Therapists in Wasco County, OR

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Photo of Jonathan Chiaravalle, MA, LPC, Licensed Professional Counselor
Jonathan Chiaravalle
Licensed Professional Counselor, MA, LPC
Verified Verified
1 Endorsed
The Dalles, OR 97058  (Online Only)
Working in the field of human services since 1988, I bring an understanding and experience around the issues of relationships, sexuality, depression, anxiety, teen life issues and transitions. I work with these issues because our culture does not address them in helpful ways. I help and encourage you to develop tools and skills for success in your life. Using tools from a mindful, humanistic & cognitive/behavioral orientation, we work together to help you focus on your situation and what will work to create change/healing in your life. I work with individuals and couples.
Working in the field of human services since 1988, I bring an understanding and experience around the issues of relationships, sexuality, depression, anxiety, teen life issues and transitions. I work with these issues because our culture does not address them in helpful ways. I help and encourage you to develop tools and skills for success in your life. Using tools from a mindful, humanistic & cognitive/behavioral orientation, we work together to help you focus on your situation and what will work to create change/healing in your life. I work with individuals and couples.
(541) 705-7045 View (541) 705-7045
Photo of Jen Mathisen - Jen Mathisen Counseling, LLC, MA, Pre-Licensed Professional
Jen Mathisen Counseling, LLC
Pre-Licensed Professional, MA
Verified Verified
The Dalles, OR 97058
WHEN YOU JUST NEED SOMEONE TO HEAR YOUR STORY. I am a faith-based counselor committed to helping my clients find solutions for the places they may feel "stuck". My training allows me to work with young children, adolescents, adults, couples, and families. Together we would utilize a collaborative approach to help you meet your goals. I am a professional counselor associate in both Oregon and Washington.
WHEN YOU JUST NEED SOMEONE TO HEAR YOUR STORY. I am a faith-based counselor committed to helping my clients find solutions for the places they may feel "stuck". My training allows me to work with young children, adolescents, adults, couples, and families. Together we would utilize a collaborative approach to help you meet your goals. I am a professional counselor associate in both Oregon and Washington.
(458) 200-4004 View (458) 200-4004
Photo of Joshua Ott, MA, Licensed Professional Counselor
Joshua Ott
Licensed Professional Counselor, MA
Verified Verified
The Dalles, OR 97058
Not accepting new clients
You are taking a courageous step in reaching out for help. I hope you will find the right person for you. Personally, I believe safety and comfort are key to any helpful relationship and my hope is that if we choose to work together we can create a space for you to be yourself over a cup of tea and good conversation. I offer a warm invitational approach to life's complications and I want to stay curious about you as growing person, your values, challenges and strengths. I offer dynamic approaches to mental health therapy and I make efforts to listen and tailor treatment to you! Healing is done together.
You are taking a courageous step in reaching out for help. I hope you will find the right person for you. Personally, I believe safety and comfort are key to any helpful relationship and my hope is that if we choose to work together we can create a space for you to be yourself over a cup of tea and good conversation. I offer a warm invitational approach to life's complications and I want to stay curious about you as growing person, your values, challenges and strengths. I offer dynamic approaches to mental health therapy and I make efforts to listen and tailor treatment to you! Healing is done together.
(458) 204-0110 View (458) 204-0110
Photo of William T Shanahan, L, P, C, Licensed Professional Counselor
William T Shanahan
Licensed Professional Counselor, L, P, C
Verified Verified
Mosier, OR 97040
My client had the courage to come to counseling to resolve their anger issues Their goal is to resolve anger at the root to face whatever it is they are unwilling to feel They wii know they achieved their goal when they feel more present and aware and with a larger self they will continue to flourish.
My client had the courage to come to counseling to resolve their anger issues Their goal is to resolve anger at the root to face whatever it is they are unwilling to feel They wii know they achieved their goal when they feel more present and aware and with a larger self they will continue to flourish.
(541) 827-8066 View (541) 827-8066
Photo of Kristen Fourcade, MSW, LCSW, Clinical Social Work/Therapist
Kristen Fourcade
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
The Dalles, OR 97058
Not accepting new clients
