Therapists in Chico, CA

Photo of Melissa Aguirre, LCSW, Clinical Social Work/Therapist
Melissa Aguirre
Clinical Social Work/Therapist, LCSW
Verified Verified
Chico, CA 95928
I am a Licensed Clinical Social Worker who has a passion for working with individuals who experience stressors and challenges to work collaboratively toward growth and change in their lives. I am based in Santa Maria, California. My approach is cognitive behavior therapy, DBT, and solution-focused. My experience is working with both teens and adults with severe mental illness, anxiety, depression, mood disorders, etc. I have worked in residential youth facilities, mental health agencies, and schools. I have supported clients with life transitions, developing coping skills to access everyday life activities and academics.
I am a Licensed Clinical Social Worker who has a passion for working with individuals who experience stressors and challenges to work collaboratively toward growth and change in their lives. I am based in Santa Maria, California. My approach is cognitive behavior therapy, DBT, and solution-focused. My experience is working with both teens and adults with severe mental illness, anxiety, depression, mood disorders, etc. I have worked in residential youth facilities, mental health agencies, and schools. I have supported clients with life transitions, developing coping skills to access everyday life activities and academics.
(530) 424-2209 View (530) 424-2209
Photo of Cody Scheer, MS, AMFT, Marriage & Family Therapist Associate
Cody Scheer
Marriage & Family Therapist Associate, MS, AMFT
Verified Verified
6 Endorsed
Chico, CA 95926
I am a young therapist who is passionate about helping people who are struggling with life's issues. I have experience working with depression, anxiety, self-esteem issues, and anger management. Growing up as teenager and young adult I experienced many of these afflictions myself and have dedicated my work towards helping those suffering from the same things. If you need help solving lifes problems or just becoming the best version of yourself, I can help you. I specialize in children, teens, and young adults, but am open to working with all ages.
I am a young therapist who is passionate about helping people who are struggling with life's issues. I have experience working with depression, anxiety, self-esteem issues, and anger management. Growing up as teenager and young adult I experienced many of these afflictions myself and have dedicated my work towards helping those suffering from the same things. If you need help solving lifes problems or just becoming the best version of yourself, I can help you. I specialize in children, teens, and young adults, but am open to working with all ages.
(530) 444-6461 View (530) 444-6461
Photo of Stephen Michael Diggs, PhD, Psychologist
Stephen Michael Diggs
Psychologist, PhD
Verified Verified
Chico, CA 95926
Not accepting new clients
My team of therapists and I welcome anyone experiencing anxiety, depression, negative self-talk, substance abuse, thoughts of suicide, despair, and other challenges that interfere with their well-being, happiness, and relationships with others. Even if you've previously found therapy to be unsuccessful, we can help! We treat the cause, not just the symptoms, of your distress. We believe that everyone is intelligent and capable; our job is to help you discover the capabilities that you already posses. You and your therapist will work together to resolve the obstacles that are preventing you from becoming your authentic self and living the life you desire.
My team of therapists and I welcome anyone experiencing anxiety, depression, negative self-talk, substance abuse, thoughts of suicide, despair, and other challenges that interfere with their well-being, happiness, and relationships with others. Even if you've previously found therapy to be unsuccessful, we can help! We treat the cause, not just the symptoms, of your distress. We believe that everyone is intelligent and capable; our job is to help you discover the capabilities that you already posses. You and your therapist will work together to resolve the obstacles that are preventing you from becoming your authentic self and living the life you desire.
(530) 773-5134 View (530) 773-5134
Photo of Charlene Sara Coscarelli, LMFT, Marriage & Family Therapist
Charlene Sara Coscarelli
Marriage & Family Therapist, LMFT
Verified Verified
Chico, CA 95926
I am dedicated to helping my clients achieve their goals. Many people come to me because they're experiencing problems in various areas of their life and they need someone to share things they can't share with anyone else.
I am dedicated to helping my clients achieve their goals. Many people come to me because they're experiencing problems in various areas of their life and they need someone to share things they can't share with anyone else.
(530) 464-1515 View (530) 464-1515
Photo of Nancy R. Calkins, MFT, Marriage & Family Therapist
Nancy R. Calkins
Marriage & Family Therapist, MFT
Verified Verified
Chico, CA 95926
When you just don't know what to do anymore. When life seems to be falling apart. Counseling may be just the thing to get you back on track. I can help you find your answers.
