Therapists in Columbia, MO

Photo of Dr. Christine Woods, EdD, LCSW, Clinical Social Work/Therapist
Dr. Christine Woods
Clinical Social Work/Therapist, EdD, LCSW
Verified Verified
Columbia, MO 65201
"It's okay not to be okay!" Sometimes all you need is to give yourself permission to not be okay. There are moments in our lives when facing issues alone is not enough and it becomes difficult to navigate life's circumstances. That's where I step in. If you are suffering from trauma, grief, life stressors, relationship conflict, depression, or anxiety, I work with you at your point of need.
"It's okay not to be okay!" Sometimes all you need is to give yourself permission to not be okay. There are moments in our lives when facing issues alone is not enough and it becomes difficult to navigate life's circumstances. That's where I step in. If you are suffering from trauma, grief, life stressors, relationship conflict, depression, or anxiety, I work with you at your point of need.
(573) 260-1603 View (573) 260-1603
Photo of Ashlea Burry, PLPC, Pre-Licensed Professional
Ashlea Burry
Pre-Licensed Professional, PLPC
Verified Verified
1 Endorsed
Columbia, MO 65203
I operate from a holistic and integrative approach; valuing each individual, their strengths and honoring their experiences. I believe you have innate behaviors and skills that you can draw upon to overcome challenges and move toward becoming a better you. I enjoy working with both individuals and couples, and can assist you in your journey to new beginnings. I primarily focus my work on helping clients navigate and work through depression, anxiety, trauma, intrapersonal and interpersonal issues.
I operate from a holistic and integrative approach; valuing each individual, their strengths and honoring their experiences. I believe you have innate behaviors and skills that you can draw upon to overcome challenges and move toward becoming a better you. I enjoy working with both individuals and couples, and can assist you in your journey to new beginnings. I primarily focus my work on helping clients navigate and work through depression, anxiety, trauma, intrapersonal and interpersonal issues.
(573) 652-3855 View (573) 652-3855
Photo of Chris Mawhinney, MA, LPC, CCTP, Licensed Professional Counselor
Chris Mawhinney
Licensed Professional Counselor, MA, LPC, CCTP
Verified Verified
1 Endorsed
Columbia, MO 65202
If you are dealing with anxiety, depression, trauma, or relationship issues, and you want to find peace of mind, balance, and resolution, then I may be the counselor for you.
If you are dealing with anxiety, depression, trauma, or relationship issues, and you want to find peace of mind, balance, and resolution, then I may be the counselor for you.
(573) 284-2918 View (573) 284-2918
Photo of Abbey Vandermillion, MSW, LCSW, Clinical Social Work/Therapist
Abbey Vandermillion
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Columbia, MO 65203
Now offering in person and virtual sessions for all ages (children, adolescents, and adults). Everyone deserves to have support in navigating challenging moments in their lives. I strive to aid clients in finding their own strengths and abilities to help them tackle and survive even the most difficult moments in their journey. I strive to make therapy a place of comfort, acceptance, and peace. My own experiences with navigating infant loss have instilled a passion in me to create a validating environment for all clients to explore their own emotions and needs safely.
Now offering in person and virtual sessions for all ages (children, adolescents, and adults). Everyone deserves to have support in navigating challenging moments in their lives. I strive to aid clients in finding their own strengths and abilities to help them tackle and survive even the most difficult moments in their journey. I strive to make therapy a place of comfort, acceptance, and peace. My own experiences with navigating infant loss have instilled a passion in me to create a validating environment for all clients to explore their own emotions and needs safely.
(573) 520-4679 View (573) 520-4679
Photo of Victoria Warren, PLPC, Pre-Licensed Professional
Victoria Warren
Pre-Licensed Professional, PLPC
Verified Verified
Columbia, MO 65203
Waitlist for new clients
I assist clients who desire to experience their relationship with self and others in a more holistic way. I strive to create a shame free environment where I can empathetically listen to clients and understand who they are in context to their own life experiences. I incorporate movement, and yoga based principles into my work with clients when the therapeutic process calls for it. It is my intention to support clients in their therapeutic journey by assisting them in becoming more aware of their own emotions, thoughts, and communication patterns in their relationships.
