Photo of Denise Alves Froede, MA, MBACP, Psychotherapist
Denise Alves Froede
Psychotherapist, MA, MBACP
Verified Verified
1 Endorsed
London SE24
I am a psychologist and registered psychotherapist. I work with a psychoanalytical approach also known as talking therapy. People come to Therapy for various reasons such as: anxiety, stress, ADHD, depression, sadness, procrastinations, panic attacks or other issues. Perhaps you are struggling understanding why you feel the way you do. You may wish to explore how you got where you are now in order to find your own solutions.
I am a psychologist and registered psychotherapist. I work with a psychoanalytical approach also known as talking therapy. People come to Therapy for various reasons such as: anxiety, stress, ADHD, depression, sadness, procrastinations, panic attacks or other issues. Perhaps you are struggling understanding why you feel the way you do. You may wish to explore how you got where you are now in order to find your own solutions.
020 8106 8826 View 020 8106 8826
Photo of Ayesha Alleyne, DCounsPsych, MBACP, Counsellor
Ayesha Alleyne
Counsellor, DCounsPsych, MBACP
Verified Verified
London SE24
Are you searching through here knowing that you have family, friends who love, care about you yet you feel alone with no one who you feel you can talk to. No one you feel that you can be your "real" and "honest" self. Worried that you may hurt or upset their feelings or that they may even judge you. At times during different stages of our life's we can experience challenges, change, loss, pain or suffering that can be hard for us to understand. These feelings and emotions can have an impact on us as individuals in a unique way.
Are you searching through here knowing that you have family, friends who love, care about you yet you feel alone with no one who you feel you can talk to. No one you feel that you can be your "real" and "honest" self. Worried that you may hurt or upset their feelings or that they may even judge you. At times during different stages of our life's we can experience challenges, change, loss, pain or suffering that can be hard for us to understand. These feelings and emotions can have an impact on us as individuals in a unique way.
020 3974 2926 View 020 3974 2926
Photo of Effie Hicks, MA, MBACP, Psychotherapist
Effie Hicks
Psychotherapist, MA, MBACP
Verified Verified
London SE24
I work as an integrative psychotherapist providing therapy in a friendly and supportive environment. My approach is psychodynamic, which means, it focuses on understanding unconscious processes. I believe in healing the whole person which includes mind, body and spirit. I have a Masters degree in psychotherapy and healing and I am a registered member with the BACP. I hold private and voluntary sector experience as a counsellor and psychotherapist with both adults and children.
I work as an integrative psychotherapist providing therapy in a friendly and supportive environment. My approach is psychodynamic, which means, it focuses on understanding unconscious processes. I believe in healing the whole person which includes mind, body and spirit. I have a Masters degree in psychotherapy and healing and I am a registered member with the BACP. I hold private and voluntary sector experience as a counsellor and psychotherapist with both adults and children.
020 3962 1512 View 020 3962 1512
Photo of Dr Lisa Masters, HCPC - Clin. Psych., Psychologist
Dr Lisa Masters
Psychologist, HCPC - Clin. Psych.
Verified Verified
1 Endorsed
London SE24
Not accepting new clients
I am a HCPC registered Clinical Psychologist. I have worked in NHS practice for ten years, most recently with people living with chronic health conditions. I also have a background working with people who have experienced difficult early life relationships, which affects their ability to feel safe with others. I am able to support people struggling with a range of difficulties, including anxiety, depression, relationship issues, and trauma. I centre my work in helping you to build a more compassionate relationship with yourself. This is something we can all find difficult, but which I believe is key to finding sustainable change.
I am a HCPC registered Clinical Psychologist. I have worked in NHS practice for ten years, most recently with people living with chronic health conditions. I also have a background working with people who have experienced difficult early life relationships, which affects their ability to feel safe with others. I am able to support people struggling with a range of difficulties, including anxiety, depression, relationship issues, and trauma. I centre my work in helping you to build a more compassionate relationship with yourself. This is something we can all find difficult, but which I believe is key to finding sustainable change.
020 3667 9867 View 020 3667 9867
Photo of Marlicah Onayomake, MBACP, Counsellor
Marlicah Onayomake
Counsellor, MBACP
Verified Verified
London SE24