Accepting clients to a waitlist for sessions via secure Telehealth video. For those looking to reduce stress and anxiety, improve mood, strengthen relationships, or build out a toolbox for mental resilience, working with a therapist is a tried and true method. Finding the right therapist is an important first step in the process, and I want to be the best fit for you and your needs. My therapeutic style focuses on insight and compassion and supports anyone looking for help and personal growth. SPECIALTIES: Age 13+, Anxiety and stress, Depression, Life transitions, Relationship issues, Trauma and PTSD, IDD, Psychosis
Accepting clients to a waitlist for sessions via secure Telehealth video. For those looking to reduce stress and anxiety, improve mood, strengthen relationships, or build out a toolbox for mental resilience, working with a therapist is a tried and true method. Finding the right therapist is an important first step in the process, and I want to be the best fit for you and your needs. My therapeutic style focuses on insight and compassion and supports anyone looking for help and personal growth. SPECIALTIES: Age 13+, Anxiety and stress, Depression, Life transitions, Relationship issues, Trauma and PTSD, IDD, Psychosis
(458) 217-6319 View (458) 217-6319
Photo of Donna C Henderson, LCSW, Clinical Social Work/Therapist
Donna C Henderson
Clinical Social Work/Therapist, LCSW
Verified Verified
Maupin, OR 97037  (Online Only)
Not accepting new clients
Interested in removing obstacles in the way of a more joyous and meaningful life? I'm here to help. I offer a strengths-based, collaborative and client-centered approach to finding solutions to a wide range of life challenges and psychological issues Drawing on (and trained in) a multitude of evidence-based styles and techniques, I work with adults, older adolescents, couples (gay and straight), to help each client identify and achieve his or her personal therapy goals. I am also a certified practitioner of Reiki, which is a powerful yet gentle stress-reduction technique.
Interested in removing obstacles in the way of a more joyous and meaningful life? I'm here to help. I offer a strengths-based, collaborative and client-centered approach to finding solutions to a wide range of life challenges and psychological issues Drawing on (and trained in) a multitude of evidence-based styles and techniques, I work with adults, older adolescents, couples (gay and straight), to help each client identify and achieve his or her personal therapy goals. I am also a certified practitioner of Reiki, which is a powerful yet gentle stress-reduction technique.
(503) 766-5661 View (503) 766-5661
Photo of Suzanne Elton, PhD, LPC, LMHC, Licensed Professional Counselor
Suzanne Elton
Licensed Professional Counselor, PhD, LPC, LMHC
Verified Verified
The Dalles, OR 97058
Waitlist for new clients
A life long learner, the focus of my current work has been the completion of a PhD in Depth Psychology and furthering my knowledge and skill in helping men and women heal from trauma. I find success working with those who are igniting that warrior spark—moving forwards through difficult transitions in life. Many are healing from old, unhealthy patterns in relationships. I like to provide a safe, nonjudgemental environment for you to work through your distress. I provide a straight-forward and practical approach, as well as working in depth with those clients desiring an in-depth therapeutic process.
A life long learner, the focus of my current work has been the completion of a PhD in Depth Psychology and furthering my knowledge and skill in helping men and women heal from trauma. I find success working with those who are igniting that warrior spark—moving forwards through difficult transitions in life. Many are healing from old, unhealthy patterns in relationships. I like to provide a safe, nonjudgemental environment for you to work through your distress. I provide a straight-forward and practical approach, as well as working in depth with those clients desiring an in-depth therapeutic process.
(971) 315-4823 View (971) 315-4823
Photo of Kathleen Marie Green, LCSW, QMHP, Clinical Social Work/Therapist
Kathleen Marie Green
Clinical Social Work/Therapist, LCSW, QMHP
Verified Verified
The Dalles, OR 97058  (Online Only)
Waitlist for new clients
If you are here, I want to help! I believe that therapy is meant to empower clients to know that they are capable of change and living a fuller, more integrated life. I work with adolescents and adults, utilizing a bio-psychosocial-spiritual approach in therapy with the goal of creating a safe haven for clients. This simply means integrating the many parts of a person into therapy in the hope of improving one’s emotional, spiritual and physical well-being. I also aspire to explore the impact of significant relationships and the influence of larger social systems on a client's sense of wholeness and ability to achieve desired growth.
If you are here, I want to help! I believe that therapy is meant to empower clients to know that they are capable of change and living a fuller, more integrated life. I work with adolescents and adults, utilizing a bio-psychosocial-spiritual approach in therapy with the goal of creating a safe haven for clients. This simply means integrating the many parts of a person into therapy in the hope of improving one’s emotional, spiritual and physical well-being. I also aspire to explore the impact of significant relationships and the influence of larger social systems on a client's sense of wholeness and ability to achieve desired growth.
