Therapists in Sacramento, CA

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Photo of Jennifer Efemena Ozomaro, Marriage & Family Therapist in Sacramento, CA
Jennifer Efemena Ozomaro
Marriage & Family Therapist, LMFT
Verified Verified
Sacramento, CA 95811
Not accepting new clients
Hello! My name is Jennifer Ozomaro. I'm a Licensed Marriage and Family Therapist in California and run my group psychotherapy practice, Seeds of Growth Counseling. I provide support in navigating life's transitions and help you get unstuck. I like to work collaboratively with my clients to help them gain more control, understand their feelings, and set achievable treatment goals for the future.
Hello! My name is Jennifer Ozomaro. I'm a Licensed Marriage and Family Therapist in California and run my group psychotherapy practice, Seeds of Growth Counseling. I provide support in navigating life's transitions and help you get unstuck. I like to work collaboratively with my clients to help them gain more control, understand their feelings, and set achievable treatment goals for the future.
(530) 212-7049 View (530) 212-7049
Photo of Sally A Martin, Licensed Professional Clinical Counselor in Sacramento, CA
Sally A Martin
Licensed Professional Clinical Counselor, MA, LPCC
Verified Verified
Sacramento, CA 95831  (Online Only)
Not accepting new clients
No Availability for new PT clients currently-if you are experiencing a mental health emergency call 911 or the 24 hour Suicide Prevention Line: 1-800-272-8255 or text 838255. If you are in need of more intensive services call Sacramento Mental Health Team (916) 875-1055. Do you have mild to moderate symptoms associated with: Anxiety, Depression, Self-Esteem, or Trauma? Goals of: increasing positive thoughts, learning conflict resolution, communication, or boundary assertion skills? I practice evidenced-backed ways to manage stress and cope with stressors/triggers? I support transgender/gender non-conforming clients.
No Availability for new PT clients currently-if you are experiencing a mental health emergency call 911 or the 24 hour Suicide Prevention Line: 1-800-272-8255 or text 838255. If you are in need of more intensive services call Sacramento Mental Health Team (916) 875-1055. Do you have mild to moderate symptoms associated with: Anxiety, Depression, Self-Esteem, or Trauma? Goals of: increasing positive thoughts, learning conflict resolution, communication, or boundary assertion skills? I practice evidenced-backed ways to manage stress and cope with stressors/triggers? I support transgender/gender non-conforming clients.
(916) 237-9468 View (916) 237-9468
Photo of Chelsea Mackey, Psychologist in Sacramento, CA
Chelsea Mackey
Psychologist, PsyD
Verified Verified
1 Endorsed
Sacramento, CA 95816
Hi there! Welcome to one more step in your search for the life you want. Therapy is one way to increase joy, be reminded of whats wonderful about yourself, and overcome the barriers that have blocked you in the past. It also gives you the tools to continue that process. Collaboratively we strengthen your sense of worth so that you have the energy and motivation to work toward your personal goals. Increasing self-compassion and awareness frees an individual from the habits or ruts we all tend to dip into in life.
Hi there! Welcome to one more step in your search for the life you want. Therapy is one way to increase joy, be reminded of whats wonderful about yourself, and overcome the barriers that have blocked you in the past. It also gives you the tools to continue that process. Collaboratively we strengthen your sense of worth so that you have the energy and motivation to work toward your personal goals. Increasing self-compassion and awareness frees an individual from the habits or ruts we all tend to dip into in life.
(916) 507-1615 View (916) 507-1615
Photo of Tracy Moore, Marriage & Family Therapist in Sacramento, CA
Tracy Moore
Marriage & Family Therapist, LMFT
Verified Verified
Sacramento, CA 95825
With nearly 20 years in the helping profession, I am honored to help create a safe place for you to come and not only feel supported but also address change and grow. It takes a great deal of courage to seek help and I can help you to find your strength to heal and meet your goals.
With nearly 20 years in the helping profession, I am honored to help create a safe place for you to come and not only feel supported but also address change and grow. It takes a great deal of courage to seek help and I can help you to find your strength to heal and meet your goals.
(916) 507-1503 View (916) 507-1503
Photo of Colleen Cotter, Marriage & Family Therapist in Sacramento, CA
Colleen Cotter
Marriage & Family Therapist, MA, LMFT
Verified Verified
Sacramento, CA 95811
Clients that find me usually feel that trauma has informed or altered their life in some way. Or they face personal or relational distress. I meet each client with their unique challenges and life experiences and offer a place to explore what you are needing in therapy. My ideal client wants to understand and grow to their full potential and I am here as a guide to offer tools, options, a place to process your emotions and/or trauma. Adults that have been through child abuse, mental illness in family, addiction, sexual abuse, relationship distress, anxiety and depression.
