Therapists in Polk County, IA

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Photo of Schuyler Paxton, LMHC, Counselor
Schuyler Paxton
Counselor, LMHC
Verified Verified
Hello! I offer a relational and personal style of therapy. I approach people and solutions by considering interpersonal dynamics, unconscious perspectives we hold, the wisdom inherent in our bodies, and our underestimated resources of strength. I want us to experience more wholeness and enrichment in our lives. The poet, Mary Oliver, says it well, “I want to think again of dangerous and noble things. I want to be light and frolicsome. I want to be improbable beautiful and afraid of nothing, as though I had wings.”
Hello! I offer a relational and personal style of therapy. I approach people and solutions by considering interpersonal dynamics, unconscious perspectives we hold, the wisdom inherent in our bodies, and our underestimated resources of strength. I want us to experience more wholeness and enrichment in our lives. The poet, Mary Oliver, says it well, “I want to think again of dangerous and noble things. I want to be light and frolicsome. I want to be improbable beautiful and afraid of nothing, as though I had wings.”
(515) 219-8510 View (515) 219-8510
Photo of Samantha Rives, LMHC, Counselor
Samantha Rives
Counselor, LMHC
Verified Verified
Are you noticing tension and discomfort in your body? I believe that this is often easier to notice than what might be contributing to your symptoms, things like anxiety, stress, or trauma. We tend to push on and avoid taking good care of ourselves, despite feeling depressed, managing grief, and experiencing life challenges. We can find ourselves feeling burned out, struggling to function in our daily lives, and needing to reconnect with ourselves and those around us. Wherever you’re at in your healing and wellness journey, I’d love to help you along the way.
Are you noticing tension and discomfort in your body? I believe that this is often easier to notice than what might be contributing to your symptoms, things like anxiety, stress, or trauma. We tend to push on and avoid taking good care of ourselves, despite feeling depressed, managing grief, and experiencing life challenges. We can find ourselves feeling burned out, struggling to function in our daily lives, and needing to reconnect with ourselves and those around us. Wherever you’re at in your healing and wellness journey, I’d love to help you along the way.
(515) 599-9060 View (515) 599-9060
Photo of Stephanie Lee - Stephanie Lee, PhD, LISW, @ Starting New Chapters , PhD, LISW, Clinical Social Work/Therapist
Stephanie Lee, PhD, LISW, @ Starting New Chapters
Clinical Social Work/Therapist, PhD, LISW
Verified Verified
1 Endorsed
Waitlist for new clients
I'm grateful to have spent over 30 years providing mental health services to individuals and families in the Des Moines area both as a Clinician and Supervisor in a variety of outpatient mental health settings, and as teaching in the field of Psychology as an adjunct teaching instructor for several years. I currently provide individual counseling services to adults (18 and above) both in-person and through tele-health. Areas of specialization include: trauma, depression, anxiety, grief and loss, and life transitions. It's truly an honor to work with those who are facing some of the most difficult and vulnerable moments in life.
I'm grateful to have spent over 30 years providing mental health services to individuals and families in the Des Moines area both as a Clinician and Supervisor in a variety of outpatient mental health settings, and as teaching in the field of Psychology as an adjunct teaching instructor for several years. I currently provide individual counseling services to adults (18 and above) both in-person and through tele-health. Areas of specialization include: trauma, depression, anxiety, grief and loss, and life transitions. It's truly an honor to work with those who are facing some of the most difficult and vulnerable moments in life.
(515) 325-4240 View (515) 325-4240
Photo of Nan King, LMHC, CADC, Counselor
Nan King
Counselor, LMHC, CADC
Verified Verified
Des Moines, IA 50309
I provide a personalized approach tailored to each persons needs to help you attain the personal growth you desire. Most people experience difficulties at some point in their lives. If you are experiencing problems, there is hope. Counseling provides a safe, warm, supportive relationship where you can openly share your thoughts and feelings, find support, and learn new strategies for coping with situations and emotions. My desire is to work with you to develop new patterns in your life that can lead to healthier coping skills, increased confidence, and a greater sense of purpose and meaning in your life.
I provide a personalized approach tailored to each persons needs to help you attain the personal growth you desire. Most people experience difficulties at some point in their lives. If you are experiencing problems, there is hope. Counseling provides a safe, warm, supportive relationship where you can openly share your thoughts and feelings, find support, and learn new strategies for coping with situations and emotions. My desire is to work with you to develop new patterns in your life that can lead to healthier coping skills, increased confidence, and a greater sense of purpose and meaning in your life.