(458) 243-4702 View (458) 243-4702
Photo of Scott Urban - Scott Urban, Urban Counseling, LLC, LCPC, LPC, MCoun, Counselor
Scott Urban, Urban Counseling, LLC
Counselor, LCPC, LPC, MCoun
Verified Verified
The Dalles, OR 97058
Hello! I am currently accepting new clients in-person or video telehealth. Life poses challenges to us all, and I collaborate with my clients to help them to understand and to process difficult life situations, and to build on their strengths and develop new coping strategies. My focus is helping teens and adults address symptoms of anxiety and depression caused by various difficult life experiences, and to develop skills supporting your desire for improved communication, relationships, personal growth, resilience and self-esteem.
Hello! I am currently accepting new clients in-person or video telehealth. Life poses challenges to us all, and I collaborate with my clients to help them to understand and to process difficult life situations, and to build on their strengths and develop new coping strategies. My focus is helping teens and adults address symptoms of anxiety and depression caused by various difficult life experiences, and to develop skills supporting your desire for improved communication, relationships, personal growth, resilience and self-esteem.
(208) 391-5457 View (208) 391-5457
Photo of Monique Adams, LCSW, LICSW, CADCIII, MAC, SUDP, Clinical Social Work/Therapist
Monique Adams
Clinical Social Work/Therapist, LCSW, LICSW, CADCIII, MAC, SUDP
Verified Verified
The Dalles, OR 97058  (Online Only)
I love to see people who are exploring helping themselves achieve a better space in their life. Many people are suffering, yet they aren't quite sure the next steps. I have experience working with many issues that can make you feel as if you have lost your path or wanting something more out of life. I try to adapt my style to your particular needs and take a collaborative approach, yet guided to therapy sessions. Sometimes we need a safe place to process our thoughts.
I love to see people who are exploring helping themselves achieve a better space in their life. Many people are suffering, yet they aren't quite sure the next steps. I have experience working with many issues that can make you feel as if you have lost your path or wanting something more out of life. I try to adapt my style to your particular needs and take a collaborative approach, yet guided to therapy sessions. Sometimes we need a safe place to process our thoughts.
(458) 217-8066 View (458) 217-8066
Photo of John Christopher Burton, PsyD, Psychologist
John Christopher Burton
Psychologist, PsyD
Verified Verified
1 Endorsed
The Dalles, OR 97058
Waitlist for new clients
My primary focus is couple therapy. I am a trained Certified EFT Therapist. EFT stands for Emotionally Focused Therapy for Couples and is far and away the best treatment for couples. I have successfully treated couples who struggled with communication issues, infidelity, childhood trauma, attachment concerns, and emotional disconnect. As an EFT therapist I have worked with many couples in which one of the partners has ADHD. I also treat trauma using EMDR therapy with individuals and in the couple setting.
My primary focus is couple therapy. I am a trained Certified EFT Therapist. EFT stands for Emotionally Focused Therapy for Couples and is far and away the best treatment for couples. I have successfully treated couples who struggled with communication issues, infidelity, childhood trauma, attachment concerns, and emotional disconnect. As an EFT therapist I have worked with many couples in which one of the partners has ADHD. I also treat trauma using EMDR therapy with individuals and in the couple setting.
(541) 203-6821 View (541) 203-6821
Photo of Scott Rower, PhD, Psychologist
Scott Rower
Psychologist, PhD
Verified Verified
1 Endorsed
The Dalles, OR 97058
The main issues I help people to work through are anxiety, depression, trauma, insecurity/self-esteem, trust/openness & excessive standards. You can go to my website to read more about these specialties & what therapy with me looks like.
The main issues I help people to work through are anxiety, depression, trauma, insecurity/self-esteem, trust/openness & excessive standards. You can go to my website to read more about these specialties & what therapy with me looks like.
(541) 824-0675 View (541) 824-0675
Photo of Paul Grim, LMHC, Counselor
Paul Grim
Counselor, LMHC
Verified Verified
1 Endorsed
The Dalles, OR 97058
