Therapists in Middlebury, VT
![Photo of Susan Malaney, LCMHC, Counselor](https://photos.psychologytoday.com/f6f3f4b6-b2ae-4569-b6a8-10036baa539f/2/320x400.jpeg)
I will provide a safe and comfortable space for you to explore issues that have caused you difficulties or hindered your goals. Sometimes we are stuck in a situation that requires someone to listen and prompt you to find solutions and sometimes issues are about finding yourself and ways to cope with the world. You are the expert about your needs.
I will provide a safe and comfortable space for you to explore issues that have caused you difficulties or hindered your goals. Sometimes we are stuck in a situation that requires someone to listen and prompt you to find solutions and sometimes issues are about finding yourself and ways to cope with the world. You are the expert about your needs.
![Photo of Zubin P. Mistri, MDiv, CHT, ACC, Registered Psychotherapist](https://photos.psychologytoday.com/af848ea0-53d1-4a42-aef8-817411f9a592/2/320x400.jpeg)
You might be struggling with difficult emotions, stressed by the demands of life, or stuck in painful cycles in your relationships. You sense you could be more connected to yourself, to others, and to the deeper purpose of your life. Maybe you've tried to make things better on your own, but you sense that with the right kind of support you could thrive in new ways in your relationships, and in other areas of your life. You're on the edge of growing into something new.
You might be struggling with difficult emotions, stressed by the demands of life, or stuck in painful cycles in your relationships. You sense you could be more connected to yourself, to others, and to the deeper purpose of your life. Maybe you've tried to make things better on your own, but you sense that with the right kind of support you could thrive in new ways in your relationships, and in other areas of your life. You're on the edge of growing into something new.
![Photo of Mika Barker-Hart, LCSW, FIPA, Counselor](https://photos.psychologytoday.com/9212e242-11f7-4ce1-a42b-1c4fc5b9ab11/1/320x400.jpeg)
Psychoanalytic work is an intensive therapy that focuses on increasing self-understanding and a sense of personal freedom. It is very helpful for anxiety, depression, OCD, relationship issues, trauma and managing grief around life transitions. I have also trained as an end-of-life doula and offer grief support groups and trainings.
Psychoanalytic work is an intensive therapy that focuses on increasing self-understanding and a sense of personal freedom. It is very helpful for anxiety, depression, OCD, relationship issues, trauma and managing grief around life transitions. I have also trained as an end-of-life doula and offer grief support groups and trainings.
![Photo of Anne Goldman, LICSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3d5afadb-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Anne Goldman
Clinical Social Work/Therapist, LICSW
Verified Verified
1 Endorsed
Middlebury, VT 05753 (Online Only)
Not accepting new clients
Therapy can be as much about finding more ease and joy in one's life as it is about reducing symptoms and suffering. Self-limiting cognitive, behavioral, emotional and sensorimotor (gestures/postures) tendencies often stand in the way of fully engaging in relationships (with self/others) and in the present moment. Bringing non-judgmental attention and awareness to these patterns allows us the freedom to replace re-activity with mindful responding. I work with adults seeking assistance with issues of anxiety, depression, stress management, trauma grief/loss and interpersonal/relational challenges.
Therapy can be as much about finding more ease and joy in one's life as it is about reducing symptoms and suffering. Self-limiting cognitive, behavioral, emotional and sensorimotor (gestures/postures) tendencies often stand in the way of fully engaging in relationships (with self/others) and in the present moment. Bringing non-judgmental attention and awareness to these patterns allows us the freedom to replace re-activity with mindful responding. I work with adults seeking assistance with issues of anxiety, depression, stress management, trauma grief/loss and interpersonal/relational challenges.
![Photo of Kelly Moriarty, MS, LCMHC, Counselor](https://photos.psychologytoday.com/50ae1459-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
Are depression, anxiety, worry, and stress preventing you from living your life to its full potential? Are you looking to lead a more gratifying life with healthy relationships and greater fulfillment? I work with men and women to identify the individual challenges that are holding them back. I will teach you skills and techniques to help you overcome your obstacles, decrease feelings of anxiety or sadness and increase your self-esteem and self-confidence. Together we will equip you with the ability to navigate confidently through the ups and downs of life allowing you to enjoy your life to its fullest.
