Photo of Katie Keyser, LCSW, Clinical Social Work/Therapist
Katie Keyser
Clinical Social Work/Therapist, LCSW
Verified Verified
Houston, TX 77006
I am a Licensed Clinical Social Worker, and I specialize in working with adults and teens who feel stuck in patterns that prevent them from living in alignment with their values, aspirations, and authentic selves. My clients are often high achievers dealing with stress, anxiety, burnout, depression, obsessive-compulsive disorder, eating disorders, and/or feelings of emotional loneliness. These symptoms can result from trauma, unresolved grief, perfectionism, and/or emotional overcontrol.
I am a Licensed Clinical Social Worker, and I specialize in working with adults and teens who feel stuck in patterns that prevent them from living in alignment with their values, aspirations, and authentic selves. My clients are often high achievers dealing with stress, anxiety, burnout, depression, obsessive-compulsive disorder, eating disorders, and/or feelings of emotional loneliness. These symptoms can result from trauma, unresolved grief, perfectionism, and/or emotional overcontrol.
(832) 648-4182 View (832) 648-4182
Photo of Jose David, LPC, LMFT, Marriage & Family Therapist
Jose David
Marriage & Family Therapist, LPC, LMFT
Verified Verified
3 Endorsed
Houston, TX 77006  (Online Only)
My passion is to empower people to change their lives. To promote this change, I start by creating a relaxed and informal environment to make you feel comfortable in the process.
My passion is to empower people to change their lives. To promote this change, I start by creating a relaxed and informal environment to make you feel comfortable in the process.
(713) 489-5108 View (713) 489-5108
Photo of Steven Serrano, MS, LPC, Licensed Professional Counselor
Steven Serrano
Licensed Professional Counselor, MS, LPC
Verified Verified
Houston, TX 77006
There are times when we experience a lack of emotional balance in our life, which can appear to be accompanied by stress, confusion, a sense of hopelessness or disconnection from families and friends. Challenging and sometimes scary, these moments provide a unique opportunity for self-discovery. My belief is that people have the potential to heal, reinvent themselves, and make meaningful life changes. I have learned through my own life experience how struggles can open a door into a deeper aspect of self, leading to a better understanding of what was missing.
There are times when we experience a lack of emotional balance in our life, which can appear to be accompanied by stress, confusion, a sense of hopelessness or disconnection from families and friends. Challenging and sometimes scary, these moments provide a unique opportunity for self-discovery. My belief is that people have the potential to heal, reinvent themselves, and make meaningful life changes. I have learned through my own life experience how struggles can open a door into a deeper aspect of self, leading to a better understanding of what was missing.
(281) 899-0597 View (281) 899-0597
Photo of Johanna Hume, Pre-Licensed Professional
Johanna Hume
Pre-Licensed Professional
Verified Verified
1 Endorsed
Houston, TX 77006
Waitlist for new clients
Seeking out therapy can be intimidating. I’m here to offer a calm space to make that a welcoming experience. I believe strongly in your story and that you and I can collaboratively build on your strengths to rewrite a different and more empowering narrative of your life. I am deeply passionate about exploring oppressive systems that affect clients, both in their relationships and in society. I take an eclectic approach to counseling-understanding that each client is unique-and include methods such as narrative and talk therapy and mindfulness techniques.
Seeking out therapy can be intimidating. I’m here to offer a calm space to make that a welcoming experience. I believe strongly in your story and that you and I can collaboratively build on your strengths to rewrite a different and more empowering narrative of your life. I am deeply passionate about exploring oppressive systems that affect clients, both in their relationships and in society. I take an eclectic approach to counseling-understanding that each client is unique-and include methods such as narrative and talk therapy and mindfulness techniques.
(832) 529-3506 View (832) 529-3506
Photo of Ivy Ruths, PhD, Psychologist
Ivy Ruths
Psychologist, PhD
Verified Verified
4 Endorsed
Houston, TX 77006
You may have found yourself in a cycle of anxiety, avoidance, and negative thinking. The ways in which we allow fear to dictate our next steps can be extremely limiting! Sometimes, it's our kids' anxiety and fears that are holding our family back. Communication difficulties with our partners or children about anxiety create stress in our most important and treasured relationships. There isn’t a one-way-fits-all best way to parent, live, or achieve success... But, with the right support you can learn new skills to transform your family and change your life. At Houston Anxiety and Wellness Center we put you and your family first.