Hello. I created A Place Called Me Therapy service understanding that your experiences are unique to you as an individual. Supporting you to release and discover, lets focus on how you are feeling on the inside. Are you struggling in areas in your life that are causing you difficult & painful emotions? Feeling stuck? You may no longer feel fulfilment or enjoyment due to life changes or simply very overwhelmed or trapped in difficult situations. Free from judgement focussed only on you, removing the views, opinions & judgement of others. My aim is to support you to find greater ease in managing your life with warmth and understanding
Hello. I created A Place Called Me Therapy service understanding that your experiences are unique to you as an individual. Supporting you to release and discover, lets focus on how you are feeling on the inside. Are you struggling in areas in your life that are causing you difficult & painful emotions? Feeling stuck? You may no longer feel fulfilment or enjoyment due to life changes or simply very overwhelmed or trapped in difficult situations. Free from judgement focussed only on you, removing the views, opinions & judgement of others. My aim is to support you to find greater ease in managing your life with warmth and understanding
020 8049 7865 View 020 8049 7865
Photo of Maddy Sakey, MBACP, Counsellor
Maddy Sakey
Counsellor, MBACP
Verified Verified
London SE24
I am a qualified Integrative Counsellor. I have experience working with clients on a range of issues such as depression, anxiety, relationship difficulties, grief, loss & self-esteem. My integrative training emphasises the importance of the relationship between client & counsellor. The client is given the opportunity to lead the way, I will actively listen and respond to what the client brings, aiming to provide an environment which feels safe, empathic and open-minded. I will however, at times, be challenging in a constructive way, allowing for potential therapeutic change, discovery & shifting within the client.
I am a qualified Integrative Counsellor. I have experience working with clients on a range of issues such as depression, anxiety, relationship difficulties, grief, loss & self-esteem. My integrative training emphasises the importance of the relationship between client & counsellor. The client is given the opportunity to lead the way, I will actively listen and respond to what the client brings, aiming to provide an environment which feels safe, empathic and open-minded. I will however, at times, be challenging in a constructive way, allowing for potential therapeutic change, discovery & shifting within the client.
020 3962 1516 View 020 3962 1516
Photo of Bea Xu, UKCP Trainee, Psychotherapist
Bea Xu
Psychotherapist, UKCP Trainee
Verified Verified
London SE24  (Online Only)
As someone who experienced a profound alignment to my artistic path and community in recent years after what felt like a lifetime of painful trial and error, I am particularly invested in helping individuals who wish to self-actualise any frustrated creative potential or uncover a calling. The transpersonal aspect of psychotherapy deals with a spiritual dimension of the human experience (not necessarily one that is religious) and in this capacity I hope to assist with people undergoing spiritual emergency.
As someone who experienced a profound alignment to my artistic path and community in recent years after what felt like a lifetime of painful trial and error, I am particularly invested in helping individuals who wish to self-actualise any frustrated creative potential or uncover a calling. The transpersonal aspect of psychotherapy deals with a spiritual dimension of the human experience (not necessarily one that is religious) and in this capacity I hope to assist with people undergoing spiritual emergency.
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Photo of Dr Emma L Smith, PsychD, HCPC - Clin. Psych., Psychologist
Dr Emma L Smith
Psychologist, PsychD, HCPC - Clin. Psych.
Verified Verified
London SE24
I am a Chartered Doctor of Clinical Psychology with over 15 years of experience working within the NHS, clinical research & private practice. I provide psychological interventions to adults with a wide range of mental health difficulties including anxiety, panic disorder, obsessive compulsive disorder, depression, low self-esteem, trauma, work related stress, & relationship difficulties. I also have specialist experience in working with issues relating to diabetes & other long-term physical health conditions.
I am a Chartered Doctor of Clinical Psychology with over 15 years of experience working within the NHS, clinical research & private practice. I provide psychological interventions to adults with a wide range of mental health difficulties including anxiety, panic disorder, obsessive compulsive disorder, depression, low self-esteem, trauma, work related stress, & relationship difficulties. I also have specialist experience in working with issues relating to diabetes & other long-term physical health conditions.
020 3835 2993 View 020 3835 2993
