Therapists in Columbia County, NY

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Photo of Jennifer Mattler, LMHC, Counselor
Jennifer Mattler
Counselor, LMHC
Verified Verified
Hudson, NY 12534  (Online Only)
I have been providing individual therapy to children, adolescents and adults for many years. I focus on helping clients with anxiety, depression and those living through traumatic experiences. I believe we all deserve to not only survive, but thrive. Living the life we deserve may look different for everyone. For some this may mean alleviating symptoms of anxiety, depression or other mental health concerns. For others it may mean better understanding how negative thoughts patterns can hinder daily living.
I have been providing individual therapy to children, adolescents and adults for many years. I focus on helping clients with anxiety, depression and those living through traumatic experiences. I believe we all deserve to not only survive, but thrive. Living the life we deserve may look different for everyone. For some this may mean alleviating symptoms of anxiety, depression or other mental health concerns. For others it may mean better understanding how negative thoughts patterns can hinder daily living.
(518) 760-0693 View (518) 760-0693
Photo of Judith Marie Creecy, LCSW, Clinical Social Work/Therapist
Judith Marie Creecy
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Germantown, NY 12526  (Online Only)
I am an experienced licensed Clinical Social Worker who has worked primarily with adults dealing with substance abuse, relational issues mood disorders, and trauma. I view therapy as a collaborative effort, where we work on your goals and improve the quality of your life!
I am an experienced licensed Clinical Social Worker who has worked primarily with adults dealing with substance abuse, relational issues mood disorders, and trauma. I view therapy as a collaborative effort, where we work on your goals and improve the quality of your life!
(617) 942-6040 View (617) 942-6040
Photo of Caitlin Enright, LCSW-R, Clinical Social Work/Therapist
Caitlin Enright
Clinical Social Work/Therapist, LCSW-R
Verified Verified
1 Endorsed
Chatham, NY 12037  (Online Only)
If you are reading this profile you've likely made the brave decision to seek help, which is to be applauded. I am a psychotherapist with 12 years' experience in psychiatric crisis management and clinical psychotherapy. As a practitioner I believe it is important to explore how family of origin issues inform an individual of their self-worth, belongingness in the world and the ability to develop healthy relationships with others. Once we've discovered where the core of a false narrative was created, we can begin to develop alternative ways of thinking and feeling.
If you are reading this profile you've likely made the brave decision to seek help, which is to be applauded. I am a psychotherapist with 12 years' experience in psychiatric crisis management and clinical psychotherapy. As a practitioner I believe it is important to explore how family of origin issues inform an individual of their self-worth, belongingness in the world and the ability to develop healthy relationships with others. Once we've discovered where the core of a false narrative was created, we can begin to develop alternative ways of thinking and feeling.
(518) 897-3541 View (518) 897-3541
Photo of Nichole Gardner, LCSW, Clinical Social Work/Therapist
Nichole Gardner
Clinical Social Work/Therapist, LCSW
Verified Verified
Hillsdale, NY 12529  (Online Only)
Are you looking for a therapist who can help navigate a difficult time, managing stress, or deal with the past? Within our therapeutic space, you will find that my approach is empathetic and engaging, as well as direct and honest. I believe that the therapeutic relationship requires all of these qualities in order to reach your goals. Together, we will work on overcoming whatever challenge stands in your way.
Are you looking for a therapist who can help navigate a difficult time, managing stress, or deal with the past? Within our therapeutic space, you will find that my approach is empathetic and engaging, as well as direct and honest. I believe that the therapeutic relationship requires all of these qualities in order to reach your goals. Together, we will work on overcoming whatever challenge stands in your way.
(518) 759-6345 View (518) 759-6345
Photo of Julia Shield, LMSW, MAT, Clinical Social Work/Therapist
Julia Shield
Clinical Social Work/Therapist, LMSW, MAT
Verified Verified
Hudson, NY 12534
Waitlist for new clients
Our relationships are our most important fuel for personal growth. I work with couples seeking deeper connection, and individuals hoping to find more fulfillment in themselves and their relationships. I enjoy working with couples navigating the life shifts of parenthood, and with new moms learning their sacred role as a mother. Our work together can help you articulate your vision for a life well-lived and ultimately, create that life through your relationships. My approach is direct, engaging, and collaborative— as part of the therapeutic process, I invite you to witness yourself becoming the person you've always wanted to be.
