Therapists in Fresno, CA

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Photo of Obed Romero, LMFT, Marriage & Family Therapist
Obed Romero
Marriage & Family Therapist, LMFT
Verified Verified
Fresno, CA 93711  (Online Only)
Waitlist for new clients
Hi! I am a Licensed Marriage and Family Therapist (LMFT) & Associate Professional Clinical Counselor (APCC). I am specialized in & have years of experience of working with adults diagnosed with anxiety disorders, depressive disorders, & anger-related disorders. My therapeutic approaches include: Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), & self-compassion focused interventions. I have also been trained in Emotion Focused Couple’s Therapy (EFT), Motivational Interviewing (MI), suicide assessment & providing sleep therapy skills through the UC Berkley sleep team.
Hi! I am a Licensed Marriage and Family Therapist (LMFT) & Associate Professional Clinical Counselor (APCC). I am specialized in & have years of experience of working with adults diagnosed with anxiety disorders, depressive disorders, & anger-related disorders. My therapeutic approaches include: Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), & self-compassion focused interventions. I have also been trained in Emotion Focused Couple’s Therapy (EFT), Motivational Interviewing (MI), suicide assessment & providing sleep therapy skills through the UC Berkley sleep team.
(559) 242-1551 View (559) 242-1551
Photo of Leticia J Chavez, PsyD, Psychologist
Leticia J Chavez
Psychologist, PsyD
Verified Verified
2 Endorsed
Fresno, CA 93704
I work with adults who are coping with various concerns such as depression, anxiety, and posttraumatic stress disorder. I also work effectively with individuals experiencing situational stressors such as bereavement, relationship conflicts, or loss. In a supportive and confidential environment, I help clients reduce emotional distress, understand problematic behaviors, and develop tools to improve their quality of life.
I work with adults who are coping with various concerns such as depression, anxiety, and posttraumatic stress disorder. I also work effectively with individuals experiencing situational stressors such as bereavement, relationship conflicts, or loss. In a supportive and confidential environment, I help clients reduce emotional distress, understand problematic behaviors, and develop tools to improve their quality of life.
(559) 717-4885 View (559) 717-4885
Photo of Lynn Young, LMFT, Marriage & Family Therapist
Lynn Young
Marriage & Family Therapist, LMFT
Verified Verified
Fresno, CA 93720
I encourage and collaboratively work with my clients to focus on solutions and their goals while highlighting individual strengths they already possess but have often forgotten or have gone unnoticed.
I encourage and collaboratively work with my clients to focus on solutions and their goals while highlighting individual strengths they already possess but have often forgotten or have gone unnoticed.
(559) 345-9580 View (559) 345-9580
Photo of Jeanne M Munsell, DD, MA, LMFT, Marriage & Family Therapist
Jeanne M Munsell
Marriage & Family Therapist, DD, MA, LMFT
Verified Verified
Fresno, CA 93711
Are you in need of a court-ordered mental health and addictions evaluation? Are you hoping your court case will be resolved with Court ordered Diversion with Mental Health treatment? Have you been abused? Neglected as a child? Has someone told you you have serious Mental Health Issues? I help. I help persons learn coping skills, sobriety skills, resolve the emotional attachment to abuses. I understand the angst of being a teen or young adult. I enjoy working with those who have stresses, strains from work, family, school, depression, and anxiety. I believe that all persons regardless of all factors deserves the best life ever
Are you in need of a court-ordered mental health and addictions evaluation? Are you hoping your court case will be resolved with Court ordered Diversion with Mental Health treatment? Have you been abused? Neglected as a child? Has someone told you you have serious Mental Health Issues? I help. I help persons learn coping skills, sobriety skills, resolve the emotional attachment to abuses. I understand the angst of being a teen or young adult. I enjoy working with those who have stresses, strains from work, family, school, depression, and anxiety. I believe that all persons regardless of all factors deserves the best life ever
(559) 345-9372 View (559) 345-9372
Photo of Tanya Blomgren, MA, AMFT, Pre-Licensed Professional
Tanya Blomgren
Pre-Licensed Professional, MA, AMFT
Verified Verified
5 Endorsed
Fresno, CA 93711
If you’ve found my profile, it may mean you’re feeling stuck and searching for help to get “unstuck”. Maybe you’re in the midst of a crisis, family conflict, grief, a transition from one thing to another, or even just wanting to understand how your past experiences are impacting you today. Reaching out for help from a therapist is a great next step! As a Registered Associate Marriage and Family Therapist, I enjoy working with children, teens, adults, and couples. While working with me as your therapist, I can offer a witness to your story, an outside professional perspective, and someone to walk with you through the hard things!
