Therapists in Hawaii County, HI

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Photo of Marvia Scott, LCSW, Clinical Social Work/Therapist
Marvia Scott
Clinical Social Work/Therapist, LCSW
Verified Verified
Hilo, HI 96720
I am a licensed therapist in the states of Alabama, Massachusetts, and Hawaii with 7 years of professional work experience. I have experience in helping clients with stress and anxiety, depression, family conflicts, relationship difficulties, trauma and abuse, and career difficulties. I believe that you are the expert of your story and that you have many strengths that will assist you in overcoming things that challenge you. Taking the first step to seeking a more fulfilling and happier life takes courage. I am here to support you in that process.
I am a licensed therapist in the states of Alabama, Massachusetts, and Hawaii with 7 years of professional work experience. I have experience in helping clients with stress and anxiety, depression, family conflicts, relationship difficulties, trauma and abuse, and career difficulties. I believe that you are the expert of your story and that you have many strengths that will assist you in overcoming things that challenge you. Taking the first step to seeking a more fulfilling and happier life takes courage. I am here to support you in that process.
(808) 201-2045 View (808) 201-2045
Photo of Michael Brian McGee, LCSW, CSAC, Clinical Social Work/Therapist
Michael Brian McGee
Clinical Social Work/Therapist, LCSW, CSAC
Verified Verified
2 Endorsed
Hilo, HI 96720  (Online Only)
Not accepting new clients
Sometimes life takes some unexpected turns. Maybe you don't know how you got to where you are or you want to head in a different direction. Whether you need to get back on track, find a track, or just need someone to listen, therapy or coaching can be a helpful tool in getting there. I work with clients to help them find their strengths and develop achievable goals. There is no shame in seeking input and guidance outside of your own brain and experience.
Sometimes life takes some unexpected turns. Maybe you don't know how you got to where you are or you want to head in a different direction. Whether you need to get back on track, find a track, or just need someone to listen, therapy or coaching can be a helpful tool in getting there. I work with clients to help them find their strengths and develop achievable goals. There is no shame in seeking input and guidance outside of your own brain and experience.
(808) 563-4965 View (808) 563-4965
Photo of Ashley Aaron, MA , LMHC, Counselor
Ashley Aaron
Counselor, MA , LMHC
Verified Verified
2 Endorsed
Kamuela, HI 96743
Greetings! Chances are, if you're reading this, you are stuck in some form of suffering from which you cannot find a way out. The fact that you've made it here means that you have already taken the bravest, hardest steps on the journey toward change; recognizing that you need help, and finding the willingness to ask for it. I firmly believe that the answers you need are already within you; in my role as therapist, I act as a mirror through which you are able to connect to your own strengths, heal, and create a life worth living.
Greetings! Chances are, if you're reading this, you are stuck in some form of suffering from which you cannot find a way out. The fact that you've made it here means that you have already taken the bravest, hardest steps on the journey toward change; recognizing that you need help, and finding the willingness to ask for it. I firmly believe that the answers you need are already within you; in my role as therapist, I act as a mirror through which you are able to connect to your own strengths, heal, and create a life worth living.
(808) 201-7093 View (808) 201-7093
Photo of Isaac Tarik, LMFT, Marriage & Family Therapist
Isaac Tarik
Marriage & Family Therapist, LMFT
Verified Verified
Volcano, HI 96785
Sometimes we experience changes or events that disrupt our lives and ignite a series of overwhelming emotions. During these times, it is important to seek support to help guide you through this process. If you are experiencing anxiety, anger, stress, sadness or a sense of hopelessness, then I support your efforts in reaching out. If you have experienced a traumatic event or are currently in an abusive relationship and are looking to make a change, then I also encourage you to begin the process of initiating a “one to one” meeting with me. I am committed to providing the support you may need to encourage healing and change.
Sometimes we experience changes or events that disrupt our lives and ignite a series of overwhelming emotions. During these times, it is important to seek support to help guide you through this process. If you are experiencing anxiety, anger, stress, sadness or a sense of hopelessness, then I support your efforts in reaching out. If you have experienced a traumatic event or are currently in an abusive relationship and are looking to make a change, then I also encourage you to begin the process of initiating a “one to one” meeting with me. I am committed to providing the support you may need to encourage healing and change.
