Therapists in Malvern, PA

Photo of Dr. Dawn N. Sheehan, PsyD, Psychologist
Dr. Dawn N. Sheehan
Psychologist, PsyD
Verified Verified
Malvern, PA 19355
Not accepting new clients
I strongly believe that each of my patients possesses the intellectual and emotional capacity required to meet the internal and external challenges of life with increased insight and drive necessary to achieve their ultimate goals.
I strongly believe that each of my patients possesses the intellectual and emotional capacity required to meet the internal and external challenges of life with increased insight and drive necessary to achieve their ultimate goals.
(610) 379-3012 View (610) 379-3012
Photo of Staci J Connolly - Cornerstone Therapy and Wellness, LCSW, Clinical Social Work/Therapist
Cornerstone Therapy and Wellness
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Malvern, PA 19355
Your full-service psychotherapy practice offering counseling, psychiatry, psychological testing and nutritional services for children, adolescents, adults, couples and families. Our goal is to partner with you in “building the foundation for healthy living,” through providing quality, comprehensive care. Our practice is designed to make quality mental health care as accessible and stress-free as possible. We will streamline care from aligning you with the appropriate therapist to meet your individual needs.
Your full-service psychotherapy practice offering counseling, psychiatry, psychological testing and nutritional services for children, adolescents, adults, couples and families. Our goal is to partner with you in “building the foundation for healthy living,” through providing quality, comprehensive care. Our practice is designed to make quality mental health care as accessible and stress-free as possible. We will streamline care from aligning you with the appropriate therapist to meet your individual needs.
(610) 616-5935 View (610) 616-5935
Photo of Steve Shapiro, PhD, Psychologist
Steve Shapiro
Psychologist, PhD
Verified Verified
2 Endorsed
Malvern, PA 19355
Are you in emotional pain and ready for a change? Are anxiety, depression, self-defeating behavior or relationship issues standing between you and your happiness or personal goals? My aim is to help you begin healing as quickly as possible, even when the issues are long-standing. As a therapist, I am actively engaged in the process and collaborate to help you remove barriers and learn to use your innate capacities for growth. Together, we will explore the present and seek out transformational processes, rather than focus on the past or simply relive old wounds as a more traditional approach might.
Are you in emotional pain and ready for a change? Are anxiety, depression, self-defeating behavior or relationship issues standing between you and your happiness or personal goals? My aim is to help you begin healing as quickly as possible, even when the issues are long-standing. As a therapist, I am actively engaged in the process and collaborate to help you remove barriers and learn to use your innate capacities for growth. Together, we will explore the present and seek out transformational processes, rather than focus on the past or simply relive old wounds as a more traditional approach might.
(610) 688-4940 View (610) 688-4940
Photo of Adam Bernstein, MA, LPC, Licensed Professional Counselor
Adam Bernstein
Licensed Professional Counselor, MA, LPC
Verified Verified
1 Endorsed
Malvern, PA 19355  (Online Only)
Fulfilling our potential is a lifelong journey of becoming more at peace with ourselves, deepening the intimacy in our relationships, being more authentically human, and feeling more alive each day. Along the way, certain challenges arise to cause us distress or confusion. Such moments can make us feel held back, afraid, or unsure of where to go from here. But these moments can also be the points of growth and healing from which we renew ourselves in ways we did not think possible.
Fulfilling our potential is a lifelong journey of becoming more at peace with ourselves, deepening the intimacy in our relationships, being more authentically human, and feeling more alive each day. Along the way, certain challenges arise to cause us distress or confusion. Such moments can make us feel held back, afraid, or unsure of where to go from here. But these moments can also be the points of growth and healing from which we renew ourselves in ways we did not think possible.
(610) 601-3637 View (610) 601-3637
Photo of Lisa Diorio, MSW, Pre-Licensed Professional
Lisa Diorio
Pre-Licensed Professional, MSW
Verified Verified
2 Endorsed
Malvern, PA 19355
Everyone deserves to live their life authentically and fully. Many of us are hindered by our past experiences and trauma. The shadow of trauma and pain may follow our daily lives and keep us from reaching our goals and deepening our relationships. Trauma therapy can be the course-correction needed to jump start your life. My passion is helping my clients sort through those experiences to reach their internal joy, peace and authenticity.