When you just don't know what to do anymore. When life seems to be falling apart. Counseling may be just the thing to get you back on track. I can help you find your answers.
(530) 645-9224 View (530) 645-9224
Photo of Sarah Frohock, LCSW, Clinical Social Work/Therapist
Sarah Frohock
Clinical Social Work/Therapist, LCSW
Verified Verified
Chico, CA 95926
Not accepting new clients
Do you feel stuck in a relationship, career, or pattern? Are you struggling to find a way to manage a difficult situation? I can work with you to develop the skills to help you regain control of your life and conquer your problems. I will bring all of my experience, compassion, and humor into the process of supporting you in finding solutions. I utilize a strength-based approach to work with you in identifying your natural abilities to tackle your current challenges. I can help you identify your goals, tap into your strengths and create a plan to move forward.
Do you feel stuck in a relationship, career, or pattern? Are you struggling to find a way to manage a difficult situation? I can work with you to develop the skills to help you regain control of your life and conquer your problems. I will bring all of my experience, compassion, and humor into the process of supporting you in finding solutions. I utilize a strength-based approach to work with you in identifying your natural abilities to tackle your current challenges. I can help you identify your goals, tap into your strengths and create a plan to move forward.
(530) 722-6163 View (530) 722-6163
Photo of Heather M. O'Connell, PhD, Psychologist
Heather M. O'Connell
Psychologist, PhD
Verified Verified
Chico, CA 95926
Not accepting new clients
I focus on helping people achieve an improved quality of life, whether it be through developing healthier relationships, overcoming an addiction, or healing from a painful past. I support people in learning how to more effectively manage life stressors that can often times contribute to other symptoms, such as anxiety and depression. I connect well with individuals who want to increase their self confidence and feel a stronger sense of empowerment in their ability to effectively manage their emotions, relationships with others, and overall life goals.
I focus on helping people achieve an improved quality of life, whether it be through developing healthier relationships, overcoming an addiction, or healing from a painful past. I support people in learning how to more effectively manage life stressors that can often times contribute to other symptoms, such as anxiety and depression. I connect well with individuals who want to increase their self confidence and feel a stronger sense of empowerment in their ability to effectively manage their emotions, relationships with others, and overall life goals.
(530) 637-3329 View (530) 637-3329
Photo of Gale Dixon Brown, LCMFT, Marriage & Family Therapist
Gale Dixon Brown
Marriage & Family Therapist, LCMFT
Verified Verified
Chico, CA 95928
Medi-Cal Anthem Blue Cross provider and Medi-Cal California Health and Wellness provider. I'm a very good listener, nonjudgmental, and have much compassion for people who are hurting. . Traumatic experiences in my family of the suicide of my brother, loss of my sister in a car accident that left me critically injured, and having a twin brother who suffered with schizophrenia has made me a strong, empathetic, and trusting therapist. Albeit, its been a tough road, but shedding many ineffective beliefs, myths, and taboos I learned from my family and society I have let go.
Medi-Cal Anthem Blue Cross provider and Medi-Cal California Health and Wellness provider. I'm a very good listener, nonjudgmental, and have much compassion for people who are hurting. . Traumatic experiences in my family of the suicide of my brother, loss of my sister in a car accident that left me critically injured, and having a twin brother who suffered with schizophrenia has made me a strong, empathetic, and trusting therapist. Albeit, its been a tough road, but shedding many ineffective beliefs, myths, and taboos I learned from my family and society I have let go.
(530) 433-5423 View (530) 433-5423
Photo of Chelsea Acosta, MA, AMFT, Marriage & Family Therapist Associate
Chelsea Acosta
Marriage & Family Therapist Associate, MA, AMFT
Verified Verified
5 Endorsed
Chico, CA 95928
I know how challenging life can be, how difficult it is to reach out during tough times and let another person into your struggles, pain, and story. But letting safe people into your life is necessary for healing, because we are not meant to navigate this life alone. It takes time to heal, and it takes support and effort on the journey. But an environment with a compassionate and trained confidant, makes all the difference. You can create the life you are hoping for! Together, we will create a safe place to help you process your pain & create a more joy filled future.
