Therapists in Washington, DC

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Photo of Liz Goll Lerner, LPC, LCPAT, ATR-BC, LCAT, Licensed Professional Counselor
Liz Goll Lerner
Licensed Professional Counselor, LPC, LCPAT, ATR-BC, LCAT
Verified Verified
Washington, DC 20015  (Online Only)
Not accepting new clients
Working with me is a collaborative process. We focus on making change a reality. We explore what isn't working in your life, relationship concerns, navigating life transitions, or the experience of a serious medical illness or a difficult childhood/adolescence. In my 30+ years as a clinician I have mastered many therapeutic techniques and methods. I love using all the tools in my toolbox to create an individualized therapeutic approach for each of my clients. Our work is action oriented, creative and encompasses healing mind, body and spirit. Free 20-minute phone consultation.
Working with me is a collaborative process. We focus on making change a reality. We explore what isn't working in your life, relationship concerns, navigating life transitions, or the experience of a serious medical illness or a difficult childhood/adolescence. In my 30+ years as a clinician I have mastered many therapeutic techniques and methods. I love using all the tools in my toolbox to create an individualized therapeutic approach for each of my clients. Our work is action oriented, creative and encompasses healing mind, body and spirit. Free 20-minute phone consultation.
(301) 859-3418 View (301) 859-3418
Photo of Beth Tutt | Art Therapist Specializing In Trauma Grief And Chronic Illness, MA, ATR-BC, BC, Art Therapist
Beth Tutt | Art Therapist Specializing In Trauma Grief And Chronic Illness
Art Therapist, MA, ATR-BC, BC
Verified Verified
Washington, DC 20003  (Online Only)
Hi there, I’m Beth. If you’re here, you might be seeking support for challenges like trauma, grief, or chronic illness. I specialize in helping adults and adolescents through these tough times using art therapy, blending creativity with therapeutic techniques to foster healing. Feeling heard and understood is crucial, especially when dealing with deep emotional pain. My approach is warm and empathetic, focusing on trauma, grief, chronic illness, body image distress, and life transitions. By integrating art therapy with mindfulness and neuroscience-based techniques, I aim to support you on your healing journey.
Hi there, I’m Beth. If you’re here, you might be seeking support for challenges like trauma, grief, or chronic illness. I specialize in helping adults and adolescents through these tough times using art therapy, blending creativity with therapeutic techniques to foster healing. Feeling heard and understood is crucial, especially when dealing with deep emotional pain. My approach is warm and empathetic, focusing on trauma, grief, chronic illness, body image distress, and life transitions. By integrating art therapy with mindfulness and neuroscience-based techniques, I aim to support you on your healing journey.
(202) 930-8089 View (202) 930-8089
Photo of Elizabeth Piren, MA, LPC, Licensed Professional Counselor
Elizabeth Piren
Licensed Professional Counselor, MA, LPC
Verified Verified
2 Endorsed
Washington, DC 20036
My aim is for you to find more peace in your life, build self trust, inner peace and a better connection with others. You'll be able to create new beliefs and move toward higher levels of growth, awareness, joy and improved relationships.  I help individuals move through sadness, anxiety, trauma, and grief. As a holistic psychotherapist, I believe we all have an innate ability to heal and transform. One of my specialties is helping individuals heal from past traumatic events.
My aim is for you to find more peace in your life, build self trust, inner peace and a better connection with others. You'll be able to create new beliefs and move toward higher levels of growth, awareness, joy and improved relationships.  I help individuals move through sadness, anxiety, trauma, and grief. As a holistic psychotherapist, I believe we all have an innate ability to heal and transform. One of my specialties is helping individuals heal from past traumatic events.
(202) 999-3572 View (202) 999-3572
Photo of Rolando J Fuentes, MSW, LICSW, Clinical Social Work/Therapist
Rolando J Fuentes
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Washington, DC 20009
Not accepting new clients
Hello! My name is Rolando Fuentes. I am a clinical social worker with over fifteen years experience working with couples, families, and individual adults. My work is focused on bicultural and bilingual couples and families as well as individual who want to integrate and explore what it means to live as an individual in two cultures.
Hello! My name is Rolando Fuentes. I am a clinical social worker with over fifteen years experience working with couples, families, and individual adults. My work is focused on bicultural and bilingual couples and families as well as individual who want to integrate and explore what it means to live as an individual in two cultures.