I assist clients who desire to experience their relationship with self and others in a more holistic way. I strive to create a shame free environment where I can empathetically listen to clients and understand who they are in context to their own life experiences. I incorporate movement, and yoga based principles into my work with clients when the therapeutic process calls for it. It is my intention to support clients in their therapeutic journey by assisting them in becoming more aware of their own emotions, thoughts, and communication patterns in their relationships.
(573) 763-2499 x101 View (573) 763-2499 x101
Photo of Marjorie Lynne Roberts, LPC, Licensed Professional Counselor
Marjorie Lynne Roberts
Licensed Professional Counselor, LPC
Verified Verified
Columbia, MO 65203
My specialties in therapy include trauma, anxiety and depression. It can be very difficult at times to know how to manage or deal with challenges in our lives. I believe every person has an inner strength that allows them to face life issues and learn new ways to accept or change these challenges. This work is completely collaborative from setting goals to hearing your feedback about progress and other possible treatments to use. I will assist you in finding healthier ways of thinking and actions to deal with difficulties. The first step to take is often the hardest but may be one of the important and meaningful step you make.
My specialties in therapy include trauma, anxiety and depression. It can be very difficult at times to know how to manage or deal with challenges in our lives. I believe every person has an inner strength that allows them to face life issues and learn new ways to accept or change these challenges. This work is completely collaborative from setting goals to hearing your feedback about progress and other possible treatments to use. I will assist you in finding healthier ways of thinking and actions to deal with difficulties. The first step to take is often the hardest but may be one of the important and meaningful step you make.
(573) 400-0373 View (573) 400-0373
Photo of Suzan Franck, MEd, MSW, LCSW, Clinical Social Work/Therapist
Suzan Franck
Clinical Social Work/Therapist, MEd, MSW, LCSW
Verified Verified
3 Endorsed
Columbia, MO 65201
Jungian analytic work understands that life is unpredictable. Everyone struggles at some point in life. Sometimes the accompanying suffering tears at the very fabric of our understanding of ourselves and how we fit in the world. Life no longer makes sense. Life is not the way you thought it would be or should be. Unbidden desires, anxieties or depression come in to interfere with your ability to live the life you want. Others in your life behave in ways that disrupt your peace of mind and ability to live a meaningful life. Issues you thought you had dealt with long ago resurface in the present.
Jungian analytic work understands that life is unpredictable. Everyone struggles at some point in life. Sometimes the accompanying suffering tears at the very fabric of our understanding of ourselves and how we fit in the world. Life no longer makes sense. Life is not the way you thought it would be or should be. Unbidden desires, anxieties or depression come in to interfere with your ability to live the life you want. Others in your life behave in ways that disrupt your peace of mind and ability to live a meaningful life. Issues you thought you had dealt with long ago resurface in the present.
(573) 535-5614 View (573) 535-5614
Photo of Kevin Crosby, LPC, Licensed Professional Counselor
Kevin Crosby
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Columbia, MO 65202
If you feel overwhelmed due to past trauma or an uncertain future, no matter the cause of anxiety, depression or psychosis, I am here to help you find the path to the abundant life you are after. I am available to work with children, teens, and adults. I can provide individual, couples, and group therapy. As social beings, I believe that all our relationships influence who we are and who we are to become. That is why I will focus on building a dynamic therapeutic relationship from the start. If this is what you are looking for, then you have found the right therapist. I specialize in men's issues, autism, and couples concerns.
If you feel overwhelmed due to past trauma or an uncertain future, no matter the cause of anxiety, depression or psychosis, I am here to help you find the path to the abundant life you are after. I am available to work with children, teens, and adults. I can provide individual, couples, and group therapy. As social beings, I believe that all our relationships influence who we are and who we are to become. That is why I will focus on building a dynamic therapeutic relationship from the start. If this is what you are looking for, then you have found the right therapist. I specialize in men's issues, autism, and couples concerns.
(573) 284-2903 View (573) 284-2903
Photo of Linda Pogo - Linda Pogo, LLC, MEd, LPC, CPC, YTT200, Licensed Professional Counselor
Linda Pogo, LLC
Licensed Professional Counselor, MEd, LPC, CPC, YTT200
Verified Verified
1 Endorsed
Columbia, MO 65203  (Online Only)