Photo of Helen O'Rourke, MBACP Accred, Counsellor
Helen O'Rourke
Counsellor, MBACP Accred
Verified Verified
London SE24
Does it seem as though your life will never get better no matter how much you try to change it? Does constant worrying make it hard for you to complete daily tasks? Is your work performance suffering? Are your relationships with co-workers strained? Is your family in turmoil and you’re feeling powerless to change things? Anxiety, depression, conflict with others, workplace issues and life events can stop us from feeling good about ourselves and achieving our goals. If you’re feeling stuck, you’re not alone. I can help you navigate confusing thoughts, feelings and behaviours to gain a deeper understanding of yourself and your needs.
Does it seem as though your life will never get better no matter how much you try to change it? Does constant worrying make it hard for you to complete daily tasks? Is your work performance suffering? Are your relationships with co-workers strained? Is your family in turmoil and you’re feeling powerless to change things? Anxiety, depression, conflict with others, workplace issues and life events can stop us from feeling good about ourselves and achieving our goals. If you’re feeling stuck, you’re not alone. I can help you navigate confusing thoughts, feelings and behaviours to gain a deeper understanding of yourself and your needs.
020 3962 2468 View 020 3962 2468
Photo of Matt Reid, MBACP Accred, Counsellor
Matt Reid
Counsellor, MBACP Accred
Verified Verified
London SE24
Do you suffer from anxiety? Feel depressed or struggle with unwanted emotions? I have helped a lot of people struggling with life and its many pressures and demands. I could also help you find a way forward with what may feel like impossible problems. I have worked with clients mainly in a general service, encountering all sorts of problems and working all kinds of developmental needs. I have also practised in an addictions setting and a bereavement service. I currently work in a rehabilitation service, in general counselling service and in private practice. I also offer a free assessment as a starting point.
Do you suffer from anxiety? Feel depressed or struggle with unwanted emotions? I have helped a lot of people struggling with life and its many pressures and demands. I could also help you find a way forward with what may feel like impossible problems. I have worked with clients mainly in a general service, encountering all sorts of problems and working all kinds of developmental needs. I have also practised in an addictions setting and a bereavement service. I currently work in a rehabilitation service, in general counselling service and in private practice. I also offer a free assessment as a starting point.
020 3856 3982 View 020 3856 3982
Photo of Brenda Purpose - CBT, EMDR, Psychological Coach & Mental Health, MSc, MBABCP, Psychotherapist
CBT, EMDR, Psychological Coach & Mental Health
Psychotherapist, MSc, MBABCP
Verified Verified
London SE24
Hey, I am Brenda, a Cognitive Behavioral Therapist, EMDR Therapist and a Registered Psychiatric Nurse and an award winner of the "Prestigious Mary Seacole Award". I offer 1:1 CBT therapy to help you to rediscover your self, to become "un-stuck", move forward and rebuild your life from past painful experiences. I use my professional expertise through a variety of evidence based techniques from Cognitive Behavioral Therapy and Coaching theories, plus my lived experiences of trauma, confidence and assertiveness challenges to help you rediscover your true self and reclaim your life. I also support with goal setting, as essential tool.
Hey, I am Brenda, a Cognitive Behavioral Therapist, EMDR Therapist and a Registered Psychiatric Nurse and an award winner of the "Prestigious Mary Seacole Award". I offer 1:1 CBT therapy to help you to rediscover your self, to become "un-stuck", move forward and rebuild your life from past painful experiences. I use my professional expertise through a variety of evidence based techniques from Cognitive Behavioral Therapy and Coaching theories, plus my lived experiences of trauma, confidence and assertiveness challenges to help you rediscover your true self and reclaim your life. I also support with goal setting, as essential tool.
020 8106 5762 View 020 8106 5762
Photo of Jonathan Husbands, MBACP, Counsellor
Jonathan Husbands
Counsellor, MBACP
Verified Verified
London SE24
I aim to provide a safe welcoming, non-judgmental space where clients can freely express their thoughts, feelings and truly be heard. I am here to listen to you and help you find the best way forward. I use a collaborative approach where we examine thoughts and feelings from the past and examine how those past feelings affect the client in the here and now. My hope is to help clients realise that they have the tools to help themselves move forward in life and I’ll assist in finding new perspectives that help to bring self-awareness, strength, self-belief and enable positive change.
