Therapists in Saint Louis, MO

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Photo of Nicole McNeil - Ellie Mental Health, MA, LPC, Licensed Professional Counselor
Nicole McNeil - Ellie Mental Health
Licensed Professional Counselor, MA, LPC
Verified Verified
Saint Louis, MO 63131  (Online Only)
Change can happen at any age. All it takes is the commitment and willingness to look at oneself and gain insight, and put steps into action toward change. I provide the support, validation, and openness to help individuals and families explore both their strengths, and address and improve the cycles that make them unhappy. I am action oriented and direct, while leaving space for self-exploration and growth in a warm and nurturing environment.
Change can happen at any age. All it takes is the commitment and willingness to look at oneself and gain insight, and put steps into action toward change. I provide the support, validation, and openness to help individuals and families explore both their strengths, and address and improve the cycles that make them unhappy. I am action oriented and direct, while leaving space for self-exploration and growth in a warm and nurturing environment.
(314) 463-4778 View (314) 463-4778
Photo of Summer Morefield, LPC, Licensed Professional Counselor
Summer Morefield
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Saint Louis, MO 63135  (Online Only)
I have worked with clients with a wide range of concerns including depression, anxiety, relationship issues, parenting problems, SUD’s, career challenges, OCD and ADHD. I also helped many people who have experienced physical trauma or emotional abuse. My counseling style is warm and empathic. I believe in treating everyone with respect, sensitivity, and compassion. My approach combines cognitive-behavioral, humanistic, psychodynamic and rational-emotive counseling.
I have worked with clients with a wide range of concerns including depression, anxiety, relationship issues, parenting problems, SUD’s, career challenges, OCD and ADHD. I also helped many people who have experienced physical trauma or emotional abuse. My counseling style is warm and empathic. I believe in treating everyone with respect, sensitivity, and compassion. My approach combines cognitive-behavioral, humanistic, psychodynamic and rational-emotive counseling.
(314) 742-7857 View (314) 742-7857
Photo of Kimberly Davis, MA, LPC, Counselor
Kimberly Davis
Counselor, MA, LPC
Verified Verified
Saint Louis, MO 63139  (Online Only)
Are you facing challenges in life? Or grappling with past traumas without a glimpse of light at the end of the tunnel? You don't have to go through it alone. I'm Kim Davis, a Licensed Professional Counselor (LPC) based in Missouri who guides clients through challenging times.
Are you facing challenges in life? Or grappling with past traumas without a glimpse of light at the end of the tunnel? You don't have to go through it alone. I'm Kim Davis, a Licensed Professional Counselor (LPC) based in Missouri who guides clients through challenging times.
(314) 208-3286 View (314) 208-3286
Photo of Reese M Bell - Reese M Bell SMB Therapy And Consulting, llc, MA, LPC, Licensed Professional Counselor
Reese M Bell SMB Therapy And Consulting, llc
Licensed Professional Counselor, MA, LPC
Verified Verified
Saint Louis, MO 63146
Hey y’all! I’m Reese Bell, LPC, your soon-to-be therapist and friendly emotional tour guide. Struggling with anxiety or depression? No problem, I’ve got you! Imagine our sessions as a heart-to-heart with a side of therapy magic – think EMDR and mindfulness. Together, we’ll tackle those tough feelings and get you back to your fabulous self. I’m like your emotional GPS, helping you navigate to a happier, healthier you. Ready to start this journey with me? Let’s go!
Hey y’all! I’m Reese Bell, LPC, your soon-to-be therapist and friendly emotional tour guide. Struggling with anxiety or depression? No problem, I’ve got you! Imagine our sessions as a heart-to-heart with a side of therapy magic – think EMDR and mindfulness. Together, we’ll tackle those tough feelings and get you back to your fabulous self. I’m like your emotional GPS, helping you navigate to a happier, healthier you. Ready to start this journey with me? Let’s go!
(314) 937-6629 View (314) 937-6629
Photo of Dr. Cherie L Swingler, PhD, LPC, Licensed Professional Counselor
Dr. Cherie L Swingler
Licensed Professional Counselor, PhD, LPC
Verified Verified
Saint Louis, MO 63101
My name is Dr. Chérie Swingler, and I am a Licensed Professional Counselor (LPC) in Missouri. I have over 12 years experience working in the arena of counseling and therapeutic services. Much of my education and work experience has been focused on issues related to careers/education, anxiety, anger management, depression, trauma, ADHD and relationship/family conflicts.
My name is Dr. Chérie Swingler, and I am a Licensed Professional Counselor (LPC) in Missouri. I have over 12 years experience working in the arena of counseling and therapeutic services. Much of my education and work experience has been focused on issues related to careers/education, anxiety, anger management, depression, trauma, ADHD and relationship/family conflicts.