Please visit my website www.whitesalmoncounseling.com in order to request a session and to learn more about me. My approach is called "integrative" counseling which is a blend of several different counseling methods and theories. I can do brief solution-oriented counseling or longer term insight-oriented counseling which emphasizes personal growth and transformation. Each client is unique, therefore the therapy should be customized and flexible. With most clients, I focus on their entire lifestyle including physical activity, diet, sleep, work, purpose, and relationships. I'm a big fan of Maslow's Hierarchy of Needs.
Please visit my website www.whitesalmoncounseling.com in order to request a session and to learn more about me. My approach is called "integrative" counseling which is a blend of several different counseling methods and theories. I can do brief solution-oriented counseling or longer term insight-oriented counseling which emphasizes personal growth and transformation. Each client is unique, therefore the therapy should be customized and flexible. With most clients, I focus on their entire lifestyle including physical activity, diet, sleep, work, purpose, and relationships. I'm a big fan of Maslow's Hierarchy of Needs.
(509) 774-5579 View (509) 774-5579
Photo of Dr. Alex Pinchot, ND
Dr. Alex Pinchot
ND
Verified Verified
The Dalles, OR 97058
Those that I work with describe me as receptive, kind, extremely engaged and at times even challenging. I am not a passive listener; my therapy work takes the form of an active, two-way dialogue. While my style is compassionate, informal, and truly nonjudgmental, I believe it is often essential for our default positions to be explored within a safe context. Good therapy provides the help of someone trained to see and artfully communicate what we sometimes cannot see ourselves. The therapeutic relationship must be compassionate, open-hearted, and enjoyable, yet honest.
Those that I work with describe me as receptive, kind, extremely engaged and at times even challenging. I am not a passive listener; my therapy work takes the form of an active, two-way dialogue. While my style is compassionate, informal, and truly nonjudgmental, I believe it is often essential for our default positions to be explored within a safe context. Good therapy provides the help of someone trained to see and artfully communicate what we sometimes cannot see ourselves. The therapeutic relationship must be compassionate, open-hearted, and enjoyable, yet honest.
(458) 235-4819 View (458) 235-4819
Photo of Lisa Makinson, LPC, Licensed Professional Counselor
Lisa Makinson
Licensed Professional Counselor, LPC
Verified Verified
The Dalles, OR 97058
Not accepting new clients
Sometimes we have a nagging thought that something isn't going right in our lives or we notice a pattern that keeps happening over and over, but we wait so long to call and get help. Making that call can be so hard, but it is so worth it. Whether you have trauma, anxiety, depression, or difficulty in relationships - whatever is bothering you, a collaborative therapeutic relationship can help you learn the skills to cope with what life brings you and get you feeling better about yourself and your path. We all want to feel connected, heard, and understood and deserve a safe space to figure things out with a therapist who listens.
Sometimes we have a nagging thought that something isn't going right in our lives or we notice a pattern that keeps happening over and over, but we wait so long to call and get help. Making that call can be so hard, but it is so worth it. Whether you have trauma, anxiety, depression, or difficulty in relationships - whatever is bothering you, a collaborative therapeutic relationship can help you learn the skills to cope with what life brings you and get you feeling better about yourself and your path. We all want to feel connected, heard, and understood and deserve a safe space to figure things out with a therapist who listens.
(541) 399-8266 View (541) 399-8266
Photo of Lauren Justice, PhD, Psychologist
Lauren Justice
Psychologist, PhD
Verified Verified
The Dalles, OR 97058
Not accepting new clients
To help you resolve problems in your mind, body, relationships, and lifestyle, I will work with you to improve your understanding of the source of your distress and refocus on what you value most. Depending on your preference, our work together may draw from traditional treatment approaches or utilize yoga therapy and mindfulness techniques. I enjoy guiding individuals and couples interested in finding the best way to overcome difficult relationship patterns, health-related problems, anxiety, depression, and trauma.
To help you resolve problems in your mind, body, relationships, and lifestyle, I will work with you to improve your understanding of the source of your distress and refocus on what you value most. Depending on your preference, our work together may draw from traditional treatment approaches or utilize yoga therapy and mindfulness techniques. I enjoy guiding individuals and couples interested in finding the best way to overcome difficult relationship patterns, health-related problems, anxiety, depression, and trauma.
(971) 754-1659 View (971) 754-1659
Photo of Tony DiCenzo, MA, LMFT, QMHP, Marriage & Family Therapist
Tony DiCenzo
Marriage & Family Therapist, MA, LMFT, QMHP
Verified Verified
The Dalles, OR 97058
