Photo of Nadine Johnson, MA, LMHCA, NCC, Counselor
Nadine Johnson
Counselor, MA, LMHCA, NCC
Verified Verified
1 Endorsed
The gift of meeting ourselves… in life, we sometimes have to endure extreme stress in difficult circumstances, and we are meant to continue to grow by making meaning and increasing the love in our lives. As an Army Veteran, I feel called to serve the veteran community, as well as others with difficult life experiences. My focus areas include trauma and PTSD, emotional imbalances, self-esteem, grief, and transitions. I draw from my spiritual path as well as personal experiences to connect deeply, and to honor each individual’s journey to healing.
The gift of meeting ourselves… in life, we sometimes have to endure extreme stress in difficult circumstances, and we are meant to continue to grow by making meaning and increasing the love in our lives. As an Army Veteran, I feel called to serve the veteran community, as well as others with difficult life experiences. My focus areas include trauma and PTSD, emotional imbalances, self-esteem, grief, and transitions. I draw from my spiritual path as well as personal experiences to connect deeply, and to honor each individual’s journey to healing.
(360) 347-2496 View (360) 347-2496
Photo of Steffanee Holt, MSW, LICSW, Clinical Social Work/Therapist
Steffanee Holt
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
As a WA State Certified DV Provider, I am now offering Court Ordered Evaluations. I believe there are times in a person's life when they need a trusted and confidential ally who can help a person explore the causes of his/her thoughts, feelings, or behaviors and develop new ways of thinking, acting and feeling. I am committed to helping individuals, couples and families achieve these goals in an environment that emphasizes confidentiality, respect, trust and compassion.
As a WA State Certified DV Provider, I am now offering Court Ordered Evaluations. I believe there are times in a person's life when they need a trusted and confidential ally who can help a person explore the causes of his/her thoughts, feelings, or behaviors and develop new ways of thinking, acting and feeling. I am committed to helping individuals, couples and families achieve these goals in an environment that emphasizes confidentiality, respect, trust and compassion.
(253) 231-7841 View (253) 231-7841
Photo of Norman Edward Dobson, MA, LMFT, LMHC, CDP, CPP, Marriage & Family Therapist
Norman Edward Dobson
Marriage & Family Therapist, MA, LMFT, LMHC, CDP, CPP
Verified Verified
2 Endorsed
Thank you for your interest. I am a retired (2001) combat veteran with twenty years of military service. My credentials/licenses are in Marriage & Family Therapy, Mental Health Counseling, and Chemical Dependency. My therapeutic approach is based on cognitive behavior research which has found a strong correlation between thoughts and behaviors. Additionally, I use the Narrative Therapy approach to understand emotions rooted in the client's life experiences that shape their strengths, fears, beliefs, values, and reactions to different types of stress.
Thank you for your interest. I am a retired (2001) combat veteran with twenty years of military service. My credentials/licenses are in Marriage & Family Therapy, Mental Health Counseling, and Chemical Dependency. My therapeutic approach is based on cognitive behavior research which has found a strong correlation between thoughts and behaviors. Additionally, I use the Narrative Therapy approach to understand emotions rooted in the client's life experiences that shape their strengths, fears, beliefs, values, and reactions to different types of stress.
(360) 810-5599 View (360) 810-5599
Photo of Tanisha Medina - SpeakLifeHealUp/Tanisha Medina, MA, LMHC, MHP, Counselor
SpeakLifeHealUp/Tanisha Medina
Counselor, MA, LMHC, MHP
Verified Verified
3 Endorsed
Not accepting new clients
*Not Accepting New Clients* I am the founder of SpeakLifeHealUp Counseling Services. My therapeutic approach is centered around my belief that we deserve to be heard and understood. Reaching out for help takes incredible courage and is one of the bravest things that you can do. My passion is to empower and equip individuals and couples experiencing invisible emotional wounds to heal themselves, build better relationships while strengthening connections and navigate through life challenges. You will discover your inner worth, love and acceptance. You have the power within yourself to do the work and awaken to your best-kept self!
*Not Accepting New Clients* I am the founder of SpeakLifeHealUp Counseling Services. My therapeutic approach is centered around my belief that we deserve to be heard and understood. Reaching out for help takes incredible courage and is one of the bravest things that you can do. My passion is to empower and equip individuals and couples experiencing invisible emotional wounds to heal themselves, build better relationships while strengthening connections and navigate through life challenges. You will discover your inner worth, love and acceptance. You have the power within yourself to do the work and awaken to your best-kept self!