(314) 916-6014 View (314) 916-6014
Photo of Afshan Malik, LPC, EMDR, Coach, MP, Licensed Professional Counselor
Afshan Malik
Licensed Professional Counselor, LPC, EMDR, Coach, MP
Verified Verified
1 Endorsed
Saint Louis, MO 63119  (Online Only)
Life transitions are the new beginning; unfortunately, past experiences, insecurities, trauma, and grief can influence the present behavior & actions. Making life transitions emotionally exhausting while getting the same results exacerbating feelings of stuck-ness in the rut. If you are tired of starting over and want to learn Why, When, & How you self-sabotage your success & relationships, If you want to gain mastery over your emotions, have clarity, focus, and commitment to your life goals. Grow personally/professionally, feel more in control, and less stressed than I am the therapeutic coach you need. Online and self-pay only.
Life transitions are the new beginning; unfortunately, past experiences, insecurities, trauma, and grief can influence the present behavior & actions. Making life transitions emotionally exhausting while getting the same results exacerbating feelings of stuck-ness in the rut. If you are tired of starting over and want to learn Why, When, & How you self-sabotage your success & relationships, If you want to gain mastery over your emotions, have clarity, focus, and commitment to your life goals. Grow personally/professionally, feel more in control, and less stressed than I am the therapeutic coach you need. Online and self-pay only.
(314) 310-7916 View (314) 310-7916
Photo of Heather Barker, MEd, LPC, Licensed Professional Counselor
Heather Barker
Licensed Professional Counselor, MEd, LPC
Verified Verified
2 Endorsed
Saint Louis, MO 63105
As a licensed professional counselor, I bring 14 years of clinical experience to my private practice and use a variety of treatment modalities to help clients navigate a wide range of issues including stress, anxiety, depression, grief, trauma and relationship problems. I believe that relationships are central to our well-being and am passionate about working with all of the individual pieces of a family – children, teens, parents, couples – and the family unit itself. On a personal level, I bring unconditional acceptance, an emphasis on grace for self and others, and genuine compassion to each one of my clients.
As a licensed professional counselor, I bring 14 years of clinical experience to my private practice and use a variety of treatment modalities to help clients navigate a wide range of issues including stress, anxiety, depression, grief, trauma and relationship problems. I believe that relationships are central to our well-being and am passionate about working with all of the individual pieces of a family – children, teens, parents, couples – and the family unit itself. On a personal level, I bring unconditional acceptance, an emphasis on grace for self and others, and genuine compassion to each one of my clients.
(314) 858-5163 View (314) 858-5163
Photo of Kathy V Guerra, MEd, LPC-S, Licensed Professional Counselor
Kathy V Guerra
Licensed Professional Counselor, MEd, LPC-S
Verified Verified
Saint Louis, MO 63146
"Life is difficult." That's a Scott Peck quote. Healing begins just by embracing this quote. Three simple words, but on a bad day, very true, right? Sunny days seem inaccessible. You've already taken the first step, which is realizing that the listening ear of a therapist just might be helpful. After graduating from Boston U, my emphasis became adolescents, family relationships, and women's issues. This is my practice emphasis, but my door is open to all who are interested in growth and self-reflection.
"Life is difficult." That's a Scott Peck quote. Healing begins just by embracing this quote. Three simple words, but on a bad day, very true, right? Sunny days seem inaccessible. You've already taken the first step, which is realizing that the listening ear of a therapist just might be helpful. After graduating from Boston U, my emphasis became adolescents, family relationships, and women's issues. This is my practice emphasis, but my door is open to all who are interested in growth and self-reflection.
(314) 200-0843 View (314) 200-0843
Photo of Karen Grayson, PhD, LPC, Licensed Professional Counselor
Karen Grayson
Licensed Professional Counselor, PhD, LPC
Verified Verified
3 Endorsed
Saint Louis, MO 63141
I work exclusively with therapists and coaches who want to bring Internal Family Systems (IFS) more fully into their lives and professional work. Heal your own trauma. Live more effectively from your best Self. Help your clients gain insight and transform their lives. The more Self-led, grounded, and confident you are as a practitioner, the more your clients will heal and the more joy you'll feel in your life and work.
