Therapists in Spokane Valley, WA

Photo of Cortney Rasley, MA, NCC, LMHC, CMHS, Counselor
Cortney Rasley
Counselor, MA, NCC, LMHC, CMHS
Verified Verified
Spokane Valley, WA 99206  (Online Only)
Whether you struggle with depression or anxiety, have experienced abuse or other traumas, want help with marital issues or other relationships, have difficulties with family dynamics or parenting, or just need a sounding board and safe place to manage other life struggles; my desire is to help you improve your emotional well-being and overall quality of life. I believe that all people deserve to feel safety, security, love, hope, and a sense of belonging; no matter what they have endured. I have a passion for working with children, adolescents, adults, families and married couples.
Whether you struggle with depression or anxiety, have experienced abuse or other traumas, want help with marital issues or other relationships, have difficulties with family dynamics or parenting, or just need a sounding board and safe place to manage other life struggles; my desire is to help you improve your emotional well-being and overall quality of life. I believe that all people deserve to feel safety, security, love, hope, and a sense of belonging; no matter what they have endured. I have a passion for working with children, adolescents, adults, families and married couples.
(509) 769-3200 View (509) 769-3200
Photo of Joseph Judd - Advanced Behavioral Health, LLC, MS, LMFT, Marriage & Family Therapist
Advanced Behavioral Health, LLC
Marriage & Family Therapist, MS, LMFT
Verified Verified
Spokane Valley, WA 99206
Life is too short to just wait for things to get better. When you’re experiencing anxiety or depression, it feels isolating, defeating, sometimes even shameful. It’s so exhausting and what worked for you in the past isn’t working anymore. Regardless if you've experienced a job loss or retirement, a new marriage or recent divorce, a complicated mid-life crisis, or addiction to social media or gaming. Whatever the reason, you know you need things to change, and you need them to change NOW. You can achieve a sense of well being, direction, and happiness. Don't wait any longer...the help, support, and tools you need are available here.
Life is too short to just wait for things to get better. When you’re experiencing anxiety or depression, it feels isolating, defeating, sometimes even shameful. It’s so exhausting and what worked for you in the past isn’t working anymore. Regardless if you've experienced a job loss or retirement, a new marriage or recent divorce, a complicated mid-life crisis, or addiction to social media or gaming. Whatever the reason, you know you need things to change, and you need them to change NOW. You can achieve a sense of well being, direction, and happiness. Don't wait any longer...the help, support, and tools you need are available here.
(509) 402-1182 View (509) 402-1182
Photo of Juliann K Haffey, MA, LMHC, Counselor
Juliann K Haffey
Counselor, MA, LMHC
Verified Verified
Spokane Valley, WA 99206
I treat adolescents and adults. My most common method of treatment is cognitive behavioral therapy. I provide assistance to those struggling with anxiety, depression, anger, sadness or grief, adjustment issues, relationship issues, problem-solving skills, and life skills. I also specialize in parent/child attachment and sports psychology. Please contact me by voicemail or text at 509.385.0292. You can also reach me by email at juliann.haffey@gmail.com
I treat adolescents and adults. My most common method of treatment is cognitive behavioral therapy. I provide assistance to those struggling with anxiety, depression, anger, sadness or grief, adjustment issues, relationship issues, problem-solving skills, and life skills. I also specialize in parent/child attachment and sports psychology. Please contact me by voicemail or text at 509.385.0292. You can also reach me by email at juliann.haffey@gmail.com
(509) 822-2913 View (509) 822-2913
Photo of Elisa A Pope, MS, LMHC, MHP, Counselor
Elisa A Pope
Counselor, MS, LMHC, MHP
Verified Verified
2 Endorsed
Spokane Valley, WA 99212
You are unique and you deserve to be treated with respect. I am passionate about seeing you learn how to embrace and love who you are today and in the future. Over the years I have worked with children and adults in a variety of roles; as an educator, a cognitive development specialist, and now as a counselor. My understanding of how the brain develops, what is needed at the various developmental stages, the importance of attachment, and the impact of trauma on brain development and the body, has prepared me to effectively work with kids, teenagers, adults, and families. Book with me now by clicking on my website.
