Therapists in Oskaloosa, IA

Photo of Shanon A. Claussen, LISW, RPT-S, CADC, Clinical Social Work/Therapist
Shanon A. Claussen
Clinical Social Work/Therapist, LISW, RPT-S, CADC
Verified Verified
1 Endorsed
Oskaloosa, IA 52577
Shanon Claussen LISW, RPT-S, CADC, Certified EMDR Therapist, has been providing mental health therapy since 2006, Shanon's clinical experience includes work with individuals (children 18 months & older, adolescents, adults, couples, & families). Shanon utilizes techniques appropriate to each client, individualizes treatment plans, & meets clients where they are at.
Shanon Claussen LISW, RPT-S, CADC, Certified EMDR Therapist, has been providing mental health therapy since 2006, Shanon's clinical experience includes work with individuals (children 18 months & older, adolescents, adults, couples, & families). Shanon utilizes techniques appropriate to each client, individualizes treatment plans, & meets clients where they are at.
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Photo of Lutheran Family Service - Lutheran Family Service, LMHC, LISW
Lutheran Family Service
LMHC, LISW
Verified Verified
1 Endorsed
Oskaloosa, IA 52577
We are here to walk with you when you need it most. Lutheran Family Service (LFS) has an expert team of compassionate therapists and counselors to help you with marital and relationship problems, depression and suicidal thoughts, anxiety and worry, trauma or post-traumatic stress disorder (PTSD), personality disorders, grief and loss, parenting concerns, life transitions, work and career concerns, or chronic mental illness.
We are here to walk with you when you need it most. Lutheran Family Service (LFS) has an expert team of compassionate therapists and counselors to help you with marital and relationship problems, depression and suicidal thoughts, anxiety and worry, trauma or post-traumatic stress disorder (PTSD), personality disorders, grief and loss, parenting concerns, life transitions, work and career concerns, or chronic mental illness.
(515) 329-3162 View (515) 329-3162
Photo of Abby Rickert, MSW, LISW, Clinical Social Work/Therapist
Abby Rickert
Clinical Social Work/Therapist, MSW, LISW
Verified Verified
2 Endorsed
Oskaloosa, IA 52577
Have you been feeling unheard, overwhelmed, misunderstood, and unsure where to turn? You deserve space for your thoughts and feelings to be heard and understood. There's no issue too big or small for therapy, and it's not one ‘size fits all’.I provide a person centered and strengths based approach. I focus on building a strong therapeutic relationship that allows us to work together through any issue, and tailor sessions to meet your unique needs. I strive to offer a safe, laid back, warm, and judgement-free space with a gentle, open minded, honest listening ear.
Have you been feeling unheard, overwhelmed, misunderstood, and unsure where to turn? You deserve space for your thoughts and feelings to be heard and understood. There's no issue too big or small for therapy, and it's not one ‘size fits all’.I provide a person centered and strengths based approach. I focus on building a strong therapeutic relationship that allows us to work together through any issue, and tailor sessions to meet your unique needs. I strive to offer a safe, laid back, warm, and judgement-free space with a gentle, open minded, honest listening ear.
(319) 220-4668 View (319) 220-4668
Photo of Jill Jordahl-Ball, MA, PsyD, LP, Psychologist
Jill Jordahl-Ball
Psychologist, MA, PsyD, LP
Verified Verified
Oskaloosa, IA 52577
It is my passion to be able to help others through the challenges of life. It is always a priority to create a safe and trusting relationship with each client where they feel there is a shared ownership in their treatment outcomes. I provide effective, collaborative and holistic therapy that results in transformation, growth and healing. My primary treatment modality is Cognitive Behavioral Therapy (CBT) but I integrate various therapeutic approaches to meet my client's individual needs.
It is my passion to be able to help others through the challenges of life. It is always a priority to create a safe and trusting relationship with each client where they feel there is a shared ownership in their treatment outcomes. I provide effective, collaborative and holistic therapy that results in transformation, growth and healing. My primary treatment modality is Cognitive Behavioral Therapy (CBT) but I integrate various therapeutic approaches to meet my client's individual needs.
(641) 715-9565 View (641) 715-9565

