Therapists in Grand Rapids, MI

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Photo of Kerry Hart, LMFT, Marriage & Family Therapist
Kerry Hart
Marriage & Family Therapist, LMFT
Not Verified Not Verified
2 Endorsed
Grand Rapids, MI 49546
Kerry Hart is a Couple and Family Therapist working from a systemic approach. Kerry helps her clients understand their pasts and helps shape their futures by pointing out patterns that have developed in her client's lives, as well as within their families, and family history. Kerry received her Master's in Family Therapy from Drexel University in Philadelphia, PA and is a member of the American Association for Marriage and Family Therapy (AAMFT). Kerry enjoys working from a client centered perspective, with individuals, couples, families, teens, and adults.
Kerry Hart is a Couple and Family Therapist working from a systemic approach. Kerry helps her clients understand their pasts and helps shape their futures by pointing out patterns that have developed in her client's lives, as well as within their families, and family history. Kerry received her Master's in Family Therapy from Drexel University in Philadelphia, PA and is a member of the American Association for Marriage and Family Therapy (AAMFT). Kerry enjoys working from a client centered perspective, with individuals, couples, families, teens, and adults.
(616) 298-3169 View (616) 298-3169
Photo of Alison Dault, LMSW, CAADC, Clinical Social Work/Therapist
Alison Dault
Clinical Social Work/Therapist, LMSW, CAADC
Verified Verified
2 Endorsed
Grand Rapids, MI 49505
I usually find myself working with people who know there's something not quite right but aren't sure where to start. Are you struggling with anxiety and depression, and don't know why? Are relationships difficult, or do you feel like you haven't found your people? Has life suddenly just switched to "hard mode"? I especially enjoy working with people who are trying balance work and managing chronic illnesses, fellow social services employees, and LGBTQ+ clients. I love working with neurodivergence!
I usually find myself working with people who know there's something not quite right but aren't sure where to start. Are you struggling with anxiety and depression, and don't know why? Are relationships difficult, or do you feel like you haven't found your people? Has life suddenly just switched to "hard mode"? I especially enjoy working with people who are trying balance work and managing chronic illnesses, fellow social services employees, and LGBTQ+ clients. I love working with neurodivergence!
(616) 512-1627 View (616) 512-1627
Photo of Dr. Elyse Rocco, PsyD, Psychologist
Dr. Elyse Rocco
Psychologist, PsyD
Verified Verified
Grand Rapids, MI 49507
I practice from an insight oriented, relational, and multicultural approach tailored to meet the unique needs of each individual I work with. My priority as a therapist is to create a warm, collaborative, non-judgmental space where you can work through your concerns and make the changes in your life you desire. People seek therapy for a number of reasons, perhaps to alleviate symptoms or distress, improve self-esteem, or address relationship issues. In my experience, symptoms often “mark the spot” of a deeper theme you may be grappling with and I aim to assist you uncover what the root of your concerns may be.
I practice from an insight oriented, relational, and multicultural approach tailored to meet the unique needs of each individual I work with. My priority as a therapist is to create a warm, collaborative, non-judgmental space where you can work through your concerns and make the changes in your life you desire. People seek therapy for a number of reasons, perhaps to alleviate symptoms or distress, improve self-esteem, or address relationship issues. In my experience, symptoms often “mark the spot” of a deeper theme you may be grappling with and I aim to assist you uncover what the root of your concerns may be.
(616) 737-0566 View (616) 737-0566
Photo of LaDawn N Evans, MA, LPC-S, Counselor
LaDawn N Evans
Counselor, MA, LPC-S
Verified Verified
3 Endorsed
Grand Rapids, MI 49546
Whether dealing with depression, anxiety, trauma, or life turmoil, you’ve made a tremendous step in your healing journey and my goal is to help you along the path to restoration and growth! You were gifted with the attributes to reach your dreams and goals. It is my job and joy to supply you with tools to unearth those jewels that are within you. I received my Bachelor’s of Science in Psychology from Cornerstone University and Masters of Arts in Counseling from Spring Arbor University. I have served as a life coach for 15+ years. I provide counseling and life coaching services to adults, couples, and families.
