Therapists in Washington

View cities and counties in Washington
Photo of Kimberly G Patterson-Hyatt - Thrive: Mind & Body Psychology, PsyD, MS, MA, Psychologist
Thrive: Mind & Body Psychology
Psychologist, PsyD, MS, MA
Verified Verified
Tacoma, WA 98402  (Online Only)
Walk away from your therapeutic experience feeling as though you have challenged yourself, expanded the framework of your thinking, psychologically evolved, learned to effectively self-reflect, reach your goals, and feel confident to navigate your life in a way that aligns with your contentment, pleasure, and fulfillment.
Walk away from your therapeutic experience feeling as though you have challenged yourself, expanded the framework of your thinking, psychologically evolved, learned to effectively self-reflect, reach your goals, and feel confident to navigate your life in a way that aligns with your contentment, pleasure, and fulfillment.
(253) 367-4502 View (253) 367-4502
Photo of Eileen C Williams, LMHC, CPC, Counselor
Eileen C Williams
Counselor, LMHC, CPC
Verified Verified
1 Endorsed
Everett, WA 98203
Not accepting new clients
I offer tools and support many have found useful in enhancing the quality of their lives. Work-life balance, self-esteem, marriage, relationship issues, as well as executive and life coaching are the focus in my practice. I have worked in the community mental health and corporate settings for over 25 years. Please contact me if you feel ready to get going in a more positive and productive direction in your life by learning skills that will show you how to make choices that will get you there.
I offer tools and support many have found useful in enhancing the quality of their lives. Work-life balance, self-esteem, marriage, relationship issues, as well as executive and life coaching are the focus in my practice. I have worked in the community mental health and corporate settings for over 25 years. Please contact me if you feel ready to get going in a more positive and productive direction in your life by learning skills that will show you how to make choices that will get you there.
(425) 876-7547 View (425) 876-7547
Photo of Wendy E Smith, MA, LMHC, Counselor
Wendy E Smith
Counselor, MA, LMHC
Verified Verified
Seattle, WA 98119
If you are seeking to work through anxiety, depression, an identity issue, a life transition, a traumatic experience, or a loss, I may be the therapist to help you. As a Certified Emotionally-Focused Couples Therapist, I can also help couples deeply reconnect on the level of needs and feelings--as opposed to having that same unproductive argument over and over again. With individuals, I often work in the here-and-now. Additionally, I pay attention to your history in order to understand (together with you) how your past experiences might be affecting your capacity to live well in the present and imagine a future.
If you are seeking to work through anxiety, depression, an identity issue, a life transition, a traumatic experience, or a loss, I may be the therapist to help you. As a Certified Emotionally-Focused Couples Therapist, I can also help couples deeply reconnect on the level of needs and feelings--as opposed to having that same unproductive argument over and over again. With individuals, I often work in the here-and-now. Additionally, I pay attention to your history in order to understand (together with you) how your past experiences might be affecting your capacity to live well in the present and imagine a future.
(206) 745-0971 View (206) 745-0971
Photo of Elaine M Cheung - Elaine Cheung, PLLC, LICSW, Clinical Social Work/Therapist
Elaine Cheung, PLLC
Clinical Social Work/Therapist, LICSW
Verified Verified
Seattle, WA 98109
I am a licensed clinical social worker in practice since 2002. I am a Linehan Board Dialectical Behavior Therapy certified clinician. I have extensive training in treatments for trauma including Prolonged Exposure and EMDR (Eye Movement Desensitization and Reprocessing). I have worked in a variety of settings including community mental health centers, hospital based care and in-home family therapy. I serve children 12 and up, teens, families, parents and adults. I treat a variety of diagnoses including Depression and other Mood Disorders, Anxiety Disorders including Obsessive Compulsive Disorder.
I am a licensed clinical social worker in practice since 2002. I am a Linehan Board Dialectical Behavior Therapy certified clinician. I have extensive training in treatments for trauma including Prolonged Exposure and EMDR (Eye Movement Desensitization and Reprocessing). I have worked in a variety of settings including community mental health centers, hospital based care and in-home family therapy. I serve children 12 and up, teens, families, parents and adults. I treat a variety of diagnoses including Depression and other Mood Disorders, Anxiety Disorders including Obsessive Compulsive Disorder.
(206) 207-3761 View (206) 207-3761
Photo of Aline Zelenskiy - Aline Zelenskiy, MA, LHMCA, Counselor
Aline Zelenskiy
Counselor, MA, LHMCA
Verified Verified
Seattle, WA 98105  (Online Only)
Not accepting new clients