Online Therapists

Photo of Brittany Orzola, LMSW, Clinical Social Work/Therapist
Brittany Orzola
Clinical Social Work/Therapist, LMSW
Verified Verified
2 Endorsed
Cedar Falls, IA 50613  (Online Only)
Your session time is your time to work through anything you want, at your own pace, without judgement. We all walk a unique path in this life and I will always support your individuality and what you want your life to look like, regardless of societal ideas of what that should be. I absolutely love celebrating successes with those I work with, and I enjoy seeing people’s faces light up with pride in their achievements. Seeing a person grow before your eyes is an amazing thing. That said, everything isn’t always rainbows.
Your session time is your time to work through anything you want, at your own pace, without judgement. We all walk a unique path in this life and I will always support your individuality and what you want your life to look like, regardless of societal ideas of what that should be. I absolutely love celebrating successes with those I work with, and I enjoy seeing people’s faces light up with pride in their achievements. Seeing a person grow before your eyes is an amazing thing. That said, everything isn’t always rainbows.
(319) 988-2515 View (319) 988-2515
Photo of Nicole Scherle Scheidel, MEd, LMHC, Counselor
Nicole Scherle Scheidel
Counselor, MEd, LMHC
Verified Verified
West Des Moines, IA 50266
I am a Licensed Mental Health Counselor with over 20 years experience in the practice of psychotherapy. I received my Bachelor and Master degrees from Loyola University Chicago. I provide counseling to older adolescents and adult individuals. My specialties include depression, anxiety, life transitions, trauma, mood disorders, perinatal mood and anxiety disorders, and OCD. I work to provide my clients with a compassionate & supportive therapeutic alliance to help them address their current concerns and help them live a happier, healthier life.
I am a Licensed Mental Health Counselor with over 20 years experience in the practice of psychotherapy. I received my Bachelor and Master degrees from Loyola University Chicago. I provide counseling to older adolescents and adult individuals. My specialties include depression, anxiety, life transitions, trauma, mood disorders, perinatal mood and anxiety disorders, and OCD. I work to provide my clients with a compassionate & supportive therapeutic alliance to help them address their current concerns and help them live a happier, healthier life.
(515) 368-8284 View (515) 368-8284
Photo of Joan N Tamara, MS, LMHC, IADC, Counselor
Joan N Tamara
Counselor, MS, LMHC, IADC
Verified Verified
1 Endorsed
West Des Moines, IA 50266
Hi, I'm Joan! Finding the right therapist and building a trusting relationship is so important to begin your healing process. As a mental health therapist, I'm committed to supporting your emotional needs, fostering a warm confidential, and non- judgmental environment in dealing with any life stressor that is present in your life. You may be asking well- what does that look like? This can include adjustment to life changes and transitions, recent injury, grief & loss, addiction, or relationship issues. Together we will examine your presenting concerns and explore underlying factors that prohibit a healthy response to the stressor .
Hi, I'm Joan! Finding the right therapist and building a trusting relationship is so important to begin your healing process. As a mental health therapist, I'm committed to supporting your emotional needs, fostering a warm confidential, and non- judgmental environment in dealing with any life stressor that is present in your life. You may be asking well- what does that look like? This can include adjustment to life changes and transitions, recent injury, grief & loss, addiction, or relationship issues. Together we will examine your presenting concerns and explore underlying factors that prohibit a healthy response to the stressor .
(515) 416-4742 View (515) 416-4742
Photo of Lindsey Lundry, MA, LMHC, Counselor
Lindsey Lundry
Counselor, MA, LMHC
Verified Verified
3 Endorsed
Muscatine, IA 52761
Waitlist for new clients
We all have struggles at some point in our lives and it can be a scary experience asking for help. My goal is to provide you with a safe and comfortable environment in which you can process what life has thrown at you, whether it be anxiety, anger, depression or stress. Or maybe you just need some help sorting through all the thoughts that are running through your head. Whatever it may be, my wish is to help you work through those struggles and meet your goals. Please call, text, or email me today!
We all have struggles at some point in our lives and it can be a scary experience asking for help. My goal is to provide you with a safe and comfortable environment in which you can process what life has thrown at you, whether it be anxiety, anger, depression or stress. Or maybe you just need some help sorting through all the thoughts that are running through your head. Whatever it may be, my wish is to help you work through those struggles and meet your goals. Please call, text, or email me today!
(563) 227-5906 View (563) 227-5906