If you’ve found my profile, it may mean you’re feeling stuck and searching for help to get “unstuck”. Maybe you’re in the midst of a crisis, family conflict, grief, a transition from one thing to another, or even just wanting to understand how your past experiences are impacting you today. Reaching out for help from a therapist is a great next step! As a Registered Associate Marriage and Family Therapist, I enjoy working with children, teens, adults, and couples. While working with me as your therapist, I can offer a witness to your story, an outside professional perspective, and someone to walk with you through the hard things!
(559) 206-9329 x109 View (559) 206-9329 x109
Photo of Anna Hawkins, Pastoral Counselor
Anna Hawkins
Pastoral Counselor
Verified Verified
1 Endorsed
Fresno, CA 93720
Have you ever wondered where God is in your grief, loneliness, anxiety, depression, or conflict? Does He have wisdom for the hurts and hardships you are experiencing? How can you experience more of His loving care? If you have ever asked these questions, Soul Care may be the right counseling option for you. Many of the challenges we face are not only mental health or relational in nature, they are matters of the soul.
Have you ever wondered where God is in your grief, loneliness, anxiety, depression, or conflict? Does He have wisdom for the hurts and hardships you are experiencing? How can you experience more of His loving care? If you have ever asked these questions, Soul Care may be the right counseling option for you. Many of the challenges we face are not only mental health or relational in nature, they are matters of the soul.
(559) 797-1150 View (559) 797-1150
Photo of Jessica L. Criner - RESET Trauma & Family Counseling Center, MS, LMFT, Marriage & Family Therapist
RESET Trauma & Family Counseling Center
Marriage & Family Therapist, MS, LMFT
Verified Verified
2 Endorsed
Fresno, CA 93729  (Online Only)
There are seasons in life that are very unpredictable, 2020 for example! If you are finding that the last few months, weeks, maybe even years have been full of overwhelming amounts of change, transition and uncertainty, your are not alone. I understand the uncertainty of life can cause depression, anxiety, and unresolved traumas to arise. My goal is to assist you with getting to the heart of the issues you are enduring, while embracing the resiliency and strength it took for you to make it this far. Emotional healing and relief is near.
There are seasons in life that are very unpredictable, 2020 for example! If you are finding that the last few months, weeks, maybe even years have been full of overwhelming amounts of change, transition and uncertainty, your are not alone. I understand the uncertainty of life can cause depression, anxiety, and unresolved traumas to arise. My goal is to assist you with getting to the heart of the issues you are enduring, while embracing the resiliency and strength it took for you to make it this far. Emotional healing and relief is near.
(209) 391-2420 View (209) 391-2420
Photo of Cynthia Callaghan, LCSW, Clinical Social Work/Therapist
Cynthia Callaghan
Clinical Social Work/Therapist, LCSW
Verified Verified
Fresno, CA 93722
hello. my name is cynthia. i am a licensed social worker. i am also a autoimmune paleo certified coach. i work with all kinds of people (adults and teens) who are stressed out. stress seems to makes so many things seems worse! i have experience in anger management, depression and anxiety symptoms, grief and loss, stress management, addiction, adoption other issues... I am certified as an anger management coach and i am certified as a DBT therapist and in two parenting models (Nurturing Parenting)....i also volunteer with AHW.... feel free to call me for a complementary consultation to see if we are the right fit....thank you....
hello. my name is cynthia. i am a licensed social worker. i am also a autoimmune paleo certified coach. i work with all kinds of people (adults and teens) who are stressed out. stress seems to makes so many things seems worse! i have experience in anger management, depression and anxiety symptoms, grief and loss, stress management, addiction, adoption other issues... I am certified as an anger management coach and i am certified as a DBT therapist and in two parenting models (Nurturing Parenting)....i also volunteer with AHW.... feel free to call me for a complementary consultation to see if we are the right fit....thank you....
(559) 715-2987 View (559) 715-2987
Photo of Christina Trindade, LMFT, Marriage & Family Therapist
Christina Trindade
Marriage & Family Therapist, LMFT
Verified Verified
Fresno, CA 93727