(202) 800-1491 View (202) 800-1491
Photo of Michael A Kaufman, LPC, Licensed Professional Counselor
Michael A Kaufman
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Washington, DC 20006
I work with a wide range of clients from a variety of cultural backgrounds in person and remotely. Clients learn to reduce stress and work with their feelings in ways that lead to personal growth and development. Mindfulness, deep breathing and body awareness are used to reduce anxiety, depression, excessive self-criticism, perfectionism, detachment and emotional flooding. These problematic feelings can lead to growth, greater empathy for self and others as well as greater kindness towards others in their life when worked with creatively in psychotherapy.
I work with a wide range of clients from a variety of cultural backgrounds in person and remotely. Clients learn to reduce stress and work with their feelings in ways that lead to personal growth and development. Mindfulness, deep breathing and body awareness are used to reduce anxiety, depression, excessive self-criticism, perfectionism, detachment and emotional flooding. These problematic feelings can lead to growth, greater empathy for self and others as well as greater kindness towards others in their life when worked with creatively in psychotherapy.
(202) 883-6605 View (202) 883-6605
Photo of Rob Stewart, LICSW, LCSW-C, LCSW, Clinical Social Work/Therapist
Rob Stewart
Clinical Social Work/Therapist, LICSW, LCSW-C, LCSW
Verified Verified
Washington, DC 20009
As of July, I have openings for new clients. I'm a practical, easygoing, and results-oriented therapist. We work in collaboration as partners, combining your goals with my research-proven techniques. These techniques include CBT, traditional talk therapy, a focus on improving SENS factors (sleep/exercise/nutrition/social), and others, always applied holistically and non-dogmatically. I do particularly well with issues that therapy has thus far failed to resolve. While traditional therapy focuses on exploring and understanding your issues, I make sure we take action, see real change, and prevent backsliding.
As of July, I have openings for new clients. I'm a practical, easygoing, and results-oriented therapist. We work in collaboration as partners, combining your goals with my research-proven techniques. These techniques include CBT, traditional talk therapy, a focus on improving SENS factors (sleep/exercise/nutrition/social), and others, always applied holistically and non-dogmatically. I do particularly well with issues that therapy has thus far failed to resolve. While traditional therapy focuses on exploring and understanding your issues, I make sure we take action, see real change, and prevent backsliding.
(202) 601-3879 View (202) 601-3879
Photo of Bernard John Knight, LPC, Licensed Professional Counselor
Bernard John Knight
Licensed Professional Counselor, LPC
Verified Verified
Washington, DC 20001
I help clients with anxiety, depression, life transitions and career issues. I enjoy helping clients live more joyful lives that better align with their goals and desires. I appreciate how COVID-19 has affected each of us personally and professionally. My sessions are solution-focused, and I strive to help my clients in a results-oriented manner. I am both a mental health counselor and a certified life coach. We will explore the issues that might be preventing you from living your life to the fullest and together develop effective tools to help.
I help clients with anxiety, depression, life transitions and career issues. I enjoy helping clients live more joyful lives that better align with their goals and desires. I appreciate how COVID-19 has affected each of us personally and professionally. My sessions are solution-focused, and I strive to help my clients in a results-oriented manner. I am both a mental health counselor and a certified life coach. We will explore the issues that might be preventing you from living your life to the fullest and together develop effective tools to help.
(202) 350-4824 View (202) 350-4824
Photo of Yael Adef Eiserike - Yael Eiserike - Anxiety, Stress, Work/Life Balance, JD, LCSW, Clinical Social Work/Therapist
Yael Eiserike - Anxiety, Stress, Work/Life Balance
Clinical Social Work/Therapist, JD, LCSW
Verified Verified
Washington, DC 20037  (Online Only)
As a lawyer-turned-therapist, I know the power of a good question. My clients are anxious professionals who have taken all the “right” steps only to wonder why they aren’t feeling satisfied. They share that I have helped them work through anxiety, insomnia, or stress from high-intensity careers. I enjoy helping people find sustainable work-life balance, in addition to moving through grief and loss. Whether it be the loss of a loved one, a career, or way of life, I can be a strong partner for you. My pragmatic approach is tailored and collaborative, helping you identify and implement strategies to both resolve and prevent problems.