Everyone deserves to live their life authentically and fully. Many of us are hindered by our past experiences and trauma. The shadow of trauma and pain may follow our daily lives and keep us from reaching our goals and deepening our relationships. Trauma therapy can be the course-correction needed to jump start your life. My passion is helping my clients sort through those experiences to reach their internal joy, peace and authenticity.
(610) 540-7171 View (610) 540-7171
Photo of Nancy Buckwalter, LCSW, Clinical Social Work/Therapist
Nancy Buckwalter
Clinical Social Work/Therapist, LCSW
Verified Verified
Malvern, PA 19355
Not accepting new clients
Need help adjusting to a life change? Choosing to seek help through psychotherapy is a positive and resourceful step toward having the life and relationships you desire. In my 20 years of practice I have had the privilege of partnering with parents who face the challenge of addressing at-risk behavior in their teen and young adult, the parents who have lost their child to substance abuse or suicide, the couples who find ways to reconnect, address intimacy issues and co-parent effectively, the college student who needs support, the teen who feels overwhelmed and the adult who experiences anxiety and depression.
Need help adjusting to a life change? Choosing to seek help through psychotherapy is a positive and resourceful step toward having the life and relationships you desire. In my 20 years of practice I have had the privilege of partnering with parents who face the challenge of addressing at-risk behavior in their teen and young adult, the parents who have lost their child to substance abuse or suicide, the couples who find ways to reconnect, address intimacy issues and co-parent effectively, the college student who needs support, the teen who feels overwhelmed and the adult who experiences anxiety and depression.
(484) 313-4287 View (484) 313-4287
Photo of Chris Williams - Chris Williams LCSW, LLC, LCSW, Clinical Social Work/Therapist
Chris Williams LCSW, LLC
Clinical Social Work/Therapist, LCSW
Verified Verified
3 Endorsed
Malvern, PA 19355
Are you angry, withdrawn, or stressed out? Do you often feel like you're spinning your wheels? I am an active therapist who will help you make meaningful, lasting change in your life. I see people who want a thorough and challenging therapy experience. Relationships, thoughts, feelings, and behaviors (and how they intermingle) are vital, and a focus of my work. My clients appreciate my balance of compassion with a direct, straightforward approach. I have advanced training in various psychotherapy approaches.
Are you angry, withdrawn, or stressed out? Do you often feel like you're spinning your wheels? I am an active therapist who will help you make meaningful, lasting change in your life. I see people who want a thorough and challenging therapy experience. Relationships, thoughts, feelings, and behaviors (and how they intermingle) are vital, and a focus of my work. My clients appreciate my balance of compassion with a direct, straightforward approach. I have advanced training in various psychotherapy approaches.
(484) 643-4196 View (484) 643-4196
Photo of Jenna Mercadante, PsyD, Psychologist
Jenna Mercadante
Psychologist, PsyD
Verified Verified
Malvern, PA 19355
My name is Dr. Jenna Mercadante. When working with individuals seeking treatment, I take a person-centered, holistic approach, focusing on the clients particular needs, preferences, and strengths and incorporating those into a practical & collaborative treatment plan. I see individuals as more than their psychiatric diagnosis, and thus, I seek to encourage personal growth & recovery (as opposed to only symptom reduction). In terms of treatment, I take a cognitive-behavioral therapeutic approach while incorporating mindfulness techniques. Mindfulness is simply intentional focusing, non-judgmentally, in the present moment.
My name is Dr. Jenna Mercadante. When working with individuals seeking treatment, I take a person-centered, holistic approach, focusing on the clients particular needs, preferences, and strengths and incorporating those into a practical & collaborative treatment plan. I see individuals as more than their psychiatric diagnosis, and thus, I seek to encourage personal growth & recovery (as opposed to only symptom reduction). In terms of treatment, I take a cognitive-behavioral therapeutic approach while incorporating mindfulness techniques. Mindfulness is simply intentional focusing, non-judgmentally, in the present moment.
(610) 646-1851 View (610) 646-1851
Photo of Carolyn P. Smith - Main Line Therapy (Carolyn Smith), LCSW, Clinical Social Work/Therapist
Main Line Therapy (Carolyn Smith)
Clinical Social Work/Therapist, LCSW
Verified Verified
Malvern, PA 19355
Therapy is learning about yourself and understanding what your triggers are, where they came from and how to best manage them. It's also about learning strategies that will help you cope with stressors specific to what is going on in your life. Whether you are looking for guidance with anxiety or depression, support in maintaining and managing a difficult relationship, tools to better manage your emotions, help with grieving a loss, confronting a fear or gaining insight, self awareness and confidence, you've found the right place and the results can be life changing.
