Photo of Julie N Tapper, LICSW, Clinical Social Work/Therapist
Julie N Tapper
Clinical Social Work/Therapist, LICSW
Verified Verified
Swampscott, MA 01907  (Online Only)
It is my goal to be able to provide you, your child, & your family with reassurance, safety, care, & strategies to help you/them manage and address whatever has led to this moment. I have worked with children, adolescents, & adults who have mental health diagnoses including depression, anxiety, ADHD, autism spectrum disorders, oppositional defiant disorders, & post traumatic stress disorders. In my practice I apply trauma-sensitive approaches, collaborative problem solving, behavior consultancy protocols, & cognitive behavioral therapies.
It is my goal to be able to provide you, your child, & your family with reassurance, safety, care, & strategies to help you/them manage and address whatever has led to this moment. I have worked with children, adolescents, & adults who have mental health diagnoses including depression, anxiety, ADHD, autism spectrum disorders, oppositional defiant disorders, & post traumatic stress disorders. In my practice I apply trauma-sensitive approaches, collaborative problem solving, behavior consultancy protocols, & cognitive behavioral therapies.
(339) 500-8265 View (339) 500-8265
Photo of John Thomas Chirban, PhD, ThD, Psychologist
John Thomas Chirban
Psychologist, PhD, ThD
Verified Verified
Swampscott, MA 01907
I work with individuals, couples, and families to address concerns with relationships, identity, intimacy and sexuality, and spirituality, in addition to general psychological problems. My approach to therapy is active, relational, and result-oriented, encouraging clients take hold of their life and find the meaning that life holds for them. I have served as an instructor at Harvard Medical School and Psychologist at the Cambridge Health Alliance for more than 25 years. And have been serving on the Advisory Board of the Dr. Phil Show, since its inception. (See drchirban.com and swampscottpsychologicalassociates.com)
I work with individuals, couples, and families to address concerns with relationships, identity, intimacy and sexuality, and spirituality, in addition to general psychological problems. My approach to therapy is active, relational, and result-oriented, encouraging clients take hold of their life and find the meaning that life holds for them. I have served as an instructor at Harvard Medical School and Psychologist at the Cambridge Health Alliance for more than 25 years. And have been serving on the Advisory Board of the Dr. Phil Show, since its inception. (See drchirban.com and swampscottpsychologicalassociates.com)
(508) 252-0157 View (508) 252-0157
Photo of Lindsey Wilder, MEd, LMHC, Counselor
Lindsey Wilder
Counselor, MEd, LMHC
Verified Verified
2 Endorsed
Swampscott, MA 01907  (Online Only)
Waitlist for new clients
It is my goal to create a safe environment to facilitate personal growth and healing. I use a variety of therapeutic modalities tailored to my client's specific needs. Together we can find a solution. My passion involves working with women, children and families to assist them with acknowledgement of their strengths and feelings, filtering through negative messages that can affect self-esteem, and encouraging growth experiences.
It is my goal to create a safe environment to facilitate personal growth and healing. I use a variety of therapeutic modalities tailored to my client's specific needs. Together we can find a solution. My passion involves working with women, children and families to assist them with acknowledgement of their strengths and feelings, filtering through negative messages that can affect self-esteem, and encouraging growth experiences.
(978) 297-8185 View (978) 297-8185
Photo of Faith Peterson, MSW, LICSW, Clinical Social Work/Therapist
Faith Peterson
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Swampscott, MA 01907
These have been difficult times and many have felt the need for counsel to deal with concerns shared by all of us. At the same time, every therapy client is a unique individual and deserves care and concern for this. Problems in living can be lessened using "here and now" techniques such as CBT, and focusing on present concerns. They can also be alleviated by looking to the past to find where some issues had their beginning. Sometimes looking at both the present and the past is helpful moving toward goals. Either can help, and sometimes a combination is effective.
These have been difficult times and many have felt the need for counsel to deal with concerns shared by all of us. At the same time, every therapy client is a unique individual and deserves care and concern for this. Problems in living can be lessened using "here and now" techniques such as CBT, and focusing on present concerns. They can also be alleviated by looking to the past to find where some issues had their beginning. Sometimes looking at both the present and the past is helpful moving toward goals. Either can help, and sometimes a combination is effective.
View
Photo of Sara Noone, LICSW, Clinical Social Work/Therapist