Are depression, anxiety, worry, and stress preventing you from living your life to its full potential? Are you looking to lead a more gratifying life with healthy relationships and greater fulfillment? I work with men and women to identify the individual challenges that are holding them back. I will teach you skills and techniques to help you overcome your obstacles, decrease feelings of anxiety or sadness and increase your self-esteem and self-confidence. Together we will equip you with the ability to navigate confidently through the ups and downs of life allowing you to enjoy your life to its fullest.
![Photo of Nicole Litchfield, AAP, Registered Psychotherapist](https://photos.psychologytoday.com/63c5f559-ddec-44f3-942b-ef37188ac5e8/1/320x400.jpeg)
I am currently accepting new clients. My practice is client centered with the goal of creating wholeness and peace. I provide counseling services to individuals from the age of 11 through end of life. Typically, I work with folks struggling with depression, anxiety, substance use, those within the LGBTQ+ community, and folks struggling to navigate life changes. If this sounds like you, please reach out, let's see if we are a good fit!
I am currently accepting new clients. My practice is client centered with the goal of creating wholeness and peace. I provide counseling services to individuals from the age of 11 through end of life. Typically, I work with folks struggling with depression, anxiety, substance use, those within the LGBTQ+ community, and folks struggling to navigate life changes. If this sounds like you, please reach out, let's see if we are a good fit!
![Photo of Willow N. Broaddus, MA, LCMHC, LPC, Counselor](https://photos.psychologytoday.com/584e5c5c-ac3b-49c4-8fc3-52a0abc2c986/2/320x400.jpeg)
Individuals/Groups/Couples. There is a light at the end of the tunnel. Life happens, so it helps to have someone who will really listen, without judgement. When we lay down our burdens, we can feel lighter, heal places that were hurt, and find a way back to ourselves. Therapy can be about coming to deeply know and understand ourselves; with help learning skills for managing life, emotions and relationships, claiming self-worth and a sense of competence. I support people with holistic, research based psychotherapy. ACT, IFS, ARC, DBT, Somatics, CBT and Jungian components. Ask me about group therapy.
Individuals/Groups/Couples. There is a light at the end of the tunnel. Life happens, so it helps to have someone who will really listen, without judgement. When we lay down our burdens, we can feel lighter, heal places that were hurt, and find a way back to ourselves. Therapy can be about coming to deeply know and understand ourselves; with help learning skills for managing life, emotions and relationships, claiming self-worth and a sense of competence. I support people with holistic, research based psychotherapy. ACT, IFS, ARC, DBT, Somatics, CBT and Jungian components. Ask me about group therapy.
![Photo of Douglas Engel, LCSW-R, LICSW, MPS, BA, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3cde71d8-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
Douglas Engel
Clinical Social Work/Therapist, LCSW-R, LICSW, MPS, BA
Verified Verified
Middlebury, VT 05753
For the past 30 years I have worked with a wide range of clients ranging from children and adolescents to older adults. I have a post graduate degree in family therapy from the Ackerman Institute in New York City, the most respected family therapy training program in the country. Currently I work with folks 17 - 80 and particularly enjoy marriage counseling and helping individuals and couples with sexual issues. I've helped individuals struggling with depression, grief, anger issues, anxiety and the effects of past trauma.
For the past 30 years I have worked with a wide range of clients ranging from children and adolescents to older adults. I have a post graduate degree in family therapy from the Ackerman Institute in New York City, the most respected family therapy training program in the country. Currently I work with folks 17 - 80 and particularly enjoy marriage counseling and helping individuals and couples with sexual issues. I've helped individuals struggling with depression, grief, anger issues, anxiety and the effects of past trauma.
![Photo of Timothy R Lyman - Timothy R Lyman, MA Clinical Psychology, LADC, MA, LADC, Drug & Alcohol Counselor](https://photos.psychologytoday.com/ef369309-37a5-4fd4-b5a8-90fb7bd6603a/2/320x400.jpeg)
Timothy R Lyman, MA Clinical Psychology, LADC
Drug & Alcohol Counselor, MA, LADC
Verified Verified
Middlebury, VT 05753
Not accepting new clients
I hope to assist in bringing compassion, respect, acceptance, insight, freedom and healing to individuals experiencing struggles with mental health challenges and or substance use concerns.
