Therapists in 22535

Photo of Yolanda Lane, Licensed Professional Counselor, MA, LPC
Yolanda Lane
Licensed Professional Counselor, MA, LPC
2 Endorsed
Serves Area
Today's families are under a lot of pressure. Relationships are strained, work is stressful, and school is overwhelming. Trauma, depression, and anxiety can immobilize the best of us. Without help, it's difficult to find the balance.
Today's families are under a lot of pressure. Relationships are strained, work is stressful, and school is overwhelming. Trauma, depression, and anxiety can immobilize the best of us. Without help, it's difficult to find the balance.
(540) 288-4802 View (540) 288-4802

More Therapists Nearby

Photo of Brandy Fallon, Resident in Counseling, MEd
Brandy Fallon
Resident in Counseling, MEd
3 Endorsed
Fredericksburg, VA 22401
Living with chronic illness, a new diagnosis, or ADHD means carrying something heavy that others often can't see — the uncertainty, the grief, the exhaustion of constantly adapting. I work with adults, teens, and young adults navigating chronic illness, medical trauma, ADHD, and the identity shifts that come with health challenges. You don't have to minimize what you're carrying here. I offer trauma-informed, stabilization-focused therapy to help you feel more grounded and anchored in your daily life.
Living with chronic illness, a new diagnosis, or ADHD means carrying something heavy that others often can't see — the uncertainty, the grief, the exhaustion of constantly adapting. I work with adults, teens, and young adults navigating chronic illness, medical trauma, ADHD, and the identity shifts that come with health challenges. You don't have to minimize what you're carrying here. I offer trauma-informed, stabilization-focused therapy to help you feel more grounded and anchored in your daily life.
(540) 732-7032 View (540) 732-7032
Photo of Nicole Morgan - Commonwealth Clinical Services, LLP, Psychologist, PsyD
Commonwealth Clinical Services, LLP
Psychologist, PsyD
3 Endorsed
Serves Area
We at CCS work with a wide range of emotional and behavioral issues providing services for adults, adolescents, and children that focus on trauma and PTSD, depression, grief counseling, parenting support, couples counseling and beyond. We provide therapy services to address: Trauma and PTSD, Military and Veteran Concerns, First Responder Concerns (Law Enforcement, Fire, etc.), Depression and Anxiety, Post-Partum Concerns, Stress Management, Substance Use Issues, Mood Disorders and Daily Life Stressors/Adjustment Issues. We also provide psychological assessments and testing.
We at CCS work with a wide range of emotional and behavioral issues providing services for adults, adolescents, and children that focus on trauma and PTSD, depression, grief counseling, parenting support, couples counseling and beyond. We provide therapy services to address: Trauma and PTSD, Military and Veteran Concerns, First Responder Concerns (Law Enforcement, Fire, etc.), Depression and Anxiety, Post-Partum Concerns, Stress Management, Substance Use Issues, Mood Disorders and Daily Life Stressors/Adjustment Issues. We also provide psychological assessments and testing.
(804) 451-6766 View (804) 451-6766
Photo of Phyllis A Burgin - Clarity Clinical Counseling Services, Clinical Social Work/Therapist, LCSW
Clarity Clinical Counseling Services
Clinical Social Work/Therapist, LCSW
Stafford, VA 22556
I believe in a strength-based approach that is holistic, integrative and client-centered. I provide a non-judgmental and compassionate atmosphere in which clients can safely explore and work through feelings, thoughts, images and beliefs that may be keeping them stuck.
I believe in a strength-based approach that is holistic, integrative and client-centered. I provide a non-judgmental and compassionate atmosphere in which clients can safely explore and work through feelings, thoughts, images and beliefs that may be keeping them stuck.
(540) 701-5718 View (540) 701-5718
Photo of Dr. Tara Ross-Barksdale, Licensed Professional Counselor, PhD, LPC-S
Dr. Tara Ross-Barksdale
Licensed Professional Counselor, PhD, LPC-S
1 Endorsed
Serves Area
Welcome! I am Dr. Tara Ross-Barksdale. I am a registered supervisor and Licensed Professional Counselor in Virginia with nearly 11 years of licensed experience and over 20 years supporting individuals with mental health challenges. I hold a Master’s degree in Counseling from Liberty University and a Doctoral degree in Human Services from Walden University. As an active member of the Virginia Counselors Association (VCA), I bring experience from diverse settings, including community mental health, residential treatment, corrections, and private practice, working with individuals, couples, and families.
