Therapists in Troy, NY

Photo of Jackie Sanchez, LCSW, PMP, Clinical Social Work/Therapist
Jackie Sanchez
Clinical Social Work/Therapist, LCSW, PMP
Verified Verified
Troy, NY 12180
Waitlist for new clients
I have been in private practice for 20+ years and have learned the joy and pain of finding purpose in the human condition with and through my clients. I have vast experience in coping/healing from various traumas, PTSD, separation, shame, a strong background in trust issues, and all types of relationships, as well as a forte for LGBTQIA relationships and parenting.
I have been in private practice for 20+ years and have learned the joy and pain of finding purpose in the human condition with and through my clients. I have vast experience in coping/healing from various traumas, PTSD, separation, shame, a strong background in trust issues, and all types of relationships, as well as a forte for LGBTQIA relationships and parenting.
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Photo of Brittany Galipeau, LMHC, Counselor
Brittany Galipeau
Counselor, LMHC
Verified Verified
Troy, NY 12180  (Online Only)
Hi there! I'm Brittany DeBell, a Licensed Mental Health Counselor, who has been treating clients with a variety of Mental Health concerns for 8 years. I've helped many people find the words, strategies, and tools to get through difficult times by better understanding what strengths they have. Together we look at what's going on in your life, the thoughts and behaviors that are difficult, and implement simple steps to building the mindset, life, and relationships that you love.
Hi there! I'm Brittany DeBell, a Licensed Mental Health Counselor, who has been treating clients with a variety of Mental Health concerns for 8 years. I've helped many people find the words, strategies, and tools to get through difficult times by better understanding what strengths they have. Together we look at what's going on in your life, the thoughts and behaviors that are difficult, and implement simple steps to building the mindset, life, and relationships that you love.
(518) 559-1184 View (518) 559-1184
Photo of Vera Fischer, LCSW, Clinical Social Work/Therapist
Vera Fischer
Clinical Social Work/Therapist, LCSW
Verified Verified
Troy, NY 12180  (Online Only)
Life presents us with an array of challenges. Managing those challenges can be overwhelming. Do you worry too much? Do you feel disconnected from your emotions? Is it hard to make decisions? It is time to identify self defeating patterns and come up with a plan. Depression, anxiety, addiction, loss and past trauma can prevent you from finding that resolution.
Life presents us with an array of challenges. Managing those challenges can be overwhelming. Do you worry too much? Do you feel disconnected from your emotions? Is it hard to make decisions? It is time to identify self defeating patterns and come up with a plan. Depression, anxiety, addiction, loss and past trauma can prevent you from finding that resolution.
(518) 333-7131 View (518) 333-7131
Photo of Taylor Bouton, LMSW
Taylor Bouton
Licensed Master Social Worker, LMSW
Verified Verified
1 Endorsed
Troy, NY 12180
Finding the right therapist for you can be daunting, but it is important to find a good fit. I am a trauma-informed, queer woman therapist that works with adults that have a desire to increase their overall wellness, manage their emotions, and become the best version of themselves. I specialize in assisting people who are LGBTQIA+, in a domestic violence situation, struggling with their body dysmorphia, eating disorders, and the struggles of aging.
Finding the right therapist for you can be daunting, but it is important to find a good fit. I am a trauma-informed, queer woman therapist that works with adults that have a desire to increase their overall wellness, manage their emotions, and become the best version of themselves. I specialize in assisting people who are LGBTQIA+, in a domestic violence situation, struggling with their body dysmorphia, eating disorders, and the struggles of aging.
(518) 351-2760 View (518) 351-2760
Photo of Beth Phillips - Peace From Pieces Counseling, LCSW, Clinical Social Work/Therapist
Peace From Pieces Counseling
Clinical Social Work/Therapist, LCSW
Verified Verified
3 Endorsed
Troy, NY 12180  (Online Only)
What if I told you that you already possess everything you need inside of you to be best version of yourself? Would you believe me? I believe it, because I believe all human beings possess these qualities. However, too often, past traumas and current stressors can steal away pieces of your true joyful self. As a result, you may feel anxious, depressed, and inadequate. When you feel these things, you may act in ways you don’t like, or repeat destructive patterns over and over again. Each time, you wonder to yourself, “What just happened! This isn’t who I am.” I am here to tell you that none of this is your fault,
