Therapists in 97203

Kelsey Williams
Professional Counselor Associate, MS, CMT
1 Endorsed
Portland, OR 97203
Insight-oriented, heart-centered healing and parts work for sensitive souls. Whether you're a human who's struggling with anxiety, exhausted by people-pleasing, highly sensitive, neurodivergent, or just a human seeking more compassion and connection, I'm glad you're here. I'm Kelsey, and I'm here because I believe in the power we each have as humans to heal and feel supported from within. Together we'll explore the experiences and contexts that shaped you, how to be kind to yourself through any situation, tools for feeling resourced in your body and mind, and how you can be authentically connected to yourself, others, and the world.
Insight-oriented, heart-centered healing and parts work for sensitive souls. Whether you're a human who's struggling with anxiety, exhausted by people-pleasing, highly sensitive, neurodivergent, or just a human seeking more compassion and connection, I'm glad you're here. I'm Kelsey, and I'm here because I believe in the power we each have as humans to heal and feel supported from within. Together we'll explore the experiences and contexts that shaped you, how to be kind to yourself through any situation, tools for feeling resourced in your body and mind, and how you can be authentically connected to yourself, others, and the world.
(971) 298-9501 View (971) 298-9501
Dan Frantz
Licensed Professional Counselor, LCPC, LPC
1 Endorsed
Portland, OR 97203
Life can feel like an obstacle course of competing needs—draining your time, attention, and energy. You're not alone. Maybe you're struggling with anxiety, ADHD, or past trauma. Distressing emotions take you for a ride. Negative self-talk erodes confidence. Persistent worries pull you out of the moment, and building boundaries or deep connections feels impossible. Or you're in a relationship where ADHD or trauma creates distance and conflict. One or both of you feels misunderstood. Patterns keep repeating. Intimacy feels out of reach when regulation is hard. Whether you're navigating this alone or as a couple, I'd like to help.
Life can feel like an obstacle course of competing needs—draining your time, attention, and energy. You're not alone. Maybe you're struggling with anxiety, ADHD, or past trauma. Distressing emotions take you for a ride. Negative self-talk erodes confidence. Persistent worries pull you out of the moment, and building boundaries or deep connections feels impossible. Or you're in a relationship where ADHD or trauma creates distance and conflict. One or both of you feels misunderstood. Patterns keep repeating. Intimacy feels out of reach when regulation is hard. Whether you're navigating this alone or as a couple, I'd like to help.
(971) 309-1129 View (971) 309-1129
River C. Delogu-Clark
Licensed Professional Counselor, LPC, NCC, CADC I
2 Endorsed
Portland, OR 97203
Current Availability: 1 New Client. I provide holistic psychotherapy to adults age 25-64 ready to embark on a deep healing journey. I have a passion for helping people find their power and rewrite the story of who they are. I have extensive experience working with anxiety, late-diagnosed ADHD, depression, family-of-origin issues, internalized shame/self-criticism, relational traumas, hEDS "Zebras," people stable in their 12-Step recovery looking to dive deeper to heal root issues; and I have unique insights into helping transplants from other cultures.
Current Availability: 1 New Client. I provide holistic psychotherapy to adults age 25-64 ready to embark on a deep healing journey. I have a passion for helping people find their power and rewrite the story of who they are. I have extensive experience working with anxiety, late-diagnosed ADHD, depression, family-of-origin issues, internalized shame/self-criticism, relational traumas, hEDS "Zebras," people stable in their 12-Step recovery looking to dive deeper to heal root issues; and I have unique insights into helping transplants from other cultures.
(971) 715-0346 View (971) 715-0346
Shawn Salter
Verified Verified
Portland, OR 97203
Immediate openings for new clients! I work with individuals and couples to create optimal, practical, effective and lasting solutions to health, relationship and life challenges. Using a variety of client-centered, solution-focused, trauma-informed strategies, our work together is founded upon present moment awareness of the body, mind and environment to empower, liberate and increase your insight and strength in order to move towards health, balance and satisfaction in your life.
Immediate openings for new clients! I work with individuals and couples to create optimal, practical, effective and lasting solutions to health, relationship and life challenges. Using a variety of client-centered, solution-focused, trauma-informed strategies, our work together is founded upon present moment awareness of the body, mind and environment to empower, liberate and increase your insight and strength in order to move towards health, balance and satisfaction in your life.
(503) 487-0538 View (503) 487-0538
