Therapists in Kirtland, OH

Photo of Beth Mishkind Roth, MSSA, LISW-S, Clinical Social Work/Therapist
Beth Mishkind Roth
Clinical Social Work/Therapist, MSSA, LISW-S
Verified Verified
1 Endorsed
Kirtland, OH 44094
I specialize in evidenced-based treatments for children, adolescents, and families. My approach to treatment is heavily skill-based, goal oriented, and highly collaborative. I view the parents/guardians as experts in their child, and feel that together, we form a unified team. My practice includes: Anxiety, Adjustment Disorders, Depression, OCD, Parent-Child Conflict/Skill Development, Phobias, and Self-Esteem Enhancement. I also specialize in working with the siblings of children with special needs, including developmental disabilities and special healthcare needs, to address family dynamics and coping skills development.
I specialize in evidenced-based treatments for children, adolescents, and families. My approach to treatment is heavily skill-based, goal oriented, and highly collaborative. I view the parents/guardians as experts in their child, and feel that together, we form a unified team. My practice includes: Anxiety, Adjustment Disorders, Depression, OCD, Parent-Child Conflict/Skill Development, Phobias, and Self-Esteem Enhancement. I also specialize in working with the siblings of children with special needs, including developmental disabilities and special healthcare needs, to address family dynamics and coping skills development.
(216) 868-7258 View (216) 868-7258
Photo of Natasha Brown, BS, MA, LMFT, Marriage & Family Therapist
Natasha Brown
Marriage & Family Therapist, BS, MA, LMFT
Verified Verified
2 Endorsed
Kirtland, OH 44094
If your marriage is struggling I can help you! I believe many of our greatest joys as well as our life challenges come from our relationships with those who are important to us. When these relationships struggle, we struggle. While seeking outside help during these challenging times can be difficult, you don't have to struggle alone. I am passionate about working with couples, families, and individuals in a way that allows them to move forward in their lives and relationships with more hope, happiness and understanding.
If your marriage is struggling I can help you! I believe many of our greatest joys as well as our life challenges come from our relationships with those who are important to us. When these relationships struggle, we struggle. While seeking outside help during these challenging times can be difficult, you don't have to struggle alone. I am passionate about working with couples, families, and individuals in a way that allows them to move forward in their lives and relationships with more hope, happiness and understanding.
(307) 466-7465 View (307) 466-7465
Photo of Renee R Molzon - Renee R Molzon Counseling, LLC, LISW-S, Clinical Social Work/Therapist
Renee R Molzon Counseling, LLC
Clinical Social Work/Therapist, LISW-S
Verified Verified
1 Endorsed
Kirtland, OH 44094
Waitlist for new clients
You know yourself best. I would love to help you bring out the best in yourself. I believe in a client centered approach to therapy. We will focus on your needs and concerns to develop an appropriate plan. I work with individuals who are dealing with mood disorders, dual diagnosis, grief, anxiety, depression, and those who have, or whose loved ones have, a chronic illness or dementia. I utilize many treatment methods to provide the support and education that you are requesting. We will complete a diagnostic assessment in order to develop the best course of treatment for you or your family.
You know yourself best. I would love to help you bring out the best in yourself. I believe in a client centered approach to therapy. We will focus on your needs and concerns to develop an appropriate plan. I work with individuals who are dealing with mood disorders, dual diagnosis, grief, anxiety, depression, and those who have, or whose loved ones have, a chronic illness or dementia. I utilize many treatment methods to provide the support and education that you are requesting. We will complete a diagnostic assessment in order to develop the best course of treatment for you or your family.
(440) 276-3949 View (440) 276-3949
Photo of Joseph A Cirino, LISW-S, Clinical Social Work/Therapist
Joseph A Cirino
Clinical Social Work/Therapist, LISW-S
Verified Verified
1 Endorsed
Kirtland, OH 44094
I believe in developing a strong therapeutic & trusting relationship where you can feel safe and valued. I'm trained in family system theory and understand the social, behavioral, emotional, and cognitive challenges many encounter. I use evidence-based modalities such as CBT, Solution-Focused Brief Therapy, Mindfulness, Talk Therapy, and the use of Eye Movement Desensitization and Reprocessing (EMDR) through The Institute For Creative Mindfulness, an approved EMDRIA training facility. I work hard to become your partner on a journey where you hold the flashlight and at times, direct your attention to illuminate the unseen.
I believe in developing a strong therapeutic & trusting relationship where you can feel safe and valued. I'm trained in family system theory and understand the social, behavioral, emotional, and cognitive challenges many encounter. I use evidence-based modalities such as CBT, Solution-Focused Brief Therapy, Mindfulness, Talk Therapy, and the use of Eye Movement Desensitization and Reprocessing (EMDR) through The Institute For Creative Mindfulness, an approved EMDRIA training facility. I work hard to become your partner on a journey where you hold the flashlight and at times, direct your attention to illuminate the unseen.
(440) 294-8428 View (440) 294-8428