(253) 285-1214 View (253) 285-1214
Photo of Denise M Coyle, LMFT, CTS, Marriage & Family Therapist
Denise M Coyle
Marriage & Family Therapist, LMFT, CTS
Verified Verified
Fort Lewis, WA 98433
Limited availability at this time. I Love what I do! Sounds Crazy- but the truth is I love working with people who have been thru unspeakable events in life and are looking to find their way back. Trauma is an abnormal event so approach it from a new perspective, talk about the things you are told not to and get into the depths of it. You have to be willing to walk into that bad neighborhood, that has become your mind, and clear it out- but you don't have to walk in there alone. Let me come with you. I'll be your lifeline.
Limited availability at this time. I Love what I do! Sounds Crazy- but the truth is I love working with people who have been thru unspeakable events in life and are looking to find their way back. Trauma is an abnormal event so approach it from a new perspective, talk about the things you are told not to and get into the depths of it. You have to be willing to walk into that bad neighborhood, that has become your mind, and clear it out- but you don't have to walk in there alone. Let me come with you. I'll be your lifeline.
(253) 336-6680 View (253) 336-6680
Photo of Amber K. Jaworski, MA, LMFT, Marriage & Family Therapist
Amber K. Jaworski
Marriage & Family Therapist, MA, LMFT
Verified Verified
6 Endorsed
Joint Base Lewis Mcchord, WA 98433  (Online Only)
I am a telehealth provider across Washington State, and I am currently accepting new clients. In life, unexpected things happen. Challenges and bumps in the road are all part of it. Sometimes with the the help of another we can make room for and navigate through planned or unexpected changes. With the help of a trained professional, life challenges can become easier to deal with. During the therapeutic process, I will work with the tools you already have in order to tackle life's problems.
I am a telehealth provider across Washington State, and I am currently accepting new clients. In life, unexpected things happen. Challenges and bumps in the road are all part of it. Sometimes with the the help of another we can make room for and navigate through planned or unexpected changes. With the help of a trained professional, life challenges can become easier to deal with. During the therapeutic process, I will work with the tools you already have in order to tackle life's problems.
(630) 352-4439 View (630) 352-4439
Photo of Kate Estadilla, MA, LMHC, Counselor
Kate Estadilla
Counselor, MA, LMHC
Verified Verified
3 Endorsed
Joint Base Lewis Mcchord, WA 98433  (Online Only)
I understand the difficulties of meeting someone new and discussing items that may leave one feeling vulnerable.  As a therapist and especially as a person, I highly value our relationship and find this to be essential in the therapy process.  I enjoy working with individuals by building trust with me and with this process.  I also believe in creating a collaborative relationship in which I respect your needs while balancing the therapeutic interventions that I can provide. I have a long history of working with individuals who struggle with anxiety and depression, and I specialize in working with those who have experienced trauma.
I understand the difficulties of meeting someone new and discussing items that may leave one feeling vulnerable.  As a therapist and especially as a person, I highly value our relationship and find this to be essential in the therapy process.  I enjoy working with individuals by building trust with me and with this process.  I also believe in creating a collaborative relationship in which I respect your needs while balancing the therapeutic interventions that I can provide. I have a long history of working with individuals who struggle with anxiety and depression, and I specialize in working with those who have experienced trauma.
(253) 319-3761 View (253) 319-3761
Photo of Cornilia E Denson, MSW, LSWAIC, Clinical Social Work/Therapist
Cornilia E Denson
Clinical Social Work/Therapist, MSW, LSWAIC
Verified Verified
1 Endorsed
Tacoma, WA 98433  (Online Only)
Hello! How would you like to start towards a path of emotional and mental healing? I would like to be entrusted to be your guide while on that path. To guide you towards autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. As someone with over 10 years of having the privilege of working with individuals who have encountered some element of a mental health crisis. I am very committed, passionate, patient, and flexible as a therapist. I possess the necessary interpersonal skills that inspire a trusting therapeutic relationship.
Hello! How would you like to start towards a path of emotional and mental healing? I would like to be entrusted to be your guide while on that path. To guide you towards autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. As someone with over 10 years of having the privilege of working with individuals who have encountered some element of a mental health crisis. I am very committed, passionate, patient, and flexible as a therapist. I possess the necessary interpersonal skills that inspire a trusting therapeutic relationship.
