Therapists in Fluvanna County, VA

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Photo of Kenneth Adrian Deneault, LPC, Licensed Professional Counselor
Kenneth Adrian Deneault
Licensed Professional Counselor, LPC
Verified Verified
Palmyra, VA 22963
Ken Deneault is a Licensed Professional Counselor (LPC) with over 5 years of experience with children, adolescents, adults and elderly persons dealing with a variety of issues that affect their well being. Ken offers office hours for outpatient therapy.
Ken Deneault is a Licensed Professional Counselor (LPC) with over 5 years of experience with children, adolescents, adults and elderly persons dealing with a variety of issues that affect their well being. Ken offers office hours for outpatient therapy.
(434) 201-7563 View (434) 201-7563
Photo of Steven Welsh, LPC, Licensed Professional Counselor
Steven Welsh
Licensed Professional Counselor, LPC
Verified Verified
Palmyra, VA 22963
Feeling overwhelmed by stress, anxiety, or depression? Yearning for a life of healing and growth? You're not alone. Let's embark on a journey together, transforming challenges into opportunities, and cultivating a sense of confidence and security within yourself.
Feeling overwhelmed by stress, anxiety, or depression? Yearning for a life of healing and growth? You're not alone. Let's embark on a journey together, transforming challenges into opportunities, and cultivating a sense of confidence and security within yourself.
(434) 277-2206 View (434) 277-2206
Photo of Devin Byam, LPC, Licensed Professional Counselor
Devin Byam
Licensed Professional Counselor, LPC
Verified Verified
2 Endorsed
Palmyra, VA 22963
I am passionate about working with individuals, couples and families in order to create healthy and sustainable thoughts, feelings, and patterns of behavior that empower them to be their best selves. My ideal client is someone who is motivated to change and recognizes that, even in life's hard times, you can still make positive changes that will empower you to move forward.
I am passionate about working with individuals, couples and families in order to create healthy and sustainable thoughts, feelings, and patterns of behavior that empower them to be their best selves. My ideal client is someone who is motivated to change and recognizes that, even in life's hard times, you can still make positive changes that will empower you to move forward.
(434) 277-2061 View (434) 277-2061
Photo of Pamela Parker Siegel, LPC, Licensed Professional Counselor
Pamela Parker Siegel
Licensed Professional Counselor, LPC
Verified Verified
Troy, VA 22974
I teach you how to help your Self by strengthening your awareness, esteem and power skills. Using a rapid insight tool, you will be able to “see” your emotional process and become an active manager of your emotions, thoughts and choices through your self-relationship. You will learn to understand and interpret your emotional pain, which actually illuminates unmet emotional needs. I will guide you in developing enough awareness and emotional competence to make intentional and informed choices, creating emotional balance and well-being. You meet your own emotional needs with healthy supply while internalizing resilience.
I teach you how to help your Self by strengthening your awareness, esteem and power skills. Using a rapid insight tool, you will be able to “see” your emotional process and become an active manager of your emotions, thoughts and choices through your self-relationship. You will learn to understand and interpret your emotional pain, which actually illuminates unmet emotional needs. I will guide you in developing enough awareness and emotional competence to make intentional and informed choices, creating emotional balance and well-being. You meet your own emotional needs with healthy supply while internalizing resilience.
(434) 208-1706 View (434) 208-1706
Photo of Jessica Campos, LCSW, Clinical Social Work/Therapist
Jessica Campos
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Palmyra, VA 22963
I have worked in the field as a mental health provider for at-risk and vulnerable populations since 2006. I am certified in Trauma and Resilience and also have a minor in special education.
I have worked in the field as a mental health provider for at-risk and vulnerable populations since 2006. I am certified in Trauma and Resilience and also have a minor in special education.
(434) 331-1023 View (434) 331-1023
Photo of Shannon Garrett-Redmond, LCSW, Clinical Social Work/Therapist
Shannon Garrett-Redmond
Clinical Social Work/Therapist, LCSW
Verified Verified
Palmyra, VA 22963
It is hard to sleep at night and you find it is hard to enjoy your life, or concentrate on the things that matter to you. You are lost and you worry that you will be overcome by fear and anger at any moment You are tired of feeling numb, but afraid you will be overwhelmed by your feelings at the same time. You are worried that his feeling will never end. If you are a parent, your child does not sleep anymore, and is worried and scared all the time. You do not know how to help your child with what has happened. They are withdrawn or angry and you miss the child they were before.