You may have found yourself in a cycle of anxiety, avoidance, and negative thinking. The ways in which we allow fear to dictate our next steps can be extremely limiting! Sometimes, it's our kids' anxiety and fears that are holding our family back. Communication difficulties with our partners or children about anxiety create stress in our most important and treasured relationships. There isn’t a one-way-fits-all best way to parent, live, or achieve success... But, with the right support you can learn new skills to transform your family and change your life. At Houston Anxiety and Wellness Center we put you and your family first.
(832) 205-8120 View (832) 205-8120
Photo of Hope Arnold, LCSW, MA, Clinical Social Work/Therapist
Hope Arnold
Clinical Social Work/Therapist, LCSW, MA
Verified Verified
1 Endorsed
Houston, TX 77006
I specialize in RODBT treatment. Do you find it hard to relax or turn off your mind? Or maybe you are normally high achiever and feel like your goals have taken a nose dive lately? Possibly you feel lonely and like no one really gets you?
I specialize in RODBT treatment. Do you find it hard to relax or turn off your mind? Or maybe you are normally high achiever and feel like your goals have taken a nose dive lately? Possibly you feel lonely and like no one really gets you?
(281) 205-1448 View (281) 205-1448
Photo of Elizabeth Lowrey, LCSW, Clinical Social Work/Therapist
Elizabeth Lowrey
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Houston, TX 77006
If you're struggling with addiction, grief, chronic pain, or illness, you are likely feeling tired. Tired of the pain .. the loss, whether it's the loss of relationships, the cycle, or the loss of what was or what could have been. What if there is a different way through the pain? Together, we can navigate what you are going through with compassion and a fresh perspective not only so you can cope, but so you can build the next chapter of your life with greater ease, meaning, and relief.
If you're struggling with addiction, grief, chronic pain, or illness, you are likely feeling tired. Tired of the pain .. the loss, whether it's the loss of relationships, the cycle, or the loss of what was or what could have been. What if there is a different way through the pain? Together, we can navigate what you are going through with compassion and a fresh perspective not only so you can cope, but so you can build the next chapter of your life with greater ease, meaning, and relief.
(832) 861-7929 View (832) 861-7929
Photo of Ashlee Knight, LPC, LMHC, MA, Counselor
Ashlee Knight
Counselor, LPC, LMHC, MA
Verified Verified
2 Endorsed
Houston, TX 77006
Are you frustrated by the quality of the relationships in your life? I help individuals and couples seeking reconnection, conflict management, communication skills, deeper intimacy, and a general sense of understanding how their past impacts their current relational patterns. Relational healing and emotional connectivity makes our experience of partnership much more fulfilling, which impacts every other area of our lives. Utilizing Emotionally Focused Therapy and trauma-informed & attachment based techniques, our work together can transform your understanding of each other as well as the quality of your life together.
Are you frustrated by the quality of the relationships in your life? I help individuals and couples seeking reconnection, conflict management, communication skills, deeper intimacy, and a general sense of understanding how their past impacts their current relational patterns. Relational healing and emotional connectivity makes our experience of partnership much more fulfilling, which impacts every other area of our lives. Utilizing Emotionally Focused Therapy and trauma-informed & attachment based techniques, our work together can transform your understanding of each other as well as the quality of your life together.
(206) 457-1478 View (206) 457-1478
Photo of Anne Slater - JustUs Therapy and Practice, LCSW-S, Clinical Social Work/Therapist
JustUs Therapy and Practice
Clinical Social Work/Therapist, LCSW-S
Verified Verified
1 Endorsed
Houston, TX 77006
I'm so glad you are here. I help folks who are feeling isolated, depressed, anxious, confused, and untethered to find safety and belonging. Whether you are an individual, couple, or family we will work collaboratively toward making conscious and conscientious choices that promote "just" relationships - relationships grounded in love and equity - with ourselves and one another. I firmly believe that this is fundamental to finding our way through life's constant changes and challenges.
I'm so glad you are here. I help folks who are feeling isolated, depressed, anxious, confused, and untethered to find safety and belonging. Whether you are an individual, couple, or family we will work collaboratively toward making conscious and conscientious choices that promote "just" relationships - relationships grounded in love and equity - with ourselves and one another. I firmly believe that this is fundamental to finding our way through life's constant changes and challenges.
