Therapists in Douglas County, NV

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Photo of Karen Piekarski, LCSW, Clinical Social Work/Therapist
Karen Piekarski
Clinical Social Work/Therapist, LCSW
Verified Verified
Gardnerville, NV 89410  (Online Only)
Have you ever felt that this life is too hard and too fast? That you are not sure what steps to take next? I believe that life is about balance and learning to navigate our paths with mindfulness and joy. I use a unique approach with each client as we are all unique individuals. I use many therapy modalities to assist a client to reach their therapeutic goals. I am interested in assisting you on your path to find your own sense of well being.
Have you ever felt that this life is too hard and too fast? That you are not sure what steps to take next? I believe that life is about balance and learning to navigate our paths with mindfulness and joy. I use a unique approach with each client as we are all unique individuals. I use many therapy modalities to assist a client to reach their therapeutic goals. I am interested in assisting you on your path to find your own sense of well being.
(833) 794-7544 View (833) 794-7544
Photo of Jenna Ortiz, MFT, MA, Marriage & Family Therapist
Jenna Ortiz
Marriage & Family Therapist, MFT, MA
Verified Verified
Minden, NV 89423
Not accepting new clients
I am a licensed Marriage and Family Therapist. Therapy is a place to explore a variety of struggles that come up in everyday life. I work with families, children, adolescents, couples, and adults. Therapy is a unique process and I want to respect each client's needs. My approach varies based on the client's past experiences, their current quality of life, and unique circumstances.
I am a licensed Marriage and Family Therapist. Therapy is a place to explore a variety of struggles that come up in everyday life. I work with families, children, adolescents, couples, and adults. Therapy is a unique process and I want to respect each client's needs. My approach varies based on the client's past experiences, their current quality of life, and unique circumstances.
(702) 820-5241 View (702) 820-5241
Photo of Marci Hinchey, MFT, LADC, Marriage & Family Therapist
Marci Hinchey
Marriage & Family Therapist, MFT, LADC
Verified Verified
1 Endorsed
Minden, NV 89423
I am a licensed Marriage and Family Therapist and a Licensed Alcohol and Drug Counselor in the state of Nevada. I have been practicing for more than 20 years. I have experience working with youth and families, depression and anxiety, as well as in the addictions field. My specialty is treating children and adolescents for issues related to trauma and abuse, as well as emotional and behavioral disturbances. My modalities include play therapy and behavioral therapy with children, as well as cognitive behavioral approach for both young people and adults.
I am a licensed Marriage and Family Therapist and a Licensed Alcohol and Drug Counselor in the state of Nevada. I have been practicing for more than 20 years. I have experience working with youth and families, depression and anxiety, as well as in the addictions field. My specialty is treating children and adolescents for issues related to trauma and abuse, as well as emotional and behavioral disturbances. My modalities include play therapy and behavioral therapy with children, as well as cognitive behavioral approach for both young people and adults.
(775) 871-0136 View (775) 871-0136
Photo of Danielle Bennett, MS, LADC, Drug & Alcohol Counselor
Danielle Bennett
Drug & Alcohol Counselor, MS, LADC
Verified Verified
Minden, NV 89423
Addiction can seem so hopeless and terrifying. It takes courage, trust and hard work to begin that recovery journey. OR maybe you got a DUI... I provide full Substance Abuse Evaluations. I have helped people navigate medicated assisted treatment, IOP (Intensive Outpatient) and private substance abuse treatment. I have worked in methadone clinic setting, intensive outpatient and mental health. Visit my website by clicking the link under my picture OR simply google “Danielle Bennett Counseling”.
Addiction can seem so hopeless and terrifying. It takes courage, trust and hard work to begin that recovery journey. OR maybe you got a DUI... I provide full Substance Abuse Evaluations. I have helped people navigate medicated assisted treatment, IOP (Intensive Outpatient) and private substance abuse treatment. I have worked in methadone clinic setting, intensive outpatient and mental health. Visit my website by clicking the link under my picture OR simply google “Danielle Bennett Counseling”.
(775) 364-1101 View (775) 364-1101
Photo of Rachel Pryde, LCSW, Clinical Social Work/Therapist
Rachel Pryde
Clinical Social Work/Therapist, LCSW
Verified Verified
Minden, NV 89423
Many young kids and teenagers struggle with loss, trauma, divorce, or other life changes. Some kids and teens struggle with mental health issues such as anxiety, depression, self-harm behaviors, and even suicidal thoughts. Many kids and teenagers need a safe place to process their thoughts and emotions outside of their family unit.
