Photo of Julie Anne Stevens, Counsellor, MBACP
Julie Anne Stevens
Counsellor, MBACP
My background is in Mental Health with over 20 years experience as a Mental Health Nurse working within the NHS and private sector. I have supported many individuals from children and young people to older adults. That has given me the experience and ability to work with a wide variety of mental Health issues.
My background is in Mental Health with over 20 years experience as a Mental Health Nurse working within the NHS and private sector. I have supported many individuals from children and young people to older adults. That has given me the experience and ability to work with a wide variety of mental Health issues.
01452 923012 View 01452 923012
Photo of Carley Ayling, Counsellor, MBACP Accred
Carley Ayling
Counsellor, MBACP Accred
1 Endorsed
Online Only
Hello, I am Carley Ayling and I’ve been working as a counsellor since my training in 2010 and I am a qualified Relational Supervisor, for counsellors working with adults, children and young people. I provide treatment to individuals aged 14 years and above. I’ve worked with many clients with depression, anxiety, OCD, relationships difficulties, neurodiversity, suicide and self-harm, sleep and sexual assault. I offer a free initial appointment where we can exchange information to see if we are happy to work together. I provide sessions via FaceTime, Zoom, Teams or WhatsApp video or telephone calls in the evenings or Friday daytime.
Hello, I am Carley Ayling and I’ve been working as a counsellor since my training in 2010 and I am a qualified Relational Supervisor, for counsellors working with adults, children and young people. I provide treatment to individuals aged 14 years and above. I’ve worked with many clients with depression, anxiety, OCD, relationships difficulties, neurodiversity, suicide and self-harm, sleep and sexual assault. I offer a free initial appointment where we can exchange information to see if we are happy to work together. I provide sessions via FaceTime, Zoom, Teams or WhatsApp video or telephone calls in the evenings or Friday daytime.
01489 346870 View 01489 346870
Photo of Chris Perry, Counsellor, MBACP
Chris Perry
Counsellor, MBACP
2 Endorsed
Welcome, I am Chris, a compassionate counsellor dedicated to supporting individuals, on their journey toward healing, growth, and connection in Gloucester, Cheltenham, Cirencester and online. I provide a safe, empathetic, and nonjudgmental space where you can explore your challenges, uncover your strengths, and work toward meaningful change. I believe that every person is unique, and so is their story. My therapeutic approach is tailored to your needs, drawing from a range of evidence-based techniques, including psychodynamic and person-centered therapy. I can help with anxiety, depression, trauma, and relationship issues.
Welcome, I am Chris, a compassionate counsellor dedicated to supporting individuals, on their journey toward healing, growth, and connection in Gloucester, Cheltenham, Cirencester and online. I provide a safe, empathetic, and nonjudgmental space where you can explore your challenges, uncover your strengths, and work toward meaningful change. I believe that every person is unique, and so is their story. My therapeutic approach is tailored to your needs, drawing from a range of evidence-based techniques, including psychodynamic and person-centered therapy. I can help with anxiety, depression, trauma, and relationship issues.
01452 923130 View 01452 923130
Photo of Barry Cook, Counsellor, MNCPS Acc.
Barry Cook
Counsellor, MNCPS Acc.
Not knowing which way to turn or who you can talk to? Life feeling something like this overwhelming, relationships strained, broken down, lacking confidence & self-esteem, difficult to voice or understand what you need, feeling down on edge & simply confused? Then welcome to Barry Cook 'The Tattooed Counsellor' When we feel this way our problems may be all mixed up growing bigger or unmanageable by the day. It could be that past or present experiences are causing us confusion & conflict. Maybe you would benefit from talking to someone who is not a part of your friends & family and will simply allow you to be you.
Not knowing which way to turn or who you can talk to? Life feeling something like this overwhelming, relationships strained, broken down, lacking confidence & self-esteem, difficult to voice or understand what you need, feeling down on edge & simply confused? Then welcome to Barry Cook 'The Tattooed Counsellor' When we feel this way our problems may be all mixed up growing bigger or unmanageable by the day. It could be that past or present experiences are causing us confusion & conflict. Maybe you would benefit from talking to someone who is not a part of your friends & family and will simply allow you to be you.
01452 923141 View 01452 923141
Photo of Claire Kennaby - Pinch of Positivity Centre, Counsellor, MSc, MBACP