Photo of Angela Hjelmeland, CADC, Drug & Alcohol Counselor
Angela Hjelmeland
Drug & Alcohol Counselor, CADC
Verified Verified
1 Endorsed
Waverly, IA 50677
I have worked in the social work field for over 25 years. My experience includes providing individual family therapy in a community-based setting, working 15 years with the State of Iowa Department of Human Services, and as a certified drug and alcohol counselor. I am also certified as a personal trainer and group fitness instructor. I believe in working with the mind, body, and spirit. I have experience working with individuals that struggle with anxiety, depression, relationship problems, stress, addictions, life changes and all age groups.
I have worked in the social work field for over 25 years. My experience includes providing individual family therapy in a community-based setting, working 15 years with the State of Iowa Department of Human Services, and as a certified drug and alcohol counselor. I am also certified as a personal trainer and group fitness instructor. I believe in working with the mind, body, and spirit. I have experience working with individuals that struggle with anxiety, depression, relationship problems, stress, addictions, life changes and all age groups.
(319) 313-2621 View (319) 313-2621
Photo of Sarah Andrews, LMFT, MS, Marriage & Family Therapist
Sarah Andrews
Marriage & Family Therapist, LMFT, MS
Verified Verified
1 Endorsed
Ankeny, IA 50023
I am accepting new (bi-weekly, daytime) clients at this time. My goal is to help others learn how they can develop peace, both with themselves and with their circumstances. I believe in client-specific techniques that empower individuals to develop the tools necessary to achieve emotional, relational, spiritual, and physical health and well-being.
I am accepting new (bi-weekly, daytime) clients at this time. My goal is to help others learn how they can develop peace, both with themselves and with their circumstances. I believe in client-specific techniques that empower individuals to develop the tools necessary to achieve emotional, relational, spiritual, and physical health and well-being.
(515) 585-6914 View (515) 585-6914
Photo of Shelly Johnson (Ifs 🫶 Therapist), LMHC, CIFST, Counselor
Shelly Johnson (Ifs 🫶 Therapist)
Counselor, LMHC, CIFST
Verified Verified
1 Endorsed
West Des Moines, IA 50265  (Online Only)
Waitlist for new clients
Life truly begins to feel less meaningful & uncomfortable when we feel stuck in our existence. Do you struggle w/ disowning aspects of your own humanness? Healing is most possible when we can access our deepest places of knowing inside & honor what our heart already knows. My ‘deepest’ intention for my clients is that they feel safe, uplifted, & more closely aligned with their hearts’ true desires. I encourage clients to cultivate a genuine & authentic approach to life, regardless of earlier life experiences, beliefs, or messaging. Are you ready to take that inner journey of exploration & discovery, without having to do it alone?
Life truly begins to feel less meaningful & uncomfortable when we feel stuck in our existence. Do you struggle w/ disowning aspects of your own humanness? Healing is most possible when we can access our deepest places of knowing inside & honor what our heart already knows. My ‘deepest’ intention for my clients is that they feel safe, uplifted, & more closely aligned with their hearts’ true desires. I encourage clients to cultivate a genuine & authentic approach to life, regardless of earlier life experiences, beliefs, or messaging. Are you ready to take that inner journey of exploration & discovery, without having to do it alone?
(515) 446-7351 View (515) 446-7351
Photo of Kelsi Kennison, MS, LMFT, Marriage & Family Therapist
Kelsi Kennison
Marriage & Family Therapist, MS, LMFT
Verified Verified
4 Endorsed
West Des Moines, IA 50266
Waitlist for new clients
I believe that therapy requires a specialized approach that recognizes each person’s unique life story. As a therapist, my goal is to understand the things that have made you who you are including your past life experiences, present circumstances, and future goals. I strive to provide a comfortable and safe environment where we can work together towards a meaningful narrative. I feel that my genuine approach and willingness to challenge and engage clients has helped me assist others to navigate life’s obstacles and improve their functioning and quality of life.
I believe that therapy requires a specialized approach that recognizes each person’s unique life story. As a therapist, my goal is to understand the things that have made you who you are including your past life experiences, present circumstances, and future goals. I strive to provide a comfortable and safe environment where we can work together towards a meaningful narrative. I feel that my genuine approach and willingness to challenge and engage clients has helped me assist others to navigate life’s obstacles and improve their functioning and quality of life.
(515) 608-5513 View (515) 608-5513
Photo of Julia Tiedeman, MSW, LMSW, Clinical Social Work/Therapist
Julia Tiedeman
Clinical Social Work/Therapist, MSW, LMSW
Verified Verified
Urbandale, IA 50322