I aim to provide a safe welcoming, non-judgmental space where clients can freely express their thoughts, feelings and truly be heard. I am here to listen to you and help you find the best way forward. I use a collaborative approach where we examine thoughts and feelings from the past and examine how those past feelings affect the client in the here and now. My hope is to help clients realise that they have the tools to help themselves move forward in life and I’ll assist in finding new perspectives that help to bring self-awareness, strength, self-belief and enable positive change.
020 4538 3458 View 020 4538 3458
Photo of Donna LeMaitre, MBACP, Counsellor
Donna LeMaitre
Counsellor, MBACP
Verified Verified
London SE24
Hi, thank you for viewing my profile. I am an experienced Integrative Counsellor, which means that I have trained in different counselling approaches. I have achieved a Diploma in Therapeutic Counselling and then enhanced my skills by attaining a Diploma in Cognitive Therapeutic Skills and Theory. I want to ensure you feel confident enough to get in touch with me and share your experience and explore your feelings in an emphatic and non-judgmental space. Encouraging you to develop insight and understanding of your situation, while supporting you to gain control over your life.
Hi, thank you for viewing my profile. I am an experienced Integrative Counsellor, which means that I have trained in different counselling approaches. I have achieved a Diploma in Therapeutic Counselling and then enhanced my skills by attaining a Diploma in Cognitive Therapeutic Skills and Theory. I want to ensure you feel confident enough to get in touch with me and share your experience and explore your feelings in an emphatic and non-judgmental space. Encouraging you to develop insight and understanding of your situation, while supporting you to gain control over your life.
07490 076285 View 07490 076285
Photo of Martin Sosa, MSc, MBACP, Psychotherapist
Martin Sosa
Psychotherapist, MSc, MBACP
Verified Verified
London SE24
Now, this is when you feel it is enough, and you want to understand why you are feeling unhappy in a low mood. Perhaps you thought the situation would get better with time. But it doesn't. You may have a pretty good idea of what to do, but it is hard to face it alone or share your thoughts with the people around you.
Now, this is when you feel it is enough, and you want to understand why you are feeling unhappy in a low mood. Perhaps you thought the situation would get better with time. But it doesn't. You may have a pretty good idea of what to do, but it is hard to face it alone or share your thoughts with the people around you.
020 8016 3591 View 020 8016 3591
Photo of Alison Bickmore, MA, HCPC-Art Therap., Psychotherapist
Alison Bickmore
Psychotherapist, MA, HCPC-Art Therap.
Verified Verified
London SE24
If you are looking for a safe confidential space to explore difficult emotions and you are interested in using a creative model of therapy to explore them please get in touch. I have worked with individuals and groups in the NHS and at my private practice for over 15 years.
If you are looking for a safe confidential space to explore difficult emotions and you are interested in using a creative model of therapy to explore them please get in touch. I have worked with individuals and groups in the NHS and at my private practice for over 15 years.
020 3835 5711 View 020 3835 5711
Photo of Gemma Elizabeth Mogg, MBACP, Psychotherapist
Gemma Elizabeth Mogg
Psychotherapist, MBACP
Verified Verified
1 Endorsed
London SE24  (Online Only)
Sometimes life feels like a struggle. I offer an opportunity to work through these struggles in a supportive and compassionate way. I will listen when you need to be heard and accept you as you are.
Sometimes life feels like a struggle. I offer an opportunity to work through these struggles in a supportive and compassionate way. I will listen when you need to be heard and accept you as you are.
020 3984 9196 View 020 3984 9196
Photo of Dennis Rice - Therapy in Dulwich, MBACP, Counsellor
Therapy in Dulwich
Counsellor, MBACP
Verified Verified
1 Endorsed
London SE24
I offer short term Cognitive Behavioural Therapy (CBT) which will enable you to better understand what is maintaining a particular issue so that we can work together towards making you feel better. To be clear you are the expert on you and my role is to support you so that you may help yourself without having to spend an inordinate amount of time having therapy or continually returning to therapy. I offer an initial six entirely confidential sessions at a safe space in North Dulwich. Alternatively I am also qualified in Gestalt humanistic therapy too for if the issue runs a bit deeper and the support needed is longer term.