I know how challenging life can be, how difficult it is to reach out during tough times and let another person into your struggles, pain, and story. But letting safe people into your life is necessary for healing, because we are not meant to navigate this life alone. It takes time to heal, and it takes support and effort on the journey. But an environment with a compassionate and trained confidant, makes all the difference. You can create the life you are hoping for! Together, we will create a safe place to help you process your pain & create a more joy filled future.
(530) 665-8648 View (530) 665-8648
Photo of Amy Rhoades, Clinical Social Work/Therapist
Amy Rhoades
Clinical Social Work/Therapist
Verified Verified
1 Endorsed
Chico, CA 95928
Not accepting new clients
Hello there, I am Amy Rhoades, LCSW. Do you feel overwhelmed, anxious, or depressed and unsure how to find new coping strategies? Are you struggling with being kind to yourself? Have you experienced trauma throughout your life, a one time event, or even through childhood and need support in managing the symptoms of the trauma or other life events? Do you struggle with grief and loss, and feel getting out of grief is never ending? Or substance use? I am here to help you find your inner strengths and resiliency. I work with those with PTSD, grief and loss, anxiety and depression, just to name a few.
Hello there, I am Amy Rhoades, LCSW. Do you feel overwhelmed, anxious, or depressed and unsure how to find new coping strategies? Are you struggling with being kind to yourself? Have you experienced trauma throughout your life, a one time event, or even through childhood and need support in managing the symptoms of the trauma or other life events? Do you struggle with grief and loss, and feel getting out of grief is never ending? Or substance use? I am here to help you find your inner strengths and resiliency. I work with those with PTSD, grief and loss, anxiety and depression, just to name a few.
(909) 787-2905 View (909) 787-2905
Photo of Chris Sims, MSW, LCSW, Clinical Social Work/Therapist
Chris Sims
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Chico, CA 95926
I help people learn to practice self compassion. Past experiences can cause us to think negatively about ourselves and the world around us. We can improve our mental health and our relationships with others by understanding who we truly are and why we think the way we do.
I help people learn to practice self compassion. Past experiences can cause us to think negatively about ourselves and the world around us. We can improve our mental health and our relationships with others by understanding who we truly are and why we think the way we do.
(530) 450-2119 View (530) 450-2119
Photo of Caylan Bakkie, LMFT, Marriage & Family Therapist
Caylan Bakkie
Marriage & Family Therapist, LMFT
Verified Verified
5 Endorsed
Chico, CA 95926
Are you working on changing old unhealthy patterns or just starting on a journey of trying to figure out who you are, what your values are, and how to create better relationships in your life? I am passionate about working with individuals who want to improve current and past relationships and heal from childhood trauma and unhealthy family patterns. I enjoy working with those who grew up with poor examples of relational health and want to learn new and healthy ways of engaging with partners, family, and friends.
Are you working on changing old unhealthy patterns or just starting on a journey of trying to figure out who you are, what your values are, and how to create better relationships in your life? I am passionate about working with individuals who want to improve current and past relationships and heal from childhood trauma and unhealthy family patterns. I enjoy working with those who grew up with poor examples of relational health and want to learn new and healthy ways of engaging with partners, family, and friends.
(530) 444-8572 View (530) 444-8572
Photo of Erika Miller, MS, Marriage & Family Therapist Associate
Erika Miller
Marriage & Family Therapist Associate, MS
Verified Verified
Chico, CA 95926
I specialize in helping individuals who suffer from depression, suicidal ideation, anxiety, self-esteem issues, relationship issues, difficulty with boundaries, co-dependency, intimate partner violence, substance use disorders, and grief, among other difficulties. I am open to ages eight through the end of life, any and all genders and ethnicities are welcome. I am a therapist at Stonebridge Counseling, we are a group practice who are passionate about serving our community, hope to hear from you soon.
I specialize in helping individuals who suffer from depression, suicidal ideation, anxiety, self-esteem issues, relationship issues, difficulty with boundaries, co-dependency, intimate partner violence, substance use disorders, and grief, among other difficulties. I am open to ages eight through the end of life, any and all genders and ethnicities are welcome. I am a therapist at Stonebridge Counseling, we are a group practice who are passionate about serving our community, hope to hear from you soon.
(530) 431-2065 View (530) 431-2065
Photo of Tami (Tamara) Keeney, 42582, Marriage & Family Therapist
Tami (Tamara) Keeney
Marriage & Family Therapist, 42582
Verified Verified
1 Endorsed
Chico, CA 95928
