Therapists in Otsego County, NY
![Photo of Bernadette Winters Bell, LMSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/44b09cfc-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Bernadette Winters Bell
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Oneonta, NY 13820
Everyone suffers many losses in their lifetime. Grief is our reaction to loss based on what we have learned from childhood, what we have experienced as adults, and how we have chosen to respond. We then struggle to determine how to evolve and change. The grieving process does not follow a prescribed path. There are many commonalities to the grieving process, yet the journey is unique to the individual. Loss is typically defined as a death, but may take many forms: a relationship, a job, a pet. I specialize in many types of Grief and Transitions including Anticipatory. Absent, Complicated, Disenfranchised, Chronic, Delayed and Inhibited.
Everyone suffers many losses in their lifetime. Grief is our reaction to loss based on what we have learned from childhood, what we have experienced as adults, and how we have chosen to respond. We then struggle to determine how to evolve and change. The grieving process does not follow a prescribed path. There are many commonalities to the grieving process, yet the journey is unique to the individual. Loss is typically defined as a death, but may take many forms: a relationship, a job, a pet. I specialize in many types of Grief and Transitions including Anticipatory. Absent, Complicated, Disenfranchised, Chronic, Delayed and Inhibited.
![Photo of Lisa Flachs, LCSW-R, Clinical Social Work/Therapist](https://photos.psychologytoday.com/5249c93c-f636-45ab-9eb1-a94701e5e8d2/2/320x400.jpeg)
Bad things have happened to you. You don't know where to turn. You feel like no one understands. You're on autopilot and that's just not working. Let's join together to put you back in the pilot's seat so that you move out of the past, live in the present, and design your path into the future. Together we can break down the barriers that are keeping you from the life you want to live. I am ready to meet you where you are and help you achieve your best life.
Bad things have happened to you. You don't know where to turn. You feel like no one understands. You're on autopilot and that's just not working. Let's join together to put you back in the pilot's seat so that you move out of the past, live in the present, and design your path into the future. Together we can break down the barriers that are keeping you from the life you want to live. I am ready to meet you where you are and help you achieve your best life.
![Photo of Timothy C Donovan, LCSW-R, ACSW, DCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3c8984c8-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Timothy C Donovan
Clinical Social Work/Therapist, LCSW-R, ACSW, DCSW
Verified Verified
Oneonta, NY 13820 (Online Only)
*Not currently accepting new referrals.*Struggling with anxiety, depression, the lingering effects of past traumatic experiences or relationship problems? Having difficulty with your children? With over 25 years experience I can help you resolve your problems and find success. Making the decision to seek professional help can be difficult. I am here to help you through these trying times. I will work collaboratively with you or your family to identify central issues, decrease symptoms and develop effective coping strategies to help you lead a more rewarding and happy life.
*Not currently accepting new referrals.*Struggling with anxiety, depression, the lingering effects of past traumatic experiences or relationship problems? Having difficulty with your children? With over 25 years experience I can help you resolve your problems and find success. Making the decision to seek professional help can be difficult. I am here to help you through these trying times. I will work collaboratively with you or your family to identify central issues, decrease symptoms and develop effective coping strategies to help you lead a more rewarding and happy life.
![Photo of Patti Noon, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/8f793ed3-19fa-4491-8eb4-62cb250075c4/2/320x400.jpeg)
Patti Noon
Clinical Social Work/Therapist, LCSW
Verified Verified
Oneonta, NY 13820
Not accepting new clients
Facing a significant life change can create a great deal of uncertainty and lead you to question where to go next or what steps to take. You may have felt like you have to make decisions based on expectations and beliefs which, at your core, are not your own. Navigating the challenges and even the celebrations that come with life transitions of any kind can be daunting, especially when exploring your own authentic journey at the same time.
Facing a significant life change can create a great deal of uncertainty and lead you to question where to go next or what steps to take. You may have felt like you have to make decisions based on expectations and beliefs which, at your core, are not your own. Navigating the challenges and even the celebrations that come with life transitions of any kind can be daunting, especially when exploring your own authentic journey at the same time.