It is hard to sleep at night and you find it is hard to enjoy your life, or concentrate on the things that matter to you. You are lost and you worry that you will be overcome by fear and anger at any moment You are tired of feeling numb, but afraid you will be overwhelmed by your feelings at the same time. You are worried that his feeling will never end. If you are a parent, your child does not sleep anymore, and is worried and scared all the time. You do not know how to help your child with what has happened. They are withdrawn or angry and you miss the child they were before.
(434) 201-4330 View (434) 201-4330
Photo of Barbara J Blair, LPC, Licensed Professional Counselor
Barbara J Blair
Licensed Professional Counselor, LPC
Verified Verified
Troy, VA 22974
Life is hard, we all struggle from time to time and just need someone to talk to about our feelings and struggles. Perhaps you have unresolved trauma or lost a loved one, or dealing with increased anxiety in this ever changing and uncertain world we are living in. If this sounds like you, please let me help. I will listen with compassion, help you identify areas in your life that are too difficult to handle on your own, help you identify healthy coping skills to manage anxiety, depression, and difficulty concentrating. Call today to see if I'm the right fit for you.
Life is hard, we all struggle from time to time and just need someone to talk to about our feelings and struggles. Perhaps you have unresolved trauma or lost a loved one, or dealing with increased anxiety in this ever changing and uncertain world we are living in. If this sounds like you, please let me help. I will listen with compassion, help you identify areas in your life that are too difficult to handle on your own, help you identify healthy coping skills to manage anxiety, depression, and difficulty concentrating. Call today to see if I'm the right fit for you.
(434) 363-9437 View (434) 363-9437
Photo of Jennifer Bailey, LCSW, Clinical Social Work/Therapist
Jennifer Bailey
Clinical Social Work/Therapist, LCSW
Verified Verified
Palmyra, VA 22963  (Online Only)
Are there things you would like to accomplish but you don't know where to start? Do you feel like you are at a crossroads and unsure which direction to choose? Do you feel unsatisfied or feel like you are not reaching your full potential in life? We all have moments where we feel this way. Whether the source of these feelings is from experiencing a loss, reaching a new milestone or feeling as though you are in a rut. Therapy is a place where you explore these feelings. You can work with me to figure out a plan for your life. A plan that you feel content with and maybe even proud of.
Are there things you would like to accomplish but you don't know where to start? Do you feel like you are at a crossroads and unsure which direction to choose? Do you feel unsatisfied or feel like you are not reaching your full potential in life? We all have moments where we feel this way. Whether the source of these feelings is from experiencing a loss, reaching a new milestone or feeling as though you are in a rut. Therapy is a place where you explore these feelings. You can work with me to figure out a plan for your life. A plan that you feel content with and maybe even proud of.
(434) 623-9402 View (434) 623-9402
Photo of Charlotte A. Schafer, BS, MA, Licensed Professional Counselor
Charlotte A. Schafer
Licensed Professional Counselor, BS, MA
Verified Verified
1 Endorsed
Palmyra, VA 22963  (Online Only)
Do you wish you knew better coping strategies for managing ADHD, anxiety, or depression? Are you feeling under the control of others and don’t know how to break free? Are you experiencing guilt, or sadness that doesn't go away? As a professional counselor I can help you find your way back to a more joyful, healthy life. As a caring professional I can teach you techniques that make these distresses lesson or even leave, and help you regain a more balanced perspective over your emotional issues. Are you looking for empowerment over emotional habiting? As a balanced Christian counselor I have answers, I would love to help you.
Do you wish you knew better coping strategies for managing ADHD, anxiety, or depression? Are you feeling under the control of others and don’t know how to break free? Are you experiencing guilt, or sadness that doesn't go away? As a professional counselor I can help you find your way back to a more joyful, healthy life. As a caring professional I can teach you techniques that make these distresses lesson or even leave, and help you regain a more balanced perspective over your emotional issues. Are you looking for empowerment over emotional habiting? As a balanced Christian counselor I have answers, I would love to help you.
(434) 595-3062 View (434) 595-3062
Photo of Cynthia Starnes, LCSW, Clinical Social Work/Therapist
Cynthia Starnes
Clinical Social Work/Therapist, LCSW
Verified Verified
Palmyra, VA 22963  (Online Only)