We all struggle at times with situations that affect our ability to experience contentment and feel at peace with ourselves and in our relationships. Solving problems can seem overwhelming and when friends and family aren't enough, you may want an objective perspective. I believe in each person's potential to make positive changes that lead to a more satisfying life. Let me assist you on your journey. I primarily serve individuals, couples, and teens. Whether you are looking for a place to reflect or a place to work together on an action plan for change, let's find your path together.
We all struggle at times with situations that affect our ability to experience contentment and feel at peace with ourselves and in our relationships. Solving problems can seem overwhelming and when friends and family aren't enough, you may want an objective perspective. I believe in each person's potential to make positive changes that lead to a more satisfying life. Let me assist you on your journey. I primarily serve individuals, couples, and teens. Whether you are looking for a place to reflect or a place to work together on an action plan for change, let's find your path together.
(515) 705-6032 View (515) 705-6032
Photo of Sarah Cammoun-Myers, LMHC, Counselor
Sarah Cammoun-Myers
Counselor, LMHC
Verified Verified
1 Endorsed
Urbandale, IA 50322
Waitlist for new clients
At Sage Counseling and Wellness, I believe that healing can occur to develop a fulfilling and harmonious life filled with meaningful connections. I strive to help clients discover and feel comfortable with their authentic self and empower them to have the courage to bring that authenticity into their relationships. I believe in the importance of maintaining a supportive and affirming environment throughout the therapeutic process. I welcome people from all walks of life, including but not limited to: LGBTQIA+, BIPOC, and individuals with disabilities by providing a safe and affirming environment to all.
At Sage Counseling and Wellness, I believe that healing can occur to develop a fulfilling and harmonious life filled with meaningful connections. I strive to help clients discover and feel comfortable with their authentic self and empower them to have the courage to bring that authenticity into their relationships. I believe in the importance of maintaining a supportive and affirming environment throughout the therapeutic process. I welcome people from all walks of life, including but not limited to: LGBTQIA+, BIPOC, and individuals with disabilities by providing a safe and affirming environment to all.
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Photo of Natalia Cherjovsky, T-LMFT, Marriage & Family Therapist
Natalia Cherjovsky
Marriage & Family Therapist, T-LMFT
Verified Verified
1 Endorsed
Coralville, IA 52241
Longing for a meaningful life is inherent to being human. Yet, no one hands us a manual, so we often feel stuck. This is where therapists can provide relief. My practice is dedicated to motivated clients ready to embrace transformation by confronting limiting beliefs and behaviors. Therapy requires courage to examine and disrupt harmful patterns and narratives to achieve clarity, resilience, and fulfillment. As your therapist, I can help you harness your innate capacity to grow in ways that align with your values. I use an integrative lens and draw on a wide array of theories and strategies to tailor sessions to your unique needs.
Longing for a meaningful life is inherent to being human. Yet, no one hands us a manual, so we often feel stuck. This is where therapists can provide relief. My practice is dedicated to motivated clients ready to embrace transformation by confronting limiting beliefs and behaviors. Therapy requires courage to examine and disrupt harmful patterns and narratives to achieve clarity, resilience, and fulfillment. As your therapist, I can help you harness your innate capacity to grow in ways that align with your values. I use an integrative lens and draw on a wide array of theories and strategies to tailor sessions to your unique needs.
(319) 253-8703 View (319) 253-8703
Photo of Darcie Lampman, MA, LMHC, Counselor
Darcie Lampman
Counselor, MA, LMHC
Verified Verified
Waterloo, IA 50702
Waitlist for new clients
Thank you for taking the time to view my profile, I look forward to working with you. It's brave and very exciting to consider how you can feel better through your own insight and growth. Challenging experiences provide the opportunity for self-exploration and a renewed sense of purpose and confidence. Take comfort in a peaceful, non-judgemental environment to explore new possibilities and areas for increased satisfaction.
Thank you for taking the time to view my profile, I look forward to working with you. It's brave and very exciting to consider how you can feel better through your own insight and growth. Challenging experiences provide the opportunity for self-exploration and a renewed sense of purpose and confidence. Take comfort in a peaceful, non-judgemental environment to explore new possibilities and areas for increased satisfaction.
(319) 774-8509 View (319) 774-8509
Photo of Leslie Orr, MS, LMHC, Counselor
Leslie Orr
Counselor, MS, LMHC
Verified Verified
4 Endorsed