Whether dealing with depression, anxiety, trauma, or life turmoil, you’ve made a tremendous step in your healing journey and my goal is to help you along the path to restoration and growth! You were gifted with the attributes to reach your dreams and goals. It is my job and joy to supply you with tools to unearth those jewels that are within you. I received my Bachelor’s of Science in Psychology from Cornerstone University and Masters of Arts in Counseling from Spring Arbor University. I have served as a life coach for 15+ years. I provide counseling and life coaching services to adults, couples, and families.
(616) 208-2138 x700 View (616) 208-2138 x700
Photo of Hillary Morgan, MA, LPC, Counselor
Hillary Morgan
Counselor, MA, LPC
Verified Verified
2 Endorsed
Grand Rapids, MI 49544
Waitlist for new clients
Hillary believes that the foundation of counseling is a therapeutic relationship that offers a safe and comfortable environment. Sharing your story while experiencing acceptance helps to drive the therapeutic process and lay the foundation for real healing and growth. She believes counseling can be a place to explore your patterns, come to understand factors that contributed to your development, and find a balance between accepting yourself and changing patterns that are no longer serving you.
Hillary believes that the foundation of counseling is a therapeutic relationship that offers a safe and comfortable environment. Sharing your story while experiencing acceptance helps to drive the therapeutic process and lay the foundation for real healing and growth. She believes counseling can be a place to explore your patterns, come to understand factors that contributed to your development, and find a balance between accepting yourself and changing patterns that are no longer serving you.
(616) 201-1305 View (616) 201-1305
Photo of Andrea Beck-Lundskow, LMSW, Clinical Social Work/Therapist
Andrea Beck-Lundskow
Clinical Social Work/Therapist, LMSW
Verified Verified
3 Endorsed
Grand Rapids, MI 49503
Hi, thanks for reaching out. I know this is hard because you’re not usually a reacher outer. You're existing in spaces with people all around you but you feel small, maybe invisible. You’re disconnected from your own body, your desires, your partner(s), and your community. You feel frazzled and fragmented and flat-out exhausted. You also have an inkling, a knowing that somewhere inside you there is another way but you haven't learned to trust your knowing yet. You don't want to keep doing what you've always done, but have no idea how to go forward.
Hi, thanks for reaching out. I know this is hard because you’re not usually a reacher outer. You're existing in spaces with people all around you but you feel small, maybe invisible. You’re disconnected from your own body, your desires, your partner(s), and your community. You feel frazzled and fragmented and flat-out exhausted. You also have an inkling, a knowing that somewhere inside you there is another way but you haven't learned to trust your knowing yet. You don't want to keep doing what you've always done, but have no idea how to go forward.
(616) 208-5776 View (616) 208-5776
Photo of Jenae Hershberger, LCSW, LMSW-C, Clinical Social Work/Therapist
Jenae Hershberger
Clinical Social Work/Therapist, LCSW, LMSW-C
Verified Verified
Grand Rapids, MI 49507  (Online Only)
Ever feel like you're carrying the world on your shoulders, thinking you have to handle everything alone, only to feel suffocated by it all? It's a common struggle, believe me. But here's the scoop: counseling isn't about getting a to-do list or being labeled "weak" for reaching out. It's about finding a cozy spot to unpack what's on your mind and in your heart. It's a sanctuary where you can just be you, no judgments or expectations. So, if you're feeling overwhelmed, know this: seeking help is a brave move towards healing. You're not alone in this journey.
Ever feel like you're carrying the world on your shoulders, thinking you have to handle everything alone, only to feel suffocated by it all? It's a common struggle, believe me. But here's the scoop: counseling isn't about getting a to-do list or being labeled "weak" for reaching out. It's about finding a cozy spot to unpack what's on your mind and in your heart. It's a sanctuary where you can just be you, no judgments or expectations. So, if you're feeling overwhelmed, know this: seeking help is a brave move towards healing. You're not alone in this journey.
(616) 366-9556 View (616) 366-9556
Photo of Lindsey Farlow, LMSW, Clinical Social Work/Therapist
Lindsey Farlow
Clinical Social Work/Therapist, LMSW
Verified Verified
Grand Rapids, MI 49506  (Online Only)
Lindsey is a licensed social worker who has experience with various populations and challenges. She specializes in relationship building in regards to family, couple/martial, and sibling bonds. Lindsey utilizes individual and group training interventions in order for families to implement positive behavioral techniques for challenging behaviors and obtain psycho-education of various diagnoses and interventions. She is trained in evidence-based treatments including CBT, DBT, Positive Family Interventions, Zones of Regulation, Motivational Interviewing, TF-CBT, Empowerment Theory, Crisis and Suicide Preventions.