I have over 17 years of experience supporting clients who suffer from trauma-related disorders, including intimate partner violence, childhood abuse/sexual abuse, post-traumatic stress disorder, depression, and loss and grief issues. As a former EMT, I have a unique perspective and training for working with EMS/First Responders as well. We will work together as partners in your treatment, developing a plan to process your trauma and move from the role of victim to that of a strong and successful survivor. I offer online sessions via a HIPAA compliant, secure, easy to use platform with easy online scheduling.
I have over 17 years of experience supporting clients who suffer from trauma-related disorders, including intimate partner violence, childhood abuse/sexual abuse, post-traumatic stress disorder, depression, and loss and grief issues. As a former EMT, I have a unique perspective and training for working with EMS/First Responders as well. We will work together as partners in your treatment, developing a plan to process your trauma and move from the role of victim to that of a strong and successful survivor. I offer online sessions via a HIPAA compliant, secure, easy to use platform with easy online scheduling.
(434) 264-5326 View (434) 264-5326
Photo of Jennifer Bates, LCSW, MDiv, Clinical Social Work/Therapist
Jennifer Bates
Clinical Social Work/Therapist, LCSW, MDiv
Verified Verified
Palmyra, VA 22963  (Online Only)
There are some changes and losses in life that break us. Completely. Totally. Every area is fragmented, jagged and raw. Sometimes the hurt is so overwhelming that we become numb, afraid, avoiding things that we used to enjoy. It’s hard to put those pieces back together again. They don’t fit the way they did before. While time may heal some wounds, moving from being functional in your pain to being free from that hurt takes effort and therapy. As a licensed clinical social worker with over ten years of experience, I’m here to assist you in moving from function to freedom.
There are some changes and losses in life that break us. Completely. Totally. Every area is fragmented, jagged and raw. Sometimes the hurt is so overwhelming that we become numb, afraid, avoiding things that we used to enjoy. It’s hard to put those pieces back together again. They don’t fit the way they did before. While time may heal some wounds, moving from being functional in your pain to being free from that hurt takes effort and therapy. As a licensed clinical social worker with over ten years of experience, I’m here to assist you in moving from function to freedom.
(434) 201-2576 View (434) 201-2576
Photo of Steven Welsh, LPC, Licensed Professional Counselor
Steven Welsh
Licensed Professional Counselor, LPC
Verified Verified
Palmyra, VA 22963
I enjoy working with teenagers, adults, and families. I have experience working with a variety of mental health needs from anxiety and depression to anger, trauma and behavioral issues. I support clients who are overwhelmed with stress and life adjustments and help them learn to transform their life challenges into opportunities for healing and growth. Individuals will learn to recognize behaviors and thoughts that keep them stuck and are provided with tools to help them process difficult emotions.
I enjoy working with teenagers, adults, and families. I have experience working with a variety of mental health needs from anxiety and depression to anger, trauma and behavioral issues. I support clients who are overwhelmed with stress and life adjustments and help them learn to transform their life challenges into opportunities for healing and growth. Individuals will learn to recognize behaviors and thoughts that keep them stuck and are provided with tools to help them process difficult emotions.
(434) 813-6309 View (434) 813-6309
Photo of Courtney D Bonilla, LPC, Licensed Professional Counselor
Courtney D Bonilla
Licensed Professional Counselor, LPC
Verified Verified
Troy, VA 22974
I believe the therapeutic relationship is a collaborative one in which you have the power to make lasting changes toward a more balanced, connected and resourced life. I am a Licensed Professional Counselor providing individual and family counseling to children, adolescents, families and adults. I have extensive knowledge of behavior management strategies and parenting skill support as a former provider of Therapeutic Day Treatment in the school setting and Intensive In-home Services.  My training in trauma and resilience informs my work and allows for the strengths of the individual to guide growth and healing.
I believe the therapeutic relationship is a collaborative one in which you have the power to make lasting changes toward a more balanced, connected and resourced life. I am a Licensed Professional Counselor providing individual and family counseling to children, adolescents, families and adults. I have extensive knowledge of behavior management strategies and parenting skill support as a former provider of Therapeutic Day Treatment in the school setting and Intensive In-home Services.  My training in trauma and resilience informs my work and allows for the strengths of the individual to guide growth and healing.
(434) 208-2615 View (434) 208-2615
Photo of Raechel Brittain, LCSW, Clinical Social Work/Therapist