When pain lingers long enough or becomes greater than our ability to keep pushing forward, we finally become willing to do whatever it takes to get relief. Psychological and emotional distress affects our sleep, our eating behaviors, use of alcohol and other drugs, our well-being, and our ability to function at home, work, and in our relationships. We're often plagued by fear, anxiety, anger, frustration, confusion, depression, self-doubt, failure, hopelessness, and even total despair.
When pain lingers long enough or becomes greater than our ability to keep pushing forward, we finally become willing to do whatever it takes to get relief. Psychological and emotional distress affects our sleep, our eating behaviors, use of alcohol and other drugs, our well-being, and our ability to function at home, work, and in our relationships. We're often plagued by fear, anxiety, anger, frustration, confusion, depression, self-doubt, failure, hopelessness, and even total despair.
(458) 218-8592 View (458) 218-8592
Photo of Emily Jimenez, LCSW, LICSW, Clinical Social Work/Therapist
Emily Jimenez
Clinical Social Work/Therapist, LCSW, LICSW
Verified Verified
2 Endorsed
The Dalles, OR 97058
My practice focuses on where you feel you need support. I take a holistic and individualized approach with each client. As we work together, we will utilize a combination of therapeutic approaches to best support you, your needs and goals.
My practice focuses on where you feel you need support. I take a holistic and individualized approach with each client. As we work together, we will utilize a combination of therapeutic approaches to best support you, your needs and goals.
(541) 667-9394 View (541) 667-9394
Photo of Angie Arledge, CSWA, SWA
Angie Arledge
Clinical Social Work Associate, CSWA, SWA
Verified Verified
The Dalles, OR 97058  (Online Only)
Currently Taking New Clients in Oregon and Washington states. My passion is to walk alongside individuals to support them in finding their strengths. I am compassionate and will meet you where you are at. I think that self-investing and community care are essential to our mental wellness, and together I will walk alongside you on your journey of finding that contentment you are searching for. I will provide a safe, non-judgmental space for you to process through and collaborate in finding those safe coping strategies to achieve your goals.
Currently Taking New Clients in Oregon and Washington states. My passion is to walk alongside individuals to support them in finding their strengths. I am compassionate and will meet you where you are at. I think that self-investing and community care are essential to our mental wellness, and together I will walk alongside you on your journey of finding that contentment you are searching for. I will provide a safe, non-judgmental space for you to process through and collaborate in finding those safe coping strategies to achieve your goals.
(971) 232-3430 View (971) 232-3430
Photo of Robin Kathleen Bodhi - Robin Bodhi Trauma-Informed Counseling, MA
Robin Bodhi Trauma-Informed Counseling
Professional Counselor Associate, MA
Verified Verified
The Dalles, OR 97058  (Online Only)
When you are triggered, have a trauma response, or in a PTSD loop it is overwhelming; this can be scary, and frustrating. Living life from this place makes it hard to connect with others and to know your sense of self. Challenging patterns become en-grained as feeling powerless leads to loss of hope. My goal with you is to help you acquire skills/tools to feel more embodied and to change the repetitive challenging loop by understanding more deeply the patterns at play. Self-empowerment is essential in our work together as my desire is to help you take your life back with confidence and ease.
When you are triggered, have a trauma response, or in a PTSD loop it is overwhelming; this can be scary, and frustrating. Living life from this place makes it hard to connect with others and to know your sense of self. Challenging patterns become en-grained as feeling powerless leads to loss of hope. My goal with you is to help you acquire skills/tools to feel more embodied and to change the repetitive challenging loop by understanding more deeply the patterns at play. Self-empowerment is essential in our work together as my desire is to help you take your life back with confidence and ease.
(503) 966-9271 View (503) 966-9271

See more therapy options for Wasco County

How does your Therapist compare?

Number of Therapists in Wasco County, OR

20+

Average cost per session

$150

Therapists in Wasco County, OR who prioritize treating:

90% Relationship Issues
90% Depression
90% Anxiety
86% Self Esteem
81% Trauma and PTSD
76% Grief
71% Coping Skills

Average years in practice

14 Years

Top 3 insurances accepted

86% PacificSource
64% BlueCross and BlueShield
50% Regence

How Therapists in Wasco County, OR see their clients

72% In Person and Online
28% Online Only

Gender breakdown

60% Female
40% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Wasco 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.