(515) 778-4440 View (515) 778-4440
Photo of Katherine Donahue, LISW, Clinical Social Work/Therapist
Katherine Donahue
Clinical Social Work/Therapist, LISW
Verified Verified
Des Moines, IA 50312
Not accepting new clients
Finding a good fit in a therapist is important. If you feel comfortable and at ease in the therapist’s presence, feel understood and affirmed, even “click” interpersonally on some level, you’re building a good foundation for getting what you want out of counseling. By nature, my personality style is welcoming, genuine and straightforward, calming, and supportive. I see the strengths in people and provide a compassionate, affirming presence. I think hope and humor are critically important aspects of therapy and in life.
Finding a good fit in a therapist is important. If you feel comfortable and at ease in the therapist’s presence, feel understood and affirmed, even “click” interpersonally on some level, you’re building a good foundation for getting what you want out of counseling. By nature, my personality style is welcoming, genuine and straightforward, calming, and supportive. I see the strengths in people and provide a compassionate, affirming presence. I think hope and humor are critically important aspects of therapy and in life.
(319) 670-2127 View (319) 670-2127
Photo of Stephanie Wheeler, LISW, Clinical Social Work/Therapist
Stephanie Wheeler
Clinical Social Work/Therapist, LISW
Verified Verified
Ankeny, IA 50023
Not Currently Accepting New Clients. As your therapist, my goal is to provide a safe and supportive environment which promotes individual healing and growth. I enjoy working with adults experiencing an array of concerns, which include, but are not limited to trauma, complex trauma, dissociation, anxiety and depressive symptoms, life transitions and stress. Through a trauma informed lens and mind-body approach, the therapeutic relationship involves supporting clients as they gain insight, explore and enhance relationships both internally and externally, which allows opportunity for long term growth and healing.
Not Currently Accepting New Clients. As your therapist, my goal is to provide a safe and supportive environment which promotes individual healing and growth. I enjoy working with adults experiencing an array of concerns, which include, but are not limited to trauma, complex trauma, dissociation, anxiety and depressive symptoms, life transitions and stress. Through a trauma informed lens and mind-body approach, the therapeutic relationship involves supporting clients as they gain insight, explore and enhance relationships both internally and externally, which allows opportunity for long term growth and healing.
(515) 305-3547 View (515) 305-3547
Photo of Haleigh Bouslog, LMHC, Counselor
Haleigh Bouslog
Counselor, LMHC
Verified Verified
Clive, IA 50325
Hi! My name is Haleigh Bouslog and I am a Licensed Mental Health Counselor (LMHC). My passion lies in empowering and supporting women through all stages of life.
Hi! My name is Haleigh Bouslog and I am a Licensed Mental Health Counselor (LMHC). My passion lies in empowering and supporting women through all stages of life.
(515) 209-3849 View (515) 209-3849
Photo of Riley Rodemaker, tLMHC, MA, Counselor
Riley Rodemaker
Counselor, tLMHC, MA
Verified Verified
Ankeny, IA 50021
Welcome! My name is Riley Rodemaker (He/Him) and I am a tLMHC at LifeWorks - Ankeny. I know that reaching out for help can be very difficult and I have a lot of respect for the bravery that it takes. My hope is that we can work together to help you feel better. I believe that empathy and compassion serve as the foundation for any helping relationship. I am a generalist counselor (meaning I have some experience with a variety of issues); however, I especially enjoy working with clients on issues related to anxiety, depression, grief/loss, and suicide/self-harm.
Welcome! My name is Riley Rodemaker (He/Him) and I am a tLMHC at LifeWorks - Ankeny. I know that reaching out for help can be very difficult and I have a lot of respect for the bravery that it takes. My hope is that we can work together to help you feel better. I believe that empathy and compassion serve as the foundation for any helping relationship. I am a generalist counselor (meaning I have some experience with a variety of issues); however, I especially enjoy working with clients on issues related to anxiety, depression, grief/loss, and suicide/self-harm.
(515) 585-6896 View (515) 585-6896
Photo of Tony J Raymer, LISW, RPT-S, Clinical Social Work/Therapist
Tony J Raymer
Clinical Social Work/Therapist, LISW, RPT-S
Verified Verified
2 Endorsed
Des Moines, IA 50313
Not accepting new clients