![Photo of Sura Page, LCSW-R, Clinical Social Work/Therapist](https://photos.psychologytoday.com/533d96b6-9ebe-4028-95e2-6111782a3610/3/320x400.jpeg)
With over 25 years of experience as a mental health social worker, I offer individual, couples, family and group therapy to children, adolescents and adults. I am a trauma informed clinician with an expertise and specialty in the area of Domestic Abuse/Intimate Partner Violence, Child Abuse, Rape, Sexual Assault, family court issues (mediation) around custody/visitation. Trained and Certified in Brainspotting (www.brainspotting.com) which is a Brain-Body psychotherapy
With over 25 years of experience as a mental health social worker, I offer individual, couples, family and group therapy to children, adolescents and adults. I am a trauma informed clinician with an expertise and specialty in the area of Domestic Abuse/Intimate Partner Violence, Child Abuse, Rape, Sexual Assault, family court issues (mediation) around custody/visitation. Trained and Certified in Brainspotting (www.brainspotting.com) which is a Brain-Body psychotherapy
![Photo of Paige Stone, LMHC, Counselor](https://photos.psychologytoday.com/3c9b1a21-140a-46ff-8cfd-7a776a666681/1/320x400.jpeg)
Life transitions can be challenging. Together we will navigate your life's challenges and find their path to healing and growth. My goal is to create a safe and supportive space where you can explore your thoughts and feelings, develop coping skills, and ultimately, thrive. Whether you’re facing a significant life change or seeking support for emotional well-being, I’m here to be a sounding board as you go through your life experiences.
Life transitions can be challenging. Together we will navigate your life's challenges and find their path to healing and growth. My goal is to create a safe and supportive space where you can explore your thoughts and feelings, develop coping skills, and ultimately, thrive. Whether you’re facing a significant life change or seeking support for emotional well-being, I’m here to be a sounding board as you go through your life experiences.
![Photo of Theresa Marie Guardiano, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/1d415f8e-76ae-4c9a-ad85-382608372795/1/320x400.jpeg)
Theresa Marie Guardiano
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
East Worcester, NY 12064
Finding the right therapist is key! The most important part of my practice is building a positive rapport in order to do the work. In doing that I offer a comfortable, judge free environment to be able to work on challenging issues. I believe that the therapeutic relationship is the most important part of the healing process. Together we can work to resolve current and past challenges and work toward future goals of a better more enjoyable life.
Finding the right therapist is key! The most important part of my practice is building a positive rapport in order to do the work. In doing that I offer a comfortable, judge free environment to be able to work on challenging issues. I believe that the therapeutic relationship is the most important part of the healing process. Together we can work to resolve current and past challenges and work toward future goals of a better more enjoyable life.
![Photo of Karrie Crippen-Hotaling, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/26e162fd-37d9-4f7d-b299-1c040f3c6425/1/320x400.jpeg)
Clients want to feel safe and understood. This is especially important when being vulnerable and sharing your emotions. Processing through tough times and tough emotions can be scary and tiring, but you won't be alone. Having someone empathetic co-pilot your way through tough times can be truly uplifting. We will work together to define your goals and reach your happiness, however you define it.
Clients want to feel safe and understood. This is especially important when being vulnerable and sharing your emotions. Processing through tough times and tough emotions can be scary and tiring, but you won't be alone. Having someone empathetic co-pilot your way through tough times can be truly uplifting. We will work together to define your goals and reach your happiness, however you define it.
![Photo of Jeanette Tolson, DSW, LCSW-R, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3e97260f-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
Jeanette Tolson
Clinical Social Work/Therapist, DSW, LCSW-R
Verified Verified
6 Endorsed
Oneonta, NY 13820
Waitlist for new clients
At this time, my practice has a waitlist and it is approximately a 6 week wait for a new client appointment. I specialize in working with sex and relationship difficulties and treat individuals and couples. I help people understand the relationship patterns they've developed and how they continue to play out, even though they aren't helpful anymore.
