Photo of Amanda Koniewicz - AK Therapy Services, LLC, LPC, CAADC, Licensed Professional Counselor
AK Therapy Services, LLC
Licensed Professional Counselor, LPC, CAADC
Verified Verified
Swarthmore, PA 19081  (Online Only)
Do you find yourself facing the same old issues in life and relationships? Does it feel like, no matter what you do, your repeating the same cycles? Maybe you’ve read some self-help books or been to therapy before, yet nothing has gotten to the bottom of your symptoms or led to the growth and change that you’re looking for in life and relationships.
Do you find yourself facing the same old issues in life and relationships? Does it feel like, no matter what you do, your repeating the same cycles? Maybe you’ve read some self-help books or been to therapy before, yet nothing has gotten to the bottom of your symptoms or led to the growth and change that you’re looking for in life and relationships.
(610) 320-2638 View (610) 320-2638
Photo of Nicole Lyman, MEd, YTT-200, Pre-Licensed Professional
Nicole Lyman
Pre-Licensed Professional, MEd, YTT-200
Verified Verified
Swarthmore, PA 19081
Life experiences impact our mental health in many different ways. I am a therapist who is committed to supporting the unique needs of each individual through a wholistic perspective and building a collaborative relationship with each client. I strive to support each person based on their own intersectional needs, characteristics, contexts, and histories. With a mindfulness based practice, I seek to provide a safe and nonjudgmental relationship to explore strengths and goals to build coping skills to deal with various life challenges.
Life experiences impact our mental health in many different ways. I am a therapist who is committed to supporting the unique needs of each individual through a wholistic perspective and building a collaborative relationship with each client. I strive to support each person based on their own intersectional needs, characteristics, contexts, and histories. With a mindfulness based practice, I seek to provide a safe and nonjudgmental relationship to explore strengths and goals to build coping skills to deal with various life challenges.
(856) 223-7380 View (856) 223-7380
Photo of Danielle Chesney, PsyD, Psychologist
Danielle Chesney
Psychologist, PsyD
Verified Verified
Swarthmore, PA 19081
You were fine...and then life happened. Death, divorce, children, retirement, the relationship - whatever it was for you, it turned your world upside down. While you used to pride yourself in "having it together," now you feel lost, depressed, overwhelmed and helpless. You are angry at yourself and others because you can't "move on." All you want to do is feel like "YOU" again, but you secretly wonder if that's even possible. It is possible. I can help you cope with the painful parts of life and feel in control again.
You were fine...and then life happened. Death, divorce, children, retirement, the relationship - whatever it was for you, it turned your world upside down. While you used to pride yourself in "having it together," now you feel lost, depressed, overwhelmed and helpless. You are angry at yourself and others because you can't "move on." All you want to do is feel like "YOU" again, but you secretly wonder if that's even possible. It is possible. I can help you cope with the painful parts of life and feel in control again.
(215) 392-6638 View (215) 392-6638
Photo of Austin Zeller, MEd, Pre-Licensed Professional
Austin Zeller
Pre-Licensed Professional, MEd
Verified Verified
1 Endorsed
Swarthmore, PA 19081
Specializing in Play Therapy with children and adolescents, I engage clients in emotional processing, healing, and self-work through movement and creativity. Layered with a Cognitive-Behavioral orientation, clients develop an understanding of how their thoughts, feelings, and behaviors are related. Offering both individual counseling and group counseling sessions, I am committed to supporting a diverse range of youth including those facing trauma, anxiety, depression, grief, and behavioral difficulties. In-Person sessions are held in Swarthmore, PA at A Place to Be Counseling. Virtual sessions are available as appropriate.
Specializing in Play Therapy with children and adolescents, I engage clients in emotional processing, healing, and self-work through movement and creativity. Layered with a Cognitive-Behavioral orientation, clients develop an understanding of how their thoughts, feelings, and behaviors are related. Offering both individual counseling and group counseling sessions, I am committed to supporting a diverse range of youth including those facing trauma, anxiety, depression, grief, and behavioral difficulties. In-Person sessions are held in Swarthmore, PA at A Place to Be Counseling. Virtual sessions are available as appropriate.
(484) 699-8284 View (484) 699-8284
Photo of Heather M Bellini, MA, LPC, Licensed Professional Counselor
Heather M Bellini
Licensed Professional Counselor, MA, LPC
Verified Verified
2 Endorsed
Swarthmore, PA 19081
