Photo of Susannah Newell, MSc, MUKCP, Psychotherapist
Susannah Newell
Psychotherapist, MSc, MUKCP
Verified Verified
Hello. As an experienced psychotherapist, I can help you manage current life challenges like sudden changes or losses; anxiety; relationship issues; bereavement; loneliness; parenthood; depression or past experiences intruding on your present. Sometimes clients come with a more general sense of unfulfilment or want to know themselves better. I offer a safe, non-judgmental space to share your load, rather than carrying it alone. Psychotherapy offers vital connection, support and opportunity to work things through with an empathic, trained professional totally unconnected to your life.
Hello. As an experienced psychotherapist, I can help you manage current life challenges like sudden changes or losses; anxiety; relationship issues; bereavement; loneliness; parenthood; depression or past experiences intruding on your present. Sometimes clients come with a more general sense of unfulfilment or want to know themselves better. I offer a safe, non-judgmental space to share your load, rather than carrying it alone. Psychotherapy offers vital connection, support and opportunity to work things through with an empathic, trained professional totally unconnected to your life.
01242 650306 View 01242 650306
Photo of Ting Chiu, MBABCP, Psychotherapist
Ting Chiu
Psychotherapist, MBABCP
Verified Verified
2 Endorsed
Cheltenham GL53  (Online Only)
Having worked with many clients over the years, I have a good understanding of what human distress looks like. Often, we try to push the difficult feelings (both physical and emotional) aside and just ‘get on with it’. Sure enough, it works for a while, but then there comes a point when the usual coping strategies just stop working, and reaching out for help feels somehow wrong too; life feels stuck in vicious circles. If this sounds frustratingly familiar, then you are not alone. With my extensive experience, I can support you to reach your goals, or simply to figure out together first what the goals might be.
Having worked with many clients over the years, I have a good understanding of what human distress looks like. Often, we try to push the difficult feelings (both physical and emotional) aside and just ‘get on with it’. Sure enough, it works for a while, but then there comes a point when the usual coping strategies just stop working, and reaching out for help feels somehow wrong too; life feels stuck in vicious circles. If this sounds frustratingly familiar, then you are not alone. With my extensive experience, I can support you to reach your goals, or simply to figure out together first what the goals might be.
01684 218544 View 01684 218544
Photo of Dr Jess Rayner, PsychD, HCPC - Clin. Psych., Psychologist
Dr Jess Rayner
Psychologist, PsychD, HCPC - Clin. Psych.
Verified Verified
Waitlist for new clients
Welcome, I am a registered Clinical Psychologist offering high quality, compassionate, therapy. You may be here because you are feeling anxious, dealing with the impact of traumatic or difficult events, stressed, or perhaps struggling with low self-esteem or critical self-talk. I create a non-judgemental space where we can work together to identify the source of your troubles, reduce distress, and build new skills and perspectives. Specialist interests include anxiety, trauma, burnout and stress, and long-term health conditions (e.g., pain/fatigue).
Welcome, I am a registered Clinical Psychologist offering high quality, compassionate, therapy. You may be here because you are feeling anxious, dealing with the impact of traumatic or difficult events, stressed, or perhaps struggling with low self-esteem or critical self-talk. I create a non-judgemental space where we can work together to identify the source of your troubles, reduce distress, and build new skills and perspectives. Specialist interests include anxiety, trauma, burnout and stress, and long-term health conditions (e.g., pain/fatigue).
01248 663871 View 01248 663871
Rosie Attard
Psychologist, PsychD, HCPC - Clin. Psych.
Verified Verified
Hello, I'm Rosie, a Cheltenham based, qualified clinical psychologist which means that I am qualified up to doctorate level and I am registered with the HCPC. I have over 10 years experience working in the NHS, with both adults and children with a variety of presenting difficulties including anxiety (social anxiety, health anxiety, generalized anxiety), depression, OCD, trauma symptoms and difficulties with adjustment to difficult life events. I am interested in lots of different areas, however I am particularly interested in the period of life around childbirth and how this impacts on parents.