What if I told you that you already possess everything you need inside of you to be best version of yourself? Would you believe me? I believe it, because I believe all human beings possess these qualities. However, too often, past traumas and current stressors can steal away pieces of your true joyful self. As a result, you may feel anxious, depressed, and inadequate. When you feel these things, you may act in ways you don’t like, or repeat destructive patterns over and over again. Each time, you wonder to yourself, “What just happened! This isn’t who I am.” I am here to tell you that none of this is your fault,
(518) 245-3236 View (518) 245-3236
Photo of Jenavieve Steinbach, LMHC-D, CCTP-II, Counselor
Jenavieve Steinbach
Counselor, LMHC-D, CCTP-II
Verified Verified
Troy, NY 12180  (Online Only)
Hi! My name is Jenavieve, I am a Licensed Mental Health Counselor with Diagnostic Privilege. I received my BA in Applied Psychology from Binghamton University and my Master’s Degree in Clinical Mental Health Counseling from SUNY Plattsburgh. I have experience working with pediatric and adult populations in inpatient, outpatient, and community settings. In addition to working in private practice, I also work full-time as a Mental Health Counselor providing counseling to students in a college setting. Prior to this, I spent two years providing counseling services through Albany Medical Center’s Pediatric Specialty Clinic.
Hi! My name is Jenavieve, I am a Licensed Mental Health Counselor with Diagnostic Privilege. I received my BA in Applied Psychology from Binghamton University and my Master’s Degree in Clinical Mental Health Counseling from SUNY Plattsburgh. I have experience working with pediatric and adult populations in inpatient, outpatient, and community settings. In addition to working in private practice, I also work full-time as a Mental Health Counselor providing counseling to students in a college setting. Prior to this, I spent two years providing counseling services through Albany Medical Center’s Pediatric Specialty Clinic.
(518) 535-3299 View (518) 535-3299
Photo of Briana Kreamer, LMHC, Counselor
Briana Kreamer
Counselor, LMHC
Verified Verified
Troy, NY 12180  (Online Only)
Hi, I am Briana Kreamer, a Licensed Mental Health Counselor with over 4 years of clinical experience. I am comfortable meeting with all types of clients, focusing on depression, anxiety, life stressors, life transitions, and interpersonal concerns. I have worked with various clients with diagnoses, most frequently depression, anxiety, bipolar disorder, and substance misuse. I pull from different types of therapy that include Cognitive Behavioral, SFBT, Narrative, Motivational Interviewing, and Strength-Based. I believe in approaching each client openly and with empathy to help find the best way to help the client meet their goals.
Hi, I am Briana Kreamer, a Licensed Mental Health Counselor with over 4 years of clinical experience. I am comfortable meeting with all types of clients, focusing on depression, anxiety, life stressors, life transitions, and interpersonal concerns. I have worked with various clients with diagnoses, most frequently depression, anxiety, bipolar disorder, and substance misuse. I pull from different types of therapy that include Cognitive Behavioral, SFBT, Narrative, Motivational Interviewing, and Strength-Based. I believe in approaching each client openly and with empathy to help find the best way to help the client meet their goals.
(518) 990-7789 View (518) 990-7789
Photo of Karin J Gardner, MSW, LCSW, LICSW, Clinical Social Work/Therapist
Karin J Gardner
Clinical Social Work/Therapist, MSW, LCSW, LICSW
Verified Verified
1 Endorsed
Troy, NY 12180  (Online Only)
I opened Kaleidoscope Psychotherapy, LCSW, PLLC to empower my clients to better understand themselves as they navigate in their personal environment so they may make positive changes and create a meaningful, joyful life. Similar to a kaleidoscope which has many colorful shapes that make the entire image, you also hold many attributes that make you who you are. In our sessions, I will help you to illuminate these attributes within yourself, and reveal behavioral patterns, so we may focus on self-discovery, self-awareness, and positive behavioral changes that attend to your personal strengths and goals.
I opened Kaleidoscope Psychotherapy, LCSW, PLLC to empower my clients to better understand themselves as they navigate in their personal environment so they may make positive changes and create a meaningful, joyful life. Similar to a kaleidoscope which has many colorful shapes that make the entire image, you also hold many attributes that make you who you are. In our sessions, I will help you to illuminate these attributes within yourself, and reveal behavioral patterns, so we may focus on self-discovery, self-awareness, and positive behavioral changes that attend to your personal strengths and goals.
(518) 840-0816 View (518) 840-0816
Photo of Carla Winner, LMHC, Counselor
Carla Winner
Counselor, LMHC
Verified Verified
Troy, NY 12180  (Online Only)