Sara Noone
Clinical Social Work/Therapist, LICSW
Verified Verified
Swampscott, MA 01907  (Online Only)
Are you feeling overwhelmed by life? Do you feel that you are caught in a cycle that you are struggling to break out of? Do you have the desire to make changes in your life, but do not know how to start and where to begin? Are you navigating grief & loss? Therapy can be a journey of self discovery and it takes much courage and hard work. It is a collaborative partnership between you and the therapist.
Are you feeling overwhelmed by life? Do you feel that you are caught in a cycle that you are struggling to break out of? Do you have the desire to make changes in your life, but do not know how to start and where to begin? Are you navigating grief & loss? Therapy can be a journey of self discovery and it takes much courage and hard work. It is a collaborative partnership between you and the therapist.
(781) 614-6561 View (781) 614-6561
Photo of Julie Kinnicutt - Our Harbor Counseling: Julie Kinnicutt, LICSW, PMH-C, Clinical Social Work/Therapist
Our Harbor Counseling: Julie Kinnicutt
Clinical Social Work/Therapist, LICSW, PMH-C
Verified Verified
3 Endorsed
Swampscott, MA 01907  (Online Only)
Welcome... I'm Julie, and I'm glad you're here. I provide talk therapy to adults who are facing stressful life transitions and want support around coping and adjustment. I work best with clients who are motivated to change and become "unstuck" in harmful thought and behavior patterns. Maybe you're navigating a fertility journey.... Maybe you or a loved one has a chronic health issue... Maybe you want to improve your negative self talk. I'm certain that I can help.
Welcome... I'm Julie, and I'm glad you're here. I provide talk therapy to adults who are facing stressful life transitions and want support around coping and adjustment. I work best with clients who are motivated to change and become "unstuck" in harmful thought and behavior patterns. Maybe you're navigating a fertility journey.... Maybe you or a loved one has a chronic health issue... Maybe you want to improve your negative self talk. I'm certain that I can help.
(978) 519-7288 View (978) 519-7288
Photo of Ashley Valcourt, LMFT, Marriage & Family Therapist
Ashley Valcourt
Marriage & Family Therapist, LMFT
Verified Verified
Swampscott, MA 01907  (Online Only)
I am a Licensed Marriage and Family Therapist providing one-on-one therapy in a safe and supportive environment. I specialize in relationship issues, depression, and anxiety. My approach to therapy is to "make it make sense". I believe that when you understand the origin and evolution of your struggles and place it within the context of your personality and family history, you will become more empowered in your life. When you become the master of your life, you will feel competent and capable to achieve your goals, overcome your struggles, and live life balanced and fulfilled.
I am a Licensed Marriage and Family Therapist providing one-on-one therapy in a safe and supportive environment. I specialize in relationship issues, depression, and anxiety. My approach to therapy is to "make it make sense". I believe that when you understand the origin and evolution of your struggles and place it within the context of your personality and family history, you will become more empowered in your life. When you become the master of your life, you will feel competent and capable to achieve your goals, overcome your struggles, and live life balanced and fulfilled.
(703) 677-8881 View (703) 677-8881
Rachelle Linda Goldberg
Marriage & Family Therapist, LMFT
Verified Verified
Swampscott, MA 01907  (Online Only)
For more than 30 years I have worked to help people find their strengths, clarify their needs and enrich their relationships and lives. I have eleven years of graduate and post-graduate training in Marriage and Family Therapy and have led Marriage Encounter weekends for thirty years with my husband. I see therapy as a collaboration between therapist and client where I help my clients with resources for general health and wellness, self-growth and exploration. No one should have to face life's crises alone. I look forward to working with you.
For more than 30 years I have worked to help people find their strengths, clarify their needs and enrich their relationships and lives. I have eleven years of graduate and post-graduate training in Marriage and Family Therapy and have led Marriage Encounter weekends for thirty years with my husband. I see therapy as a collaboration between therapist and client where I help my clients with resources for general health and wellness, self-growth and exploration. No one should have to face life's crises alone. I look forward to working with you.
(978) 480-0969 View (978) 480-0969
Photo of Jill Evans Wuonola, MA, MSW, LICSW, Clinical Social Work/Therapist
Jill Evans Wuonola
Clinical Social Work/Therapist, MA, MSW, LICSW
Verified Verified
1 Endorsed
Swampscott, MA 01907