At this time, my practice has a waitlist and it is approximately a 6 week wait for a new client appointment. I specialize in working with sex and relationship difficulties and treat individuals and couples. I help people understand the relationship patterns they've developed and how they continue to play out, even though they aren't helpful anymore.
![Photo of Helen Bridges, MA, CPLC, CPNLP](https://photos.psychologytoday.com/3c3b8fa2-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Are you a woman who wants to live your dreams? Wanting to make changes in your life? Are you ready to imagine a difference, to plan the way, and to commit to your intention? I am here to help you see the possibility of obstacles becoming tools for change. Your intentions, motivations and your life purposes will become clearer. This action research approach transforms issues into positive challenges. Goal: Overcoming obstacles to take you to where you are meant to be!
Are you a woman who wants to live your dreams? Wanting to make changes in your life? Are you ready to imagine a difference, to plan the way, and to commit to your intention? I am here to help you see the possibility of obstacles becoming tools for change. Your intentions, motivations and your life purposes will become clearer. This action research approach transforms issues into positive challenges. Goal: Overcoming obstacles to take you to where you are meant to be!
![Photo of Melissa Fallon-Korb, PhD, Psychologist](https://photos.psychologytoday.com/d02d70cf-13e6-4c06-9d0c-d493cf11508d/3/320x400.jpeg)
In 20 years as a psychologist, I find healing and emotional growth start with developing a compassionate understanding of your life story and current circumstances. I focus on strengths and capabilities as the foundation for your growth and empowerment. I will regard you as the expert of your life and partner with you to develop treatment goals and approaches. I will focus on your emotional needs and help you develop skills for healthy relationships and better functioning in your life. I will also directly address the negative effects of oppression and discrimination as it impacts your mental health.
In 20 years as a psychologist, I find healing and emotional growth start with developing a compassionate understanding of your life story and current circumstances. I focus on strengths and capabilities as the foundation for your growth and empowerment. I will regard you as the expert of your life and partner with you to develop treatment goals and approaches. I will focus on your emotional needs and help you develop skills for healthy relationships and better functioning in your life. I will also directly address the negative effects of oppression and discrimination as it impacts your mental health.
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![Photo of Mandi Mader, LCSW-C, Clinical Social Work/Therapist](https://photos.psychologytoday.com/19fef96e-3892-44c2-b418-9a032cf64a8f/1/320x400.jpeg)
Mandi Mader
Clinical Social Work/Therapist, LCSW-C
Verified Verified
1 Endorsed
Oneonta, NY 13820 (Online Only)
I love helping people improve their sleep! I have been treating insomnia for almost 10 years. I have received advanced training in Cognitive Behavioral Therapy for Insomnia at UPenn. I can see anyone in NY State and in Maryland by tele-health.
I love helping people improve their sleep! I have been treating insomnia for almost 10 years. I have received advanced training in Cognitive Behavioral Therapy for Insomnia at UPenn. I can see anyone in NY State and in Maryland by tele-health.
![Photo of Crystal Huffstickler, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/df159038-6585-4c1f-96de-dc89362981c2/1/320x400.jpeg)
Crystal Huffstickler
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Oneonta, NY 13820
I am passionate about working with people of the global majority (or Black, Indigenous, and People of Color) and/or LGBTQIA+ adults. I focus on helping you feel empowered and effective in your life. My approach pendulates between somatic, or body-based, techniques and guided conversation to cultivate self awareness, emotional regulation, insight, and meaning making. Using your goals, experiences, and preferences, we will co-create a path towards wellness, however that looks for you. You will come away from sessions feeling understood and valued, and with the skills and mindset to navigate life's obstacles.
I am passionate about working with people of the global majority (or Black, Indigenous, and People of Color) and/or LGBTQIA+ adults. I focus on helping you feel empowered and effective in your life. My approach pendulates between somatic, or body-based, techniques and guided conversation to cultivate self awareness, emotional regulation, insight, and meaning making. Using your goals, experiences, and preferences, we will co-create a path towards wellness, however that looks for you. You will come away from sessions feeling understood and valued, and with the skills and mindset to navigate life's obstacles.
