Therapists in Page County, VA

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Photo of Brittany Williams, LPC, Licensed Professional Counselor
Brittany Williams
Licensed Professional Counselor, LPC
Verified Verified
Stanley, VA 22851
My name is Brittany Williams. I am an LPC in Virginia and I mostly use cognitive-behavioral therapy. I enjoy working with a wide range of people of all ages and conditions from kids to teenagers to adults to older adults, who are experiencing anything from depression to anxiety to life changes such as grief and loss or anything in between! I look forward to working with you! I have worked with clients of all ages but enjoy mostly working with kids and teenagers. I feel like they have a lot going on in life that is very difficult to navigate and can have a lot of depression and anxiety on top of everything else.
My name is Brittany Williams. I am an LPC in Virginia and I mostly use cognitive-behavioral therapy. I enjoy working with a wide range of people of all ages and conditions from kids to teenagers to adults to older adults, who are experiencing anything from depression to anxiety to life changes such as grief and loss or anything in between! I look forward to working with you! I have worked with clients of all ages but enjoy mostly working with kids and teenagers. I feel like they have a lot going on in life that is very difficult to navigate and can have a lot of depression and anxiety on top of everything else.
(804) 251-3723 View (804) 251-3723
Photo of Jeff Lown, MA, EdS, LPC, Licensed Professional Counselor
Jeff Lown
Licensed Professional Counselor, MA, EdS, LPC
Verified Verified
Luray, VA 22835
Not accepting new clients
There is never a wrong time to start therapy, nor is there a right one. We won’t worry about right or wrong, but instead we’ll accept where you are - as we work together to discover where you want to go and how to get there. I spend a lot of my free time hiking, seeking out new and interesting terrain. The growth you will hopefully experience during our work together may be much like a challenging hike, with some gentle slopes and triumphant summits, but also with trips, stumbles, and strenuous climbs. I cannot climb your mountains for you, but I will climb them with you and help to show you the way forward.
There is never a wrong time to start therapy, nor is there a right one. We won’t worry about right or wrong, but instead we’ll accept where you are - as we work together to discover where you want to go and how to get there. I spend a lot of my free time hiking, seeking out new and interesting terrain. The growth you will hopefully experience during our work together may be much like a challenging hike, with some gentle slopes and triumphant summits, but also with trips, stumbles, and strenuous climbs. I cannot climb your mountains for you, but I will climb them with you and help to show you the way forward.
(540) 534-4438 View (540) 534-4438
Photo of Deveney Elizabeth Quinney, MA, Licensed Professional Counselor
Deveney Elizabeth Quinney
Licensed Professional Counselor, MA
Verified Verified
Luray, VA 22835
Not accepting new clients
I enjoy working with a wide variety of individuals and believe that the therapeutic relationship can be a catalyst for an array of life affirming changes. Every individual has the right to find peace, joy and satisfaction in life. Often our inner dialogues, messages we've received from others, as well as traumatic and painful life experiences can interfere with our ability to find peace. In our work together, my goal will be to assist you in reaching whatever it is that you define as the best life for you.
I enjoy working with a wide variety of individuals and believe that the therapeutic relationship can be a catalyst for an array of life affirming changes. Every individual has the right to find peace, joy and satisfaction in life. Often our inner dialogues, messages we've received from others, as well as traumatic and painful life experiences can interfere with our ability to find peace. In our work together, my goal will be to assist you in reaching whatever it is that you define as the best life for you.
(540) 534-0313 View (540) 534-0313
Photo of Robin Beck, LPC, Licensed Professional Counselor
Robin Beck
Licensed Professional Counselor, LPC
Verified Verified
Shenandoah, VA 22849
Welcome! My name is Robin Beck and I am a Licensed Professional Counselor. I will work with individuals, couples, and families experiencing depression, anxiety, bipolar, trauma, PTSD, substance use as a comorbid issue, ADHD, adjustment disorder, anger management, behavioral issues, and relational issues. I specialize in CBT, DBT, person-centered, positive psychology, solution-focused, existential, and trauma-informed therapy when working with clients. I believe once the root of the problem is discovered, we can process it and find positive strategies to heal through the painful core issue.
Welcome! My name is Robin Beck and I am a Licensed Professional Counselor. I will work with individuals, couples, and families experiencing depression, anxiety, bipolar, trauma, PTSD, substance use as a comorbid issue, ADHD, adjustment disorder, anger management, behavioral issues, and relational issues. I specialize in CBT, DBT, person-centered, positive psychology, solution-focused, existential, and trauma-informed therapy when working with clients. I believe once the root of the problem is discovered, we can process it and find positive strategies to heal through the painful core issue.
(757) 780-5630 View (757) 780-5630
Photo of Janae Jackson, LCSW, Clinical Social Work/Therapist
Janae Jackson
Clinical Social Work/Therapist, LCSW
Verified Verified
Shenandoah, VA 22849
Licensed Clinical Social Worker with clinical experience across a variety of settings, including Intensive In-Home (IIH), Therapeutic Day Treatment (TDT), crisis intervention, school-based, community-based, and military and family lifestyle counseling. I have experience working with the military population, adults, children, adolescents, couples, and families.
