Photo of Dana Andrews, MA, LMFT, Marriage & Family Therapist
Dana Andrews
Marriage & Family Therapist, MA, LMFT
Verified Verified
3 Endorsed
San Francisco, CA 94104
Are you struggling with anxiety and/or depression and looking for support? Is trauma from the past affecting your functioning and relationships? Have you recently lost someone and experiencing grief? I offer a warm and compassionate space for you to share you story, process any feelings arising, and further guide you to identify and heal the patterns and wounds that are holding you back. Providing personalized tools and exercises (now including optional Ketamine-Assisted Psychotherapy) to feel well-resourced both in and outside of session, we can work together to create a healing experience that works best for you and your needs.
Are you struggling with anxiety and/or depression and looking for support? Is trauma from the past affecting your functioning and relationships? Have you recently lost someone and experiencing grief? I offer a warm and compassionate space for you to share you story, process any feelings arising, and further guide you to identify and heal the patterns and wounds that are holding you back. Providing personalized tools and exercises (now including optional Ketamine-Assisted Psychotherapy) to feel well-resourced both in and outside of session, we can work together to create a healing experience that works best for you and your needs.
(415) 231-5013 View (415) 231-5013
Photo of Sandra L Goozée, PhD, Marriage & Family Therapist
Sandra L Goozée
Marriage & Family Therapist, PhD
Verified Verified
1 Endorsed
San Francisco, CA 94104
Most therapists will say they specialize in what you’re dealing with. Given my decades of experience, I have become fairly scrupulous about the clients I choose to work with. I see therapy as collaborative. If you’re ready to put in the work necessary for change, you’ve come to the right place. If the following sounds like you, feel free to reach out to me now: You know what you want to change in your life; you realize that a commitment to change means that most of the work is going to be on your end; and you're ready to trust in someone to partner with you.
Most therapists will say they specialize in what you’re dealing with. Given my decades of experience, I have become fairly scrupulous about the clients I choose to work with. I see therapy as collaborative. If you’re ready to put in the work necessary for change, you’ve come to the right place. If the following sounds like you, feel free to reach out to me now: You know what you want to change in your life; you realize that a commitment to change means that most of the work is going to be on your end; and you're ready to trust in someone to partner with you.
(415) 236-3193 View (415) 236-3193
Photo of James O'Dowd, PsyD, Psychologist
James O'Dowd
Psychologist, PsyD
Verified Verified
San Francisco, CA 94104
We all get stuck at some point in our lives. Sometimes we compensate by reverting to older, familiar patterns of coping, that may have been effective in the past, but don't quite address the complexity of the problems you face today.
We all get stuck at some point in our lives. Sometimes we compensate by reverting to older, familiar patterns of coping, that may have been effective in the past, but don't quite address the complexity of the problems you face today.
(415) 237-2119 View (415) 237-2119
Photo of Alena Bell, MFT, Marriage & Family Therapist
Alena Bell
Marriage & Family Therapist, MFT
Verified Verified
San Francisco, CA 94104
Are you feeling anxious or down? Are you unsure about the future of a relationship, or wondering why you find yourself repeating the same patterns and behaviors? Therapy is a collaborative process of self-discovery and personal growth. I focus on helping my clients through the development of greater self-understanding, self-awareness and self-acceptance. I want to support you to make the changes you desire, and to live your life to the fullest. I treat a wide range of clinical issues and invite clients of diverse identities and backgrounds into my therapy practice.
Are you feeling anxious or down? Are you unsure about the future of a relationship, or wondering why you find yourself repeating the same patterns and behaviors? Therapy is a collaborative process of self-discovery and personal growth. I focus on helping my clients through the development of greater self-understanding, self-awareness and self-acceptance. I want to support you to make the changes you desire, and to live your life to the fullest. I treat a wide range of clinical issues and invite clients of diverse identities and backgrounds into my therapy practice.
(628) 800-0232 View (628) 800-0232
Photo of Ilya Parizhsky, MFT, Marriage & Family Therapist
Ilya Parizhsky
Marriage & Family Therapist, MFT
Verified Verified
6 Endorsed
San Francisco, CA 94104  (Online Only)
