Therapists in Macomb County, MI

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Photo of Dana Agrusa, MA, LPC, Licensed Professional Counselor
Dana Agrusa
Licensed Professional Counselor, MA, LPC
Verified Verified
2 Endorsed
Macomb, MI 48044  (Online Only)
I’m a Licensed Professional Counselor with experience in working with Depression, Anxiety, Mood Disorders, Personality Disorders, Self-harming Behaviors, Suicidal Ideation and Major Life Events. I’m trained in dialectical behavior therapy (DBT) Cognitive Behavioral Therapy (CBT), Person-Centered Therapy and Motivational Interviewing (MI). I'm able to incorporate my techniques on a client to client basis to help make each session a unique, comfortable and safe place. My goal as a therapist is to guide others in identifying their barriers and create healthy coping mechanisms in order for them to achieve their best quality of life.
I’m a Licensed Professional Counselor with experience in working with Depression, Anxiety, Mood Disorders, Personality Disorders, Self-harming Behaviors, Suicidal Ideation and Major Life Events. I’m trained in dialectical behavior therapy (DBT) Cognitive Behavioral Therapy (CBT), Person-Centered Therapy and Motivational Interviewing (MI). I'm able to incorporate my techniques on a client to client basis to help make each session a unique, comfortable and safe place. My goal as a therapist is to guide others in identifying their barriers and create healthy coping mechanisms in order for them to achieve their best quality of life.
(586) 221-9569 View (586) 221-9569
Photo of Wendy Warner, LPC, Counselor
Wendy Warner
Counselor, LPC
Verified Verified
Waitlist for new clients
Whether you are struggling with conflicts in marriage, parenting, anxiety, depression or any of the other challenges that come from being in relationships, I am ready to help you work on solutions that work for you. You can experience hope in the midst of your struggle, and work towards a healthier approach in relationships. As a mother of two grown daughters and a wife of over 30 years, I have a heart for hurting couples and families. I enjoy working with children, adolescents and teens, and I have a passion to help couples find their way back to help and healing.
Whether you are struggling with conflicts in marriage, parenting, anxiety, depression or any of the other challenges that come from being in relationships, I am ready to help you work on solutions that work for you. You can experience hope in the midst of your struggle, and work towards a healthier approach in relationships. As a mother of two grown daughters and a wife of over 30 years, I have a heart for hurting couples and families. I enjoy working with children, adolescents and teens, and I have a passion to help couples find their way back to help and healing.
(586) 690-4382 x4 View (586) 690-4382 x4
Photo of Tina Marie Persha - Tina M Persha, MA, LPC, MA, LPC, CAADC, Licensed Professional Counselor
Tina M Persha, MA, LPC
Licensed Professional Counselor, MA, LPC, CAADC
Verified Verified
I have I have been in private practice for almost 30 years. I see clients ages five and up for individual, group, couples and family counseling. I specialize in substance abuse and my agency is licensed by the state of Michigan. I provide the full range of mental health counseling, substance abuse services, screening and assessments, DLAD evaluations, alcohol safety education courses and drug testing. I accept most insurances and provide a warm and safe counseling environment.
I have I have been in private practice for almost 30 years. I see clients ages five and up for individual, group, couples and family counseling. I specialize in substance abuse and my agency is licensed by the state of Michigan. I provide the full range of mental health counseling, substance abuse services, screening and assessments, DLAD evaluations, alcohol safety education courses and drug testing. I accept most insurances and provide a warm and safe counseling environment.
(586) 789-9471 View (586) 789-9471
Photo of Wesley Lawton, MA, LPC, Licensed Professional Counselor
Wesley Lawton
Licensed Professional Counselor, MA, LPC
Verified Verified
1 Endorsed
Mount Clemens, MI 48043
Are you struggling with the effects of distressing things you've been through, or with grieving or adjusting to a major change or loss? My name is Wesley, and I specialize in helping individuals address these challenges and find their way to a more fulfilling life. I help people who have experienced distress, trauma, grief, and loss find peace in their lives through personalized talk therapy or through an effective therapeutic process called EMDR.
Are you struggling with the effects of distressing things you've been through, or with grieving or adjusting to a major change or loss? My name is Wesley, and I specialize in helping individuals address these challenges and find their way to a more fulfilling life. I help people who have experienced distress, trauma, grief, and loss find peace in their lives through personalized talk therapy or through an effective therapeutic process called EMDR.