Hello, I'm Rosie, a Cheltenham based, qualified clinical psychologist which means that I am qualified up to doctorate level and I am registered with the HCPC. I have over 10 years experience working in the NHS, with both adults and children with a variety of presenting difficulties including anxiety (social anxiety, health anxiety, generalized anxiety), depression, OCD, trauma symptoms and difficulties with adjustment to difficult life events. I am interested in lots of different areas, however I am particularly interested in the period of life around childbirth and how this impacts on parents.
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Photo of Louise Ann Adamson - Come Alongside, MBACP Accred, Counsellor
Come Alongside
Counsellor, MBACP Accred
Verified Verified
My aim is to come alongside you - to really listen and understand how you experience life. I work collaboratively - taking into account what you want and need and how you want to work. I will also offer insights and suggestions if I think this may be of help to you, without directing our work together. My hope is to help you make sense of your experiences and associated symptoms, such as: Anxiety, Depression, Anger, Low self-esteem, patterns of behaviours and relating or coping mechanisms which may no longer helpful. Improved self understanding and compassion will help you foster new ways of being, feeling and behaving.
My aim is to come alongside you - to really listen and understand how you experience life. I work collaboratively - taking into account what you want and need and how you want to work. I will also offer insights and suggestions if I think this may be of help to you, without directing our work together. My hope is to help you make sense of your experiences and associated symptoms, such as: Anxiety, Depression, Anger, Low self-esteem, patterns of behaviours and relating or coping mechanisms which may no longer helpful. Improved self understanding and compassion will help you foster new ways of being, feeling and behaving.
01242 903233 View 01242 903233
Photo of Cara Robin, UKCP Trainee, Counsellor
Cara Robin
Counsellor, UKCP Trainee
Verified Verified
1 Endorsed
I am here to offer my clients the opportunity to explore their authentic self with non-judgemental, caring, support. You may have received black and white messages about who you are supposed to be, or how you are supposed to feel that just aren't quite right for you, but you aren't sure of the alternatives. Or perhaps, you find yourself at a crossroads or experiencing huge change. This may have left you feeling uncertain, overwhelmed or confused. I work with you to help you through this times, providing tools and coping strategies to help you long term too.
I am here to offer my clients the opportunity to explore their authentic self with non-judgemental, caring, support. You may have received black and white messages about who you are supposed to be, or how you are supposed to feel that just aren't quite right for you, but you aren't sure of the alternatives. Or perhaps, you find yourself at a crossroads or experiencing huge change. This may have left you feeling uncertain, overwhelmed or confused. I work with you to help you through this times, providing tools and coping strategies to help you long term too.
01905 917326 View 01905 917326
Photo of Gemma Slobom, MBACP, Counsellor
Gemma Slobom
Counsellor, MBACP
Verified Verified
1 Endorsed
Hello, I'm Gemma. I run a Private Practice in central Cheltenham, offering counselling to individuals. I support people with a wide range of issues, including anxiety and depression, relationship issues, and emotional issues. I work from an Intergrative perspective, which encompasses Psychodynamic theory, Person Centred Theory, Gestalt Theory and Transactional Analysis.
Hello, I'm Gemma. I run a Private Practice in central Cheltenham, offering counselling to individuals. I support people with a wide range of issues, including anxiety and depression, relationship issues, and emotional issues. I work from an Intergrative perspective, which encompasses Psychodynamic theory, Person Centred Theory, Gestalt Theory and Transactional Analysis.
01242 501160 View 01242 501160
Photo of Kaukab Rasul, MBACP, Counsellor
Kaukab Rasul
Counsellor, MBACP
Verified Verified
Over 15 years experience of working with couples and individuals. I am passionate about helping people achieve their greatest potential recognising their strengths and weaknesses; moving towards a life where they can thrive. Training: Professional Diploma in Counselling awarded by the University of the West of England. Registered member of the BACP. My Approach As an Integrative Counsellor is to work collaboratively with clients and draw on different approaches to try to match client/couple needs. I am fluent in English, Urdu, Hindi & Punjabi.
Over 15 years experience of working with couples and individuals. I am passionate about helping people achieve their greatest potential recognising their strengths and weaknesses; moving towards a life where they can thrive. Training: Professional Diploma in Counselling awarded by the University of the West of England. Registered member of the BACP. My Approach As an Integrative Counsellor is to work collaboratively with clients and draw on different approaches to try to match client/couple needs. I am fluent in English, Urdu, Hindi & Punjabi.