Clients that find me usually feel that trauma has informed or altered their life in some way. Or they face personal or relational distress. I meet each client with their unique challenges and life experiences and offer a place to explore what you are needing in therapy. My ideal client wants to understand and grow to their full potential and I am here as a guide to offer tools, options, a place to process your emotions and/or trauma. Adults that have been through child abuse, mental illness in family, addiction, sexual abuse, relationship distress, anxiety and depression.
(916) 237-9292 View (916) 237-9292
Photo of Laura Naughton, Clinical Social Work/Therapist in Sacramento, CA
Laura Naughton
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Sacramento, CA 95816
We often come to points in life that leave us feeling lost, stuck and untethered. Whether you are grappling with anxiety, depression, addiction, trauma, relationship issues, or beyond, you are not alone. I am a Licensed Clinical Social Worker and would be honored to work with you. For many, therapy can provide a safe space to unpack and explore your feelings, experiences, thoughts, and fears while aligning with your values, goals and hopes to become more present, connected and fulfilled in your life. The relationship is key to this process and I strive to understand you, your identity, and your background.
We often come to points in life that leave us feeling lost, stuck and untethered. Whether you are grappling with anxiety, depression, addiction, trauma, relationship issues, or beyond, you are not alone. I am a Licensed Clinical Social Worker and would be honored to work with you. For many, therapy can provide a safe space to unpack and explore your feelings, experiences, thoughts, and fears while aligning with your values, goals and hopes to become more present, connected and fulfilled in your life. The relationship is key to this process and I strive to understand you, your identity, and your background.
(916) 634-0293 View (916) 634-0293
Photo of Beth Laskosky, Marriage & Family Therapist Associate in Sacramento, CA
Beth Laskosky
Marriage & Family Therapist Associate, BS, MA, AMFT
Verified Verified
3 Endorsed
Sacramento, CA 95821
If you could embody all of your identities without shame and judgment - who would you be? Much of my work has been centered around transgender teens and queer individuals & couples. I enjoy working with all humans trying to navigate life with childhood trauma, anxiety, depression, self-esteem issues, and identity formation. As a queer therapist, I understand the safety and security needed to create a healing relationship. I also assist with psychedelic integration for individuals processing the larger meanings derived from healing mystical experiences and life transitions.
If you could embody all of your identities without shame and judgment - who would you be? Much of my work has been centered around transgender teens and queer individuals & couples. I enjoy working with all humans trying to navigate life with childhood trauma, anxiety, depression, self-esteem issues, and identity formation. As a queer therapist, I understand the safety and security needed to create a healing relationship. I also assist with psychedelic integration for individuals processing the larger meanings derived from healing mystical experiences and life transitions.
(916) 269-5556 View (916) 269-5556
Photo of Allison Jean Pichardo, Marriage & Family Therapist in Sacramento, CA
Allison Jean Pichardo
Marriage & Family Therapist, LMFT
Verified Verified
Sacramento, CA 95811
I am passionate about helping individuals achieve their best selves and find fulfillment in life. Sometimes, we are held back by past hurts, low self esteem, anxiety, loss, or other life challenges. If you want to find ways to overcome life challenges, feel more confident, and have better relationships, I am here to help! I also love working with couples. Relationships, especially those with our spouse or partner are the most important thing in life. Often couples find themselves struggling to communicate and feel disconnected from one another. I would love to help you and your partner feel more connected!
I am passionate about helping individuals achieve their best selves and find fulfillment in life. Sometimes, we are held back by past hurts, low self esteem, anxiety, loss, or other life challenges. If you want to find ways to overcome life challenges, feel more confident, and have better relationships, I am here to help! I also love working with couples. Relationships, especially those with our spouse or partner are the most important thing in life. Often couples find themselves struggling to communicate and feel disconnected from one another. I would love to help you and your partner feel more connected!
(408) 705-2569 View (408) 705-2569