(586) 300-4009 View (586) 300-4009
Photo of Dora Elliott, LLMSW , Clinical Social Work/Therapist
Dora Elliott
Clinical Social Work/Therapist, LLMSW
Verified Verified
The world has become an increasingly complex place to navigate these days. I am passionate about helping individuals, families and young people get through these challenging times together. I enjoy collaborating with schools and parents alike to best support children, teens, and young adults. I particularly enjoy supporting teen girls and women; teaching coping skills for anxiety and depression, skills to strengthen interpersonal relationships, build self-esteem, identify core values and ways to prioritize self-care, mindfulness, body positivity and overall wellness.
The world has become an increasingly complex place to navigate these days. I am passionate about helping individuals, families and young people get through these challenging times together. I enjoy collaborating with schools and parents alike to best support children, teens, and young adults. I particularly enjoy supporting teen girls and women; teaching coping skills for anxiety and depression, skills to strengthen interpersonal relationships, build self-esteem, identify core values and ways to prioritize self-care, mindfulness, body positivity and overall wellness.
(586) 203-3058 View (586) 203-3058
Photo of Ashley Kotowski, MA, LPC, CAADC, Counselor
Ashley Kotowski
Counselor, MA, LPC, CAADC
Verified Verified
Lenox, MI 48048
Accepting that anxiousness, depression, strained relationships, or substance use have gotten in the way of living the life you want can be overwhelming and finding the help you deserve can be challenging. As a therapist, it is my goal to provide a safe and open environment for you to feel empowered to overcome the struggles you are encountering. I work primarily with older adolescents and adults. You can expect me to use eclectic therapeutic techniques, specifically chosen for your needs.However, I primarily use cognitive behavioral therapy, motivational interviewing, and solution focused therapy.
Accepting that anxiousness, depression, strained relationships, or substance use have gotten in the way of living the life you want can be overwhelming and finding the help you deserve can be challenging. As a therapist, it is my goal to provide a safe and open environment for you to feel empowered to overcome the struggles you are encountering. I work primarily with older adolescents and adults. You can expect me to use eclectic therapeutic techniques, specifically chosen for your needs.However, I primarily use cognitive behavioral therapy, motivational interviewing, and solution focused therapy.
(586) 371-8354 View (586) 371-8354
Photo of Jeffrey M Steenbergh, MSW, LMSW, CAADC, ADS, Clinical Social Work/Therapist
Jeffrey M Steenbergh
Clinical Social Work/Therapist, MSW, LMSW, CAADC, ADS
Verified Verified
Shelby Township, MI 48316  (Online Only)
I work with people who want change from a variety of concerns. No matter what it is, I believe we can all change and find a life we deserve and are happy with. I believe a therapist’s role is to help people find a life they never thought was possible, not just a life they once had. Additionally, I provide the services of Substance Use Disorder evaluations for individuals who are seeking driver's license reinstatement through the Secretary of State Driver's License Appeal And Assessment Division.
I work with people who want change from a variety of concerns. No matter what it is, I believe we can all change and find a life we deserve and are happy with. I believe a therapist’s role is to help people find a life they never thought was possible, not just a life they once had. Additionally, I provide the services of Substance Use Disorder evaluations for individuals who are seeking driver's license reinstatement through the Secretary of State Driver's License Appeal And Assessment Division.
(947) 222-7350 View (947) 222-7350
Photo of Madison Selewski, TLLP, Limited Licensed Psychologist
Madison Selewski
Limited Licensed Psychologist, TLLP
Verified Verified
Shelby Township, MI 48316  (Online Only)
My personal experience includes working in a variety of settings including inpatient, private practice, group setting, and community mental health. I have specialized training in Eating Disorders and Adolescents. My training includes supervision from a specialist in eating disorders, nutrition and body image for eating disorders, eating disorders with athletes, and eating disorders within adolescents. I also have experience with depression, anxiety, self-esteem, body image, and trauma. I provide an accepting and nonjudgmental approach to help you get to your ideal self. I aim to instill hope and ensure that you don’t feel alone.
