Therapists in 57501

Photo of Carl A.l. Johnson - Rising Hope Counseling, Pre-Licensed Professional, MA-PC
Rising Hope Counseling
Pre-Licensed Professional, MA-PC
Pierre, SD 57501
Family units are the backbone of our society and community, I want to help make them great. I speak and preach publicly about the importance of faith, fatherhood, marriage and families. I especially look forward to working with other men who want to be great husbands and fathers but may be struggling to do so. In general, men want tools and direction in order to solve problems. My education combined with my background in the military (Army) and college athletics (basketball) gives me insight into what tools and direction will help men to become what God intended them to be.
Family units are the backbone of our society and community, I want to help make them great. I speak and preach publicly about the importance of faith, fatherhood, marriage and families. I especially look forward to working with other men who want to be great husbands and fathers but may be struggling to do so. In general, men want tools and direction in order to solve problems. My education combined with my background in the military (Army) and college athletics (basketball) gives me insight into what tools and direction will help men to become what God intended them to be.
(605) 210-5614 View (605) 210-5614
Photo of Jill Viedt, Counselor, MS, LPC-MH, LAC
Jill Viedt
Counselor, MS, LPC-MH, LAC
Pierre, SD 57501
My goal is to provide support and empower each individual I work with to feel happier and to progress towards accomplishing their target goals. I work with individuals to help empower them to achieve an overall sense of wellness. I am able to treat co-occurring disorders such as mental health concerns, substance use concerns, stress management, grief and loss, relationship challenges, thinking pattern issues, and ineffective coping skills. I believe a person should be treated from a holistic approach, allowing them to work on their entire self in one place.
My goal is to provide support and empower each individual I work with to feel happier and to progress towards accomplishing their target goals. I work with individuals to help empower them to achieve an overall sense of wellness. I am able to treat co-occurring disorders such as mental health concerns, substance use concerns, stress management, grief and loss, relationship challenges, thinking pattern issues, and ineffective coping skills. I believe a person should be treated from a holistic approach, allowing them to work on their entire self in one place.
(605) 250-0570 View (605) 250-0570
Photo of Lindsay Bruckner, Clinical Social Work/Therapist, MSW , LCSWPIP, QMHP
Lindsay Bruckner
Clinical Social Work/Therapist, MSW , LCSWPIP, QMHP
Pierre, SD 57501
I offer therapy to individuals, families and couples who are hoping to make positive changes in their lives. I believe that the client is the expert in their own life and that I am there as a helpful resource to offer support, reflect on patterns of behavior that may no longer serve you, and to offer encouragement and guidance to release the painful hurt of the past while moving forward to embrace a better tomorrow.
I offer therapy to individuals, families and couples who are hoping to make positive changes in their lives. I believe that the client is the expert in their own life and that I am there as a helpful resource to offer support, reflect on patterns of behavior that may no longer serve you, and to offer encouragement and guidance to release the painful hurt of the past while moving forward to embrace a better tomorrow.
(605) 356-8377 View (605) 356-8377
Photo of Mary Pat Mueller, Counselor, MS, LPC-MH, CGT, QMHP
Mary Pat Mueller
Counselor, MS, LPC-MH, CGT, QMHP
Pierre, SD 57501
I work with teens, individuals, and couples who have anxiety or depression, have been through trauma, are experiencing a struggle in their relationships or marriage, are trying to decide whether to stay in their marriage, suffer with alcohol or drug issues, have experienced infidelity in their relationship, or struggles in their careers. My approach comes from advanced training in evidenced based, scientifically proven treatment that I have gained over several decades. I love meeting my clients, exploring where they want to be and watching them grow.
I work with teens, individuals, and couples who have anxiety or depression, have been through trauma, are experiencing a struggle in their relationships or marriage, are trying to decide whether to stay in their marriage, suffer with alcohol or drug issues, have experienced infidelity in their relationship, or struggles in their careers. My approach comes from advanced training in evidenced based, scientifically proven treatment that I have gained over several decades. I love meeting my clients, exploring where they want to be and watching them grow.
(605) 789-5351 View (605) 789-5351
Photo of Dennis Nolf, Clinical Social Work/Therapist, MSW, CSW, QMHP