Licensed Clinical Social Worker with clinical experience across a variety of settings, including Intensive In-Home (IIH), Therapeutic Day Treatment (TDT), crisis intervention, school-based, community-based, and military and family lifestyle counseling. I have experience working with the military population, adults, children, adolescents, couples, and families.
(804) 657-4377 View (804) 657-4377
Photo of Jenna L Cohen, LPC, Licensed Professional Counselor
Jenna L Cohen
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Luray, VA 22835  (Online Only)
Do you spend too much time distressed about the past or future? Do you want to be more focused on the things that are important to you? I am glad you're here and seeking change & self-exploration! Therapy is a unique place to seek healing & growth, and it can only occur in a place where you feel safe, believed, & supported. I believe that the development of self-awareness, deepening meaningful and substantial connections with others, & improving emotional resilience creates a space for change, growth, and healing to take place. You aren't alone in this walk and you can be sure we're on the same team as you navigate therapy.
Do you spend too much time distressed about the past or future? Do you want to be more focused on the things that are important to you? I am glad you're here and seeking change & self-exploration! Therapy is a unique place to seek healing & growth, and it can only occur in a place where you feel safe, believed, & supported. I believe that the development of self-awareness, deepening meaningful and substantial connections with others, & improving emotional resilience creates a space for change, growth, and healing to take place. You aren't alone in this walk and you can be sure we're on the same team as you navigate therapy.
(540) 889-3285 View (540) 889-3285
Photo of Stephanie Gosnell - EAS Winchester, PLLC, LCSW, Clinical Social Work/Therapist
EAS Winchester, PLLC
Clinical Social Work/Therapist, LCSW
Verified Verified
Shenandoah, VA 22849
Children, At-Risk-youth, criminally involved juveniles and adults, children and adults with a history of trauma (physical abuse, sexual abuse, neglect), depression, anxiety.
Children, At-Risk-youth, criminally involved juveniles and adults, children and adults with a history of trauma (physical abuse, sexual abuse, neglect), depression, anxiety.
(540) 390-1471 View (540) 390-1471
Photo of Anna Marguerite Karola, PhD
Anna Marguerite Karola
PhD
Verified Verified
Shenandoah, VA 22849
I have extensive experience working with individuals in transition and working with clients who are seeking their own personal growth. Having lived and worked overseas, I am familiar with diversity, multicultural and multi-socioeconomic backgrounds. I travel with you, acting as a Transition Coach/ Guide as you explore your inner worlds clarifying your purpose, and shaping to your life's goals. I am also a spiritual coach providing guidance and support for those who are graduating from this life and who need help with this transition. All life is transition and transition is where we create growth.
I have extensive experience working with individuals in transition and working with clients who are seeking their own personal growth. Having lived and worked overseas, I am familiar with diversity, multicultural and multi-socioeconomic backgrounds. I travel with you, acting as a Transition Coach/ Guide as you explore your inner worlds clarifying your purpose, and shaping to your life's goals. I am also a spiritual coach providing guidance and support for those who are graduating from this life and who need help with this transition. All life is transition and transition is where we create growth.
(540) 307-1175 View (540) 307-1175
Photo of Sarah McClelland, LCSW, Clinical Social Work/Therapist
Sarah McClelland
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Shenandoah, VA 22849
Have your negative thoughts taken over? Have you been feeling sad or stressed while trying to keep it all together? Struggling with motivation? Are your relationships distant or full of conflict? Have you been feeling disconnected from those around you? Wanting to talk with someone but not knowing with whom, or how? Asking for help can be hard! Seeking therapy requires a great deal of strength and commitment and you have taken a great first step.
Have your negative thoughts taken over? Have you been feeling sad or stressed while trying to keep it all together? Struggling with motivation? Are your relationships distant or full of conflict? Have you been feeling disconnected from those around you? Wanting to talk with someone but not knowing with whom, or how? Asking for help can be hard! Seeking therapy requires a great deal of strength and commitment and you have taken a great first step.
(540) 501-6595 View (540) 501-6595
Photo of Kadie A King, LPC, LMHP, Licensed Professional Counselor
Kadie A King
Licensed Professional Counselor, LPC, LMHP
Verified Verified
1 Endorsed
Luray, VA 22835
Not accepting new clients
****Not Accepting New Clients at this time**** Rocktown Counseling LLC, was created in order to meet continued mental health needs in our community after the COVID19 pandemic began. Primarily my work focuses on children, adolescents, parents, and helping families see how the whole family impacts one another. In my 10+ years of experience I have worked with individuals with different abilities, at-risk youth experiencing trauma, and families desiring to develop a deeper attachment. Individual goals range from coping strategies for anxiety/depression, trauma treatment, and attachment parenting.
****Not Accepting New Clients at this time**** Rocktown Counseling LLC, was created in order to meet continued mental health needs in our community after the COVID19 pandemic began. Primarily my work focuses on children, adolescents, parents, and helping families see how the whole family impacts one another. In my 10+ years of experience I have worked with individuals with different abilities, at-risk youth experiencing trauma, and families desiring to develop a deeper attachment. Individual goals range from coping strategies for anxiety/depression, trauma treatment, and attachment parenting.
(540) 426-3855 View (540) 426-3855

