Therapists in Louisville, KY

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Photo of Beth Lyons, LPCC
Beth Lyons
Licensed Professional Clinical Counselor, LPCC
Verified Verified
1 Endorsed
Louisville, KY 40222
As a licensed professional clinical counselor with 25 years of experience in the mental health field, I specialize in helping people discover their best selves and their own power to overcome trauma and adversity. If you find yourself being controlled by the events of your past and your own emotions, that may be because our bodies and brains are wired for protection and preservation. When that happens, our own thoughts and feelings can seem to betray us and hold us back with feelings of overwhelm, depression and anxiety. However, our bodies also have the intrinsic ability to heal given the right guidance and interventions.
As a licensed professional clinical counselor with 25 years of experience in the mental health field, I specialize in helping people discover their best selves and their own power to overcome trauma and adversity. If you find yourself being controlled by the events of your past and your own emotions, that may be because our bodies and brains are wired for protection and preservation. When that happens, our own thoughts and feelings can seem to betray us and hold us back with feelings of overwhelm, depression and anxiety. However, our bodies also have the intrinsic ability to heal given the right guidance and interventions.
(502) 403-2257 View (502) 403-2257
Photo of Melanie A Albin, PsyS, LMFT, Marriage & Family Therapist
Melanie A Albin
Marriage & Family Therapist, PsyS, LMFT
Verified Verified
Louisville, KY 40222
The essence of my work is to facilitate self-growth that benefits you and your relationship with others. I specialize in couples and family therapy with children of all ages. I provide tools to guide you and your spouse to communicate and resolve issues including infidelity or grief. I work with couples who want to prevent a breakup or improve their relationship. I provide family therapy for children and teens who are anxious, hyperactive or underperforming in school or who are difficult to manage in school or at home. I also specialize with individuals who have anxiety, panic attacks or depression. ​
The essence of my work is to facilitate self-growth that benefits you and your relationship with others. I specialize in couples and family therapy with children of all ages. I provide tools to guide you and your spouse to communicate and resolve issues including infidelity or grief. I work with couples who want to prevent a breakup or improve their relationship. I provide family therapy for children and teens who are anxious, hyperactive or underperforming in school or who are difficult to manage in school or at home. I also specialize with individuals who have anxiety, panic attacks or depression. ​
(502) 797-2424 View (502) 797-2424
Photo of Barbara J Martin, LCSW, MSSW, OSW, IIC, ESSE, Clinical Social Work/Therapist
Barbara J Martin
Clinical Social Work/Therapist, LCSW, MSSW, OSW, IIC, ESSE
Verified Verified
Louisville, KY 40203
Waitlist for new clients
Heuser Hearing Institute Integrative Counseling & Wellness Clinic provides in-clinic, telehealth and video remote sessions for individuals, families and caregivers of all ages to cope with the stress and practical challenges of life, hearing health, as well as for those in need of connection to Community Health Navigation and/or other community-based resources. We offer patient-centered assessment, diagnosis and counseling services, integrative traditional and modern therapy approaches. We work with patients experiencing stress during sudden or progressive illness, traumatic brain injuries, hearing loss and ear-related disorders
Heuser Hearing Institute Integrative Counseling & Wellness Clinic provides in-clinic, telehealth and video remote sessions for individuals, families and caregivers of all ages to cope with the stress and practical challenges of life, hearing health, as well as for those in need of connection to Community Health Navigation and/or other community-based resources. We offer patient-centered assessment, diagnosis and counseling services, integrative traditional and modern therapy approaches. We work with patients experiencing stress during sudden or progressive illness, traumatic brain injuries, hearing loss and ear-related disorders
(502) 829-6834 View (502) 829-6834
Photo of Caroline Church, LPCA, Licensed Professional Counselor
Caroline Church
Licensed Professional Counselor, LPCA
Verified Verified
Louisville, KY 40222
Hello and welcome! I'm an EMDR trained, dedicated counselor who is focused on creating a warm and supportive space where you can navigate your past and find healing in the present. My focus extends to aiding individuals dealing with anxiety, depression, relational issues, trauma, infertility, and I hold a special passion for helping those who've experienced birth trauma. Guiding you towards a brighter future is a true joy for me, and I'm here to celebrate every step of your journey.