Transform yourself and your relationships. I use evidence-based treatment strategies and mindfulness practices to help my clients strengthen themselves and their families, improve their overall health, find balance and achieve their personal goals.
Transform yourself and your relationships. I use evidence-based treatment strategies and mindfulness practices to help my clients strengthen themselves and their families, improve their overall health, find balance and achieve their personal goals.
(509) 412-3732 View (509) 412-3732
Photo of Leah Bowden - Higher Ground Behavioral Health, PsyD, Psychologist
Higher Ground Behavioral Health
Psychologist, PsyD
Verified Verified
Swarthmore, PA 19081
Welcome to Higher Ground Behavioral Health! We are a private practice that aims to provide quality services to children, adults, and their families. We understand the sensitivity and compassion it takes to help our clients succeed. Furthermore, we strive to be collaborative and work with you on identifying and accomplishing the goals you set forth. Please explore our page which addresses our services, fees, and other important information. We look forward to hearing from you. For questions, comments, or to schedule an appointment, please call or email us.
Welcome to Higher Ground Behavioral Health! We are a private practice that aims to provide quality services to children, adults, and their families. We understand the sensitivity and compassion it takes to help our clients succeed. Furthermore, we strive to be collaborative and work with you on identifying and accomplishing the goals you set forth. Please explore our page which addresses our services, fees, and other important information. We look forward to hearing from you. For questions, comments, or to schedule an appointment, please call or email us.
(610) 638-2642 View (610) 638-2642
Photo of Camila Anderson, MSEd, Pre-Licensed Professional
Camila Anderson
Pre-Licensed Professional, MSEd
Verified Verified
1 Endorsed
Swarthmore, PA 19081
About Me I am a pre-licensed professional counselor with specialized experience working with children, adolescents, and families from diverse backgrounds. I have focused on supporting those navigating anxiety, trauma, ADHD, Autism Spectrum Disorder, Bipolar I/II, and other mood and behavioral challenges. I have worked across various settings, including schools, crisis intervention services, and outpatient care, providing compassionate support tailored to each individual's needs.
About Me I am a pre-licensed professional counselor with specialized experience working with children, adolescents, and families from diverse backgrounds. I have focused on supporting those navigating anxiety, trauma, ADHD, Autism Spectrum Disorder, Bipolar I/II, and other mood and behavioral challenges. I have worked across various settings, including schools, crisis intervention services, and outpatient care, providing compassionate support tailored to each individual's needs.
(484) 578-3172 View (484) 578-3172
Photo of Jeannette Jefferson, MA
Jeannette Jefferson
MA
Verified Verified
1 Endorsed
Swarthmore, PA 19081  (Online Only)
I am enthusiastic about working with young adults, teens, children and I believe there is no such thing as an ideal client since we're not living in the most ideal world. I believe in being that supportive and directive person in a client's life who is taking the journey with them. I work with a wide range of issues and address these through evidence based practices and skills within Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, sand tray, and positive psychology. In regards to children, I focus my skills on therapeutic play and art to aid in processing and emotion regulation.
I am enthusiastic about working with young adults, teens, children and I believe there is no such thing as an ideal client since we're not living in the most ideal world. I believe in being that supportive and directive person in a client's life who is taking the journey with them. I work with a wide range of issues and address these through evidence based practices and skills within Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, sand tray, and positive psychology. In regards to children, I focus my skills on therapeutic play and art to aid in processing and emotion regulation.
(610) 839-7508 View (610) 839-7508
Photo of Robert Heasley, PhD, LMFT, Marriage & Family Therapist
Robert Heasley
Marriage & Family Therapist, PhD, LMFT
Verified Verified
Swarthmore, PA 19081
I work with individuals and couples to create positive changes in their lives. This includes those struggling in areas such as self-esteem, intimacy, addressing emotional needs, healing from past hurts/trauma, a history of neglect or abuse, or challenges regarding gender and sexuality. I work with couples, straight/lesbian/gay, who are working on their relationship, whether as a result of an affair, or realizing differences that keep them from being close. My research focuses on men and the effects of expectations on men’s lives. Pursuing therapy represents a longing to heal. My work is about supporting that process.