Many young kids and teenagers struggle with loss, trauma, divorce, or other life changes. Some kids and teens struggle with mental health issues such as anxiety, depression, self-harm behaviors, and even suicidal thoughts. Many kids and teenagers need a safe place to process their thoughts and emotions outside of their family unit.
(775) 526-4735 View (775) 526-4735
Photo of Misty Guantonio - Misty Guantonio: Intensive EMDR Therapy, MEd, MA, LMFT, LCADC, Marriage & Family Therapist
Misty Guantonio: Intensive EMDR Therapy
Marriage & Family Therapist, MEd, MA, LMFT, LCADC
Verified Verified
Minden, NV 89423
Waitlist for new clients
When difficulties drown out the pleasures of life, it is easy to turn your focus toward avoiding complex matters. Beginning therapy is a step onto the path of healing; it is an act of hope and strength toward reclaiming your life. As your therapist, I can help you find the solutions to quiet the struggles and restore the balance needed in order for you to thrive. My ideal clients are those with high-stress and high-risk careers such as health care professionals, first responders, lawyers, educators, and more.
When difficulties drown out the pleasures of life, it is easy to turn your focus toward avoiding complex matters. Beginning therapy is a step onto the path of healing; it is an act of hope and strength toward reclaiming your life. As your therapist, I can help you find the solutions to quiet the struggles and restore the balance needed in order for you to thrive. My ideal clients are those with high-stress and high-risk careers such as health care professionals, first responders, lawyers, educators, and more.
(775) 237-8020 View (775) 237-8020
Photo of Stephani Halladay, LCPC, Licensed Professional Counselor
Stephani Halladay
Licensed Professional Counselor, LCPC
Verified Verified
Minden, NV 89423
As a therapist I strive to build a strong therapeutic relationship with each client through empathy, acceptance, authenticity, and humor. My goals are for you to feel seen and understood, to provide space for processing emotions in a trauma-informed and culturally responsive way, and to join you in your journey to find congruence between your ideal and real self. I enjoy helping people who want to learn how to help themselves. You're the expert, I'm the guide. I appreciate finding what is feasible for you in your life along with identifying incremental goals to help you on your journey.
As a therapist I strive to build a strong therapeutic relationship with each client through empathy, acceptance, authenticity, and humor. My goals are for you to feel seen and understood, to provide space for processing emotions in a trauma-informed and culturally responsive way, and to join you in your journey to find congruence between your ideal and real self. I enjoy helping people who want to learn how to help themselves. You're the expert, I'm the guide. I appreciate finding what is feasible for you in your life along with identifying incremental goals to help you on your journey.
(775) 372-2775 View (775) 372-2775
Photo of Liz Nunez, LCSW, LMSW, Clinical Social Work/Therapist
Liz Nunez
Clinical Social Work/Therapist, LCSW, LMSW
Verified Verified
1 Endorsed
Minden, NV 89423
Currently only accepting new patients in the Minden, NV area or on telehealth. Welcome, my name is Liz and I hope I can be the one to help you through whatever hardship is currently on your plate. Congratulations on taking the first step towards getting the help you need and “no longer staying stuck in the suck”. I am more than willing to meet you where you are and help you let go of the fear. It is time to make an active change. Therapy can be intimidating to start, and I am flexible in fitting your needs. I work in partnership with you to help you not only overcome the barriers you are facing, but to rise above them.
Currently only accepting new patients in the Minden, NV area or on telehealth. Welcome, my name is Liz and I hope I can be the one to help you through whatever hardship is currently on your plate. Congratulations on taking the first step towards getting the help you need and “no longer staying stuck in the suck”. I am more than willing to meet you where you are and help you let go of the fear. It is time to make an active change. Therapy can be intimidating to start, and I am flexible in fitting your needs. I work in partnership with you to help you not only overcome the barriers you are facing, but to rise above them.
(775) 256-8304 View (775) 256-8304
Photo of Cynthia M Thorp, MA, PsyD, Psychologist
Cynthia M Thorp
Psychologist, MA, PsyD
Verified Verified
1 Endorsed
Gardnerville, NV 89410
I practice the belief that all people deserve to live authentic, fulfilling lives. Psychotherapy helps individuals to develop an active and genuine expression of one's self. People have a great capacity for growth and change, and having a knowledgeable guide during that process is incredibly helpful. Relationships with others are a central component in our lives. Partners, children, parents, family and friends influence and impact the way we live day to day. Even relationships from our past can affect the way we feel now. I have a particular strength in helping people understand and change relationships.