Lindsey is a licensed social worker who has experience with various populations and challenges. She specializes in relationship building in regards to family, couple/martial, and sibling bonds. Lindsey utilizes individual and group training interventions in order for families to implement positive behavioral techniques for challenging behaviors and obtain psycho-education of various diagnoses and interventions. She is trained in evidence-based treatments including CBT, DBT, Positive Family Interventions, Zones of Regulation, Motivational Interviewing, TF-CBT, Empowerment Theory, Crisis and Suicide Preventions.
(616) 585-0292 View (616) 585-0292
Photo of Stefanie Hathaway, MA, LPC, Licensed Professional Counselor
Stefanie Hathaway
Licensed Professional Counselor, MA, LPC
Verified Verified
Grand Rapids, MI 49546
Waitlist for new clients
Ready to overcome that thing you’re struggling with? Feel like anxiety is constantly taking over? Or that your past is holding you back? Do your emotions control your day? Do you desire something different but can’t seem to figure out how to get there? I’d love to help you find relief so you can create a life you love.
Ready to overcome that thing you’re struggling with? Feel like anxiety is constantly taking over? Or that your past is holding you back? Do your emotions control your day? Do you desire something different but can’t seem to figure out how to get there? I’d love to help you find relief so you can create a life you love.
(616) 205-9757 View (616) 205-9757
Photo of Caroline Lowry Hall, MA, LPC, Licensed Professional Counselor
Caroline Lowry Hall
Licensed Professional Counselor, MA, LPC
Verified Verified
Grand Rapids, MI 49546
Waitlist for new clients
It is my goal to help you create change in your life and develop new understanding as you face life's challenges. Together we will maximize your ability to achieve personal fulfillment, explore the enormous capacity within you, and reach a healthy state of balance and well-being. I enjoy working with a diverse clientele. Most individuals I see are dealing with anxiety related disorders, relationship issues, grief and loss, or simply adjusting to a life transition. I look forward to the opportunity to meet you and discuss your needs and expectations.
It is my goal to help you create change in your life and develop new understanding as you face life's challenges. Together we will maximize your ability to achieve personal fulfillment, explore the enormous capacity within you, and reach a healthy state of balance and well-being. I enjoy working with a diverse clientele. Most individuals I see are dealing with anxiety related disorders, relationship issues, grief and loss, or simply adjusting to a life transition. I look forward to the opportunity to meet you and discuss your needs and expectations.
(616) 200-6984 View (616) 200-6984
Photo of Miriam Goldstein Lorrain, PhD, Psychologist
Miriam Goldstein Lorrain
Psychologist, PhD
Verified Verified
1 Endorsed
Grand Rapids, MI 49503
Waitlist for new clients
Life can be challenging for all of us at times. Maybe a new challenge or crisis has arisen, or maybe you want to address a problem you've carried for years. It can be hard, and takes strength, to acknowledge when you're stuck and need help dealing with painful feelings or self-defeating behaviors. I see adults and teens with a range of difficulties and goals, working together to understand and ease sorrow, anxiety, or anger; explore or (re-)discover parts of themselves; address problems in work, school, or relationships; heal from trauma; resolve ongoing battles with their mind or body; and/or live with greater joy and satisfaction.
Life can be challenging for all of us at times. Maybe a new challenge or crisis has arisen, or maybe you want to address a problem you've carried for years. It can be hard, and takes strength, to acknowledge when you're stuck and need help dealing with painful feelings or self-defeating behaviors. I see adults and teens with a range of difficulties and goals, working together to understand and ease sorrow, anxiety, or anger; explore or (re-)discover parts of themselves; address problems in work, school, or relationships; heal from trauma; resolve ongoing battles with their mind or body; and/or live with greater joy and satisfaction.
(734) 822-7173 View (734) 822-7173
Photo of Nicolette McGahey, LCSW, Clinical Social Work/Therapist
Nicolette McGahey
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Grand Rapids, MI 49546  (Online Only)
My name is Nicolette, and my pronouns are she/her. I am an indigenous therapist, a member of the queer community, and a person in long-term recovery from alcohol and substance use.
My name is Nicolette, and my pronouns are she/her. I am an indigenous therapist, a member of the queer community, and a person in long-term recovery from alcohol and substance use.
(248) 289-9546 View (248) 289-9546
Photo of Erin Watson, LMSW, CAADC, Clinical Social Work/Therapist
Erin Watson
Clinical Social Work/Therapist, LMSW, CAADC