As a lawyer-turned-therapist, I know the power of a good question. My clients are anxious professionals who have taken all the “right” steps only to wonder why they aren’t feeling satisfied. They share that I have helped them work through anxiety, insomnia, or stress from high-intensity careers. I enjoy helping people find sustainable work-life balance, in addition to moving through grief and loss. Whether it be the loss of a loved one, a career, or way of life, I can be a strong partner for you. My pragmatic approach is tailored and collaborative, helping you identify and implement strategies to both resolve and prevent problems.
(202) 978-4558 View (202) 978-4558
Photo of Rebecca Tolbert, LICSW, Clinical Social Work/Therapist
Rebecca Tolbert
Clinical Social Work/Therapist, LICSW
Verified Verified
2 Endorsed
Washington, DC 20019
Waitlist for new clients
Are you feeling overwhelmed? Maybe the pandemic resurfaced old issues and messed with your coping strategies. Maybe reintegrating into the world has been harder than you expected. If you already struggled with focus, motivation, and organization, all of these issues can pile on top of each other. You want to feel grounded and joyful, with a life that fits and feels like your own... not one you have to shove yourself into. You want your relationships to thrive. You deserve to wake up in the morning and feel ready and excited for the day ahead.
Are you feeling overwhelmed? Maybe the pandemic resurfaced old issues and messed with your coping strategies. Maybe reintegrating into the world has been harder than you expected. If you already struggled with focus, motivation, and organization, all of these issues can pile on top of each other. You want to feel grounded and joyful, with a life that fits and feels like your own... not one you have to shove yourself into. You want your relationships to thrive. You deserve to wake up in the morning and feel ready and excited for the day ahead.
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Photo of Monica P. Band, CRC, NCC, ACS, CCC, Licensed Professional Counselor
Monica P. Band
Licensed Professional Counselor, CRC, NCC, ACS, CCC
Verified Verified
5 Endorsed
Washington, DC 20002
Not accepting new clients
The mind and body are connected. Sometimes, our body will tell us something is wrong before we allow ourselves to feel it. I specialize in providing counseling for grief, loss, anxiety, depression, and relationship issues with a focus on this connection. I help individuals and couples heal from difficult and past trauma. I have specialized training in C-PTSD and intergenerational trauma. Above all, I value our therapeutic relationship and your culture. I take time and care in getting to know what's important to you.
The mind and body are connected. Sometimes, our body will tell us something is wrong before we allow ourselves to feel it. I specialize in providing counseling for grief, loss, anxiety, depression, and relationship issues with a focus on this connection. I help individuals and couples heal from difficult and past trauma. I have specialized training in C-PTSD and intergenerational trauma. Above all, I value our therapeutic relationship and your culture. I take time and care in getting to know what's important to you.
(202) 915-6527 View (202) 915-6527
Photo of Brittany Bordonaro, LICSW, Clinical Social Work/Therapist
Brittany Bordonaro
Clinical Social Work/Therapist, LICSW
Verified Verified
Washington, DC 20003  (Online Only)
Ms. Bordonaro works with clients who have issues with relationships, anxiety, depression, stress management, self-esteem, work related issues, and trauma. Her clients can expect to feel supported through out the therapeutic process. Her clients report gaining valuable insight, skills, and symptom relief from working with her.
Ms. Bordonaro works with clients who have issues with relationships, anxiety, depression, stress management, self-esteem, work related issues, and trauma. Her clients can expect to feel supported through out the therapeutic process. Her clients report gaining valuable insight, skills, and symptom relief from working with her.
(888) 836-4718 View (888) 836-4718
Photo of Zephaniah Mukendi - Zephy's Social Work Services, Clinical Social Work/Therapist
Zephy's Social Work Services
Clinical Social Work/Therapist
Verified Verified
1 Endorsed
Washington, DC 20005
Are you struggling with negative thoughts, losing interest in things? You are at a point where you have difficulties coping and getting back to your life. You may find yourself in a situation in which you experienced a personal loss such as a loved one, a job promotion, the stresses of being a family caregiver for a loved one. There's help to alleviate your situation.
