Therapists in San Diego, CA

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Photo of A-Lisa Miles, PhD, Psychologist
A-Lisa Miles
Psychologist, PhD
Verified Verified
San Diego, CA 92130
Not accepting new clients
I provide psychological treatment and services to address the difficulties associated with a variety of challenges and transitions. My approach to treatment is tailored to meet the unique needs of each individual client and I aim to create an atmosphere where people feel comfortable discussing and exploring their life. I view therapy as a collaboration and partnership between the client and myself. I provide support and guidance to help you identify areas of your life that need improvement or change and help you to set goals and create an action plan that will allow you to grow, shift, and live the life you want for yourself.
I provide psychological treatment and services to address the difficulties associated with a variety of challenges and transitions. My approach to treatment is tailored to meet the unique needs of each individual client and I aim to create an atmosphere where people feel comfortable discussing and exploring their life. I view therapy as a collaboration and partnership between the client and myself. I provide support and guidance to help you identify areas of your life that need improvement or change and help you to set goals and create an action plan that will allow you to grow, shift, and live the life you want for yourself.
(858) 951-1890 View (858) 951-1890
Photo of Gregory Ross, MA, LMFT, LPCC, Marriage & Family Therapist
Gregory Ross
Marriage & Family Therapist, MA, LMFT, LPCC
Verified Verified
San Diego, CA 92130
Specialized therapy for teens and young adults: Are you the parent of a teenager who is having problems at school, with friends, and/or issues at home? Are you a college student or young adult dealing with issues relating to school, work, relationships, and/or family? I come to therapy with years of corporate business experience and my therapeutic background includes working as a mental health therapist at Los Altos High School in Los Altos, CA, teaching the Heart to Heart seminar at Stanford Children’s Hospital in Palo Alto, CA, and training at the Community Health Awareness Council (CHAC) in Mountain View, CA.
Specialized therapy for teens and young adults: Are you the parent of a teenager who is having problems at school, with friends, and/or issues at home? Are you a college student or young adult dealing with issues relating to school, work, relationships, and/or family? I come to therapy with years of corporate business experience and my therapeutic background includes working as a mental health therapist at Los Altos High School in Los Altos, CA, teaching the Heart to Heart seminar at Stanford Children’s Hospital in Palo Alto, CA, and training at the Community Health Awareness Council (CHAC) in Mountain View, CA.
(858) 333-4454 View (858) 333-4454
Photo of Ruth Millican - Dr Millican, Child and Teen Autism + ADHD Testing , PsyD, Psychologist
Dr Millican, Child and Teen Autism + ADHD Testing
Psychologist, PsyD
Verified Verified
1 Endorsed
San Diego, CA 92102
Welcome! If you are looking to have your child or teenager tested for Autism, ADHD other forms of neurodiversity from an affirming lens, you are in the right place! I provide assessment for children ages 6 to 18. The process involves an in-person testing session with the child as well as thorough interviews with the parents, family members, and teachers. I will also do a record review of any previous testing that has been completed, report cards, and any lEPs/504 plans. This is an extensive deep dive assessment that will help you better understand your child's identity, support needs, and ways to best parent them.
Welcome! If you are looking to have your child or teenager tested for Autism, ADHD other forms of neurodiversity from an affirming lens, you are in the right place! I provide assessment for children ages 6 to 18. The process involves an in-person testing session with the child as well as thorough interviews with the parents, family members, and teachers. I will also do a record review of any previous testing that has been completed, report cards, and any lEPs/504 plans. This is an extensive deep dive assessment that will help you better understand your child's identity, support needs, and ways to best parent them.
(619) 340-2715 View (619) 340-2715
Photo of Shanice Applewhaite, APCC
Shanice Applewhaite
Associate Professional Clinical Counselor, APCC
Verified Verified
1 Endorsed
San Diego, CA 92101  (Online Only)
We humans are wired for connection – we need it on the most basic level. I’m here to remind you that YOU are not the problem. For real! The systems and social environments you have been in are the problem. I’m here to uproot those damaging beliefs that were put on you and in you and that continually get in the way of you remembering the icon you are. Let’s get underneath the layers of shame and unlearn cultural and systemic bullshit together.