Verified Verified
1 Endorsed
Grand Rapids, MI 49525
Does it feel as though you are struggling to stay on top of responsibilities as a parent, having issues with interpersonal relationships, turning to drugs or alcohol to cope with stressors, or just feel like you want to know yourself better? We can work together to help you make changes in your life to feel more empowered and make meaningful change.
Does it feel as though you are struggling to stay on top of responsibilities as a parent, having issues with interpersonal relationships, turning to drugs or alcohol to cope with stressors, or just feel like you want to know yourself better? We can work together to help you make changes in your life to feel more empowered and make meaningful change.
(616) 737-8185 View (616) 737-8185
Photo of Melanie Tibbitts, LMSW, Clinical Social Work/Therapist
Melanie Tibbitts
Clinical Social Work/Therapist, LMSW
Verified Verified
Grand Rapids, MI 49505
Depression and anxiety can feel like a heavy fog that won't lift. I am here to walk with you through the fog, helping you to find clarity and relief from emotional pain. I offer a safe and supportive therapeutic environment that respects your emotional journey, helps you to feel more authentically yourself, and releases you from the fog of depression and anxiety.
Depression and anxiety can feel like a heavy fog that won't lift. I am here to walk with you through the fog, helping you to find clarity and relief from emotional pain. I offer a safe and supportive therapeutic environment that respects your emotional journey, helps you to feel more authentically yourself, and releases you from the fog of depression and anxiety.
(616) 303-7524 View (616) 303-7524
Photo of Phil Koole, LLMSW, Clinical Social Work/Therapist
Phil Koole
Clinical Social Work/Therapist, LLMSW
Verified Verified
1 Endorsed
Grand Rapids, MI 49507  (Online Only)
Do you wish you had someone to talk to about your issues and not feel judged? Please know that you are not alone. So many of us need a non-biased outside ear to help us process and walk through life’s ups and downs. I'm here to help you create a safe space to navigate your emotional landscape.
Do you wish you had someone to talk to about your issues and not feel judged? Please know that you are not alone. So many of us need a non-biased outside ear to help us process and walk through life’s ups and downs. I'm here to help you create a safe space to navigate your emotional landscape.
(616) 439-2840 View (616) 439-2840
Photo of Stacey VanderKlok, LMSW, Clinical Social Work/Therapist
Stacey VanderKlok
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Grand Rapids, MI 49544
I have 26 years of experience in healthcare working with patients, families, and medical professionals. I have had the privilege of meeting with people in moments of deep challenge - living with serious and chronic illnesses, facing end of life, managing caregiving stress, working through grief and loss and dealing with all the changes and transitions that can happen in life. I work with clients who want support through all stages of adult life from leaving home for the first time to empty nests, from caring for aging parents to adjusting to the changes that come with aging.
I have 26 years of experience in healthcare working with patients, families, and medical professionals. I have had the privilege of meeting with people in moments of deep challenge - living with serious and chronic illnesses, facing end of life, managing caregiving stress, working through grief and loss and dealing with all the changes and transitions that can happen in life. I work with clients who want support through all stages of adult life from leaving home for the first time to empty nests, from caring for aging parents to adjusting to the changes that come with aging.
(616) 557-7514 View (616) 557-7514
Photo of Susie Kim-VanderGriend, LMSW, PMH-C, Clinical Social Work/Therapist
Susie Kim-VanderGriend
Clinical Social Work/Therapist, LMSW, PMH-C
Verified Verified
1 Endorsed
Grand Rapids, MI 49503
Life can be complicated with challenging experiences, thoughts, feelings and even body sensations and my hope is that you are not holding it all alone. As a therapist, I strive to provide a secure space for you to engage in a non-judgmental, collaborative relationship. I believe in the strength and healing power that resides in the core of each person. Whatever challenges you are facing, I seek to come alongside you in the therapy space to facilitate healing and growth. I trust that together, we can work to make sense of what is happening - now and in the past to lead more empowered and fulfilled lives moving forward.
Life can be complicated with challenging experiences, thoughts, feelings and even body sensations and my hope is that you are not holding it all alone. As a therapist, I strive to provide a secure space for you to engage in a non-judgmental, collaborative relationship. I believe in the strength and healing power that resides in the core of each person. Whatever challenges you are facing, I seek to come alongside you in the therapy space to facilitate healing and growth. I trust that together, we can work to make sense of what is happening - now and in the past to lead more empowered and fulfilled lives moving forward.