Not currently accepting new clients at this time. I am happy to help you connect with others. Is it difficult to feel close to your child because of defiance, emotional outbursts, or behavioral struggles? Have you tried therapy before, but the therapist didn’t seem to understand you? My approach to counseling for adults and play therapy for children is nonjudgmental, supportive, and often fun. I believe interacting with the world through joy and humor lets us build healing connections with others. I have 11 years of experience helping families of kids ages 2-12 with skill building to become confident, peaceful, and connected.
Not currently accepting new clients at this time. I am happy to help you connect with others. Is it difficult to feel close to your child because of defiance, emotional outbursts, or behavioral struggles? Have you tried therapy before, but the therapist didn’t seem to understand you? My approach to counseling for adults and play therapy for children is nonjudgmental, supportive, and often fun. I believe interacting with the world through joy and humor lets us build healing connections with others. I have 11 years of experience helping families of kids ages 2-12 with skill building to become confident, peaceful, and connected.
(515) 303-2026 View (515) 303-2026
Photo of Shelly Stewart-Sandusky, MS, LMFT, Marriage & Family Therapist
Shelly Stewart-Sandusky
Marriage & Family Therapist, MS, LMFT
Verified Verified
Des Moines, IA 50322
Hello. I am a Licensed Marriage and Family Therapist who works with couples and individuals needing help with relationship issues. I thrive on working with couples struggling with infidelity, rebuilding trust or communication/fair fighting and high conflict. The dynamic of a couple is unique and should be approached as such. I believe that every relationship can work and be healthy for both partners if both partners are willing to do the work and make changes. I am also certifified in treatment of personality disorders and am able to help in both individual and couples dynamics.
Hello. I am a Licensed Marriage and Family Therapist who works with couples and individuals needing help with relationship issues. I thrive on working with couples struggling with infidelity, rebuilding trust or communication/fair fighting and high conflict. The dynamic of a couple is unique and should be approached as such. I believe that every relationship can work and be healthy for both partners if both partners are willing to do the work and make changes. I am also certifified in treatment of personality disorders and am able to help in both individual and couples dynamics.
(515) 346-6974 View (515) 346-6974
Photo of Kira Conard, LMSW, Clinical Social Work/Therapist
Kira Conard
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Urbandale, IA 50322
Waitlist for new clients
***Currently Accepting New Clients*** Do you find yourself overwhelmed and need someone to talk to? Are you tired of struggling? Do you feel like you are a burden to your supports? If you answered yes to any of these questions, then I welcome you to the beginning of your journey to healing. It can be difficult to deal with stressors and trauma alone. Therapy is a safe place where you will be able to unpack your hurt and concerns at your own pace. I collaborate with clients to identify their goals for therapy, and we will work as a team to help you meet these goals.
***Currently Accepting New Clients*** Do you find yourself overwhelmed and need someone to talk to? Are you tired of struggling? Do you feel like you are a burden to your supports? If you answered yes to any of these questions, then I welcome you to the beginning of your journey to healing. It can be difficult to deal with stressors and trauma alone. Therapy is a safe place where you will be able to unpack your hurt and concerns at your own pace. I collaborate with clients to identify their goals for therapy, and we will work as a team to help you meet these goals.
(515) 446-7284 View (515) 446-7284
Photo of Natalie Rose Meyle, LCSW, Clinical Social Work/Therapist
Natalie Rose Meyle
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Des Moines, IA 50304  (Online Only)
Maybe your parenthood journey has been harder than you anticipated. Or you are struggling with feeling good enough. Perhaps you’re ending a relationship or starting a new career. You might be feeling disconnected from your partner or children, feeling touched out and overwhelmed. Life is full of change and transitions that can at times leave us feeling alone, anxious and exhausted. Therapy is a safe and accepting space where we can work together for you to boldly live as your authentic self. Imagine being able to focus on your healing and self and turn off the worry.
Maybe your parenthood journey has been harder than you anticipated. Or you are struggling with feeling good enough. Perhaps you’re ending a relationship or starting a new career. You might be feeling disconnected from your partner or children, feeling touched out and overwhelmed. Life is full of change and transitions that can at times leave us feeling alone, anxious and exhausted. Therapy is a safe and accepting space where we can work together for you to boldly live as your authentic self. Imagine being able to focus on your healing and self and turn off the worry.