I work with individuals and couples to create positive changes in their lives. This includes those struggling in areas such as self-esteem, intimacy, addressing emotional needs, healing from past hurts/trauma, a history of neglect or abuse, or challenges regarding gender and sexuality. I work with couples, straight/lesbian/gay, who are working on their relationship, whether as a result of an affair, or realizing differences that keep them from being close. My research focuses on men and the effects of expectations on men’s lives. Pursuing therapy represents a longing to heal. My work is about supporting that process.
(484) 406-4186 View (484) 406-4186
Photo of Pollie M Lang, MSS, LCSW, Clinical Social Work/Therapist
Pollie M Lang
Clinical Social Work/Therapist, MSS, LCSW
Verified Verified
Swarthmore, PA 19081
My goal in working with you is to hear your story, patiently help you make sense of your confusion and pain, help you create unique coping skills, and build a preferred life worth living. Years ago I worked with cancer patients and their families at a Bone Marrow Transplant Unit in South Carolina. Their situations were varied and complex, their physical and emotional pain was deep. As they talked about their pain, hopelessness, worthlessness, loss, anxiety, and uncertainty, together we made sense of their confusion. Likewise, as we work together, I will help you and your challenges in the same caring and skillful way.
My goal in working with you is to hear your story, patiently help you make sense of your confusion and pain, help you create unique coping skills, and build a preferred life worth living. Years ago I worked with cancer patients and their families at a Bone Marrow Transplant Unit in South Carolina. Their situations were varied and complex, their physical and emotional pain was deep. As they talked about their pain, hopelessness, worthlessness, loss, anxiety, and uncertainty, together we made sense of their confusion. Likewise, as we work together, I will help you and your challenges in the same caring and skillful way.
(610) 549-1620 View (610) 549-1620
Photo of Lydia Debiase, PhD, LCSW, Clinical Social Work/Therapist
Lydia Debiase
Clinical Social Work/Therapist, PhD, LCSW
Verified Verified
Swarthmore, PA 19081
Life is a journey and on our journey we will experience love, joy, and happiness. We will also encounter pain, loss, suffering and hardship. As a licensed clinical social worker I offer a safe space where you can safely talk about your experiences and feelings. I want to help you trust your own intuition as you talk about your life and make decisions about the direction of it. I am accepting, caring, and supportive. I believe in cultural humility which allows the individual to teach me about their self identity to include their ethnicity, spirituality, sexual identity, and other aspects of their cultural.
Life is a journey and on our journey we will experience love, joy, and happiness. We will also encounter pain, loss, suffering and hardship. As a licensed clinical social worker I offer a safe space where you can safely talk about your experiences and feelings. I want to help you trust your own intuition as you talk about your life and make decisions about the direction of it. I am accepting, caring, and supportive. I believe in cultural humility which allows the individual to teach me about their self identity to include their ethnicity, spirituality, sexual identity, and other aspects of their cultural.
(610) 365-4436 View (610) 365-4436
Photo of Nanine Valen, MSW, LCSW, BCD, Clinical Social Work/Therapist
Nanine Valen
Clinical Social Work/Therapist, MSW, LCSW, BCD
Verified Verified
Swarthmore, PA 19081
Drawing on extensive training and background, I offer a widely varied range of treatment specialties in an interactive emotionally present therapy supporting my client's personal growth and well being as they learn techniques to reduce stress, clear the mind of fears and illusions, connecting to their own needs and feelings. My experience confirms that the expertise of the therapist is important, but equally vital is her depth of caring. I approach each client with an eclectic and open mind, drawing on techniques from Structural Family Therapy for Marital and Family problems, Cognitive/Behavioral, Mind/Body, Psychodynamic, Jungian-Oriented Dreamwork, Existential/Humanistic, Hypnotherapy.
Drawing on extensive training and background, I offer a widely varied range of treatment specialties in an interactive emotionally present therapy supporting my client's personal growth and well being as they learn techniques to reduce stress, clear the mind of fears and illusions, connecting to their own needs and feelings. My experience confirms that the expertise of the therapist is important, but equally vital is her depth of caring. I approach each client with an eclectic and open mind, drawing on techniques from Structural Family Therapy for Marital and Family problems, Cognitive/Behavioral, Mind/Body, Psychodynamic, Jungian-Oriented Dreamwork, Existential/Humanistic, Hypnotherapy.
(610) 915-8420 View (610) 915-8420
Photo of Hal Shorey, PhD, Psychologist
Hal Shorey