(509) 303-4247 View (509) 303-4247
Photo of Mike Pereira, MSW, LICSWA, MHP, Clinical Social Work/Therapist
Mike Pereira
Clinical Social Work/Therapist, MSW, LICSWA, MHP
Verified Verified
Accepting new clients. The journey to healing begins with a desire to feel better. Together, we’ll work to discover what “better” looks like and what can be done to achieve it. There are many ways life shows us we are stuck in our own story; addiction, depression, anxiety, anger and many other indicators can be present when we’re experiencing such pain. How did we get here? How do we get out? What are we holding onto? Who can we not let go?
Accepting new clients. The journey to healing begins with a desire to feel better. Together, we’ll work to discover what “better” looks like and what can be done to achieve it. There are many ways life shows us we are stuck in our own story; addiction, depression, anxiety, anger and many other indicators can be present when we’re experiencing such pain. How did we get here? How do we get out? What are we holding onto? Who can we not let go?
(360) 227-6842 View (360) 227-6842
Photo of Robin L Pellerin, LMFTA, LMHCA, CGP, Marriage & Family Therapist Associate
Robin L Pellerin
Marriage & Family Therapist Associate, LMFTA, LMHCA, CGP
Verified Verified
3 Endorsed
Tacoma, WA 98433
When life gets messy, we can feel lost and disconnected not only from others but from ourselves. Are you struggling with a loss in your life? A family member or friend? A divorce? A relationship? Or yourself? As a certified grief professional, mental health counselor associate, marriage and family therapist associate, and first responder therapist, I have spent 5 years supporting military members, their families, and veterans who are working through one of life's most challenging journey's and the complex emotions that accompany them. My hope is to provide a safe, respectful, and nonjudgmental space to process these emotions.
When life gets messy, we can feel lost and disconnected not only from others but from ourselves. Are you struggling with a loss in your life? A family member or friend? A divorce? A relationship? Or yourself? As a certified grief professional, mental health counselor associate, marriage and family therapist associate, and first responder therapist, I have spent 5 years supporting military members, their families, and veterans who are working through one of life's most challenging journey's and the complex emotions that accompany them. My hope is to provide a safe, respectful, and nonjudgmental space to process these emotions.
(253) 733-1216 View (253) 733-1216
Photo of Jordan Zollinger, MA, LMHCA, Counselor
Jordan Zollinger
Counselor, MA, LMHCA
Verified Verified
I remember when I showed up to my first counseling appointment as a client. I was nervous, embarrassed, and feeling defeated. In that moment, my physical body carried those emotions in that it felt on edge, almost willing me to get up and leave the counseling center. I also remember the connection I made with my counselor during that first session, and how I knew that is what I needed for that season of life. I understand that for most clients, showing up to their first (or second, or fiftieth..) counseling appointment is terrifying. For many, it feels like they don’t know where else to go, what to do, or who to turn to.
I remember when I showed up to my first counseling appointment as a client. I was nervous, embarrassed, and feeling defeated. In that moment, my physical body carried those emotions in that it felt on edge, almost willing me to get up and leave the counseling center. I also remember the connection I made with my counselor during that first session, and how I knew that is what I needed for that season of life. I understand that for most clients, showing up to their first (or second, or fiftieth..) counseling appointment is terrifying. For many, it feels like they don’t know where else to go, what to do, or who to turn to.
(253) 544-6209 View (253) 544-6209
Photo of Jessica L Flores, LMFTA, Marriage & Family Therapist Associate
Jessica L Flores
Marriage & Family Therapist Associate, LMFTA
Verified Verified
1 Endorsed
I'm a licensed marriage and family therapy associate specializing in providing mental health support to individuals and families. I cater my approach with each client I encounter to create an empathetic, non-judgmental, and collaborative therapeutic relationship. I take a holistic approach to therapy with the understanding that therapy is not one-size-fits all; utilizing an array of therapeutic approaches and models, I work with my clients to find the personal growth and healing they are looking for with the belief that those who seek change, will find it.
I'm a licensed marriage and family therapy associate specializing in providing mental health support to individuals and families. I cater my approach with each client I encounter to create an empathetic, non-judgmental, and collaborative therapeutic relationship. I take a holistic approach to therapy with the understanding that therapy is not one-size-fits all; utilizing an array of therapeutic approaches and models, I work with my clients to find the personal growth and healing they are looking for with the belief that those who seek change, will find it.
