Therapists in 97204

Photo of Tyne Zewadski Clifton, Marriage & Family Therapist Associate, MA MFT
Tyne Zewadski Clifton
Marriage & Family Therapist Associate, MA MFT
Portland, OR 97204
I love supporting neurodivergent folks! Do you find yourself in a cycle of overwork leading to burnout and collapse? Craving connection, but feeling exhausted by socializing? Struggling to identify your needs and feeling disconnected from your body? These are common experiences of neurodivergent people that can be transformed with therapy! We can connect to our embodied experience of the world, opening the door to unmasking, reducing social stress, and finding sustainable rhythms. We can break cycles of burnout and build systems that can enable us to meet our needs through fluctuations in our energy.
I love supporting neurodivergent folks! Do you find yourself in a cycle of overwork leading to burnout and collapse? Craving connection, but feeling exhausted by socializing? Struggling to identify your needs and feeling disconnected from your body? These are common experiences of neurodivergent people that can be transformed with therapy! We can connect to our embodied experience of the world, opening the door to unmasking, reducing social stress, and finding sustainable rhythms. We can break cycles of burnout and build systems that can enable us to meet our needs through fluctuations in our energy.
(503) 852-9208 View (503) 852-9208
Photo of Florencia Lopez - Pacific Center for Mind & Health
Pacific Center for Mind & Health
Verified Verified
Portland, OR 97204
At Pacific Center for Mind & Health, we are building a team of highly trained therapists to meet the diverse mental health needs of the Portland community. It is our goal to make the process of beginning your mental heath journey as seamless as possible by providing a welcoming and inclusive environment that is designed to allow judgement free introspection. Reach out today for a free initial assessment to see how we can help you.
At Pacific Center for Mind & Health, we are building a team of highly trained therapists to meet the diverse mental health needs of the Portland community. It is our goal to make the process of beginning your mental heath journey as seamless as possible by providing a welcoming and inclusive environment that is designed to allow judgement free introspection. Reach out today for a free initial assessment to see how we can help you.
(971) 571-5193 View (971) 571-5193
Photo of Dr. Scott Kopoian, Psychologist, PhD
Dr. Scott Kopoian
Psychologist, PhD
Portland, OR 97204
Hi, I’m Dr. Scott Kopoian, a licensed clinical psychologist in Oregon and California. I help individuals work through anxiety, mood disorders, and trauma-related challenges. Whether you're feeling overwhelmed or simply ready for a change, I’m here to support you in building a more balanced, fulfilling life where you feel steady, capable, and more in control.
Hi, I’m Dr. Scott Kopoian, a licensed clinical psychologist in Oregon and California. I help individuals work through anxiety, mood disorders, and trauma-related challenges. Whether you're feeling overwhelmed or simply ready for a change, I’m here to support you in building a more balanced, fulfilling life where you feel steady, capable, and more in control.
(971) 290-2186 View (971) 290-2186
Photo of Bertranna Muruthi, Marriage & Family Therapist, PhD
Bertranna Muruthi
Marriage & Family Therapist, PhD
Portland, OR 97204
I am a licensed therapist with over a decade of experience helping individuals, couples, and families navigate life’s challenges and build healthier, more fulfilling relationships. My approach to therapy is warm, collaborative, and grounded in respect for each person’s story and strengths. I work with clients experiencing a wide range of concerns, including stress, anxiety, depression, relationship or family conflict, grief, identity transitions, and the effects of trauma. I also have extensive experience supporting people from diverse cultural and family backgrounds who are balancing multiple roles, and life transitions.
I am a licensed therapist with over a decade of experience helping individuals, couples, and families navigate life’s challenges and build healthier, more fulfilling relationships. My approach to therapy is warm, collaborative, and grounded in respect for each person’s story and strengths. I work with clients experiencing a wide range of concerns, including stress, anxiety, depression, relationship or family conflict, grief, identity transitions, and the effects of trauma. I also have extensive experience supporting people from diverse cultural and family backgrounds who are balancing multiple roles, and life transitions.
(971) 320-7980 View (971) 320-7980
Photo of Stacey Gregory Martin, Clinical Social Work/Therapist, MSW, LCSW
Stacey Gregory Martin
Clinical Social Work/Therapist, MSW, LCSW
Portland, OR 97204
As a clinician at Abri Psychotherapy, I specialize in treating adults who struggle with excessive self-control—what’s often referred to as "over-control." This can show up as chronic perfectionism, rigidity, depression, anxiety, obsessive-compulsive traits, disordered eating, loneliness, or difficulties in relationships. I am also passionate about supporting individuals with Body-Focused Repetitive Behaviors, such as skin-picking or hair pulling.
As a clinician at Abri Psychotherapy, I specialize in treating adults who struggle with excessive self-control—what’s often referred to as "over-control." This can show up as chronic perfectionism, rigidity, depression, anxiety, obsessive-compulsive traits, disordered eating, loneliness, or difficulties in relationships. I am also passionate about supporting individuals with Body-Focused Repetitive Behaviors, such as skin-picking or hair pulling.