Psychologist, PhD
Verified Verified
Swarthmore, PA 19081
I am an experienced clinician with training in a host of treatments and interventions and will tailor a treatment specifically suited to your needs and life circumstances.If you are like most clients, you have been trying to find ways to have a more satisfying and rewarding life that is free of distress and the pain of the past. The good news is that I can help you overcome the symptoms and situations that have been keeping you from enjoying your life the way you deserve. I work with individuals, couples, and provide discrete services for working professionals.
I am an experienced clinician with training in a host of treatments and interventions and will tailor a treatment specifically suited to your needs and life circumstances.If you are like most clients, you have been trying to find ways to have a more satisfying and rewarding life that is free of distress and the pain of the past. The good news is that I can help you overcome the symptoms and situations that have been keeping you from enjoying your life the way you deserve. I work with individuals, couples, and provide discrete services for working professionals.
(215) 515-2486 View (215) 515-2486
Photo of Camila Spaulonci, MSEd, Pre-Licensed Professional
Camila Spaulonci
Pre-Licensed Professional, MSEd
Verified Verified
Swarthmore, PA 19081
I am a pre-licensed professional counselor with specialized experience working with children, adolescents, and families from diverse backgrounds. I have focused on supporting those navigating anxiety, trauma, ADHD, Autism Spectrum Disorder, Bipolar I/II, and other mood and behavioral challenges. I have worked across various settings, including schools, crisis intervention services, and outpatient care, providing compassionate support tailored to each individual's needs.
I am a pre-licensed professional counselor with specialized experience working with children, adolescents, and families from diverse backgrounds. I have focused on supporting those navigating anxiety, trauma, ADHD, Autism Spectrum Disorder, Bipolar I/II, and other mood and behavioral challenges. I have worked across various settings, including schools, crisis intervention services, and outpatient care, providing compassionate support tailored to each individual's needs.
(484) 372-3695 View (484) 372-3695
Photo of Alexandra Nelson, PhD, Psychologist
Alexandra Nelson
Psychologist, PhD
Verified Verified
Swarthmore, PA 19081
I am a clinical psychologist specializing in women's health psychology and maternal mental health. My therapeutic style is warm, engaging, collaborative, and solution-focused. I use evidence-based treatments grounded in cognitive-behavioral therapy (CBT) and mindfulness techniques to foster an affirming and productive experience. I work with clients to develop effective coping skills to improve mood and quality of life, reduce anxiety and distress, enhance resilience and self-worth, and identify and modify thinking and behavior patterns to support achievement of personal, family, relationship, and career goals.
I am a clinical psychologist specializing in women's health psychology and maternal mental health. My therapeutic style is warm, engaging, collaborative, and solution-focused. I use evidence-based treatments grounded in cognitive-behavioral therapy (CBT) and mindfulness techniques to foster an affirming and productive experience. I work with clients to develop effective coping skills to improve mood and quality of life, reduce anxiety and distress, enhance resilience and self-worth, and identify and modify thinking and behavior patterns to support achievement of personal, family, relationship, and career goals.
(857) 412-7962 View (857) 412-7962
Radka Jurkech
Marriage & Family Therapist, MEd, LMFT
Verified Verified
Swarthmore, PA 19081
In my practice I work with individuals and couples. I believe that therapy can be a useful tool in learning to understand ourselves better, and in building more rewarding and healthy relationships with others. It is a unique opportunity to focus on what is important to us, and what may be preventing us from living to our full potential. In my practice I like to address emotional, cognitive and relational aspects of individual experience. My approach focuses on both, accomplishment of more pressing short term goals, as well as long term goals and personal growth.
In my practice I work with individuals and couples. I believe that therapy can be a useful tool in learning to understand ourselves better, and in building more rewarding and healthy relationships with others. It is a unique opportunity to focus on what is important to us, and what may be preventing us from living to our full potential. In my practice I like to address emotional, cognitive and relational aspects of individual experience. My approach focuses on both, accomplishment of more pressing short term goals, as well as long term goals and personal growth.
(215) 618-1535 View (215) 618-1535
Photo of Thanh Nguyen, LCSW-PA, LCSW-NJ, Clinical Social Work/Therapist
Thanh Nguyen
