Photo of Vanessa Lopez, Licensed Professional Counselor in 78213, TX
Vanessa Lopez
Licensed Professional Counselor, MS, LPC
Verified Verified
1 Endorsed
San Antonio, TX 78213  (Online Only)
Is it difficult for you to set boundaries with others? Do you find yourself constantly battling that inner voice that says what you are doing is not good enough? Is it exhausting having to fight the changes you want to make against family values that are not you? I can help you navigate changes that make you proud of the person you are. I enjoy working with teenagers and young adults who battle with their self-esteem, overcoming traumatic events, and learning how to create peace of mind within themselves. My goal is to help you understand the root causes of these behaviors/ thoughts so we can make changes that support your healing.
Is it difficult for you to set boundaries with others? Do you find yourself constantly battling that inner voice that says what you are doing is not good enough? Is it exhausting having to fight the changes you want to make against family values that are not you? I can help you navigate changes that make you proud of the person you are. I enjoy working with teenagers and young adults who battle with their self-esteem, overcoming traumatic events, and learning how to create peace of mind within themselves. My goal is to help you understand the root causes of these behaviors/ thoughts so we can make changes that support your healing.
(210) 942-8443 View (210) 942-8443
Photo of Carolyn Tubbs, Marriage & Family Therapist in 78213, TX
Carolyn Tubbs
Marriage & Family Therapist, PhD, LMFT, LMFT-S
Verified Verified
1 Endorsed
San Antonio, TX 78213
I have been a family therapist over 20 years; and such, I work from a systemic or relational orientation, which focuses on mental health concerns within the contexts they occur. I work with individuals, couples and families experiencing a variety of mental health and relational concerns, such as depression, important life decisions, spiritual struggles, premarital counseling, marital conflict, communication problems, parenting challenges, family transitions, relationship enhancement, domestic violence, family violence and mid-life transitions.
I have been a family therapist over 20 years; and such, I work from a systemic or relational orientation, which focuses on mental health concerns within the contexts they occur. I work with individuals, couples and families experiencing a variety of mental health and relational concerns, such as depression, important life decisions, spiritual struggles, premarital counseling, marital conflict, communication problems, parenting challenges, family transitions, relationship enhancement, domestic violence, family violence and mid-life transitions.
(210) 981-3983 View (210) 981-3983
Photo of Michael A Saahene, Licensed Professional Counselor in 78213, TX
Michael A Saahene
Licensed Professional Counselor, MA, LPC, NCC, LCDC-I
Verified Verified
7 Endorsed
San Antonio, TX 78213
Counseling is a tool one uses to identify personal shortcomings as well as gaining insight into one's own self-exploration. My approach to counseling begins with establishing a working collaboration with the client. As a therapist, I believe it is my responsibility to demonstrate to each client that they are in a safe, trusting, environment, and to help them understand why they are having difficulties. Call Today!
Counseling is a tool one uses to identify personal shortcomings as well as gaining insight into one's own self-exploration. My approach to counseling begins with establishing a working collaboration with the client. As a therapist, I believe it is my responsibility to demonstrate to each client that they are in a safe, trusting, environment, and to help them understand why they are having difficulties. Call Today!
(210) 960-9324 View (210) 960-9324
Photo of Ashley Klasing, LPC Intern in 78213, TX
Ashley Klasing
LPC Intern, MA, LPC-A
Verified Verified
San Antonio, TX 78213
Do you find that you are comparing yourself to others on social media? It sucks to feel like you have to change who you are in order to match the images you see online. It's difficult when we have to deal with negative feelings, and all the criticism we give ourselves about our bodies.
Do you find that you are comparing yourself to others on social media? It sucks to feel like you have to change who you are in order to match the images you see online. It's difficult when we have to deal with negative feelings, and all the criticism we give ourselves about our bodies.
(210) 880-9140 View (210) 880-9140
Photo of Saraphina Njoroge, Clinical Social Work/Therapist in 78213, TX
Saraphina Njoroge
Clinical Social Work/Therapist, LMSW
Verified Verified
San Antonio, TX 78213
I specialize in trauma-informed care, creating a safe and nurturing space for my clients to explore, understand, and overcome unresolved past issues. By using a client-centered approach, I am able to tailor interventions to fit your individual needs. I will empower you to embrace growth and resilience so that you can thrive!