(281) 729-4828 View (281) 729-4828
Photo of Allison Leibman, MEd
Allison Leibman
LPC-Associate, MEd
Verified Verified
1 Endorsed
Houston, TX 77006
At Houston Anxiety & Wellness Center, I provide a space free of judgment and filled with compassion. I work specifically with older adolescents and adults who are in a season of transition, anxious about change, and who need support while they learn new, evidence-based coping skills. I also have a specific interest in individuals struggling with self-esteem, negative body image, or disordered eating. By honoring the uniqueness of each person’s journey I am able to create a space where clients feel seen, heard and valued.
At Houston Anxiety & Wellness Center, I provide a space free of judgment and filled with compassion. I work specifically with older adolescents and adults who are in a season of transition, anxious about change, and who need support while they learn new, evidence-based coping skills. I also have a specific interest in individuals struggling with self-esteem, negative body image, or disordered eating. By honoring the uniqueness of each person’s journey I am able to create a space where clients feel seen, heard and valued.
(832) 205-8120 View (832) 205-8120
Photo of Sarah Hoffman, LCSW, Clinical Social Work/Therapist
Sarah Hoffman
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Houston, TX 77006  (Online Only)
Life feels like a constant game of catch-up, leaving you feeling drained and overwhelmed. You're often running late, forgetting important things, and struggling to keep up with your to-do list. People may think you're doing okay because you hide how you feel, but inside, you feel like you're falling apart. You feel consumed by worry, anxiety, and your fear of messing up and failing. You long to feel normal and in control of your life. You want to wake up refreshed and enjoy your life. You need a break from the noise in your head and a chance to catch your breath. I get it, and I can help you find joy and balance in your life.
Life feels like a constant game of catch-up, leaving you feeling drained and overwhelmed. You're often running late, forgetting important things, and struggling to keep up with your to-do list. People may think you're doing okay because you hide how you feel, but inside, you feel like you're falling apart. You feel consumed by worry, anxiety, and your fear of messing up and failing. You long to feel normal and in control of your life. You want to wake up refreshed and enjoy your life. You need a break from the noise in your head and a chance to catch your breath. I get it, and I can help you find joy and balance in your life.
(832) 770-7762 View (832) 770-7762
Photo of Becky Dodds, MS, Licensed Professional Counselor
Becky Dodds
Licensed Professional Counselor, MS
Verified Verified
2 Endorsed
Houston, TX 77006
Every one of us will experience crisis in our lifetime. These intense times of difficulty may be easy to name: relationship strife, a significant loss, or traumatic events. Other times you may be living with the gnawing sense that the life you’ve built doesn’t serve who you truly are. You may be experiencing anxiety and depression, unfulfilling relationships, or a resurfacing of unmet grief or trauma. No matter what distress has arrived at your door, it’s possible that you feel lost and confused and wonder what you can do. You are not alone. I’ve been there, and so has almost everyone you know.
Every one of us will experience crisis in our lifetime. These intense times of difficulty may be easy to name: relationship strife, a significant loss, or traumatic events. Other times you may be living with the gnawing sense that the life you’ve built doesn’t serve who you truly are. You may be experiencing anxiety and depression, unfulfilling relationships, or a resurfacing of unmet grief or trauma. No matter what distress has arrived at your door, it’s possible that you feel lost and confused and wonder what you can do. You are not alone. I’ve been there, and so has almost everyone you know.
(346) 483-8357 View (346) 483-8357
Photo of John K Dietrich - Wise Minds, LLC, LCSW, Clinical Social Work/Therapist
Wise Minds, LLC
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Houston, TX 77006
Cultivating and maintaining meaningful connections is an important key to well being.Disconnection often occurs as the result of relationship challenges, difficult losses, interpersonal struggles and addictive patterns. In addition, shame is often associated with interpersonal struggles and may be at the root of many psychological issues including depression and anxiety. My training includes an internship and post-graduate fellowship at the Menninger Clinic, Professionals In Crisis Unit. I have also completed specialized training in couples therapy, shame resiliency and mindfulness-based treatment for depression and anxiety.