I practice the belief that all people deserve to live authentic, fulfilling lives. Psychotherapy helps individuals to develop an active and genuine expression of one's self. People have a great capacity for growth and change, and having a knowledgeable guide during that process is incredibly helpful. Relationships with others are a central component in our lives. Partners, children, parents, family and friends influence and impact the way we live day to day. Even relationships from our past can affect the way we feel now. I have a particular strength in helping people understand and change relationships.
(775) 234-4138 View (775) 234-4138
Photo of Michael L Elterman, MA, MFT, LPCC, Marriage & Family Therapist
Michael L Elterman
Marriage & Family Therapist, MA, MFT, LPCC
Verified Verified
1 Endorsed
Gardnerville, NV 89460
LIFE is PRECIOUS. Learn to be the actor in your life, not the reactor. I've worked with individuals, couples, families, & groups. Being licensed since 1984 has provided me the opportunity to learn from pioneers in family & individual therapy. Work well with adults who suffer from deep atrocities as children & have many years working with preteens & teens. I assist parents with disabled children using behavioral approaches, adding to the parents' toolbox. ON-LINE-VIDEO, TELEHEALTH THERAPY IN CALIFORNIA & NEVADA. I do see clients in-person in Gardnerville, NV. 17mi South of Carson City.
LIFE is PRECIOUS. Learn to be the actor in your life, not the reactor. I've worked with individuals, couples, families, & groups. Being licensed since 1984 has provided me the opportunity to learn from pioneers in family & individual therapy. Work well with adults who suffer from deep atrocities as children & have many years working with preteens & teens. I assist parents with disabled children using behavioral approaches, adding to the parents' toolbox. ON-LINE-VIDEO, TELEHEALTH THERAPY IN CALIFORNIA & NEVADA. I do see clients in-person in Gardnerville, NV. 17mi South of Carson City.
(530) 264-8748 View (530) 264-8748
Photo of Kelly K. Edmundson, LMFT, LCADC, EMDR, Marriage & Family Therapist
Kelly K. Edmundson
Marriage & Family Therapist, LMFT, LCADC, EMDR
Verified Verified
11 Endorsed
Zephyr Cove, NV 89448  (Online Only)
Not accepting new clients
Do you desire to feel more grounded and able to respond to life stressors with more ease? Perhaps you aspire for a more purposeful and balanced life? Let's work together and address any barriers that are holding you back from achieving and sustaining purposeful engagement in your life.
Do you desire to feel more grounded and able to respond to life stressors with more ease? Perhaps you aspire for a more purposeful and balanced life? Let's work together and address any barriers that are holding you back from achieving and sustaining purposeful engagement in your life.
(775) 242-5617 View (775) 242-5617
Photo of Leila Yenina Gail - Eudaimonia Coaching & Consulting, LLC, MS
Eudaimonia Coaching & Consulting, LLC
MS
Verified Verified
Minden, NV 89423
Hello! I am a life coach and doctoral student pursuing my PsyD., I am passionate about connecting with clients who have a deep desire for change and growth, wanting to create a life with deeper meaning and in line with purpose. My own is rooted in helping others to thrive in all aspects of life and guiding to reframe negative beliefs and behaviors. Certified Master level Coach, MS in Autism Studies, MS in Psychology, current PsyD student in Clinical Psychology. Certified Master Coach, and Mindfulness Trainer. Insurance NOT accepted. Cash only. Telehealth primary. NOTE: I am not a licensed therapist and provide only coaching.
Hello! I am a life coach and doctoral student pursuing my PsyD., I am passionate about connecting with clients who have a deep desire for change and growth, wanting to create a life with deeper meaning and in line with purpose. My own is rooted in helping others to thrive in all aspects of life and guiding to reframe negative beliefs and behaviors. Certified Master level Coach, MS in Autism Studies, MS in Psychology, current PsyD student in Clinical Psychology. Certified Master Coach, and Mindfulness Trainer. Insurance NOT accepted. Cash only. Telehealth primary. NOTE: I am not a licensed therapist and provide only coaching.
(775) 242-5226 View (775) 242-5226
Photo of Rich Mcguffin, PhD, MFT, Marriage & Family Therapist
Rich Mcguffin
Marriage & Family Therapist, PhD, MFT
Verified Verified
Minden, NV 89423  (Online Only)
I believe that we all have issues and struggles in life and there are times when we need a trained professional counselor to help us navigate through life's storms. My philosophy is that every person is responsible to create meaning in their lives and to fulfill our potential as human beings. My approach is empathetic and non-judgmental. It is my goal with every individual, every couple and every family to help facilitate peace, joy and a sense of fulfillment in their lives. Specialized training in couples therapy through The Couples Institute, Eye Movement Desensitization and Reprocessing (EMDR) through EMDR International Assoc.