Our relationships are our most important fuel for personal growth. I work with couples seeking deeper connection, and individuals hoping to find more fulfillment in themselves and their relationships. I enjoy working with couples navigating the life shifts of parenthood, and with new moms learning their sacred role as a mother. Our work together can help you articulate your vision for a life well-lived and ultimately, create that life through your relationships. My approach is direct, engaging, and collaborative— as part of the therapeutic process, I invite you to witness yourself becoming the person you've always wanted to be.
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Photo of Steven D Brown, PsyaD, LCSW, Licensed Psychoanalyst
Steven D Brown
Licensed Psychoanalyst, PsyaD, LCSW
Verified Verified
1 Endorsed
Stuyvesant, NY 12173
Dr. Brown is a licensed Psychoanalyst practicing near Hudson, NY and New York City. Professional activities include training school guidance counselors to develop and run adolescent resiliency groups. For 13 years, Dr. Brown was on staff at Kaiser Permanente HMO and Northeast Permanente Medical Group. Utilizing a solution-focused model of psychotherapy, he provided psychotherapy to Kaiser Permanente's membership. Dr. Brown developed and provided EAP services to medical and administrative staff at Kaiser and NPMG. He developed, conducted, and supervised various workshops and groups including community and corporate workshops on stress management, support groups for children of divorced families, "Fair Fighting" workshops & support groups.
Dr. Brown is a licensed Psychoanalyst practicing near Hudson, NY and New York City. Professional activities include training school guidance counselors to develop and run adolescent resiliency groups. For 13 years, Dr. Brown was on staff at Kaiser Permanente HMO and Northeast Permanente Medical Group. Utilizing a solution-focused model of psychotherapy, he provided psychotherapy to Kaiser Permanente's membership. Dr. Brown developed and provided EAP services to medical and administrative staff at Kaiser and NPMG. He developed, conducted, and supervised various workshops and groups including community and corporate workshops on stress management, support groups for children of divorced families, "Fair Fighting" workshops & support groups.
(518) 312-4554 View (518) 312-4554
Photo of Mary Kristjen, PhD, Psychologist
Mary Kristjen
Psychologist, PhD
Verified Verified
Hudson, NY 12534
I am a clinical psychologist with over 30 years of experience. I work with adolescents, adults and elders. My orientation is primarily psychodynamic. However, I also use a behavioral approach as needed. I provide a safe, nonjudgmental space in which to help individuals face and work through their difficulties. I help them identify and change repetitive patterns and assumptions that interfere with obtaining satisfaction in their lives and with successfully pursuing their goals. This includes addressing and resolving anxiety, depression, self-esteem problems and relationship and career issues.
I am a clinical psychologist with over 30 years of experience. I work with adolescents, adults and elders. My orientation is primarily psychodynamic. However, I also use a behavioral approach as needed. I provide a safe, nonjudgmental space in which to help individuals face and work through their difficulties. I help them identify and change repetitive patterns and assumptions that interfere with obtaining satisfaction in their lives and with successfully pursuing their goals. This includes addressing and resolving anxiety, depression, self-esteem problems and relationship and career issues.
(646) 846-5941 View (646) 846-5941
Photo of Andrea Horowitz, LMHC, BC-TMH, Counselor
Andrea Horowitz
Counselor, LMHC, BC-TMH
Verified Verified
1 Endorsed
Valatie, NY 12184  (Online Only)
In the beginning there was fun, excitement and sex in your relationship. Now your relationship has moved to roommate status and you don’t know how to get the spark back.You love your partner but lately things have not felt the same. TV and phones have replaced long conversations and kids take up any “adult” time the two of you can have together. Sometimes you find yourself thinking some pretty negative things about your partner and sometimes they come out of your mouth, which leads to a fight or worse, stoney silence.
In the beginning there was fun, excitement and sex in your relationship. Now your relationship has moved to roommate status and you don’t know how to get the spark back.You love your partner but lately things have not felt the same. TV and phones have replaced long conversations and kids take up any “adult” time the two of you can have together. Sometimes you find yourself thinking some pretty negative things about your partner and sometimes they come out of your mouth, which leads to a fight or worse, stoney silence.
(518) 348-4345 View (518) 348-4345
Photo of Nataleigh Kohn, LCSW, Clinical Social Work/Therapist
Nataleigh Kohn