(910) 294-5663 View (910) 294-5663
Photo of Marie Villhauer, LMHC, Counselor
Marie Villhauer
Counselor, LMHC
Verified Verified
Ankeny, IA 50021
Accepting clients for 9am-3pm appointments. My clients, friends, and family would describe me as their personal cheerleader. My goal as your therapist is to help you explore the parts of you that feel burdened by wounds from relationships in your adult and young years. I want to encourage you every step of the way. I utilize Internal Family Systems, EMDR, IFIO couples/relationship therapies to help you reach your goals. I completed level two training in April 2024.
Accepting clients for 9am-3pm appointments. My clients, friends, and family would describe me as their personal cheerleader. My goal as your therapist is to help you explore the parts of you that feel burdened by wounds from relationships in your adult and young years. I want to encourage you every step of the way. I utilize Internal Family Systems, EMDR, IFIO couples/relationship therapies to help you reach your goals. I completed level two training in April 2024.
(515) 375-2514 View (515) 375-2514
Photo of Michele M. Skaggs, LISW, Clinical Social Work/Therapist
Michele M. Skaggs
Clinical Social Work/Therapist, LISW
Verified Verified
Des Moines, IA 50322
Not accepting new clients
Accepting NEW Patients aged 25+ for individual therapy. I am here to help you address a variety of issues including trauma (EMDR), personality disorders, grief, relationship problems, sexuality concerns, codependency, and overall life stressors. With over 10 years of clinical experience, I am here to help you heal from emotional distress and guide you on your path to self-awareness and positive change. Give me a call today and we can discuss your needs. I offer in person and telehealth sessions for state of Iowa residents.
Accepting NEW Patients aged 25+ for individual therapy. I am here to help you address a variety of issues including trauma (EMDR), personality disorders, grief, relationship problems, sexuality concerns, codependency, and overall life stressors. With over 10 years of clinical experience, I am here to help you heal from emotional distress and guide you on your path to self-awareness and positive change. Give me a call today and we can discuss your needs. I offer in person and telehealth sessions for state of Iowa residents.
(515) 219-4935 View (515) 219-4935
Photo of Steph Crandall, LMSW, Clinical Social Work/Therapist
Steph Crandall
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Des Moines, IA 50313  (Online Only)
When you are feeling stressed or overwhelmed to the point it is impacting your day-to-day life, it helps to talk with someone who is both kind and practical — offering hope and nonjudgmental support, but also collaborating with you on finding real solutions. We all need a guide sometimes when life is hard. I am the type of therapist who will provide validation when you need it but also encourage you to take charge of the things within your control. I work with adults who are experiencing anxiety, stress, trouble communicating with a partner or family, and job burnout. In particular, I enjoy working with educators at all levels.
When you are feeling stressed or overwhelmed to the point it is impacting your day-to-day life, it helps to talk with someone who is both kind and practical — offering hope and nonjudgmental support, but also collaborating with you on finding real solutions. We all need a guide sometimes when life is hard. I am the type of therapist who will provide validation when you need it but also encourage you to take charge of the things within your control. I work with adults who are experiencing anxiety, stress, trouble communicating with a partner or family, and job burnout. In particular, I enjoy working with educators at all levels.
(515) 474-7463 View (515) 474-7463
Photo of Katie Smith, LMSW, Clinical Social Work/Therapist
Katie Smith
Clinical Social Work/Therapist, LMSW
Verified Verified
2 Endorsed
Ankeny, IA 50023
Recognizing that you need some help and support is the first step in making a change in your life. I am here to help you on your mental health journey. I am passionate about meeting my clients where they are at, providing them with tools that they can use to achieve their goals. I have experience working with teens and adults through individual, couple and family sessions. I help my clients by addressing a variety of concerns, with a focus on treating anxiety, depression, relationship issues, loss and grief. I strive to create a safe and supportive therapeutic environment that evokes growth and positive change without judgment.
Recognizing that you need some help and support is the first step in making a change in your life. I am here to help you on your mental health journey. I am passionate about meeting my clients where they are at, providing them with tools that they can use to achieve their goals. I have experience working with teens and adults through individual, couple and family sessions. I help my clients by addressing a variety of concerns, with a focus on treating anxiety, depression, relationship issues, loss and grief. I strive to create a safe and supportive therapeutic environment that evokes growth and positive change without judgment.