Hello and welcome! I'm an EMDR trained, dedicated counselor who is focused on creating a warm and supportive space where you can navigate your past and find healing in the present. My focus extends to aiding individuals dealing with anxiety, depression, relational issues, trauma, infertility, and I hold a special passion for helping those who've experienced birth trauma. Guiding you towards a brighter future is a true joy for me, and I'm here to celebrate every step of your journey.
(502) 427-6194 View (502) 427-6194
Photo of Samantha Graves - Total Restoration Group, LLC, L, M, F, T, Marriage & Family Therapist
Total Restoration Group, LLC
Marriage & Family Therapist, L, M, F, T
Verified Verified
2 Endorsed
Louisville, KY 40218
Client center and treatment focused! Always working in the client's best interest.
Client center and treatment focused! Always working in the client's best interest.
(502) 443-9215 View (502) 443-9215
Photo of Lena Kline
Lena Kline
Licensed Professional Clinical Counselor
Verified Verified
2 Endorsed
Louisville, KY 40218
The mind matters. How you feel, what you think, and what you are experiencing all contribute to your overall life experience. I feel as a LPCC-S my role in working beside my clients is to provide understanding, hope, and improved functioning and feeling.
The mind matters. How you feel, what you think, and what you are experiencing all contribute to your overall life experience. I feel as a LPCC-S my role in working beside my clients is to provide understanding, hope, and improved functioning and feeling.
(502) 628-4174 View (502) 628-4174
Photo of Molly Fitzgerald King, LPCC-S, LPAT, Counselor
Molly Fitzgerald King
Counselor, LPCC-S, LPAT
Verified Verified
Louisville, KY 40220
I help adults who struggle with emotional reactivity, anxiety, and distractibility. I specialise in Dialectical Behavioral Therapy and treat individuals with addiction, trauma disorders, depression, and anxiety. My current primary focus is Autism. I use shame resilience methods and mindful self compassion. I love to incorporate art, dance, yoga, and music into my work. I also strive to make mindfulness skills more accessible for people who struggle with sitting still.
I help adults who struggle with emotional reactivity, anxiety, and distractibility. I specialise in Dialectical Behavioral Therapy and treat individuals with addiction, trauma disorders, depression, and anxiety. My current primary focus is Autism. I use shame resilience methods and mindful self compassion. I love to incorporate art, dance, yoga, and music into my work. I also strive to make mindfulness skills more accessible for people who struggle with sitting still.
(502) 878-7209 View (502) 878-7209
Photo of Maryam Muhammad, DrPH, LPCC-S, LCADC-S
Maryam Muhammad
Licensed Professional Clinical Counselor, DrPH, LPCC-S, LCADC-S
Verified Verified
Louisville, KY 40217
At Youth Outreach Intervention Center, we believe that children are the very essence of the future. Who they are tomorrow is essentially the outcome of how they are raised and nurtured today. As a leading Youth Organization in Kentucky, we go above and beyond to provide our youth an empowering environment where they can fully embrace their identity and gain all the skills they need to be leaders of tomorrow.
At Youth Outreach Intervention Center, we believe that children are the very essence of the future. Who they are tomorrow is essentially the outcome of how they are raised and nurtured today. As a leading Youth Organization in Kentucky, we go above and beyond to provide our youth an empowering environment where they can fully embrace their identity and gain all the skills they need to be leaders of tomorrow.
(502) 427-0581 View (502) 427-0581
Photo of Jim Walker - Live Proud LGBT Mental Health Svcs, LCSW, Clinical Social Work/Therapist
Live Proud LGBT Mental Health Svcs
Clinical Social Work/Therapist, LCSW
Verified Verified
Louisville, KY 40207
Are you a gay, lesbian, bisexual, or transgender person trying to find someone who understands your unique struggles and needs ? Have you struggled to communicate and develop the loving relationship you so strongly desire? Do loneliness, anger, and fear disrupt your closeness with others? I can help. I offer practical and personal guidance in finding the solutions you need to live free and love proud. Being a LGBT person and/or couple is often challenging- but it can ultimately be an exciting and rewarding life with the support and guidance you need.
Are you a gay, lesbian, bisexual, or transgender person trying to find someone who understands your unique struggles and needs ? Have you struggled to communicate and develop the loving relationship you so strongly desire? Do loneliness, anger, and fear disrupt your closeness with others? I can help. I offer practical and personal guidance in finding the solutions you need to live free and love proud. Being a LGBT person and/or couple is often challenging- but it can ultimately be an exciting and rewarding life with the support and guidance you need.