As a licensed therapist, I have dedicated my career to helping people thrive. But the uneven nature of the process always struck me as limiting the human potential. Each of my clients has an incredible power to heal other people, but they’re not being empowered to use it when they see me for 1-1 therapy. I now specialize in an innovative and transformative small-group approach called Effective Listening. This unique method is taught in groups of 6 people, and each person gets to learn to use their awesome healing power and to be an instrumental part of each other person’s transformational journey.
As a licensed therapist, I have dedicated my career to helping people thrive. But the uneven nature of the process always struck me as limiting the human potential. Each of my clients has an incredible power to heal other people, but they’re not being empowered to use it when they see me for 1-1 therapy. I now specialize in an innovative and transformative small-group approach called Effective Listening. This unique method is taught in groups of 6 people, and each person gets to learn to use their awesome healing power and to be an instrumental part of each other person’s transformational journey.
(510) 876-4835 View (510) 876-4835
Photo of Pearl B Werfel, PhD, Psychologist
Pearl B Werfel
Psychologist, PhD
Verified Verified
San Francisco, CA 94104
Even the most capable and intelligent person will sometimes need help. My clients include professionals, supervisors, executives, and healthcare providers who seek to better manage the stressors of their professional and personal lives. I create a safe and comfortable environment where you can learn how to decrease stress and anxiety, sleep better, reduce or eliminate pain, live well with chronic illness, resolve past trauma and stop self-limiting behaviors. My over 25 years of experience and training enables me to tailor therapeutic interventions to your needs.
Even the most capable and intelligent person will sometimes need help. My clients include professionals, supervisors, executives, and healthcare providers who seek to better manage the stressors of their professional and personal lives. I create a safe and comfortable environment where you can learn how to decrease stress and anxiety, sleep better, reduce or eliminate pain, live well with chronic illness, resolve past trauma and stop self-limiting behaviors. My over 25 years of experience and training enables me to tailor therapeutic interventions to your needs.
(510) 665-5802 View (510) 665-5802
Photo of Ruben Velazquez, AMFT, Marriage & Family Therapist Associate
Ruben Velazquez
Marriage & Family Therapist Associate, AMFT
Verified Verified
San Francisco, CA 94104  (Online Only)
I work with individuals and couples who have ADHD or identify as neurodiverse, LGBTQ+, ENM, who seek therapy to increase healthy relationships and their self-esteem. Clients that I work with often have difficulty with communication and social interaction, sensory overload, executive function, anxiety and depression, low self-esteem, relationship problems, and/or have experiences with discrimination and oppression.
I work with individuals and couples who have ADHD or identify as neurodiverse, LGBTQ+, ENM, who seek therapy to increase healthy relationships and their self-esteem. Clients that I work with often have difficulty with communication and social interaction, sensory overload, executive function, anxiety and depression, low self-esteem, relationship problems, and/or have experiences with discrimination and oppression.
(628) 237-3725 x6 View (628) 237-3725 x6
Photo of Shawanda Powell, LCSW, Clinical Social Work/Therapist
Shawanda Powell
Clinical Social Work/Therapist, LCSW
Verified Verified
3 Endorsed
San Francisco, CA 94104  (Online Only)
Hello. My name is Shawanda Powell. I am currently an Licensed Clinical Social Worker (LCSW). I received my Masters Degree in Social Work from Mississippi Valley State University, and have been practicing social work for over 10 years in the states of Mississippi, California, and Arkansas. I have experience in providing services to both children and adults in-patient and out-patient.
Hello. My name is Shawanda Powell. I am currently an Licensed Clinical Social Worker (LCSW). I received my Masters Degree in Social Work from Mississippi Valley State University, and have been practicing social work for over 10 years in the states of Mississippi, California, and Arkansas. I have experience in providing services to both children and adults in-patient and out-patient.
(415) 903-8261 View (415) 903-8261
Photo of Stephanie Lee - Bay Area Relationship Support, LCSW, Clinical Social Work/Therapist
Bay Area Relationship Support
Clinical Social Work/Therapist, LCSW
Verified Verified
3 Endorsed
San Francisco, CA 94104
I work with Asian American individuals and couples around relationship issues. Most of my clients are thriving in their careers, but they want more. They want meaningful and deep connections. They want to be seen and accepted for who they are. But as Asians living in the US, being seen and understood is often complicated by cultural misunderstandings, holding conflicting values and identities, communication differences, prejudice and racism, intergenerational trauma, and immigration issues.