We humans are wired for connection – we need it on the most basic level. I’m here to remind you that YOU are not the problem. For real! The systems and social environments you have been in are the problem. I’m here to uproot those damaging beliefs that were put on you and in you and that continually get in the way of you remembering the icon you are. Let’s get underneath the layers of shame and unlearn cultural and systemic bullshit together.
(619) 738-6663 View (619) 738-6663
Photo of Marelys Padilla, LCSW, PMH-C, Clinical Social Work/Therapist
Marelys Padilla
Clinical Social Work/Therapist, LCSW, PMH-C
Verified Verified
4 Endorsed
San Diego, CA 92111  (Online Only)
Not accepting new clients
Acknowledging your emotional pain and accessing help are the first steps towards wellness. You deserve the highest of praise for loving yourself and your family enough to embark on the path towards healing. I am so glad you are here! I can offer you a safe space to navigate the complexity of emotions that comes with wanting or actively raising a family. If you have suffered a loss, together we can work to transform debilitating grief into a more peaceful and dynamic experience. Through our work together, we can foster presence with your emotional process and encourage your healing. Caring for yourself is caring for your family!
Acknowledging your emotional pain and accessing help are the first steps towards wellness. You deserve the highest of praise for loving yourself and your family enough to embark on the path towards healing. I am so glad you are here! I can offer you a safe space to navigate the complexity of emotions that comes with wanting or actively raising a family. If you have suffered a loss, together we can work to transform debilitating grief into a more peaceful and dynamic experience. Through our work together, we can foster presence with your emotional process and encourage your healing. Caring for yourself is caring for your family!
(858) 533-1064 View (858) 533-1064
Photo of Tamara Halperin, PsyD, Psychologist
Tamara Halperin
Psychologist, PsyD
Verified Verified
3 Endorsed
San Diego, CA 92123  (Online Only)
Life can be stressful for adults, and children too. I specialize in working with youth, families, and adults to process their past traumatic events and childhood abuse. I utilize a cognitive behavioral, integrative approach, with a trauma informed lens and an emphasis on evidence-based therapies. I know that it can be difficult to talk about these events. That is why in therapy we will work at your pace to identify the impact that your trauma has had on your daily functioning. You will learn skills that help you express and regulate your feelings, challenge negative thinking patterns, and build healthy relationships.
Life can be stressful for adults, and children too. I specialize in working with youth, families, and adults to process their past traumatic events and childhood abuse. I utilize a cognitive behavioral, integrative approach, with a trauma informed lens and an emphasis on evidence-based therapies. I know that it can be difficult to talk about these events. That is why in therapy we will work at your pace to identify the impact that your trauma has had on your daily functioning. You will learn skills that help you express and regulate your feelings, challenge negative thinking patterns, and build healthy relationships.
(858) 203-9019 View (858) 203-9019
Photo of Christina Napolitano, LCSW, LAC, Clinical Social Work/Therapist
Christina Napolitano
Clinical Social Work/Therapist, LCSW, LAC
Verified Verified
San Diego, CA 92103
Hi! My name is Christina Napolitano and I'm a licensed clinical social worker as well as a licensed acupuncturist. As a therapist, I work with adults at every stage of life. Whether you are struggling with everyday stressors, conflict in your relationships or are in need of healing from trauma I will provide a safe, compassionate, nonjudgmental space for you to begin your healing journey. Our therapeutic alliance will provide you with the insights and tools to make the changes you seek in your life and relationships. I will supportively walk alongside and help you discover a deeper understanding of yourself and the life you desire.
Hi! My name is Christina Napolitano and I'm a licensed clinical social worker as well as a licensed acupuncturist. As a therapist, I work with adults at every stage of life. Whether you are struggling with everyday stressors, conflict in your relationships or are in need of healing from trauma I will provide a safe, compassionate, nonjudgmental space for you to begin your healing journey. Our therapeutic alliance will provide you with the insights and tools to make the changes you seek in your life and relationships. I will supportively walk alongside and help you discover a deeper understanding of yourself and the life you desire.
(619) 382-2095 View (619) 382-2095
Photo of Dr. Nadia N Cano, PhD, Psychologist
Dr. Nadia N Cano
Psychologist, PhD
Verified Verified
1 Endorsed
San Diego, CA 92104  (Online Only)
I have experience working with clients presenting with a number of issues that include depression, anxiety, substance abuse, personality disorders, trauma and severe and persistent mental illness.