Welcome! I am Dr. Tara Ross-Barksdale. I am a registered supervisor and Licensed Professional Counselor in Virginia with nearly 11 years of licensed experience and over 20 years supporting individuals with mental health challenges. I hold a Master’s degree in Counseling from Liberty University and a Doctoral degree in Human Services from Walden University. As an active member of the Virginia Counselors Association (VCA), I bring experience from diverse settings, including community mental health, residential treatment, corrections, and private practice, working with individuals, couples, and families.
(434) 280-3296 View (434) 280-3296
Photo of Tierra Roberts, Resident in Counseling, MS, RIC
Tierra Roberts
Resident in Counseling, MS, RIC
Stafford, VA 22554
My ideal clients are children, teens, adults, and couples seeking growth, clarity, and meaningful change while navigating challenges related to mental health, relationships, life transitions, or involvement with the legal system. I work well with clients who value a structured, collaborative approach and are ready to build insight, strengthen accountability, and develop healthier coping skills. As a doctoral candidate in Forensic Psychology, I bring advanced training in the intersection of mental health and the legal system while helping clients create practical strategy for lasting personal growth and positive changes.
My ideal clients are children, teens, adults, and couples seeking growth, clarity, and meaningful change while navigating challenges related to mental health, relationships, life transitions, or involvement with the legal system. I work well with clients who value a structured, collaborative approach and are ready to build insight, strengthen accountability, and develop healthier coping skills. As a doctoral candidate in Forensic Psychology, I bring advanced training in the intersection of mental health and the legal system while helping clients create practical strategy for lasting personal growth and positive changes.
(540) 386-0338 View (540) 386-0338
Photo of Kristin Gartner - Bright Horizons Counseling Services, Licensed Professional Counselor
Bright Horizons Counseling Services
Licensed Professional Counselor
Stafford, VA 22554
At Bright Horizons, we know all people face obstacles they don’t know how to overcome on their own which are stopping them from living their best life. When people don’t have the tools to overcome the obstacles they face, their lives often become hopeless and they give up. Bright Horizons provides a supportive space where people learn to overcome these obstacles, so they’re empowered to live their best life now.
At Bright Horizons, we know all people face obstacles they don’t know how to overcome on their own which are stopping them from living their best life. When people don’t have the tools to overcome the obstacles they face, their lives often become hopeless and they give up. Bright Horizons provides a supportive space where people learn to overcome these obstacles, so they’re empowered to live their best life now.
(540) 889-0813 View (540) 889-0813
Photo of Rachel Pendergraft - Rachel Pendergraft, Individual & Couples Therapy, Marriage & Family Therapist, LMFT
Rachel Pendergraft, Individual & Couples Therapy
Marriage & Family Therapist, LMFT
Fredericksburg, VA 22407
I work with both individuals and couples who are longing for deeper connection, healing, and understanding. Relationships can be hard, especially when old hurts or well-worn patterns keep showing up. If you and your partner find yourselves stuck in cycles of conflict, distance, or misunderstanding, I want you to know you’re not alone. Often, partners bring different attachment styles into a relationship. One may lean in, pushing for closeness, resolution, or reassurance, while the other pulls away, hoping to calm things down or avoid making it worse. Over time, this pattern creates further disconnection, distrust, and distress.
I work with both individuals and couples who are longing for deeper connection, healing, and understanding. Relationships can be hard, especially when old hurts or well-worn patterns keep showing up. If you and your partner find yourselves stuck in cycles of conflict, distance, or misunderstanding, I want you to know you’re not alone. Often, partners bring different attachment styles into a relationship. One may lean in, pushing for closeness, resolution, or reassurance, while the other pulls away, hoping to calm things down or avoid making it worse. Over time, this pattern creates further disconnection, distrust, and distress.
(540) 210-1621 View (540) 210-1621
Photo of Arezoo Khanzadeh Malon, Psychologist, PsyD, LCP
Arezoo Khanzadeh Malon
Psychologist, PsyD, LCP
4 Endorsed
Fredericksburg, VA 22407
I have worked in the Fredericksburg/Stafford community for the past 24 years. I am currently taking referrals for psychological testing, custody evaluations and parental capacity evaluations. For psychological evaluations, I test age 8+. We can do evaluations for school accommodations, autism testing (ages 8-22), ADD testing, Intellectual disability, and other mental health evaluations.