Is the stress of work and family life becoming difficult to manage? Do you struggle to find meaning in your life? Are you working to understand competing aspects of your identity? It is my privilege to help my clients work through their personal struggles, using a psychodynamic approach that is both relational and existential. I believe that the relationship between a therapist and client provides an empowering, life-affirming space to work through life's struggles and to bring about healing.
Is the stress of work and family life becoming difficult to manage? Do you struggle to find meaning in your life? Are you working to understand competing aspects of your identity? It is my privilege to help my clients work through their personal struggles, using a psychodynamic approach that is both relational and existential. I believe that the relationship between a therapist and client provides an empowering, life-affirming space to work through life's struggles and to bring about healing.
(617) 505-4439 View (617) 505-4439
Photo of Susana Puertas Manso, LMHC, Counselor
Susana Puertas Manso
Counselor, LMHC
Verified Verified
Swampscott, MA 01907  (Online Only)
I believe that in pain and struggle there is also resilience, strength and even opportunity. Therapy is a process of growth and self understanding that leads to relief and change. I work with clients facing many challenges including trauma, depression, anxiety, relationship difficulties and work problems. I have extensive experience working with diverse populations, I welcome all people, including LGBTQ+, ethnic racial minorities and anyone who may have felt othered due to their identities.
I believe that in pain and struggle there is also resilience, strength and even opportunity. Therapy is a process of growth and self understanding that leads to relief and change. I work with clients facing many challenges including trauma, depression, anxiety, relationship difficulties and work problems. I have extensive experience working with diverse populations, I welcome all people, including LGBTQ+, ethnic racial minorities and anyone who may have felt othered due to their identities.
(505) 557-1192 View (505) 557-1192
Photo of Sherry Ranjbar, LMHC, Counselor
Sherry Ranjbar
Counselor, LMHC
Verified Verified
Swampscott, MA 01907  (Online Only)
Are you looking for support in this complex journey called life? I am here for you. My ideal client is someone seeking meaning, clarity, and growth amidst the challenges of relationships, anxiety, depression, trauma, or anger. Together, we'll embark on a collaborative therapeutic journey towards empowerment, self-discovery, and a more fulfilling life. I believe in the power of our connection and will guide you through psychodynamic principles, exploring relationships and existential aspects along the way.
Are you looking for support in this complex journey called life? I am here for you. My ideal client is someone seeking meaning, clarity, and growth amidst the challenges of relationships, anxiety, depression, trauma, or anger. Together, we'll embark on a collaborative therapeutic journey towards empowerment, self-discovery, and a more fulfilling life. I believe in the power of our connection and will guide you through psychodynamic principles, exploring relationships and existential aspects along the way.
(978) 613-1254 View (978) 613-1254
Photo of Lindita Murrizi, MEd, LMHC
Lindita Murrizi
Mental Health Counselor , MEd, LMHC
Verified Verified
Swampscott, MA 01907  (Online Only)
Sometimes life is full of challenges and unwelcome stress, and I am here to help and support you through the tough times in your life. Whether or not you have received counseling before, it takes insight and courage to reach out for professional help. My goal is to help clients overcome obstacles in order to find peace and contentment. Each client is unique and adapting techniques to fit the individual is considered vital to the success of therapy.
Sometimes life is full of challenges and unwelcome stress, and I am here to help and support you through the tough times in your life. Whether or not you have received counseling before, it takes insight and courage to reach out for professional help. My goal is to help clients overcome obstacles in order to find peace and contentment. Each client is unique and adapting techniques to fit the individual is considered vital to the success of therapy.
(781) 309-7166 View (781) 309-7166
Photo of Charles W Tirrell, LICSW, Clinical Social Work/Therapist
Charles W Tirrell
Clinical Social Work/Therapist, LICSW
Verified Verified
Swampscott, MA 01907
I serve a varied population seeking improvement in multiple areas of life. Clients can be as young as three;elders are often 80 yrs+! My work is governed by the principles of respect,compassion and mutuality. I assist those with mood,anxiety,focus problems as well as multiple other disorders impeding life satisfaction. I see couples seeking balance and equity in their relationship endeavoring to strengthen it. My practice reflects the community at large; I see as many women as men and children of all ages and ethnicities. My therapeutic approach: client-centered, strengths-based and eclectic. (**not taking new clients at present**)