There are times in our lives when we are faced with challenges and suffering that we can no longer just push through or face alone any longer. I strive to come along side my clients as they journey through this difficult time in their life by giving them empathy, practical tools, helpful strategies and encouraging them in their faith to a place of healing. My practice and my counseling approach are rooted in the Christian faith. It is also unique in that it’s solely video conferencing and telephone sessions. This gives my clients less time traveling to one more appointment and more time in the comfort of their own home.
There are times in our lives when we are faced with challenges and suffering that we can no longer just push through or face alone any longer. I strive to come along side my clients as they journey through this difficult time in their life by giving them empathy, practical tools, helpful strategies and encouraging them in their faith to a place of healing. My practice and my counseling approach are rooted in the Christian faith. It is also unique in that it’s solely video conferencing and telephone sessions. This gives my clients less time traveling to one more appointment and more time in the comfort of their own home.
(518) 520-1843 View (518) 520-1843
Photo of Kim Noakes, MEd, LMHC, Counselor
Kim Noakes
Counselor, MEd, LMHC
Verified Verified
1 Endorsed
Troy, NY 12182  (Online Only)
As an experienced counselor, I understand that life can be full of unexpected stressful moments. You may be considering the need for another perspective on your situation. In my practice, I support adults seeking help with relationship, career, health, and family issues. As a Christian therapist, I provide respectful and non-judgmental therapy in an environment where you can explore your concerns securely and confidentially. I understand that when you are in conflict about what to do, it helps to have an unbiased person you can trust to hear your thoughts.
As an experienced counselor, I understand that life can be full of unexpected stressful moments. You may be considering the need for another perspective on your situation. In my practice, I support adults seeking help with relationship, career, health, and family issues. As a Christian therapist, I provide respectful and non-judgmental therapy in an environment where you can explore your concerns securely and confidentially. I understand that when you are in conflict about what to do, it helps to have an unbiased person you can trust to hear your thoughts.
(838) 384-8094 View (838) 384-8094
Photo of Julianne Patterson, LMSW, Clinical Social Work/Therapist
Julianne Patterson
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Troy, NY 12180  (Online Only)
Are you experiencing frequent conflicts and arguments about the same things, but nothing ever seems to get resolved? Do you feel the harder you try to make things better, the worse it seems to get? When people feel they are underappreciated, misunderstood, or blamed for things that don't feel are their fault, people stop listening and can become stuck pointing fingers and assigning blame. No one is changing behaviors or focused on solutions. All you know is you feel stuck, scared and realize that your family relationships are in trouble and need help.
Are you experiencing frequent conflicts and arguments about the same things, but nothing ever seems to get resolved? Do you feel the harder you try to make things better, the worse it seems to get? When people feel they are underappreciated, misunderstood, or blamed for things that don't feel are their fault, people stop listening and can become stuck pointing fingers and assigning blame. No one is changing behaviors or focused on solutions. All you know is you feel stuck, scared and realize that your family relationships are in trouble and need help.
(518) 849-8559 View (518) 849-8559
Photo of Kristey Palmisano, LMSW, MSW, Clinical Social Work/Therapist
Kristey Palmisano
Clinical Social Work/Therapist, LMSW, MSW
Verified Verified
2 Endorsed
Troy, NY 12180
Ever felt like you get in your own way ? Do you feel energetically stuck in one place and feel like there is no way to move forward in life? We all have the strength to heal ourselves as long as we have a safe space to explore emotions, negative thought patterns, and unresolved trauma within the soul. It is human nature to connect with others, sometimes it takes an unbiased support system to discover your authentic self through mind, body, and spirit. Our work together will explore healing your inner world through creativity, compassion, and positive self exploration.
Ever felt like you get in your own way ? Do you feel energetically stuck in one place and feel like there is no way to move forward in life? We all have the strength to heal ourselves as long as we have a safe space to explore emotions, negative thought patterns, and unresolved trauma within the soul. It is human nature to connect with others, sometimes it takes an unbiased support system to discover your authentic self through mind, body, and spirit. Our work together will explore healing your inner world through creativity, compassion, and positive self exploration.
(518) 975-3234 View (518) 975-3234
Photo of Julia Lajeunesse, LMHC, Counselor