(808) 746-2239 View (808) 746-2239
Photo of Akoni L Kanaele - Big Island Health Clinic, INC., Marriage & Family Therapist
Big Island Health Clinic, INC.
Marriage & Family Therapist
Verified Verified
Hilo, HI 96720  (Online Only)
Big Island Health Clinic is committed to providing treatment that is Culturally Competent & Trauma Informed. Collectively we provide individual and family therapy for all ages. There are 3 therapists to choose from. Elvina Nartatez's areas of specialties include anger management & PTSD. Josephine Volpe is a certified substance abuse, anger management and Hospice counselor. Akoni Kanaele provides treatment for behavioral & anxiety disorders.
Big Island Health Clinic is committed to providing treatment that is Culturally Competent & Trauma Informed. Collectively we provide individual and family therapy for all ages. There are 3 therapists to choose from. Elvina Nartatez's areas of specialties include anger management & PTSD. Josephine Volpe is a certified substance abuse, anger management and Hospice counselor. Akoni Kanaele provides treatment for behavioral & anxiety disorders.
(808) 518-2648 View (808) 518-2648
Photo of Amber Fitzgerald, MA, Pre-Licensed Professional
Amber Fitzgerald
Pre-Licensed Professional, MA
Verified Verified
1 Endorsed
Hilo, HI 96720  (Online Only)
Most people experience times in life when they don’t know how to cope or don’t know what to do about something they are struggling with. Some people struggle for years, either alone or in their relationships, before they are ready to talk with someone about things they want to change in their life. Some feel content in life except in one area, and they could use an unbiased third party to help them solve that last piece of their puzzle. Whatever your reason is, seeking help is not easy, and it is a brave move that speaks volumes of your readiness to better your life.
Most people experience times in life when they don’t know how to cope or don’t know what to do about something they are struggling with. Some people struggle for years, either alone or in their relationships, before they are ready to talk with someone about things they want to change in their life. Some feel content in life except in one area, and they could use an unbiased third party to help them solve that last piece of their puzzle. Whatever your reason is, seeking help is not easy, and it is a brave move that speaks volumes of your readiness to better your life.
(808) 374-5059 View (808) 374-5059
Photo of Rachel Leigh Lewis, LMFT, Marriage & Family Therapist
Rachel Leigh Lewis
Marriage & Family Therapist, LMFT
Verified Verified
Pahoa, HI 96778  (Online Only)
I work with survivors of PTSD and Complex trauma, including relationship trauma and dissociation disorders. Common issues my clients present with include challenges with setting relationship boundaries with friends and family, coping with intense emotions, and an inability to be decisive in small or big life choices. Many are survivors of sexual or physical childhood abuse. Others say "childhood wasn't that bad," but have an intense inner critic and struggle with attracting and maintaining positive relationships and occupations, and are often unaware of the impact of emotional neglect and harsh criticism they experienced.
I work with survivors of PTSD and Complex trauma, including relationship trauma and dissociation disorders. Common issues my clients present with include challenges with setting relationship boundaries with friends and family, coping with intense emotions, and an inability to be decisive in small or big life choices. Many are survivors of sexual or physical childhood abuse. Others say "childhood wasn't that bad," but have an intense inner critic and struggle with attracting and maintaining positive relationships and occupations, and are often unaware of the impact of emotional neglect and harsh criticism they experienced.
(808) 201-5179 View (808) 201-5179
Photo of Glenn Pressel, MA, MFT, Marriage & Family Therapist
Glenn Pressel
Marriage & Family Therapist, MA, MFT
Verified Verified
1 Endorsed
Keaau, HI 96749
I love working with couples. I know how difficult it is to get caught up in the negative repeated dance of conflict that feels unresolvable. I work with couples to focus on the attachment or bonding issues that come up in conflicts. When we feel truly secure with one another we can hear issues without negative escalation that just angers and terrifies each other. When I am not working with couples I work with people who are committed to recover from depression, anxiety, addictions (chemical and behavioral), PTSD, relationship issues, sexuality and death and dying issues. I have been in practice since the early 1980's and I belie