(253) 649-6029 View (253) 649-6029
Photo of Jolene D Rogers, MA, LPC, Licensed Professional Counselor
Jolene D Rogers
Licensed Professional Counselor, MA, LPC
Verified Verified
Fort Lewis, WA 98433
I am a licensed professional counselor, in Washington, Oregon, Idaho, and Alaska. With experience working in schools, hospitals, community-based care settings, and residential programs, I offer a wide array of tools and strategies for supporting you, your child, and your family. I work to build a relationship with each client and their family to provide a welcome, inviting, and supportive space for therapy.
I am a licensed professional counselor, in Washington, Oregon, Idaho, and Alaska. With experience working in schools, hospitals, community-based care settings, and residential programs, I offer a wide array of tools and strategies for supporting you, your child, and your family. I work to build a relationship with each client and their family to provide a welcome, inviting, and supportive space for therapy.
(844) 780-5134 View (844) 780-5134
Photo of Kristen Moore - Key Counseling PLLC, EdD, LMHC, Counselor
Key Counseling PLLC
Counselor, EdD, LMHC
Verified Verified
Now accepting new clients! Hello! I'm Dr. Kristen Moore (nee Bradley). My focus is on adult clients who have anxiety, depression, trauma, or PTSD. I strive to create a supportive environment and work with you to come up with a plan that addresses your concerns where you are right now. I believe everyone has strengths and that sometimes people become so overwhelmed they lose sight of themselves. I'm a guide that helps you find your way back and encourages you to keep moving forward. If you experience insomnia, nightmares, flashbacks, fatigue, sudden anger, anxiety or depression and feel it is time to get control back, call me.
Now accepting new clients! Hello! I'm Dr. Kristen Moore (nee Bradley). My focus is on adult clients who have anxiety, depression, trauma, or PTSD. I strive to create a supportive environment and work with you to come up with a plan that addresses your concerns where you are right now. I believe everyone has strengths and that sometimes people become so overwhelmed they lose sight of themselves. I'm a guide that helps you find your way back and encourages you to keep moving forward. If you experience insomnia, nightmares, flashbacks, fatigue, sudden anger, anxiety or depression and feel it is time to get control back, call me.
(360) 795-5283 View (360) 795-5283
Photo of Frankie Kennedy - The Daniel Clinic, LLC, Counselor
The Daniel Clinic, LLC
Counselor
Verified Verified
1 Endorsed
Tacoma, WA 98433
I am Frankie Kennedy, the director of a group practice that strives to offer top-notch care to clients across the state of Washington. After nearly two decades of providing care and support to my clients, I have decided to pass the baton to the many experienced counselors at The Daniel Clinic. Visit our website to make an appointment. You can read more about our clinicians on our website or here on Psychology Today
I am Frankie Kennedy, the director of a group practice that strives to offer top-notch care to clients across the state of Washington. After nearly two decades of providing care and support to my clients, I have decided to pass the baton to the many experienced counselors at The Daniel Clinic. Visit our website to make an appointment. You can read more about our clinicians on our website or here on Psychology Today
(253) 544-3938 View (253) 544-3938
Photo of Robin DeBates, LCSW, BSN-RN, Clinical Social Work/Therapist
Robin DeBates
Clinical Social Work/Therapist, LCSW, BSN-RN
Verified Verified
Tacoma, WA 98433
Geeks, nerds, hackers, burners, and makers are my specialty! Tired of having a therapist roll their eyes when you talk about gaming? Over it trying to explain that Discord is a chat server and not a state of disharmony? Feeling finished with people who don't understand online friendships are valid social support? You deserve a therapist who gets you in all of your delightful nerdiness and awkwardness. Therapy for geeks from a geek therapist might just be the support you're looking for.
Geeks, nerds, hackers, burners, and makers are my specialty! Tired of having a therapist roll their eyes when you talk about gaming? Over it trying to explain that Discord is a chat server and not a state of disharmony? Feeling finished with people who don't understand online friendships are valid social support? You deserve a therapist who gets you in all of your delightful nerdiness and awkwardness. Therapy for geeks from a geek therapist might just be the support you're looking for.
(215) 273-3504 View (215) 273-3504
Photo of Kae K Starr, PhD, LMFTA, LMHCA, Counselor
Kae K Starr
Counselor, PhD, LMFTA, LMHCA
Verified Verified
1 Endorsed
Fort Lewis, WA 98433  (Online Only)
Not accepting new clients
I am a Family, and Individual mental health counselor, versed in multiple modalities of therapeutic interventions, providing family and individual therapy, career counseling, counseling assessment, and multicultural psychology. I am very proficient in working with adolescents (13+), LGBTQ+ youth, Military families, and BIPOC populations.