I have worked in the Fredericksburg/Stafford community for the past 24 years. I am currently taking referrals for psychological testing, custody evaluations and parental capacity evaluations. For psychological evaluations, I test age 8+. We can do evaluations for school accommodations, autism testing (ages 8-22), ADD testing, Intellectual disability, and other mental health evaluations.
(540) 736-4212 View (540) 736-4212
Photo of Sharlene Hamilton - Cardinal Family Counseling, PLLC, Licensed Professional Counselor, LPC, NCC, CCHMC
Cardinal Family Counseling, PLLC
Licensed Professional Counselor, LPC, NCC, CCHMC
8 Endorsed
Ruther Glen, VA 22546
Cardinal Family Counseling is a team of experienced Licensed Counselors and Residents in Counseling, and Counseling Interns providing therapy to children, teens, adults, couples, and families. We help clients address anxiety, depression, relationship/marital difficulties, grief & loss difficulties, parental separation/divorce, trauma/PTSD, social phobias, peer relationship and social skills difficulties, and behavioral Issues. We use a variety of techniques to include Cognitive Behavioral Therapy and Solution Focused Therapy techniques to guide clients through their difficulties.
Cardinal Family Counseling is a team of experienced Licensed Counselors and Residents in Counseling, and Counseling Interns providing therapy to children, teens, adults, couples, and families. We help clients address anxiety, depression, relationship/marital difficulties, grief & loss difficulties, parental separation/divorce, trauma/PTSD, social phobias, peer relationship and social skills difficulties, and behavioral Issues. We use a variety of techniques to include Cognitive Behavioral Therapy and Solution Focused Therapy techniques to guide clients through their difficulties.
(804) 294-4310 View (804) 294-4310
Photo of Lisa Olivia Gibbs - Time Two Heal LLC, Licensed Professional Counselor, MA
Time Two Heal LLC
Licensed Professional Counselor, MA
1 Endorsed
Fredericksburg, VA 22401
I am a dedicated and licensed professional counselor with a mission to provide, protect, and treat others with love and respect. I am committed to inspiring my clients to believe in themselves and fostering a positive and trusting therapeutic relationship. With a focus on creating a safe environment, I help her my clients process their feelings, address disappointments, and rebuild what is broken.
I am a dedicated and licensed professional counselor with a mission to provide, protect, and treat others with love and respect. I am committed to inspiring my clients to believe in themselves and fostering a positive and trusting therapeutic relationship. With a focus on creating a safe environment, I help her my clients process their feelings, address disappointments, and rebuild what is broken.
(540) 274-3038 View (540) 274-3038
Photo of Barbara Horn - Courage Health & Wellness, Licensed Professional Counselor, LPC
Courage Health & Wellness
Licensed Professional Counselor, LPC
Fredericksburg, VA 22408
If you’re feeling overwhelmed, distracted or are coping with loss or low mood, you’re not alone. You might be stuck in patterns that are hard to change. If you suspect you might have ADHD, or find that your relationships feel more stressful or disconnected than you want them to be, it is time to find someone who can listen and be there for you, who will understand and guide you through these difficult times. My approach is person-centered meaning I integrate the emotional, physical, mental, behavioral, relational, and spiritual aspects of your life. For clients who would like it, spirituality can be included in therapy as well.
If you’re feeling overwhelmed, distracted or are coping with loss or low mood, you’re not alone. You might be stuck in patterns that are hard to change. If you suspect you might have ADHD, or find that your relationships feel more stressful or disconnected than you want them to be, it is time to find someone who can listen and be there for you, who will understand and guide you through these difficult times. My approach is person-centered meaning I integrate the emotional, physical, mental, behavioral, relational, and spiritual aspects of your life. For clients who would like it, spirituality can be included in therapy as well.
(540) 684-5319 View (540) 684-5319
Photo of Eeremene Piaro, Licensed Professional Counselor, LPC
Eeremene Piaro
Licensed Professional Counselor, LPC
Fredericksburg, VA 22401
Feeling stuck, overwhelmed, or unsure where to start? You're not alone—and I'm here to help. I'm a licensed therapist with 4 years of experience supporting children, teens, and adults through challenges like anxiety, depression, trauma, life transitions, and more. I use a holistic, culturally aware approach, blending evidence-based therapies like CBT and mindfulness with creative tools like art, music, and yoga. Together, we’ll find what works for you. Let’s start the journey—your mental wellness matters.