I work with Asian American individuals and couples around relationship issues. Most of my clients are thriving in their careers, but they want more. They want meaningful and deep connections. They want to be seen and accepted for who they are. But as Asians living in the US, being seen and understood is often complicated by cultural misunderstandings, holding conflicting values and identities, communication differences, prejudice and racism, intergenerational trauma, and immigration issues.
(415) 969-4331 View (415) 969-4331
Photo of Tess Brigham, MA, LMFT, BCC, Marriage & Family Therapist
Tess Brigham
Marriage & Family Therapist, MA, LMFT, BCC
Verified Verified
San Francisco, CA 94104  (Online Only)
No one warned you "adulting" would be so hard. You’re tired of feeling overwhelmed by trying to figure out if you’re on the right path, frustrated by an unfulfilling job or possibly annoyed by your dating life (or lack thereof). The problem is you’re not sure what else to do. You’ve spent your entire life following a carefully laid-out plan. You’ve gotten the degrees, secured the job, and landed the apartment. Your life is good but you wonder if "good" is enough. This is where I come in. We’ll work together to define your goals, create a clear path forward, and take action.
No one warned you "adulting" would be so hard. You’re tired of feeling overwhelmed by trying to figure out if you’re on the right path, frustrated by an unfulfilling job or possibly annoyed by your dating life (or lack thereof). The problem is you’re not sure what else to do. You’ve spent your entire life following a carefully laid-out plan. You’ve gotten the degrees, secured the job, and landed the apartment. Your life is good but you wonder if "good" is enough. This is where I come in. We’ll work together to define your goals, create a clear path forward, and take action.
(415) 639-5893 View (415) 639-5893
Photo of Kavitha Goldowitz, MA, MFT, Marriage & Family Therapist
Kavitha Goldowitz
Marriage & Family Therapist, MA, MFT
Verified Verified
6 Endorsed
San Francisco, CA 94104  (Online Only)
I have over 10 years experience working with individuals and couples. My area of expertise includes working with ethnic and multicultural population and addressing issues related to couples in inter-racial marriages, struggles with cultural assimilation and family relationship dynamics. I speak 5 languages and I am keenly aware of the specific issues faced by Indian-Americans in particular and Asian Americans and Latinos in general, especially with regards to struggles with personal and cultural identity. I offer brief and long term models of therapy. I also provide tele-therapy (online) in addition to face-to-face counseling.
I have over 10 years experience working with individuals and couples. My area of expertise includes working with ethnic and multicultural population and addressing issues related to couples in inter-racial marriages, struggles with cultural assimilation and family relationship dynamics. I speak 5 languages and I am keenly aware of the specific issues faced by Indian-Americans in particular and Asian Americans and Latinos in general, especially with regards to struggles with personal and cultural identity. I offer brief and long term models of therapy. I also provide tele-therapy (online) in addition to face-to-face counseling.
(707) 549-6681 View (707) 549-6681
Photo of Kealy Spring, MA, MS, LMFT, Marriage & Family Therapist
Kealy Spring
Marriage & Family Therapist, MA, MS, LMFT
Verified Verified
1 Endorsed
San Francisco, CA 94104
Are you feeling overwhelmed, anxious, depressed, or are struggling with communication challenges, imposter syndrome or perfectionism? Whether you are looking for individual support or with your partner, I may be able to help. Those I work with often appear to have everything together to the outside observer, but feel like they are struggling on the inside. Together we'll find ways to give the issues impacting you less power over you and your relationships. We will help you make positive, meaningful changes that will better serve you moving forward.
Are you feeling overwhelmed, anxious, depressed, or are struggling with communication challenges, imposter syndrome or perfectionism? Whether you are looking for individual support or with your partner, I may be able to help. Those I work with often appear to have everything together to the outside observer, but feel like they are struggling on the inside. Together we'll find ways to give the issues impacting you less power over you and your relationships. We will help you make positive, meaningful changes that will better serve you moving forward.
(628) 227-6249 View (628) 227-6249
Photo of Zena Vevaina, LMFT, Marriage & Family Therapist
Zena Vevaina
Marriage & Family Therapist, LMFT
Verified Verified
2 Endorsed
San Francisco, CA 94104  (Online Only)
Hello and a warm welcome! While I bring a diverse background to my role, my current focus involves pursuing certification in Emotionally Focused Therapy (EFT). My dedication lies in offering assistance to individuals and couples grappling with attachment issues within their present relationships. EFT centers around fostering transformative emotional experiences through the therapeutic relationship. I look forward to supporting you on your journey to emotional well-being. Additionally, I proudly serve as a Clinical Supervisor for associates on the journey to becoming licensed therapists.