You're seeking relief and meaningful transformation. On the outside, you may appear to have everything under control, but deep down, you're overwhelmed, and feeling stuck. Perhaps, you yearn to connect but find it hard to trust others, and anxious about their perceptions of you. You may feel burnt out and exhausted from constantly prioritizing everyone else's needs over your own. Society, family, relationships, or past trauma may make you feel unsafe and doubtful. If you resonate with these and ready to get support, I'd love to help you navigate through these challenges, find inner peace, greater self-love and become more resilient.
You're seeking relief and meaningful transformation. On the outside, you may appear to have everything under control, but deep down, you're overwhelmed, and feeling stuck. Perhaps, you yearn to connect but find it hard to trust others, and anxious about their perceptions of you. You may feel burnt out and exhausted from constantly prioritizing everyone else's needs over your own. Society, family, relationships, or past trauma may make you feel unsafe and doubtful. If you resonate with these and ready to get support, I'd love to help you navigate through these challenges, find inner peace, greater self-love and become more resilient.
(206) 594-2368 View (206) 594-2368
Photo of Isabel Taccheri, MSW, LICSW, Clinical Social Work/Therapist
Isabel Taccheri
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Spokane, WA 99205  (Online Only)
As my client, you know what you want from therapy and are ready to work on measurable goals. You may be dealing with PTSD or anxiety and are seeking structured strategies to manage symptoms. You want a therapist who can support you in gaining control over your mental health and achieving stability. I provide the guidance and practical tools you need to navigate your journey toward healing and growth. Together, we can work towards a more balanced and fulfilling life.
As my client, you know what you want from therapy and are ready to work on measurable goals. You may be dealing with PTSD or anxiety and are seeking structured strategies to manage symptoms. You want a therapist who can support you in gaining control over your mental health and achieving stability. I provide the guidance and practical tools you need to navigate your journey toward healing and growth. Together, we can work towards a more balanced and fulfilling life.
(509) 284-4127 View (509) 284-4127
Photo of Laila Josephine Ayyoub, LCSW, LICSW, Clinical Social Work/Therapist
Laila Josephine Ayyoub
Clinical Social Work/Therapist, LCSW, LICSW
Verified Verified
Port Townsend, WA 98368
Not accepting new clients
All people are one of a kind, but here's where we're all alike: All of us come from a personal history and context: A past that got us through to where we are now. And "Right Now" is where all the choices and opportunities are. Some things we may want to change, other things we may choose to accept as they are. Therapy can be helpful in understanding yourself well enough to know which is which. And therapy can offer some things you may need to go forward with your choices: Hope, perspective and someone who believes in you while you practice believing in yourself.
All people are one of a kind, but here's where we're all alike: All of us come from a personal history and context: A past that got us through to where we are now. And "Right Now" is where all the choices and opportunities are. Some things we may want to change, other things we may choose to accept as they are. Therapy can be helpful in understanding yourself well enough to know which is which. And therapy can offer some things you may need to go forward with your choices: Hope, perspective and someone who believes in you while you practice believing in yourself.
(458) 207-2062 View (458) 207-2062
Photo of Kristoffer John Rouse, PhD, MA, LMHC, CCTP, ASDCS, Counselor
Kristoffer John Rouse
Counselor, PhD, MA, LMHC, CCTP, ASDCS
Verified Verified
3 Endorsed
Redmond, WA 98052
Not accepting new clients
I am dedicated toward helping you solve your life issues or interpersonal problems. With respect to the uniqueness of each person, I provide mental health care that is tailored to your specific needs and concerns. Whether it is depression, anxiety, anger management, or life troubles, I will aid you in the journey to find the answers that best fits your personal needs. With my personal origins linked to the gamer and comic book community, I offer sound solutions and therapeutic care to equip you on your life quest.
I am dedicated toward helping you solve your life issues or interpersonal problems. With respect to the uniqueness of each person, I provide mental health care that is tailored to your specific needs and concerns. Whether it is depression, anxiety, anger management, or life troubles, I will aid you in the journey to find the answers that best fits your personal needs. With my personal origins linked to the gamer and comic book community, I offer sound solutions and therapeutic care to equip you on your life quest.
(360) 205-3092 View (360) 205-3092