More Therapists Nearby

Photo of Stephanie Cerula, LPCC, Counselor
Stephanie Cerula
Counselor, LPCC
Verified Verified
3 Endorsed
Willoughby, OH 44094  (Online Only)
Are you feeling imbalance in your life due to stress, anxiety, depression, or trauma? I am focused on assisting you in achieving your best self and regaining your balance. I practice client centered therapy which creates a welcoming environment that is safe for you to explore your thoughts and feelings. I utilize a strengths-based, collaborative approach to support you in overcoming life's challenges that prevent you from reaching your goals. I have extensive training and experience working with survivors of sexual assault, domestic violence, trauma, and PTSD.
Are you feeling imbalance in your life due to stress, anxiety, depression, or trauma? I am focused on assisting you in achieving your best self and regaining your balance. I practice client centered therapy which creates a welcoming environment that is safe for you to explore your thoughts and feelings. I utilize a strengths-based, collaborative approach to support you in overcoming life's challenges that prevent you from reaching your goals. I have extensive training and experience working with survivors of sexual assault, domestic violence, trauma, and PTSD.
(440) 220-6746 View (440) 220-6746
Photo of Amy Lomis, MSSA, LISW-S, Clinical Social Work/Therapist
Amy Lomis
Clinical Social Work/Therapist, MSSA, LISW-S
Verified Verified
1 Endorsed
Mentor, OH 44060
Having difficulty managing negative thoughts, feelings. and behaviors? Is this impacting your daily functioning and your relationship with yourself and others? Are you wanting to feel your best and ultimately live your best life?
Having difficulty managing negative thoughts, feelings. and behaviors? Is this impacting your daily functioning and your relationship with yourself and others? Are you wanting to feel your best and ultimately live your best life?
(440) 271-5862 View (440) 271-5862
Photo of Bill Smith, LISW, Clinical Social Work/Therapist
Bill Smith
Clinical Social Work/Therapist, LISW
Verified Verified
Willoughby, OH 44095
Bill Smith is a licensed independent therapist in Ohio and Florida and is in the Willoughby hills office seasonally. He has received training at the Milton Erickson Foundation in hypnosis and brief therapy and is a member of the American Society of Clinical Hypnosis. He has supervised clinical staff and graduate students, trained professionals in family and strategic therapy and has been an adjunct professor in the graduate school at Cleveland State University. His therapy style is problem focused and solution oriented based on the following beliefs: 1.
Bill Smith is a licensed independent therapist in Ohio and Florida and is in the Willoughby hills office seasonally. He has received training at the Milton Erickson Foundation in hypnosis and brief therapy and is a member of the American Society of Clinical Hypnosis. He has supervised clinical staff and graduate students, trained professionals in family and strategic therapy and has been an adjunct professor in the graduate school at Cleveland State University. His therapy style is problem focused and solution oriented based on the following beliefs: 1.
(440) 379-1536 View (440) 379-1536
Photo of Faith Beddick, Licensed Professional Counselor
Faith Beddick
Licensed Professional Counselor
Verified Verified
Willoughby, OH 44095  (Online Only)
You deserve to live a life that allows you to be who you truly are and release what no longer serves you. Faith will support you in the process of self-discovery. You will work collaboratively to choose goals and find ways that suit you best for achieving your goals. Whether you are experiencing anxiety, depression, relationship difficulties, or stress, there is hope. Often, our troubles feel as if we are walking alone on a dark path. Faith would be honored to join you on this journey, holding the flashlight to help you find your way, then passing you the flashlight when you are ready to continue on your own with a renewed sense of
You deserve to live a life that allows you to be who you truly are and release what no longer serves you. Faith will support you in the process of self-discovery. You will work collaboratively to choose goals and find ways that suit you best for achieving your goals. Whether you are experiencing anxiety, depression, relationship difficulties, or stress, there is hope. Often, our troubles feel as if we are walking alone on a dark path. Faith would be honored to join you on this journey, holding the flashlight to help you find your way, then passing you the flashlight when you are ready to continue on your own with a renewed sense of
(614) 412-8849 View (614) 412-8849