01452 930096 View 01452 930096
Photo of Claire King, MBACP, Counsellor
Claire King
Counsellor, MBACP
Verified Verified
Counselling for adults, young people 13+ and couples in Cheltenham, Gloucestershire with fully qualified, experienced counsellor. ​Counselling can help with difficult feelings like anxiety, depression, grief, anger, loneliness and low self-esteem. Counselling can help you cope better with issues such as loss, relationship difficulties, stress, past traumas. Counselling can help you learn about yourself- your wants and needs – and how to meet them. ​Counselling for couples can help you remember what is right with your relationship, find ways to communicate more effectively and work together on what is difficult
Counselling for adults, young people 13+ and couples in Cheltenham, Gloucestershire with fully qualified, experienced counsellor. ​Counselling can help with difficult feelings like anxiety, depression, grief, anger, loneliness and low self-esteem. Counselling can help you cope better with issues such as loss, relationship difficulties, stress, past traumas. Counselling can help you learn about yourself- your wants and needs – and how to meet them. ​Counselling for couples can help you remember what is right with your relationship, find ways to communicate more effectively and work together on what is difficult
01242 903215 View 01242 903215
Photo of Chris Matcham, MA, MBACP Accred, Psychotherapist
Chris Matcham
Psychotherapist, MA, MBACP Accred
Verified Verified
Let's work together to figure out the next steps to feeling better: Seeking help, as you are doing by searching this site, is a brave and important step in satisfying your own needs - in doing this, you are already creating some relief and a pathway towards yourself as you wish to be. You may feel lost or confused as to what comes next, but you have already shown that you can think in new ways and adapt in order to change a situation which isn’t working for you. Our task is to get in touch with feelings that can further open up your awareness, to allow change to happen.
Let's work together to figure out the next steps to feeling better: Seeking help, as you are doing by searching this site, is a brave and important step in satisfying your own needs - in doing this, you are already creating some relief and a pathway towards yourself as you wish to be. You may feel lost or confused as to what comes next, but you have already shown that you can think in new ways and adapt in order to change a situation which isn’t working for you. Our task is to get in touch with feelings that can further open up your awareness, to allow change to happen.
07480 538802 View 07480 538802
Photo of Natasha Dancy, MBACP Accred, Counsellor
Natasha Dancy
Counsellor, MBACP Accred
Verified Verified
1 Endorsed
Hi! My name is Natasha and I'm a qualified integrative counsellor since 2017 providing short and long term therapy to adults and young people (thirteen and older). Often, we're able to manage life and what comes our way. However, at times situations can feel overwhelming and impossible to face on your own. Maybe you're unable to share with friends and family what's burdening you for fear they won't understand or judge you. Or you're worried about your child and don't know how else to help them. I'm here to offer you phased support you or your child need with the goal to help you grow into a free and hopeful life ahead.
Hi! My name is Natasha and I'm a qualified integrative counsellor since 2017 providing short and long term therapy to adults and young people (thirteen and older). Often, we're able to manage life and what comes our way. However, at times situations can feel overwhelming and impossible to face on your own. Maybe you're unable to share with friends and family what's burdening you for fear they won't understand or judge you. Or you're worried about your child and don't know how else to help them. I'm here to offer you phased support you or your child need with the goal to help you grow into a free and hopeful life ahead.
01242 503544 View 01242 503544
Photo of Nicola Lambert, MA, MBACP Accred, Counsellor
Nicola Lambert
Counsellor, MA, MBACP Accred
Verified Verified
We all respond differently to the pressures and changes- you may be swinging from one emotion to another, or feeling numb and tired, or just can't think straight... We are all doing our best to cope, but maybe your normal ways of coping aren't working well enough at the moment? Or maybe you have turned to ways of coping that are unhelpful- like drinking too much ? I can help you find your feet and see what is important for you right now. I know how important it is to find a breathing space to process what is happening when you are living with chaos and uncertainty