Hello and a warm welcome! While I bring a diverse background to my role, my current focus involves pursuing certification in Emotionally Focused Therapy (EFT). My dedication lies in offering assistance to individuals and couples grappling with attachment issues within their present relationships. EFT centers around fostering transformative emotional experiences through the therapeutic relationship. I look forward to supporting you on your journey to emotional well-being. Additionally, I proudly serve as a Clinical Supervisor for associates on the journey to becoming licensed therapists.
(415) 843-6640 View (415) 843-6640
Photo of Sarah Dunn, LCSW, Clinical Social Work/Therapist
Sarah Dunn
Clinical Social Work/Therapist, LCSW
Verified Verified
San Francisco, CA 94104
There are many things that draw us to therapy. Some arrive struggling with anxiety, depression, relationship issues, or career uncertainty. Others have difficulty managing  the roller coaster of emotions inherent in the journey of becoming a parent, while some experience a more general or vague sense of distress. Whatever your goals and challenges, I welcome the opportunity to see whether I may be a good fit for your journey.
There are many things that draw us to therapy. Some arrive struggling with anxiety, depression, relationship issues, or career uncertainty. Others have difficulty managing  the roller coaster of emotions inherent in the journey of becoming a parent, while some experience a more general or vague sense of distress. Whatever your goals and challenges, I welcome the opportunity to see whether I may be a good fit for your journey.
(628) 200-3716 View (628) 200-3716
Photo of Saloomeh N. Saz - Private Practice of Saloomeh Nakh Saz, LMFT, MA, Marriage & Family Therapist
Private Practice of Saloomeh Nakh Saz
Marriage & Family Therapist, LMFT, MA
Verified Verified
San Francisco, CA 94104  (Online Only)
Welcome to a journey of transformation and empowerment. I am a seasoned therapist committed to guiding professionals and couples through the intricate maze of anxiety, the nuances of relationship dynamics, and the shadows of past traumas. With a profound blend of deep empathy and strategic insight, I create a sanctuary for healing—a space where personal growth and resilience are not just goals but tangible realities. My practice is rooted in cultural sensitivity and grounded in evidence-based methodologies. This approach ensures that every individual who walks through my doors feels deeply understood and immensely valued.
Welcome to a journey of transformation and empowerment. I am a seasoned therapist committed to guiding professionals and couples through the intricate maze of anxiety, the nuances of relationship dynamics, and the shadows of past traumas. With a profound blend of deep empathy and strategic insight, I create a sanctuary for healing—a space where personal growth and resilience are not just goals but tangible realities. My practice is rooted in cultural sensitivity and grounded in evidence-based methodologies. This approach ensures that every individual who walks through my doors feels deeply understood and immensely valued.
(415) 802-0286 View (415) 802-0286
Celeste Balaban
Pre-Licensed Professional, ASW
Verified Verified
San Francisco, CA 94104
Each person has a unique and compelling story, and I’m passionate about helping each one of them. I am committed to supporting individuals struggling with mental health and life challenges by using evidence-based interventions in a supportive environment. My clients have diverse backgrounds and present with a variety of concerns, including depression, anxiety, relationship issues, trauma, substance use, grief and loss, dealing with a family member or friend who is on the autism spectrum or has a disability, coping with illness, and spirituality/religion.
Each person has a unique and compelling story, and I’m passionate about helping each one of them. I am committed to supporting individuals struggling with mental health and life challenges by using evidence-based interventions in a supportive environment. My clients have diverse backgrounds and present with a variety of concerns, including depression, anxiety, relationship issues, trauma, substance use, grief and loss, dealing with a family member or friend who is on the autism spectrum or has a disability, coping with illness, and spirituality/religion.
(415) 941-6453 View (415) 941-6453
Photo of Alexandria Adeosun - Alexandria Adeosun Psychotherapy , MA, LMFT, Marriage & Family Therapist
Alexandria Adeosun Psychotherapy
Marriage & Family Therapist, MA, LMFT
Verified Verified
1 Endorsed
San Francisco, CA 94104
Hi! I specialize in treating individuals who are struggling with anxiety, depression, life transitions, and relationship issues. Additionally, I work with couples and families who are experiencing conflict.
Hi! I specialize in treating individuals who are struggling with anxiety, depression, life transitions, and relationship issues. Additionally, I work with couples and families who are experiencing conflict.