(616) 208-3196 View (616) 208-3196
Photo of Kirsten Rahn, LMSW, Clinical Social Work/Therapist
Kirsten Rahn
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Grand Rapids, MI 49525
People are the expert on their own lives. As we work together to identify concerns and set goals, our work may include discussing behaviors, emotions, or thought patterns which do not serve the end goal and learning skills to manage or change them. I have experience and training to provide clinical support while someone navigates the changes they would like to see in their life. Wherever the person is in their need, that is where we will start.
People are the expert on their own lives. As we work together to identify concerns and set goals, our work may include discussing behaviors, emotions, or thought patterns which do not serve the end goal and learning skills to manage or change them. I have experience and training to provide clinical support while someone navigates the changes they would like to see in their life. Wherever the person is in their need, that is where we will start.
(218) 328-8459 View (218) 328-8459
Photo of Renee Braune, MA, MS, LLPC, Pre-Licensed Professional
Renee Braune
Pre-Licensed Professional, MA, MS, LLPC
Verified Verified
1 Endorsed
Grand Rapids, MI 49503  (Online Only)
Hey there! Reaching out for help can be scary and I am proud of you for taking that step. I consider it a privilege to help people on their healing journey. An important part of the therapeutic process is the relationship between client and therapist. I strive to cultivate a nurturing and supportive therapeutic environment. Everyone wants to feel heard and understood, and providing that is the foundation of our work together. My diverse and unique experiences make me a strong ally for change and healing. I provide a compassionate, yet direct approach to therapy which helps my clients feel supported on their journey.
Hey there! Reaching out for help can be scary and I am proud of you for taking that step. I consider it a privilege to help people on their healing journey. An important part of the therapeutic process is the relationship between client and therapist. I strive to cultivate a nurturing and supportive therapeutic environment. Everyone wants to feel heard and understood, and providing that is the foundation of our work together. My diverse and unique experiences make me a strong ally for change and healing. I provide a compassionate, yet direct approach to therapy which helps my clients feel supported on their journey.
(989) 467-7548 View (989) 467-7548
Photo of Timothy Dean, MA, LMFT, Marriage & Family Therapist
Timothy Dean
Marriage & Family Therapist, MA, LMFT
Verified Verified
3 Endorsed
Grand Rapids, MI 49546
Life can be difficult and we don't have to walk through it alone. If you want to feel more connected with your spouse, have a better relationship with your children, or find more meaning in life, therapy can help you achieve these goals and many others. As your therapist my goal is to work alongside you, and through our therapeutic relationship, help you identify goals and remove barriers that have been holding you back from reaching these goals. I work with individuals, couples, and families to address marital/couple conflict, relationship issues, depression, anxiety, stress, PTSD/Trauma, as well as finding more purpose in life.
Life can be difficult and we don't have to walk through it alone. If you want to feel more connected with your spouse, have a better relationship with your children, or find more meaning in life, therapy can help you achieve these goals and many others. As your therapist my goal is to work alongside you, and through our therapeutic relationship, help you identify goals and remove barriers that have been holding you back from reaching these goals. I work with individuals, couples, and families to address marital/couple conflict, relationship issues, depression, anxiety, stress, PTSD/Trauma, as well as finding more purpose in life.
(616) 580-0801 x107 View (616) 580-0801 x107
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How does your Therapist compare?

Number of Therapists in Grand Rapids, MI

1,000+

Average cost per session

$150

Therapists in Grand Rapids, MI who prioritize treating:

92% Anxiety
89% Depression
76% Self Esteem
75% Relationship Issues
72% Trauma and PTSD
71% Stress
70% Coping Skills

Average years in practice

10 Years

Top 3 insurances accepted

94% BlueCross and BlueShield
70% Priority Health
67% Aetna

How Therapists in Grand Rapids, MI see their clients

72% In Person and Online
28% Online Only

Gender breakdown

78% Female
21% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Grand Rapids?

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.