I have experience working with clients presenting with a number of issues that include depression, anxiety, substance abuse, personality disorders, trauma and severe and persistent mental illness.
(619) 737-1788 View (619) 737-1788
Photo of Andrew R Jones, LMFT, Marriage & Family Therapist
Andrew R Jones
Marriage & Family Therapist, LMFT
Verified Verified
San Diego, CA 92111  (Online Only)
My name is Andrew Jones, and I am a licensed Therapist (LMFT) in California. You can take a look at my profile to learn a little bit more about my background, education, experience and therapeutic approach. Online counseling is fairly new, and I've found it to be really just as effective therapeutically when applied in a personal way, that is by video face to face contact. My counseling style is engaging and inclusive. That is, I am aware of the fact that we all have flaws that require professional intervention.
My name is Andrew Jones, and I am a licensed Therapist (LMFT) in California. You can take a look at my profile to learn a little bit more about my background, education, experience and therapeutic approach. Online counseling is fairly new, and I've found it to be really just as effective therapeutically when applied in a personal way, that is by video face to face contact. My counseling style is engaging and inclusive. That is, I am aware of the fact that we all have flaws that require professional intervention.
(858) 533-2637 View (858) 533-2637
Photo of Christina Elizabeth Ames-Cotto - Hope, Growth & Healing Counseling, LMFT, Marriage & Family Therapist
Hope, Growth & Healing Counseling
Marriage & Family Therapist, LMFT
Verified Verified
San Diego, CA 92121  (Online Only)
Offer Telehealth Only - Life provides happiness as well as its share of challenges. I believe individuals and couples are capable of navigating life but sometimes need a little extra help and compassion. Therapy can be that place where a person can discuss, learn and work through any past or present challenges that may be getting in the way of living a happy and hopeful life.
Offer Telehealth Only - Life provides happiness as well as its share of challenges. I believe individuals and couples are capable of navigating life but sometimes need a little extra help and compassion. Therapy can be that place where a person can discuss, learn and work through any past or present challenges that may be getting in the way of living a happy and hopeful life.
(619) 776-3039 View (619) 776-3039
Photo of Brian Hodgson, AMFT, Marriage & Family Therapist Associate
Brian Hodgson
Marriage & Family Therapist Associate, AMFT
Verified Verified
San Diego, CA 92109
Not accepting new clients
I am an associate marriage and family therapist (AMFT) with expertise in assessing and treating substance addiction, marital and family conflict, mood, thought, behavior, and personality disorders. I have extensive experience working with culturally diverse adult populations utilizing evidence-based practices within a multi-disciplinary team of mental health service providers.
I am an associate marriage and family therapist (AMFT) with expertise in assessing and treating substance addiction, marital and family conflict, mood, thought, behavior, and personality disorders. I have extensive experience working with culturally diverse adult populations utilizing evidence-based practices within a multi-disciplinary team of mental health service providers.
(858) 922-9359 View (858) 922-9359
Photo of Roger Carey, LCP, Psychologist
Roger Carey
Psychologist, LCP
Verified Verified
San Diego, CA 92126
Dr. Roger Carey, Clinical Psychologist, PSY 20871. Dr. Carey has practiced clinical psychology for the past 35 years in many different contexts, including private practice, residential treatment programs, schools, clinics, hospitals, institutions, and the California Prison system. Dr. Carey provides treatment to adults who suffer from varied mental health disorders. His primary aim is to help the individual recover, get better, stay better and practice research-based treatment strategies that work that are validated and confirmed by research studies.
Dr. Roger Carey, Clinical Psychologist, PSY 20871. Dr. Carey has practiced clinical psychology for the past 35 years in many different contexts, including private practice, residential treatment programs, schools, clinics, hospitals, institutions, and the California Prison system. Dr. Carey provides treatment to adults who suffer from varied mental health disorders. His primary aim is to help the individual recover, get better, stay better and practice research-based treatment strategies that work that are validated and confirmed by research studies.
(858) 422-0148 View (858) 422-0148
Photo of Nora Davis - Inner Compass, Licensed Clinical Social Worker Inc, LCSW, Clinical Social Work/Therapist
Inner Compass, Licensed Clinical Social Worker Inc
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
San Diego, CA 92108