(415) 841-2263 View (415) 841-2263
Photo of Milam Freitag, PhD, Psychologist
Milam Freitag
Psychologist, PhD
Verified Verified
San Francisco, CA 94104
Waitlist for new clients
Whatever your current struggle, loss, transition or self-limiting behaviors are, I am committed to helping you access your own wisdom and healing potential. I am interactive, supportive, engaged and solution-based, tailoring interventions to your personal needs. Goals can include helping you: Find personal freedom, hope, and self-compassion that are the calling beneath fear/anxiety; Become happier and stronger as you navigate through loss and change related to career, relationships, aging, etc; Find balance in your life and what really brings you passion and joy; Relinquish problematic behaviors and beliefs and find a more workable and heartfelt connection to yourself and others.
Whatever your current struggle, loss, transition or self-limiting behaviors are, I am committed to helping you access your own wisdom and healing potential. I am interactive, supportive, engaged and solution-based, tailoring interventions to your personal needs. Goals can include helping you: Find personal freedom, hope, and self-compassion that are the calling beneath fear/anxiety; Become happier and stronger as you navigate through loss and change related to career, relationships, aging, etc; Find balance in your life and what really brings you passion and joy; Relinquish problematic behaviors and beliefs and find a more workable and heartfelt connection to yourself and others.
(415) 630-2959 View (415) 630-2959
Photo of Natalie Spautz, LMFT, Marriage & Family Therapist
Natalie Spautz
Marriage & Family Therapist, LMFT
Verified Verified
20 Endorsed
San Francisco, CA 94104  (Online Only)
I specialize in stress, anxiety and ADHD. If you're struggling with managing life, mood or relationships, I can help. As you struggle, you know something needs to change. You're tired of avoiding or obsessing about dealing with these issues. You notice it's affecting your mental health and want to find new ways to manage it. You know your mood and stress levels affect your mental health and all parts of life. With ADHD, supports are so key for balance. You've struggled long enough and ready to make changes to feel better about them. If this is you, I can help and welcome you to reach out.
I specialize in stress, anxiety and ADHD. If you're struggling with managing life, mood or relationships, I can help. As you struggle, you know something needs to change. You're tired of avoiding or obsessing about dealing with these issues. You notice it's affecting your mental health and want to find new ways to manage it. You know your mood and stress levels affect your mental health and all parts of life. With ADHD, supports are so key for balance. You've struggled long enough and ready to make changes to feel better about them. If this is you, I can help and welcome you to reach out.
(628) 266-2245 View (628) 266-2245
Photo of Ellen Suski, LCSW, Clinical Social Work/Therapist
Ellen Suski
Clinical Social Work/Therapist, LCSW
Verified Verified
3 Endorsed
San Francisco, CA 94104  (Online Only)
Hello, my name is Ellen Suski, I go by Elly. I am a licensed clinical social worker (LCSW). I have been working in the mental health field for almost 9 years and providing therapy for about 5 years. I have experience working with individuals with depression, anxiety, and ADHD as well as concerns around interpersonal relationships and stress management (related to work, school, family, and friends). My approach to therapy includes allowing the client to guide the direction of each session. I choose this approach as I do not like my clients to feel forced to speak on a topic or area in their life that they aren’t comfortable with yet.
Hello, my name is Ellen Suski, I go by Elly. I am a licensed clinical social worker (LCSW). I have been working in the mental health field for almost 9 years and providing therapy for about 5 years. I have experience working with individuals with depression, anxiety, and ADHD as well as concerns around interpersonal relationships and stress management (related to work, school, family, and friends). My approach to therapy includes allowing the client to guide the direction of each session. I choose this approach as I do not like my clients to feel forced to speak on a topic or area in their life that they aren’t comfortable with yet.
(415) 985-1645 View (415) 985-1645
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How does your Therapist compare?

Number of Therapists in 94104

300+

Average cost per session

$200

Therapists in 94104 who prioritize treating:

95% Anxiety
90% Relationship Issues
90% Depression
79% Self Esteem
74% Trauma and PTSD
71% Grief
69% Stress

Average years in practice

12 Years

Top 3 insurances accepted

48% Cigna and Evernorth
47% Aetna
41% UnitedHealthcare UHC | UBH

How Therapists in 94104 see their clients

60% In Person and Online
40% Online Only

Gender breakdown

72% Female
26% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 94104?

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.