We all respond differently to the pressures and changes- you may be swinging from one emotion to another, or feeling numb and tired, or just can't think straight... We are all doing our best to cope, but maybe your normal ways of coping aren't working well enough at the moment? Or maybe you have turned to ways of coping that are unhelpful- like drinking too much ? I can help you find your feet and see what is important for you right now. I know how important it is to find a breathing space to process what is happening when you are living with chaos and uncertainty
01793 250417 View 01793 250417
Photo of Kate Gregory, MA, MBACP, Counsellor
Kate Gregory
Counsellor, MA, MBACP
Verified Verified
Hello, I'm Kate. I offer 1:1 counselling to adults. This can be short or long term depending on your needs. I work face to face in Cheltenham or online via Zoom. I offer a warm, supportive and confidential space to explore your feelings, thoughts and experiences. Counselling can help you to look at a particular issue that is worrying you, to make sense of difficult feelings, to explore deeply rooted issues, or simply to understand yourself better. I work with clients on many issues including anxiety, depression, grief and loss, low self-esteem, feeling stuck and unmotivated, questions of identity, and adapting to life changes.
Hello, I'm Kate. I offer 1:1 counselling to adults. This can be short or long term depending on your needs. I work face to face in Cheltenham or online via Zoom. I offer a warm, supportive and confidential space to explore your feelings, thoughts and experiences. Counselling can help you to look at a particular issue that is worrying you, to make sense of difficult feelings, to explore deeply rooted issues, or simply to understand yourself better. I work with clients on many issues including anxiety, depression, grief and loss, low self-esteem, feeling stuck and unmotivated, questions of identity, and adapting to life changes.
01242 505859 View 01242 505859
Photo of Dr Janette Rankine, DCounsPsych, CPsychol, Psychologist
Dr Janette Rankine
Psychologist, DCounsPsych, CPsychol
Verified Verified
Hi, Are you are looking for someone who will really listen to you without judgement? I am a fully qualified HCPC registered Counselling Psychologist. I provide a safe space to be heard, in a peacfeul haven in central Cheltenham. I offer Intergrative Counselling and Psychological Therapy for all kinds of distress, conflict or confusion. We all go through tough times when we need someone to tell our story to. Oftentimes, just sharing it, without fear of consequencies is all that is required to start a healing journey.
Hi, Are you are looking for someone who will really listen to you without judgement? I am a fully qualified HCPC registered Counselling Psychologist. I provide a safe space to be heard, in a peacfeul haven in central Cheltenham. I offer Intergrative Counselling and Psychological Therapy for all kinds of distress, conflict or confusion. We all go through tough times when we need someone to tell our story to. Oftentimes, just sharing it, without fear of consequencies is all that is required to start a healing journey.
01242 384074 View 01242 384074
Photo of Hayley Carmichael, MA, MNCPS Acc., Psychotherapist
Hayley Carmichael
Psychotherapist, MA, MNCPS Acc.
Verified Verified
1 Endorsed
Cheltenham GL53  (Online Only)
Want to move forwards but feel stuck, or a change is proving tough to navigate?Perhaps the past feels too much part of your present? Therapy can help. As a psychodynamic psychotherapist I am guided by your needs, we'll work at your pace to explore what is going on and help you to find a way to manage what this means for you. You may need a space that feels neutral and safe to talk about things that you have never talked about before; and to talk to someone who is there to fully listen to you with no distractions. Many clients say they just want to be able to find their joy again and know themselves better.
Want to move forwards but feel stuck, or a change is proving tough to navigate?Perhaps the past feels too much part of your present? Therapy can help. As a psychodynamic psychotherapist I am guided by your needs, we'll work at your pace to explore what is going on and help you to find a way to manage what this means for you. You may need a space that feels neutral and safe to talk about things that you have never talked about before; and to talk to someone who is there to fully listen to you with no distractions. Many clients say they just want to be able to find their joy again and know themselves better.
01453 703128 View 01453 703128
Photo of Hilary Lynn, MNCPS Acc., Counsellor
Hilary Lynn
Counsellor, MNCPS Acc.
Verified Verified
2 Endorsed
