who feel disconnected from their body in the aftermath of trauma.

How long does art therapy last?

The duration of art therapy varies, but a common length for treatment is 10 to 15 weekly sessions. Some people may see improvement in just a few weeks, while others may choose to remain in therapy longer term. Patients should periodically discuss their goals with their therapist to make sure the two are aligned on process and progress.

What are the limitations of art therapy?

Art therapy is helpful for many people, but a limitation is that it doesn’t have as robust an evidence base as other forms of therapy, such as cognitive behavioral therapy or acceptance and commitment therapy. The evidence on art therapy is mixed; some research demonstrates its benefits, while other research suggests that it has little impact on patients.