You are unique and you deserve to be treated with respect. I am passionate about seeing you learn how to embrace and love who you are today and in the future. Over the years I have worked with children and adults in a variety of roles; as an educator, a cognitive development specialist, and now as a counselor. My understanding of how the brain develops, what is needed at the various developmental stages, the importance of attachment, and the impact of trauma on brain development and the body, has prepared me to effectively work with kids, teenagers, adults, and families. Book with me now by clicking on my website.
(509) 281-5146 View (509) 281-5146
Photo of Justin Van Elsberg, Pre-Licensed Professional
Justin Van Elsberg
Pre-Licensed Professional
Verified Verified
2 Endorsed
Spokane Valley, WA 99206
Now accepting clients! I primarily work with teenagers and adults. Whether you have a history of complex trauma, specific concerns you want to address, or are not sure what you are looking for, I am honored to join. I strive to see things how my clients do, so that we can move forward with intention. This often means leaning into discomfort and as we move in the direction of your values. This also means considering the roles that we have taken on in our past and present relationships. Together we can work to process difficult emotions, develop flexibility to life’s challenges, and move in the direction of your life values.
Now accepting clients! I primarily work with teenagers and adults. Whether you have a history of complex trauma, specific concerns you want to address, or are not sure what you are looking for, I am honored to join. I strive to see things how my clients do, so that we can move forward with intention. This often means leaning into discomfort and as we move in the direction of your values. This also means considering the roles that we have taken on in our past and present relationships. Together we can work to process difficult emotions, develop flexibility to life’s challenges, and move in the direction of your life values.
(509) 285-9599 View (509) 285-9599
Photo of Laura Schrotenboer, MS, LMHC, MHP, CMHS, Counselor
Laura Schrotenboer
Counselor, MS, LMHC, MHP, CMHS
Verified Verified
Spokane Valley, WA 99212
Not accepting new clients
Everything we do is an attempt to meet our needs. Life is full of unexpected challenges, and sometimes these challenges overwhelm us. We may find that our old ways of handling challenges are no longer working, and we need some help finding new strategies or new supports. I am here to help you express your needs in a healthier way and develop new skills. I have worked with both youth and adults experiencing a variety of challenges, helping them understand what lies beneath the here and now.
Everything we do is an attempt to meet our needs. Life is full of unexpected challenges, and sometimes these challenges overwhelm us. We may find that our old ways of handling challenges are no longer working, and we need some help finding new strategies or new supports. I am here to help you express your needs in a healthier way and develop new skills. I have worked with both youth and adults experiencing a variety of challenges, helping them understand what lies beneath the here and now.
(509) 215-1595 View (509) 215-1595
Photo of Derek Ormiston, LPC Intern
Derek Ormiston
LPC Intern
Verified Verified
1 Endorsed
Spokane Valley, WA 99206
I would love to help you! I am a friendly and enthusiastic listener who is passionate about helping adolescents and adults. I firmly believe that everyone is worthy of dignity and respect. I love integrating pop culture and therapy as these two ideas can allow us to better understand not only ourselves, but the world in which we live. I am a registered intern completing an MS degree in counseling at Grand Canyon University.
I would love to help you! I am a friendly and enthusiastic listener who is passionate about helping adolescents and adults. I firmly believe that everyone is worthy of dignity and respect. I love integrating pop culture and therapy as these two ideas can allow us to better understand not only ourselves, but the world in which we live. I am a registered intern completing an MS degree in counseling at Grand Canyon University.
(509) 581-2542 View (509) 581-2542
Photo of Elizabeth Campbell - Family Essentials Counseling - Valley, PhD, MA, LMHC, LICSW, LMFT, Counselor
Family Essentials Counseling - Valley
Counselor, PhD, MA, LMHC, LICSW, LMFT
Verified Verified
2 Endorsed
Spokane Valley, WA 99212
At Family Essentials Counseling we have the right counselor for you. Check out our website for a detailed information on providers available - FamilyEssentialsCounseling.com
At Family Essentials Counseling we have the right counselor for you. Check out our website for a detailed information on providers available - FamilyEssentialsCounseling.com
(509) 761-3150 View (509) 761-3150
Photo of Agustin Reyes Lopez, MA, LMFTA, Marriage & Family Therapist Associate
Agustin Reyes Lopez
Marriage & Family Therapist Associate, MA, LMFTA
Verified Verified
1 Endorsed
Spokane Valley, WA 99206