Are you feeling low, confused, anxious or sad? Maybe you’ve lost someone close to you or find yourself stuck in a cycle of self-sabotaging behaviour. Or perhaps you’ve realised that you no longer know who you truly are. If you’re exhausted and overwhelmed by your feelings, if you’re struggling just to get through each day – you’re not alone. I’m here to help. My passion for helping others stems from a genuine desire to see individuals reclaim their lives and find inner peace. I know how important it is to feel listened to, heard and understood.
Are you feeling low, confused, anxious or sad? Maybe you’ve lost someone close to you or find yourself stuck in a cycle of self-sabotaging behaviour. Or perhaps you’ve realised that you no longer know who you truly are. If you’re exhausted and overwhelmed by your feelings, if you’re struggling just to get through each day – you’re not alone. I’m here to help. My passion for helping others stems from a genuine desire to see individuals reclaim their lives and find inner peace. I know how important it is to feel listened to, heard and understood.
01452 930082 View 01452 930082
Photo of Jaimie Marc Cahlil - Jaimie Cahlil, PsychD, MUKCP, Psychotherapist
Jaimie Cahlil
Psychotherapist, PsychD, MUKCP
Verified Verified
1 Endorsed
Here you are, searching for something that feels right for you. So, to introduce my way of working: as a transpersonal (psychospiritual) psychotherapist, the work of psychotherapy is placed within the immense context, or ultimate reality, of oneness. As you read my words, you may be feeling anxious, depressed, sad, angry, confused, imprisoned, disconnected, numb, lost....or yet something else. However, as you read these words, I suggest you assess your readiness for the spiritual self-development I offer: a courageously self-honest, open-mindedly questioning, process of deepening awakening consciousness.
Here you are, searching for something that feels right for you. So, to introduce my way of working: as a transpersonal (psychospiritual) psychotherapist, the work of psychotherapy is placed within the immense context, or ultimate reality, of oneness. As you read my words, you may be feeling anxious, depressed, sad, angry, confused, imprisoned, disconnected, numb, lost....or yet something else. However, as you read these words, I suggest you assess your readiness for the spiritual self-development I offer: a courageously self-honest, open-mindedly questioning, process of deepening awakening consciousness.
01242 903238 View 01242 903238
Photo of Vicky Jones, BACP, Counsellor
Vicky Jones
Counsellor, BACP
Verified Verified
Every person has individual needs and their life experiences are unique. There are many different reasons people seek counselling support. Issues such as anxiety, low self-esteem, relationships, life events, difficult childhood experiences, loss and bereavement are just a few examples. By offering counselling to adults, children and young people it is my aim to provide empathy and understanding, to empower clients and enable them to grow in confidence to realise and understand that they hold the answers. You are the expert of you.
Every person has individual needs and their life experiences are unique. There are many different reasons people seek counselling support. Issues such as anxiety, low self-esteem, relationships, life events, difficult childhood experiences, loss and bereavement are just a few examples. By offering counselling to adults, children and young people it is my aim to provide empathy and understanding, to empower clients and enable them to grow in confidence to realise and understand that they hold the answers. You are the expert of you.
01452 941752 View 01452 941752
Photo of Stefan Mihailov, MBACP, Counsellor
Stefan Mihailov
Counsellor, MBACP
Verified Verified
Hi! I'm a therapist who walks alongside you. Whatever it is, you're not alone. Whatever you are feeling, this is real, and there is a reason. There is also a way towards change, and this is a journey of self-discovery. Feeling lost, anxious, or stuck? Life gets you down sometimes and you're trying to make sense of things? Want to gain more understanding of yourself? Feel the need to make changes? Would you like to enhance your self-esteem, sense of self or self-worth? Perhaps you're dealing with the impact of growing up with emotionally unavailable parents, or facing challenging romantic, social or friendship relationships.
Hi! I'm a therapist who walks alongside you. Whatever it is, you're not alone. Whatever you are feeling, this is real, and there is a reason. There is also a way towards change, and this is a journey of self-discovery. Feeling lost, anxious, or stuck? Life gets you down sometimes and you're trying to make sense of things? Want to gain more understanding of yourself? Feel the need to make changes? Would you like to enhance your self-esteem, sense of self or self-worth? Perhaps you're dealing with the impact of growing up with emotionally unavailable parents, or facing challenging romantic, social or friendship relationships.
01242 502933 View 01242 502933