Are you struggling with negative thoughts, losing interest in things? You are at a point where you have difficulties coping and getting back to your life. You may find yourself in a situation in which you experienced a personal loss such as a loved one, a job promotion, the stresses of being a family caregiver for a loved one. There's help to alleviate your situation.
(202) 793-8229 View (202) 793-8229
Photo of Sherell Hebert -  Headway Therapist In DC, MA, LPC-S, Licensed Professional Counselor
Headway Therapist In DC
Licensed Professional Counselor, MA, LPC-S
Verified Verified
3 Endorsed
Washington, DC 20036  (Online Only)
Life is a field of unlimited possibilities. Are you ready to begin exploring? I believe we are all here to help one another learn and grow. I would be honored to be a part of your journey. I specialize in anxiety disorders because this is an area that I know intimately. I once had really bad anxiety and panics attacks. I learned to overcome them and they are now a distant memory. I would like to show you how this can be true for you as well. I offer flexible scheduling with options that include evenings and weekends for my DC clients. Go to the scheduling link to get started.
Life is a field of unlimited possibilities. Are you ready to begin exploring? I believe we are all here to help one another learn and grow. I would be honored to be a part of your journey. I specialize in anxiety disorders because this is an area that I know intimately. I once had really bad anxiety and panics attacks. I learned to overcome them and they are now a distant memory. I would like to show you how this can be true for you as well. I offer flexible scheduling with options that include evenings and weekends for my DC clients. Go to the scheduling link to get started.
(281) 666-2278 View (281) 666-2278
Photo of Lisa Himmelfarb, LICSW, RDN, Clinical Social Work/Therapist
Lisa Himmelfarb
Clinical Social Work/Therapist, LICSW, RDN
Verified Verified
Washington, DC 20008
Have you been struggling to feel good, feel good about yourself, your body and your relationships with food and people? Are destructive patterns and behaviors getting in the way? Are you feeling overwhelmed going through a major life transition such as a move, graduating college, loss of a loved one, divorce, new parenting role or any new role? I can support and guide you in navigating these challenges. You don't have to do it alone.
Have you been struggling to feel good, feel good about yourself, your body and your relationships with food and people? Are destructive patterns and behaviors getting in the way? Are you feeling overwhelmed going through a major life transition such as a move, graduating college, loss of a loved one, divorce, new parenting role or any new role? I can support and guide you in navigating these challenges. You don't have to do it alone.
(202) 953-2062 View (202) 953-2062
Photo of Michelle Sinkgraven, LICSW, Clinical Social Work/Therapist
Michelle Sinkgraven
Clinical Social Work/Therapist, LICSW
Verified Verified
Washington, DC 20036
Feeling overwhelmed, anxious, hopeless, or trapped by a past trauma? Curious about what it could mean for you to begin to feel more grounded and centered, less stuck? Therapy is a space to explore, name and learn from one's feelings and can be a tremendous gateway to healing and change. I aim to support clients in finding and believing in their strengths, listening to their emotions, creating healthy flexible boundaries and developing coping strategies. I specialize in grief and loss; trauma - including: abuse, neglect, PTSD; anxiety and depression. Together we co-create a space for self-awareness and self-compassion.
Feeling overwhelmed, anxious, hopeless, or trapped by a past trauma? Curious about what it could mean for you to begin to feel more grounded and centered, less stuck? Therapy is a space to explore, name and learn from one's feelings and can be a tremendous gateway to healing and change. I aim to support clients in finding and believing in their strengths, listening to their emotions, creating healthy flexible boundaries and developing coping strategies. I specialize in grief and loss; trauma - including: abuse, neglect, PTSD; anxiety and depression. Together we co-create a space for self-awareness and self-compassion.
(202) 946-8131 View (202) 946-8131
Photo of Charles Harney, LICSW, LCSW-C, Clinical Social Work/Therapist
Charles Harney
Clinical Social Work/Therapist, LICSW, LCSW-C
Verified Verified
Washington, DC 20036
Are you feeling stuck in life, unable to move forward and grow? Life can sometimes feel out of control, leading to feelings of anxiety, depression, anger, frustration, loneliness, isolation, and boredom. These emotions can lead to unhealthy coping mechanisms such as drug or alcohol abuse, excessive spending, or other destructive behaviors. My approach focuses on helping clients regain control and develop healthy coping skills. I work with young adults, adults and couples, specializing in LGBTQ issues, substance abuse and co-occurring disorders, trauma, and mood disorders.