Online Therapists

Photo of Julia B. Sayre - Julia B. Sayre, LMFT, LLC, MS, LMFT, CT, Marriage & Family Therapist
Julia B. Sayre, LMFT, LLC
Marriage & Family Therapist, MS, LMFT, CT
Verified Verified
1 Endorsed
Front Royal, VA 22630  (Online Only)
I offer tele-sessions in VA or SC, for trauma-informed marriage counseling, relationship and individual therapy. You may be in a transition: marriage; parenthood; military service or veteran; divorce; or remarriage. Or feeling frustrated with your child or teen, extended family, or coworkers. You may be noticing relationship effects of recent or past trauma, or grief and loss. You or a family member may be addressing aging, chronic pain or medical issues. Healthy relationships start with self-understanding and self-compassion, enabling you to know yourself so that you can hear and connect with others who are important in your life.
I offer tele-sessions in VA or SC, for trauma-informed marriage counseling, relationship and individual therapy. You may be in a transition: marriage; parenthood; military service or veteran; divorce; or remarriage. Or feeling frustrated with your child or teen, extended family, or coworkers. You may be noticing relationship effects of recent or past trauma, or grief and loss. You or a family member may be addressing aging, chronic pain or medical issues. Healthy relationships start with self-understanding and self-compassion, enabling you to know yourself so that you can hear and connect with others who are important in your life.
(843) 271-4771 View (843) 271-4771
Photo of Justine Ruotolo (Aka Miss Add), LMFT, Marriage & Family Therapist
Justine Ruotolo (Aka Miss Add)
Marriage & Family Therapist, LMFT
Verified Verified
McLean, VA 22101
I have been an ADHD/Executive Function Coach for 31 years. I am also a Licensed Marriage and Family Therapist. I specialize in working with children, adolescents, adults, couples, and families, who are challenged with the executive function deficits associated with ADHD.I use I utilize mindfulness and meditation, which can create neuroplasticity in the brain. Through this process, the Gifts associated with the creative mindset seen in those with ADHD, can finally be experienced and utilized! I am certified in EMDR, which I use to help my ADHD clients deal with the "Shame" associated with trauma that affected their life.
I have been an ADHD/Executive Function Coach for 31 years. I am also a Licensed Marriage and Family Therapist. I specialize in working with children, adolescents, adults, couples, and families, who are challenged with the executive function deficits associated with ADHD.I use I utilize mindfulness and meditation, which can create neuroplasticity in the brain. Through this process, the Gifts associated with the creative mindset seen in those with ADHD, can finally be experienced and utilized! I am certified in EMDR, which I use to help my ADHD clients deal with the "Shame" associated with trauma that affected their life.
(571) 470-5551 View (571) 470-5551
Photo of Richard Krogmann, EdS
Richard Krogmann
EdS
Verified Verified
Richmond, VA 23225
We provide a range of psychological evaluations in Richmond–for children, teens, and adults. Assessments for dyslexia, dysgraphia, and dyscalculia (learning disabilities in reading, writing, and math). We also provide evaluations for ADHD and autism. And, because many of our clients also struggle with anxiety, depression, or similar, we can help sort out how these impact day-to-day functioning.
We provide a range of psychological evaluations in Richmond–for children, teens, and adults. Assessments for dyslexia, dysgraphia, and dyscalculia (learning disabilities in reading, writing, and math). We also provide evaluations for ADHD and autism. And, because many of our clients also struggle with anxiety, depression, or similar, we can help sort out how these impact day-to-day functioning.
(804) 457-8516 View (804) 457-8516
Photo of Allison Howe, EdM, MA, LPC, Licensed Professional Counselor
Allison Howe
Licensed Professional Counselor, EdM, MA, LPC
Verified Verified
Herndon, VA 20171