![Photo of Janet Ballute, LCSWR, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3f355716-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Janet Ballute
Clinical Social Work/Therapist, LCSWR
Verified Verified
Oneonta, NY 13820 (Online Only)
As individuals, partners, or parents, we know when something is out of sync. Changing situations, relationships and emotions are all part of the human condition. Sometimes we struggle to adjust. How we act -- physically, mentally, emotionally and spiritually-- all determine our level of health. I specialize in mood disorders, trauma, bereavement, and suicide survivors. My clients are the experts. They experience the situation. I observe and listen, provide support, and suggest tools they may use as they challenge themselves, as they find a better to deal with their problems. Small changes equal big impacts in our lives.
As individuals, partners, or parents, we know when something is out of sync. Changing situations, relationships and emotions are all part of the human condition. Sometimes we struggle to adjust. How we act -- physically, mentally, emotionally and spiritually-- all determine our level of health. I specialize in mood disorders, trauma, bereavement, and suicide survivors. My clients are the experts. They experience the situation. I observe and listen, provide support, and suggest tools they may use as they challenge themselves, as they find a better to deal with their problems. Small changes equal big impacts in our lives.
![Photo of Pete Tolson, LMHC, Counselor](https://photos.psychologytoday.com/43ef4599-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
Pete Tolson
Counselor, LMHC
Verified Verified
2 Endorsed
Oneonta, NY 13820
Not accepting new clients
In my practice, individuals who are dealing with mental health concerns will find a supportive, safe space to explore their thoughts and feelings. My approach is person-centered which means that I will meet each client where they are at in the counseling process and help them work toward their individual or relational goals.
In my practice, individuals who are dealing with mental health concerns will find a supportive, safe space to explore their thoughts and feelings. My approach is person-centered which means that I will meet each client where they are at in the counseling process and help them work toward their individual or relational goals.
![Photo of Heather Bradley, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/425946e7-87ac-4ce2-a147-e20eee6ff5a9/2/320x400.jpeg)
Heather Bradley
Clinical Social Work/Therapist, LCSW
Verified Verified
Oneonta, NY 13820 (Online Only)
I have been providing therapy for almost a decade and I believe that therapy is driven by YOU. You let me know what you would like to work on and we move forward from there. I use a variety of therapy methods to help personalize your experience. I value providing a safe, judgement free space to process whatever is on your mind. A little about me, I love dogs and mine might pop in during a telehealth session. My availability is mostly evenings for appointments. I work with adults (18+ years old).
I have been providing therapy for almost a decade and I believe that therapy is driven by YOU. You let me know what you would like to work on and we move forward from there. I use a variety of therapy methods to help personalize your experience. I value providing a safe, judgement free space to process whatever is on your mind. A little about me, I love dogs and mine might pop in during a telehealth session. My availability is mostly evenings for appointments. I work with adults (18+ years old).
![Photo of Crystal Moore, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/ac5077cb-b9d9-49fe-87d1-ea0e668120bd/1/320x400.jpeg)
Crystal Moore
Clinical Social Work/Therapist, LCSW
Verified Verified
Oneonta, NY 13820
Not accepting new clients
Welcome to my private practice. I am a Licensed Clinical Social Worker specializing in anxiety disorders, depression, addiction, relationship issues, and trauma. I like to meet my clients where they are at, collaboratively coming up with goals and objectives for treatment, and to help them move forward with their lives.
Welcome to my private practice. I am a Licensed Clinical Social Worker specializing in anxiety disorders, depression, addiction, relationship issues, and trauma. I like to meet my clients where they are at, collaboratively coming up with goals and objectives for treatment, and to help them move forward with their lives.