(502) 494-6631 View (502) 494-6631
Photo of Ariel Brooks, MA, LCSW , Clinical Social Work/Therapist
Ariel Brooks
Clinical Social Work/Therapist, MA, LCSW
Verified Verified
Louisville, KY 40217  (Online Only)
I believe that every client is an individual living within a larger system that impacts their well-being, and that change must happen on multiple levels to truly improve someone's quality of life. I believe that improving a client's confidence and sense of safety is a crucial part of the therapeutic process.
I believe that every client is an individual living within a larger system that impacts their well-being, and that change must happen on multiple levels to truly improve someone's quality of life. I believe that improving a client's confidence and sense of safety is a crucial part of the therapeutic process.
(502) 317-1264 View (502) 317-1264
Photo of Ellie Stigger, MFTA, Marriage & Family Therapist Associate
Ellie Stigger
Marriage & Family Therapist Associate, MFTA
Verified Verified
2 Endorsed
Louisville, KY 40207
If you're seeking a therapist, I offer a welcoming and inclusive space for clients of all backgrounds, including LGBTQIA+ population. I understand the unique challenges and dynamics that LGBTQIA+ individuals and relationship. My ideal clients are those who are facing various challenges in their interpersonal connections, such as communication breakdowns, unresolved conflicts, trust issues, and emotional disconnection. They may be experiencing feelings of loneliness, frustration, or dissatisfaction within their relationships and are seeking space to explore and address these issues. Their needs revolve around finding effect
If you're seeking a therapist, I offer a welcoming and inclusive space for clients of all backgrounds, including LGBTQIA+ population. I understand the unique challenges and dynamics that LGBTQIA+ individuals and relationship. My ideal clients are those who are facing various challenges in their interpersonal connections, such as communication breakdowns, unresolved conflicts, trust issues, and emotional disconnection. They may be experiencing feelings of loneliness, frustration, or dissatisfaction within their relationships and are seeking space to explore and address these issues. Their needs revolve around finding effect
(502) 837-7712 View (502) 837-7712
Photo of Jane E Gainer, MA, KY LPCC, WV LPC, NCC, BC-TMH
Jane E Gainer
Licensed Professional Clinical Counselor, MA, KY LPCC, WV LPC, NCC, BC-TMH
Verified Verified
2 Endorsed
Louisville, KY 40223
Starting counseling can be hard...what will counseling sessions be like, which therapist will be the best fit, and what if I don't "click" with the therapist? Utilizing over 28 years of experience, i can help make starting the process more comfortable and less intimidating. I help clients successfully manage depression, anxiety, grief, relationship difficulties, substance-use, body image, and stress-related issues in a warm. judgment-free, supportive environment. I am currently accepting new adult clients in WV and KY.
Starting counseling can be hard...what will counseling sessions be like, which therapist will be the best fit, and what if I don't "click" with the therapist? Utilizing over 28 years of experience, i can help make starting the process more comfortable and less intimidating. I help clients successfully manage depression, anxiety, grief, relationship difficulties, substance-use, body image, and stress-related issues in a warm. judgment-free, supportive environment. I am currently accepting new adult clients in WV and KY.
(502) 653-8263 View (502) 653-8263
Photo of Charles Manda, PhD, KLPC, Pastoral Counselor
Charles Manda
Pastoral Counselor, PhD, KLPC
Verified Verified
1 Endorsed
Louisville, KY 40205  (Online Only)
Hi, and welcome to my profile. I'm Dr. Manda, a Licensed Pastoral Counselor in Kentucky, and the author of "Re-authoring Life Narratives After Trauma." I work with clients who are experiencing anxiety, depression, behavioral and relationship issues, losses, life transitions, and spiritual issues. I integrate spirituality in my practice to support those clients who want their spiritual needs to be addressed in therapy. Studies show that spiritual well-being reduces despair, anxiety, depression, the wish to die, and improves the quality of life.
Hi, and welcome to my profile. I'm Dr. Manda, a Licensed Pastoral Counselor in Kentucky, and the author of "Re-authoring Life Narratives After Trauma." I work with clients who are experiencing anxiety, depression, behavioral and relationship issues, losses, life transitions, and spiritual issues. I integrate spirituality in my practice to support those clients who want their spiritual needs to be addressed in therapy. Studies show that spiritual well-being reduces despair, anxiety, depression, the wish to die, and improves the quality of life.
(502) 215-3847 View (502) 215-3847
Photo of Shipra Singh, MS MA, LPCC, NCC, CMCP, PhD Can
Shipra Singh