My name is Christina Trindade and I am a Licensed Marriage & Family Therapist (LMFT) based in Modesto, California, and working with clients statewide via telehealth. I work with couples and individuals specializing in anxiety, stress, phase of life adjustments, and relational distress utilizing Cognitive Behavioral Therapy, Narrative Therapy, Strategic Therapy, and Gottman theories to help my clients make progress, heal relationships, and start feeling better.
My name is Christina Trindade and I am a Licensed Marriage & Family Therapist (LMFT) based in Modesto, California, and working with clients statewide via telehealth. I work with couples and individuals specializing in anxiety, stress, phase of life adjustments, and relational distress utilizing Cognitive Behavioral Therapy, Narrative Therapy, Strategic Therapy, and Gottman theories to help my clients make progress, heal relationships, and start feeling better.
(559) 702-5122 View (559) 702-5122
Photo of Paola Beatriz Caraker, MS, MFT, Marriage & Family Therapist
Paola Beatriz Caraker
Marriage & Family Therapist, MS, MFT
Verified Verified
Fresno, CA 93710
Are you struggling to find life balance and feel overhwhelmed? Are you struggling with concerns related to relationships, navigating love and dating or life post divorce ? Are you trying to cope with occupational stressors or wanting to increase peak performance in your occupation, sports performance or any other aspects related to performance? I will focus on using your strengths and resiliency to find healing as well as develop actual solutions to your current and/ or unresolved concerns. Visit my website for further information: www.paola-caraker.com
Are you struggling to find life balance and feel overhwhelmed? Are you struggling with concerns related to relationships, navigating love and dating or life post divorce ? Are you trying to cope with occupational stressors or wanting to increase peak performance in your occupation, sports performance or any other aspects related to performance? I will focus on using your strengths and resiliency to find healing as well as develop actual solutions to your current and/ or unresolved concerns. Visit my website for further information: www.paola-caraker.com
(559) 421-9416 View (559) 421-9416
Photo of Laura Salas Medina, AMFT, Marriage & Family Therapist Associate
Laura Salas Medina
Marriage & Family Therapist Associate, AMFT
Verified Verified
Fresno, CA 93711  (Online Only)
Whether it be feeling overwhelmed, stressed, unheard, anxious all the time, or down on yourself, it can all be related to our past. Our past or our trauma experiences, like adverse childhood experiences(ACEs), neglect, rejection, familial trauma, and loss can cause us to feel strong emotions. My focus as an Associate Marriage and Family Therapist at Transcendence Psychological Services is allowing you to share your experience in order to gain new insight and ways of coping with past traumas. I offer a safe and inviting space for you to process and feel heard while guiding you towards healing.
Whether it be feeling overwhelmed, stressed, unheard, anxious all the time, or down on yourself, it can all be related to our past. Our past or our trauma experiences, like adverse childhood experiences(ACEs), neglect, rejection, familial trauma, and loss can cause us to feel strong emotions. My focus as an Associate Marriage and Family Therapist at Transcendence Psychological Services is allowing you to share your experience in order to gain new insight and ways of coping with past traumas. I offer a safe and inviting space for you to process and feel heard while guiding you towards healing.
(559) 657-6237 View (559) 657-6237
Photo of Bao Mai Moua Vue, AMFT, Marriage & Family Therapist Associate
Bao Mai Moua Vue
Marriage & Family Therapist Associate, AMFT
Verified Verified
2 Endorsed
Fresno, CA 93711
You may not have considered therapy before because openly discussing personal struggles might not align with the customs of your life or culture. However, if you find yourself experiencing symptoms such as persistent low energy, difficulty concentrating, or feelings of irritability, tension, or restlessness—it's essential to recognize that you're not alone. While these experiences are common, it's equally important to acknowledge that hope and assistance are readily available. If starting therapy is making you feel overwhelmed by fear, shame, or uncertainty, rest assured that you don't have to navigate these emotions alone.
You may not have considered therapy before because openly discussing personal struggles might not align with the customs of your life or culture. However, if you find yourself experiencing symptoms such as persistent low energy, difficulty concentrating, or feelings of irritability, tension, or restlessness—it's essential to recognize that you're not alone. While these experiences are common, it's equally important to acknowledge that hope and assistance are readily available. If starting therapy is making you feel overwhelmed by fear, shame, or uncertainty, rest assured that you don't have to navigate these emotions alone.