Cultivating and maintaining meaningful connections is an important key to well being.Disconnection often occurs as the result of relationship challenges, difficult losses, interpersonal struggles and addictive patterns. In addition, shame is often associated with interpersonal struggles and may be at the root of many psychological issues including depression and anxiety. My training includes an internship and post-graduate fellowship at the Menninger Clinic, Professionals In Crisis Unit. I have also completed specialized training in couples therapy, shame resiliency and mindfulness-based treatment for depression and anxiety.
(832) 932-7598 View (832) 932-7598
Photo of Rachel Dunlay, LMHC, LPC, Licensed Professional Counselor
Rachel Dunlay
Licensed Professional Counselor, LMHC, LPC
Verified Verified
Houston, TX 77006
My ideal client is one whom truly desires to heal. The work they see us putting into their therapy and healing as a team within session, is the same work they want and challenge themselves in implementing outside of the therapy setting. I work my best with adolescents, and love when parents have the ability to respect their child’s treatment boundaries but are involved enough to be receptive to their child’s needs. Ultimately however, it does not matter the client’s age or issue, as long as they are as committed to their growth as I am. That is ideal.
My ideal client is one whom truly desires to heal. The work they see us putting into their therapy and healing as a team within session, is the same work they want and challenge themselves in implementing outside of the therapy setting. I work my best with adolescents, and love when parents have the ability to respect their child’s treatment boundaries but are involved enough to be receptive to their child’s needs. Ultimately however, it does not matter the client’s age or issue, as long as they are as committed to their growth as I am. That is ideal.
(512) 714-3403 View (512) 714-3403
Photo of Melissa Fasteau, PsyD, Psychologist
Melissa Fasteau
Psychologist, PsyD
Verified Verified
5 Endorsed
Houston, TX 77006
Do you desire freedom from obsessive thoughts? Are you trapped in a loop of worries, feel anxious, or find yourself stuck repeating behaviors that prevent you from living your best life? Recovery is possible. I am a licensed psychologist specialized in evidence-based treatments for OCD and related disorders, anxiety disorders, depressive disorders, and body-focused repetitive behaviors. I have expertise in evidence-based treatments, including cognitive behavioral therapy (CBT), exposure and response prevention (ERP), and comprehensive behavioral model (ComB). I treat adolescents, adults and those with autism spectrum disorder.
Do you desire freedom from obsessive thoughts? Are you trapped in a loop of worries, feel anxious, or find yourself stuck repeating behaviors that prevent you from living your best life? Recovery is possible. I am a licensed psychologist specialized in evidence-based treatments for OCD and related disorders, anxiety disorders, depressive disorders, and body-focused repetitive behaviors. I have expertise in evidence-based treatments, including cognitive behavioral therapy (CBT), exposure and response prevention (ERP), and comprehensive behavioral model (ComB). I treat adolescents, adults and those with autism spectrum disorder.
(713) 424-8188 View (713) 424-8188
Photo of John Raymond Barnett, MA, LPC, Licensed Professional Counselor
John Raymond Barnett
Licensed Professional Counselor, MA, LPC
Verified Verified
1 Endorsed
Houston, TX 77006
If you're feeling burdened by unresolved conflict or are finding it difficult to forgive and release resentments, I can help. I completed a Master of Arts degree in Clinical Psychology from the University of Houston - Clear Lake in 1997. I have been practicing as a Licensed Professional Counselor since 2000 and have worked in the mental health field for 25 years. Former Credentialed Distinguished Mediator with over 15 years of experience conducting reconciliation mediations and coaching others in conflict resolution.
If you're feeling burdened by unresolved conflict or are finding it difficult to forgive and release resentments, I can help. I completed a Master of Arts degree in Clinical Psychology from the University of Houston - Clear Lake in 1997. I have been practicing as a Licensed Professional Counselor since 2000 and have worked in the mental health field for 25 years. Former Credentialed Distinguished Mediator with over 15 years of experience conducting reconciliation mediations and coaching others in conflict resolution.
(281) 205-8292 View (281) 205-8292
Photo of Judith Cornelius, LMFT, LPC, Licensed Professional Counselor
Judith Cornelius
Licensed Professional Counselor, LMFT, LPC
Verified Verified
Houston, TX 77006  (Online Only)
Good day. I am Judith Cornelius, licensed in the state of Texas and have active LMFT, LPC credentials. I have 20 plus years as a behavioral health professional. My approach is systems focused/problem solving. The client is the expert on the problems that bring them to therapy. My job is to assist clients with identifying problematic thinking and behaving patterns. This is a doorway to find alternatives to overcoming most problems. Sometimes folks just need a fresh perspective of the difficulties of daily life. That is something I offer.