Are you feeling stuck in life, unable to move forward and grow? Life can sometimes feel out of control, leading to feelings of anxiety, depression, anger, frustration, loneliness, isolation, and boredom. These emotions can lead to unhealthy coping mechanisms such as drug or alcohol abuse, excessive spending, or other destructive behaviors. My approach focuses on helping clients regain control and develop healthy coping skills. I work with young adults, adults and couples, specializing in LGBTQ issues, substance abuse and co-occurring disorders, trauma, and mood disorders.
(202) 831-3804 View (202) 831-3804
Photo of Jason Powell, LMFT, CST, Marriage & Family Therapist
Jason Powell
Marriage & Family Therapist, LMFT, CST
Verified Verified
Washington, DC 20009
I am a Licensed Marriage and Family Therapist (LMFT) as well as a Certified Sex Therapist (CST) through AASECT. My work focuses on marriage and couples therapy, specifically centered on infidelity repair, communication issues, couples in crisis, relationships on the brink, and those experiencing a range of frustrations and challenges with physical intimacy. I have been featured in Forbes, the Knot, and other leading media outlets offering my insight into relationships and communication. I would love to meet with you about your unique circumstances and how I might be able to help.
I am a Licensed Marriage and Family Therapist (LMFT) as well as a Certified Sex Therapist (CST) through AASECT. My work focuses on marriage and couples therapy, specifically centered on infidelity repair, communication issues, couples in crisis, relationships on the brink, and those experiencing a range of frustrations and challenges with physical intimacy. I have been featured in Forbes, the Knot, and other leading media outlets offering my insight into relationships and communication. I would love to meet with you about your unique circumstances and how I might be able to help.
(202) 873-9614 View (202) 873-9614
Photo of Rose Love Smith, LPC, Licensed Professional Counselor
Rose Love Smith
Licensed Professional Counselor, LPC
Verified Verified
Washington, DC 20016
Overwhelmed?? Looking for a compassionate and experienced practitioner whose focus is on practical and creative solutions to life's everyday work/life problems? Whether your issues are personal or professional, large or small, unique or universal, I can make a thorough assessment based on your individual needs and through an integrative and collaborative approach bring you to a higher level of self regulation, empowerment and awareness.
Overwhelmed?? Looking for a compassionate and experienced practitioner whose focus is on practical and creative solutions to life's everyday work/life problems? Whether your issues are personal or professional, large or small, unique or universal, I can make a thorough assessment based on your individual needs and through an integrative and collaborative approach bring you to a higher level of self regulation, empowerment and awareness.
(202) 470-0131 View (202) 470-0131
Photo of Cristiano Santostefano, PsyD, Psychologist
Cristiano Santostefano
Psychologist, PsyD
Verified Verified
Washington, DC 20016
You're looking to untie emotional knots that complicate fulfilling relationships and developing confidence. In treatment, we'll work together to uncover core emotional issues, learning techniques that foster insight about how these issues affect you, both in the past and present. I believe these insights can support you to make meaningful changes.
You're looking to untie emotional knots that complicate fulfilling relationships and developing confidence. In treatment, we'll work together to uncover core emotional issues, learning techniques that foster insight about how these issues affect you, both in the past and present. I believe these insights can support you to make meaningful changes.
(202) 839-9827 View (202) 839-9827
Photo of Victoria Campbell, LPCC, Licensed Professional Counselor
Victoria Campbell
Licensed Professional Counselor, LPCC
Verified Verified
Washington, DC 20036  (Online Only)
Do you have so much on your mind all at once that it is difficult to understand it all and communicate your thoughts and feelings? Do you feel overwhelmed with life changes and need someone to process them with? Do you just need a non-judgmental space to explore your inner thoughts and emotions?
Do you have so much on your mind all at once that it is difficult to understand it all and communicate your thoughts and feelings? Do you feel overwhelmed with life changes and need someone to process them with? Do you just need a non-judgmental space to explore your inner thoughts and emotions?
(202) 517-0843 View (202) 517-0843
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How does your Therapist compare?

