Therapists in 64506
![Photo of Lisa Doyle, MA, CRADC, DVI, SQP, DOT, Drug & Alcohol Counselor](https://photos.psychologytoday.com/3ce8c760-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
Lisa Doyle
Drug & Alcohol Counselor, MA, CRADC, DVI, SQP, DOT
Verified Verified
Saint Joseph, MO 64506
Offering assessments days, evenings and weekends virtually telephonically or in person
Offering assessments days, evenings and weekends virtually telephonically or in person
![Photo of Tausha Taylor, MS, LPC, NBCC, SQP, CCTP, Licensed Professional Counselor](https://photos.psychologytoday.com/3d512132-46cd-11ea-a6ad-06142c356176/4/320x400.jpeg)
Tausha Taylor
Licensed Professional Counselor, MS, LPC, NBCC, SQP, CCTP
Verified Verified
1 Endorsed
Saint Joseph, MO 64506 (Online Only)
I'm currently taking new clients who live in Missouri, Kansas, or Iowa. I take pride in providing confidential counseling sessions which are tailored to the individual needs of each client online from the comfort of your own home or office.
I'm currently taking new clients who live in Missouri, Kansas, or Iowa. I take pride in providing confidential counseling sessions which are tailored to the individual needs of each client online from the comfort of your own home or office.
![Photo of Vanessa Groves, LMSW](https://photos.psychologytoday.com/4f8463e4-5945-4671-b05b-776aba7008cc/1/320x400.jpeg)
You have been struggling with life challenges and relationship difficulties, and you are needing a safe place to process these challenges. You may be feeling exhausted, overwhelmed, and frustrated from trying many different things, and nothing seems to work. Vanessa partners with you to find new ways to support you and your family to develop a deeper understanding of how these challenges have impacted your daily life and find ways to cope. Whether you’re struggling in your relationship, your family, or with individual situations, Vanessa is a safe and warm counselor to guide you on your journey.
You have been struggling with life challenges and relationship difficulties, and you are needing a safe place to process these challenges. You may be feeling exhausted, overwhelmed, and frustrated from trying many different things, and nothing seems to work. Vanessa partners with you to find new ways to support you and your family to develop a deeper understanding of how these challenges have impacted your daily life and find ways to cope. Whether you’re struggling in your relationship, your family, or with individual situations, Vanessa is a safe and warm counselor to guide you on your journey.
![Photo of Joseph M Kline, MSW, LCSW, LSCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/e4e12a46-f41a-42aa-b381-b8e111451544/1/320x400.jpeg)
Joseph M Kline
Clinical Social Work/Therapist, MSW, LCSW, LSCSW
Verified Verified
Saint Joseph, MO 64506
Waitlist for new clients
Prior to opening St Joe Therapist LLC I have been helping individuals for 6+ years. I treat individuals who may have a variety of diagnosis including PTSD/trauma, anxiety, depression, and other mood disorders. If you have been struggling with life challenges, you may be feeling exhausted, overwhelmed, and frustrated from trying many different things, and I am here to help. If you are needing a safe place to process these challenges, please call me and we can discuss how to begin your treatment journey.
Prior to opening St Joe Therapist LLC I have been helping individuals for 6+ years. I treat individuals who may have a variety of diagnosis including PTSD/trauma, anxiety, depression, and other mood disorders. If you have been struggling with life challenges, you may be feeling exhausted, overwhelmed, and frustrated from trying many different things, and I am here to help. If you are needing a safe place to process these challenges, please call me and we can discuss how to begin your treatment journey.
![Photo of Sally A. Frede, LCSW, CCLS, RPT-S, Clinical Social Work/Therapist](https://photos.psychologytoday.com/69dfbc92-b5fa-457c-afb3-52536da4535d/2/320x400.jpeg)
Sally A. Frede
Clinical Social Work/Therapist, LCSW, CCLS, RPT-S
Verified Verified
1 Endorsed
Saint Joseph, MO 64506
I love working with Children of all ages! My goal is to help children navigate the increasingly complex world and difficulties that come with it. This includes family and school challenges. I enjoy partnering with parents to create family environment where children can thrive.
I love working with Children of all ages! My goal is to help children navigate the increasingly complex world and difficulties that come with it. This includes family and school challenges. I enjoy partnering with parents to create family environment where children can thrive.