Pinch of Positivity Centre
Counsellor, MSc, MBACP
Hi, and a warm welcome. I'm a qualified counsellor and have been for many years offering therapeutic support for adults, adolescents, children and families either together or individually, in my private practice and within primary and secondary schools. I can offer support too many for many reasons and offer flexible Integrative approaches to suit you. I always welcome a free initial email or chat or meet and briefly discuss ways of support that suits all. This can also give you all an opportunity to see the space, meet and talk with me with no obligation. This helps in deciding what is best for you.
Hi, and a warm welcome. I'm a qualified counsellor and have been for many years offering therapeutic support for adults, adolescents, children and families either together or individually, in my private practice and within primary and secondary schools. I can offer support too many for many reasons and offer flexible Integrative approaches to suit you. I always welcome a free initial email or chat or meet and briefly discuss ways of support that suits all. This can also give you all an opportunity to see the space, meet and talk with me with no obligation. This helps in deciding what is best for you.
01452 923058 View 01452 923058
Photo of Jen O'Brien, Counsellor, MBACP
Jen O'Brien
Counsellor, MBACP
I work with individuals and couples using an integrative approach, drawing on different therapeutic models such as the Person-Centred approach and Cognitive Behavioural Therapy (CBT), which means I can tailor the therapy to fit your needs. Some reasons why people choose counselling may include: • Depression • Bereavement and loss • Low Self-esteem • Anxiety • Stress • Relationship difficulties and Divorce • Trauma and life changes • Personal development • PTSD • Sexuality and many more issues.
I work with individuals and couples using an integrative approach, drawing on different therapeutic models such as the Person-Centred approach and Cognitive Behavioural Therapy (CBT), which means I can tailor the therapy to fit your needs. Some reasons why people choose counselling may include: • Depression • Bereavement and loss • Low Self-esteem • Anxiety • Stress • Relationship difficulties and Divorce • Trauma and life changes • Personal development • PTSD • Sexuality and many more issues.
01452 941664 View 01452 941664
Photo of Hayley De-Niro, Counsellor, MBACP
Hayley De-Niro
Counsellor, MBACP
Are you grappling with difficult emotions? Struggling with anxiety, depression or stress? Do you have negative or critical thoughts about yourself, holding you back from reaching what you truly desire? Perhaps you are repeating patterns such as people pleasing, leaving you feeling confused and stuck? Or are traumatic memories and feelings haunting you? These can be very tricky and painful emotions to navigate alone. My hope is that by the end of our work together you will feel able to cope with your emotions, developed a stronger sense of self and feel empowered to live your life authentically.
Are you grappling with difficult emotions? Struggling with anxiety, depression or stress? Do you have negative or critical thoughts about yourself, holding you back from reaching what you truly desire? Perhaps you are repeating patterns such as people pleasing, leaving you feeling confused and stuck? Or are traumatic memories and feelings haunting you? These can be very tricky and painful emotions to navigate alone. My hope is that by the end of our work together you will feel able to cope with your emotions, developed a stronger sense of self and feel empowered to live your life authentically.
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Photo of Claudette Roberts, Counsellor, MBACP
Claudette Roberts
Counsellor, MBACP
Are you questioning life, struggling, feeling lost, wondering what is wrong and why does it feel I'm not getting it quite right! You're not alone and within us we all have the need to be connected with ourselves and sometimes we struggle feeling connected to others, to feel okay and have our own sense of purpose. We live in a fast pace changing world, which doesn't always support us, when we wish to be truly heard, at our pace and to have the private time to reflect and make changes.
Are you questioning life, struggling, feeling lost, wondering what is wrong and why does it feel I'm not getting it quite right! You're not alone and within us we all have the need to be connected with ourselves and sometimes we struggle feeling connected to others, to feel okay and have our own sense of purpose. We live in a fast pace changing world, which doesn't always support us, when we wish to be truly heard, at our pace and to have the private time to reflect and make changes.
01452 227733 View 01452 227733
Photo of Kathy Marie Allen - Freedom Counselling, Counsellor, MBACP
Freedom Counselling
Counsellor, MBACP
1 Endorsed