I help you heal from the past, accept what is, and live life with intention. Relationship wounds can cause you to lose touch with parts of yourself. You can learn to reconnect with and heal those parts, become the source of your own self-love, self-acceptance, and self-worth. Through radical acceptance of self, others and the world, you can cultivate wisdom and compassion as an internal refuge. I can help you face what is painful and create intention for how you want to be in a world that is not always as you wish it to be. A sense of well-being and peace can be cultivated, even in the midst of chaos, loss and unwanted change.
I help you heal from the past, accept what is, and live life with intention. Relationship wounds can cause you to lose touch with parts of yourself. You can learn to reconnect with and heal those parts, become the source of your own self-love, self-acceptance, and self-worth. Through radical acceptance of self, others and the world, you can cultivate wisdom and compassion as an internal refuge. I can help you face what is painful and create intention for how you want to be in a world that is not always as you wish it to be. A sense of well-being and peace can be cultivated, even in the midst of chaos, loss and unwanted change.
(573) 340-9934 View (573) 340-9934
Photo of Laurel C Harlan - Human Dynamics, Inc., MSW, LCSW, Clinical Social Work/Therapist
Human Dynamics, Inc.
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Columbia, MO 65203
Founded in 1984, Human Dynamics, Inc. is an association of independent practioners offering psychological services to individuals, couples, families, and children.  Each individual therapist brings a unique approach to his/her clients and has a diverse professional background.  
Founded in 1984, Human Dynamics, Inc. is an association of independent practioners offering psychological services to individuals, couples, families, and children.  Each individual therapist brings a unique approach to his/her clients and has a diverse professional background.  
(573) 535-5765 View (573) 535-5765
Photo of Jessika Twehous, LPC, Licensed Professional Counselor
Jessika Twehous
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Columbia, MO 65201
Taking the first step towards therapy can be daunting, but it’s also a powerful act of self-care and a courageous step towards personal growth. Whether you're struggling with anxiety, navigating a major life transition, or seeking to improve your relationships, I am here to support you every step of the way. I am committed to accompanying you on your journey with empathy, understanding, and unwavering support, empowering you to navigate life's challenges with a newfound resilience and self-compassion. Life can be overwhelming, but you don't have to figure it all out alone. You deserve a space to be heard, seen, and understood.
Taking the first step towards therapy can be daunting, but it’s also a powerful act of self-care and a courageous step towards personal growth. Whether you're struggling with anxiety, navigating a major life transition, or seeking to improve your relationships, I am here to support you every step of the way. I am committed to accompanying you on your journey with empathy, understanding, and unwavering support, empowering you to navigate life's challenges with a newfound resilience and self-compassion. Life can be overwhelming, but you don't have to figure it all out alone. You deserve a space to be heard, seen, and understood.
(573) 463-6514 View (573) 463-6514
Photo of Mallory Zarcone, LPC Intern
Mallory Zarcone
LPC Intern
Verified Verified
1 Endorsed
Columbia, MO 65203
Hello, I'm Mallory! I'm a Student Counselor at Strong Heart Counseling. I love to work with young adults, adults, couples and members of the LGBTQ+ community. I am passionate about helping individuals through various aspects of self-discovery and growth, including, identity exploration, addressing religious trauma, navigating life transitions, understanding attachment dynamics, and fostering healthy relationships.
Hello, I'm Mallory! I'm a Student Counselor at Strong Heart Counseling. I love to work with young adults, adults, couples and members of the LGBTQ+ community. I am passionate about helping individuals through various aspects of self-discovery and growth, including, identity exploration, addressing religious trauma, navigating life transitions, understanding attachment dynamics, and fostering healthy relationships.
(573) 463-6934 View (573) 463-6934
Photo of Kelly F Jackson, MSW, LCSW, Clinical Social Work/Therapist
Kelly F Jackson
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Columbia, MO 65203
I have dedicated decades to helping others in one capacity or another and started my career as a nurse. I have training in numerous therapeutic interventions and strive for excellence in my work. I will work to provide you, your child and/or your family with the highest quality service in order to help you achieve your goals in therapy and in life. I will work with you in a way that builds on your strengths and potential, and challenges you to take your life to the next level.