(515) 966-8964 x1 View (515) 966-8964 x1
Photo of Mark Poeppe, PsyD, Psychologist
Mark Poeppe
Psychologist, PsyD
Verified Verified
Dr. Mark Poeppe ("Peppy") specializes in psychological assessment and is particularly interested in objective psychological, neuropsychological, and forensic assessment for all ages. In addition to assessment services, Dr. Poeppe provides psychotherapy to adults, adolescents, and children. His assessment scope includes but is not limited to disability examinations, veteran’s compensation examinations, child custody evaluations, workman’s compensation, personal injury, ADHD, Intellectual Disability waivers, academic learning disabilities, memory, neurodevelopmental disorders and cognitive functioning.
Dr. Mark Poeppe ("Peppy") specializes in psychological assessment and is particularly interested in objective psychological, neuropsychological, and forensic assessment for all ages. In addition to assessment services, Dr. Poeppe provides psychotherapy to adults, adolescents, and children. His assessment scope includes but is not limited to disability examinations, veteran’s compensation examinations, child custody evaluations, workman’s compensation, personal injury, ADHD, Intellectual Disability waivers, academic learning disabilities, memory, neurodevelopmental disorders and cognitive functioning.
(515) 329-9074 View (515) 329-9074
Photo of Melissa Steenhoven, LISW, Clinical Social Work/Therapist
Melissa Steenhoven
Clinical Social Work/Therapist, LISW
Verified Verified
Des Moines, IA 50310
Seeking to make changes in your life for a better tomorrow? I have been helping people to make these changes for over 20 years by offering a safe and accepting environment and starting with where you are at in the change process. I believe that by making small changes in one's life, we can start on the path of making life more fulfilling and closer to the life that you want to live.
Seeking to make changes in your life for a better tomorrow? I have been helping people to make these changes for over 20 years by offering a safe and accepting environment and starting with where you are at in the change process. I believe that by making small changes in one's life, we can start on the path of making life more fulfilling and closer to the life that you want to live.
(515) 393-6906 View (515) 393-6906
Photo of Amy Beth Lapham, LICSW, LISW, Clinical Social Work/Therapist
Amy Beth Lapham
Clinical Social Work/Therapist, LICSW, LISW
Verified Verified
Des Moines, IA 50312
I have been providing therapy for children (age 8 and up), adolescents and adults since 1995 in a variety of therapeutic settings. I have specialize in the area of trauma and other forms of abuse causing emotional distress/ negative impact on many levels of a person and their families life.
I have been providing therapy for children (age 8 and up), adolescents and adults since 1995 in a variety of therapeutic settings. I have specialize in the area of trauma and other forms of abuse causing emotional distress/ negative impact on many levels of a person and their families life.
(218) 451-5035 View (218) 451-5035
Photo of Angela Ruiz, Clinical Social Work/Therapist
Angela Ruiz
Clinical Social Work/Therapist
Verified Verified
Ankeny, IA 50023
Hi there! Life gives us many different experiences and from those experiences we become stronger and more knowledgeable. My experiences, personally and professionally, have made me competent in the areas of adoption, anxiety, depression, stress, trauma, ADHD, autism, grief, and life transitions. I work with all ages and find it a privilege to work with everyone, regardless of age, race, religion and sexual orientation.
Hi there! Life gives us many different experiences and from those experiences we become stronger and more knowledgeable. My experiences, personally and professionally, have made me competent in the areas of adoption, anxiety, depression, stress, trauma, ADHD, autism, grief, and life transitions. I work with all ages and find it a privilege to work with everyone, regardless of age, race, religion and sexual orientation.
(515) 516-3498 View (515) 516-3498

How does your Therapist compare?

Number of Therapists in Polk County, IA

700+

Average cost per session

$158

Therapists in Polk County, IA who prioritize treating:

95% Anxiety
89% Depression
78% Relationship Issues
78% Self Esteem
77% Trauma and PTSD
74% Stress
70% Coping Skills

Average years in practice

10 Years

Top 3 insurances accepted

83% BlueCross and BlueShield
76% Wellmark BCBS
52% UnitedHealthcare UHC | UBH

How Therapists in Polk County, IA see their clients

80% In Person and Online
20% Online Only

Gender breakdown

82% Female
17% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Polk 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.