As a Certified PACT therapist, I presently live in Virginia and I’m licensed to work with couples living in New York, Maine and Virginia. I’m a registered telehealth provider for couples in Vermont and Florida. I have trained with Dr. Stan Tatkin of the PACT Institute since 2011. Additionally, I’ve assisted founders Stan and Tracey Tatkin in their Wired for Love retreats both in the US and abroad. I’m a faculty instructor for the PACT Institute’s Level 1 training which is available to therapists across the globe.
As a Certified PACT therapist, I presently live in Virginia and I’m licensed to work with couples living in New York, Maine and Virginia. I’m a registered telehealth provider for couples in Vermont and Florida. I have trained with Dr. Stan Tatkin of the PACT Institute since 2011. Additionally, I’ve assisted founders Stan and Tracey Tatkin in their Wired for Love retreats both in the US and abroad. I’m a faculty instructor for the PACT Institute’s Level 1 training which is available to therapists across the globe.
(571) 548-3748 View (571) 548-3748
Photo of Sean Walsh, PhD, Psychologist
Sean Walsh
Psychologist, PhD
Verified Verified
2 Endorsed
Alexandria, VA 22303
Understanding the causes of anxiety, depression, and other types of psychological suffering by increasing self-awareness is the key to navigating life's challenges. With years of experience in clinical practice and academia, I've had the privilege of assisting individuals from various walks of life in navigating their psychological challenges. My approach to therapy is based on empathic attunement, fostering self-awareness, and empirically supported approaches tailored to the needs of each person. I am committed to fostering a safe and supportive environment where clients can explore their thoughts and feelings openly.
Understanding the causes of anxiety, depression, and other types of psychological suffering by increasing self-awareness is the key to navigating life's challenges. With years of experience in clinical practice and academia, I've had the privilege of assisting individuals from various walks of life in navigating their psychological challenges. My approach to therapy is based on empathic attunement, fostering self-awareness, and empirically supported approaches tailored to the needs of each person. I am committed to fostering a safe and supportive environment where clients can explore their thoughts and feelings openly.
(703) 810-3532 View (703) 810-3532
Photo of Rachel Hilker - Hilker Marriage & Family Therapy, MS, LMFT, Marriage & Family Therapist
Hilker Marriage & Family Therapy
Marriage & Family Therapist, MS, LMFT
Verified Verified
Waynesboro, VA 22980
You've waited so long to take this step. It's time. You’re ready. Take that next step toward transforming yourself and/or your relationship.
You've waited so long to take this step. It's time. You’re ready. Take that next step toward transforming yourself and/or your relationship.
(540) 277-9381 View (540) 277-9381
Photo of Matthew G Neverusky, MEd, LPC, LCPC, Licensed Professional Counselor
Matthew G Neverusky
Licensed Professional Counselor, MEd, LPC, LCPC
Verified Verified
Vienna, VA 22180  (Online Only)
My practice is dedicated to Career Counseling services. If you are interested in exploring new career paths, growing in your current career, or expanding into related fields, I can help you with your journey. I offer career counseling sessions, career assessments, and sessions that can identify careers/career trends as well as college/training opportunities. For those wishing to apply to college/university, I can help you find a major, apply to programs, and create a plan to get you where you want to go. I also offer Resumé preparation and review sessions, networking support, and interview preparation and practice.
My practice is dedicated to Career Counseling services. If you are interested in exploring new career paths, growing in your current career, or expanding into related fields, I can help you with your journey. I offer career counseling sessions, career assessments, and sessions that can identify careers/career trends as well as college/training opportunities. For those wishing to apply to college/university, I can help you find a major, apply to programs, and create a plan to get you where you want to go. I also offer Resumé preparation and review sessions, networking support, and interview preparation and practice.
(571) 556-4203 View (571) 556-4203