I have dedicated decades to helping others in one capacity or another and started my career as a nurse. I have training in numerous therapeutic interventions and strive for excellence in my work. I will work to provide you, your child and/or your family with the highest quality service in order to help you achieve your goals in therapy and in life. I will work with you in a way that builds on your strengths and potential, and challenges you to take your life to the next level.
(573) 880-4468 View (573) 880-4468
Photo of Jessie Back, LCSW, Clinical Social Work/Therapist
Jessie Back
Clinical Social Work/Therapist, LCSW
Verified Verified
Columbia, MO 65203
I have a true passion for working with older adults and caregivers. I have worked with this population both in residential and community settings. I also have experience working in substance abuse and with individuals living with chronic illness. I enjoy not only individual work, but also working with couples and families to initiate and maintain change within the family system. Some issues I commonly work with include: depression, grief and loss, spirituality, life review, caregiver stress, interpersonal relationship problems, and anxiety.
I have a true passion for working with older adults and caregivers. I have worked with this population both in residential and community settings. I also have experience working in substance abuse and with individuals living with chronic illness. I enjoy not only individual work, but also working with couples and families to initiate and maintain change within the family system. Some issues I commonly work with include: depression, grief and loss, spirituality, life review, caregiver stress, interpersonal relationship problems, and anxiety.
(573) 561-5022 x1015 View (573) 561-5022 x1015
Photo of Barbara J. Scott, PLPC, NCC, MSCC, Pre-Licensed Professional
Barbara J. Scott
Pre-Licensed Professional, PLPC, NCC, MSCC
Verified Verified
Columbia, MO 65203
Counseling is a wonderful investment in yourself and your relationships, but finding the right counselor is tough. I provide a safe space for clients to pause, reflect, feel, and find their way... Struggling with anxiety, relationship conflict/divorce, loneliness, grief, loss, or major life changes? I bring a depth of life experience and professional training in communication, grief/loss counseling, taming anxiety, & de-escalating/healing relationships. I bring an open, caring, inquisitive, and deeply compassionate presence to our time together. I'm here to sit with you—sometimes to challenge you—but always to truly listen.
Counseling is a wonderful investment in yourself and your relationships, but finding the right counselor is tough. I provide a safe space for clients to pause, reflect, feel, and find their way... Struggling with anxiety, relationship conflict/divorce, loneliness, grief, loss, or major life changes? I bring a depth of life experience and professional training in communication, grief/loss counseling, taming anxiety, & de-escalating/healing relationships. I bring an open, caring, inquisitive, and deeply compassionate presence to our time together. I'm here to sit with you—sometimes to challenge you—but always to truly listen.
(573) 515-2986 View (573) 515-2986
Photo of Katherine Ottofy, MSW, LCSW, Clinical Social Work/Therapist
Katherine Ottofy
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Columbia, MO 65201
Navigating life’s challenges can often feel overwhelming. You might be grappling with trauma, chronic worry, anxiety, or struggling with low self-esteem and depression. You're looking for more than just coping mechanisms or quick fixes; you seek a transformative healing journey. You want to feel empowered and validated, to see tangible progress in your life. In short, it's time to build a life where past pains and stressors no longer dictate your present or future. You're ready to invest in therapy that extends its benefits beyond the therapy room, integrating what you learn into your daily life for lasting change and well-being.
Navigating life’s challenges can often feel overwhelming. You might be grappling with trauma, chronic worry, anxiety, or struggling with low self-esteem and depression. You're looking for more than just coping mechanisms or quick fixes; you seek a transformative healing journey. You want to feel empowered and validated, to see tangible progress in your life. In short, it's time to build a life where past pains and stressors no longer dictate your present or future. You're ready to invest in therapy that extends its benefits beyond the therapy room, integrating what you learn into your daily life for lasting change and well-being.
(573) 367-5751 View (573) 367-5751
Photo of Jackie Esser, MEd, LPC, Licensed Professional Counselor
Jackie Esser
Licensed Professional Counselor, MEd, LPC
Verified Verified
Columbia, MO 65203
I work with eating disorders, suicidal and self-injurious behaviors, and trauma. I am a licensed clinical therapist in Columbia, Missouri. One of my goals is to bring awareness to the client through tracking, reflecting, and attunement. I have over 90 hours of trauma-informed yoga training and 20 hours of somatic experience. I use this knowledge when working with bodies that hold depression, anxiety, and various kinds of trauma.