I specialize in trauma-informed care, creating a safe and nurturing space for my clients to explore, understand, and overcome unresolved past issues. By using a client-centered approach, I am able to tailor interventions to fit your individual needs. I will empower you to embrace growth and resilience so that you can thrive!
(726) 224-7813 View (726) 224-7813
Photo of Juazzelyn A. Barrera, Licensed Professional Counselor in 78213, TX
Juazzelyn A. Barrera
Licensed Professional Counselor, MEd, LPC, CSC
Verified Verified
San Antonio, TX 78213
Have you been trying to stay afloat on your own? Are you overwhelmed with work, kids, or school? Do you have nights when you are unable to fall asleep and the lists keep running in your mind? You don't have to go on this journey alone. I empower you to develop skills that you have always had inside and may not have tapped into them yet. Stop second guessing your decisions and find your voice and inner peace.
Have you been trying to stay afloat on your own? Are you overwhelmed with work, kids, or school? Do you have nights when you are unable to fall asleep and the lists keep running in your mind? You don't have to go on this journey alone. I empower you to develop skills that you have always had inside and may not have tapped into them yet. Stop second guessing your decisions and find your voice and inner peace.
(210) 361-3112 View (210) 361-3112
Photo of Jessie Mae Estrada, Licensed Professional Counselor in 78213, TX
Jessie Mae Estrada
Licensed Professional Counselor, MA, LPC, CEDS
Verified Verified
2 Endorsed
San Antonio, TX 78213  (Online Only)
Are you or a loved one struggling with an eating disorder? Do you feel no one understands or do you feel too much shame to talk about it? Let us help. Our goal is to provide you with a safe, confidential and understanding environment that allows you to explore these struggles through our therapeutic relationship. With valuable feedback and gentle guidance you can be empowered to reach your potential. Whether you are experiencing current struggles, are having trouble letting go of the past or are seeking a change in your life overall; we look forward to helping you find the inner strength to navigate your own path to recovery.
Are you or a loved one struggling with an eating disorder? Do you feel no one understands or do you feel too much shame to talk about it? Let us help. Our goal is to provide you with a safe, confidential and understanding environment that allows you to explore these struggles through our therapeutic relationship. With valuable feedback and gentle guidance you can be empowered to reach your potential. Whether you are experiencing current struggles, are having trouble letting go of the past or are seeking a change in your life overall; we look forward to helping you find the inner strength to navigate your own path to recovery.
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Photo of Dawn Fey Hedgepeth, Clinical Social Work/Therapist in 78213, TX
Dawn Fey Hedgepeth
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
San Antonio, TX 78213
As a clinical therapist with 25 years of experience working with teens and adults, I believe that connection, joy, curiosity and hope are essential for a meaningful and fulfilling life. My approach to therapy is collaborative and I am passionate about helping my clients achieve their goals and live their best lives. I specialize in working with anxiety, depression, and trauma. I understand that these challenges can be overwhelming and isolating, You are not alone, and there is hope for a better future. I would be honored to partner with you on your journey to healing.
As a clinical therapist with 25 years of experience working with teens and adults, I believe that connection, joy, curiosity and hope are essential for a meaningful and fulfilling life. My approach to therapy is collaborative and I am passionate about helping my clients achieve their goals and live their best lives. I specialize in working with anxiety, depression, and trauma. I understand that these challenges can be overwhelming and isolating, You are not alone, and there is hope for a better future. I would be honored to partner with you on your journey to healing.
(210) 985-8349 View (210) 985-8349
Photo of Mary A Dom, Licensed Professional Counselor in 78213, TX
Mary A Dom
Licensed Professional Counselor, MA, LPC
Verified Verified
2 Endorsed
San Antonio, TX 78213  (Online Only)
Talking about your concerns can help clarify what you want and need in your life. Finding choices helps us to grow and change personally and emotionally. I am here to give you the knowledge, perspective and experience gained through working with people in therapy for over 30 years. As a licensed professional counselor with experience in providing preteen, teen, couples, and individual counseling, let me offer you a warm and accepting environment where being non-judgmental is necessary to make you feel comfortable. Please note I work by telehealth only and my hours are Sunday through Friday from 7am to 3pm.