I hope to assist in bringing compassion, respect, acceptance, insight, freedom and healing to individuals experiencing struggles with mental health challenges and or substance use concerns.
![Photo of Margaret A Olson, MACP, CSD, Counselor](https://photos.psychologytoday.com/a001b727-a5b8-4d58-b982-e0d92de20472/5/320x400.jpeg)
Grief is perhaps the most challenging and inescapable of all life experiences. While there are many different kinds of loss (i.e. job, relationship, physical health) the death of a loved one takes one to new level of emotional, mental and spiritual challenge. The death of a loved one changes us forever. From within this space of confusing emotions, doubts and uncertainties a desire to share your story may arise. It is a natural human instinct to want to explore in a safe setting the deeper questions of life as you learn to navigate the many facets of grief. I look forward to providing guidance as you discover, grieve and recover.
Grief is perhaps the most challenging and inescapable of all life experiences. While there are many different kinds of loss (i.e. job, relationship, physical health) the death of a loved one takes one to new level of emotional, mental and spiritual challenge. The death of a loved one changes us forever. From within this space of confusing emotions, doubts and uncertainties a desire to share your story may arise. It is a natural human instinct to want to explore in a safe setting the deeper questions of life as you learn to navigate the many facets of grief. I look forward to providing guidance as you discover, grieve and recover.
![Photo of Danielle Bergeron Ingram, MS, LCMHC, Psychologist](https://photos.psychologytoday.com/256b6faf-fb23-45de-8e0f-55db150ed2f3/2/320x400.jpeg)
Danielle Bergeron Ingram
Psychologist, MS, LCMHC
Verified Verified
2 Endorsed
Middlebury, VT 05753 (Online Only)
Not accepting new clients
Together we will explore issues and obstacles so that you can feel better and work toward a healthier, happier way of living. I will help you gain greater insight into the problems you face, to increase self confidence, learn problem solving skills and effective ways of coping with stress. We will examine patterns in your life that may be affecting your relationships, the way you think about yourself, and limiting your ability to achieve the changes that you want to make.
Together we will explore issues and obstacles so that you can feel better and work toward a healthier, happier way of living. I will help you gain greater insight into the problems you face, to increase self confidence, learn problem solving skills and effective ways of coping with stress. We will examine patterns in your life that may be affecting your relationships, the way you think about yourself, and limiting your ability to achieve the changes that you want to make.
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![Photo of Clare Evancie, MS, LCMHC, Counselor](https://photos.psychologytoday.com/1b50c6ea-2952-436d-9761-04ec1458711c/2/320x400.png)
Sometimes life throws us one too many curveballs, and our usual manner of coping just isn’t enough. Counseling can be very helpful at such times, offering a dedicated place to speak aloud about thoughts and struggles, and to be heard and understood without being judged. I work hard to create a therapeutic environment in which people feel safe enough to explore and process their experiences, and supported enough to try new ways of thinking and being in their lives. I am a firm believer in every individual's capacity to heal and to grow, and it is an honor and a privilege to be a witness, ally and guide along the way.
Sometimes life throws us one too many curveballs, and our usual manner of coping just isn’t enough. Counseling can be very helpful at such times, offering a dedicated place to speak aloud about thoughts and struggles, and to be heard and understood without being judged. I work hard to create a therapeutic environment in which people feel safe enough to explore and process their experiences, and supported enough to try new ways of thinking and being in their lives. I am a firm believer in every individual's capacity to heal and to grow, and it is an honor and a privilege to be a witness, ally and guide along the way.
![Photo of Cary Beckwith, MEd, LCMHC, Counselor](https://photos.psychologytoday.com/ba9f2fa2-4e2d-4e97-bb60-8b0d1de77e8a/4/320x400.jpeg)
If you are feeling stressed, anxious, or depressed, or you are struggling with grief and loss, or the effects of trauma, I can offer you a safe place to share your feelings and experiences, and to be heard with compassion and understanding. Together we can help you find a greater sense of happiness and well-being.