Clinical Social Work/Therapist, LCSW
Verified Verified
Germantown, NY 12526
I love working with people to understand their own patterns of thoughts, feelings, behaviors, and relationships. All of these patterns have a root cause, and have served you in some way at some time—even if they are now proving to be unhelpful or harmful. In our work together, we will come to better understand the problems you face, develop a plan to make a change, and then put that plan into action. I specialize in working with pre-teens, teens, and adults struggling with depression, anxiety, bipolar disorder, trauma, BPD, ADHD, patterns of difficulty regulating emotions, and pervasive isolation/interpersonal conflict.
I love working with people to understand their own patterns of thoughts, feelings, behaviors, and relationships. All of these patterns have a root cause, and have served you in some way at some time—even if they are now proving to be unhelpful or harmful. In our work together, we will come to better understand the problems you face, develop a plan to make a change, and then put that plan into action. I specialize in working with pre-teens, teens, and adults struggling with depression, anxiety, bipolar disorder, trauma, BPD, ADHD, patterns of difficulty regulating emotions, and pervasive isolation/interpersonal conflict.
(518) 855-6598 View (518) 855-6598
Photo of Ted J McGlone, Ted McGlone, PhD, LP, Licensed Psychoanalyst
Ted J McGlone
Licensed Psychoanalyst, Ted McGlone, PhD, LP
Verified Verified
Hillsdale, NY 12529
Do you want a space where you can be present and develop in the "here and now"? Do you want to bring your experience of self to clear awareness with support for healing and discovery of new ways to integrate your thinking, feeling and willing? If so, I am available to explore with you how to work with the issues that are important to you.
Do you want a space where you can be present and develop in the "here and now"? Do you want to bring your experience of self to clear awareness with support for healing and discovery of new ways to integrate your thinking, feeling and willing? If so, I am available to explore with you how to work with the issues that are important to you.
(516) 789-2245 View (516) 789-2245
Photo of Ellen Kahn - Ellen Kahn Psychotherapy, MFA, LP, MFA, LP, Licensed Psychoanalyst
Ellen Kahn Psychotherapy, MFA, LP
Licensed Psychoanalyst, MFA, LP
Verified Verified
Ghent, NY 12075
Have you been feeling overwhelmed lately? Are you feeling depressed, anxious, not sleeping well, or just not yourself ? Have you wanted to tackle some things that have been holding you back from achieving your full potential? Are there aspects of your past you may be avoiding? Are you wondering if you have addiction issues? Perhaps your family's history is something you need to discuss with someone?
Have you been feeling overwhelmed lately? Are you feeling depressed, anxious, not sleeping well, or just not yourself ? Have you wanted to tackle some things that have been holding you back from achieving your full potential? Are there aspects of your past you may be avoiding? Are you wondering if you have addiction issues? Perhaps your family's history is something you need to discuss with someone?
(917) 746-5342 View (917) 746-5342
Photo of Vicki Wolfe, LMHC, CASAC
Vicki Wolfe
Mental Health Counselor, LMHC, CASAC
Verified Verified
Hudson, NY 12534  (Online Only)
I am a Licensed Mental Health Counselor and Credentialed Alcohol and Substance Abuse Counselor in New York State. I mostly have experience in working with adults. I also have experience working with couples, teens and families. Some clinical issues I have the most experience in include substance abuse, depression, anxiety, and stress management. My main focus in my treatment approach centers around the establishment of a therapeutic relationship with the person I'm working with. I feel that having a good connection helps facilitate effective counseling and provides the best outcomes from the therapy process.
I am a Licensed Mental Health Counselor and Credentialed Alcohol and Substance Abuse Counselor in New York State. I mostly have experience in working with adults. I also have experience working with couples, teens and families. Some clinical issues I have the most experience in include substance abuse, depression, anxiety, and stress management. My main focus in my treatment approach centers around the establishment of a therapeutic relationship with the person I'm working with. I feel that having a good connection helps facilitate effective counseling and provides the best outcomes from the therapy process.
(518) 543-7221 View (518) 543-7221
Photo of Lorraine C Gray, MA, LMFT, Marriage & Family Therapist
Lorraine C Gray
Marriage & Family Therapist, MA, LMFT
Verified Verified
Hudson, NY 12534
Life holds challenges for all of us but the tumultuous times have created stresses and strains that none of us could have foreseen. I offer a safe and supportive place to work in partnership with people who need help tackling issues, problems or changes. My clients and I discover ways for them to change their lives in positive ways. I have been told that my nonjudgemental, warm, and smart, approach to whatever my clients are experiencing has helped me to develop strong relationships with the people I work with. I believe a sense of humor is essential for insight and perspective. Let's get started moving you to where you want to be.