I serve a varied population seeking improvement in multiple areas of life. Clients can be as young as three;elders are often 80 yrs+! My work is governed by the principles of respect,compassion and mutuality. I assist those with mood,anxiety,focus problems as well as multiple other disorders impeding life satisfaction. I see couples seeking balance and equity in their relationship endeavoring to strengthen it. My practice reflects the community at large; I see as many women as men and children of all ages and ethnicities. My therapeutic approach: client-centered, strengths-based and eclectic. (**not taking new clients at present**)
(781) 423-3098 View (781) 423-3098
Photo of Karen Shanahan, LMHC, Counselor
Karen Shanahan
Counselor, LMHC
Verified Verified
2 Endorsed
Swampscott, MA 01907  (Online Only)
Each of us possesses an internal core of resilience, strength and determination. My goal in treatment is to help individuals to recognize, embrace, and utilize these attributes to navigate the challenges they face and to achieve peak emotional wellness, as defined by a state in which the mind is capable of staying away from negative thoughts and can focus on creative and constructive tasks. To achieve this, we will nurture your mind and body while building on the qualities and values you already possess. Therapy will allow us to embark on this mission together, guided by your individualized life goals.
Each of us possesses an internal core of resilience, strength and determination. My goal in treatment is to help individuals to recognize, embrace, and utilize these attributes to navigate the challenges they face and to achieve peak emotional wellness, as defined by a state in which the mind is capable of staying away from negative thoughts and can focus on creative and constructive tasks. To achieve this, we will nurture your mind and body while building on the qualities and values you already possess. Therapy will allow us to embark on this mission together, guided by your individualized life goals.
(978) 354-7476 View (978) 354-7476
Photo of Laura Wayne, LICSW, Clinical Social Work/Therapist
Laura Wayne
Clinical Social Work/Therapist, LICSW
Verified Verified
3 Endorsed
Swampscott, MA 01907  (Online Only)
"It's never too late to be what you might have been" (George Eliot). I believe that it takes strength and courage to seek therapy and that everyone is capable of making positive, healthy changes in their lives. I am here to support you in making those changes. I provide strength-based, client centered psychotherapy for adults. I use a variety of therapeutic methods in order to individualize treatment which include, but are not limited to, cognitive behavioral therapy (CBT), solution focused therapy, narrative therapy, exposure therapy and mindfulness.
"It's never too late to be what you might have been" (George Eliot). I believe that it takes strength and courage to seek therapy and that everyone is capable of making positive, healthy changes in their lives. I am here to support you in making those changes. I provide strength-based, client centered psychotherapy for adults. I use a variety of therapeutic methods in order to individualize treatment which include, but are not limited to, cognitive behavioral therapy (CBT), solution focused therapy, narrative therapy, exposure therapy and mindfulness.
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Photo of Gené Hollenbach, LMHC, Counselor
Gené Hollenbach
Counselor, LMHC
Verified Verified
Swampscott, MA 01907
My focus is to help individuals regain hope that their lives can improve and that they have the potential to be instrumental in this process. With therapy, individuals learn to identify detrimental patterns in their own behavior, thought processes and interactions. When one can step back from oneself in a safe and therapeutic space, perspective, change, and acceptance follows.Anthony Storr puts it beautifully: " Putting things into words has another function, It is the means whereby we detach ourselves from the world about us and from the inner world of our own emotions and thoughts".
My focus is to help individuals regain hope that their lives can improve and that they have the potential to be instrumental in this process. With therapy, individuals learn to identify detrimental patterns in their own behavior, thought processes and interactions. When one can step back from oneself in a safe and therapeutic space, perspective, change, and acceptance follows.Anthony Storr puts it beautifully: " Putting things into words has another function, It is the means whereby we detach ourselves from the world about us and from the inner world of our own emotions and thoughts".
(339) 298-2725 View (339) 298-2725
Photo of Jen Barrows, MEd, LMHC, Counselor
Jen Barrows
Counselor, MEd, LMHC
Verified Verified
Swampscott, MA 01907
Now accepting new clients for immediate openings. Therapy is sometimes like trying to untangle a great big knot from the inside out. I am there to guide you in choosing which strands to look at first, which ones to save for later and how to cope with the emotions that are released with the loosening of each string.