Cathedral Park Counseling
Clinical Social Work/Therapist, LCSW, LICSW
2 Endorsed
Portland, OR 97203
Are you feeling overwhelmed by worries or scared of intrusive thoughts or routines that don’t make sense? I specialize in anxiety and OCD and I understand the challenges and COURAGE it takes to live with these often frightening symptoms. You aren’t crazy. These problems are very treatable. I can help you get rid of the noise and be present in your life. I treat all types of anxiety. Whether it's social anxiety holding you back from enjoying life to the fullest, frightening thoughts, rituals, or just non stop worrying, I can help you. We can even sprinkle in some personal growth if you’re up for it! .
Are you feeling overwhelmed by worries or scared of intrusive thoughts or routines that don’t make sense? I specialize in anxiety and OCD and I understand the challenges and COURAGE it takes to live with these often frightening symptoms. You aren’t crazy. These problems are very treatable. I can help you get rid of the noise and be present in your life. I treat all types of anxiety. Whether it's social anxiety holding you back from enjoying life to the fullest, frightening thoughts, rituals, or just non stop worrying, I can help you. We can even sprinkle in some personal growth if you’re up for it! .
(971) 800-2078 View (971) 800-2078
Heather Baucum
Clinical Social Work/Therapist, LCSW
Portland, OR 97203
Feeling stuck? Lonely? Have the felt sense that everyone else knows the social rules of being Human except for you? Are relationships hard? Maybe you’re having a hard time doing the things everyone says you “have such great potential” to do. If so, I think you’re in the right place.
Feeling stuck? Lonely? Have the felt sense that everyone else knows the social rules of being Human except for you? Are relationships hard? Maybe you’re having a hard time doing the things everyone says you “have such great potential” to do. If so, I think you’re in the right place.
(971) 365-5536 View (971) 365-5536
David A Sangster
Clinical Social Work/Therapist, LCSW
Portland, OR 97203
From struggling to THRIVING. Become more fully "yourself." Enjoy relationship satisfaction. Strengthen connection to something bigger that is meaningful. Get relief from depression and anxiety (really!). Improve effectiveness at work. Feel more at home in your body, content. Mindful and present. LAUGH. Choosing a therapist that is both really good AND a great fit is important. There is a difference here you will experience from the get go. The office is in a 1930's Cape Cod style house...inviting & comfortable. With warmth and character. David is unusually relational and "real." Sessions are 60, 75 or 90 minutes rather than 50.
From struggling to THRIVING. Become more fully "yourself." Enjoy relationship satisfaction. Strengthen connection to something bigger that is meaningful. Get relief from depression and anxiety (really!). Improve effectiveness at work. Feel more at home in your body, content. Mindful and present. LAUGH. Choosing a therapist that is both really good AND a great fit is important. There is a difference here you will experience from the get go. The office is in a 1930's Cape Cod style house...inviting & comfortable. With warmth and character. David is unusually relational and "real." Sessions are 60, 75 or 90 minutes rather than 50.
(503) 444-8649 View (503) 444-8649
Jess Sappenfield
Professional Counselor Associate, MA
1 Endorsed
Portland, OR 97203
Counseling is a relationship; one where you get to experience care, discovery, and belonging as your whole self, unconditionally. I believe healing is a collaborative process – one rooted in compassion, authenticity, and a strong sense of care. My style is steady and attuned; I offer both gentle presence and thoughtful challenge. I make room for you to unlearn, to unravel, reveal, and reconnect.
Counseling is a relationship; one where you get to experience care, discovery, and belonging as your whole self, unconditionally. I believe healing is a collaborative process – one rooted in compassion, authenticity, and a strong sense of care. My style is steady and attuned; I offer both gentle presence and thoughtful challenge. I make room for you to unlearn, to unravel, reveal, and reconnect.
(971) 405-5700 View (971) 405-5700
Mike Schwarting
Licensed Professional Counselor, LPC, CADC-I
1 Endorsed
Portland, OR 97203
This all sucks. You already know that. The world, life, people ... it's all just objectively hard. And brains? Brains are the WORST. Sometimes we need support to simply make it through, let alone actually feel -good- once in a while. Tools are useful; but tools for using the tools are even better. You know some of the things, of course. You know the things that are -supposed- to make you feel better. Mindfulness! Meditation! Exercise! Blah blah blah... If it was that easy we'd have all done it already and you wouldn't be reading this. But it's just not that easy, despite what other people may want us to believe.