Life holds challenges for all of us but the tumultuous times have created stresses and strains that none of us could have foreseen. I offer a safe and supportive place to work in partnership with people who need help tackling issues, problems or changes. My clients and I discover ways for them to change their lives in positive ways. I have been told that my nonjudgemental, warm, and smart, approach to whatever my clients are experiencing has helped me to develop strong relationships with the people I work with. I believe a sense of humor is essential for insight and perspective. Let's get started moving you to where you want to be.
(518) 267-7907 View (518) 267-7907
Photo of Benedikta Karaisl von Karais, MHC LP
Benedikta Karaisl von Karais
MHC LP
Verified Verified
Hudson, NY 12534
My intention is to create a collaborative environment to support clients to reconnect to their heart’s desire as we address obstacles that might be in the way. With a focus on developmental trauma, the client works on discovering new ways of relating to themselves and their environment.
My intention is to create a collaborative environment to support clients to reconnect to their heart’s desire as we address obstacles that might be in the way. With a focus on developmental trauma, the client works on discovering new ways of relating to themselves and their environment.
(845) 506-1953 View (845) 506-1953
Photo of Pam Carroll, LMFT, Marriage & Family Therapist
Pam Carroll
Marriage & Family Therapist, LMFT
Verified Verified
Chatham, NY 12037
In my 15-year career as a Marriage & Family Therapist in private practice, I help individuals and couples navigate change: Identify change they desire. Achieve and sustain conscious change. Endure change they didn’t expect and/or don’t want. If communication is a problem... If your relationship is conflict-filled, lonely, sexually unsatisfying, stuck... If you're struggling with a major life decision, change or crisis... Please reach out. Together, we'll figure out what's in your way. That is, what needs to stop, start or be different to make your relationship with yourself or significant others feel good?
In my 15-year career as a Marriage & Family Therapist in private practice, I help individuals and couples navigate change: Identify change they desire. Achieve and sustain conscious change. Endure change they didn’t expect and/or don’t want. If communication is a problem... If your relationship is conflict-filled, lonely, sexually unsatisfying, stuck... If you're struggling with a major life decision, change or crisis... Please reach out. Together, we'll figure out what's in your way. That is, what needs to stop, start or be different to make your relationship with yourself or significant others feel good?
(518) 989-0775 View (518) 989-0775
Photo of Geraldine P Sweetman, LMFT, Marriage & Family Therapist
Geraldine P Sweetman
Marriage & Family Therapist, LMFT
Verified Verified
Hudson, NY 12534
Emotional Intelligence, I suggest to you this is the powerful era that we humans are experiencing, whereby we are exploring and discovering more and more, how our brains and our bodies work. We are learning how to harness our potential, how to understand the influences of our education and socialization and how it has shaped, restricted our thinking, our choices. I believe, it is when we become curious, when we ask the questions, how did I become the way I am? how did I develop my beliefs about the world? Asking such questions gives us permission to explore our deeply held beliefs and understanding, liberating our future choices.
Emotional Intelligence, I suggest to you this is the powerful era that we humans are experiencing, whereby we are exploring and discovering more and more, how our brains and our bodies work. We are learning how to harness our potential, how to understand the influences of our education and socialization and how it has shaped, restricted our thinking, our choices. I believe, it is when we become curious, when we ask the questions, how did I become the way I am? how did I develop my beliefs about the world? Asking such questions gives us permission to explore our deeply held beliefs and understanding, liberating our future choices.
(518) 412-7541 View (518) 412-7541
Photo of Maureen Sharp, LMHC, Counselor
Maureen Sharp
Counselor, LMHC
Verified Verified
1 Endorsed
Hudson, NY 12534  (Online Only)
Welcome! I've created a space where you can freely express yourself and feel genuinely understood. I'm here to support adults, college students, and teens from all backgrounds and identities, with a special focus on queer/LGBTQIA+ individuals. In a safe and affirming environment we'll explore themes such as self-acceptance, identity, relationships, and personal growth. We will address experiences of anxiety, depression, trauma, and mind/body concerns while nurturing resilience and fostering healthy boundaries and self-trust. I'm here to accompany you on your journey toward personal growth and overall well-being.