Photo of Micheal Kane, PsyD, MSW, MA, LICSW, CTTS, Clinical Social Work/Therapist
Micheal Kane
Clinical Social Work/Therapist, PsyD, MSW, MA, LICSW, CTTS
Verified Verified
Seattle, WA 98118
Emotional pain distorts our view of the world. The longer our pain lasts, the more unhappy we become. Unlike a well meaning friend or relative, a therapist can consider your concerns from a fresh, objective, perspective. But a therapist will not solve your problems for you; he will guide you by listening, questioning and observing—- so that you can find your own answers when extreme unhappiness, overwhelming anxiety or fear, feelings of inadequacy and low self esteem, sexual problems, and traumatic events interfere with your life or relationships with others.
Emotional pain distorts our view of the world. The longer our pain lasts, the more unhappy we become. Unlike a well meaning friend or relative, a therapist can consider your concerns from a fresh, objective, perspective. But a therapist will not solve your problems for you; he will guide you by listening, questioning and observing—- so that you can find your own answers when extreme unhappiness, overwhelming anxiety or fear, feelings of inadequacy and low self esteem, sexual problems, and traumatic events interfere with your life or relationships with others.
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Photo of Sabra P. Larsen, LCSW, Clinical Social Work/Therapist
Sabra P. Larsen
Clinical Social Work/Therapist, LCSW
Verified Verified
Vancouver, WA 98663
Life's challenges may overwhelm your ability to cope and leave you confused and distressed. As a skilled therapist, I can assist to make this time fruitful rather then just a time to get through. I provide a safe comfortable place to focus on your experience of life. You will receive kindness, respect and genuine caring. My approach is client directed,with compassionate inquiry and creative exploration, using collaborative problem-solving to assist you in restoring your balance and moving in a positive direction; often with deeper insight and a greater capacity for joy and contentment.
Life's challenges may overwhelm your ability to cope and leave you confused and distressed. As a skilled therapist, I can assist to make this time fruitful rather then just a time to get through. I provide a safe comfortable place to focus on your experience of life. You will receive kindness, respect and genuine caring. My approach is client directed,with compassionate inquiry and creative exploration, using collaborative problem-solving to assist you in restoring your balance and moving in a positive direction; often with deeper insight and a greater capacity for joy and contentment.
(360) 525-9073 View (360) 525-9073
Photo of Christine Suhan, MA, LMFTA, Marriage & Family Therapist Associate
Christine Suhan
Marriage & Family Therapist Associate, MA, LMFTA
Verified Verified
Burien, WA 98166  (Online Only)
Welcome! My name is Christine and connecting with people has been a passion of mine since as early as I can remember. I grew up moving frequently (living on three different continents before I was 18) and traveling the world which perpetuated my curiosity and desire to understand the diversity and complexity of the human experience. I believe all behavior makes sense given context and my therapy process is an eclectic approach designed to guide you toward compassionately discovering what is driving your unhelpful behaviors.
Welcome! My name is Christine and connecting with people has been a passion of mine since as early as I can remember. I grew up moving frequently (living on three different continents before I was 18) and traveling the world which perpetuated my curiosity and desire to understand the diversity and complexity of the human experience. I believe all behavior makes sense given context and my therapy process is an eclectic approach designed to guide you toward compassionately discovering what is driving your unhelpful behaviors.
(206) 944-6084 View (206) 944-6084
Photo of Jenai Ogden, LMHC, Counselor
Jenai Ogden
Counselor, LMHC
Verified Verified
Bellingham, WA 98227  (Online Only)
Waitlist for new clients
I Have A Wait List Right Now... Are you ready for a change? Any kind of change? Whether it be learning some new coping skills or learning to unpack years of childhood trauma, therapy is the place to start once you admit that you are ready. Or maybe you have always felt disconnected in the way that you think about things, process information, and connect with others. Have you wondered if you are ADHD, Autistic, or just somewhere under the neurodivergent umbrella? Let's talk about it.
I Have A Wait List Right Now... Are you ready for a change? Any kind of change? Whether it be learning some new coping skills or learning to unpack years of childhood trauma, therapy is the place to start once you admit that you are ready. Or maybe you have always felt disconnected in the way that you think about things, process information, and connect with others. Have you wondered if you are ADHD, Autistic, or just somewhere under the neurodivergent umbrella? Let's talk about it.