Feeling stuck, overwhelmed, or unsure where to start? You're not alone—and I'm here to help. I'm a licensed therapist with 4 years of experience supporting children, teens, and adults through challenges like anxiety, depression, trauma, life transitions, and more. I use a holistic, culturally aware approach, blending evidence-based therapies like CBT and mindfulness with creative tools like art, music, and yoga. Together, we’ll find what works for you. Let’s start the journey—your mental wellness matters.
(540) 329-2448 View (540) 329-2448
Photo of Neelege Ayana Coston, Pre-Licensed Professional
Neelege Ayana Coston
Pre-Licensed Professional
Fredericksburg, VA 22401
Welcome and thank you for stopping by. This is a meaningful first step in your search for the right therapist for you. I understand that choosing a therapist can feel overwhelming, and you may find yourself asking important questions such as: How old is my therapist? How long have they been practicing? How can they help me? And even, have they experienced anything that allows them to truly understand what I am going through? The answer is yes, yes, and yes because these are valid and important questions. I am currently a pre-licensed professional, meaning I am a master’s student pursuing licensure in counseling.
Welcome and thank you for stopping by. This is a meaningful first step in your search for the right therapist for you. I understand that choosing a therapist can feel overwhelming, and you may find yourself asking important questions such as: How old is my therapist? How long have they been practicing? How can they help me? And even, have they experienced anything that allows them to truly understand what I am going through? The answer is yes, yes, and yes because these are valid and important questions. I am currently a pre-licensed professional, meaning I am a master’s student pursuing licensure in counseling.
(540) 726-6680 View (540) 726-6680
Photo of Sabrina Floyd, Pre-Licensed Professional
Sabrina Floyd
Pre-Licensed Professional
Fredericksburg, VA 22401
I’m Sabrina Floyd, a Supervisee in Social Work operating out of New York since 2021, when I moved back with my fiancé and our four children. I have been an enthusiastic member of the human services field for over 10 years. I welcome new experiences and help my clients adjust to life transitions. I’m committed to establishing relationships and building rapport with each client, identifying strengths, and providing helpful tools that enable individuals to independently resolve issues and achieve their goals. My areas of specialization include parenting/step-parenting, blended families, and advocating for children.
I’m Sabrina Floyd, a Supervisee in Social Work operating out of New York since 2021, when I moved back with my fiancé and our four children. I have been an enthusiastic member of the human services field for over 10 years. I welcome new experiences and help my clients adjust to life transitions. I’m committed to establishing relationships and building rapport with each client, identifying strengths, and providing helpful tools that enable individuals to independently resolve issues and achieve their goals. My areas of specialization include parenting/step-parenting, blended families, and advocating for children.
(540) 625-1602 View (540) 625-1602
Photo of Rachael Dembowski, Licensed Professional Counselor, LPC, R-DMT
Rachael Dembowski
Licensed Professional Counselor, LPC, R-DMT
1 Endorsed
Stafford, VA 22554
Rachael Dembowski is a Licensed Professional Counselor and a Registered Dance/Movement therapist who works with children, teens, and adults. She specializes in depression, anxiety, autism spectrum disorders, and trauma. Rachael has experience working with individuals with an array of physical, cognitive, and intellectual needs. Rachael received a Master of Education degree in Dance/ Movement Therapy and Counseling from Drexel University. She believes the therapeutic process is about self-discovery, and practices from a person-centered approach with strength, and solution-based focuses.
Rachael Dembowski is a Licensed Professional Counselor and a Registered Dance/Movement therapist who works with children, teens, and adults. She specializes in depression, anxiety, autism spectrum disorders, and trauma. Rachael has experience working with individuals with an array of physical, cognitive, and intellectual needs. Rachael received a Master of Education degree in Dance/ Movement Therapy and Counseling from Drexel University. She believes the therapeutic process is about self-discovery, and practices from a person-centered approach with strength, and solution-based focuses.
(540) 328-6576 View (540) 328-6576
Photo of Jeff Sumpolec, Licensed Professional Clinical Counselor, LPCC, LPC
Jeff Sumpolec
Licensed Professional Clinical Counselor, LPCC, LPC
2 Endorsed
Serves Area
Everyone needs a little help sometimes. I enjoy helping people to find their innermost strengths; their gifts, talents and abilities, as well as working on their challenges. Whether you’re experiencing feelings of anxiety, depression, relationship difficulties, or just feeling stuck, therapy can provide a safe place to work things out and find solutions that are right for you. I have 20 years experience in private practice and ten more in health care settings. I use a variety of methods, and will adapt them to what is useful for you. Please call to schedule an appointment!