Welcome! I've created a space where you can freely express yourself and feel genuinely understood. I'm here to support adults, college students, and teens from all backgrounds and identities, with a special focus on queer/LGBTQIA+ individuals. In a safe and affirming environment we'll explore themes such as self-acceptance, identity, relationships, and personal growth. We will address experiences of anxiety, depression, trauma, and mind/body concerns while nurturing resilience and fostering healthy boundaries and self-trust. I'm here to accompany you on your journey toward personal growth and overall well-being.
(347) 434-6845 View (347) 434-6845
Photo of John Alan Metzger - John Metzger, LCSW, MA, MFA, New Era Therapeutics, LCSW, MA, MFA, Clinical Social Work/Therapist
John Metzger, LCSW, MA, MFA, New Era Therapeutics
Clinical Social Work/Therapist, LCSW, MA, MFA
Verified Verified
Hudson, NY 12534
My approach is to help you create more self-understanding so you can open to a more authentic, engaging, and fulfilling life. Therapy is the place where you can build a new kind relationship with yourself and your world, one that taps into the fundamental dynamism of the human spirit so that you can enjoy a fuller sense of connection and purpose. My approach is a blend of trauma-informed relational and psychodynamic theories with an emphasis on attachment and developmental issues pertaining to anxiety, depression, and addiction.
My approach is to help you create more self-understanding so you can open to a more authentic, engaging, and fulfilling life. Therapy is the place where you can build a new kind relationship with yourself and your world, one that taps into the fundamental dynamism of the human spirit so that you can enjoy a fuller sense of connection and purpose. My approach is a blend of trauma-informed relational and psychodynamic theories with an emphasis on attachment and developmental issues pertaining to anxiety, depression, and addiction.
(518) 412-3033 View (518) 412-3033
Photo of Sarah Jamison, LCSW, Clinical Social Work/Therapist
Sarah Jamison
Clinical Social Work/Therapist, LCSW
Verified Verified
Hudson, NY 12534
I specialize in working with Queer, Gender Non-Conforming Individuals and Women as well as people in relationships. People come, or come back, to therapy for lots of reasons. You might be experiencing a crisis or maybe you've identified a behavior that isn't working anymore. Perhaps you only know that you feel awful and need something to change. You might even be doing okay but have the desire to show up to life in a more open and whole hearted way. Therapy can help.
I specialize in working with Queer, Gender Non-Conforming Individuals and Women as well as people in relationships. People come, or come back, to therapy for lots of reasons. You might be experiencing a crisis or maybe you've identified a behavior that isn't working anymore. Perhaps you only know that you feel awful and need something to change. You might even be doing okay but have the desire to show up to life in a more open and whole hearted way. Therapy can help.
(845) 875-9341 View (845) 875-9341
Photo of Lia Carroll, LCSW, Clinical Social Work/Therapist
Lia Carroll
Clinical Social Work/Therapist, LCSW
Verified Verified
Kinderhook, NY 12106
CURRENTLY ACCEPTING NEW CLIENTS. Welcome... I look forward to hearing from you to explore whether we might work well together. I view the therapy process as a dynamic and equal partnership. I have experience working with young children to seniors, individuals, partnerships, groups and families. I consider it an honor and privilege to have worked with former clients and look forward to hearing your story. Phone appointments and/or “walk and talk” sessions.
CURRENTLY ACCEPTING NEW CLIENTS. Welcome... I look forward to hearing from you to explore whether we might work well together. I view the therapy process as a dynamic and equal partnership. I have experience working with young children to seniors, individuals, partnerships, groups and families. I consider it an honor and privilege to have worked with former clients and look forward to hearing your story. Phone appointments and/or “walk and talk” sessions.
(845) 217-3055 View (845) 217-3055

See more therapy options for Columbia County

How does your Therapist compare?

Number of Therapists in Columbia County, NY

100+

Average cost per session

$165

Therapists in Columbia County, NY who prioritize treating:

93% Anxiety
86% Depression
78% Relationship Issues
70% Self Esteem
67% Grief
66% Stress
63% Trauma and PTSD

Average years in practice

13 Years

Top 3 insurances accepted

73% Aetna
61% UnitedHealthcare UHC | UBH
47% Cigna and Evernorth

How Therapists in Columbia County, NY see their clients

60% In Person and Online
40% Online Only

Gender breakdown

73% Female
26% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Columbia 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.