Talking about your concerns can help clarify what you want and need in your life. Finding choices helps us to grow and change personally and emotionally. I am here to give you the knowledge, perspective and experience gained through working with people in therapy for over 30 years. As a licensed professional counselor with experience in providing preteen, teen, couples, and individual counseling, let me offer you a warm and accepting environment where being non-judgmental is necessary to make you feel comfortable. Please note I work by telehealth only and my hours are Sunday through Friday from 7am to 3pm.
(210) 978-0987 View (210) 978-0987
Photo of John Amundson, Licensed Professional Counselor in 78213, TX
John Amundson
Licensed Professional Counselor, MA, NCC, LPC
Verified Verified
3 Endorsed
San Antonio, TX 78213
You're struggling in your relationships. It's either hard to get your needs met or hard to feel like you're enough for everyone else. Finding balance can be difficult especially if we come from an emotionally rigid or chaotic background.
You're struggling in your relationships. It's either hard to get your needs met or hard to feel like you're enough for everyone else. Finding balance can be difficult especially if we come from an emotionally rigid or chaotic background.
(512) 855-6730 View (512) 855-6730
Photo of Wellspring Wellness Manifest Center, Pre-Licensed Professional in 78213, TX
Wellspring Wellness Manifest Center
Pre-Licensed Professional, MA, MHFA, LCDCI, RSS, BCLC
Verified Verified
1 Endorsed
San Antonio, TX 78213
Are you feeling stuck in life? Are you feeling overwhelmed with the demands of your life, career, or relationships? Do you have mental health concerns due to substance use and other habitual addictions? We help you discover, explore, and overcome what is getting in your way. We provide a safe space where you can began to expand, explore, find hope, discover solutions, and experience healing. We provide Life Coaching and Recovery Support Services for your Life Hurts, Habit and Hangups to individuals, families, and couples.
Are you feeling stuck in life? Are you feeling overwhelmed with the demands of your life, career, or relationships? Do you have mental health concerns due to substance use and other habitual addictions? We help you discover, explore, and overcome what is getting in your way. We provide a safe space where you can began to expand, explore, find hope, discover solutions, and experience healing. We provide Life Coaching and Recovery Support Services for your Life Hurts, Habit and Hangups to individuals, families, and couples.
(210) 625-7689 View (210) 625-7689
Photo of Jim Toombs, Marriage & Family Therapist in 78213, TX
Jim Toombs
Marriage & Family Therapist, MA, LMFT, EMDR
Verified Verified
San Antonio, TX 78213
Emotional pain ... sucks. I can help your pain. Flashbacks, nightmares and PTSD respond very well to EMDR, as do intrusive thoughts and disturbing memories. I have been using it since 1993, so early that Francine Shapiro, the creator of EMDR, trained me herself. In addition, my basic training is Marriage and Family so I excel in relationships. But memories cause most of our problems.
Emotional pain ... sucks. I can help your pain. Flashbacks, nightmares and PTSD respond very well to EMDR, as do intrusive thoughts and disturbing memories. I have been using it since 1993, so early that Francine Shapiro, the creator of EMDR, trained me herself. In addition, my basic training is Marriage and Family so I excel in relationships. But memories cause most of our problems.
(210) 417-4687 View (210) 417-4687
Photo of Texas Center for Sport Psychology, Psychologist in 78213, TX
Texas Center for Sport Psychology
Psychologist, PsyD
Verified Verified
San Antonio, TX 78213
Highest qualifications and total preparedness equals confidence and results. I was a varsity three sport high school athlete: volleyball, basketball, and softball and an academic and athletic All-American softball player in college and beyond. I received my doctorate in 2002 (age 28) and have been in the mental health field for over 20 years. I am the only licensed clinical sport psychologist in San Antonio who is certified by the Association of Applied Sport Psychology. My clinical and sport psychology extensive training gives me the credibility to work with total athlete needs, not just sport performance.
Highest qualifications and total preparedness equals confidence and results. I was a varsity three sport high school athlete: volleyball, basketball, and softball and an academic and athletic All-American softball player in college and beyond. I received my doctorate in 2002 (age 28) and have been in the mental health field for over 20 years. I am the only licensed clinical sport psychologist in San Antonio who is certified by the Association of Applied Sport Psychology. My clinical and sport psychology extensive training gives me the credibility to work with total athlete needs, not just sport performance.