![Photo of Summer E Ward, MA, LPC, CTS, Licensed Professional Counselor](https://photos.psychologytoday.com/3d9f3bff-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Summer E Ward
Licensed Professional Counselor, MA, LPC, CTS
Verified Verified
Saint Joseph, MO 64506
Waitlist for new clients
I would be truly privileged to support and guide you through the process of life and heart change through counseling. It is my honor to help you discover more meaning, purpose, and joy in your life. I provide a safe, genuine, and compassionate therapeutic environment for those experiencing emotional pain or difficulty. With a Christian worldview, I treat individuals using an integrated approach that combines elements from the study of psychology with biblical truth and faith in Christ.
I would be truly privileged to support and guide you through the process of life and heart change through counseling. It is my honor to help you discover more meaning, purpose, and joy in your life. I provide a safe, genuine, and compassionate therapeutic environment for those experiencing emotional pain or difficulty. With a Christian worldview, I treat individuals using an integrated approach that combines elements from the study of psychology with biblical truth and faith in Christ.
![Photo of Lisa D Fisher, MS, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/ba266ae3-42ed-42fc-aefe-03ba24d6bfb3/3/320x400.jpeg)
Lisa D Fisher
Licensed Professional Counselor, MS, LPC
Verified Verified
Saint Joseph, MO 64506
Waitlist for new clients
I am a Licensed Professional Counselor who works with adults, adolescents, children and families. I have experience working with clients who are experiencing symptoms of stress, depression, anxiety, emotional dysregulation, and trauma in a variety of outpatient settings. I utilize a holistic, strengths based approach that combines elements from Neuroscience, Attachment theory, Mindfulness, Cognitive-Behavioral theory, Art and Play therapy. I am now offering Direct Neurofeedback, which offers a drug-free approach to improving brain performance and forming new and enhanced patterns of functioning.
I am a Licensed Professional Counselor who works with adults, adolescents, children and families. I have experience working with clients who are experiencing symptoms of stress, depression, anxiety, emotional dysregulation, and trauma in a variety of outpatient settings. I utilize a holistic, strengths based approach that combines elements from Neuroscience, Attachment theory, Mindfulness, Cognitive-Behavioral theory, Art and Play therapy. I am now offering Direct Neurofeedback, which offers a drug-free approach to improving brain performance and forming new and enhanced patterns of functioning.
Rennie Chastain Gitthens
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Saint Joseph, MO 64506
I believe you have taken the first step of your journey toward healing by seeking a therapist. By using an empowerment and strength-based approach, I guide others in utilizing their own strengths and assets to resolve and heal their struggles and improve the quality of their life, in addition to living a more fulfilled life. It is very important for you, as the client, to feel comfortable with your therapist so that honesty and rapport can be built. I look forward to working with you.
I believe you have taken the first step of your journey toward healing by seeking a therapist. By using an empowerment and strength-based approach, I guide others in utilizing their own strengths and assets to resolve and heal their struggles and improve the quality of their life, in addition to living a more fulfilled life. It is very important for you, as the client, to feel comfortable with your therapist so that honesty and rapport can be built. I look forward to working with you.
![Photo of Lori Ann Kanke - Lori Kanke, Lcsw, LLC, LCSW, CRADC, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3e820e5d-46cd-11ea-a6ad-06142c356176/1/320x400.jpeg)
Lori Kanke, Lcsw, LLC
Clinical Social Work/Therapist, LCSW, CRADC
Verified Verified
Saint Joseph, MO 64506
Waitlist for new clients
Relationships can be very difficult and emotionally exhausting. In fact, problems in relationships can increase depression and anxiety. Depression and anxiety can affect all areas of life. I believe that there is hope for anyone who is having problems with relationships or mental health issues. I enjoy helping people make changes and improve their lives. For over 28 years, I've been helping clients with relationship issues, depression, anxiety, post traumatic stress disorder, and substance abuse. In addition, I've had the privilege to help couples resolve conflicts and improve communications.
Relationships can be very difficult and emotionally exhausting. In fact, problems in relationships can increase depression and anxiety. Depression and anxiety can affect all areas of life. I believe that there is hope for anyone who is having problems with relationships or mental health issues. I enjoy helping people make changes and improve their lives. For over 28 years, I've been helping clients with relationship issues, depression, anxiety, post traumatic stress disorder, and substance abuse. In addition, I've had the privilege to help couples resolve conflicts and improve communications.
![Photo of Gene Arnold, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3c9ca069-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
I have been working with individuals, couples, children and families for nearly a decade. My approach as a therapist is heartfelt, direct, genuine, and above all down-to-earth. Building rapport and making connections are the foundations to my style of therapy. I specialize in depression, anxiety, life transitions, divorce, blended families, individual, couple and family issues. It's not always easy to pin-point exactly "where it hurts" or what the main issue may be causing us pain. Please feel free to call or e-mail me anytime and we can discuss what your concerns.