I offer short term Cognitive Behavioural Therapy (CBT) which will enable you to better understand what is maintaining a particular issue so that we can work together towards making you feel better. To be clear you are the expert on you and my role is to support you so that you may help yourself without having to spend an inordinate amount of time having therapy or continually returning to therapy. I offer an initial six entirely confidential sessions at a safe space in North Dulwich. Alternatively I am also qualified in Gestalt humanistic therapy too for if the issue runs a bit deeper and the support needed is longer term.
020 3984 8565 View 020 3984 8565
Photo of Fiona McKinstrie - Young People And Adolescent Therapy, MSc, MBACP, Psychotherapist
Fiona McKinstrie - Young People And Adolescent Therapy
Psychotherapist, MSc, MBACP
Verified Verified
2 Endorsed
London SE24
Adolescent and young adult therapy - Growing up can be hard and the teenage and young adult years can be particularly challenging. It is a time of significant transition, bringing with it creativity, heightened emotions and turbulent feelings. Whilst this period of life can be exhilarating and enriching, it can also stir up feelings of confusion, frustration, loneliness, anger, sadness, shame and anxiety. At times this can lead to depression, anxiety, self-harm or risk taking behaviours.
Adolescent and young adult therapy - Growing up can be hard and the teenage and young adult years can be particularly challenging. It is a time of significant transition, bringing with it creativity, heightened emotions and turbulent feelings. Whilst this period of life can be exhilarating and enriching, it can also stir up feelings of confusion, frustration, loneliness, anger, sadness, shame and anxiety. At times this can lead to depression, anxiety, self-harm or risk taking behaviours.
020 4530 8405 View 020 4530 8405
Photo of Anissa Sedira, MBACP, Counsellor
Anissa Sedira
Counsellor, MBACP
Verified Verified
1 Endorsed
London SE24
I am a compassionate & experienced Counsellor & Psychotherapist who is able to support you with a range of issues. My integrative approach creates a safe, warm & non-judgmental space where you can freely explore your thoughts, feelings & past experiences. Whether you are facing anxiety, depression, low self-esteem, relationship difficulties or dealing with trauma/abuse, I am here to help you navigate these challenges. My aim is to support you in building resilience & developing practical skills to manage your life’s difficulties. Together we'll work towards fostering greater self-awareness & gaining deeper understanding of yourself.
I am a compassionate & experienced Counsellor & Psychotherapist who is able to support you with a range of issues. My integrative approach creates a safe, warm & non-judgmental space where you can freely explore your thoughts, feelings & past experiences. Whether you are facing anxiety, depression, low self-esteem, relationship difficulties or dealing with trauma/abuse, I am here to help you navigate these challenges. My aim is to support you in building resilience & developing practical skills to manage your life’s difficulties. Together we'll work towards fostering greater self-awareness & gaining deeper understanding of yourself.
020 3772 3458 View 020 3772 3458
Photo of Chloe DaCosta, MSc, MBACP, Psychotherapist
Chloe DaCosta
Psychotherapist, MSc, MBACP
Verified Verified
London SE24
To say a bit about myself, I’m trained at Masters (MSc) level in Psychodynamic Counselling and Psychotherapy. I've managed a mental health team (Student Support and Wellbeing) at University College London, worked at Waterloo Community Counselling, within an NHS multidisciplinary team working with survivors of child sexual abuse and a men’s residential unit which delivers personalised support for men with complex mental health needs. My style of working is psychodynamic. In its simplest form, this involves thinking about how your past impacts your current lived experience.
To say a bit about myself, I’m trained at Masters (MSc) level in Psychodynamic Counselling and Psychotherapy. I've managed a mental health team (Student Support and Wellbeing) at University College London, worked at Waterloo Community Counselling, within an NHS multidisciplinary team working with survivors of child sexual abuse and a men’s residential unit which delivers personalised support for men with complex mental health needs. My style of working is psychodynamic. In its simplest form, this involves thinking about how your past impacts your current lived experience.
020 3835 5381 View 020 3835 5381
1

See more therapy options for SE24

How does your Counsellor compare?

Number of Counsellors in SE24

60+

Average cost per session

£70

Counsellors in SE24 who prioritize treating:

96% Anxiety
93% Depression
91% Self Esteem
87% Relationship Issues
84% Stress
67% Trauma and PTSD
67% Life Transitions

Average years in practice

8 Years

Top 3 insurances accepted

57% AXA PPP
57% Vitality
50% Aviva

How Counsellors in SE24 see their clients

86% In Person and Online
14% Online Only

Gender breakdown

68% Female
29% Male
3% Non-Binary
FAQs - About Therapy and Counselling

How can I find a therapist in SE24?

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.