I love working with couples. I know how difficult it is to get caught up in the negative repeated dance of conflict that feels unresolvable. I work with couples to focus on the attachment or bonding issues that come up in conflicts. When we feel truly secure with one another we can hear issues without negative escalation that just angers and terrifies each other. When I am not working with couples I work with people who are committed to recover from depression, anxiety, addictions (chemical and behavioral), PTSD, relationship issues, sexuality and death and dying issues. I have been in practice since the early 1980's and I belie
(808) 933-9113 x3 View (808) 933-9113 x3
Photo of Cristy McDowall, LCSW, Clinical Social Work/Therapist
Cristy McDowall
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Mountain View, HI 96771  (Online Only)
I specialize in working with those who have experienced trauma.
I specialize in working with those who have experienced trauma.
(808) 400-6918 View (808) 400-6918
Photo of Bertram Kalani Spain, PhD, LMFT, Marriage & Family Therapist
Bertram Kalani Spain
Marriage & Family Therapist, PhD, LMFT
Verified Verified
Hilo, HI 96720
B. Kalani Spain, PhD, LMFT, helping individuals, couples and families in the State of Hawaii with an understanding of cross-cultural issues. Specializing in trauma informed care, couples and family therapy, anger management and substance abuse issues. Allow me to assist you in overcoming the obstacles of unresolved conflicts, grudges, blame and miscommunication. Reclaim the harmony you deserve and can achieve
B. Kalani Spain, PhD, LMFT, helping individuals, couples and families in the State of Hawaii with an understanding of cross-cultural issues. Specializing in trauma informed care, couples and family therapy, anger management and substance abuse issues. Allow me to assist you in overcoming the obstacles of unresolved conflicts, grudges, blame and miscommunication. Reclaim the harmony you deserve and can achieve
(808) 495-0127 View (808) 495-0127
Photo of Alyssa S Kratz, LSW, BA, Pre-Licensed Professional
Alyssa S Kratz
Pre-Licensed Professional, LSW, BA
Verified Verified
1 Endorsed
Kailua Kona, HI 96740
Alyssa Kratz, LSW, received her Master’s Degree in Social Work with an emphasis in Behavioral Mental Health from the University of Hawaiʻi at Manoa. Alyssa is passionate about mental health & wellness. She believes that vast healing potential lies within each individual, and that given tools and a supportive, safe environment, one's unique potential can thrive. Her work is client-centered and trauma focused. Alyssa works with adults on various mental health experiences including addictions, codependency, anxiety, depression, mood disorders, grief and loss, self-harm, PTSD, trauma, abuse, and relational difficulties.
Alyssa Kratz, LSW, received her Master’s Degree in Social Work with an emphasis in Behavioral Mental Health from the University of Hawaiʻi at Manoa. Alyssa is passionate about mental health & wellness. She believes that vast healing potential lies within each individual, and that given tools and a supportive, safe environment, one's unique potential can thrive. Her work is client-centered and trauma focused. Alyssa works with adults on various mental health experiences including addictions, codependency, anxiety, depression, mood disorders, grief and loss, self-harm, PTSD, trauma, abuse, and relational difficulties.
(808) 201-5393 View (808) 201-5393
Madalyn Freedman
Pre-Licensed Professional, MA
Verified Verified
Kailua Kona, HI 96740
Madalyn Freedman (she/her) is a Mental Health Counselor with a therapeutic approach rooted in the belief that everyone has the capacity for healing through reconnection with their authentic self. Committed to creating a safe and empowering environment, Madalyn feels honored to support individuals of diverse identities along their unique journey, drawing on their inherent strengths and values. With a trauma-informed perspective, Madalyn specializes in working with complex and developmental trauma, employing modalities such as mindfulness-based therapies, somatic techniques, and Internal Family Systems Therapy.
Madalyn Freedman (she/her) is a Mental Health Counselor with a therapeutic approach rooted in the belief that everyone has the capacity for healing through reconnection with their authentic self. Committed to creating a safe and empowering environment, Madalyn feels honored to support individuals of diverse identities along their unique journey, drawing on their inherent strengths and values. With a trauma-informed perspective, Madalyn specializes in working with complex and developmental trauma, employing modalities such as mindfulness-based therapies, somatic techniques, and Internal Family Systems Therapy.
(718) 395-5226 View (718) 395-5226
Photo of Caroline Culverhouse, MSS, LCSW, ERYT, CGP, Clinical Social Work/Therapist
Caroline Culverhouse
Clinical Social Work/Therapist, MSS, LCSW, ERYT, CGP
Verified Verified
1 Endorsed
Waimea, HI 96743