Photo of Dr. Joan E. Winter, PhD, Clinical Social Work/Therapist
Dr. Joan E. Winter
Clinical Social Work/Therapist, PhD
Verified Verified
Richmond, VA 23221
Dr. Joan E. Winter lectures on the subjects of marital therapy, family therapy, and incest. Her writings include extensive discourse on the practice and evaluation of family therapy. Additionally, Dr. Winter is on the Clinical faculty of the VCU Medical College of Virginia Department of Psychiatry where she supervises residents in family therapy. She also serves as a consultant to many organizations, both in the non-profit and private sectors. Her credentials include licenses in social work and Marriage and Family Therapy as well as Approved Supervisor Status for the American Association of Marriage and Family Therapists.
Dr. Joan E. Winter lectures on the subjects of marital therapy, family therapy, and incest. Her writings include extensive discourse on the practice and evaluation of family therapy. Additionally, Dr. Winter is on the Clinical faculty of the VCU Medical College of Virginia Department of Psychiatry where she supervises residents in family therapy. She also serves as a consultant to many organizations, both in the non-profit and private sectors. Her credentials include licenses in social work and Marriage and Family Therapy as well as Approved Supervisor Status for the American Association of Marriage and Family Therapists.
(804) 587-8825 View (804) 587-8825
Photo of Lakeisha Grayer - Modern Mind Therapy + Life Coaching, LPC, Licensed Professional Counselor
Modern Mind Therapy + Life Coaching
Licensed Professional Counselor, LPC
Verified Verified
Arlington, VA 22203
Modern Mind is a new approach to mental wellness focused on updating your mental consciousness in a way that frees you from negative thought patterns. By using an integrative approach that treats you as a whole person, not a diagnosis. The goal is to empower you by helping you to develop problem-solving and enhanced coping skills that create long-lasting, growth-oriented solutions tailored to your unique needs.
Modern Mind is a new approach to mental wellness focused on updating your mental consciousness in a way that frees you from negative thought patterns. By using an integrative approach that treats you as a whole person, not a diagnosis. The goal is to empower you by helping you to develop problem-solving and enhanced coping skills that create long-lasting, growth-oriented solutions tailored to your unique needs.
(571) 200-3932 View (571) 200-3932
Photo of Tyler Nicole Grosskopf, MA, Licensed Professional Counselor
Tyler Nicole Grosskopf
Licensed Professional Counselor, MA
Verified Verified
1 Endorsed
Manassas, VA 20110
I believe one of the bravest things you can do is begin to understand your own story. Are you ready to make a positive change in your life? Asking for help takes courage, but the rewards of doing so can lead to a lifetime of fulfillment. In working together, we will cultivate growth by understanding the obstacles that you face and develop solutions that can help you gain control of your life and achieve your goals.
I believe one of the bravest things you can do is begin to understand your own story. Are you ready to make a positive change in your life? Asking for help takes courage, but the rewards of doing so can lead to a lifetime of fulfillment. In working together, we will cultivate growth by understanding the obstacles that you face and develop solutions that can help you gain control of your life and achieve your goals.
(571) 200-2164 x713 View (571) 200-2164 x713

See more therapy options for Page County

How does your Therapist compare?

Number of Therapists in Page County, VA

10+

Average cost per session

$105

Therapists in Page County, VA who prioritize treating:

90% Anxiety
80% Depression
80% Coping Skills
80% Self Esteem
70% Relationship Issues
70% Grief
60% Parenting

Average years in practice

9 Years

Top 3 insurances accepted

86% UnitedHealthcare UHC | UBH
86% Anthem | Elevance
86% Optum

How Therapists in Page County, VA see their clients

90% In Person and Online
10% Online Only

Gender breakdown

78% Female
11% Male
11% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Page 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.