Julia Lajeunesse
Counselor, LMHC
Verified Verified
1 Endorsed
Troy, NY 12180  (Online Only)
Waitlist for new clients
Whether you have been to therapy before or are making the leap to explore yourself for the first time, starting therapy can be intimidating. Maybe you feel that despite your best attempts at putting the puzzle pieces of your life/situation together, you still can't seem to find peace. Maybe you don't know where to even start. We can't evade having emotional experiences, so learning to not only cope, but embrace our emotions is an invaluable skill. If you are struggling with the present, ruminating on the past, or worrying about the future- there is a path forward that is worth exploring.
Whether you have been to therapy before or are making the leap to explore yourself for the first time, starting therapy can be intimidating. Maybe you feel that despite your best attempts at putting the puzzle pieces of your life/situation together, you still can't seem to find peace. Maybe you don't know where to even start. We can't evade having emotional experiences, so learning to not only cope, but embrace our emotions is an invaluable skill. If you are struggling with the present, ruminating on the past, or worrying about the future- there is a path forward that is worth exploring.
(518) 500-3115 View (518) 500-3115
Photo of Dr. Brian T. Clemente, PhD, Psychologist
Dr. Brian T. Clemente
Psychologist, PhD
Verified Verified
Troy, NY 12180
I grew up in the Capital Region but moved to the west coast to pursue my graduate education and ended up staying for twenty years. Now I am back in the area with an office space in downtown Troy where I offer therapy services and also conduct psychological evaluations and other consultation services. I can conduct online sessions utilizing a HIPPA compliant video platform. Lastly, I do still offer, when possible, a free consultation to answer any questions and/or determine if you feel we would be a good fit.
I grew up in the Capital Region but moved to the west coast to pursue my graduate education and ended up staying for twenty years. Now I am back in the area with an office space in downtown Troy where I offer therapy services and also conduct psychological evaluations and other consultation services. I can conduct online sessions utilizing a HIPPA compliant video platform. Lastly, I do still offer, when possible, a free consultation to answer any questions and/or determine if you feel we would be a good fit.
(518) 201-1892 View (518) 201-1892
Photo of Cary Fosback, LMHC, Counselor
Cary Fosback
Counselor, LMHC
Verified Verified
1 Endorsed
Troy, NY 12182  (Online Only)
As a psychotherapist and certified trauma professional, I have found meaning in helping people who are lost, disconnected, or overwhelmed. I have a history of success treating people suffering from trauma, depression, and anxiety. If you are trapped self-medicating or you are stuck in avoidant patterns, I will help you find hope, feel more grounded, and become more connected to yourself so that you can get back to what really matters. If these things sound important to you, I believe that I can be the person to help you pivot to a fulfilling life direction.
As a psychotherapist and certified trauma professional, I have found meaning in helping people who are lost, disconnected, or overwhelmed. I have a history of success treating people suffering from trauma, depression, and anxiety. If you are trapped self-medicating or you are stuck in avoidant patterns, I will help you find hope, feel more grounded, and become more connected to yourself so that you can get back to what really matters. If these things sound important to you, I believe that I can be the person to help you pivot to a fulfilling life direction.
(518) 900-1178 View (518) 900-1178
Photo of Sarah Vulgamore, MA, MS, NCC, Counselor
Sarah Vulgamore
Counselor, MA, MS, NCC
Verified Verified
Troy, NY 12180
I deeply respect your wanting to address something in your life that keeps you from feeling happy and whole. Maybe it's a recent event or loss, or a troubled relationship, or maybe a past pain that continues to hurt. Perhaps you are feeling a lack of purpose, or a lack of connection with who you really are. As a compassionate listener and guide, I will sit with you as you explore a deeper self-understanding, reflect back to you your insights, discuss options and goals, then assist you in designing an effective path of healing and change. For those living with breast cancer, I am honored to offer my support as a fellow thriver.
I deeply respect your wanting to address something in your life that keeps you from feeling happy and whole. Maybe it's a recent event or loss, or a troubled relationship, or maybe a past pain that continues to hurt. Perhaps you are feeling a lack of purpose, or a lack of connection with who you really are. As a compassionate listener and guide, I will sit with you as you explore a deeper self-understanding, reflect back to you your insights, discuss options and goals, then assist you in designing an effective path of healing and change. For those living with breast cancer, I am honored to offer my support as a fellow thriver.