This all sucks. You already know that. The world, life, people ... it's all just objectively hard. And brains? Brains are the WORST. Sometimes we need support to simply make it through, let alone actually feel -good- once in a while. Tools are useful; but tools for using the tools are even better. You know some of the things, of course. You know the things that are -supposed- to make you feel better. Mindfulness! Meditation! Exercise! Blah blah blah... If it was that easy we'd have all done it already and you wouldn't be reading this. But it's just not that easy, despite what other people may want us to believe.
(971) 412-4493 View (971) 412-4493
Katie Ray
Licensed Professional Counselor, LPC, LMHC, RYT
1 Endorsed
Portland, OR 97203
I help trauma survivors break free from old, damaging patterns and reconnect with a sense of safety and self-worth. My clients are often high-achievers and perfectionists who feel overwhelmed, stressed, and caught in the cycle of keeping everyone else happy. They’re highly sensitive to conflict and often struggle to feel secure or connected in their relationships. Many have attachment patterns shaped by trauma, leading to feelings of anxiety, disconnection, or even suffocation in relationships.
I help trauma survivors break free from old, damaging patterns and reconnect with a sense of safety and self-worth. My clients are often high-achievers and perfectionists who feel overwhelmed, stressed, and caught in the cycle of keeping everyone else happy. They’re highly sensitive to conflict and often struggle to feel secure or connected in their relationships. Many have attachment patterns shaped by trauma, leading to feelings of anxiety, disconnection, or even suffocation in relationships.
(971) 299-7729 View (971) 299-7729
Annie Calhoun Randall
Pre-Licensed Professional, MA, LMHCA, NCC
1 Endorsed
Portland, OR 97203
Is food constantly on your mind? Do you avoid certain foods due to a fear of weight gain? Do certain foods cause you to feel guilt and shame? Do you sometimes feel out-of-control around food, as though you literally cannot stop eating? Do you feel uncomfortable in your skin? Are you tired of feeling stuck and exhausted? Freedom from restriction, binge eating, purging, food fears and dieting is possible, and your journey to freedom can start here. I am an eating disorder therapist in Portland, OR. I help teens (13+) and adults build healthier relationships with food, body, self, and others.
Is food constantly on your mind? Do you avoid certain foods due to a fear of weight gain? Do certain foods cause you to feel guilt and shame? Do you sometimes feel out-of-control around food, as though you literally cannot stop eating? Do you feel uncomfortable in your skin? Are you tired of feeling stuck and exhausted? Freedom from restriction, binge eating, purging, food fears and dieting is possible, and your journey to freedom can start here. I am an eating disorder therapist in Portland, OR. I help teens (13+) and adults build healthier relationships with food, body, self, and others.
(971) 754-2662 View (971) 754-2662
Rachel Starck
Licensed Professional Counselor, LPC
9 Endorsed
Portland, OR 97203
Are you feeling stressed, depleted, or exhausted? Frustrated or dissatisfied with your relationships? Overwhelmed by your life? I utilize strength based, mindfulness focused, and cognitive behavioral approaches to work with my clients. My focus is to assist you in developing more effective relationship and mood management skills while seeking ways to reduce stress and lead a more peaceful, fulfilling life. The process of change and healing involves supporting you in understanding, adapting, healing, resetting, and creating solutions based on your individual needs, goals, and resources.
Are you feeling stressed, depleted, or exhausted? Frustrated or dissatisfied with your relationships? Overwhelmed by your life? I utilize strength based, mindfulness focused, and cognitive behavioral approaches to work with my clients. My focus is to assist you in developing more effective relationship and mood management skills while seeking ways to reduce stress and lead a more peaceful, fulfilling life. The process of change and healing involves supporting you in understanding, adapting, healing, resetting, and creating solutions based on your individual needs, goals, and resources.
(971) 626-6535 View (971) 626-6535
Stacy Sheffler
Licensed Professional Counselor, MA, LPC
1 Endorsed
Portland, OR 97203
I am aligned with joining people in their journey of healing, exploring and supporting their needs of growth. I primarily work with queer, transgender, polyamorous/ENM/RA people. I work in the attachment and somatic modality and practice EMDR. I am here to be present and provide space for trauma, adjustments, identity exploration, learning coping skills, effective communication in relationships of all types, and learning new perspectives in life to alleviate the suffering we experience in this world.