(210) 418-2293 View (210) 418-2293
Photo of Jesse Cardin, Clinical Social Work/Therapist in 78213, TX
Jesse Cardin
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
San Antonio, TX 78213  (Online Only)
Acknowledging that you might be in over your head isn't weak, it's wise. Have you tried calming techniques, but your anxiety still attacks you? Or relationships always seem to go sour or you never quite feel at ease even when everything's OK? Maybe it's time to look a little deeper. It's not that cutting off toxic people or upping your cardio won't help, because they probably will! But sometimes the wound goes deeper than that or the situation you're in is just too overwhelming to sort through on your own. When things like that go unaddressed, they sabotage even our best efforts at creating the life we want.
Acknowledging that you might be in over your head isn't weak, it's wise. Have you tried calming techniques, but your anxiety still attacks you? Or relationships always seem to go sour or you never quite feel at ease even when everything's OK? Maybe it's time to look a little deeper. It's not that cutting off toxic people or upping your cardio won't help, because they probably will! But sometimes the wound goes deeper than that or the situation you're in is just too overwhelming to sort through on your own. When things like that go unaddressed, they sabotage even our best efforts at creating the life we want.
(210) 761-4480 View (210) 761-4480
Photo of Celeste Gusme, Licensed Professional Counselor in 78213, TX
Celeste Gusme
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
San Antonio, TX 78213  (Online Only)
Are you a high-achieving BIPOC woman who excels in school or the workplace, but find yourself grappling with emotions, negative thought patterns, self-confidence and assertiveness? Do you battle with chronic worry, body tension, or the lingering effects of childhood trauma? My passion lies in working with individuals like you, helping you navigate through the interpersonal struggle of anxiety, trauma, and mood disorders. Together, we will work towards reducing the inner chaos and growth into a healed and empowered version of yourself.
Are you a high-achieving BIPOC woman who excels in school or the workplace, but find yourself grappling with emotions, negative thought patterns, self-confidence and assertiveness? Do you battle with chronic worry, body tension, or the lingering effects of childhood trauma? My passion lies in working with individuals like you, helping you navigate through the interpersonal struggle of anxiety, trauma, and mood disorders. Together, we will work towards reducing the inner chaos and growth into a healed and empowered version of yourself.
(210) 934-0030 View (210) 934-0030
Photo of Austin Mcneel Siegel, Licensed Professional Counselor in 78213, TX
Austin Mcneel Siegel
Licensed Professional Counselor, MA, LPC, CST
Verified Verified
San Antonio, TX 78213  (Online Only)
I am a Licensed Professional Counselor and AASECT-certified Sex Therapist providing sex therapy to individuals and couples, helping them to overcome obstacles that interfere with sexual fulfillment to improve their relationships and strengthen their sexual expression. My practice addresses a wide range of issues ranging from erectile dysfunction to difficulty in achieving female orgasm, but much of my practice involves helping couples resolve issues to obtain a fulfilling sex life. Many therapists dislike or are uncomfortable with marital and couples therapy. I consider it to be one of my passions, strengths, and specialties.
I am a Licensed Professional Counselor and AASECT-certified Sex Therapist providing sex therapy to individuals and couples, helping them to overcome obstacles that interfere with sexual fulfillment to improve their relationships and strengthen their sexual expression. My practice addresses a wide range of issues ranging from erectile dysfunction to difficulty in achieving female orgasm, but much of my practice involves helping couples resolve issues to obtain a fulfilling sex life. Many therapists dislike or are uncomfortable with marital and couples therapy. I consider it to be one of my passions, strengths, and specialties.
(210) 899-5672 View (210) 899-5672
Photo of Rhonda L Wright, Drug & Alcohol Counselor in 78213, TX
Rhonda L Wright
Drug & Alcohol Counselor, LCDC
Verified Verified
San Antonio, TX 78213  (Online Only)
Hello I am Rhonda and I am here to help you restore what you have lost. I will lock arms with you and walk alongside you while you are on this journey to wholeness. I have been in the mental health field for over 36 years. My specialty is in cognitive behavioral therapy, rational emotive behavioral therapy, and dialectical behavioral therapy. I am a fully licensed Masters level LCDC and I am working on my third Masters towards and Licensed Professional Counselor. I believe that Jesus meets us in our brokenness and has healed us through His scars.