Photo of Rachel Haufe, Marriage & Family Therapist in Sacramento, CA
Rachel Haufe
Marriage & Family Therapist, MA
Verified Verified
Sacramento, CA 95811
Waitlist for new clients
Are you feeling anxious and overwhelmed? Do you struggle with codependency in your relationships? My clients come feeling weighed down and burnt out but are dedicated to doing the work to feel better.
Are you feeling anxious and overwhelmed? Do you struggle with codependency in your relationships? My clients come feeling weighed down and burnt out but are dedicated to doing the work to feel better.
(916) 295-6741 View (916) 295-6741
Photo of Angela Hall, Clinical Social Work/Therapist in Sacramento, CA
Angela Hall
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Sacramento, CA 95833  (Online Only)
During unprecedented times, we can feel as though we are being pulled in many directions. Balance, emotional stability, and restoration of self are priority and an absolute necessity to face challenges. Therapy is a collaborative process that can aid in resolving past trauma and achieving your authentic self. If you are prepared to make way for self-discovery and healing, you have come to the right place.
During unprecedented times, we can feel as though we are being pulled in many directions. Balance, emotional stability, and restoration of self are priority and an absolute necessity to face challenges. Therapy is a collaborative process that can aid in resolving past trauma and achieving your authentic self. If you are prepared to make way for self-discovery and healing, you have come to the right place.
(916) 587-4509 View (916) 587-4509
Photo of David Keith Nylund, Clinical Social Work/Therapist in Sacramento, CA
David Keith Nylund
Clinical Social Work/Therapist, PhD, LCSW
Verified Verified
5 Endorsed
Sacramento, CA 95811
I have been a therapist for 35 years working in non-profits, managed care, and private practice. My current work is couples therapy utilizing a relationship focused, resolution based approach. I have experience in working with anxiety/depression; trauma; ADHD; eating disorders; and family therapy. I am a Social Work Professor at Sacramento State Univ. I conduct workshops nationwide/internationally. I serve as the Clinical Director of the Gender Health Center, an agency serving the transgendercommunity. I have worked with hunderds of transgender youth and their families. I teach for the Vancouver School for Narrative Therapy.
I have been a therapist for 35 years working in non-profits, managed care, and private practice. My current work is couples therapy utilizing a relationship focused, resolution based approach. I have experience in working with anxiety/depression; trauma; ADHD; eating disorders; and family therapy. I am a Social Work Professor at Sacramento State Univ. I conduct workshops nationwide/internationally. I serve as the Clinical Director of the Gender Health Center, an agency serving the transgendercommunity. I have worked with hunderds of transgender youth and their families. I teach for the Vancouver School for Narrative Therapy.
(916) 382-7565 View (916) 382-7565
Photo of Stewart Bloom, Clinical Social Work/Therapist in Sacramento, CA
Stewart Bloom
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Sacramento, CA 95816
Hello, I received a Masters degree from the Boston University School of Social Work, postgraduate training in addiction, couples treatment, cognitive behavioral therapy and brief therapy at the Harvard Medical School/Cambridge Hospital; licensed since 1990. Areas of expertise include addiction disorders, dual-diagnosis and couples therapy. I work with adults and youth experiencing anxiety, depression, mood disturbances and trauma; and utilize evidence-based interventions including cognitive-behavioral, dialectical, motivational and trauma-focused care. My goal is to help people attain wellness efficiently, thoroughly and safely.
Hello, I received a Masters degree from the Boston University School of Social Work, postgraduate training in addiction, couples treatment, cognitive behavioral therapy and brief therapy at the Harvard Medical School/Cambridge Hospital; licensed since 1990. Areas of expertise include addiction disorders, dual-diagnosis and couples therapy. I work with adults and youth experiencing anxiety, depression, mood disturbances and trauma; and utilize evidence-based interventions including cognitive-behavioral, dialectical, motivational and trauma-focused care. My goal is to help people attain wellness efficiently, thoroughly and safely.
(916) 545-7594 View (916) 545-7594
Photo of Abbi Abshire, Marriage & Family Therapist Associate in Sacramento, CA
Abbi Abshire
Marriage & Family Therapist Associate, AMFT
Verified Verified
Sacramento, CA 95811  (Online Only)
I am accepting new clients! I have had the privilege of working with a diverse set of clients with a wide range of backgrounds and needs. I offer a supportive space that counters the normativity within this culture that often is oppressive to people based on their identities. I recognize that what healing journey one person, relationship or family may need may be different than another and help to support you on that journey. In addition to being neurodivergent and transgender myself, I have also supported folks who are neurodivergent, queer and/or plural.