Dennis Nolf
Clinical Social Work/Therapist, MSW, CSW, QMHP
3 Endorsed
Serves Area
My ideal client may be experiencing grief, loss, anxiety, depression, or the cumulative effects of trauma and chronic stress. They may feel emotionally overwhelmed, burned out, or stuck in patterns that no longer serve them. Many have lacked a safe space to process their experiences. I offer a supportive, nonjudgmental environment where clients can begin to make sense of their struggles, build emotional resilience, and move toward meaningful, lasting change.
My ideal client may be experiencing grief, loss, anxiety, depression, or the cumulative effects of trauma and chronic stress. They may feel emotionally overwhelmed, burned out, or stuck in patterns that no longer serve them. Many have lacked a safe space to process their experiences. I offer a supportive, nonjudgmental environment where clients can begin to make sense of their struggles, build emotional resilience, and move toward meaningful, lasting change.
(605) 702-4722 View (605) 702-4722
Photo of Dr. Dean Leav - Psychological Testing & Evaluations - Dr. Dean, Psychologist, PsyD, QME, Author
Psychological Testing & Evaluations - Dr. Dean
Psychologist, PsyD, QME, Author
Serves Area
I’m Dr. Dean Leav. I've been featured on ABC, NBC, KCAL, and other programs as an expert psychologist. I conduct ADHD / autism / learning disability evaluations, legal / forensic evaluations for court, risk assessment (violence / sexual), cognitive / neuropsychological evaluations, diagnostic psychological evaluations, immigration evaluations, adoption evaluations, parenting / bonding assessments, drug & alcohol evaluations, fitness for duty evaluations, workers' compensation (QME/AME) evaluations, and other types of psychological evaluations / assessments.
I’m Dr. Dean Leav. I've been featured on ABC, NBC, KCAL, and other programs as an expert psychologist. I conduct ADHD / autism / learning disability evaluations, legal / forensic evaluations for court, risk assessment (violence / sexual), cognitive / neuropsychological evaluations, diagnostic psychological evaluations, immigration evaluations, adoption evaluations, parenting / bonding assessments, drug & alcohol evaluations, fitness for duty evaluations, workers' compensation (QME/AME) evaluations, and other types of psychological evaluations / assessments.
(605) 836-6854 View (605) 836-6854
Photo of Tracy Chapman Stuart, Licensed Professional Counselor, MA, LPC-MH, QMHP
Tracy Chapman Stuart
Licensed Professional Counselor, MA, LPC-MH, QMHP
1 Endorsed
Serves Area
I primarily work with women and teens who are navigating anxiety, depression, relationship challenges, or major life transitions. My goal is to create a calm, nonjudgmental space where you can be honest about what’s been on your mind and feel genuinely heard and supported. My practice is client-centered, which means you get to decide the direction we go in therapy, but I'll be here to help if you're not sure what that looks like. Some people benefit most from a safe space to reflect and gain alternative perspectives, while others enjoy learning practical strategies they can use outside of our sessions.
I primarily work with women and teens who are navigating anxiety, depression, relationship challenges, or major life transitions. My goal is to create a calm, nonjudgmental space where you can be honest about what’s been on your mind and feel genuinely heard and supported. My practice is client-centered, which means you get to decide the direction we go in therapy, but I'll be here to help if you're not sure what that looks like. Some people benefit most from a safe space to reflect and gain alternative perspectives, while others enjoy learning practical strategies they can use outside of our sessions.
(605) 349-2683 View (605) 349-2683
Photo of Sarah Swantner, Licensed Professional Counselor, LPC-MH, CFT, CFP
Sarah Swantner
Licensed Professional Counselor, LPC-MH, CFT, CFP
Serves Area
You’ve always been the one who gets things done. You push yourself hard, and people admire how much you can juggle. But underneath that polished image is exhaustion, constant worry, and the fear that one mistake will bring it all crashing down. The late nights, the overthinking, the self-criticism—it’s wearing you down. You’ve tried to outwork the anxiety, but no matter how much you accomplish, it never feels like enough. The pressure is catching up, and it’s beginning to impact your health, your focus, and the relationships you care most about.
You’ve always been the one who gets things done. You push yourself hard, and people admire how much you can juggle. But underneath that polished image is exhaustion, constant worry, and the fear that one mistake will bring it all crashing down. The late nights, the overthinking, the self-criticism—it’s wearing you down. You’ve tried to outwork the anxiety, but no matter how much you accomplish, it never feels like enough. The pressure is catching up, and it’s beginning to impact your health, your focus, and the relationships you care most about.