EMDR, IFS, Mindfulness and Psychodynamic therapy for trauma/PTSD, anxiety and relationship issues. Inner Compass, Licensed Clinical Social Worker, Inc. is a group practice committed to helping individuals navigate the complex emotional landscapes of trauma and overwhelm. Our team of compassionate and skilled therapists are dedicated to providing a safe and supportive environment where clients can explore their feelings, uncover underlying issues, and develop effective coping strategies. We believe in a holistic approach that considers the whole person—mind, body, and spirit—tailoring our services to meet each client's unique needs.
EMDR, IFS, Mindfulness and Psychodynamic therapy for trauma/PTSD, anxiety and relationship issues. Inner Compass, Licensed Clinical Social Worker, Inc. is a group practice committed to helping individuals navigate the complex emotional landscapes of trauma and overwhelm. Our team of compassionate and skilled therapists are dedicated to providing a safe and supportive environment where clients can explore their feelings, uncover underlying issues, and develop effective coping strategies. We believe in a holistic approach that considers the whole person—mind, body, and spirit—tailoring our services to meet each client's unique needs.
(619) 771-0797 View (619) 771-0797
Photo of Natalie L Small, LMFT, Marriage & Family Therapist
Natalie L Small
Marriage & Family Therapist, LMFT
Verified Verified
San Diego, CA 92106
"You are not a drop in the ocean but the entire ocean in one drop"-Rumi. You have everything you need already within you and I am honored to come along side you and support you in your journey to self re-covery.
"You are not a drop in the ocean but the entire ocean in one drop"-Rumi. You have everything you need already within you and I am honored to come along side you and support you in your journey to self re-covery.
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Photo of Carissa Sanchez, ACSW115, Pre-Licensed Professional
Carissa Sanchez
Pre-Licensed Professional, ACSW115
Verified Verified
1 Endorsed
San Diego, CA 92127
Hello, I'm Carissa. I'm an Associate Social Worker who enjoys working with children, adolescents, teens, adults, and families. I provide a strengths-based and client-centered approach to support clients with reaching goals and making positive changes within themselves and their lives. ​I have a passion to support individuals during their mental health journeys, navigating major life stressors, and addressing past trauma.
Hello, I'm Carissa. I'm an Associate Social Worker who enjoys working with children, adolescents, teens, adults, and families. I provide a strengths-based and client-centered approach to support clients with reaching goals and making positive changes within themselves and their lives. ​I have a passion to support individuals during their mental health journeys, navigating major life stressors, and addressing past trauma.
(858) 758-4965 View (858) 758-4965
Photo of Brian Lamoreux, ND, MA, LPCC, Licensed Professional Counselor
Brian Lamoreux
Licensed Professional Counselor, ND, MA, LPCC
Verified Verified
1 Endorsed
San Diego, CA 92122
In my practice I focus on treating trauma with EMDR informed by Internal Family Systems Therapy (IFS). Many mental health symptoms such as depression, anxiety, panic attacks, addictions, and disordered eating can be connected to past traumas and conflicts between inner parts of ourselves. I believe everyone has the capacity to heal from these traumas, resolve inner conflicts, and to experience a more fulfilling life.
In my practice I focus on treating trauma with EMDR informed by Internal Family Systems Therapy (IFS). Many mental health symptoms such as depression, anxiety, panic attacks, addictions, and disordered eating can be connected to past traumas and conflicts between inner parts of ourselves. I believe everyone has the capacity to heal from these traumas, resolve inner conflicts, and to experience a more fulfilling life.
(858) 533-7922 View (858) 533-7922
Photo of Jamie (Lydia) Shorthill, LMFT, CCTP, MA, Marriage & Family Therapist
Jamie (Lydia) Shorthill
Marriage & Family Therapist, LMFT, CCTP, MA
Verified Verified
2 Endorsed
San Diego, CA 92123  (Online Only)
As a Licensed Marriage and Family Therapist with over 20 years of helping clients, I strive to help each person come to a better place of understanding, fulfillment and peace. The quest to understand and conquer trauma, anxiety, mood difficulties, stress and grief in a safe and caring environment is possible. Each plan is tailored to the client and their specific needs and wants to help find relief from symptoms and feel more confident. Connecting through Telehealth and/or Video Therapy to begin the healing process.
As a Licensed Marriage and Family Therapist with over 20 years of helping clients, I strive to help each person come to a better place of understanding, fulfillment and peace. The quest to understand and conquer trauma, anxiety, mood difficulties, stress and grief in a safe and caring environment is possible. Each plan is tailored to the client and their specific needs and wants to help find relief from symptoms and feel more confident. Connecting through Telehealth and/or Video Therapy to begin the healing process.