I am accepting new clients! I have had the privilege of working with a diverse set of clients with a wide range of backgrounds and needs. I offer a supportive space that counters the normativity within this culture that often is oppressive to people based on their identities. I recognize that what healing journey one person, relationship or family may need may be different than another and help to support you on that journey. In addition to being neurodivergent and transgender myself, I have also supported folks who are neurodivergent, queer and/or plural.
(916) 269-4955 View (916) 269-4955
Photo of Deborah Miller-Froh, Marriage & Family Therapist in Sacramento, CA
Deborah Miller-Froh
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Sacramento, CA 95825
Waitlist for new clients
I work with people who are struggling, and decide take the courageous step to ask for help. Many have a history of trauma and suffer from anxiety, depression, eating disorders, addiction, parenting challenges, sleep issues, sexual difficulties, chronic pain, relationship problems, and other post-traumatic responses. Also, present-day situations in our personal or collective worlds can be objectively hard to bear. Our experiences leave traces psychologically and somatically, so I use evidence-based, body-oriented, mindfulness techniques to address limiting patterns so that you can live more authentically today's challenging world.
I work with people who are struggling, and decide take the courageous step to ask for help. Many have a history of trauma and suffer from anxiety, depression, eating disorders, addiction, parenting challenges, sleep issues, sexual difficulties, chronic pain, relationship problems, and other post-traumatic responses. Also, present-day situations in our personal or collective worlds can be objectively hard to bear. Our experiences leave traces psychologically and somatically, so I use evidence-based, body-oriented, mindfulness techniques to address limiting patterns so that you can live more authentically today's challenging world.
(916) 378-6706 View (916) 378-6706
Photo of Aaron Horne, Marriage & Family Therapist in Sacramento, CA
Aaron Horne
Marriage & Family Therapist, LMFT, APCC
Verified Verified
1 Endorsed
Sacramento, CA 95815
I strongly believe clients are the experts in their own experience and that their thoughts, feelings, and beliefs should be valued as such. In working together we will aim to find a deeper awareness and understanding of your personal value system, and explore how living in alignment with those values can create motivation to take appropriate action that promotes optimal mental-emotional health. We can explore how your current strengths (talents, relationships, resources, and community connections) can be used to support your goals for improved living and functioning.
I strongly believe clients are the experts in their own experience and that their thoughts, feelings, and beliefs should be valued as such. In working together we will aim to find a deeper awareness and understanding of your personal value system, and explore how living in alignment with those values can create motivation to take appropriate action that promotes optimal mental-emotional health. We can explore how your current strengths (talents, relationships, resources, and community connections) can be used to support your goals for improved living and functioning.
(916) 354-6531 View (916) 354-6531
Photo of Annisa Exline, Marriage & Family Therapist in Sacramento, CA
Annisa Exline
Marriage & Family Therapist, LMFT
Verified Verified
Sacramento, CA 95814  (Online Only)
Over the past several years, my focus has been on completing comprehensive and advanced training in working with the perinatal population, women who have transitioned to motherhood, as well as women who have experienced perinatal grief and loss. I am passionate about providing a safe, supportive, and nonjudgmental space for women and mothers, and their families. Therapy can be a vulnerable and unique process, and I strive to create a safe and supportive space throughout this process that fosters each person's desired healing and growth.
Over the past several years, my focus has been on completing comprehensive and advanced training in working with the perinatal population, women who have transitioned to motherhood, as well as women who have experienced perinatal grief and loss. I am passionate about providing a safe, supportive, and nonjudgmental space for women and mothers, and their families. Therapy can be a vulnerable and unique process, and I strive to create a safe and supportive space throughout this process that fosters each person's desired healing and growth.
(310) 448-1638 View (310) 448-1638
Photo of Veronica Fry, Clinical Social Work/Therapist in Sacramento, CA