Are you finding it hard to understand your feelings? Maybe you feel totally in control when faced with a crisis, only to fall apart over something trivial. I’m here to help you make sense of your feelings and to help you understand yourself on a much deeper level. With compassion and curiosity, let’s explore together what you need to live an authentic and balanced life.
Are you finding it hard to understand your feelings? Maybe you feel totally in control when faced with a crisis, only to fall apart over something trivial. I’m here to help you make sense of your feelings and to help you understand yourself on a much deeper level. With compassion and curiosity, let’s explore together what you need to live an authentic and balanced life.
01452 941801 View 01452 941801
Photo of Cath Woolford, Counsellor, MBACP
Cath Woolford
Counsellor, MBACP
Hi, I’m Cath and a very warm welcome to my practice. Do you wake up at night worrying about things? Perhaps you’re struggling with feelings of stress or anxiety? Maybe you’re overwhelmed with an uneasy feeling and know something has to change, but you’re not quite sure what, or where to start. My hope is that in our time together you will get to know yourself better and learn to live your life as you’d like to, rather than being held back by the past, anxiety or worry
Hi, I’m Cath and a very warm welcome to my practice. Do you wake up at night worrying about things? Perhaps you’re struggling with feelings of stress or anxiety? Maybe you’re overwhelmed with an uneasy feeling and know something has to change, but you’re not quite sure what, or where to start. My hope is that in our time together you will get to know yourself better and learn to live your life as you’d like to, rather than being held back by the past, anxiety or worry
01452 941940 View 01452 941940
Photo of Martyn Pars, Counsellor, MBACP
Martyn Pars
Counsellor, MBACP
My Offer To You: Being heard, understood, believed in and supported. We all need this kind of support at some point in our lives. This is my offer to you. I am an accredited professional registrant counsellor psychotherapist (PNCPS acc.) registered through the British Association of Counselling and Psychotherapy (MBACP reg) which means I am held on the Professional Standards Authority Accredited Register thus ensuring protection to the public. I am a BUPA and Harley Street Online registered therapist and I have a particular interest in those with later in life ADHD diagnosis or suspect they might be
My Offer To You: Being heard, understood, believed in and supported. We all need this kind of support at some point in our lives. This is my offer to you. I am an accredited professional registrant counsellor psychotherapist (PNCPS acc.) registered through the British Association of Counselling and Psychotherapy (MBACP reg) which means I am held on the Professional Standards Authority Accredited Register thus ensuring protection to the public. I am a BUPA and Harley Street Online registered therapist and I have a particular interest in those with later in life ADHD diagnosis or suspect they might be
01242 507893 View 01242 507893
Photo of Claire Harrison, Counsellor, MNCPS Acc.
Claire Harrison
Counsellor, MNCPS Acc.
Serves Area
Are you struggling with anxiety and low self esteem ? If so this will affect many areas of your life from relationships to the job you do. By challenging your negative beliefs and finding where they come from we can replace them with positive beliefs.Often there can be painful memories which have made us feel stuck emotionally through fear and then we can become unable to move forward. You can start again with a new self confidence. You can change how you feel about yourself and learn to accept yourself.You can learn strategies to help you keep emotionally regulated and more in control of your emotions.
Are you struggling with anxiety and low self esteem ? If so this will affect many areas of your life from relationships to the job you do. By challenging your negative beliefs and finding where they come from we can replace them with positive beliefs.Often there can be painful memories which have made us feel stuck emotionally through fear and then we can become unable to move forward. You can start again with a new self confidence. You can change how you feel about yourself and learn to accept yourself.You can learn strategies to help you keep emotionally regulated and more in control of your emotions.
01905 677509 View 01905 677509
Photo of Ellen Waterer - Cbt Therapist - Ellen Waterer - CBT Therapist, Psychotherapist, MBABCP
Ellen Waterer - CBT Therapist
Psychotherapist, MBABCP
1 Endorsed
Serves Area