I have been working with individuals, couples, children and families for nearly a decade. My approach as a therapist is heartfelt, direct, genuine, and above all down-to-earth. Building rapport and making connections are the foundations to my style of therapy. I specialize in depression, anxiety, life transitions, divorce, blended families, individual, couple and family issues. It's not always easy to pin-point exactly "where it hurts" or what the main issue may be causing us pain. Please feel free to call or e-mail me anytime and we can discuss what your concerns.
![Photo of Nicolette Rogers, LPC, NCC, Licensed Professional Counselor](https://photos.psychologytoday.com/6f3f63b3-9a28-48ae-be49-d539fbd12be6/2/320x400.jpeg)
Nicolette Rogers
Licensed Professional Counselor, LPC, NCC
Verified Verified
1 Endorsed
Saint Joseph, MO 64506
Stop. Take a deep breath, hold it...and slowly release. I’m sure you’re stressed and tense from all your searching. Finding a therapist can be difficult! There’s many assumptions about what therapy looks like, but let me tell you what to expect from me. I’m fairly direct, but I will be as authentic and transparent as I expect you to be. I will work with you to identify past and current experiences that may be impacting your career, relationships, parenting, and even health. Nothing is off limits when it comes to processing your concerns, as everything you experience is valid. Together we focus on healing and growth!
Stop. Take a deep breath, hold it...and slowly release. I’m sure you’re stressed and tense from all your searching. Finding a therapist can be difficult! There’s many assumptions about what therapy looks like, but let me tell you what to expect from me. I’m fairly direct, but I will be as authentic and transparent as I expect you to be. I will work with you to identify past and current experiences that may be impacting your career, relationships, parenting, and even health. Nothing is off limits when it comes to processing your concerns, as everything you experience is valid. Together we focus on healing and growth!
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![Photo of Whitney Blake Ide - Whitney B Ide Counseling, LLC, MA, LPC, Counselor](https://photos.psychologytoday.com/4626ab94-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Making the decision to seek help is the the first step towards living a healthier, happier life. The second step is finding the right therapist. I believe that success in therapy is dependent on the strength of the relationship between the counselor and client. I view myself as an advocate, a catalyst for change, and an objective sounding board, rather than an expert who can listen to your problems for an hour and then magically know how to run your life better than you do. You are the expert on you! My job is to help you learn how to help yourself.
Making the decision to seek help is the the first step towards living a healthier, happier life. The second step is finding the right therapist. I believe that success in therapy is dependent on the strength of the relationship between the counselor and client. I view myself as an advocate, a catalyst for change, and an objective sounding board, rather than an expert who can listen to your problems for an hour and then magically know how to run your life better than you do. You are the expert on you! My job is to help you learn how to help yourself.
![Photo of Kristen Siler-Kline, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/81c0dc78-948b-48bd-a477-8a5ee7779e3d/1/320x400.jpeg)
Kristen has extensive experience working with individuals with trauma, depression, anxiety, grief, loss, relationship issues and substance use. She meets individuals wherever they are at on life's journey and works to empower them as the experts in their own lives. Kristen offers a safe, non-judgmental and warm environment in which to spark healing and relief from current struggles. She uses a validating and empathetic approach, and would be honored to walk with you on your journey.
Kristen has extensive experience working with individuals with trauma, depression, anxiety, grief, loss, relationship issues and substance use. She meets individuals wherever they are at on life's journey and works to empower them as the experts in their own lives. Kristen offers a safe, non-judgmental and warm environment in which to spark healing and relief from current struggles. She uses a validating and empathetic approach, and would be honored to walk with you on your journey.
![Photo of Tina W. Sanborn, MSMFT, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/3c11d23b-46cd-11ea-a6ad-06142c356176/1/320x400.jpeg)
Tina W. Sanborn
Marriage & Family Therapist, MSMFT, LMFT
Verified Verified
4 Endorsed
Saint Joseph, MO 64506
Difficult seasons in our lives can often leave us feeling uncertain, overwhelmed and disconnected from others. If you find yourself struggling with emotional pain, past hurts, depression, anxiety, grief, parenting issues or other relationship concerns, there is hope.
It is my sincerest desire to provide a safe, supportive environment where clients can begin to heal and discover a restorative place of peace, emotional health and relational well-being. Using a collaborative process, I am committed to partnering with you as we seek to outline and address the changes that you desire.
Difficult seasons in our lives can often leave us feeling uncertain, overwhelmed and disconnected from others. If you find yourself struggling with emotional pain, past hurts, depression, anxiety, grief, parenting issues or other relationship concerns, there is hope.