Veronica Fry
Clinical Social Work/Therapist, LCSW
Verified Verified
Sacramento, CA 95838
I have accompanied individuals in their journey of healing and finding new ways to manage life stressors for the past fourteen years. Life may have brought depression, anxiety, PTSD, Grief, and Loss to your life, making you feel overwhelmed and stuck. I provide a respectful, empathic, and caring service to my clients. I am an LGBTQ+ ally and provide supportive therapy to individuals going through the transitioning process.
I have accompanied individuals in their journey of healing and finding new ways to manage life stressors for the past fourteen years. Life may have brought depression, anxiety, PTSD, Grief, and Loss to your life, making you feel overwhelmed and stuck. I provide a respectful, empathic, and caring service to my clients. I am an LGBTQ+ ally and provide supportive therapy to individuals going through the transitioning process.
(916) 666-6577 View (916) 666-6577
Photo of Guy E Washington, Psychologist in Sacramento, CA
Guy E Washington
Psychologist, PsyD, MA
Verified Verified
1 Endorsed
Sacramento, CA 95825
Collaboration is always in order when addressing individual differences and needs, since no two people are the same. My approach is to work close with patients utilizing empirically vallidated techniques conveyed in a user friendly manner. Identifying core conflicts, enhancing patient understanding and education,and treating underlying causes, not symptoms, is essential if relief from the distress is to be achieved.
Collaboration is always in order when addressing individual differences and needs, since no two people are the same. My approach is to work close with patients utilizing empirically vallidated techniques conveyed in a user friendly manner. Identifying core conflicts, enhancing patient understanding and education,and treating underlying causes, not symptoms, is essential if relief from the distress is to be achieved.
(916) 913-9186 View (916) 913-9186
Photo of Lindsay Glass, Marriage & Family Therapist in Sacramento, CA
Lindsay Glass
Marriage & Family Therapist, MA, LMFT
Verified Verified
1 Endorsed
Sacramento, CA 95816
You love your partner, but you are exhausted and overwhelmed by having the same conversation or argument over and over again only to feel even more alone, unheard, and unloved each time . I am a relationship therapist who supports adult couples and individuals with emotional and physical intimacy, communication, anxiety, and loss. I use an attachment-focused lens and have advanced training in Emotionally Focused Therapy for Couples and Individuals. Visit www.lovehealgrow.com to learn more or schedule your first appointment today.
You love your partner, but you are exhausted and overwhelmed by having the same conversation or argument over and over again only to feel even more alone, unheard, and unloved each time . I am a relationship therapist who supports adult couples and individuals with emotional and physical intimacy, communication, anxiety, and loss. I use an attachment-focused lens and have advanced training in Emotionally Focused Therapy for Couples and Individuals. Visit www.lovehealgrow.com to learn more or schedule your first appointment today.
(530) 420-8204 View (530) 420-8204
Photo of Prestige Therapy, Marriage & Family Therapist in Sacramento, CA
Prestige Therapy
Marriage & Family Therapist, LMFT
Verified Verified
Sacramento, CA 95811
Welcome to P R E S T I G E Therapy. We are a team of therapists who specialize in Dialectical Behavior Therapy, focusing on those who have borderline personality traits. We often work with individuals who experience intense emotions, suicidal ideation, self-harming behaviors, high conflict relationships, and other high risk behaviors. We also work with symptoms such as depression, anxiety, and relationship issues. We also work with families, couples, teens, and young adults.
Welcome to P R E S T I G E Therapy. We are a team of therapists who specialize in Dialectical Behavior Therapy, focusing on those who have borderline personality traits. We often work with individuals who experience intense emotions, suicidal ideation, self-harming behaviors, high conflict relationships, and other high risk behaviors. We also work with symptoms such as depression, anxiety, and relationship issues. We also work with families, couples, teens, and young adults.
(916) 619-2254 View (916) 619-2254

How does your Therapist compare?

Number of Therapists in Sacramento, CA

1,000+

Average cost per session

$150

Therapists in Sacramento, CA who prioritize treating:

92% Anxiety
86% Depression
73% Relationship Issues
70% Self Esteem
68% Trauma and PTSD
67% Coping Skills
67% Stress

Average years in practice

11 Years

Top 3 insurances accepted

68% Aetna
62% Cigna and Evernorth
60% UnitedHealthcare UHC | UBH

How Therapists in Sacramento, CA see their clients

68% In Person and Online
32% Online Only

Gender breakdown

79% Female
20% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Sacramento?

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.