(360) 323-2295 View (360) 323-2295
Photo of Heidi Hust, LISW, Clinical Social Work/Therapist
Heidi Hust
Clinical Social Work/Therapist, LISW
Verified Verified
Pasco, WA 99301  (Online Only)
Hi! My name is Heidi Hust, MSW, LICSW, LW60912071, and I have worked in the mental health and crisis management field for over 10 years serving individuals, couples, adolescents, and children. When I am not practicing therapy, I am likely to be planning a family event, camping, fishing, or spending quality time with my family and friends.
Hi! My name is Heidi Hust, MSW, LICSW, LW60912071, and I have worked in the mental health and crisis management field for over 10 years serving individuals, couples, adolescents, and children. When I am not practicing therapy, I am likely to be planning a family event, camping, fishing, or spending quality time with my family and friends.
(323) 643-8569 View (323) 643-8569
Photo of Kathrane M Ignacio - Ignacio Counseling, LLC, MS, LMHC, Counselor
Ignacio Counseling, LLC
Counselor, MS, LMHC
Verified Verified
2 Endorsed
Spokane, WA 99218
Everyone needs a safe place to express their thoughts, feelings, hopes and fears. Sometimes that means seeking out a professional. Someone who can listen, support, and assist in helping to overcome obstacles or reduce emotional pain. This is my ultimate goal for everyone with whom I work. I have been working in the field of counseling for 18 years and have experience working with a wide variety of individuals. Some need help adjusting to a life change. Others have experienced significant trauma or struggle with suicidal thoughts. Mostly, I am here to meet you where you are at and to help you reach your goals.
Everyone needs a safe place to express their thoughts, feelings, hopes and fears. Sometimes that means seeking out a professional. Someone who can listen, support, and assist in helping to overcome obstacles or reduce emotional pain. This is my ultimate goal for everyone with whom I work. I have been working in the field of counseling for 18 years and have experience working with a wide variety of individuals. Some need help adjusting to a life change. Others have experienced significant trauma or struggle with suicidal thoughts. Mostly, I am here to meet you where you are at and to help you reach your goals.
(509) 822-5812 View (509) 822-5812
Photo of Rachaud L Smith, PsyD, Psychologist
Rachaud L Smith
Psychologist, PsyD
Verified Verified
Renton, WA 98059
I have been practicing psychology in Washington State since 2009. As a clinical health psychologist I understand the role that the mind and body have on each other and have learned/fine tuned the mental and emotional strategies to not only improve emotional and mental well-being, but also have some positive effects on improving physical well-being.
I have been practicing psychology in Washington State since 2009. As a clinical health psychologist I understand the role that the mind and body have on each other and have learned/fine tuned the mental and emotional strategies to not only improve emotional and mental well-being, but also have some positive effects on improving physical well-being.
(425) 598-0389 x433 View (425) 598-0389 x433
Photo of Kjersten Hillers, MA, LPCI, LMCHA, Pre-Licensed Professional
Kjersten Hillers
Pre-Licensed Professional, MA, LPCI, LMCHA
Verified Verified
Tacoma, WA 98402
Seeking therapy is a courageous and important decision. As your therapist, I am honored to meet you in your current state. I am here to support you in creating meaningful change and growth in your personal wellbeing. I strive to create an environment of safety, warmth, and compassion, in order to empower you to optimize your potential and live a meaningful life. I am a licensed professional counselor, with extensive experience working with children, adolescents, couples, and families in addressing needs related to trauma, anxiety, depression, and adjustment.
Seeking therapy is a courageous and important decision. As your therapist, I am honored to meet you in your current state. I am here to support you in creating meaningful change and growth in your personal wellbeing. I strive to create an environment of safety, warmth, and compassion, in order to empower you to optimize your potential and live a meaningful life. I am a licensed professional counselor, with extensive experience working with children, adolescents, couples, and families in addressing needs related to trauma, anxiety, depression, and adjustment.
(206) 203-0203 View (206) 203-0203
Photo of Shirlee Clark, LMHCA
Shirlee Clark
LMHCA
Verified Verified
Spokane, WA 99223  (Online Only)
I believe therapy should be a space where people feel accepted and secure to lead and discern what is most supportive for their therapy journey to flourish. My background working with individuals, families, and children has equipped me to support those looking to conquer individual goals, raise a healthy family unit, or support their children. If you're a parent looking to enhance your skillsets, or if you're seeking the right person to support your child- that is where my heart is. A passion for serving those struggling with daily life encourages me to walk with each person toward healing.