Licensed Professional Clinical Counselor, MS MA, LPCC, NCC, CMCP, PhD Can
Verified Verified
Louisville, KY 40208
Not accepting new clients
In today’s world, we witness a plethora of stressors, which affect our day to day life’s mental health wellbeing. With the increased stress, and exhaustion in routine life, meeting the demands of family, work, and personal goals, especially during the pandemic period, it gets difficult to cope. The restrictions of social distancing has further isolated individuals who are seeking support to manage their overwhelming psycho emotional state. This extent of exertion leads to mental health issues e.g., depression, anxiety. These individuals can be a wife, a mother, a student, a teacher, a doctor, or a mental health professional.
In today’s world, we witness a plethora of stressors, which affect our day to day life’s mental health wellbeing. With the increased stress, and exhaustion in routine life, meeting the demands of family, work, and personal goals, especially during the pandemic period, it gets difficult to cope. The restrictions of social distancing has further isolated individuals who are seeking support to manage their overwhelming psycho emotional state. This extent of exertion leads to mental health issues e.g., depression, anxiety. These individuals can be a wife, a mother, a student, a teacher, a doctor, or a mental health professional.
(315) 277-6931 View (315) 277-6931
Photo of Sarah Cunningham Allen, LCSW, Clinical Social Work/Therapist
Sarah Cunningham Allen
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Louisville, KY 40222
I work with children, adolescents, families and adults to address a wide range of emotional, behavioral and interpersonal problems such as anxiety, depression, grief and loss, PTSD, trauma, and ADHD. I work with my clients to gain insight, break patterns and thrive. Please check out: www.lifesjourneyky.com/
I work with children, adolescents, families and adults to address a wide range of emotional, behavioral and interpersonal problems such as anxiety, depression, grief and loss, PTSD, trauma, and ADHD. I work with my clients to gain insight, break patterns and thrive. Please check out: www.lifesjourneyky.com/
(502) 305-3879 View (502) 305-3879
Photo of Lauren Kircher, MSSW, LMFT, Marriage & Family Therapist
Lauren Kircher
Marriage & Family Therapist, MSSW, LMFT
Verified Verified
Louisville, KY 40206
Not accepting new clients
Today you are one step closer to a new you where you feel empowered and on a positive path to growth and well-being. I offer a safe and comfortable environment to identify and relieve obstacles or distress by providing tools to progress toward self-actualization and build healthy relationships. As a solution-focused therapist, my goal is to help you uncover your true potential and lead a life that is worth celebrating. While we can't change difficult situations of the past, we can work together to better understand and resolve challenges in your life
Today you are one step closer to a new you where you feel empowered and on a positive path to growth and well-being. I offer a safe and comfortable environment to identify and relieve obstacles or distress by providing tools to progress toward self-actualization and build healthy relationships. As a solution-focused therapist, my goal is to help you uncover your true potential and lead a life that is worth celebrating. While we can't change difficult situations of the past, we can work together to better understand and resolve challenges in your life
(502) 822-5386 View (502) 822-5386
Photo of Jason Sandquist, LCSW, Clinical Social Work/Therapist
Jason Sandquist
Clinical Social Work/Therapist, LCSW
Verified Verified
Louisville, KY 40299
I am a Christian therapist, though I have no difficulties working with clients of all beliefs. I am comfortable meeting with individuals and families, and I'm comfortable meeting with children and/or adults. I believe in the power of healing and restoration. I believe in hope and change. I believe life has meaning and we can find it. I believe in strong individuals, couples, and families who can learn to live life in honesty and contentment. I also know that working through life's issues/obstacles takes time and I want to help you on your journey towards wholeness and fulfillment.
I am a Christian therapist, though I have no difficulties working with clients of all beliefs. I am comfortable meeting with individuals and families, and I'm comfortable meeting with children and/or adults. I believe in the power of healing and restoration. I believe in hope and change. I believe life has meaning and we can find it. I believe in strong individuals, couples, and families who can learn to live life in honesty and contentment. I also know that working through life's issues/obstacles takes time and I want to help you on your journey towards wholeness and fulfillment.
(502) 252-1943 View (502) 252-1943
Photo of Suzette Turner-Clark, LCSW-S, RPT/S, RYT-200, Clinical Social Work/Therapist
Suzette Turner-Clark