I believe that we all have issues and struggles in life and there are times when we need a trained professional counselor to help us navigate through life's storms. My philosophy is that every person is responsible to create meaning in their lives and to fulfill our potential as human beings. My approach is empathetic and non-judgmental. It is my goal with every individual, every couple and every family to help facilitate peace, joy and a sense of fulfillment in their lives. Specialized training in couples therapy through The Couples Institute, Eye Movement Desensitization and Reprocessing (EMDR) through EMDR International Assoc.
(775) 589-2826 View (775) 589-2826
Donna Buddington
Marriage & Family Therapist, MA, MFT
Verified Verified
1 Endorsed
Gardnerville, NV 89460
The longer I have worked to help people come to terms with their traumas the more I respect each individuals innate wisdom and essential resiliency to know their truths. I have trained, indeed matured as a therapist, during the era of emerging trauma treatments...all kinds. I am most interested in helping individuals unlock the transformative energies held in painful intrusive memories, but without re-traumatizing them in the present. I offer a wonderful supportive environment to support your exploration in to realms of thoughts and feelings and most importantly your contact with your own authentic experience.
The longer I have worked to help people come to terms with their traumas the more I respect each individuals innate wisdom and essential resiliency to know their truths. I have trained, indeed matured as a therapist, during the era of emerging trauma treatments...all kinds. I am most interested in helping individuals unlock the transformative energies held in painful intrusive memories, but without re-traumatizing them in the present. I offer a wonderful supportive environment to support your exploration in to realms of thoughts and feelings and most importantly your contact with your own authentic experience.
(775) 591-8960 View (775) 591-8960
Photo of Erin Eisenlohr, LMFT, Marriage & Family Therapist
Erin Eisenlohr
Marriage & Family Therapist, LMFT
Verified Verified
2 Endorsed
Zephyr Cove, NV 89448
Are you struggling with depression or anxiety? Have you faced a recent trauma that's making it hard to get back on your feet? Are you someone who wants your life to change for the better? I might be able to help. In our work together, you'll learn specific strategies, skills and tools, catered to your individual needs and concerns, that you can use to make changes, relieve stress, achieve your goals and live your life to the fullest.
Are you struggling with depression or anxiety? Have you faced a recent trauma that's making it hard to get back on your feet? Are you someone who wants your life to change for the better? I might be able to help. In our work together, you'll learn specific strategies, skills and tools, catered to your individual needs and concerns, that you can use to make changes, relieve stress, achieve your goals and live your life to the fullest.
(775) 277-6271 View (775) 277-6271
Photo of Kristen Susan Peck, LMFTi, MAED, Marriage & Family Therapist Intern
Kristen Susan Peck
Marriage & Family Therapist Intern, LMFTi, MAED
Verified Verified
Minden, NV 89423
People are not broken and they don’t need to be “fixed”. We need insight, tools and new perspectives to make good choices and discover what it is we really need and want. Therapy is a process of discovery and implementation of the findings.
People are not broken and they don’t need to be “fixed”. We need insight, tools and new perspectives to make good choices and discover what it is we really need and want. Therapy is a process of discovery and implementation of the findings.
(775) 259-0341 View (775) 259-0341
Photo of Shawna Pisciotti, LCSW, Clinical Social Work/Therapist
Shawna Pisciotti
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Gardnerville, NV 89460
Life is a complex journey, filled with transitions and turnarounds that can evoke a wide range of emotions. These experiences, at times, can be joyful, challenging, and even harrowing. In such moments, what often serves as a lifeline is the bridge of belonging and compassion. It's through understanding, empathy, and therapeutic relationships that we can navigate these tumultuous waters.I specialize in working with families, children, teenagers, and young adults, recognizing the unique dynamics and challenges that each of these groups faces.
Life is a complex journey, filled with transitions and turnarounds that can evoke a wide range of emotions. These experiences, at times, can be joyful, challenging, and even harrowing. In such moments, what often serves as a lifeline is the bridge of belonging and compassion. It's through understanding, empathy, and therapeutic relationships that we can navigate these tumultuous waters.I specialize in working with families, children, teenagers, and young adults, recognizing the unique dynamics and challenges that each of these groups faces.
(775) 258-7139 View (775) 258-7139
Photo of Brian Crane - Tahoe Youth and Family Services