Therapy is learning about yourself and understanding what your triggers are, where they came from and how to best manage them. It's also about learning strategies that will help you cope with stressors specific to what is going on in your life. Whether you are looking for guidance with anxiety or depression, support in maintaining and managing a difficult relationship, tools to better manage your emotions, help with grieving a loss, confronting a fear or gaining insight, self awareness and confidence, you've found the right place and the results can be life changing.
(610) 484-1255 View (610) 484-1255
Photo of Lauren Melissa Lippincott - Lippincott Psychological Services PLLC, PhD, LMHC, Psychologist
Lippincott Psychological Services PLLC
Psychologist, PhD, LMHC
Verified Verified
Malvern, PA 19355
Not accepting new clients
Everyone is on their own journey toward self-fulfillment and satisfaction. Therapy can be a powerful tool to use while on this journey. I work collaboratively with my clients, grounding myself in a humanistic-existential perspective. I am honored to be a part of my clients’ journeys as they move through life. In addition to therapy, I also offer psychological assessments including pre-bariatric surgical assessments, forensic assessments, child custody, parental fitness, learning disability, ADHD, IQ, and disability. I look forward to working with you.
Everyone is on their own journey toward self-fulfillment and satisfaction. Therapy can be a powerful tool to use while on this journey. I work collaboratively with my clients, grounding myself in a humanistic-existential perspective. I am honored to be a part of my clients’ journeys as they move through life. In addition to therapy, I also offer psychological assessments including pre-bariatric surgical assessments, forensic assessments, child custody, parental fitness, learning disability, ADHD, IQ, and disability. I look forward to working with you.
(484) 209-5210 View (484) 209-5210
Photo of Ethan Tankel, MSEd, Licensed Professional Counselor
Ethan Tankel
Licensed Professional Counselor, MSEd
Verified Verified
1 Endorsed
Malvern, PA 19355
It can be hard to pin down what’s wrong. Life is can be challenging and sometimes we have difficulty seeing how to get back on track. This probably isn’t your first time considering therapy, but you’re hoping something changes this time. Let’s make that change together.
It can be hard to pin down what’s wrong. Life is can be challenging and sometimes we have difficulty seeing how to get back on track. This probably isn’t your first time considering therapy, but you’re hoping something changes this time. Let’s make that change together.
(610) 439-9395 View (610) 439-9395
Photo of Ryan Strathy, LPC, Licensed Professional Counselor
Ryan Strathy
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Malvern, PA 19355
As a Licensed Professional Counselor, I consider it to be an honor and a privilege to be a part of each individual’s healing and journey through therapy. I believe in the importance of creating a strong therapeutic relationship between myself and my clients. I strive to create such a relationship by treating each client with unconditional positive regard and empathy. Seeking and asking for help can be difficult especially if you have ever felt invalidated or unheard. I aim to support my clients in expressing their needs and becoming their authentic self and creating a meaningful, purposeful life.
As a Licensed Professional Counselor, I consider it to be an honor and a privilege to be a part of each individual’s healing and journey through therapy. I believe in the importance of creating a strong therapeutic relationship between myself and my clients. I strive to create such a relationship by treating each client with unconditional positive regard and empathy. Seeking and asking for help can be difficult especially if you have ever felt invalidated or unheard. I aim to support my clients in expressing their needs and becoming their authentic self and creating a meaningful, purposeful life.
(610) 756-1451 View (610) 756-1451
Photo of Abby S Mcgillivray, MSW, LCSW, BCD, Clinical Social Work/Therapist
Abby S Mcgillivray
Clinical Social Work/Therapist, MSW, LCSW, BCD
Verified Verified
1 Endorsed
Malvern, PA 19355
Not accepting new clients
Abby specializes in psychotherapy and integrative wellness coaching. She has thirty years of experience counseling children, adults and families and coaching adults through life transitions. Abby obtained her Master's degree in Social Work from Syracuse University with a concentration in Family Mental Health. She is a Licensed Clinical Social Worker and upholds the highest standards in her field as a Board Certified Clinical Social Worker.