(605) 519-6141 View (605) 519-6141
Photo of Lesley Atkins, Clinical Social Work/Therapist, MSW, CSW-PIP, CSITP, QMHP
Lesley Atkins
Clinical Social Work/Therapist, MSW, CSW-PIP, CSITP, QMHP
1 Endorsed
Serves Area
Life to me is an adventure of ups and downs where everyone has the potential to expand their emotional well-being. Through collaboration with the client, and often times a significant other or family, the therapeutic work done in session can promote a better quality of life.
Life to me is an adventure of ups and downs where everyone has the potential to expand their emotional well-being. Through collaboration with the client, and often times a significant other or family, the therapeutic work done in session can promote a better quality of life.
(605) 307-3079 View (605) 307-3079
Photo of Jennifer Blume - Jackalope Therapy, Clinical Social Work/Therapist, CSW-PIP
Jackalope Therapy
Clinical Social Work/Therapist, CSW-PIP
1 Endorsed
Serves Area
Now Accepting New Telehealth Clients — Have you or someone you love been affected by trauma? Struggling with anxiety, depression, or insomnia? You're not alone — and you don’t have to go through it alone either. Therapy can help you talk through what you're experiencing and discover real, practical ways to move forward. Whether you're dealing with flashbacks, acting-out behaviors, or the heavy toll of mental health challenges, support is available — and healing is possible. You deserve a space to feel heard, understood, and empowered. Let’s work together toward the life you want.
Now Accepting New Telehealth Clients — Have you or someone you love been affected by trauma? Struggling with anxiety, depression, or insomnia? You're not alone — and you don’t have to go through it alone either. Therapy can help you talk through what you're experiencing and discover real, practical ways to move forward. Whether you're dealing with flashbacks, acting-out behaviors, or the heavy toll of mental health challenges, support is available — and healing is possible. You deserve a space to feel heard, understood, and empowered. Let’s work together toward the life you want.
(605) 316-3192 View (605) 316-3192
Photo of Ashley Anson, Pre-Licensed Professional, JD, MELP
Ashley Anson
Pre-Licensed Professional, JD, MELP
1 Endorsed
Serves Area
As an LMFT-Licensee, I offer a compassionate, trauma-informed approach rooted in both professional training and lived experience. I specialize in trauma and PTSD, family conflict, ADHD, marital and premarital issues, especially narcissistic abuse, and support across all life transitions. With a background in healing from childhood abuse, chronic anxiety, and relationship violence, I meet clients with empathy and insight. Whether working with individuals, children, couples, or families, I use systemic therapy, creative interventions, and practical coping strategies to guide others toward self-trust and healthier relationships.
As an LMFT-Licensee, I offer a compassionate, trauma-informed approach rooted in both professional training and lived experience. I specialize in trauma and PTSD, family conflict, ADHD, marital and premarital issues, especially narcissistic abuse, and support across all life transitions. With a background in healing from childhood abuse, chronic anxiety, and relationship violence, I meet clients with empathy and insight. Whether working with individuals, children, couples, or families, I use systemic therapy, creative interventions, and practical coping strategies to guide others toward self-trust and healthier relationships.
(605) 250-0971 View (605) 250-0971
Photo of Alyssa Mendel, Licensed Professional Counselor, MA, LPC, QMHP
Alyssa Mendel
Licensed Professional Counselor, MA, LPC, QMHP
Serves Area
Waitlist for new clients
We all go through challenges in life and shouldn’t have to face hard times alone. My passion is to come alongside and help you navigate these challenges. As a therapist pursing my certification as a Certified Eating Disorder Specialist, I specialize in working with teens and their families, and adults who struggle with symptoms from eating disorders, such as anorexia-nervosa, bulimia, binge eating disorder, over exercising, body dysmorphia, and disordered eating. I also work with adults and teens who have symptoms of anxiety, obsessive compulsive disorder, depression, and day to day life stressors.
We all go through challenges in life and shouldn’t have to face hard times alone. My passion is to come alongside and help you navigate these challenges. As a therapist pursing my certification as a Certified Eating Disorder Specialist, I specialize in working with teens and their families, and adults who struggle with symptoms from eating disorders, such as anorexia-nervosa, bulimia, binge eating disorder, over exercising, body dysmorphia, and disordered eating. I also work with adults and teens who have symptoms of anxiety, obsessive compulsive disorder, depression, and day to day life stressors.