La salud mental al igual que la salud física, es esencial para un funcionamiento óptimo en la vida cotidiana. ¿Vive con síntomas depresivos, ansiedad, tiene dificultades con su pareja, familia o le cuesta controlar su enojo? Si esta es su situación, le gustaría embarcarse a un viaje hacia su interior y descubrir las herramientas que posee? La terapia psicológica es la medicina de la mente y el alma, es un paso hacia la reconstrucción de un pasado turbulento y esperanza para un mejor presente.
La salud mental al igual que la salud física, es esencial para un funcionamiento óptimo en la vida cotidiana. ¿Vive con síntomas depresivos, ansiedad, tiene dificultades con su pareja, familia o le cuesta controlar su enojo? Si esta es su situación, le gustaría embarcarse a un viaje hacia su interior y descubrir las herramientas que posee? La terapia psicológica es la medicina de la mente y el alma, es un paso hacia la reconstrucción de un pasado turbulento y esperanza para un mejor presente.
(509) 646-7559 View (509) 646-7559
Photo of Kelsey Graham, MA, LMFT, Marriage & Family Therapist
Kelsey Graham
Marriage & Family Therapist, MA, LMFT
Verified Verified
Spokane Valley, WA 99212  (Online Only)
Not accepting new clients
Sometimes life offers experiences which are difficult to walk through and often these times feel quite lonely or confusing. Whether it be feelings of sadness, anxiety, fear, anger, exhaustion, or loneliness; I would like to join you on this walk we call life to help you navigate your path. I believe in relationship with the people we are surrounded by on a daily basis and will strive to assist you in creating relationships that support you on your daily life walk.
Sometimes life offers experiences which are difficult to walk through and often these times feel quite lonely or confusing. Whether it be feelings of sadness, anxiety, fear, anger, exhaustion, or loneliness; I would like to join you on this walk we call life to help you navigate your path. I believe in relationship with the people we are surrounded by on a daily basis and will strive to assist you in creating relationships that support you on your daily life walk.
(509) 774-5296 View (509) 774-5296
Photo of Rebecca Molina Wall - Rebecca M Wall Counseling, LLC, MA, LMHCA, LLC, Counselor
Rebecca M Wall Counseling, LLC
Counselor, MA, LMHCA, LLC
Verified Verified
Spokane Valley, WA 99212
If you find yourself struggling with life and relationships, in need of someone to come alongside you, I would like to offer support and aid on your healing journey. I will help you approach your challenges in safety and with compassion. I have 20+ years of experience providing counseling to hurting and broken people and specialize in trauma, anxiety, PTSD, relapse prevention, and relational issues. Your past does not define you and your future is hopeful. Sometimes the present seems uncertain. My desire is to help peel back the layers so you can be free to be who you were made to be and function out of your true and noble self.
If you find yourself struggling with life and relationships, in need of someone to come alongside you, I would like to offer support and aid on your healing journey. I will help you approach your challenges in safety and with compassion. I have 20+ years of experience providing counseling to hurting and broken people and specialize in trauma, anxiety, PTSD, relapse prevention, and relational issues. Your past does not define you and your future is hopeful. Sometimes the present seems uncertain. My desire is to help peel back the layers so you can be free to be who you were made to be and function out of your true and noble self.
(509) 519-4531 View (509) 519-4531
Photo of Kimberly L Cole, PsyD, Psychologist
Kimberly L Cole
Psychologist, PsyD
Verified Verified
1 Endorsed
Spokane Valley, WA 99206
Not accepting new clients
Dr. Kimberly Cole is the founder of Briar Rose Center and a Licensed Clinical Psychologist. She is a Certified EMDR (Eye Movement Desensitization Reprocessing) Therapist. She has been in an independent practice in the Spokane-Seattle areas since January 2007. Her areas of expertise includes Complex Trauma (DID), PTSD, Depression, Anxiety, Phobias, Panic Attacks, Grief-Loss, Sexual Orientation, Self-Care, Effective Communication, Problem Solving, Substance Abuse, Consultation, and Stress Management. Dr. Cole focuses on empowerment and independence; enhancement of strengths rather than a focus on weaknesses; lack of emphasis on pathology and victim blaming; and the importance of psycho-education.
Dr. Kimberly Cole is the founder of Briar Rose Center and a Licensed Clinical Psychologist. She is a Certified EMDR (Eye Movement Desensitization Reprocessing) Therapist. She has been in an independent practice in the Spokane-Seattle areas since January 2007. Her areas of expertise includes Complex Trauma (DID), PTSD, Depression, Anxiety, Phobias, Panic Attacks, Grief-Loss, Sexual Orientation, Self-Care, Effective Communication, Problem Solving, Substance Abuse, Consultation, and Stress Management. Dr. Cole focuses on empowerment and independence; enhancement of strengths rather than a focus on weaknesses; lack of emphasis on pathology and victim blaming; and the importance of psycho-education.