Abby specializes in psychotherapy and integrative wellness coaching. She has thirty years of experience counseling children, adults and families and coaching adults through life transitions. Abby obtained her Master's degree in Social Work from Syracuse University with a concentration in Family Mental Health. She is a Licensed Clinical Social Worker and upholds the highest standards in her field as a Board Certified Clinical Social Worker.
(610) 898-3226 View (610) 898-3226
Photo of Britni Harris, MA, LPC, Licensed Professional Counselor
Britni Harris
Licensed Professional Counselor, MA, LPC
Verified Verified
Malvern, PA 19355  (Online Only)
As a therapist, I recognize the courage it takes to address and heal from trauma, and I want to assure you that I am here to support you. I will approach our work with empathy, understanding, and a deep respect for your experiences. I am dedicated to creating a space where you feel heard, validated, and empowered as we navigate your healing journey. Your trust is fundamental to our therapeutic relationship, and I am committed to earning and maintaining it. As I work with you and your journey dealing with trauma, grief, loss, and anxiety, I will meet you with empathy understanding, and a deep respect for your traumatic experiences.
As a therapist, I recognize the courage it takes to address and heal from trauma, and I want to assure you that I am here to support you. I will approach our work with empathy, understanding, and a deep respect for your experiences. I am dedicated to creating a space where you feel heard, validated, and empowered as we navigate your healing journey. Your trust is fundamental to our therapeutic relationship, and I am committed to earning and maintaining it. As I work with you and your journey dealing with trauma, grief, loss, and anxiety, I will meet you with empathy understanding, and a deep respect for your traumatic experiences.
(484) 371-7661 View (484) 371-7661
Photo of Jenny Hoving, LPC, Licensed Professional Counselor
Jenny Hoving
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Malvern, PA 19355
I work with individuals at all stages of life struggling with anxiety, OCD, and related challenges. Anxiety comes in many “flavors” and looks different on everyone. As a former teacher, I am especially passionate about working with children and adolescents. Parents often report feeling heartbroken and frustrated as they try to figure out ways to help their child. I work with parents to strengthen their relationship with their child while also going beyond temporary fixes to address core issues. I also have a special interest in working with young adults struggling with stress and anxiety.
I work with individuals at all stages of life struggling with anxiety, OCD, and related challenges. Anxiety comes in many “flavors” and looks different on everyone. As a former teacher, I am especially passionate about working with children and adolescents. Parents often report feeling heartbroken and frustrated as they try to figure out ways to help their child. I work with parents to strengthen their relationship with their child while also going beyond temporary fixes to address core issues. I also have a special interest in working with young adults struggling with stress and anxiety.
(267) 209-6523 View (267) 209-6523
Photo of Michele Chubb, LCSW, Clinical Social Work/Therapist
Michele Chubb
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Malvern, PA 19355
Have you been struggling with depression, anxiety or relationship issues? Do you feel like you are stuck or in a spiral? Have you had trauma in your life? Do you feel like you have no one to talk to or that no one understands what you are going through? I can help with these issues and more. I offer a safe and accepting environment while using an eclectic approach that best fits your individual needs and strengths. I take the time to listen and understand. We will also take the time to develop the therapeutic relationship which is a key element to successful therapy.
Have you been struggling with depression, anxiety or relationship issues? Do you feel like you are stuck or in a spiral? Have you had trauma in your life? Do you feel like you have no one to talk to or that no one understands what you are going through? I can help with these issues and more. I offer a safe and accepting environment while using an eclectic approach that best fits your individual needs and strengths. I take the time to listen and understand. We will also take the time to develop the therapeutic relationship which is a key element to successful therapy.
(484) 406-3130 View (484) 406-3130
Photo of Diana Gevurtz, LMFT, Marriage & Family Therapist
Diana Gevurtz
Marriage & Family Therapist, LMFT
Verified Verified
Malvern, PA 19355  (Online Only)
I am Diana, a Licensed & Marriage and Family Therapist working to create a warm and compassionate space for individuals, couples, and families on their journey toward healing and growth. With a passion for fostering positive connections and promoting emotional well-being, my approach is rooted in respect, empathy, and collaboration - recognizing the uniqueness of each person's story.