Are you or a young person close to you struggling with anxiety, low mood or have other mental health struggles? I promise to be there for you every step of your journey. My mission is help young minds flourish through CBT. CBT is a therapy that explores how your thoughts, feelings, physical sensations and actions are linked, and that negative/anxious thoughts and feelings can trap you in a negative/anxious cycle. I am an expert in cognitive behavioural models, however, you are an expert of yourself and your experiences. I therefore promise to work collaboratively with you to reach your goals of better mental health and wellbeing.
Are you or a young person close to you struggling with anxiety, low mood or have other mental health struggles? I promise to be there for you every step of your journey. My mission is help young minds flourish through CBT. CBT is a therapy that explores how your thoughts, feelings, physical sensations and actions are linked, and that negative/anxious thoughts and feelings can trap you in a negative/anxious cycle. I am an expert in cognitive behavioural models, however, you are an expert of yourself and your experiences. I therefore promise to work collaboratively with you to reach your goals of better mental health and wellbeing.
01453 707138 View 01453 707138
Photo of John Andrews, Counsellor, MBACP
John Andrews
Counsellor, MBACP
2 Endorsed
Serves Area
Do you need help with a difficult time in your life? Are you feeling low or anxious, consumed with worry? Perhaps what helped in the past is no longer working. You may be feeling numb or withdrawn. Are traumatic events from your past resurfacing? These challenging experiences are part of us, and when we feel ready it is good to have help. I work closely along side you and together we find out more about yourself, what you want, what is blocking you and how you might overcome this. By addressing these issues can help remove shackles allowing you to grow and realize your full potential.
Do you need help with a difficult time in your life? Are you feeling low or anxious, consumed with worry? Perhaps what helped in the past is no longer working. You may be feeling numb or withdrawn. Are traumatic events from your past resurfacing? These challenging experiences are part of us, and when we feel ready it is good to have help. I work closely along side you and together we find out more about yourself, what you want, what is blocking you and how you might overcome this. By addressing these issues can help remove shackles allowing you to grow and realize your full potential.
01453 702862 View 01453 702862
Photo of Megan Frankie Curtis, Counsellor, MBACP
Megan Frankie Curtis
Counsellor, MBACP
1 Endorsed
Serves Area
Hello, I am a qualified, experienced counsellor offering face-to face counselling in Cheltenham as well as online sessions, to suit your needs. I work compassionately and empathically, without judgement, to create a confidential and safe space for you to talk and explore your experiences. There might be something particular you would like to work through, or, maybe you're not sure what you need to focus on? I can help you to understand your thoughts and feelings to create a better understanding of yourself, others, and your relationships, to promote healing and growth.
Hello, I am a qualified, experienced counsellor offering face-to face counselling in Cheltenham as well as online sessions, to suit your needs. I work compassionately and empathically, without judgement, to create a confidential and safe space for you to talk and explore your experiences. There might be something particular you would like to work through, or, maybe you're not sure what you need to focus on? I can help you to understand your thoughts and feelings to create a better understanding of yourself, others, and your relationships, to promote healing and growth.
01242 504447 View 01242 504447
Photo of Rachel Williams - Talking Healing, Counsellor, MNCPS Acc.
Talking Healing
Counsellor, MNCPS Acc.
Serves Area
I am a qualified counsellor, mental health nurse (for 13 years) and lecturer in mental health nursing, however, more importantly I am an approachable and non-judgemental person. I work with my clients to help them explore some difficult emotions and experiences as well as to find self-acceptance and resources to manage challenging experiences and emotions. I work in collaboration with my clients where they feel empowered and in control of their therapy journey. I now also offer hypnotherapy as well as coaching (fees for hypnotherapy may vary).
I am a qualified counsellor, mental health nurse (for 13 years) and lecturer in mental health nursing, however, more importantly I am an approachable and non-judgemental person. I work with my clients to help them explore some difficult emotions and experiences as well as to find self-acceptance and resources to manage challenging experiences and emotions. I work in collaboration with my clients where they feel empowered and in control of their therapy journey. I now also offer hypnotherapy as well as coaching (fees for hypnotherapy may vary).
07572 528030 View 07572 528030
Photo of Keira Lianne Rowlands - KeiraLianne Counselling, Counsellor, MBACP
KeiraLianne Counselling
Counsellor, MBACP