(858) 914-2841 View (858) 914-2841
Photo of Mary Jerome, MA, LPCC
Mary Jerome
Licensed Professional Clinical Counselor, MA, LPCC
Verified Verified
1 Endorsed
San Diego, CA 92116  (Online Only)
If you struggle with emotional problems like grief, anxiety and depression, or behavioral issues such as anger management, I can help you build the skills needed for you to overcome these challenges. You don't have to feel the way you do forever. I can teach you strategies to help you manage your stress, improve your moods and communicate effectively. You can take the steps to improve the quality of your life by allowing me to guide you through the process of change. I’ll help you find emotional freedom, think more positively, act more calmly, and enjoy the confidence that comes with learning how to master your emotions.
If you struggle with emotional problems like grief, anxiety and depression, or behavioral issues such as anger management, I can help you build the skills needed for you to overcome these challenges. You don't have to feel the way you do forever. I can teach you strategies to help you manage your stress, improve your moods and communicate effectively. You can take the steps to improve the quality of your life by allowing me to guide you through the process of change. I’ll help you find emotional freedom, think more positively, act more calmly, and enjoy the confidence that comes with learning how to master your emotions.
(619) 432-3537 x8 View (619) 432-3537 x8
Photo of Ekaete Ekpo, LMFT, Marriage & Family Therapist
Ekaete Ekpo
Marriage & Family Therapist, LMFT
Verified Verified
San Diego, CA 92130
Hello and thank you for considering me in your wellness journey. My name is Ekaete Ekpo and I'm a licensed marriage and family therapist (LMFT) with over 10 years of experience providing psychotherapy. My approach to our therapeutic relationship will be with warmth, care, compassion, and non-judgment approach, adapting to the unique needs of each individual client. My focus areas of practice include working across life span with all ages. I have experience working with clients who experience difficulty with anxiety, depression, relational stress, trauma, or grief and loss, together we can walk through the journey of self-healing.
Hello and thank you for considering me in your wellness journey. My name is Ekaete Ekpo and I'm a licensed marriage and family therapist (LMFT) with over 10 years of experience providing psychotherapy. My approach to our therapeutic relationship will be with warmth, care, compassion, and non-judgment approach, adapting to the unique needs of each individual client. My focus areas of practice include working across life span with all ages. I have experience working with clients who experience difficulty with anxiety, depression, relational stress, trauma, or grief and loss, together we can walk through the journey of self-healing.
(619) 759-5358 View (619) 759-5358
Photo of Gina S Schneider - Schneider Counseling and Corporate Solutions, PhD, Marriage & Family Therapist
Schneider Counseling and Corporate Solutions
Marriage & Family Therapist, PhD
Verified Verified
San Diego, CA 92127
If you struggle with life, career, and/or relationships right now, I can help you identify ways of thinking and behaving that will help you feel stronger and more effective. We have the potential at any age to deepen, grow, change and re-invent ourselves. My job is to provide guidance, empathy, and unwavering support in an atmosphere of complete confidentiality. We work together to define and achieve your goals by creating specific assignments to motivate you to action. You will learn proven techniques, research, and inspiration to help you feel happier and accomplish your goals.
If you struggle with life, career, and/or relationships right now, I can help you identify ways of thinking and behaving that will help you feel stronger and more effective. We have the potential at any age to deepen, grow, change and re-invent ourselves. My job is to provide guidance, empathy, and unwavering support in an atmosphere of complete confidentiality. We work together to define and achieve your goals by creating specific assignments to motivate you to action. You will learn proven techniques, research, and inspiration to help you feel happier and accomplish your goals.
(858) 943-4859 x2 View (858) 943-4859 x2
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How does your Therapist compare?

Number of Therapists in San Diego, CA

3,000+

Average cost per session

$165

Therapists in San Diego, CA who prioritize treating:

92% Anxiety
86% Depression
70% Coping Skills
70% Self Esteem
65% Relationship Issues
63% Stress
62% Trauma and PTSD

Average years in practice

11 Years

Top 3 insurances accepted

83% Aetna
76% Cigna and Evernorth
67% UnitedHealthcare UHC | UBH

How Therapists in San Diego, CA see their clients

53% Online Only
47% In Person and Online

Gender breakdown

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

How can I find a therapist in San Diego?

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.