(559) 206-4575 View (559) 206-4575
Photo of Samantha Avila - Samantha Avila, Hope Rises Family Counseling , LMFT, Marriage & Family Therapist
Samantha Avila, Hope Rises Family Counseling
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Fresno, CA 93710  (Online Only)
Hey there! I'm Sam! If you're feeling down, not yourself, anxious or just need to "get back on track" with life, you've come to right spot. A calm and approachable environment is something I take pride in, a place where you can be yourself in whatever form that may be.
Hey there! I'm Sam! If you're feeling down, not yourself, anxious or just need to "get back on track" with life, you've come to right spot. A calm and approachable environment is something I take pride in, a place where you can be yourself in whatever form that may be.
(562) 280-2843 View (562) 280-2843
Photo of Elizabeth Sánchez Arvizu, MA, Psychological Associate
Elizabeth Sánchez Arvizu
Psychological Associate, MA
Verified Verified
Fresno, CA 93711
It can be challenging to process painful memories/emotions in therapy. I aim to create a safe space for everyone to feel comfortable being themselves. I have years of experience working with children, adolescents, and adults in different settings like schools, community clinics, hospitals, etc. I seek to reduce the stigma placed on mental health, the geek/nerd community, ethnic minorities, and everyone who is often viewed as ‘other.’
It can be challenging to process painful memories/emotions in therapy. I aim to create a safe space for everyone to feel comfortable being themselves. I have years of experience working with children, adolescents, and adults in different settings like schools, community clinics, hospitals, etc. I seek to reduce the stigma placed on mental health, the geek/nerd community, ethnic minorities, and everyone who is often viewed as ‘other.’
(559) 354-7749 View (559) 354-7749
Photo of Susan Amador, LMFT, Marriage & Family Therapist
Susan Amador
Marriage & Family Therapist, LMFT
Verified Verified
Fresno, CA 93704
I am passionate about helping others. My role as a therapist is to help my clients make progress toward meeting their goals in therapy. Counseling should be a positive and productive process in which the client works closely with the therapist to learn and grow through self exploration.
I am passionate about helping others. My role as a therapist is to help my clients make progress toward meeting their goals in therapy. Counseling should be a positive and productive process in which the client works closely with the therapist to learn and grow through self exploration.
(559) 682-3122 View (559) 682-3122
Photo of Breyona Midgett, MA, Marriage & Family Therapist Associate
Breyona Midgett
Marriage & Family Therapist Associate, MA
Verified Verified
4 Endorsed
Fresno, CA 93711
As a Registered Associate Marriage and Family Therapist at Link Care Counseling Center, I specialize in working with individuals, children, couples, and families experiencing difficulty in adjusting to life changes and transitions, anxiety, depression, family conflict, race-related issues. I have completed additional training in trauma as it relates to migration, racial identity and sexual trauma, EFT (externship), and Gottman Couples Therapy. I strive to offer a safe, nonjudgmental environment where individuals and couples have space to explore and process the stressors within family, parenting, and trauma (past and present).
As a Registered Associate Marriage and Family Therapist at Link Care Counseling Center, I specialize in working with individuals, children, couples, and families experiencing difficulty in adjusting to life changes and transitions, anxiety, depression, family conflict, race-related issues. I have completed additional training in trauma as it relates to migration, racial identity and sexual trauma, EFT (externship), and Gottman Couples Therapy. I strive to offer a safe, nonjudgmental environment where individuals and couples have space to explore and process the stressors within family, parenting, and trauma (past and present).
(559) 236-6483 x148 View (559) 236-6483 x148
Photo of Bryan Van Ravenhorst, ASW, Pre-Licensed Professional
Bryan Van Ravenhorst
Pre-Licensed Professional, ASW
Verified Verified
2 Endorsed
Fresno, CA 93711
Life is hard. Keeping up with everything that’s going on around us can sometimes make it difficult for us to recognize and deal with what is going on within us. Perhaps you are struggling to manage stress, navigate relationships (with partners, family members, friends, coworkers, etc.), or adjust to changing life circumstances. Or maybe you are feeling stuck, overwhelmed, and looking for a change.