Serves Area
Not accepting new clients
I hope to offer a safe space, warm and trusting environment and non-judgemental relationship, where we can discuss the difficult and uncomfortable elements of your life. Be those early life experiences and relationships, significant life events (pregnancy/birth/death/marriage/divorce), anxiety, depression, trauma, abuse, identity, sense of self, loss or diagnosis.
I hope to offer a safe space, warm and trusting environment and non-judgemental relationship, where we can discuss the difficult and uncomfortable elements of your life. Be those early life experiences and relationships, significant life events (pregnancy/birth/death/marriage/divorce), anxiety, depression, trauma, abuse, identity, sense of self, loss or diagnosis.
01242 903226 View 01242 903226
Photo of Gemma Slobom, Counsellor, MBACP
Gemma Slobom
Counsellor, MBACP
1 Endorsed
Serves Area
Hello, I'm Gemma. I run a Private Practice in central Cheltenham, offering counselling to individuals. I support people with a wide range of issues, including anxiety and depression, relationship issues, and emotional issues. I work from an Intergrative perspective, which encompasses Psychodynamic theory, Person Centred Theory, Gestalt Theory and Transactional Analysis. I'm also a qualified Emotional Freedom Technique (EFT) practitioner, and where appropriate, bring this into the work. EFT is also known as tapping and is highly useful in supporting people to calm and ground in their own bodies.
Hello, I'm Gemma. I run a Private Practice in central Cheltenham, offering counselling to individuals. I support people with a wide range of issues, including anxiety and depression, relationship issues, and emotional issues. I work from an Intergrative perspective, which encompasses Psychodynamic theory, Person Centred Theory, Gestalt Theory and Transactional Analysis. I'm also a qualified Emotional Freedom Technique (EFT) practitioner, and where appropriate, bring this into the work. EFT is also known as tapping and is highly useful in supporting people to calm and ground in their own bodies.
01242 501160 View 01242 501160
Photo of Serena Fisher, Counsellor, MBACP Accred
Serena Fisher
Counsellor, MBACP Accred
Serves Area
We all face difficult times in life, in fact I think we could just say, life is difficult. In counselling you will be thinking with another person about how you manage life’s struggles, how you relate to friends and family and how your present situation may be related to your past experiences. Talking and thinking with another can bring about a new perspective to old problems or worries and help you find new ways of approaching things. in. In my experience even small changes can have a very positive impact. Speaking to someone might feel a bit daunting to begin with but I find people soon settle in.
We all face difficult times in life, in fact I think we could just say, life is difficult. In counselling you will be thinking with another person about how you manage life’s struggles, how you relate to friends and family and how your present situation may be related to your past experiences. Talking and thinking with another can bring about a new perspective to old problems or worries and help you find new ways of approaching things. in. In my experience even small changes can have a very positive impact. Speaking to someone might feel a bit daunting to begin with but I find people soon settle in.
01257 449513 View 01257 449513
Photo of Simon Chapman - Avon CBT & Psychotherapy, Psychotherapist, ACC-AC
Avon CBT & Psychotherapy
Psychotherapist, ACC-AC
1 Endorsed
Serves Area
Waitlist for new clients
My counselling practice is guided by 25 years of supporting people in difficult and often stressful situations, gained by working operationally in the NHS, Armed Forces, Emergency Services and the RNLI, as well as teaching in schools and a university. This experience informs my practice, enabling me to provide a safe and non-judgemental environment to work through the concern, challenge or problem being faced. I offer CBT, Relationship (Couples) Counselling and ADHD Support to individuals and couples, delivered with a warm, calm and compassionate focus. I can provide counselling face-to-face, online or whilst walking outdoors.
My counselling practice is guided by 25 years of supporting people in difficult and often stressful situations, gained by working operationally in the NHS, Armed Forces, Emergency Services and the RNLI, as well as teaching in schools and a university. This experience informs my practice, enabling me to provide a safe and non-judgemental environment to work through the concern, challenge or problem being faced. I offer CBT, Relationship (Couples) Counselling and ADHD Support to individuals and couples, delivered with a warm, calm and compassionate focus. I can provide counselling face-to-face, online or whilst walking outdoors.
0117 463 0084 View 0117 463 0084
1