I am delighted you found me! I am here to work with you on whatever issues and potentials for growth you'd like to explore. I work holistically-mind-body-spirit. I am a licensed LCSW in the states of Hawaii and Pennsylvania as well as a certified psychoanalytic psychotherapist, certified group psychotherapist and certified clinical trauma professional. I work with children, teens and adults. For more info on me and my specialties please visit www.hOMePYM.com and www.integrative-awakening.com
I am delighted you found me! I am here to work with you on whatever issues and potentials for growth you'd like to explore. I work holistically-mind-body-spirit. I am a licensed LCSW in the states of Hawaii and Pennsylvania as well as a certified psychoanalytic psychotherapist, certified group psychotherapist and certified clinical trauma professional. I work with children, teens and adults. For more info on me and my specialties please visit www.hOMePYM.com and www.integrative-awakening.com
(610) 427-8979 View (610) 427-8979
Photo of Alison Steiner, PsyD, Psychologist
Alison Steiner
Psychologist, PsyD
Verified Verified
Kailua Kona, HI 96740
As a clinical psychologist, I have a broad base of training and experience working with individuals seeking help with a wide range of clinical issues as well as life transitions and personal growth. I emphasize an open, trusting, non-judgmental, and collaborative process. From a practical approach comes a goal of transformation: allowing for new patterns of thought and behavior, and a more balanced and flourishing life.
As a clinical psychologist, I have a broad base of training and experience working with individuals seeking help with a wide range of clinical issues as well as life transitions and personal growth. I emphasize an open, trusting, non-judgmental, and collaborative process. From a practical approach comes a goal of transformation: allowing for new patterns of thought and behavior, and a more balanced and flourishing life.
(808) 784-7928 View (808) 784-7928
Photo of Maya Asidon, MS MFT, Pre-Licensed Professional
Maya Asidon
Pre-Licensed Professional, MS MFT
Verified Verified
3 Endorsed
Kailua Kona, HI 96745  (Online Only)
Are you feeling overwhelmed with the demands of life? Do you have a lot on your plate and struggle to find time for your needs? Are you looking for ways to fill your cup and feel like yourself again? Let’s explore and find solutions that are right for you.
Are you feeling overwhelmed with the demands of life? Do you have a lot on your plate and struggle to find time for your needs? Are you looking for ways to fill your cup and feel like yourself again? Let’s explore and find solutions that are right for you.
(828) 426-5390 View (828) 426-5390
Photo of Dr. Jude McAnesby, PsyD, Psychologist
Dr. Jude McAnesby
Psychologist, PsyD
Verified Verified
Waimea, HI 96743  (Online Only)
Life can offer us incredible beauty. It can also bring tremendous suffering. If you find yourself in pain, know you are not alone. As much as we may not like it, pain is intrinsic to the human condition. It certainly gets our attention. And, offers us the opportunity to deepen into greater wholeness and eventual joy. With support and guidance, we learn to see our experiences more clearly and understand their impact on our present circumstances. We become freer to make better choices and find we too are worthy of love and care. Our outer lives then begin to reflect this inner shift in our consciousness and understanding.
Life can offer us incredible beauty. It can also bring tremendous suffering. If you find yourself in pain, know you are not alone. As much as we may not like it, pain is intrinsic to the human condition. It certainly gets our attention. And, offers us the opportunity to deepen into greater wholeness and eventual joy. With support and guidance, we learn to see our experiences more clearly and understand their impact on our present circumstances. We become freer to make better choices and find we too are worthy of love and care. Our outer lives then begin to reflect this inner shift in our consciousness and understanding.
(208) 595-5164 View (208) 595-5164
Photo of Judy A Johnson, MSW, LCSW, Clinical Social Work/Therapist
Judy A Johnson
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Kailua Kona, HI 96740  (Online Only)
I commend you for taking the first step in self-discovery and healing! I invite you to share your feelings and emerge with a "Lighter Heart." I want to hear YOUR story. Does the world often overwhelm you? Do you seem to "feel" things deeply or become easily emotional? Then you may be a Highly Sensitive Person (HSP). HSPs are more prone to over-stimulation, depression, anxiety, addictions and relationship difficulties. As a Highly Sensitive therapist, I can help you to recognize the benefits and hardships of this trait, be more productive, have better relationships, and protect yourself from overwhelm.