(518) 720-6212 View (518) 720-6212
Photo of Andrea Paola Rodriguez, LMHC
Andrea Paola Rodriguez
LMHC
Verified Verified
Troy, NY 12180
Currently Accepting New Clients - In Person Availibility Are you struggling to enjoy your day to day life? Do you find that the traumatic events of your past are still affecting you? Oftentimes negative events from our past will present themselves at the most inopportune moments, causing us many problems. They sometimes show up as depression, anxiety, isolating ourselves, and repeating negative relationship patterns. If this sounds like something you are struggling with I just want you to know it is not your fault. You are not alone in this and I can help you!
Currently Accepting New Clients - In Person Availibility Are you struggling to enjoy your day to day life? Do you find that the traumatic events of your past are still affecting you? Oftentimes negative events from our past will present themselves at the most inopportune moments, causing us many problems. They sometimes show up as depression, anxiety, isolating ourselves, and repeating negative relationship patterns. If this sounds like something you are struggling with I just want you to know it is not your fault. You are not alone in this and I can help you!
(518) 989-0631 View (518) 989-0631
Photo of Rebecca Freedman, LCSW-R, Clinical Social Work/Therapist
Rebecca Freedman
Clinical Social Work/Therapist, LCSW-R
Verified Verified
Troy, NY 12180  (Online Only)
I love to help my clients achieve their goals. To instill hope that good things are possible and that change can produce positive effects in our lives is the cornerstone of my therapeutic philosophy.
I love to help my clients achieve their goals. To instill hope that good things are possible and that change can produce positive effects in our lives is the cornerstone of my therapeutic philosophy.
(518) 720-7450 View (518) 720-7450
Photo of Nancy H. Dupont, PhD, NS, LP, Licensed Psychoanalyst
Nancy H. Dupont
Licensed Psychoanalyst, PhD, NS, LP
Verified Verified
Troy, NY 12180
Have you ever considered that your feelings are messages that can guide you? Together we can explore these feelings and ways your mind tries to protect you from the discomforts of the past in present situations. The person you need to know and get along with is you. Personal happiness depends upon being mindfully aware of your needs and how to fulfill them. Learn to accept and care for yourself and know that contentment comes from within. Embrace this precious gift of life and make peace with your past and find fulfillment in your present. I am here to support your journey towards inner acceptance, dignity, and love.
Have you ever considered that your feelings are messages that can guide you? Together we can explore these feelings and ways your mind tries to protect you from the discomforts of the past in present situations. The person you need to know and get along with is you. Personal happiness depends upon being mindfully aware of your needs and how to fulfill them. Learn to accept and care for yourself and know that contentment comes from within. Embrace this precious gift of life and make peace with your past and find fulfillment in your present. I am here to support your journey towards inner acceptance, dignity, and love.
(518) 874-0103 View (518) 874-0103
Photo of Vic Steinbiss - Experiential Mental Health Counseling (EMHC), LMHC, Counselor
Experiential Mental Health Counseling (EMHC)
Counselor, LMHC
Not Verified Not Verified
Troy, NY 12180
Waitlist for new clients
We are a practice of mental health counselors who utilizes an integrated approach. We offer individual, couple, and family therapy to those who are looking to work on their emotional, behavioral, and mental health. We provide a safe and genuine space to help clients improve skills to manage symptoms of anxiety, depression, and trauma and work on interpersonal relationships.
We are a practice of mental health counselors who utilizes an integrated approach. We offer individual, couple, and family therapy to those who are looking to work on their emotional, behavioral, and mental health. We provide a safe and genuine space to help clients improve skills to manage symptoms of anxiety, depression, and trauma and work on interpersonal relationships.
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How does your Therapist compare?

Number of Therapists in Troy, NY

100+

Average cost per session

$127

Therapists in Troy, NY who prioritize treating:

93% Anxiety
91% Depression
81% Relationship Issues
79% Self Esteem
74% Trauma and PTSD
68% Life Transitions
64% Coping Skills

Average years in practice

9 Years

Top 3 insurances accepted

62% Aetna
60% UnitedHealthcare UHC | UBH
58% Cigna and Evernorth

How Therapists in Troy, NY see their clients

61% In Person and Online
39% Online Only

Gender breakdown

75% Female
21% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Troy?

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.