Photo of Emma Bogard, MSSA, LISW-S, Clinical Social Work/Therapist
Emma Bogard
Clinical Social Work/Therapist, MSSA, LISW-S
Verified Verified
1 Endorsed
Willoughby, OH 44094
Not accepting new clients
I find passion in empowering others to help them develop skills in order to become the best person they can be. I believe in helping clients identify and use their strengths to help overcome difficulties, whether it is struggling with managing life stressors or chronic mental illness. I have provided counseling to children and adolescents with symptoms of anxiety, depression, oppositional defiant disorder, and ADHD. I enjoy working with clients in the LGBTQ+ population, and I also have had training in trauma focused cognitive behavioral therapy.
I find passion in empowering others to help them develop skills in order to become the best person they can be. I believe in helping clients identify and use their strengths to help overcome difficulties, whether it is struggling with managing life stressors or chronic mental illness. I have provided counseling to children and adolescents with symptoms of anxiety, depression, oppositional defiant disorder, and ADHD. I enjoy working with clients in the LGBTQ+ population, and I also have had training in trauma focused cognitive behavioral therapy.
(216) 503-2267 View (216) 503-2267
Photo of Patricia Fields Wright, Drug & Alcohol Counselor
Patricia Fields Wright
Drug & Alcohol Counselor
Verified Verified
Willoughby, OH 44095  (Online Only)
First of all, thank you for reaching out and giving yourself a chance to find answers. Life today can be full of challenges and struggles to meet those challenges resulting in feelings of anger, resentment, depression, anxiety and just lost with no answers. I understand how it feels when it seems there is no one who understands, or you may not even understand yourself. But guess what? You do have all the answers; they are within you. It just takes someone to help you birth them and I can do that—with no judgment. I can not only suggest what to do; but how to do it
First of all, thank you for reaching out and giving yourself a chance to find answers. Life today can be full of challenges and struggles to meet those challenges resulting in feelings of anger, resentment, depression, anxiety and just lost with no answers. I understand how it feels when it seems there is no one who understands, or you may not even understand yourself. But guess what? You do have all the answers; they are within you. It just takes someone to help you birth them and I can do that—with no judgment. I can not only suggest what to do; but how to do it
(220) 235-5631 View (220) 235-5631
Photo of John A Glovan, PsyD, Psychologist
John A Glovan
Psychologist, PsyD
Verified Verified
2 Endorsed
Willoughby, OH 44094
INTENSIVE OUTPATIENT PROGRAM (IOP) Exhausted, stressed, overwhelmed? Unable to accomplish day to day activities, your job or schoolwork? Struggling with pain, stomach issues, high blood pressure or diabetes? Can't sleep, concentrate or have changes in your appetite or weight? Been more frustrated and irritable? Are you depressed and anxious and don't know where to turn? You don't need to suffer in silence anymore. I developed the Health and Wellness Intensive Outpatient Program with cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and proven coping skills to help you reclaim yourself and your life!
INTENSIVE OUTPATIENT PROGRAM (IOP) Exhausted, stressed, overwhelmed? Unable to accomplish day to day activities, your job or schoolwork? Struggling with pain, stomach issues, high blood pressure or diabetes? Can't sleep, concentrate or have changes in your appetite or weight? Been more frustrated and irritable? Are you depressed and anxious and don't know where to turn? You don't need to suffer in silence anymore. I developed the Health and Wellness Intensive Outpatient Program with cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and proven coping skills to help you reclaim yourself and your life!
(440) 261-4276 View (440) 261-4276
Photo of Jennifer N Rauzan, MEd, LPCC
Jennifer N Rauzan
Licensed Professional Clinical Counselor, MEd, LPCC
Verified Verified
Willoughby, OH 44094
**DAY TIME AVAILABILITY ONLY** I believe that change is always possible. My approach is direct and genuine, hopefully insightful, and certainly empathetic. I specialize in working with self harm and suicidal adolescents as well as anxious and depressed adults. I can help you develop effective communication skills, increase your ability to express and handle emotions effectively, to be aware of your needs, and to learn how to resolve conflict successfully.
**DAY TIME AVAILABILITY ONLY** I believe that change is always possible. My approach is direct and genuine, hopefully insightful, and certainly empathetic. I specialize in working with self harm and suicidal adolescents as well as anxious and depressed adults. I can help you develop effective communication skills, increase your ability to express and handle emotions effectively, to be aware of your needs, and to learn how to resolve conflict successfully.
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Photo of Alicia Thomas - Alicia Thomas, M.Ed., LPCC, MEd, LPCC-S