My personal experience includes working in a variety of settings including inpatient, private practice, group setting, and community mental health. I have specialized training in Eating Disorders and Adolescents. My training includes supervision from a specialist in eating disorders, nutrition and body image for eating disorders, eating disorders with athletes, and eating disorders within adolescents. I also have experience with depression, anxiety, self-esteem, body image, and trauma. I provide an accepting and nonjudgmental approach to help you get to your ideal self. I aim to instill hope and ensure that you don’t feel alone.
(248) 218-9615 View (248) 218-9615
Photo of Lisa S Shepard, MA, LPC, NCC, Licensed Professional Counselor
Lisa S Shepard
Licensed Professional Counselor, MA, LPC, NCC
Verified Verified
Utica, MI 48317  (Online Only)
My goal is to help to empower your true potential and lead a LIFE WORTH CELEBRATING, EVERY SINGLE DAY! I am a compassionate, solution-focused/integrative therapist specializing in children/adolescents, adults & families. I am dedicated to guiding my clients toward wholeness and healing by offering a safe place to share your story and focus on what you want to achieve. Whether you are struggling with anxiety, depression, relationship issues or failure to succeed, together we will unearth behavior patterns or perceptions that may be holding you back from experiencing a BALANCED and JOYFUL LIFE; Mind, Body and Spirit!
My goal is to help to empower your true potential and lead a LIFE WORTH CELEBRATING, EVERY SINGLE DAY! I am a compassionate, solution-focused/integrative therapist specializing in children/adolescents, adults & families. I am dedicated to guiding my clients toward wholeness and healing by offering a safe place to share your story and focus on what you want to achieve. Whether you are struggling with anxiety, depression, relationship issues or failure to succeed, together we will unearth behavior patterns or perceptions that may be holding you back from experiencing a BALANCED and JOYFUL LIFE; Mind, Body and Spirit!
(586) 217-3826 View (586) 217-3826
Photo of Rebecca Cahill, LMSW, Clinical Social Work/Therapist
Rebecca Cahill
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Saint Clair Shores, MI 48081  (Online Only)
First of all, I want to express how happy I am that you're here! Seeking out a mental health provider is a HUGE step and I am here and ready to help. I have experience working with various populations, from childhood to middle adulthood. My areas of specialty include LGBTQ+, neurodiversity, anxiety, depression, trauma, codependence, chronic illness and life transitions. I spent my first few years post-graduation working in Community Mental Health (CMH), so I also understand deeply the impact of socioeconomic factors on mental health and physical wellbeing.
First of all, I want to express how happy I am that you're here! Seeking out a mental health provider is a HUGE step and I am here and ready to help. I have experience working with various populations, from childhood to middle adulthood. My areas of specialty include LGBTQ+, neurodiversity, anxiety, depression, trauma, codependence, chronic illness and life transitions. I spent my first few years post-graduation working in Community Mental Health (CMH), so I also understand deeply the impact of socioeconomic factors on mental health and physical wellbeing.
(586) 460-4584 View (586) 460-4584
Photo of Amanda Johnson, LPC, Licensed Professional Counselor
Amanda Johnson
Licensed Professional Counselor, LPC
Verified Verified
Amanda has worked as a mental health professional for almost 10 years in a variety of settings including outpatient, partial hospitalization, and residential treatment. Amanda provides a person-centered approach focusing on psychoeducation of therapy skills, self-exploration and even a little dose of humor.
Amanda has worked as a mental health professional for almost 10 years in a variety of settings including outpatient, partial hospitalization, and residential treatment. Amanda provides a person-centered approach focusing on psychoeducation of therapy skills, self-exploration and even a little dose of humor.
(586) 460-3942 View (586) 460-3942
Photo of Erin Carr, LMSW, ODS, Clinical Social Work/Therapist
Erin Carr
Clinical Social Work/Therapist, LMSW, ODS
Verified Verified
Whether by choice or circumstance, change is a process that requires bravery, patience, and a great partner.
Whether by choice or circumstance, change is a process that requires bravery, patience, and a great partner.
(586) 500-6267 View (586) 500-6267
Photo of Marilee R Trombley, MA, LPC, Counselor
Marilee R Trombley
Counselor, MA, LPC
Verified Verified
5 Endorsed
My specialty lies in trauma and complicated grief and loss. We all need a safe place to talk and express our emotions...knowing that the person listening understands the impact of YOUR loss/trauma on YOUR life. Many times we learn through our tragedies...but ALWAYS it changes who we are and our perspective. By talking out the new emotional/perspective changes, at times forced upon you, we can defuse the shame, the fear, and the doubts; helping you move forward from tragedy. The fact is you CAN move forward, through and past tragedy.