How does your Counsellor compare?

Number of Counsellors in GL2

30+

Average cost per session

£55

Counsellors in GL2 who prioritize treating:

97% Depression
97% Anxiety
87% Self Esteem
84% Trauma and PTSD
81% Relationship Issues
81% Bereavement
71% Stress

Average years in practice

9 Years

Top 3 insurances accepted

60% WPA
20% Cigna and Evernorth
20% Other

How Counsellors in GL2 see their clients

94% In Person and Online
6% Online Only

Gender breakdown

80% Female
20% Male
FAQs - About Therapy and Counselling

How can I find a therapist in GL2?

Search for nearby therapists or counsellors by inputting your city, postcode, 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 postcode into the search bar.

Learn more about how to find a therapist

Is everyone in the Psychology Today Therapy Directory a licensed therapist?

Counsellors and Psychotherapists listed in the directory are members of the main professional associations, mainly the British Association for Counselling and Psychotherapy (BACP) and the UK Council for Psychotherapy (UKCP). Most Psychologists in the directory are accredited members of the British Psychological Society (BPS) and/or are registered in the Health and Care Professions Council (HPCP).

Providers whose professional membership or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Given that professional memberships are not a statutory requirement for psychotherapists and counsellors in the UK, certain qualified professionals or organisations may choose not to maintain such memberships despite possessing the necessary qualifications. They may be selectively included without the “Verified” seal.

What’s the difference between a psychologist, a therapist, and a counsellor?

Counsellors, psychotherapists and psychologists can all provide counselling or talking therapy and have credentials and experience that enable them to do so in the UK. Psychologists have earned a degree in psychology and many are members of the British Psychological Society (BPS) and have completed a postgraduate qualification in a specialism. Counsellors and Psychotherapists are not required to have a psychology degree, but to belong to a professional organisation such as the BACP or UKCP, they are required to have completed a training course as well as clinical and supervision hours.

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 UK could be between £30 - £60 when seeing a counsellor and £60 - £150 and up when seeing a clinical psychologist. If you have private insurance, your plan may cover some if not all of your sessions. You should contact your insurance provider to determine if they provide coverage for therapy sessions and to determine what, if any, requirements they might have in order for your sessions to be covered, such as a referral from your GP or medical specialist.

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.

If you are struggling to access therapy due to budget constraints, you could also consider public funded mental health services. The NHS Talking therapies programme offers free of charge counselling for common mental health problems like anxiety and depression. The service is available to anyone registered with a GP, though you do not necessarily need to be referred by your GP and can refer yourself directly to a Talking therapies service. The service will provide different solutions, including group and individual therapy, for a limited number of sessions which are generally up to six.

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 postcode.

Are therapy sessions confidential?

Therapists who are part of a professional organisation such as the BACP, the UKCP, or BPS are bound by an ethical framework that requires them to uphold a confidentiality agreement. Confidentiality is a crucial part of the therapeutic relationship and only under specific circumstances, such as when there has been participation in a criminal act or act of terror, or if there is potential or known harm to the client or others, will a therapist be obligated to break the agreement. These exceptions to the confidentiality agreement are usually discussed during the initial consultation.