Everyone needs a little help sometimes. I enjoy helping people to find their innermost strengths; their gifts, talents and abilities, as well as working on their challenges. Whether you’re experiencing feelings of anxiety, depression, relationship difficulties, or just feeling stuck, therapy can provide a safe place to work things out and find solutions that are right for you. I have 20 years experience in private practice and ten more in health care settings. I use a variety of methods, and will adapt them to what is useful for you. Please call to schedule an appointment!
(626) 329-4812 View (626) 329-4812
Photo of Alycia Burant, Licensed Professional Counselor, MA, LPC, CMHIMP
Alycia Burant
Licensed Professional Counselor, MA, LPC, CMHIMP
12 Endorsed
Fredericksburg, VA 22401
You are a high achieving individual in many ways, but seem to come up short when it comes to having meaningful, successful relationships with others and struggle with self confidence. You have been defined by others in your life as “successful” but are still left feeling unfilled and unhappy. Maybe negative thoughts swirl around your head when you are trying to get work done or fall asleep at night. Or maybe you experience difficulty concentrating because you are so worried if the person next to you is upset with you and constantly worry if you can make the people around you happy.
You are a high achieving individual in many ways, but seem to come up short when it comes to having meaningful, successful relationships with others and struggle with self confidence. You have been defined by others in your life as “successful” but are still left feeling unfilled and unhappy. Maybe negative thoughts swirl around your head when you are trying to get work done or fall asleep at night. Or maybe you experience difficulty concentrating because you are so worried if the person next to you is upset with you and constantly worry if you can make the people around you happy.
(703) 270-0386 x1 View (703) 270-0386 x1
Photo of Scott Foor, Supervisee in Clinical Social Work, MSW
Scott Foor
Supervisee in Clinical Social Work, MSW
1 Endorsed
Fredericksburg, VA 22401
When your mind won’t slow down, school feels overwhelming, and it seems like everyone else is handling life better than you are, it can feel exhausting and isolating. Many teens & young adults I work with feel constantly “on” but still falling behind — unsure how to calm their thoughts, manage emotions, or meet expectations without burning out. Parents often tell me they’ve tried everything & don’t know what else to do. When anxiety, stress, or emotional overload begin to take over daily life, therapy can offer steadier ground — helping teens & young adults build regulation, confidence, & practical tools so life feels more stable.
When your mind won’t slow down, school feels overwhelming, and it seems like everyone else is handling life better than you are, it can feel exhausting and isolating. Many teens & young adults I work with feel constantly “on” but still falling behind — unsure how to calm their thoughts, manage emotions, or meet expectations without burning out. Parents often tell me they’ve tried everything & don’t know what else to do. When anxiety, stress, or emotional overload begin to take over daily life, therapy can offer steadier ground — helping teens & young adults build regulation, confidence, & practical tools so life feels more stable.
(540) 253-1720 View (540) 253-1720
Photo of Jennifer Eid - Jennifer at Northern Virginia Counseling Solutions, Supervisee in Clinical Social Work, MSW, MBA
Jennifer at Northern Virginia Counseling Solutions
Supervisee in Clinical Social Work, MSW, MBA
Serves Area
Anxiety and Burnout Therapy. You show up for everyone else, at work, and at home. Yet, privately, you may be feeling overwhelmed, anxious, emotionally exhausted, or disconnected from yourself.
Anxiety and Burnout Therapy. You show up for everyone else, at work, and at home. Yet, privately, you may be feeling overwhelmed, anxious, emotionally exhausted, or disconnected from yourself.
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How does your Therapist compare?

Number of Therapists in 22535

< 10

Therapists in 22535 who prioritize treating:

100% Relationship Issues
100% Depression
100% Anxiety
100% Life Coaching
100% Parenting
100% Trauma and PTSD
100% Family Conflict

Average years in practice

11 Years

Top 3 insurances accepted

100% Aetna
100% BlueCross and BlueShield
100% Cigna and Evernorth

How Therapists in 22535 see their clients

100% In Person and Online

Gender breakdown

100% Female
FAQs - About Therapy and Counseling

How can I find a therapist in 22535?

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.