I work exclusively with therapists and coaches who want to bring Internal Family Systems (IFS) more fully into their lives and professional work. Heal your own trauma. Live more effectively from your best Self. Help your clients gain insight and transform their lives. The more Self-led, grounded, and confident you are as a practitioner, the more your clients will heal and the more joy you'll feel in your life and work.
(314) 714-4233 View (314) 714-4233
Photo of Dr. Derek J. Wall, PhD, LPC, Licensed Professional Counselor
Dr. Derek J. Wall
Licensed Professional Counselor, PhD, LPC
Verified Verified
Saint Louis, MO 63123
I provide therapeutic counseling services to individuals, couples, and families who are hurting due to conflict, anxiety, grief, and depression. With consistent, positive support, I serve my clients with a deep appreciation of their individuality and sensitivity to their struggle. Conflict and harm can be devastating, but it does not have to be. You deserve the opportunity to discover peace and to know that you do not have to search alone. Contact me today or learn more about me on my website.
I provide therapeutic counseling services to individuals, couples, and families who are hurting due to conflict, anxiety, grief, and depression. With consistent, positive support, I serve my clients with a deep appreciation of their individuality and sensitivity to their struggle. Conflict and harm can be devastating, but it does not have to be. You deserve the opportunity to discover peace and to know that you do not have to search alone. Contact me today or learn more about me on my website.
(314) 786-3623 View (314) 786-3623
Photo of David K McGraw, LPC, Licensed Professional Counselor
David K McGraw
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Saint Louis, MO 63108
Our world often stigmatizes needing support, but let's face it: no one gets anywhere without help! Change and growth come with challenges, and having the support of a genuine and compassionate therapist can make a positive difference. Whether you are experiencing a significant personal development, struggling to relate to others, or feeling stuck and looking for a change for the better, reaching out to someone trained to help is a critical step towards finding a way to live more authentically. As a therapist, I work with individuals & couples to create a space to process experiences and find a path forward to greater well-being.
Our world often stigmatizes needing support, but let's face it: no one gets anywhere without help! Change and growth come with challenges, and having the support of a genuine and compassionate therapist can make a positive difference. Whether you are experiencing a significant personal development, struggling to relate to others, or feeling stuck and looking for a change for the better, reaching out to someone trained to help is a critical step towards finding a way to live more authentically. As a therapist, I work with individuals & couples to create a space to process experiences and find a path forward to greater well-being.
(314) 926-9030 View (314) 926-9030
Photo of Ilana R Luft-Barrett, PhD, Psychologist
Ilana R Luft-Barrett
Psychologist, PhD
Verified Verified
Saint Louis, MO 63116  (Online Only)
I am a Clinical Psychologist licensed to treat clients in Missouri and New York State, and Authorized to Practice Interjurisdictional Telepsychology in all PSYPACT states. Therapy is a collaboration between therapist and client. My goal is to understand where you are at this moment in your life, help you to identify your goals and work with you, as a partner, to attain them. I use evidence-based approaches that assist you in changing unhelpful thinking and behaviors, improve awareness and control over emotions, increase tolerance of difficult emotions, and enhance your ability to live mindfully in the present moment.
I am a Clinical Psychologist licensed to treat clients in Missouri and New York State, and Authorized to Practice Interjurisdictional Telepsychology in all PSYPACT states. Therapy is a collaboration between therapist and client. My goal is to understand where you are at this moment in your life, help you to identify your goals and work with you, as a partner, to attain them. I use evidence-based approaches that assist you in changing unhelpful thinking and behaviors, improve awareness and control over emotions, increase tolerance of difficult emotions, and enhance your ability to live mindfully in the present moment.
(314) 858-5660 View (314) 858-5660
Photo of Cari Nelson, MA, LPC, NCC, Licensed Professional Counselor
Cari Nelson
Licensed Professional Counselor, MA, LPC, NCC
Verified Verified
1 Endorsed
Saint Louis, MO 63127
If you are struggling with anxiety, relational discontent, a challenging life event or you’re soul-searching, there is a way out. You are reading this, so you have already taken the hardest step. Life seems to be increasingly heavy these days, we are overwhelmed, overworked, we feel helpless and even hopeless at times. These feelings not only effect our thoughts, our bodies are tired, and our relationships are strained.