Alicia Thomas, M.Ed., LPCC
Licensed Professional Clinical Counselor, MEd, LPCC-S
Verified Verified
2 Endorsed
Willoughby, OH 44094
Sometimes it feels like life is just too hard, or you aren't getting the most from it. Maybe you've been trying to change, but don't know how. That's where I come in! I provide a safe, non-judgmental space to tell your story, learn about yourself, and build upon strengths you already possess. Dealing with stress and sadness can get easier. I treat individuals and couples ages 16 and up using many treatment modalities. Overall, I use a person-centered or holistic style to develop a plan which best suits each of my clients.
Sometimes it feels like life is just too hard, or you aren't getting the most from it. Maybe you've been trying to change, but don't know how. That's where I come in! I provide a safe, non-judgmental space to tell your story, learn about yourself, and build upon strengths you already possess. Dealing with stress and sadness can get easier. I treat individuals and couples ages 16 and up using many treatment modalities. Overall, I use a person-centered or holistic style to develop a plan which best suits each of my clients.
(440) 424-4674 View (440) 424-4674
Photo of Emily Tamas
Emily Tamas
Licensed Professional Clinical Counselor
Verified Verified
Willoughby, OH 44095  (Online Only)
I graduated in 2014 from Walsh University with a Bachelor's in Behavioral Science. I began my career in mental health as a case manager, assisting clients with a wide range of severe and persistent mental illness. In 2017 I graduated with my Master's in Counseling and Human Development. As a licensed therapist I have worked with transitional aged youth and served as a Team Lead for a group that focuses on transition to independence for young adults. I have also done home based therapy for two years with clients diagnosed with OCD, PTSD, Hoarding Disorder, and Agoraphobia.
I graduated in 2014 from Walsh University with a Bachelor's in Behavioral Science. I began my career in mental health as a case manager, assisting clients with a wide range of severe and persistent mental illness. In 2017 I graduated with my Master's in Counseling and Human Development. As a licensed therapist I have worked with transitional aged youth and served as a Team Lead for a group that focuses on transition to independence for young adults. I have also done home based therapy for two years with clients diagnosed with OCD, PTSD, Hoarding Disorder, and Agoraphobia.
(216) 279-6612 View (216) 279-6612
Photo of Kim Cowles, MSSA, LISW, Clinical Social Work/Therapist
Kim Cowles
Clinical Social Work/Therapist, MSSA, LISW
Verified Verified
Mentor, OH 44060
Not accepting new clients
Are you going through a lot? Do you feel as though friends or family just don't quite understand? Do you feel like you're not getting the adequate support you need? Are you wondering where to turn next? I'm here to help you. Together we'll talk things out, navigate these tough times, build coping skills, and get you where you want to be. Life can be so challenging. There's no shame in reaching out for help. Whether it's grief, marital/relationship issues, depression, or trauma, contact me at Insight Counseling and Wellness to begin your road to wellness! 440-701-6170.
Are you going through a lot? Do you feel as though friends or family just don't quite understand? Do you feel like you're not getting the adequate support you need? Are you wondering where to turn next? I'm here to help you. Together we'll talk things out, navigate these tough times, build coping skills, and get you where you want to be. Life can be so challenging. There's no shame in reaching out for help. Whether it's grief, marital/relationship issues, depression, or trauma, contact me at Insight Counseling and Wellness to begin your road to wellness! 440-701-6170.
(440) 271-8156 View (440) 271-8156
Photo of Alyssa Butler, CT, Pre-Licensed Professional
Alyssa Butler
Pre-Licensed Professional, CT
Verified Verified
1 Endorsed
Mentor, OH 44060
My name is Alyssa; and I am a Clinical Mental Health Counseling Intern. I have a special interest of working with children, adolescents, and young adults with anxiety disorder, depression, ADHD, life transitions, and interpersonal communication. My goal is to help you grow no matter what you are going through.