Now accepting new clients for immediate openings. Therapy is sometimes like trying to untangle a great big knot from the inside out. I am there to guide you in choosing which strands to look at first, which ones to save for later and how to cope with the emotions that are released with the loosening of each string.
(781) 908-2031 View (781) 908-2031
Photo of Monique Illona, MAET, LMT
Monique Illona
MAET, LMT
Verified Verified
Swampscott, MA 01907
Teaching my clients how to play gongs are a major part of my therapeutic process. Gong play requires a certain sense of presence, facilitating focus, grounding, centering, listening and connecting to the heart. This work is particularly helpful to those experiencing stress, anxiety, lack of self-esteem, loss of sense of self and ADHD. I have been an Expressive Arts Therapist since 1989, a Massage Professional since 1991 and am a Certified Sound Healer and flumie instructor. For over 30 years I have experienced the mind/body connection integral to achieving health and balance and work through gongs can be extremely powerful.
Teaching my clients how to play gongs are a major part of my therapeutic process. Gong play requires a certain sense of presence, facilitating focus, grounding, centering, listening and connecting to the heart. This work is particularly helpful to those experiencing stress, anxiety, lack of self-esteem, loss of sense of self and ADHD. I have been an Expressive Arts Therapist since 1989, a Massage Professional since 1991 and am a Certified Sound Healer and flumie instructor. For over 30 years I have experienced the mind/body connection integral to achieving health and balance and work through gongs can be extremely powerful.
(781) 512-6989 View (781) 512-6989
Photo of Jay Carey, MEd, MSW, LICSW, Clinical Social Work/Therapist
Jay Carey
Clinical Social Work/Therapist, MEd, MSW, LICSW
Verified Verified
2 Endorsed
Swampscott, MA 01907
***WE'RE ACCEPTING NEW CLIENTS INTO OUR GROUP PRACTICE (of which I am a partner)*** Are you ready to live a better version of your life? Is it time to release your sense of feeling stuck? Do you find yourself saying internally that “this shouldn’t hurt anymore”? Have you experienced painful or even horrible life events, and struggle to make peace with your past? Are you overcome with deep sadness, excessive worrying, pandemic anxiety, or having trouble meeting your goals? Are you ready to heal but not sure where to start?
***WE'RE ACCEPTING NEW CLIENTS INTO OUR GROUP PRACTICE (of which I am a partner)*** Are you ready to live a better version of your life? Is it time to release your sense of feeling stuck? Do you find yourself saying internally that “this shouldn’t hurt anymore”? Have you experienced painful or even horrible life events, and struggle to make peace with your past? Are you overcome with deep sadness, excessive worrying, pandemic anxiety, or having trouble meeting your goals? Are you ready to heal but not sure where to start?
(339) 217-6098 View (339) 217-6098
Photo of Betsy Lang, LICSW, CT, MSW, LLC, Clinical Social Work/Therapist
Betsy Lang
Clinical Social Work/Therapist, LICSW, CT, MSW, LLC
Verified Verified
Swampscott, MA 01907  (Online Only)
As a Licensed Clinical Social Worker, a Thanatologist, and a musician my unique practice blends two life passions, built on privacy, respect and trust, but most importantly, focusing on hope. I serve people struggling with the fears of life threatening illnesses and life altering transitions. With extended experience I help people cope with past traumas, including stress, anxiety, and depression caused by these fears and losses. Losses may include job, financial security, health, or relationships. Losses alter our lives, causing us to question the meaning of life, and re-prioritize what is important.
As a Licensed Clinical Social Worker, a Thanatologist, and a musician my unique practice blends two life passions, built on privacy, respect and trust, but most importantly, focusing on hope. I serve people struggling with the fears of life threatening illnesses and life altering transitions. With extended experience I help people cope with past traumas, including stress, anxiety, and depression caused by these fears and losses. Losses may include job, financial security, health, or relationships. Losses alter our lives, causing us to question the meaning of life, and re-prioritize what is important.
(978) 294-9980 View (978) 294-9980
1

How does your Therapist compare?

Number of Therapists in 01907

60+

Average cost per session

$150

Therapists in 01907 who prioritize treating:

98% Anxiety
93% Depression
87% Relationship Issues
82% Coping Skills
80% Self Esteem
75% Peer Relationships
73% Trauma and PTSD

Average years in practice

17 Years

Top 3 insurances accepted

96% BlueCross and BlueShield
53% Harvard Pilgrim
53% Tufts

How Therapists in 01907 see their clients

67% In Person and Online
33% Online Only

Gender breakdown

74% Female
26% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 01907?

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.