My specialty lies in trauma and complicated grief and loss. We all need a safe place to talk and express our emotions...knowing that the person listening understands the impact of YOUR loss/trauma on YOUR life. Many times we learn through our tragedies...but ALWAYS it changes who we are and our perspective. By talking out the new emotional/perspective changes, at times forced upon you, we can defuse the shame, the fear, and the doubts; helping you move forward from tragedy. The fact is you CAN move forward, through and past tragedy.
(586) 648-1616 View (586) 648-1616
Photo of Angilean Fleming, LLMSW, CAADC-D, Clinical Social Work/Therapist
Angilean Fleming
Clinical Social Work/Therapist, LLMSW, CAADC-D
Verified Verified
Warren, MI 48091
Angilean works with adolescents 16+, men and women of all ages providing individual therapy, group therapy with an emphasis on self-awareness, emotional regulation, and coping skills. Angilean treats people who experience symptoms of substance use disorder, anxiety, depression, identity concerns, life adjustment difficulties, stress management, mood disorders, and career concerns.
Angilean works with adolescents 16+, men and women of all ages providing individual therapy, group therapy with an emphasis on self-awareness, emotional regulation, and coping skills. Angilean treats people who experience symptoms of substance use disorder, anxiety, depression, identity concerns, life adjustment difficulties, stress management, mood disorders, and career concerns.
(313) 474-8049 View (313) 474-8049
Photo of Angela Arnold - Agentic Behavioral Health LLC, LMSW, Clinical Social Work/Therapist
Agentic Behavioral Health LLC
Clinical Social Work/Therapist, LMSW
Verified Verified
Macomb, MI 48044
Waitlist for new clients
There is a lot of things going on in world today from, economic changes to post Covid-19 adjustments increasing the level of stress on top of the day-to-day life. Especially, for clients diagnosed with depression or anxiety being in a place of extreme fearfulness or withdrawn makes if increasingly difficulty to navigate emotionally. Also, clients who are struggling with a medical diagnosis, cancer, diabetes or hypertension to name a few causing life changing disruptions. The overall goal is to provide new coping skills and move clients from a place of despair, self-doubt and hopelessness.
There is a lot of things going on in world today from, economic changes to post Covid-19 adjustments increasing the level of stress on top of the day-to-day life. Especially, for clients diagnosed with depression or anxiety being in a place of extreme fearfulness or withdrawn makes if increasingly difficulty to navigate emotionally. Also, clients who are struggling with a medical diagnosis, cancer, diabetes or hypertension to name a few causing life changing disruptions. The overall goal is to provide new coping skills and move clients from a place of despair, self-doubt and hopelessness.
(586) 600-7799 View (586) 600-7799
Photo of Gail A. Mills, MA, LLP, Limited Licensed Psychologist
Gail A. Mills
Limited Licensed Psychologist, MA, LLP
Verified Verified
I earned my Masters degree from Wayne State University's Marriage and Family Therapy Program. I have worked extensively with adults, children and adolescents, specializing in assessment and individual and group therapy, while working in the Court system for 27 years. In addition, I have provided therapy in various outpatient settings. I have worked contractually at Thrive Therapy Group for six years.
I earned my Masters degree from Wayne State University's Marriage and Family Therapy Program. I have worked extensively with adults, children and adolescents, specializing in assessment and individual and group therapy, while working in the Court system for 27 years. In addition, I have provided therapy in various outpatient settings. I have worked contractually at Thrive Therapy Group for six years.
(586) 500-6782 View (586) 500-6782
Photo of Tabitha Adkins, LLMSW, Clinical Social Work/Therapist
Tabitha Adkins
Clinical Social Work/Therapist, LLMSW
Verified Verified
2 Endorsed
Today's world is too often scary and overwhelming. For many of us, learning to function & adapt in life as a child, teen or young adult is confusing & difficult. These challenges lead to feeling lonely, frustrated or hopeless. Through our work together, you will become confident in yourself, begin to not just 'get by', but thrive. You will begin to experience a life where being you is more than good enough. Unavoidable challenges become opportunities & you gain control of the most important area, yourself. Working together, you will become equipped to navigate day to day life & the unexpected, emerging stronger, smarter & happier.