Clinical Social Work/Therapist, LCSW-S, RPT/S, RYT-200
Verified Verified
2 Endorsed
Louisville, KY 40223  (Online Only)
People consult with a therapist for a positive connection and to problem solve troubles. Therapy is a very special journey, and I will help you to be successful with that process. I am a goal-oriented, accepting therapist working from a strength-based perspective focusing on what clients wish to accomplish at their own pace. Many individuals are looking for effective coping/communication skills, as well as understanding of feelings associated with specific life changes. Clients find it beneficial to receive direction identifying their unhelpful beliefs and replace them with healthier ways of thinking to improve their life quality.
People consult with a therapist for a positive connection and to problem solve troubles. Therapy is a very special journey, and I will help you to be successful with that process. I am a goal-oriented, accepting therapist working from a strength-based perspective focusing on what clients wish to accomplish at their own pace. Many individuals are looking for effective coping/communication skills, as well as understanding of feelings associated with specific life changes. Clients find it beneficial to receive direction identifying their unhelpful beliefs and replace them with healthier ways of thinking to improve their life quality.
(502) 354-8911 View (502) 354-8911
Photo of Nicole Elise Robinson, LMFT, Marriage & Family Therapist
Nicole Elise Robinson
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Louisville, KY 40220
Not accepting new clients
Do you feel stuck in a cycle of unhealthy relationships, patterns, and habits? It is my goal as a therapist to provide a safe environment to share issues that may be hindering you from your personal growth and development. With care and compassion I will provide support and practical feedback to help you reach your therapy goals. I have experience working with individuals, couples, and families with various challenges such as depression, trauma, sexual abuse, and addictions. I have a passion working with teenagers that have experienced trauma and abuse. Please feel free to call with questions.
Do you feel stuck in a cycle of unhealthy relationships, patterns, and habits? It is my goal as a therapist to provide a safe environment to share issues that may be hindering you from your personal growth and development. With care and compassion I will provide support and practical feedback to help you reach your therapy goals. I have experience working with individuals, couples, and families with various challenges such as depression, trauma, sexual abuse, and addictions. I have a passion working with teenagers that have experienced trauma and abuse. Please feel free to call with questions.
(502) 443-1342 View (502) 443-1342
Photo of Alanna Allman Culler, MSW, LCSW, Clinical Social Work/Therapist
Alanna Allman Culler
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Louisville, KY 40222
Waitlist for new clients
Alanna is a Licensed Clinical Social Worker, invested in the well-being of this community. Alanna is a firm believer in the power of hope and hard work. With 23 years of experience as a Social Worker and more than 19 years as a Therapist, Alanna is committed to the collaborative process of mental and emotional health recovery. Alanna believes that everyone is unique. No one approach fits every situation. You may be looking for help to relieve a particular distress or you may be looking to get to know your own inner world better. In the therapeutic process, Alanna can work with you to choose a way to go forward on your path.
Alanna is a Licensed Clinical Social Worker, invested in the well-being of this community. Alanna is a firm believer in the power of hope and hard work. With 23 years of experience as a Social Worker and more than 19 years as a Therapist, Alanna is committed to the collaborative process of mental and emotional health recovery. Alanna believes that everyone is unique. No one approach fits every situation. You may be looking for help to relieve a particular distress or you may be looking to get to know your own inner world better. In the therapeutic process, Alanna can work with you to choose a way to go forward on your path.
(502) 334-0981 View (502) 334-0981
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How does your Therapist compare?

Number of Therapists in Louisville, KY

1,000+

Average cost per session

$120

Therapists in Louisville, KY who prioritize treating:

91% Anxiety
85% Depression
72% Trauma and PTSD
70% Self Esteem
67% Coping Skills
59% Relationship Issues
58% Grief

Average years in practice

10 Years

Top 3 insurances accepted

75% Aetna
70% UnitedHealthcare UHC | UBH
65% Humana

How Therapists in Louisville, KY see their clients

66% In Person and Online
34% Online Only

Gender breakdown

81% Female
18% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Louisville?

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.