(509) 978-0863 View (509) 978-0863
Photo of Suzie K B-Liljneberg, MS, LMHCA, Counselor
Suzie K B-Liljneberg
Counselor, MS, LMHCA
Verified Verified
1 Endorsed
Spokane Valley, WA 99206
This world is big and can be difficult to navigate alone. Working on finding your life balance between work, family, and recreation can be difficult without the right tools. Are you noticing patterns and cycles that are no longer working, but don’t know how to change them? I am here to help you face your fears. I strive to empower my clients face barriers keeping them from walking their authentic path, while tackling pain and frustration through coping skills and self-care. Through identifying patterns and creating a safe place without judgement, we can explore your internal self to help you find the courage to take back your life.
This world is big and can be difficult to navigate alone. Working on finding your life balance between work, family, and recreation can be difficult without the right tools. Are you noticing patterns and cycles that are no longer working, but don’t know how to change them? I am here to help you face your fears. I strive to empower my clients face barriers keeping them from walking their authentic path, while tackling pain and frustration through coping skills and self-care. Through identifying patterns and creating a safe place without judgement, we can explore your internal self to help you find the courage to take back your life.
(509) 400-6064 View (509) 400-6064
Photo of Dalene Loder, MS, LMHC, Counselor
Dalene Loder
Counselor, MS, LMHC
Verified Verified
Spokane Valley, WA 99206
Life can be very stressful at times. Our moods, anxiety levels, thinking and behaviors can depend on how well we are able to manage these stressors over time. Sometimes, the coping skills we have learned simply are not enough and we feel overwhelmed and out of control. There is a solution to almost every problem. My goal in therapy is to provide a safe environment so that you can learn to better manage your thinking, feeling and behavior and regain control and power in your life.
Life can be very stressful at times. Our moods, anxiety levels, thinking and behaviors can depend on how well we are able to manage these stressors over time. Sometimes, the coping skills we have learned simply are not enough and we feel overwhelmed and out of control. There is a solution to almost every problem. My goal in therapy is to provide a safe environment so that you can learn to better manage your thinking, feeling and behavior and regain control and power in your life.
(509) 774-5058 View (509) 774-5058
Photo of Brenda L Tracey, PhD, LMHCA, Counselor
Brenda L Tracey
Counselor, PhD, LMHCA
Verified Verified
Spokane Valley, WA 99037
In the beginning was the word. Thoughts are words in our head. Those words are what we talk about. What we talk about finds support. These words, given support, is literally how we create our lives. In childhood, our primary lesson was to learn how to care for ourselves in adulthood. Many of the adults around us didn’t know how to care for themselves. Some were absent, some were medicated, some seemed aloof and caught up in their own troubles. And for some of us, the adults were abusive.
In the beginning was the word. Thoughts are words in our head. Those words are what we talk about. What we talk about finds support. These words, given support, is literally how we create our lives. In childhood, our primary lesson was to learn how to care for ourselves in adulthood. Many of the adults around us didn’t know how to care for themselves. Some were absent, some were medicated, some seemed aloof and caught up in their own troubles. And for some of us, the adults were abusive.
(509) 721-7875 x1 View (509) 721-7875 x1
Photo of Jaime Sparber - Riverside Therapy Center, PLLC, LMHC, SUDP, MHP, LCPC
Riverside Therapy Center, PLLC
Mental Health Counselor, LMHC, SUDP, MHP, LCPC
Verified Verified
1 Endorsed
Spokane Valley, WA 99206
My belief is that counseling is a journey we travel together. Our first step is to define where you want to go – discovering the reasons that you have chosen to meet with me at this point in your life. We will also identify your strengths, what’s working well in your life, and the things that can be changed to get you to your destination. My goal is to work myself out of a job as you develop the skills and tools that you can use in the present and the future to have the life that you desire.
My belief is that counseling is a journey we travel together. Our first step is to define where you want to go – discovering the reasons that you have chosen to meet with me at this point in your life. We will also identify your strengths, what’s working well in your life, and the things that can be changed to get you to your destination. My goal is to work myself out of a job as you develop the skills and tools that you can use in the present and the future to have the life that you desire.