It is my sincerest desire to provide a safe, supportive environment where clients can begin to heal and discover a restorative place of peace, emotional health and relational well-being. Using a collaborative process, I am committed to partnering with you as we seek to outline and address the changes that you desire.
![Photo of Jackie Moser, MS, LPC, LMHC, Licensed Professional Counselor](https://photos.psychologytoday.com/40c35271-46cd-11ea-a6ad-06142c356176/1/320x400.jpeg)
Jackie Moser
Licensed Professional Counselor, MS, LPC, LMHC
Verified Verified
1 Endorsed
Saint Joseph, MO 64506 (Online Only)
We ARE accepting new referrals at this time. We are virtual only. If this is a good format for you please contact us. We focus on adjustment issues related to life transitions, ADHD, stress management, behavioral issues with children, family and relationship conflicts. We have an empathetic approach and believe together, a solution can be found that matches your views and beliefs. It is important to us when seeking a therapist, you are matched with someone whom you are comfortable, can trust, and want to be open with.
We ARE accepting new referrals at this time. We are virtual only. If this is a good format for you please contact us. We focus on adjustment issues related to life transitions, ADHD, stress management, behavioral issues with children, family and relationship conflicts. We have an empathetic approach and believe together, a solution can be found that matches your views and beliefs. It is important to us when seeking a therapist, you are matched with someone whom you are comfortable, can trust, and want to be open with.
![Photo of Janet Luzmoor, MS, MA, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/1100c4bf-ffa6-40ff-bdee-1ef4a6db5d94/1/320x400.jpeg)
Janet Luzmoor
Licensed Professional Counselor, MS, MA, LPC
Verified Verified
1 Endorsed
Saint Joseph, MO 64506
It can be difficult to reach out and begin therapy! We understand that and work to make you feel welcome and safe by giving you a counselor with compassion and genuineness, coupled with a wide variety of life experiences, a strong educational background, and a range of past work settings. This combination of qualities fit together to provide you with wise counsel that brings relief and gives hope, resulting in satisfied clients whose lives have been significantly improved. Feel free to check out our website at www.janetluzmoorcounseling.com, where you can directly book your first session online, or call or email with questions.
It can be difficult to reach out and begin therapy! We understand that and work to make you feel welcome and safe by giving you a counselor with compassion and genuineness, coupled with a wide variety of life experiences, a strong educational background, and a range of past work settings. This combination of qualities fit together to provide you with wise counsel that brings relief and gives hope, resulting in satisfied clients whose lives have been significantly improved. Feel free to check out our website at www.janetluzmoorcounseling.com, where you can directly book your first session online, or call or email with questions.
![Photo of Devin Utz, LCSW , LMSW , CTRP-C, Clinical Social Work/Therapist](https://photos.psychologytoday.com/12ae6033-d18a-447a-9f02-2f50264d6f74/1/320x400.jpeg)
Devin Utz
Clinical Social Work/Therapist, LCSW , LMSW , CTRP-C
Verified Verified
Saint Joseph, MO 64506
Life can be difficult to navigate. Do you or your teen wish you could find the strength and confidence to push through the pressures and challenges of life? Do you or your teen struggle with overthinking, negative self talk or thoughts of not feeling good enough? Do you feel shame for not being able to perform, enjoy relationships, or cope with everyday life? Do you or your teen wish you could wake up happy and go to bed satisfied? You might even remember a time when you didn’t feel this way. Are you ready to feel confident again and make goals in life without the need to power through exhaustion or maladaptive coping.
Life can be difficult to navigate. Do you or your teen wish you could find the strength and confidence to push through the pressures and challenges of life? Do you or your teen struggle with overthinking, negative self talk or thoughts of not feeling good enough? Do you feel shame for not being able to perform, enjoy relationships, or cope with everyday life? Do you or your teen wish you could wake up happy and go to bed satisfied? You might even remember a time when you didn’t feel this way. Are you ready to feel confident again and make goals in life without the need to power through exhaustion or maladaptive coping.
![Photo of Hayston Wilson, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/329339ec-995b-41df-a7f1-0bc556442f62/1/320x400.jpeg)
Hayston Wilson
Licensed Professional Counselor, LPC
Verified Verified
2 Endorsed
Saint Joseph, MO 64506
I provide clinically focused and Biblically based mental health counseling and therapy services tailored for kids, teens, and adults. My services are offered both locally in rural Northwest Missouri and online. Taking the step to reach out for support can be incredibly challenging, and I genuinely appreciate your consideration in choosing me as your therapist.