I believe therapy should be a space where people feel accepted and secure to lead and discern what is most supportive for their therapy journey to flourish. My background working with individuals, families, and children has equipped me to support those looking to conquer individual goals, raise a healthy family unit, or support their children. If you're a parent looking to enhance your skillsets, or if you're seeking the right person to support your child- that is where my heart is. A passion for serving those struggling with daily life encourages me to walk with each person toward healing.
(509) 416-0236 View (509) 416-0236
Photo of Courtney Covington, LICSW, Clinical Social Work/Therapist
Courtney Covington
Clinical Social Work/Therapist, LICSW
Verified Verified
2 Endorsed
Tacoma, WA 98418
As your therapist, my goal is to partner with you on your journey towards healing and personal growth. With over 5 years of experience in the field, I offer a compassionate and non-judgmental space where you can explore your experiences and find relief. In our sessions, we will collaborate to create customized goals and a plan to achieve them. By addressing today's obstacles, you'll emerge better equipped to handle future challenges. I strive to create an environment where humor and authenticity are welcome and where we can work together to find the path forward that feels best for you.
As your therapist, my goal is to partner with you on your journey towards healing and personal growth. With over 5 years of experience in the field, I offer a compassionate and non-judgmental space where you can explore your experiences and find relief. In our sessions, we will collaborate to create customized goals and a plan to achieve them. By addressing today's obstacles, you'll emerge better equipped to handle future challenges. I strive to create an environment where humor and authenticity are welcome and where we can work together to find the path forward that feels best for you.
(253) 262-0151 View (253) 262-0151
Photo of Connie L Sais, MA, LMHC, Counselor
Connie L Sais
Counselor, MA, LMHC
Verified Verified
1 Endorsed
Shoreline, WA 98133
Hello and Welcome. I currently have Friday and Saturday appointments available. There are any number of reasons why someone seeks help from a psychotherapist. These starting points are unique to each person. Yet there is often an awareness that a remedy of some kind is needed. This realization may not make securing support any easier. Talking to someone about your concerns, thoughts and feelings can be helpful. I strive to listen attentively and share my thoughts simply.
Hello and Welcome. I currently have Friday and Saturday appointments available. There are any number of reasons why someone seeks help from a psychotherapist. These starting points are unique to each person. Yet there is often an awareness that a remedy of some kind is needed. This realization may not make securing support any easier. Talking to someone about your concerns, thoughts and feelings can be helpful. I strive to listen attentively and share my thoughts simply.
(206) 929-4531 View (206) 929-4531
Photo of Robert Espiau, LMHC, Counselor
Robert Espiau
Counselor, LMHC
Verified Verified
3 Endorsed
Kirkland, WA 98033
I have over 30 years experience, and can help you to resolve panic attacks, anxiety, complex trauma, religious trauma and/or sexual abuse; I also work with couples counseling, Military and Combat-related PTSD, sexual addictions, nightmares, sexual abuse, and depression. I also have a strong background in cross-cultural psychology, having lived in 7 countries and studied the nature of consciousness as a monastic for six years; this has given me a diverse and complex perspective on life and people. I currently live in Vietnam and the US.
I have over 30 years experience, and can help you to resolve panic attacks, anxiety, complex trauma, religious trauma and/or sexual abuse; I also work with couples counseling, Military and Combat-related PTSD, sexual addictions, nightmares, sexual abuse, and depression. I also have a strong background in cross-cultural psychology, having lived in 7 countries and studied the nature of consciousness as a monastic for six years; this has given me a diverse and complex perspective on life and people. I currently live in Vietnam and the US.
(206) 875-2731 x125339 View (206) 875-2731 x125339
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How does your Therapist compare?

Average cost per session

$150

Therapists in Washington who prioritize treating:

92% Anxiety
86% Depression
75% Relationship Issues
74% Self Esteem
73% Trauma and PTSD
69% Stress
65% Coping Skills

Average years in practice

9 Years

Top 3 insurances accepted

71% Premera Blue Cross
62% Aetna
60% Regence

How Therapists in Washington see their clients

60% In Person and Online
40% Online Only

Gender breakdown

77% Female
21% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Washington?

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.