![Photo of Victoria Anne McElligott, LCSWR, Clinical Social Work/Therapist](https://photos.psychologytoday.com/e4d89655-df44-447d-9491-6d0a1ef6b34c/1/320x400.jpeg)
Victoria Anne McElligott
Clinical Social Work/Therapist, LCSWR
Verified Verified
1 Endorsed
Cooperstown, NY 13326 (Online Only)
I have always wanted to help people and found that focusing on mental health needs of individuals is my passion. I am a great listener, warm and empathetic. Are you feeling depressed? Are you not sure? Do you notice any of the following: lack of interest/pleasure, low energy/fatigue, difficulty with sleep/appetite, concentration/making decisions, feel bad about yourself/feel worthless, relationships are impacted and you are struggling to function in your day to day life? Depression changes the way we think about ourselves, others and the world. Depression impacts our mood, thoughts and behaviors.
I have always wanted to help people and found that focusing on mental health needs of individuals is my passion. I am a great listener, warm and empathetic. Are you feeling depressed? Are you not sure? Do you notice any of the following: lack of interest/pleasure, low energy/fatigue, difficulty with sleep/appetite, concentration/making decisions, feel bad about yourself/feel worthless, relationships are impacted and you are struggling to function in your day to day life? Depression changes the way we think about ourselves, others and the world. Depression impacts our mood, thoughts and behaviors.
![Photo of Francesca Parry, LCSW-R, Clinical Social Work/Therapist](https://photos.psychologytoday.com/b5000e6d-008f-4f16-9bed-a7a1f41cb6cc/1/320x400.jpeg)
Francesca Parry
Clinical Social Work/Therapist, LCSW-R
Verified Verified
1 Endorsed
Oneonta, NY 13820
Anxiety. Depression. Have one or both shown up uninvited in your life? Keeping you awake at night with worries and self-doubt, convincing your mind and body that 2 am is the ideal time to problem-solve and gain an enlightened mindset about whatever is troubling you? Most people feel worried or sad from time to time–we’re human, not robots after all–but if you’re searching for a therapist, I’m guessing that these uninvited guests have overstayed their welcome and are reeking havoc with your peace of mind and interfering with your life. You're unsure about whether it's time to change a situation or time to change your mindset.
Anxiety. Depression. Have one or both shown up uninvited in your life? Keeping you awake at night with worries and self-doubt, convincing your mind and body that 2 am is the ideal time to problem-solve and gain an enlightened mindset about whatever is troubling you? Most people feel worried or sad from time to time–we’re human, not robots after all–but if you’re searching for a therapist, I’m guessing that these uninvited guests have overstayed their welcome and are reeking havoc with your peace of mind and interfering with your life. You're unsure about whether it's time to change a situation or time to change your mindset.
![Photo of Sue Newman, LMHC](https://photos.psychologytoday.com/f62954f8-06bf-4905-a2b9-f25b98d432fb/1/320x400.jpeg)
Helping people improve their quality of life has been my passion and my work for more than 25 years. I have had extensive training in Dialectical Behavior Therapy (DBT) and am trained and experienced in Cognitive Behavior Therapy.
Helping people improve their quality of life has been my passion and my work for more than 25 years. I have had extensive training in Dialectical Behavior Therapy (DBT) and am trained and experienced in Cognitive Behavior Therapy.
See more therapy options for Otsego County
How does your Therapist compare?
Number of Therapists in Otsego County, NY
70+
Average cost per session
$125
Therapists in Otsego County, NY who prioritize treating:
93% | Anxiety |
88% | Depression |
71% | Coping Skills |
69% | Relationship Issues |
69% | Stress |
63% | Self Esteem |
57% | Grief |
Average years in practice
17 Years
Top 3 insurances accepted
90% | Aetna |
80% | UnitedHealthcare UHC | UBH |
73% | Cigna and Evernorth |
How Therapists in Otsego County, NY see their clients
67% | In Person and Online | |
33% | Online Only |
Gender breakdown
89% | Female | |
11% | Male |
FAQs - About Therapy and Counseling
How can I find a therapist in Otsego 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
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.
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.
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.