I commend you for taking the first step in self-discovery and healing! I invite you to share your feelings and emerge with a "Lighter Heart." I want to hear YOUR story. Does the world often overwhelm you? Do you seem to "feel" things deeply or become easily emotional? Then you may be a Highly Sensitive Person (HSP). HSPs are more prone to over-stimulation, depression, anxiety, addictions and relationship difficulties. As a Highly Sensitive therapist, I can help you to recognize the benefits and hardships of this trait, be more productive, have better relationships, and protect yourself from overwhelm.
(619) 735-7447 View (619) 735-7447
Photo of Laura Dvorak, LCSW, Clinical Social Work/Therapist
Laura Dvorak
Clinical Social Work/Therapist, LCSW
Verified Verified
Hilo, HI 96720  (Online Only)
Are you searching for a deeper sense of purpose? I am here to educate, empower, and hold space as you navigate life’s uncertain terrain. Together we can create a safe container to lean into difficult emotions and identify opportunities and challenges, whether in your relationships, health, career, or family patterns. I enjoy working with couples, families, and individuals from adolescents to elders. I am passionate about connecting people to resources both internal and external.
Are you searching for a deeper sense of purpose? I am here to educate, empower, and hold space as you navigate life’s uncertain terrain. Together we can create a safe container to lean into difficult emotions and identify opportunities and challenges, whether in your relationships, health, career, or family patterns. I enjoy working with couples, families, and individuals from adolescents to elders. I am passionate about connecting people to resources both internal and external.
(808) 515-3520 View (808) 515-3520
Photo of Camille Bourcier, LCSW, Clinical Social Work/Therapist
Camille Bourcier
Clinical Social Work/Therapist, LCSW
Verified Verified
Hilo, HI 96720
Camille is a licensed social worker, psychotherapist and behavioral specialist who received her Master’s Degree in Social Work with an emphasis in Mental and Behavioral Health from the University of Hawaiʻi at Manoa. With over ten years experience working with adolescents, young adults, and families in outdoor, educational and therapeutic settings she brings a dynamic style, utilizing a strength-based approach. Camille has experience working with military families and local behavioral health organizations.
Camille is a licensed social worker, psychotherapist and behavioral specialist who received her Master’s Degree in Social Work with an emphasis in Mental and Behavioral Health from the University of Hawaiʻi at Manoa. With over ten years experience working with adolescents, young adults, and families in outdoor, educational and therapeutic settings she brings a dynamic style, utilizing a strength-based approach. Camille has experience working with military families and local behavioral health organizations.
(808) 650-5936 View (808) 650-5936
Photo of Janet Puanani Eblen, LMFT, Marriage & Family Therapist
Janet Puanani Eblen
Marriage & Family Therapist, LMFT
Verified Verified
Honokaa, HI 96727  (Online Only)
Do you find yourself fighting back tears at work? Do you feel like you have to lie and pretend when people ask you how you're doing? Are you starting to question your decisions, maybe even losing trust in yourself? When you notice that "small" things are causing "overreactions," you may feel like there's something wrong with you, and spiral deeper into confusion and self-doubt. These feelings are often connected to older issues that we try to shut away and pretend aren't affecting us. We can usually get by using denial and avoidance for awhile, but it almost always catches up with us.
Do you find yourself fighting back tears at work? Do you feel like you have to lie and pretend when people ask you how you're doing? Are you starting to question your decisions, maybe even losing trust in yourself? When you notice that "small" things are causing "overreactions," you may feel like there's something wrong with you, and spiral deeper into confusion and self-doubt. These feelings are often connected to older issues that we try to shut away and pretend aren't affecting us. We can usually get by using denial and avoidance for awhile, but it almost always catches up with us.
(808) 825-6382 View (808) 825-6382
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See more therapy options for Hawaii County

How does your Therapist compare?

Number of Therapists in Hawaii County, HI

200+

Average cost per session

$150

Therapists in Hawaii County, HI who prioritize treating:

91% Anxiety
83% Depression
77% Self Esteem
73% Relationship Issues
71% Trauma and PTSD
70% Coping Skills
66% Stress

Average years in practice

10 Years

Top 3 insurances accepted

73% Hawaii Medical Services Association
48% Hawaii Medical Assurance Association
44% University Health Alliance

How Therapists in Hawaii County, HI see their clients

57% In Person and Online
43% Online Only

Gender breakdown

79% Female
20% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Hawaii County?

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.