If you are struggling with anxiety, relational discontent, a challenging life event or you’re soul-searching, there is a way out. You are reading this, so you have already taken the hardest step. Life seems to be increasingly heavy these days, we are overwhelmed, overworked, we feel helpless and even hopeless at times. These feelings not only effect our thoughts, our bodies are tired, and our relationships are strained.
(314) 207-3819 View (314) 207-3819
Photo of Amy Frankel - Amy Frankel, Ph.D., LLC, PhD, Psychologist
Amy Frankel, Ph.D., LLC
Psychologist, PhD
Verified Verified
Saint Louis, MO 63123
I am a clinical psychologist licensed in the state of Missouri since 1988. I've worked in psychiatric hospitals, residential care facilities, and private practice. I currently work in a solo private practice in south St. Louis County and also as a consultant to a child and adolescent residential treatment program in Florissant. I have been a featured presenter and trainer on a variety of topics to community groups, schools, and mental health organizations.
I am a clinical psychologist licensed in the state of Missouri since 1988. I've worked in psychiatric hospitals, residential care facilities, and private practice. I currently work in a solo private practice in south St. Louis County and also as a consultant to a child and adolescent residential treatment program in Florissant. I have been a featured presenter and trainer on a variety of topics to community groups, schools, and mental health organizations.
(314) 309-3676 View (314) 309-3676
Photo of Tonya Winingar, LPC, Licensed Professional Counselor
Tonya Winingar
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Saint Louis, MO 63146
You’ve had enough of the stress. You've been trying to hold everything in but the littlest thing pushes you over the edge and after it's all over you are exhausted. You know you don't want to keep living this way and want to move forward with your life but you feel stuck! No one really understand everything you've been through. The trauma you've been through makes it hard to just function and be around other people. You try to push it away and have some normalcy but the triggers make it impossible. Your world becomes small in hopes that you can avoid these feelings but it only makes things worse. You are stuck in a vicious cycle.
You’ve had enough of the stress. You've been trying to hold everything in but the littlest thing pushes you over the edge and after it's all over you are exhausted. You know you don't want to keep living this way and want to move forward with your life but you feel stuck! No one really understand everything you've been through. The trauma you've been through makes it hard to just function and be around other people. You try to push it away and have some normalcy but the triggers make it impossible. Your world becomes small in hopes that you can avoid these feelings but it only makes things worse. You are stuck in a vicious cycle.
(314) 310-5882 View (314) 310-5882
Photo of Kat Seal, LMSW
Kat Seal
Licensed Master Social Worker, LMSW
Verified Verified
1 Endorsed
Saint Louis, MO 63108
Feeling fractured from your once-strong sense of self can be confusing, isolating, and painful. Oftentimes these feelings can arise from societal pressures to conform, living in a sex-negative society, or relationship and systemic trauma. Sex & relationship therapy can be a good fit for improving the relational quality of your life and accessing desire as a tool for living well. I specialize in supporting individuals and relationships (of all styles) who struggle to access authenticity and wholeness in their daily lives. I work best with engaged clients who practice active self reflection.
Feeling fractured from your once-strong sense of self can be confusing, isolating, and painful. Oftentimes these feelings can arise from societal pressures to conform, living in a sex-negative society, or relationship and systemic trauma. Sex & relationship therapy can be a good fit for improving the relational quality of your life and accessing desire as a tool for living well. I specialize in supporting individuals and relationships (of all styles) who struggle to access authenticity and wholeness in their daily lives. I work best with engaged clients who practice active self reflection.
(314) 897-4049 View (314) 897-4049
Photo of Rynn Wyrick, LPC, NCC, Licensed Professional Counselor
Rynn Wyrick
Licensed Professional Counselor, LPC, NCC
Verified Verified
1 Endorsed
Saint Louis, MO 63101
Waitlist for new clients
I specialize in offering trauma-informed therapy to LGBTQIA+ and neurodivergent adults residing in Missouri. As a queer and trans individual myself, my focus is on co-creating a safe and affirming environment for folks to thrive. I hold space for clients to explore and process their experiences of grief, complex trauma, and challenges stemming from the impacts of living in a traumatic and oppressive society. I particularly enjoy working with queer and neurodiverse individuals who are interested in taking a more deliberate approach to their personal growth and who wish to develop a deeper connection with themselves and their bodies.