Hello I am Rhonda and I am here to help you restore what you have lost. I will lock arms with you and walk alongside you while you are on this journey to wholeness. I have been in the mental health field for over 36 years. My specialty is in cognitive behavioral therapy, rational emotive behavioral therapy, and dialectical behavioral therapy. I am a fully licensed Masters level LCDC and I am working on my third Masters towards and Licensed Professional Counselor. I believe that Jesus meets us in our brokenness and has healed us through His scars.
(210) 851-9523 View (210) 851-9523
Photo of Rosie Cantu, Clinical Social Work/Therapist in 78213, TX
Rosie Cantu
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
San Antonio, TX 78213
I believe that we are all here on borrowed time and that tomorrow is not promised. I would like to sit with you and have a conversation about your struggles, and needs. Let's talk about your happiness and what steps need to be taken to work towards the BEST version of yourself. In a session with me expect for us to explore your thinking patterns because how you think and what you do impacts your everyday life. Expect exploration of goals, a comfortable, and safe place for sharing.
I believe that we are all here on borrowed time and that tomorrow is not promised. I would like to sit with you and have a conversation about your struggles, and needs. Let's talk about your happiness and what steps need to be taken to work towards the BEST version of yourself. In a session with me expect for us to explore your thinking patterns because how you think and what you do impacts your everyday life. Expect exploration of goals, a comfortable, and safe place for sharing.
(210) 899-6298 View (210) 899-6298
Photo of Amaris Sanchez, Licensed Professional Counselor in 78213, TX
Amaris Sanchez
Licensed Professional Counselor, LPC-S, MS
Verified Verified
2 Endorsed
San Antonio, TX 78213
Hi! My name is Amaris Sanchez, I am a Licensed Professional Counselor and Supervisor for LPC-Associates in San Antonio, TX. My Private Practice is Encouraging Counseling & Wellness, LLC - the name defines my intent as a Counselor. I seek to encourage and support clients in their counseling journey, whether their goals revolve around processing life situations, solving an issue, or breaking unhealthy cycles or thought patterns. I have interests in improving mental health for Individuals Living with Special Needs, Caregivers, New Parents, Educators, & First Responders. I value working with all ages, backgrounds, and lifestyles.
Hi! My name is Amaris Sanchez, I am a Licensed Professional Counselor and Supervisor for LPC-Associates in San Antonio, TX. My Private Practice is Encouraging Counseling & Wellness, LLC - the name defines my intent as a Counselor. I seek to encourage and support clients in their counseling journey, whether their goals revolve around processing life situations, solving an issue, or breaking unhealthy cycles or thought patterns. I have interests in improving mental health for Individuals Living with Special Needs, Caregivers, New Parents, Educators, & First Responders. I value working with all ages, backgrounds, and lifestyles.
(210) 501-7662 View (210) 501-7662
Photo of Stephanie Triana, Psychologist in 78213, TX
Stephanie Triana
Psychologist, PhD
Verified Verified
San Antonio, TX 78213
Healing begins with you, but you don't have to do it alone. I'm here for you during this journey. I have 17 years experience in the mental health field and 15 years experience in treatment. I am EMDR trained, and love helping clients heal from trauma, depression, and anxiety. Trauma is a lot more common than you realize, and includes any experience that has affected your self worth and/or wellbeing. If you feel different or like you don't belong, come see me. I'm real, compassionate, empathic, and transparent.
Healing begins with you, but you don't have to do it alone. I'm here for you during this journey. I have 17 years experience in the mental health field and 15 years experience in treatment. I am EMDR trained, and love helping clients heal from trauma, depression, and anxiety. Trauma is a lot more common than you realize, and includes any experience that has affected your self worth and/or wellbeing. If you feel different or like you don't belong, come see me. I'm real, compassionate, empathic, and transparent.
(210) 880-1810 View (210) 880-1810

How does your Therapist compare?

Number of Therapists in 78213

70+

Average cost per session

$135

Therapists in 78213 who prioritize treating:

92% Anxiety
89% Depression
77% Coping Skills
75% Trauma and PTSD
73% Relationship Issues
68% Self Esteem
62% Grief

Average years in practice

12 Years

Top 3 insurances accepted

82% Aetna
82% BlueCross and BlueShield
74% UnitedHealthcare UHC | UBH

How Therapists in 78213 see their clients

74% In Person and Online
26% Online Only

Gender breakdown

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

How can I find a therapist in 78213?

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.