I work with eating disorders, suicidal and self-injurious behaviors, and trauma. I am a licensed clinical therapist in Columbia, Missouri. One of my goals is to bring awareness to the client through tracking, reflecting, and attunement. I have over 90 hours of trauma-informed yoga training and 20 hours of somatic experience. I use this knowledge when working with bodies that hold depression, anxiety, and various kinds of trauma.
(573) 515-2478 View (573) 515-2478
Photo of Debi Hake, MEd, LPC, Licensed Professional Counselor
Debi Hake
Licensed Professional Counselor, MEd, LPC
Verified Verified
Columbia, MO 65203
Waitlist for new clients
Do you feel disconnected from your partner or spouse? Are you looking for ways to improve your communication, resolve perpetual conflicts or heal from deep wounds? Do you long for more peace and a sense of calm in your home? If you answered yes to any of these questions, I can help. I am passionate about helping couples, individuals and families find healing, restoration and hope. I strive to provide a safe, empathetic and non-judgmental environment where you feel validated and equipped to enact changes that help you develop the relationship, family or life that you want to have.
Do you feel disconnected from your partner or spouse? Are you looking for ways to improve your communication, resolve perpetual conflicts or heal from deep wounds? Do you long for more peace and a sense of calm in your home? If you answered yes to any of these questions, I can help. I am passionate about helping couples, individuals and families find healing, restoration and hope. I strive to provide a safe, empathetic and non-judgmental environment where you feel validated and equipped to enact changes that help you develop the relationship, family or life that you want to have.
(573) 240-8516 View (573) 240-8516
Photo of Amanda Lucas, LMSW, Pre-Licensed Professional
Amanda Lucas
Pre-Licensed Professional, LMSW
Verified Verified
1 Endorsed
Columbia, MO 65203
Hello! I am an individual, family, and couples therapist and an integrative wellness expert. I love working with adolescents, families, and healthcare workers. I specialize in working with eating disorders, disordered eating and body image. I help clients find flexibility, explore values and open themselves up to recovery. I work with families and couples to develop skills for communication, validation and redefining the family systems’ relationships with food and body.
Hello! I am an individual, family, and couples therapist and an integrative wellness expert. I love working with adolescents, families, and healthcare workers. I specialize in working with eating disorders, disordered eating and body image. I help clients find flexibility, explore values and open themselves up to recovery. I work with families and couples to develop skills for communication, validation and redefining the family systems’ relationships with food and body.
(573) 494-6767 View (573) 494-6767
Photo of Lindsey Backer-Fulghum, PhD, Psychologist
Lindsey Backer-Fulghum
Psychologist, PhD
Verified Verified
Columbia, MO 65203
Life is hard. Whether you are struggling with transitions into adulthood, a new career, the process of parenthood, or other major life changes, you do not have to travel alone. Dr. Lindsey works with adults of all ages providing both therapy and psychological testing. She has specialized training in perinatal mental health and experience working with infertility, pregnancy/infant loss, as well as pregnancy and postpartum related mood and anxiety disorders. As someone who has experienced pregnancy loss herself, she has a passion for helping individuals mourn their significant loss, and in given time, help one find personal meaning.
Life is hard. Whether you are struggling with transitions into adulthood, a new career, the process of parenthood, or other major life changes, you do not have to travel alone. Dr. Lindsey works with adults of all ages providing both therapy and psychological testing. She has specialized training in perinatal mental health and experience working with infertility, pregnancy/infant loss, as well as pregnancy and postpartum related mood and anxiety disorders. As someone who has experienced pregnancy loss herself, she has a passion for helping individuals mourn their significant loss, and in given time, help one find personal meaning.
(573) 920-4867 View (573) 920-4867
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How does your Therapist compare?

Number of Therapists in Columbia, MO

300+

Average cost per session

$100

Therapists in Columbia, MO who prioritize treating:

91% Anxiety
86% Depression
73% Stress
67% Trauma and PTSD
63% Relationship Issues
61% Grief
61% Life Transitions

Average years in practice

8 Years

Top 3 insurances accepted

83% Aetna
77% Cigna and Evernorth
77% UnitedHealthcare UHC | UBH

How Therapists in Columbia, MO see their clients

52% In Person and Online
48% Online Only

Gender breakdown

74% Female
23% Male
3% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Columbia?

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.