Raechel Brittain
Clinical Social Work/Therapist, LCSW
Verified Verified
Palmyra, VA 22963  (Online Only)
Welcome – I’m happily accepting new clients with availability on Saturday mornings and evenings on weekdays! I am a Licensed Clinical Social Worker (LCSW) in Virginia with over ten years of clinical experience working with adolescents and adults in a variety of therapeutic settings. In moments of great change, challenging decisions, or feeling disconnected from ourselves and others, a welcoming non-judgmental therapeutic environment can help you reconnect with your inner resilience and find new ways forward.
Welcome – I’m happily accepting new clients with availability on Saturday mornings and evenings on weekdays! I am a Licensed Clinical Social Worker (LCSW) in Virginia with over ten years of clinical experience working with adolescents and adults in a variety of therapeutic settings. In moments of great change, challenging decisions, or feeling disconnected from ourselves and others, a welcoming non-judgmental therapeutic environment can help you reconnect with your inner resilience and find new ways forward.
(434) 474-1629 View (434) 474-1629
Photo of Karen Cersley, LPC, MBA, MA, Licensed Professional Counselor
Karen Cersley
Licensed Professional Counselor, LPC, MBA, MA
Verified Verified
2 Endorsed
Troy, VA 22974
Waitlist for new clients
Are you looking for more fulfillment in life, more happiness, and more tools for self-discovery, relationship-building, and problem-solving? Through our collaboration, we will identify and set specific goals and then work together to make meaningful changes. Through a spiritual psychology approach, we will partner together to help you maintain physical, emotional, mental, and spiritual health & well-being. If you are willing to invest yourself in the process, I will walk beside you on your journey to reach your goals and dreams while you learn more effectively how to deal with situations in your life. How can I serve you?
Are you looking for more fulfillment in life, more happiness, and more tools for self-discovery, relationship-building, and problem-solving? Through our collaboration, we will identify and set specific goals and then work together to make meaningful changes. Through a spiritual psychology approach, we will partner together to help you maintain physical, emotional, mental, and spiritual health & well-being. If you are willing to invest yourself in the process, I will walk beside you on your journey to reach your goals and dreams while you learn more effectively how to deal with situations in your life. How can I serve you?
(434) 473-7243 View (434) 473-7243
Photo of Megan Osburn, MS, LPC, Licensed Professional Counselor
Megan Osburn
Licensed Professional Counselor, MS, LPC
Verified Verified
Palmyra, VA 22963  (Online Only)
My ideal client is someone who is wanting to take a deeper look at their own reflection. Have you ever seen a movie or television show with an insensitive therapist and thought: Is this what therapy is supposed to look like? I can tell you therapy with me will not look like the disinterested professional depicted on television. My therapy style is built on the keystone of rapport building. I value our time together and respect boundaries as we work collaboratively to navigate some of life’s hardships.
My ideal client is someone who is wanting to take a deeper look at their own reflection. Have you ever seen a movie or television show with an insensitive therapist and thought: Is this what therapy is supposed to look like? I can tell you therapy with me will not look like the disinterested professional depicted on television. My therapy style is built on the keystone of rapport building. I value our time together and respect boundaries as we work collaboratively to navigate some of life’s hardships.
(434) 204-4413 View (434) 204-4413
Photo of Christina Michelle Taylor - A Step Forward Counseling, LMFT, Marriage & Family Therapist
A Step Forward Counseling
Marriage & Family Therapist, LMFT
Verified Verified
Palmyra, VA 22963
First and foremost I want to praise you for taking the first step in making a positive change in your life (as I'm well aware this is NOT easy)! Here are issues/concerns I best target that can help along your journey: anger control, anxiety, blended family issues, depression, low self-esteem/worth, lying/manipulative, miscommunication, negative thinking, oppositional defiant, parenting, Relationship conflict resolution, and helping others to see perspectives different from their own. Again, these shifts are NOT easy to make so please know therapy is what you make it; if you put the work in you WILL see the changes you desire!
First and foremost I want to praise you for taking the first step in making a positive change in your life (as I'm well aware this is NOT easy)! Here are issues/concerns I best target that can help along your journey: anger control, anxiety, blended family issues, depression, low self-esteem/worth, lying/manipulative, miscommunication, negative thinking, oppositional defiant, parenting, Relationship conflict resolution, and helping others to see perspectives different from their own. Again, these shifts are NOT easy to make so please know therapy is what you make it; if you put the work in you WILL see the changes you desire!