Life is hard. Keeping up with everything that’s going on around us can sometimes make it difficult for us to recognize and deal with what is going on within us. Perhaps you are struggling to manage stress, navigate relationships (with partners, family members, friends, coworkers, etc.), or adjust to changing life circumstances. Or maybe you are feeling stuck, overwhelmed, and looking for a change.
(559) 370-3027 View (559) 370-3027
Photo of Cindy Vang, LMFT, Marriage & Family Therapist
Cindy Vang
Marriage & Family Therapist, LMFT
Verified Verified
2 Endorsed
Fresno, CA 93720
My core philosophy on effective therapy is one that is relationship-driven and collaborative of my client’s views and narratives that guide their life stories. I believe that clients are the expert of their lives and that my role is to be a guide and witness to the stories that my clients bring into treatment. Every session is crucial to the overall health and well-being of my clients, and so I believe in creating a space that will allow for freedom, agency, and safety in expressing and fully showing up as one needs to.
My core philosophy on effective therapy is one that is relationship-driven and collaborative of my client’s views and narratives that guide their life stories. I believe that clients are the expert of their lives and that my role is to be a guide and witness to the stories that my clients bring into treatment. Every session is crucial to the overall health and well-being of my clients, and so I believe in creating a space that will allow for freedom, agency, and safety in expressing and fully showing up as one needs to.
(559) 206-6447 View (559) 206-6447
Photo of Katie Romley, MEd, LPCC, PPSC, Counselor
Katie Romley
Counselor, MEd, LPCC, PPSC
Verified Verified
1 Endorsed
Fresno, CA 93722
Tell me your story. Have you felt it difficult to be seen for who you actually are? Are you an adult who has difficulty relating to your parents and being understood or supported? If you're looking for a therapist who gets you, who understands what it's like to think differently, artistically, come on by. Safety and support are hugely important to me. I offer therapy in a supportive, non-judgmental style. My style has been described as: warm, personal, REAL, insightful, thought-provoking, relaxed. If need a therapist who is easy to talk with, but can also help you strategically think through issues, I might be the right fit.
Tell me your story. Have you felt it difficult to be seen for who you actually are? Are you an adult who has difficulty relating to your parents and being understood or supported? If you're looking for a therapist who gets you, who understands what it's like to think differently, artistically, come on by. Safety and support are hugely important to me. I offer therapy in a supportive, non-judgmental style. My style has been described as: warm, personal, REAL, insightful, thought-provoking, relaxed. If need a therapist who is easy to talk with, but can also help you strategically think through issues, I might be the right fit.
(661) 215-8656 View (661) 215-8656
Photo of Dora Cantu, MSW, ACSW
Dora Cantu
Associate Clinical Social Worker, MSW, ACSW
Verified Verified
Fresno, CA 93711
I understand that we all have times in our lives when we feel alone and as if no one understands our struggles. Society’s mental health stigmas can make afraid to tell our families and friends what we’re going through. I am here to share with you that you are not alone in your feelings. My goal is to assist you in discovering your inner power and approaching life’s challenges from a different perspective. I believe we are the only ones who truly understand ourselves. We possess the inner strength to live happy lives. As a result, there are times when we require assistance in discovering our inner power.
I understand that we all have times in our lives when we feel alone and as if no one understands our struggles. Society’s mental health stigmas can make afraid to tell our families and friends what we’re going through. I am here to share with you that you are not alone in your feelings. My goal is to assist you in discovering your inner power and approaching life’s challenges from a different perspective. I believe we are the only ones who truly understand ourselves. We possess the inner strength to live happy lives. As a result, there are times when we require assistance in discovering our inner power.
(559) 316-5852 View (559) 316-5852
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How does your Therapist compare?

Number of Therapists in Fresno, CA

800+

Average cost per session

$150

Therapists in Fresno, CA who prioritize treating:

91% Anxiety
88% Depression
72% Coping Skills
71% Self Esteem
68% Stress
67% Relationship Issues
65% Trauma and PTSD

Average years in practice

10 Years

Top 3 insurances accepted

78% Aetna
71% Cigna and Evernorth
70% UnitedHealthcare UHC | UBH

How Therapists in Fresno, CA see their clients

79% In Person and Online
21% Online Only

Gender breakdown

80% Female
19% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Fresno?

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.