If you are feeling stressed, anxious, or depressed, or you are struggling with grief and loss, or the effects of trauma, I can offer you a safe place to share your feelings and experiences, and to be heard with compassion and understanding. Together we can help you find a greater sense of happiness and well-being.
![Photo of Alison Hunt McKenney, LCMHC, ATR, CIMHP, Counselor](https://photos.psychologytoday.com/3d547aee-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Alison Hunt McKenney
Counselor, LCMHC, ATR, CIMHP
Verified Verified
Middlebury, VT 05753 (Online Only)
I have been practicing as an Art Therapist and Counselor in Vermont for over 13 years, working with individuals and families who are in need of support. I have a holistic approach to therapy and am a Certified Integrative Mental Health Provider. I integrate nutritional interventions, mindfulness and art therapy into my practice to address the mental, physical and spiritual wellness of my clients. I specialize in helping individuals and families with issues around life transitions, stress management, anxiety, depression, grief, communication, and emotional regulation.
I have been practicing as an Art Therapist and Counselor in Vermont for over 13 years, working with individuals and families who are in need of support. I have a holistic approach to therapy and am a Certified Integrative Mental Health Provider. I integrate nutritional interventions, mindfulness and art therapy into my practice to address the mental, physical and spiritual wellness of my clients. I specialize in helping individuals and families with issues around life transitions, stress management, anxiety, depression, grief, communication, and emotional regulation.
![Photo of Sarah Lawton, MS, Registered Psychotherapist](https://photos.psychologytoday.com/6a27eb04-18a8-40d0-a2d2-7d3a92e094fd/2/320x400.png)
Sarah Lawton
Registered Psychotherapist, MS
Verified Verified
Middlebury, VT 05753
Not accepting new clients
We are expected to tend to our physical wellness with annual physicals as a means to prevent acute illness and chronic disease. However, when it comes to our mental health, we often do not give the same attention and care. I provide a non-judgmental, safe space where you have the opportunity to nurture yourself fully; mind, body, and spirit.
We are expected to tend to our physical wellness with annual physicals as a means to prevent acute illness and chronic disease. However, when it comes to our mental health, we often do not give the same attention and care. I provide a non-judgmental, safe space where you have the opportunity to nurture yourself fully; mind, body, and spirit.
![Photo of Amanda Pacheco Silva, MA, Pre-Licensed Professional](https://photos.psychologytoday.com/21f7212d-b273-4fbc-8382-bffed06d097b/2/320x400.jpeg)
Amanda Pacheco Silva
Pre-Licensed Professional, MA
Verified Verified
2 Endorsed
Middlebury, VT 05753 (Online Only)
I am a pre-licensed professional who is committed to helping teens and adults rise above challenges and adversity. My work is trauma-focused and is oriented in psychodynamic and humanistic techniques. I believe in taking a collaborative approach to helping clients reach their goals.
I am a pre-licensed professional who is committed to helping teens and adults rise above challenges and adversity. My work is trauma-focused and is oriented in psychodynamic and humanistic techniques. I believe in taking a collaborative approach to helping clients reach their goals.
![Photo of Julie R Tatkon, LCSW, MSW, Imago, EMDR, Clinical Social Work/Therapist](https://photos.psychologytoday.com/45469694-46cd-11ea-a6ad-06142c356176/4/320x400.jpeg)
Julie R Tatkon
Clinical Social Work/Therapist, LCSW, MSW, Imago, EMDR
Verified Verified
Middlebury, VT 05753
Waitlist for new clients
Good therapy can produce long lasting life changes. I approach therapy as a collaborative effort. I start with where the client finds themselves in the present. I listen with both curiosity and empathy to understand an individual's unique experience. In treatment I create an atmosphere of trust where together we can identify your strengths, find practical solutions to problems and unfold underlying difficulties that are obstacles to your experience of a rich and fulfilling life.
Good therapy can produce long lasting life changes. I approach therapy as a collaborative effort. I start with where the client finds themselves in the present. I listen with both curiosity and empathy to understand an individual's unique experience. In treatment I create an atmosphere of trust where together we can identify your strengths, find practical solutions to problems and unfold underlying difficulties that are obstacles to your experience of a rich and fulfilling life.