Are you struggling with daily life or an intimate relationship? Has something happened that has turned you upside down? Tami Keeney has the experience and compassion to help you feel better and get back on track. Tami Keeney is a Licensed Marriage and Family Therapist who works with children, teens, adults and couples. She has worked in private practice, local non profit agencies and public school settings.
Are you struggling with daily life or an intimate relationship? Has something happened that has turned you upside down? Tami Keeney has the experience and compassion to help you feel better and get back on track. Tami Keeney is a Licensed Marriage and Family Therapist who works with children, teens, adults and couples. She has worked in private practice, local non profit agencies and public school settings.
(530) 464-6072 View (530) 464-6072
Photo of Kristin B Free, LCSW, Clinical Social Work/Therapist
Kristin B Free
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Chico, CA 95926
The body carries the legacy of trauma and attachment dynamics in habits of movement, posture and nervous system regulation that can keep us stuck in the past. Therapeutic engagement doesn't have to be dysregulating and overwhelming. You shouldn't leave a therapy session feeling worse than you did when you showed up. Unfortunately, traditional talk therapies can inadvertently trigger your nervous system into survival mode. If we aren't tracking and recognizing what is happening underneath the words, therapy can feel excruciating, especially if there is a history of trauma at any stage of development.
The body carries the legacy of trauma and attachment dynamics in habits of movement, posture and nervous system regulation that can keep us stuck in the past. Therapeutic engagement doesn't have to be dysregulating and overwhelming. You shouldn't leave a therapy session feeling worse than you did when you showed up. Unfortunately, traditional talk therapies can inadvertently trigger your nervous system into survival mode. If we aren't tracking and recognizing what is happening underneath the words, therapy can feel excruciating, especially if there is a history of trauma at any stage of development.
(530) 389-4817 View (530) 389-4817
Photo of Kimberly Chijiiwa, MA, AMFT, Marriage & Family Therapist Associate
Kimberly Chijiiwa
Marriage & Family Therapist Associate, MA, AMFT
Verified Verified
1 Endorsed
Chico, CA 95928  (Online Only)
Not accepting new clients
I became a therapist after years of working in the performing arts in New York City. My work continues to be influenced by my trainings in dance and somatic modalities from that time. I describe my therapy style as warm, direct, and open, all housed within a creative sensibility. Folks I work with hold a variety of intersecting identities and bring a wide variety of concerns, stressors, and challenges into session. I work with anxiety, depression, trauma, relationship challenges, parenting concerns and more.
I became a therapist after years of working in the performing arts in New York City. My work continues to be influenced by my trainings in dance and somatic modalities from that time. I describe my therapy style as warm, direct, and open, all housed within a creative sensibility. Folks I work with hold a variety of intersecting identities and bring a wide variety of concerns, stressors, and challenges into session. I work with anxiety, depression, trauma, relationship challenges, parenting concerns and more.
(530) 684-1276 View (530) 684-1276
Photo of Men's Mental Health Specialist - Tommy Mattera, MS, LMFT, Marriage & Family Therapist
Men's Mental Health Specialist - Tommy Mattera
Marriage & Family Therapist, MS, LMFT
Verified Verified
1 Endorsed
Chico, CA 95973
You've tried therapy. It hasn't clicked, and that's not your fault. Most therapy wasn't designed with you in mind—it's not tailored for men like you. That's why I specialize in guiding men like you towards growth and empowerment. Are you feeling overwhelmed by the pressures of work and personal life? Struggling with anxiety or depression but unsure how to express it? Finding it difficult to communicate your needs in relationships? Facing challenges in navigating life transitions or career changes? You deserve therapy designed with you in mind. I'll help you achieve the personal growth and strength you seek. Call me today!
You've tried therapy. It hasn't clicked, and that's not your fault. Most therapy wasn't designed with you in mind—it's not tailored for men like you. That's why I specialize in guiding men like you towards growth and empowerment. Are you feeling overwhelmed by the pressures of work and personal life? Struggling with anxiety or depression but unsure how to express it? Finding it difficult to communicate your needs in relationships? Facing challenges in navigating life transitions or career changes? You deserve therapy designed with you in mind. I'll help you achieve the personal growth and strength you seek. Call me today!
(530) 285-5276 View (530) 285-5276
Photo of Charissa (Chrissy) Graham, MS, AMFT, Marriage & Family Therapist Associate
Charissa (Chrissy) Graham
Marriage & Family Therapist Associate, MS, AMFT
Verified Verified
7 Endorsed