(605) 468-1876 View (605) 468-1876
Photo of Allison Fosheim, Counselor, LPC, LCPC, LPC-MH
Allison Fosheim
Counselor, LPC, LCPC, LPC-MH
1 Endorsed
Online Only
Hi, my name is Allison and I am a mental health therapist licensed in Texas, Illinois, South Dakota, Georgia, and Florida. I most enjoy working with people who experience high emotion dysregulation. These might include people with personality disorders, self-harm, ADHD, PTSD, anger issues, anxiety, and/or depression. I help my clients learn skills to gain control over their thoughts, emotions, and behaviors so they can build successful lives.
Hi, my name is Allison and I am a mental health therapist licensed in Texas, Illinois, South Dakota, Georgia, and Florida. I most enjoy working with people who experience high emotion dysregulation. These might include people with personality disorders, self-harm, ADHD, PTSD, anger issues, anxiety, and/or depression. I help my clients learn skills to gain control over their thoughts, emotions, and behaviors so they can build successful lives.
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Photo of Johanna Tietze - Therapy Lawgic LLC, Clinical Social Work/Therapist, LSW
Therapy Lawgic LLC
Clinical Social Work/Therapist, LSW
1 Endorsed
Online Only
Life is complicated. Navigating transitions from career decisions to relationships can be more pleasant with help. I offer individual therapy using an existential approach, drawing from years of experience as a career counselor.
Life is complicated. Navigating transitions from career decisions to relationships can be more pleasant with help. I offer individual therapy using an existential approach, drawing from years of experience as a career counselor.
(605) 210-5675 View (605) 210-5675
Photo of Daryaan McLeod - Kweli Counseling, Licensed Professional Counselor, MS, LPC-S
Kweli Counseling
Licensed Professional Counselor, MS, LPC-S
Online Only
My mission is to provide supportive, affirming, and culturally grounded psychoeducational spaces that uplift the Black community. I believe everyone deserves access to tools that nurture resilience, healing, and joy — and my role is to walk alongside you as you put those tools into practice. Although I am open to working with everyone, my allegiance is with Black community members who are seeking growth, healing, and practical tools for everyday life. My approach is compassionate, strengths-based, and rooted in the understanding that your experiences matter.
My mission is to provide supportive, affirming, and culturally grounded psychoeducational spaces that uplift the Black community. I believe everyone deserves access to tools that nurture resilience, healing, and joy — and my role is to walk alongside you as you put those tools into practice. Although I am open to working with everyone, my allegiance is with Black community members who are seeking growth, healing, and practical tools for everyday life. My approach is compassionate, strengths-based, and rooted in the understanding that your experiences matter.
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Photo of Dr. Amy Sue Ott, Licensed Professional Counselor, PhD, LPCS
Dr. Amy Sue Ott
Licensed Professional Counselor, PhD, LPCS
Online Only
Anxiety over the future, over today, small or big....this feeling can be overwhelming and to say the least difficult to live with. Depression sends you to the back of the class, inside yourself and away from people. Feeling overwhelmed by simple questions..."are our okay?" can seem to big to answer; and so your voice goes inside where you ask yourself a million questions and can't answer any of them. These experiences are real, and starting therapy can feel too hard to do, it could the first step to some life changing experiences
Anxiety over the future, over today, small or big....this feeling can be overwhelming and to say the least difficult to live with. Depression sends you to the back of the class, inside yourself and away from people. Feeling overwhelmed by simple questions..."are our okay?" can seem to big to answer; and so your voice goes inside where you ask yourself a million questions and can't answer any of them. These experiences are real, and starting therapy can feel too hard to do, it could the first step to some life changing experiences
(940) 489-4232 View (940) 489-4232
Photo of Tina Cloutier, Licensed Professional Counselor, LPC, QMHP
Tina Cloutier
Licensed Professional Counselor, LPC, QMHP
Online Only
Feeling overwhelmed, stuck, or unsure where to turn? You're not alone. I work with teens and adults facing depression, anxiety, life transitions, identity exploration, and trauma. I provide a safe, affirming space—especially for veterans, LGBTQ+ individuals and anyone facing difficult life circumstances —to explore your experiences at your pace. Together, we’ll build trust, set goals, and find your path forward.