I am a Family, and Individual mental health counselor, versed in multiple modalities of therapeutic interventions, providing family and individual therapy, career counseling, counseling assessment, and multicultural psychology. I am very proficient in working with adolescents (13+), LGBTQ+ youth, Military families, and BIPOC populations.
(360) 594-0473 View (360) 594-0473
Photo of Yolonda Massey - Calmli Guided Psychotherapy, PLLC, MA, LMFT, Marriage & Family Therapist
Calmli Guided Psychotherapy, PLLC
Marriage & Family Therapist, MA, LMFT
Verified Verified
As a Systemic therapist who also understands the importance of a person-centered approach, I help individuals, couples, and family’s increase awareness of current emotional, behavioral, and communicative patterns that create a barrier to personal and interpersonal growth. Recognizing the importance of culture and identity, I utilize an intersectional approach to each individual and family.
As a Systemic therapist who also understands the importance of a person-centered approach, I help individuals, couples, and family’s increase awareness of current emotional, behavioral, and communicative patterns that create a barrier to personal and interpersonal growth. Recognizing the importance of culture and identity, I utilize an intersectional approach to each individual and family.
(253) 342-4289 View (253) 342-4289
Photo of Mindy Alexander, LMHC
Mindy Alexander
Mental Health Counselor, LMHC
Verified Verified
Tacoma, WA 98433  (Online Only)
Not accepting new clients
Are you feeling overwhelmed by everyday tasks? Is something lacking in your relationship? Are you bogged down by work stress? Do worrying and feelings of unease take up much of your day? Life is too short to feel “stuck.” Sometimes, obstacles can get in the way of living your best life. Seeking outside guidance and support can be helpful. Utilizing a variety of therapeutic techniques and approaches, I strive to provide a safe and supportive environment to help you reach your goals. With over two decades of experience in the behavioral health field, I specialize in working with adults and couples dealing with various concerns.
Are you feeling overwhelmed by everyday tasks? Is something lacking in your relationship? Are you bogged down by work stress? Do worrying and feelings of unease take up much of your day? Life is too short to feel “stuck.” Sometimes, obstacles can get in the way of living your best life. Seeking outside guidance and support can be helpful. Utilizing a variety of therapeutic techniques and approaches, I strive to provide a safe and supportive environment to help you reach your goals. With over two decades of experience in the behavioral health field, I specialize in working with adults and couples dealing with various concerns.
(253) 528-5546 View (253) 528-5546
Photo of Robert E Bates, MA, LMHC, Counselor
Robert E Bates
Counselor, MA, LMHC
Verified Verified
Joint Base Lewis Mcchord, WA 98433  (Online Only)
I am currently Focusing on Military Veterans in my practice: We can all use a little help now and then. I bring a diverse skill set of life and counseling experience. I grew up with a tumultuous household in a small community. I joined the military at a young age and have lived and worked throughout the world. I have had my own family, raising children weathering many successes and failures in the process. I have experienced counseling as a client; my personal experience enhances my great respect for my clients' vulnerability in our sessions. I am a fellow traveler in life, as you learn and grow so do I.
I am currently Focusing on Military Veterans in my practice: We can all use a little help now and then. I bring a diverse skill set of life and counseling experience. I grew up with a tumultuous household in a small community. I joined the military at a young age and have lived and worked throughout the world. I have had my own family, raising children weathering many successes and failures in the process. I have experienced counseling as a client; my personal experience enhances my great respect for my clients' vulnerability in our sessions. I am a fellow traveler in life, as you learn and grow so do I.
(509) 236-1418 View (509) 236-1418

See more therapy options for 98433

How does your Therapist compare?

Number of Therapists in 98433

20+

Average cost per session

$140

Therapists in 98433 who prioritize treating:

100% Anxiety
90% Depression
85% Trauma and PTSD
85% Self Esteem
80% Coping Skills
80% Veterans
80% Life Transitions

Average years in practice

7 Years

Top 3 insurances accepted

81% Premera
75% Regence
56% Aetna

How Therapists in 98433 see their clients

70% In Person and Online
30% Online Only

Gender breakdown

80% Female
20% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 98433?

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

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.

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.

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.