Good day. I am Judith Cornelius, licensed in the state of Texas and have active LMFT, LPC credentials. I have 20 plus years as a behavioral health professional. My approach is systems focused/problem solving. The client is the expert on the problems that bring them to therapy. My job is to assist clients with identifying problematic thinking and behaving patterns. This is a doorway to find alternatives to overcoming most problems. Sometimes folks just need a fresh perspective of the difficulties of daily life. That is something I offer.
(346) 594-9915 View (346) 594-9915
Photo of Kathryn Kozak, LCSW, Clinical Social Work/Therapist
Kathryn Kozak
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Houston, TX 77006
Finding a therapist can be like shopping for shoes - sometimes it is hard to find the right fit, but when you find it, they help you to feel strong and supported. Life can present so many difficulties, and sometimes it is hard to find the tools to be our best self. If you or a family member are experiencing stress or anxiety, relationship troubles, want to change behaviors, or need help coping with difficult moods and emotions, I would be honored to join you in your journey for happiness and balance. I believe we all have unique strengths and capacity for change, and my goal is to help you to find what allows you to thrive!
Finding a therapist can be like shopping for shoes - sometimes it is hard to find the right fit, but when you find it, they help you to feel strong and supported. Life can present so many difficulties, and sometimes it is hard to find the tools to be our best self. If you or a family member are experiencing stress or anxiety, relationship troubles, want to change behaviors, or need help coping with difficult moods and emotions, I would be honored to join you in your journey for happiness and balance. I believe we all have unique strengths and capacity for change, and my goal is to help you to find what allows you to thrive!
(832) 735-5140 View (832) 735-5140
Photo of Maria Rocha, LMSW, Clinical Social Work/Therapist
Maria Rocha
Clinical Social Work/Therapist, LMSW
Verified Verified
Houston, TX 77006
Are you feeling stressed by any of the systems that impact us every day like work, family life, or self-esteem? What about your marriage, school, or identity? Do you want to learn more about childhood impacts who you are today - maybe even in ways you didn't realize? My goal as a clinician is to offer a nonjudgmental listening space and work with you to define your goals. We can work together to understand your strengths and use them to address what you bring to our sessions. I promote healing, empowerment, growth, and change for my clients. Let's break some cycles!
Are you feeling stressed by any of the systems that impact us every day like work, family life, or self-esteem? What about your marriage, school, or identity? Do you want to learn more about childhood impacts who you are today - maybe even in ways you didn't realize? My goal as a clinician is to offer a nonjudgmental listening space and work with you to define your goals. We can work together to understand your strengths and use them to address what you bring to our sessions. I promote healing, empowerment, growth, and change for my clients. Let's break some cycles!
(346) 482-2431 View (346) 482-2431
Photo of Ruchi S Kukreja, MS, PsyD, Psychologist
Ruchi S Kukreja
Psychologist, MS, PsyD
Verified Verified
Houston, TX 77006
My approach to therapy is one that appreciates the client as an expert on their life and thus an active participant in their therapy. I help the client explore family dynamics, interpersonal relationships, and behavioral patterns that may contribute to their presenting concerns. Together, through trust and understanding, we alleviate the internal conflict and struggles that make happiness feel unreachable.
My approach to therapy is one that appreciates the client as an expert on their life and thus an active participant in their therapy. I help the client explore family dynamics, interpersonal relationships, and behavioral patterns that may contribute to their presenting concerns. Together, through trust and understanding, we alleviate the internal conflict and struggles that make happiness feel unreachable.
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How does your Therapist compare?

Number of Therapists in 77006

400+

Average cost per session

$150

Therapists in 77006 who prioritize treating:

94% Anxiety
88% Depression
79% Relationship Issues
75% Self Esteem
70% Trauma and PTSD
70% Stress
70% Life Transitions

Average years in practice

9 Years

Top 3 insurances accepted

87% Aetna
66% UnitedHealthcare UHC | UBH
61% BlueCross and BlueShield

How Therapists in 77006 see their clients

73% In Person and Online
27% Online Only

Gender breakdown

75% Female
24% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 77006?

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.