![Photo of Natasha V Chang, MS, LCMHC, NCC, Counselor](https://photos.psychologytoday.com/57fe0634-415a-43a0-872a-36a85e532b2d/1/320x400.jpeg)
Natasha V Chang
Counselor, MS, LCMHC, NCC
Verified Verified
2 Endorsed
Middlebury, VT 05753
Not accepting new clients
I specialize in working with adults and emerging adults from diverse racial, cultural and ethnic backgrounds. I accept clients who struggle to find competent care due to the overall inadequate support in mental health for individuals who occupy marginalized identity positions. I bring to my practice both deep knowledge about many socio-cultural factors and power dynamics that can profoundly affect a person's lived experiences, as well as deep humility about the limits of my knowledge. I use traditional talk therapy and EMDR -- an integrative therapy that uses a body-based technique called bilateral stimulation.
I specialize in working with adults and emerging adults from diverse racial, cultural and ethnic backgrounds. I accept clients who struggle to find competent care due to the overall inadequate support in mental health for individuals who occupy marginalized identity positions. I bring to my practice both deep knowledge about many socio-cultural factors and power dynamics that can profoundly affect a person's lived experiences, as well as deep humility about the limits of my knowledge. I use traditional talk therapy and EMDR -- an integrative therapy that uses a body-based technique called bilateral stimulation.
![Photo of Katherine Jordan, MA, Counselor](https://photos.psychologytoday.com/83407858-49db-4acb-9740-79317b5d4cc6/2/320x400.jpeg)
I work with clients on issues such as stress and anxiety, lgbtq+ related topics (including gender identity and expression), self confidence, life transitions, self-compassion, as well as trying to find meaning and purpose in life, facing climate change anxiety, coping with uncertainty/change, and existential concerns.
I work with clients on issues such as stress and anxiety, lgbtq+ related topics (including gender identity and expression), self confidence, life transitions, self-compassion, as well as trying to find meaning and purpose in life, facing climate change anxiety, coping with uncertainty/change, and existential concerns.
![Photo of Gabrielle Jensen, MSW, Pre-Licensed Professional](https://photos.psychologytoday.com/78e1b2d6-1a7a-42a7-958f-663c52c43ef8/2/320x400.jpeg)
Gabrielle Jensen
Pre-Licensed Professional, MSW
Verified Verified
Middlebury, VT 05753
Waitlist for new clients
I believe therapy is about collaboration, working together to discover and explore your strengths and find your unique story. I offer a caring and non-judgmental space where you’ll feel heard as you move toward achieving your personal goals. I’ve been working as a school counselor in Vermont with families in crisis and these past few years have been especially tough due to the pandemic, impacting our youth profoundly. Having witnessed this firsthand within the school system, I was inspired to start my own practice.
I believe therapy is about collaboration, working together to discover and explore your strengths and find your unique story. I offer a caring and non-judgmental space where you’ll feel heard as you move toward achieving your personal goals. I’ve been working as a school counselor in Vermont with families in crisis and these past few years have been especially tough due to the pandemic, impacting our youth profoundly. Having witnessed this firsthand within the school system, I was inspired to start my own practice.
See more therapy options for Middlebury
Nearby Searches for Middlebury
- Brandon
- Bristol
- Charlotte
- Hinesburg
- Moretown
- Northfield
- Pittsford
- Randolph
- Richmond
- Shelburne
- Vergennes
- Waitsfield
How does your Therapist compare?
Number of Therapists in Middlebury, VT
80+
Average cost per session
$130
Therapists in Middlebury, VT who prioritize treating:
94% | Depression |
93% | Anxiety |
90% | Relationship Issues |
80% | Self Esteem |
74% | Life Transitions |
73% | Grief |
73% | Stress |
Average years in practice
12 Years
Top 3 insurances accepted
83% | BlueCross and BlueShield |
77% | Medicaid |
67% | MVP Health Care |
How Therapists in Middlebury, VT see their clients
66% | In Person and Online | |
34% | Online Only |
Gender breakdown
81% | Female | |
18% | Male | |
1% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in Middlebury?
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
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.
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.
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.