Chico, CA 95926  (Online Only)
Now Accepting New Clients! Therapy can be a safe way to process difficult emotions, past wounds, and life changes. I have experienced trauma, grief, relationship struggles, and unhealthy coping mechanisms myself so I work from a place of non-judgement and compassion. I believe people are doing the best they can with what they have and what they know. Together, we can help you heal and grow into your best self.
Now Accepting New Clients! Therapy can be a safe way to process difficult emotions, past wounds, and life changes. I have experienced trauma, grief, relationship struggles, and unhealthy coping mechanisms myself so I work from a place of non-judgement and compassion. I believe people are doing the best they can with what they have and what they know. Together, we can help you heal and grow into your best self.
(530) 431-2790 View (530) 431-2790
Photo of Kathleen (Kathy) Dahlstrom, LMFT, Marriage & Family Therapist
Kathleen (Kathy) Dahlstrom
Marriage & Family Therapist, LMFT
Verified Verified
Chico, CA 95926
Is your teen or pre-teen struggling and you know they need help, but you are not sure where to start? Would you like them to talk to someone who specializes in adolescents? I can help your child and your family get through the rough patches. I help with a wide variety of teen and pre-teen issues including depression, anxiety, school attendance, substance abuse and family conflict. I also have expertise and experience working with transgender and gender non-conforming youth, and helping parents and families through the transition experience from a gender positive approach. If you are a parent and you are here looking for help, I know already that you are your child’s advocate. You are in your child’s corner. That support is a powerful force in their life, and so important for resilience, but when your child is struggling it can be so scary and so hard to know what to do. With grown kids of my own, I’ve been there as a parent through the rocky times too. I can help. Give me a call.
Is your teen or pre-teen struggling and you know they need help, but you are not sure where to start? Would you like them to talk to someone who specializes in adolescents? I can help your child and your family get through the rough patches. I help with a wide variety of teen and pre-teen issues including depression, anxiety, school attendance, substance abuse and family conflict. I also have expertise and experience working with transgender and gender non-conforming youth, and helping parents and families through the transition experience from a gender positive approach. If you are a parent and you are here looking for help, I know already that you are your child’s advocate. You are in your child’s corner. That support is a powerful force in their life, and so important for resilience, but when your child is struggling it can be so scary and so hard to know what to do. With grown kids of my own, I’ve been there as a parent through the rocky times too. I can help. Give me a call.
(530) 364-5663 View (530) 364-5663
Photo of Diavonti Escasena, MA, AMFT, Marriage & Family Therapist Associate
Diavonti Escasena
Marriage & Family Therapist Associate, MA, AMFT
Verified Verified
6 Endorsed
Chico, CA 95928
I work with clients who need support in making positive, lasting changes. Making change is simple, but not easy. I've helped many individuals over the years reach personal goals such as: healing trauma, rebuilding after loss, learning coping skills to manage anxiety, maintaining sobriety, setting boundaries in relationships, identifying & communicating feelings, & developing self-compassion. In our sessions, you can expect me to be relational; clients have described me as warm & easy to open up to. I'm passionate about helping people as they transition through & process difficult experiences.
I work with clients who need support in making positive, lasting changes. Making change is simple, but not easy. I've helped many individuals over the years reach personal goals such as: healing trauma, rebuilding after loss, learning coping skills to manage anxiety, maintaining sobriety, setting boundaries in relationships, identifying & communicating feelings, & developing self-compassion. In our sessions, you can expect me to be relational; clients have described me as warm & easy to open up to. I'm passionate about helping people as they transition through & process difficult experiences.
(530) 684-1843 View (530) 684-1843
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How does your Therapist compare?

Number of Therapists in Chico, CA

300+

Average cost per session

$140

Therapists in Chico, CA who prioritize treating:

93% Anxiety
90% Depression
75% Trauma and PTSD
75% Coping Skills
74% Relationship Issues
74% Stress
73% Self Esteem

Average years in practice

11 Years

Top 3 insurances accepted

57% MHN | Health Net
54% Aetna
52% UnitedHealthcare UHC | UBH

How Therapists in Chico, CA see their clients

81% In Person and Online
19% Online Only

Gender breakdown

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

How can I find a therapist in Chico?

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.