Feeling overwhelmed, stuck, or unsure where to turn? You're not alone. I work with teens and adults facing depression, anxiety, life transitions, identity exploration, and trauma. I provide a safe, affirming space—especially for veterans, LGBTQ+ individuals and anyone facing difficult life circumstances —to explore your experiences at your pace. Together, we’ll build trust, set goals, and find your path forward.
(605) 853-8295 View (605) 853-8295
Photo of Kelcey Roberts, Licensed Professional Counselor, LPCMH
Kelcey Roberts
Licensed Professional Counselor, LPCMH
Online Only
Hello :) My name is Kelcey Roberts, MS, LPC, LIMHP, LPC-MH. I have been a counselor for 15 years, specializing in children and families. I provide support for individuals struggling in relationships with children, parents, spouses, and family. I approach therapy from a relationship-based view. I am here to support you in identifying your goals and then guiding you to find the tools you need to accomplish those goals. I am trauma informed. I implement cognitive behavioral therapy when appropriate for clients. I also implement attachment-based therapy, particularly when working with children.
Hello :) My name is Kelcey Roberts, MS, LPC, LIMHP, LPC-MH. I have been a counselor for 15 years, specializing in children and families. I provide support for individuals struggling in relationships with children, parents, spouses, and family. I approach therapy from a relationship-based view. I am here to support you in identifying your goals and then guiding you to find the tools you need to accomplish those goals. I am trauma informed. I implement cognitive behavioral therapy when appropriate for clients. I also implement attachment-based therapy, particularly when working with children.
(605) 600-2126 View (605) 600-2126
Photo of Sandi Lynn Forsythe, Marriage & Family Therapist, LMFT, EDIT-1, BSP, KAP
Sandi Lynn Forsythe
Marriage & Family Therapist, LMFT, EDIT-1, BSP, KAP
4 Endorsed
Online Only
Are you feeling overwhelmed, stuck, anxious, or alone—even after trying everything you can think of? Unsure where to begin your healing journey? You’re not alone, and you don’t have to navigate this path without support. I’m a compassionate, trauma-informed therapist who works with individuals and couples navigating anxiety, eating disorders, relationship challenges, and unresolved trauma. I offer an empathetic and holistic approach to therapy, creating a safe and supportive space to explore your thoughts, experiences, and emotions.
Are you feeling overwhelmed, stuck, anxious, or alone—even after trying everything you can think of? Unsure where to begin your healing journey? You’re not alone, and you don’t have to navigate this path without support. I’m a compassionate, trauma-informed therapist who works with individuals and couples navigating anxiety, eating disorders, relationship challenges, and unresolved trauma. I offer an empathetic and holistic approach to therapy, creating a safe and supportive space to explore your thoughts, experiences, and emotions.
(605) 674-6894 View (605) 674-6894
Photo of Barbara L Lefdal, Licensed Professional Counselor, LPC-MH
Barbara L Lefdal
Licensed Professional Counselor, LPC-MH
Online Only
As a Licensed Professional Counselor-Mental Health (LPC-MH) with 30 years of experience, I am here to provide a warm, open, and encouraging space where you feel safe to explore your emotions and find strategies that work for you. I work with people of all ages and backgrounds. I am particularly experienced with caregiver fatigue, end of life issues, and anxiety struggles. I truly want to become a partner on your therapeutic journey. Helping my clients moving forward in life brings me such joy. I employ virtual sessions to make therapy as accessible as possible.
As a Licensed Professional Counselor-Mental Health (LPC-MH) with 30 years of experience, I am here to provide a warm, open, and encouraging space where you feel safe to explore your emotions and find strategies that work for you. I work with people of all ages and backgrounds. I am particularly experienced with caregiver fatigue, end of life issues, and anxiety struggles. I truly want to become a partner on your therapeutic journey. Helping my clients moving forward in life brings me such joy. I employ virtual sessions to make therapy as accessible as possible.
(605) 593-0905 View (605) 593-0905

See more therapy options for 57501

How does your Therapist compare?

Number of Therapists in 57501

20+

Average cost per session

$140

Therapists in 57501 who prioritize treating:

87% Depression
87% Coping Skills
83% Anxiety
83% Self Esteem
70% Trauma and PTSD
70% Family Conflict
70% Stress

Average years in practice

8 Years

Top 3 insurances accepted

74% BlueCross and BlueShield
74% Sanford Health Plan
63% Avera Health Plans

How Therapists in 57501 see their clients

52% In Person and Online
48% Online Only

Gender breakdown

86% Female
14% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 57501?

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.