My name is Alyssa; and I am a Clinical Mental Health Counseling Intern. I have a special interest of working with children, adolescents, and young adults with anxiety disorder, depression, ADHD, life transitions, and interpersonal communication. My goal is to help you grow no matter what you are going through.
(440) 805-2461 x100 View (440) 805-2461 x100
Photo of Matthew Geraldi, LPCC-S, LICDC
Matthew Geraldi
Licensed Professional Clinical Counselor, LPCC-S, LICDC
Verified Verified
2 Endorsed
Mentor, OH 44060  (Online Only)
Mental Health and substance use awareness is growing more and more each day. Anyone should be welcomed with open arms to work through issues that create a dark cloud over their happiness. Working as a team and at a pace where you are comfortable is the goal that we will work to progress towards. There is not a concrete formula to happiness or managing our inner demons, but we can create one and I would be honored to help you on your journey.
Mental Health and substance use awareness is growing more and more each day. Anyone should be welcomed with open arms to work through issues that create a dark cloud over their happiness. Working as a team and at a pace where you are comfortable is the goal that we will work to progress towards. There is not a concrete formula to happiness or managing our inner demons, but we can create one and I would be honored to help you on your journey.
(440) 683-6532 View (440) 683-6532
Photo of Janeane Grisez Art Therapist And Counselor, ATR-BC, LPCC-S, LICDC-S, GAMB
Janeane Grisez Art Therapist And Counselor
Licensed Professional Clinical Counselor, ATR-BC, LPCC-S, LICDC-S, GAMB
Verified Verified
Willoughby, OH 44094
Reaching out for help can be an overwhelming process that requires you to be courageous and vulnerable. When you are feeling sad, disconnected, hopeless, and uncomfortable in your own skin, the obstacles you face may seem hard to overcome. You have now taken the first step towards wellness and it is no longer out of your reach. I am glad you are here, especially if you may be feeling stressed and trapped in a world that just does not understand.
Reaching out for help can be an overwhelming process that requires you to be courageous and vulnerable. When you are feeling sad, disconnected, hopeless, and uncomfortable in your own skin, the obstacles you face may seem hard to overcome. You have now taken the first step towards wellness and it is no longer out of your reach. I am glad you are here, especially if you may be feeling stressed and trapped in a world that just does not understand.
(216) 930-2956 View (216) 930-2956
Photo of Bryan Traband
Bryan Traband
Licensed Professional Clinical Counselor
Verified Verified
Willoughby, OH 44095  (Online Only)
He is a Licensed Professional Clinical Counselor and an Independent Chemical Dependency Counselor in the State of Ohio. He provided services and consistently updates for training in working with trauma, anxiety, depression, communication in marriage and relationships while providing telehealth services since 2020.
He is a Licensed Professional Clinical Counselor and an Independent Chemical Dependency Counselor in the State of Ohio. He provided services and consistently updates for training in working with trauma, anxiety, depression, communication in marriage and relationships while providing telehealth services since 2020.
(220) 241-1067 View (220) 241-1067
Photo of John D Ludway, Ed Sp, LPCC, Counselor
John D Ludway
Counselor, Ed Sp, LPCC
Verified Verified
Willoughby, OH 44094
We all struggle with life issues! None of us are meant to do this thing called LIFE alone. I want to help you find that 'missing piece,' that was left behind through trauma, family issues, personal decisions, and mental health or drug issues.
We all struggle with life issues! None of us are meant to do this thing called LIFE alone. I want to help you find that 'missing piece,' that was left behind through trauma, family issues, personal decisions, and mental health or drug issues.
(440) 434-3599 View (440) 434-3599

See more therapy options for Kirtland

How does your Therapist compare?

Number of Therapists in Kirtland, OH

< 10

Therapists in Kirtland, OH who prioritize treating:

100% Depression
100% Anxiety
100% Coping Skills
100% Self Esteem
75% Relationship Issues
75% ADHD
75% Life Coaching

Average years in practice

19 Years

Top 3 insurances accepted

100% Medical Mutual
67% Aetna
67% Cigna and Evernorth

How Therapists in Kirtland, OH see their clients

100% In Person and Online

Gender breakdown

75% Female
25% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Kirtland?

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.