I am Diana, a Licensed & Marriage and Family Therapist working to create a warm and compassionate space for individuals, couples, and families on their journey toward healing and growth. With a passion for fostering positive connections and promoting emotional well-being, my approach is rooted in respect, empathy, and collaboration - recognizing the uniqueness of each person's story.
(215) 402-5457 View (215) 402-5457
Photo of Ginny Virginia Burke, MSW, LMSW, CGE, Clinical Social Work/Therapist
Ginny Virginia Burke
Clinical Social Work/Therapist, MSW, LMSW, CGE
Verified Verified
Malvern, PA 19355
I specialize in addiction recovery, improving low self-esteem, managing depression, anxiety, PTSD and trauma for Individuals and their Families struggling with SUD. Combining my knowledge of CBT, DBT, Motivational Interviewing, IFS, Grief Counseling and my own life experiences, I am able to bring a level of understanding, empathy and compassion to each session while teaching and collaborating with you to re-discover your self-worth, identity and purpose in life eradicating all negative thoughts, stigma and shame others would have you believe. It is all inside you, I can help you find who you already are.
I specialize in addiction recovery, improving low self-esteem, managing depression, anxiety, PTSD and trauma for Individuals and their Families struggling with SUD. Combining my knowledge of CBT, DBT, Motivational Interviewing, IFS, Grief Counseling and my own life experiences, I am able to bring a level of understanding, empathy and compassion to each session while teaching and collaborating with you to re-discover your self-worth, identity and purpose in life eradicating all negative thoughts, stigma and shame others would have you believe. It is all inside you, I can help you find who you already are.
(610) 840-6162 View (610) 840-6162
Photo of Megan Levan -  Megan Levan CAADC, LPC, CAADC, LPC, Licensed Professional Counselor
Megan Levan CAADC, LPC
Licensed Professional Counselor, CAADC, LPC
Verified Verified
Malvern, PA 19355
Not accepting new clients
Megan’s biggest passion is serving as a sounding board for those in need of unconditional support, validation, and acceptance. Her philosophy is that every person is of unique value and capable of great change. She believes strongly in the process of change, helping others navigate that path, and encouraging others to find hope. Megan is specialized in three areas: addictions, trauma and relational/ marital conflict. Megan enjoys doing individuals, couples and family work and being a guide through the process of mending and repair. Experience in marriages/ separation/divorce/coparenting/children adjusting to change/ relationships.
Megan’s biggest passion is serving as a sounding board for those in need of unconditional support, validation, and acceptance. Her philosophy is that every person is of unique value and capable of great change. She believes strongly in the process of change, helping others navigate that path, and encouraging others to find hope. Megan is specialized in three areas: addictions, trauma and relational/ marital conflict. Megan enjoys doing individuals, couples and family work and being a guide through the process of mending and repair. Experience in marriages/ separation/divorce/coparenting/children adjusting to change/ relationships.
(484) 559-7525 View (484) 559-7525
Photo of Susie Macciocca - Chester County Connections LLC, MS Ed, LPC, Licensed Professional Counselor
Chester County Connections LLC
Licensed Professional Counselor, MS Ed, LPC
Verified Verified
Malvern, PA 19355
Life is full of challenges that test our resilience and leave us questioning or doubting ourselves. Therapy is a place to get the support you need to move forward and discover new meaning and joy in your world. While I tend to focus on the here and now of life’s obstacles, during therapy, we will likely explore family patterns and incorporate mindfulness to help you feel more in control in the future.
Life is full of challenges that test our resilience and leave us questioning or doubting ourselves. Therapy is a place to get the support you need to move forward and discover new meaning and joy in your world. While I tend to focus on the here and now of life’s obstacles, during therapy, we will likely explore family patterns and incorporate mindfulness to help you feel more in control in the future.
(484) 214-2963 View (484) 214-2963
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How does your Therapist compare?

Number of Therapists in Malvern, PA

100+

Average cost per session

$150

Therapists in Malvern, PA who prioritize treating:

92% Anxiety
87% Depression
75% Relationship Issues
75% Self Esteem
67% Stress
64% Coping Skills
62% Trauma and PTSD

Average years in practice

12 Years

Top 3 insurances accepted

75% Aetna
71% Highmark
64% UnitedHealthcare UHC | UBH

How Therapists in Malvern, PA see their clients

78% In Person and Online
22% Online Only

Gender breakdown

79% Female
21% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Malvern?

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.