See more therapy options for GL53

How does your Counsellor compare?

Number of Counsellors in GL53

10+

Average cost per session

£60

Counsellors in GL53 who prioritize treating:

100% Anxiety
95% Self Esteem
89% Depression
84% Stress
79% Bereavement
74% Life Transitions
68% Relationship Issues

Average years in practice

9 Years

Top 3 insurances accepted

50% WPA
25% Any/Out-of-network Insurance
25% Aviva

How Counsellors in GL53 see their clients

90% In Person and Online
10% Online Only

Gender breakdown

78% Female
22% Male
FAQs - About Therapy and Counselling

How can I find a therapist in GL53?

Search for nearby therapists or counsellors by inputting your city, postcode, or a provider’s name into the search bar. From there, you can filter providers by the issues they treat, cost, insurance, gender, and other factors to find providers who are well-suited to your needs. To navigate between locations within the same country, enter a new city or postcode into the search bar.

Learn more about how to find a therapist

Is everyone in the Psychology Today Therapy Directory a licensed therapist?

Counsellors and Psychotherapists listed in the directory are members of the main professional associations, mainly the British Association for Counselling and Psychotherapy (BACP) and the UK Council for Psychotherapy (UKCP). Most Psychologists in the directory are accredited members of the British Psychological Society (BPS) and/or are registered in the Health and Care Professions Council (HPCP).

Providers whose professional membership or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Given that professional memberships are not a statutory requirement for psychotherapists and counsellors in the UK, certain qualified professionals or organisations may choose not to maintain such memberships despite possessing the necessary qualifications. They may be selectively included without the “Verified” seal.

What’s the difference between a psychologist, a therapist, and a counsellor?

Counsellors, psychotherapists and psychologists can all provide counselling or talking therapy and have credentials and experience that enable them to do so in the UK. Psychologists have earned a degree in psychology and many are members of the British Psychological Society (BPS) and have completed a postgraduate qualification in a specialism. Counsellors and Psychotherapists are not required to have a psychology degree, but to belong to a professional organisation such as the BACP or UKCP, they are required to have completed a training course as well as clinical and supervision hours.

What type of therapy is right for me?

The type of therapy best suited to a particular individual depends on several factors, including their primary reason for seeking therapy, their preferred timeline (some therapy types last for a set number of sessions, while others are open-ended), and their personality and preferences—some may prefer a more structured approach. For many individuals, multiple types of therapy could provide a good fit.

How much does therapy cost?

The cost of therapy depends on a number of variables, including location and the therapist’s experience and training. On average, a therapy session in the UK could be between £30 - £60 when seeing a counsellor and £60 - £150 and up when seeing a clinical psychologist. If you have private insurance, your plan may cover some if not all of your sessions. You should contact your insurance provider to determine if they provide coverage for therapy sessions and to determine what, if any, requirements they might have in order for your sessions to be covered, such as a referral from your GP or medical specialist.

What are more affordable or low cost therapy solutions?

Many therapists offer sliding scale payments, usually on a limited number of slots, which consists in an agreement between the therapist and a client to pay a reduced rate. Therapists who provide such arrangements often consider the client's income or ability to pay, but the extent of the discount is ultimately at the therapist's discretion. Furthermore, while group therapy may have different goals and benefits compared to individual therapy, it can be a more affordable solution to address certain types of issues.

If you are struggling to access therapy due to budget constraints, you could also consider public funded mental health services. The NHS Talking therapies programme offers free of charge counselling for common mental health problems like anxiety and depression. The service is available to anyone registered with a GP, though you do not necessarily need to be referred by your GP and can refer yourself directly to a Talking therapies service. The service will provide different solutions, including group and individual therapy, for a limited number of sessions which are generally up to six.

Is online therapy cheaper than in-person therapy?

Many therapists charge the same amount for online therapy as they do for in-person therapy—though clients may still find this cost-effective if it cuts down on their transportation costs. Health insurance plans often offer equivalent coverage for online and in-person therapy; indeed, in many places, they are legally required to do so. Text-based or on-demand therapy apps may be cheaper than traditional one-on-one psychotherapy; however, the practice may be less effective and is not likely to be covered by insurance.

Is online therapy a good option?

Therapy conducted online can be just as effective as in-person therapy, as long as there is a strong alliance between the client and the therapist. To find a therapist who provides telehealth services to clients in your area, click “Online Therapy” on the directory homepage and search by your city or town or your postcode.

Are therapy sessions confidential?

Therapists who are part of a professional organisation such as the BACP, the UKCP, or BPS are bound by an ethical framework that requires them to uphold a confidentiality agreement. Confidentiality is a crucial part of the therapeutic relationship and only under specific circumstances, such as when there has been participation in a criminal act or act of terror, or if there is potential or known harm to the client or others, will a therapist be obligated to break the agreement. These exceptions to the confidentiality agreement are usually discussed during the initial consultation.