Today's world is too often scary and overwhelming. For many of us, learning to function & adapt in life as a child, teen or young adult is confusing & difficult. These challenges lead to feeling lonely, frustrated or hopeless. Through our work together, you will become confident in yourself, begin to not just 'get by', but thrive. You will begin to experience a life where being you is more than good enough. Unavoidable challenges become opportunities & you gain control of the most important area, yourself. Working together, you will become equipped to navigate day to day life & the unexpected, emerging stronger, smarter & happier.
(586) 846-4835 View (586) 846-4835
Photo of Patricia Thaar-Tocco - Thaar Care Counseling , MA, LPC, NCC, Licensed Professional Counselor
Thaar Care Counseling
Licensed Professional Counselor, MA, LPC, NCC
Verified Verified
1 Endorsed
Our goal at Thaar Care Foundation is to create a safe and supportive therapeutic environment in which a client can become more aware of themselves and how to use their strengths to overcome the obstacles that contribute to pain and dysfunction in their daily life. Our therapists are most influenced by Solution-Focused techniques which empowers a client to move past where they have been and embrace where they would like to be in their lives.
Our goal at Thaar Care Foundation is to create a safe and supportive therapeutic environment in which a client can become more aware of themselves and how to use their strengths to overcome the obstacles that contribute to pain and dysfunction in their daily life. Our therapists are most influenced by Solution-Focused techniques which empowers a client to move past where they have been and embrace where they would like to be in their lives.
(248) 600-5178 View (248) 600-5178
Photo of Rachel Wolf, LPC, CCTP, Licensed Professional Counselor
Rachel Wolf
Licensed Professional Counselor, LPC, CCTP
Verified Verified
Rachel Wolf is a Licensed Professional Counselor in the state of Michigan. She has over a decade of experience working with a widely diverse population of adults seeking help with depression, anxiety, substance abuse/addiction, sexuality, and life transitions. She also has experience working with those in alternative relationship structures (polyamory) and individuals in the LGBTQIA+ community. Rachel received her Bachelor of Arts in Psychology and Master of Arts in Counseling from Oakland University.
Rachel Wolf is a Licensed Professional Counselor in the state of Michigan. She has over a decade of experience working with a widely diverse population of adults seeking help with depression, anxiety, substance abuse/addiction, sexuality, and life transitions. She also has experience working with those in alternative relationship structures (polyamory) and individuals in the LGBTQIA+ community. Rachel received her Bachelor of Arts in Psychology and Master of Arts in Counseling from Oakland University.
(586) 210-9415 View (586) 210-9415
Photo of Elizabeth M Strong, LMSW, Clinical Social Work/Therapist
Elizabeth M Strong
Clinical Social Work/Therapist, LMSW
Verified Verified
Utica, MI 48317
Not accepting new clients
I graduated in 2009 with my Master of Social Work from Wayne State University, with a concentration in Cognitive Behavioral Therapy. I have experience with children, families and adults with a number of diagnoses including anxiety, depression, Bipolar Disorder, trauma, borderline personality disorder, ADHD and Oppositional Defiant Disorder. I have a passion for children, teens, parents and adults and seek to provide a safe, non-judgemental space for people to learn and grow. I also have a strong area of passion for pregnant and postpartum moms! I am a mom just like you and I would love to connect and offer support!
I graduated in 2009 with my Master of Social Work from Wayne State University, with a concentration in Cognitive Behavioral Therapy. I have experience with children, families and adults with a number of diagnoses including anxiety, depression, Bipolar Disorder, trauma, borderline personality disorder, ADHD and Oppositional Defiant Disorder. I have a passion for children, teens, parents and adults and seek to provide a safe, non-judgemental space for people to learn and grow. I also have a strong area of passion for pregnant and postpartum moms! I am a mom just like you and I would love to connect and offer support!
(586) 991-3967 View (586) 991-3967

See more therapy options for Macomb County

How does your Therapist compare?

Number of Therapists in Macomb County, MI

900+

Average cost per session

$130

Therapists in Macomb County, MI who prioritize treating:

92% Anxiety
88% Depression
75% Self Esteem
71% Relationship Issues
71% Coping Skills
67% Trauma and PTSD
66% Grief

Average years in practice

10 Years

Top 3 insurances accepted

92% BlueCross and BlueShield
68% Aetna
61% Blue Care Network

How Therapists in Macomb County, MI see their clients

75% In Person and Online
25% Online Only

Gender breakdown

82% Female
17% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Macomb 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.