Clinical Social Work/Therapist, LCSW-PA, LCSW-NJ
Verified Verified
1 Endorsed
Swarthmore, PA 19081  (Online Only)
Hi, my name is Thanh Nguyen. I am a Licensed Clinical Social Worker in the Greater Philadelphia Area. I specialize in perinatal mental health and have a passion in supporting women through their journeys. I provide individual therapy for those struggling with trauma/PTSD, postpartum depression/anxiety, and general depression and anxiety due to life stressors and transitions.
Hi, my name is Thanh Nguyen. I am a Licensed Clinical Social Worker in the Greater Philadelphia Area. I specialize in perinatal mental health and have a passion in supporting women through their journeys. I provide individual therapy for those struggling with trauma/PTSD, postpartum depression/anxiety, and general depression and anxiety due to life stressors and transitions.
(610) 549-1076 View (610) 549-1076
Photo of Dana Fry, PhD, Psychologist
Dana Fry
Psychologist, PhD
Verified Verified
Swarthmore, PA 19081
My style is very down to earth, including humor, warmth, and acceptance. I am open to your ideas and your strengths. I listen closely to your feelings and to the challenges you face. I can help by offering new ways of looking at problems, at relationships, and at coping efforts. In this way, you can develop a better understanding of what may be keeping you stuck or making you unhappy, as well as new ways of responding to life's challenges.
My style is very down to earth, including humor, warmth, and acceptance. I am open to your ideas and your strengths. I listen closely to your feelings and to the challenges you face. I can help by offering new ways of looking at problems, at relationships, and at coping efforts. In this way, you can develop a better understanding of what may be keeping you stuck or making you unhappy, as well as new ways of responding to life's challenges.
(610) 486-3806 View (610) 486-3806
Photo of Paul H Himmelberg, PhD, Psychologist
Paul H Himmelberg
Psychologist, PhD
Verified Verified
Swarthmore, PA 19081
Many individuals who appear to function well nonetheless experience considerable emotional pain. Some suffer in silence, burdened by shame over being unable to "get over it" or "stop feeling sorry for themselves." Others find themselves stuck in self-defeating patterns. Despite a longing for close relationships, they continually alienate others and end up in powerful loneliness. Both groups sense that life is slipping away from them. With perseverance and a willingness to risk opening up, a person can shed these crippling patterns and find greater satisfaction in both relationships and in work.
Many individuals who appear to function well nonetheless experience considerable emotional pain. Some suffer in silence, burdened by shame over being unable to "get over it" or "stop feeling sorry for themselves." Others find themselves stuck in self-defeating patterns. Despite a longing for close relationships, they continually alienate others and end up in powerful loneliness. Both groups sense that life is slipping away from them. With perseverance and a willingness to risk opening up, a person can shed these crippling patterns and find greater satisfaction in both relationships and in work.
(610) 915-8746 View (610) 915-8746
Photo of Gene R Purdie Jr, MA, LPC, Licensed Professional Counselor
Gene R Purdie Jr
Licensed Professional Counselor, MA, LPC
Verified Verified
2 Endorsed
Swarthmore, PA 19081
Waitlist for new clients
I am a licensed professional counselor specializing in mental health, relationships, and addiction recovery. I collaborate with young adults, couples, and families to move beyond seeming impasses and engage fulfilled and connected lives. My approach includes identifying the message behind uncomfortable emotions and problematic behaviors, disconnecting from unhelpful thoughts and self-judgements, and exploring alternative perspectives through use of relatable (and often humorous) analogies.
I am a licensed professional counselor specializing in mental health, relationships, and addiction recovery. I collaborate with young adults, couples, and families to move beyond seeming impasses and engage fulfilled and connected lives. My approach includes identifying the message behind uncomfortable emotions and problematic behaviors, disconnecting from unhelpful thoughts and self-judgements, and exploring alternative perspectives through use of relatable (and often humorous) analogies.
(215) 240-1316 View (215) 240-1316
1

How does your Therapist compare?

Number of Therapists in 19081

100+

Average cost per session

$140

Therapists in 19081 who prioritize treating:

94% Anxiety
90% Depression
78% Self Esteem
73% Relationship Issues
65% Trauma and PTSD
64% Coping Skills
63% Grief

Average years in practice

8 Years

Top 3 insurances accepted

92% Aetna
78% BlueCross and BlueShield
77% Cigna and Evernorth

How Therapists in 19081 see their clients

89% In Person and Online
11% Online Only

Gender breakdown

77% Female
22% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 19081?

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.