I provide clinically focused and Biblically based mental health counseling and therapy services tailored for kids, teens, and adults. My services are offered both locally in rural Northwest Missouri and online. Taking the step to reach out for support can be incredibly challenging, and I genuinely appreciate your consideration in choosing me as your therapist.
![Photo of Courtney Koch, LPC, NCC, Licensed Professional Counselor](https://photos.psychologytoday.com/0032f8b9-bbd3-4b31-894c-0127229cda9b/1/320x400.jpeg)
Navigating life's challenges is no small feat. If you find yourself in a time of uncertainty, not sure of the next steps, or wrestling with difficult emotions, know that you're not alone. In the therapeutic journey, I provide a safe and secure environment where healing can take place. Counseling is a transformative process that empowers individuals to navigate their emotions, fostering lasting positive change. With 9 years of experience as a counselor, I bring a wealth of knowledge to our sessions.
Navigating life's challenges is no small feat. If you find yourself in a time of uncertainty, not sure of the next steps, or wrestling with difficult emotions, know that you're not alone. In the therapeutic journey, I provide a safe and secure environment where healing can take place. Counseling is a transformative process that empowers individuals to navigate their emotions, fostering lasting positive change. With 9 years of experience as a counselor, I bring a wealth of knowledge to our sessions.
See more therapy options for 64506
How does your Therapist compare?
Number of Therapists in 64506
10+
Average cost per session
$120
Therapists in 64506 who prioritize treating:
84% | Depression |
84% | Anxiety |
84% | Coping Skills |
79% | Relationship Issues |
79% | Trauma and PTSD |
74% | Grief |
68% | Self Esteem |
Average years in practice
13 Years
Top 3 insurances accepted
53% | Aetna |
53% | Optum |
47% | TRICARE |
How Therapists in 64506 see their clients
90% | In Person and Online | |
10% | Online Only |
Gender breakdown
95% | Female | |
5% | Male |
FAQs - About Therapy and Counseling
How can I find a therapist in 64506?
Search for nearby therapists or counselors by inputting your city, town, or suburb; or zip code; 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 zip code into the search bar.
Learn more about how to find a therapist
Learn more about how to find a therapist
Is everyone in the Psychology Today Therapy Directory a licensed therapist?
The Psychology Today directory lists providers who offer legitimate mental health services to the public, including psychologists, psychiatrists, social workers, and counselors.
Many have been licensed by the country or state where they practice; providers whose license or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Some clinicians or organizations provide services for which their state or country does not offer licenses, such as pastoral counseling. They may be selectively included without the “Verified” seal.
Many have been licensed by the country or state where they practice; providers whose license or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Some clinicians or organizations provide services for which their state or country does not offer licenses, such as pastoral counseling. They may be selectively included without the “Verified” seal.
What’s the difference between a psychologist, a therapist, and a counselor?
Therapists, psychologists, and counselors are all licensed mental health professionals. In the US, psychologists have earned a doctoral degree. The terms “therapist” and “counselor” are used somewhat interchangeably, but generally therapists offer longer-term, mental health care, while counselors offer shorter-term care that may focus on one domain, such as marriage, career, or academic challenges.
Clients should consider factors such as insurance coverage and their primary reason(s) for seeking therapy to determine the type of professional best suited to their needs. Someone struggling with mental health challenges such as depression or anxiety, for example, may wish to seek out a clinical psychologist or therapist, while someone navigating career obstacles or marital upheaval may benefit from seeing a counselor who can offer short-term, targeted support.
Clients should consider factors such as insurance coverage and their primary reason(s) for seeking therapy to determine the type of professional best suited to their needs. Someone struggling with mental health challenges such as depression or anxiety, for example, may wish to seek out a clinical psychologist or therapist, while someone navigating career obstacles or marital upheaval may benefit from seeing a counselor who can offer short-term, targeted support.
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 United States could cost between $100 and $200 or more. If you have insurance, the expense of mental health care is typically lower, but it varies based on your insurance plan details and whether you choose an in-network or out-of-network mental healthcare provider.
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.
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 zip code.
Are therapy sessions confidential?
Confidentiality is a crucial part of the therapeutic relationship. Therapists in the United States are bound by the regulations set out by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which aims to protect sensitive health information. With very few exceptions, a therapist will only discuss their client with others when the client has given their written permission. The instances in which a therapist would be required to disclose personal information are: if a client poses a danger to themselves or others, if the therapist suspects the abuse of a child or an elderly or otherwise dependent adult, or if they are legally forced to by court order. These exceptions to the confidentiality agreement are usually discussed with a client before their first session.