(434) 436-2925 View (434) 436-2925
Photo of Rebecca McIntyre - Rebecca McIntyre Psychotherapy LLC, MA, MEd, LCSW, Clinical Social Work/Therapist
Rebecca McIntyre Psychotherapy LLC
Clinical Social Work/Therapist, MA, MEd, LCSW
Verified Verified
Palmyra, VA 22963
Rebecca is a licensed clinical social worker with extensive training and experience working with individuals, couples and families dealing with the challenges of mental health issues, and/or physical illness such as cancer. She has expertise working with anxiety, depression, ADHD (Adults and Children), trauma, dealing with serious illness, relationships, and grief and loss. Rebecca practices with a kind and gentle approach using proven strategies to help clients regain control and move forward with a focus on building resilience and overall healthy functioning.
Rebecca is a licensed clinical social worker with extensive training and experience working with individuals, couples and families dealing with the challenges of mental health issues, and/or physical illness such as cancer. She has expertise working with anxiety, depression, ADHD (Adults and Children), trauma, dealing with serious illness, relationships, and grief and loss. Rebecca practices with a kind and gentle approach using proven strategies to help clients regain control and move forward with a focus on building resilience and overall healthy functioning.
(434) 218-0654 View (434) 218-0654
Photo of Erinn Falls, MSW
Erinn Falls
MSW
Verified Verified
1 Endorsed
Palmyra, VA 22963  (Online Only)
When we feel securely and safely connected to our significant other we experience a sense of well-being and the ability to respond more flexibly to the inevitable stressors of life. When we feel disconnected however, we may experience anxiety, irritability, anger or depression. This distress impacts every area of our lives and diminishes our ability to live, work and parent from our optimal self. Often we numb that disconnection through work, addiction, or an over-focus on being co-parents versus best friends and romantic partners. Usually this impairs our ability to connect sexually in a meaningful and satisfying way as well.
When we feel securely and safely connected to our significant other we experience a sense of well-being and the ability to respond more flexibly to the inevitable stressors of life. When we feel disconnected however, we may experience anxiety, irritability, anger or depression. This distress impacts every area of our lives and diminishes our ability to live, work and parent from our optimal self. Often we numb that disconnection through work, addiction, or an over-focus on being co-parents versus best friends and romantic partners. Usually this impairs our ability to connect sexually in a meaningful and satisfying way as well.
(434) 361-3155 View (434) 361-3155
Photo of Angela L. Leyshon, MA, LPC, Licensed Professional Counselor
Angela L. Leyshon
Licensed Professional Counselor, MA, LPC
Verified Verified
Palmyra, VA 22963
Journeying alongside clients during life struggles takes relationship building and rebuilding: relationship with self and others. My goal is helping clients work through strongholds to create a healthier person to have a healthier life and healthier relationships. Getting rid of old habits and wrong beliefs to usher in habits and truths that benefit a well lived life, is a complete life changing make-over that takes time, effort, sweat, and tears. Together, my clients and I work toward conquering mountains by uncovering these strongholds, allowing healing and empowerment to be achieved to live a life with authority.
Journeying alongside clients during life struggles takes relationship building and rebuilding: relationship with self and others. My goal is helping clients work through strongholds to create a healthier person to have a healthier life and healthier relationships. Getting rid of old habits and wrong beliefs to usher in habits and truths that benefit a well lived life, is a complete life changing make-over that takes time, effort, sweat, and tears. Together, my clients and I work toward conquering mountains by uncovering these strongholds, allowing healing and empowerment to be achieved to live a life with authority.
(434) 201-8019 View (434) 201-8019
1

See more therapy options for Fluvanna County

How does your Therapist compare?

Number of Therapists in Fluvanna County, VA

30+

Average cost per session

$140

Therapists in Fluvanna County, VA who prioritize treating:

91% Anxiety
82% Depression
76% Trauma and PTSD
76% Coping Skills
74% Self Esteem
74% Stress
71% Grief

Average years in practice

11 Years

Top 3 insurances accepted

81% Aetna
78% Elevance
59% BlueCross and BlueShield

How Therapists in Fluvanna County, VA see their clients

74% In Person and Online
26% Online Only

Gender breakdown

77% Female
23% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Fluvanna 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.