Tahoe Youth and Family Services (TYFS) provides counseling and support programs to promote healthy development of families, children and individuals. We envision resilient communities that achieve healthy outcomes through affordable behavioral services. We have a proud 50-year tradition of providing mental health & substance abuse services to our community and surrounding areas. We are an inclusive supportive ally to anyone in crisis. Download an intake packet at tahoeyouth.org or call our office to pick up an intake packet.
Tahoe Youth and Family Services (TYFS) provides counseling and support programs to promote healthy development of families, children and individuals. We envision resilient communities that achieve healthy outcomes through affordable behavioral services. We have a proud 50-year tradition of providing mental health & substance abuse services to our community and surrounding areas. We are an inclusive supportive ally to anyone in crisis. Download an intake packet at tahoeyouth.org or call our office to pick up an intake packet.
(775) 346-6470 View (775) 346-6470
Photo of Diana Lee Brown, LMFT, Marriage & Family Therapist
Diana Lee Brown
Marriage & Family Therapist, LMFT
Verified Verified
Gardnerville, NV 89410  (Online Only)
I love to work with individual adults who are struggling with loneliness, self-doubt, unresolved prolonged grief, low self-esteem, anxiety, feeling disconnected, stressed, overwhelmed or other difficult emotions, thoughts, or behaviors getting in the way of enjoying life. I provide the guidance for acknowledging and transforming whatever pain you want to change without spending a lot of time going in depth to talk about the details. You will have the opportunity to tap into your own wellness to release the pain and be connected to the freedom to choose the happy and meaningful life you desire moving forward.
I love to work with individual adults who are struggling with loneliness, self-doubt, unresolved prolonged grief, low self-esteem, anxiety, feeling disconnected, stressed, overwhelmed or other difficult emotions, thoughts, or behaviors getting in the way of enjoying life. I provide the guidance for acknowledging and transforming whatever pain you want to change without spending a lot of time going in depth to talk about the details. You will have the opportunity to tap into your own wellness to release the pain and be connected to the freedom to choose the happy and meaningful life you desire moving forward.
(775) 258-7867 View (775) 258-7867
Photo of Maddy Romanowitz, MA, LMFT, Marriage & Family Therapist
Maddy Romanowitz
Marriage & Family Therapist, MA, LMFT
Verified Verified
Minden, NV 89423
I am a Licensed Marriage and Family Therapist in the Carson Valley. Choosing to begin therapy is both a vulnerable and brave decision that deserves to be met with support and compassion. It is my mission to help my clients achieve their therapeutic goals by stepping into their world and gaining a comprehensive understanding of how their life experiences impact their current functioning.
I am a Licensed Marriage and Family Therapist in the Carson Valley. Choosing to begin therapy is both a vulnerable and brave decision that deserves to be met with support and compassion. It is my mission to help my clients achieve their therapeutic goals by stepping into their world and gaining a comprehensive understanding of how their life experiences impact their current functioning.
(775) 312-5628 View (775) 312-5628

See more therapy options for Douglas County

How does your Therapist compare?

Number of Therapists in Douglas County, NV

50+

Average cost per session

$150

Therapists in Douglas County, NV who prioritize treating:

89% Anxiety
83% Depression
81% Trauma and PTSD
70% Grief
70% Self Esteem
65% Relationship Issues
61% Coping Skills

Average years in practice

12 Years

Top 3 insurances accepted

66% Aetna
46% BlueCross and BlueShield
46% UnitedHealthcare UHC | UBH

How Therapists in Douglas County, NV see their clients

78% In Person and Online
22% Online Only

Gender breakdown

88% Female
12% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Douglas County?

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

Learn more about how to find a therapist

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

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

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

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

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

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

What type of therapy is right for me?

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

How much does therapy cost?

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

What are more affordable or low cost therapy solutions?

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

Is online therapy cheaper than in-person therapy?

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

Is online therapy a good option?

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

Are therapy sessions confidential?

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