Number of Therapists in Washington, DC

3,000+

Average cost per session

$180

Therapists in Washington, DC who prioritize treating:

93% Anxiety
88% Depression
81% Relationship Issues
77% Self Esteem
68% Trauma and PTSD
68% Stress
65% Coping Skills

Average years in practice

13 Years

Top 3 insurances accepted

63% BlueCross and BlueShield
57% CareFirst
53% Cigna and Evernorth

How Therapists in Washington, DC see their clients

55% In Person and Online
45% Online Only

Gender breakdown

81% Female
18% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Washington?

Search for nearby therapists or counselors by inputting your city, town, or suburb; or zip code; or a provider’s name into the search bar. From there, you can filter providers by the issues they treat, cost, insurance, gender, and other factors to find providers who are well-suited to your needs. To navigate between locations within the same country, enter a new city or zip code into the search bar.

Learn more about how to find a therapist

Is everyone in the Psychology Today Therapy Directory a licensed therapist?

The Psychology Today directory lists providers who offer legitimate mental health services to the public, including psychologists, psychiatrists, social workers, and counselors.

Many have been licensed by the country or state where they practice; providers whose license or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Some clinicians or organizations provide services for which their state or country does not offer licenses, such as pastoral counseling. They may be selectively included without the “Verified” seal.

What’s the difference between a psychologist, a therapist, and a counselor?

Therapists, psychologists, and counselors are all licensed mental health professionals. In the US, psychologists have earned a doctoral degree. The terms “therapist” and “counselor” are used somewhat interchangeably, but generally therapists offer longer-term, mental health care, while counselors offer shorter-term care that may focus on one domain, such as marriage, career, or academic challenges.

Clients should consider factors such as insurance coverage and their primary reason(s) for seeking therapy to determine the type of professional best suited to their needs. Someone struggling with mental health challenges such as depression or anxiety, for example, may wish to seek out a clinical psychologist or therapist, while someone navigating career obstacles or marital upheaval may benefit from seeing a counselor who can offer short-term, targeted support.

What type of therapy is right for me?

The type of therapy best suited to a particular individual depends on several factors, including their primary reason for seeking therapy, their preferred timeline (some therapy types last for a set number of sessions, while others are open-ended), and their personality and preferences—some may prefer a more structured approach. For many individuals, multiple types of therapy could provide a good fit.

How much does therapy cost?

The cost of therapy depends on a number of variables, including location and the therapist’s experience and training. On average, a therapy session in the United States could cost between $100 and $200 or more. If you have insurance, the expense of mental health care is typically lower, but it varies based on your insurance plan details and whether you choose an in-network or out-of-network mental healthcare provider.

What are more affordable or low cost therapy solutions?

Many therapists offer sliding scale payments, usually on a limited number of slots, which consists in an agreement between the therapist and a client to pay a reduced rate. Therapists who provide such arrangements often consider the client's income or ability to pay, but the extent of the discount is ultimately at the therapist's discretion. Furthermore, while group therapy may have different goals and benefits compared to individual therapy, it can be a more affordable solution to address certain types of issues.

Is online therapy cheaper than in-person therapy?

Many therapists charge the same amount for online therapy as they do for in-person therapy—though clients may still find this cost-effective if it cuts down on their transportation costs. Health insurance plans often offer equivalent coverage for online and in-person therapy; indeed, in many places, they are legally required to do so. Text-based or on-demand therapy apps may be cheaper than traditional one-on-one psychotherapy; however, the practice may be less effective and is not likely to be covered by insurance.

Is online therapy a good option?

Therapy conducted online can be just as effective as in-person therapy, as long as there is a strong alliance between the client and the therapist. To find a therapist who provides telehealth services to clients in your area, click “Online Therapy” on the directory homepage and search by your city or town or your zip code.

Are therapy sessions confidential?

Confidentiality is a crucial part of the therapeutic relationship. Therapists in the United States are bound by the regulations set out by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which aims to protect sensitive health information. With very few exceptions, a therapist will only discuss their client with others when the client has given their written permission. The instances in which a therapist would be required to disclose personal information are: if a client poses a danger to themselves or others, if the therapist suspects the abuse of a child or an elderly or otherwise dependent adult, or if they are legally forced to by court order. These exceptions to the confidentiality agreement are usually discussed with a client before their first session.