Hiawatha, IA 52233
Doing my own personal work in therapy is what led me to become a therapist. I believe strongly in paying it forward, and I would like to be there for you to normalize the process of participating in mental health counseling. You don’t need to suffer in silence. Unconditional positive regard and validation can be uplifting to those who are struggling. I believe that people have the ability to grow and change into who they want to become. As your therapist, my goal is to help you live the best life you can.
Doing my own personal work in therapy is what led me to become a therapist. I believe strongly in paying it forward, and I would like to be there for you to normalize the process of participating in mental health counseling. You don’t need to suffer in silence. Unconditional positive regard and validation can be uplifting to those who are struggling. I believe that people have the ability to grow and change into who they want to become. As your therapist, my goal is to help you live the best life you can.
(319) 458-5206 View (319) 458-5206
Photo of Jason Drwal - Evergreen Therapy Center, PhD, LMHC, LMFT, LISW, RPT, Psychologist
Evergreen Therapy Center
Psychologist, PhD, LMHC, LMFT, LISW, RPT
Verified Verified
1 Endorsed
Cedar Rapids, IA 52402
Are you struggling to move forward? Do you feel overwhelmed all the time? We have immediate openings with a therapist or psychologist. Let us help you find a solution to your problems. We will listen, support and help you build the courage to face your challenges.
Are you struggling to move forward? Do you feel overwhelmed all the time? We have immediate openings with a therapist or psychologist. Let us help you find a solution to your problems. We will listen, support and help you build the courage to face your challenges.
(319) 220-3971 View (319) 220-3971
Photo of Katrina Serfling, LMHC, NCC, Counselor
Katrina Serfling
Counselor, LMHC, NCC
Verified Verified
West Des Moines, IA 50265
Human to Human counseling believes you are the one who knows best about yourself; working together with you as a team to work on goals the client bring to sessions. Therapy is a place to feel supported, learn new skills and how to implement them, and work through past trauma with an educated and genuine guide. Human to Human Counseling will always support the person that shows up, recognizing we are all human beings with a story and experiences of our own. Three of our five clinicians are trained in EMDR, and the other two use CBT and other methods to support clients through healing after trauma.
Human to Human counseling believes you are the one who knows best about yourself; working together with you as a team to work on goals the client bring to sessions. Therapy is a place to feel supported, learn new skills and how to implement them, and work through past trauma with an educated and genuine guide. Human to Human Counseling will always support the person that shows up, recognizing we are all human beings with a story and experiences of our own. Three of our five clinicians are trained in EMDR, and the other two use CBT and other methods to support clients through healing after trauma.
(515) 650-1632 View (515) 650-1632
Photo of Marcy Shrum, MSW, LISW, Clinical Social Work/Therapist
Marcy Shrum
Clinical Social Work/Therapist, MSW, LISW
Verified Verified
West Des Moines, IA 50265
I have limited availability, but feel free to e-mail with name, insurance provider and general concerns to begin the process. I desire to create a collaborative relationship that is grounded in mutual respect and positive regard so you can address the real issues that are affecting your quality of life. I will help you establish reasonable goals to guide you to become your best self. I have worked with individuals who have experienced adverse life experiences which can impact ones ability to live in the moment. I ask 'what happened to you?', not 'what is wrong with you?'.
I have limited availability, but feel free to e-mail with name, insurance provider and general concerns to begin the process. I desire to create a collaborative relationship that is grounded in mutual respect and positive regard so you can address the real issues that are affecting your quality of life. I will help you establish reasonable goals to guide you to become your best self. I have worked with individuals who have experienced adverse life experiences which can impact ones ability to live in the moment. I ask 'what happened to you?', not 'what is wrong with you?'.
(515) 599-3439 View (515) 599-3439

See more therapy options for Oskaloosa

How does your Therapist compare?

Number of Therapists in Oskaloosa, IA

< 10

Therapists in Oskaloosa, IA who prioritize treating:

100% Relationship Issues
100% Depression
100% Anxiety
100% Family Conflict
100% Self Esteem
100% Stress
100% Life Transitions

Average years in practice

16 Years

Top 3 insurances accepted

100% UnitedHealthcare UHC | UBH
75% BlueCross and BlueShield
75% Optum

How Therapists in Oskaloosa, IA see their clients

100% In Person and Online

Gender breakdown

100% Female
FAQs - About Therapy and Counseling

How can I find a therapist in Oskaloosa?

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.