I am aligned with joining people in their journey of healing, exploring and supporting their needs of growth. I primarily work with queer, transgender, polyamorous/ENM/RA people. I work in the attachment and somatic modality and practice EMDR. I am here to be present and provide space for trauma, adjustments, identity exploration, learning coping skills, effective communication in relationships of all types, and learning new perspectives in life to alleviate the suffering we experience in this world.
(503) 379-9761 View (503) 379-9761
Molly Sterling Counseling
Licensed Professional Counselor, LPC
1 Endorsed
Portland, OR 97203
My name is Molly Sterling (she/her) and I am a Licensed Professional Counselor (LPC) here in beautiful Portland, OR. I see adults 18+ with a wide variety of presenting goals and issues, including PTSD/trauma, anxiety/panic, depression, grief and/or difficulties navigating a major life transition. I specialize in working with trauma, including complex/developmental trauma and how early attachment patterns continue to show up in our relationships as adults. I particularly enjoy working with helping professionals, perfectionists, and individuals who have a hard time “getting out of their heads”.
My name is Molly Sterling (she/her) and I am a Licensed Professional Counselor (LPC) here in beautiful Portland, OR. I see adults 18+ with a wide variety of presenting goals and issues, including PTSD/trauma, anxiety/panic, depression, grief and/or difficulties navigating a major life transition. I specialize in working with trauma, including complex/developmental trauma and how early attachment patterns continue to show up in our relationships as adults. I particularly enjoy working with helping professionals, perfectionists, and individuals who have a hard time “getting out of their heads”.
(971) 385-5789 View (971) 385-5789
Myra Bazell
Clinical Social Work/Therapist, LCSW
Portland, OR 97203
Re-discover your natural strength & deep rooted source of power. Give yourself permission to do you. Overcome stress & enjoy your daily challenges. Explore early attachment & its impact on your current self-view. Improve your relationships. Rewrite self-script. Plan your next move while learning to be in this moment. Discover reasons to be holistic. Transform negative energy into creative ability. I am a proponent of deep self care as well as setting realistic goals & actionable plans.
Re-discover your natural strength & deep rooted source of power. Give yourself permission to do you. Overcome stress & enjoy your daily challenges. Explore early attachment & its impact on your current self-view. Improve your relationships. Rewrite self-script. Plan your next move while learning to be in this moment. Discover reasons to be holistic. Transform negative energy into creative ability. I am a proponent of deep self care as well as setting realistic goals & actionable plans.
(971) 265-2835 View (971) 265-2835
Molz Wirtz-Wold
Counselor, MS, LMHC, LPC
1 Endorsed
Portland, OR 97203
Accepting clients now - 10/16/26 Couples: doing the same fight over and over and not sure how get a different result? Wish you knew how to read your partner better and they could for you too? Wanting some specific tools how to resolve conflict quickly or avoid altogether? I help to learn a partner's needs quicker, and to soothe better. Learn the ways to "fight fair" to avoid resentment and address the core of the issue. Be guided in compassion and care when your partners attachment wounds are triggered. I have 20 years doing this work, let me help your find more peace, joy, and intimacy in your relationship. Individuals, see below.
Accepting clients now - 10/16/26 Couples: doing the same fight over and over and not sure how get a different result? Wish you knew how to read your partner better and they could for you too? Wanting some specific tools how to resolve conflict quickly or avoid altogether? I help to learn a partner's needs quicker, and to soothe better. Learn the ways to "fight fair" to avoid resentment and address the core of the issue. Be guided in compassion and care when your partners attachment wounds are triggered. I have 20 years doing this work, let me help your find more peace, joy, and intimacy in your relationship. Individuals, see below.
(503) 379-9742 View (503) 379-9742
Grace Klein
Clinical Social Work/Therapist, MSW, LCSW
Portland, OR 97203
My name is Grace, and I specialize in supporting folks on their relationship to food, exercise, and their body. Perhaps your relationship to your body is feeling very loud, and you’re actively battling disordered eating and struggling to find a recovery path on your own. Or perhaps you have a long history of dieting, with a nagging voice in the background quietly dictating many of your decisions throughout the day. Some people struggle to imagine how it’s possible to feel at home in your body and feel at peace with food choices. Not only is it possible, but I am truly honored to walk this path with folks as they find their way.