I specialize in offering trauma-informed therapy to LGBTQIA+ and neurodivergent adults residing in Missouri. As a queer and trans individual myself, my focus is on co-creating a safe and affirming environment for folks to thrive. I hold space for clients to explore and process their experiences of grief, complex trauma, and challenges stemming from the impacts of living in a traumatic and oppressive society. I particularly enjoy working with queer and neurodiverse individuals who are interested in taking a more deliberate approach to their personal growth and who wish to develop a deeper connection with themselves and their bodies.
(314) 970-3579 View (314) 970-3579
Tiny Hearts Play Therapy, LLC
Licensed Professional Counselor, LPC
Verified Verified
Saint Louis, MO 63132
Not accepting new clients
Is your child struggling with communication and needs to work through grief, anxiety or find a way to express their feelings in a healthy way? I can provide a safe place to explore these feelings through play at my practice.
Is your child struggling with communication and needs to work through grief, anxiety or find a way to express their feelings in a healthy way? I can provide a safe place to explore these feelings through play at my practice.
View
Photo of Carol Love, LMFT, Marriage & Family Therapist
Carol Love
Marriage & Family Therapist, LMFT
Verified Verified
2 Endorsed
Saint Louis, MO 63117
I specialize in working with families who have had, or are going through a divorce or parental separation. Chronic conflict will have a lasting negative effect on you and your children BUT if you are able to manage your emotions and parent successfully, you and your children can thrive in the future. It is important to develop a good coparenting relationship and make sure your children have the support they need to deal with divorce/separation issues. In order to facilitate a positive outcome for families, I provide Coparent Counseling, Family Therapy, Reunification Therapy Group and Individual Therapy (adult and child).
I specialize in working with families who have had, or are going through a divorce or parental separation. Chronic conflict will have a lasting negative effect on you and your children BUT if you are able to manage your emotions and parent successfully, you and your children can thrive in the future. It is important to develop a good coparenting relationship and make sure your children have the support they need to deal with divorce/separation issues. In order to facilitate a positive outcome for families, I provide Coparent Counseling, Family Therapy, Reunification Therapy Group and Individual Therapy (adult and child).
(314) 665-2301 View (314) 665-2301
Photo of Michelle Smart, LCSW, MSW, Clinical Social Work/Therapist
Michelle Smart
Clinical Social Work/Therapist, LCSW, MSW
Verified Verified
1 Endorsed
Saint Louis, MO 63108  (Online Only)
Just imagine a time in your life when your difficulties were so surmountable that the quality of your life diminished—struggling with weighty feelings from the loss of a loved one to thoughts of suicide. There is a solution: therapy! When individuals seek help and fully engage in the therapeutic process, the results lead to individuals living healthier lives. Together, we will create change in the areas of your life that no longer have meaning and purpose. I work to make everyone's therapy the best fit for them. I will use evidence-based therapy concepts, but I do not limit our work to any single model. My treatment style is rooted
Just imagine a time in your life when your difficulties were so surmountable that the quality of your life diminished—struggling with weighty feelings from the loss of a loved one to thoughts of suicide. There is a solution: therapy! When individuals seek help and fully engage in the therapeutic process, the results lead to individuals living healthier lives. Together, we will create change in the areas of your life that no longer have meaning and purpose. I work to make everyone's therapy the best fit for them. I will use evidence-based therapy concepts, but I do not limit our work to any single model. My treatment style is rooted
(314) 470-9254 View (314) 470-9254
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How does your Therapist compare?

Number of Therapists in Saint Louis, MO

1,000+

Average cost per session

$130

Therapists in Saint Louis, MO who prioritize treating:

92% Anxiety
86% Depression
76% Relationship Issues
74% Self Esteem
69% Trauma and PTSD
67% Stress
66% Coping Skills

Average years in practice

10 Years

Top 3 insurances accepted

75% Aetna
74% UnitedHealthcare UHC | UBH
72% Cigna and Evernorth

How Therapists in Saint Louis, MO see their clients

75% In Person and Online
25% Online Only

Gender breakdown

79% Female
19% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Saint Louis?

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.