(509) 347-0380 View (509) 347-0380
Photo of Zoie Patch, LICSWA, Counselor
Zoie Patch
Counselor, LICSWA
Verified Verified
Spokane Valley, WA 99206
I am a dedicated Licensed Independent Clinical Social Work Associate (LSWAIC) with a passion for supporting children, adolescents and their families through their journey with anxiety, depression, and life transitions. With a compassionate approach to therapy, I aim to walk alongside clients as they navigate life's challenges while empowering them to take beneficial steps forward.
I am a dedicated Licensed Independent Clinical Social Work Associate (LSWAIC) with a passion for supporting children, adolescents and their families through their journey with anxiety, depression, and life transitions. With a compassionate approach to therapy, I aim to walk alongside clients as they navigate life's challenges while empowering them to take beneficial steps forward.
(509) 778-7769 View (509) 778-7769
Photo of Angela Dee Peters, MSW, LICSW, Clinical Social Work/Therapist
Angela Dee Peters
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Spokane Valley, WA 99206
Let’s nourish and find clarity within ourselves by healing. Through your life experiences you have gained the ability to manage these life challenges. Today you may find yourself struggling with the skills that once helped you overcome your Anxiety, Depression, Grief, and Traumatic Event’s. Through therapeutic approach’s together we can find your healing. Together we will learn and process these life challenges no matter what your life-stage might be. Let’s empower your deeper scene of hope, purpose, and positive self-esteem. Allowing yourself to live your best possible life.
Let’s nourish and find clarity within ourselves by healing. Through your life experiences you have gained the ability to manage these life challenges. Today you may find yourself struggling with the skills that once helped you overcome your Anxiety, Depression, Grief, and Traumatic Event’s. Through therapeutic approach’s together we can find your healing. Together we will learn and process these life challenges no matter what your life-stage might be. Let’s empower your deeper scene of hope, purpose, and positive self-esteem. Allowing yourself to live your best possible life.
(509) 213-1704 View (509) 213-1704
Photo of Jeff Wirth, MA, LMFTA, LMHC, Counselor
Jeff Wirth
Counselor, MA, LMFTA, LMHC
Verified Verified
4 Endorsed
Spokane Valley, WA 99206
Not accepting new clients
I practice mental health counseling by prioritizing the clinical relationship between myself and my client. Counseling is hard, so it's important to me that you feel I'm on your team, that we can delve into challenging subject matter together in a way which feels safe to you.
I practice mental health counseling by prioritizing the clinical relationship between myself and my client. Counseling is hard, so it's important to me that you feel I'm on your team, that we can delve into challenging subject matter together in a way which feels safe to you.
(509) 434-9128 View (509) 434-9128
Photo of Kathleen D Roberts, MA, LMHC, Counselor
Kathleen D Roberts
Counselor, MA, LMHC
Verified Verified
1 Endorsed
Spokane Valley, WA 99206
I am a licensed mental health counselor and certified EMDR clinician. My approach is holistic which views the body, mind and spirit as interconnected. I help people to interact in more authentic ways in order to derive meaning and purpose from life, and to have more positive interactions with others. By examining patterns and habits that keep you stuck, you can increase your options and flexibility in your responses to life.
I am a licensed mental health counselor and certified EMDR clinician. My approach is holistic which views the body, mind and spirit as interconnected. I help people to interact in more authentic ways in order to derive meaning and purpose from life, and to have more positive interactions with others. By examining patterns and habits that keep you stuck, you can increase your options and flexibility in your responses to life.
(509) 571-2496 View (509) 571-2496
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How does your Therapist compare?

Number of Therapists in Spokane Valley, WA

100+

Average cost per session

$130

Therapists in Spokane Valley, WA who prioritize treating:

91% Anxiety
87% Depression
78% Trauma and PTSD
76% Relationship Issues
71% Self Esteem
69% Stress
68% Coping Skills

Average years in practice

10 Years

Top 3 insurances accepted

86% Premera Blue Cross
78% Aetna
78% BlueCross and BlueShield

How Therapists in Spokane Valley, WA see their clients

73% In Person and Online
27% Online Only

Gender breakdown

75% Female
24% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Spokane Valley?

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.