My name is Grace, and I specialize in supporting folks on their relationship to food, exercise, and their body. Perhaps your relationship to your body is feeling very loud, and you’re actively battling disordered eating and struggling to find a recovery path on your own. Or perhaps you have a long history of dieting, with a nagging voice in the background quietly dictating many of your decisions throughout the day. Some people struggle to imagine how it’s possible to feel at home in your body and feel at peace with food choices. Not only is it possible, but I am truly honored to walk this path with folks as they find their way.
(503) 966-2415 View (503) 966-2415
Dr. Clio Belle Weisman
Clinical Social Work/Therapist, PhD, LCSW
Portland, OR 97203
It is widely acknowledged that at the heart of any therapeutic success is not the methodology used, or the theoretical approach. Nor is it the specific treatment chosen or prescribed. Research demonstrates clearly that truly, what matters most – what makes the difference and leads to positive outcomes for individuals - is the relationship between therapist and client. Determine for yourself whether you can work with a person, or not. There is no magical cure, no manual that will apply to every person. Finding the right therapist is much like finding a partner, in that it may take some time but you should not have to 'settle'.
It is widely acknowledged that at the heart of any therapeutic success is not the methodology used, or the theoretical approach. Nor is it the specific treatment chosen or prescribed. Research demonstrates clearly that truly, what matters most – what makes the difference and leads to positive outcomes for individuals - is the relationship between therapist and client. Determine for yourself whether you can work with a person, or not. There is no magical cure, no manual that will apply to every person. Finding the right therapist is much like finding a partner, in that it may take some time but you should not have to 'settle'.
(971) 389-3218 View (971) 389-3218
Sitting By The Well Psychotherapy, LLC
Licensed Professional Counselor, MFT, LPC
Portland, OR 97203
Welcome! My approach to therapy is relational and depth oriented!We all need a trusted and caring companion when facing our most difficult moments in life. The therapeutic process has the potential to become a sacred place where we meet, re-connect with and befriend our own inner parts and companions, be they challenging or empowering on our ever-unfolding soul journey. It is always a privilege and honour for me to BE in that space with my clients, walking alongside them as they are held and challenged in the deep care of our therapeutic relationship.
Welcome! My approach to therapy is relational and depth oriented!We all need a trusted and caring companion when facing our most difficult moments in life. The therapeutic process has the potential to become a sacred place where we meet, re-connect with and befriend our own inner parts and companions, be they challenging or empowering on our ever-unfolding soul journey. It is always a privilege and honour for me to BE in that space with my clients, walking alongside them as they are held and challenged in the deep care of our therapeutic relationship.
(971) 387-7506 View (971) 387-7506
Marijana Knez
Clinical Social Work/Therapist, LCSW
1 Endorsed
Portland, OR 97203
Do you feel stuck, confused, exhausted and hopeless that life can get better for you? Do you seek to find more peace, joy, maybe more intimacy? I am a European-born therapist with close to two great decades of counseling individuals and couples challenged with life stressors and transitions, trauma, lack of intimacy, relationship issues, self-esteem and image, mood, focus, grief, addictions... Over the years I have successfully supported youth, adults, couples and families from all walks of life and cultural backgrounds. Please note, the demand for services can be overwhelming, I try to respond to each inquiry if at all possible.
Do you feel stuck, confused, exhausted and hopeless that life can get better for you? Do you seek to find more peace, joy, maybe more intimacy? I am a European-born therapist with close to two great decades of counseling individuals and couples challenged with life stressors and transitions, trauma, lack of intimacy, relationship issues, self-esteem and image, mood, focus, grief, addictions... Over the years I have successfully supported youth, adults, couples and families from all walks of life and cultural backgrounds. Please note, the demand for services can be overwhelming, I try to respond to each inquiry if at all possible.
(541) 449-9684 View (541) 449-9684

See more therapy options for 97203

How does your Therapist compare?

Number of Therapists in 97203

100+

Average cost per session

$175

Therapists in 97203 who prioritize treating:

90% Anxiety
90% Social Anxiety
90% Health Anxiety
90% Driving Anxiety
84% Depression
77% Trauma and PTSD
77% Complex PTSD

Average years in practice

11 Years

Top 3 insurances accepted

74% Aetna
59% Regence
57% BlueCross and BlueShield

How Therapists in 97203 see their clients

52% In Person and Online
48% Online Only

Gender breakdown

75% Female
19% Male
6% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 97203?

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.