(971) 444-8623 View (971) 444-8623
Photo of Amanda Melbostad, Professional Counselor Associate, MA
Amanda Melbostad
Professional Counselor Associate, MA
2 Endorsed
Portland, OR 97204
I love working with adults (young and old) navigating life's challenges and looking to better understand their nervous system. My clients are open to change, motivated to heal, and looking for a non-traditional approach to therapy often seeking something deeper that includes creative and somatic exploration. I help clients navigate grief, life transitions, career changes, identity exploration, anxiety, and more. My focus is on guiding individuals toward self-discovery and empowerment, beyond the confines of traditional therapy.
I love working with adults (young and old) navigating life's challenges and looking to better understand their nervous system. My clients are open to change, motivated to heal, and looking for a non-traditional approach to therapy often seeking something deeper that includes creative and somatic exploration. I help clients navigate grief, life transitions, career changes, identity exploration, anxiety, and more. My focus is on guiding individuals toward self-discovery and empowerment, beyond the confines of traditional therapy.
(503) 980-4720 View (503) 980-4720
Photo of Kirsten McAteer - Abri Psychotherapy, Licensed Professional Counselor, LPC
Abri Psychotherapy
Licensed Professional Counselor, LPC
Portland, OR 97204
Abri Psychotherapy guides individuals with strength and grace, helping you embrace flexibility, openness, and deeper connections. Whether you’re navigating high expectations or seeking personal growth, we empower you to build a life worth sharing.
Abri Psychotherapy guides individuals with strength and grace, helping you embrace flexibility, openness, and deeper connections. Whether you’re navigating high expectations or seeking personal growth, we empower you to build a life worth sharing.
(971) 328-4051 View (971) 328-4051
Photo of Leily Villela, Social Worker, CSWA, MSW, LSWAIC
Leily Villela
Social Worker, CSWA, MSW, LSWAIC
Portland, OR 97204
My name is Leily, and I am a Clinical Social Work Associate. Mental health is something I truly hold dear to my heart. I have worked with all ages over the last decade, and use a trauma informed, strengths based; person centered approach. Our mind is such an important part of our everyday lives, and when it doesn’t function properly, we can feel so lost. Using attachment theory, I guide my clients while creating a therapeutic relationship where they can do the “hard work” in a compassionate and empathic, safe setting. Using an eclectic approach of modalities, I tailor the therapeutic journey individually to each client.
My name is Leily, and I am a Clinical Social Work Associate. Mental health is something I truly hold dear to my heart. I have worked with all ages over the last decade, and use a trauma informed, strengths based; person centered approach. Our mind is such an important part of our everyday lives, and when it doesn’t function properly, we can feel so lost. Using attachment theory, I guide my clients while creating a therapeutic relationship where they can do the “hard work” in a compassionate and empathic, safe setting. Using an eclectic approach of modalities, I tailor the therapeutic journey individually to each client.
(971) 309-1773 View (971) 309-1773
Photo of Sara Badour, Licensed Professional Counselor, LPC, NCC
Sara Badour
Licensed Professional Counselor, LPC, NCC
Portland, OR 97204
Building rapport and a therapeutic relationship is a necessary foundation for any therapy and heightens the efficacy of individualized interventions like CBT, DBT, and trauma-informed care. I also have a background in neuroscience which I integrate into my therapy to provide clients an understanding of how the brain works, relating it back to their presenting problem(s). I worked with clients experiencing a wide variety of issues from depression and anxiety to substance use, trauma, and personality disorders.
Building rapport and a therapeutic relationship is a necessary foundation for any therapy and heightens the efficacy of individualized interventions like CBT, DBT, and trauma-informed care. I also have a background in neuroscience which I integrate into my therapy to provide clients an understanding of how the brain works, relating it back to their presenting problem(s). I worked with clients experiencing a wide variety of issues from depression and anxiety to substance use, trauma, and personality disorders.
(971) 265-8504 View (971) 265-8504
Photo of Julie Kahler, Psychologist, PhD
Julie Kahler
Psychologist, PhD
1 Endorsed
Portland, OR 97204
I am a licensed psychologist providing video telehealth & in-person counseling to adults in Oregon who are struggling in their lives and relationships. Together, we explore the habits and beliefs that keep them from realizing their potential. In my practice, clients discover clarity about their values and boundaries, and are empowered to make change in their lives. My approach is to build a relationship of support and trust with you that offers the safety to explore problems with flexibility and curiosity. My clinical and research experience has given me expertise in human behaviors and emotions, but you are the expert of yourself.
I am a licensed psychologist providing video telehealth & in-person counseling to adults in Oregon who are struggling in their lives and relationships. Together, we explore the habits and beliefs that keep them from realizing their potential. In my practice, clients discover clarity about their values and boundaries, and are empowered to make change in their lives. My approach is to build a relationship of support and trust with you that offers the safety to explore problems with flexibility and curiosity. My clinical and research experience has given me expertise in human behaviors and emotions, but you are the expert of yourself.
(503) 298-5208 View (503) 298-5208
Photo of Andrew Friede - Depression Weight Addiction | Andrew Friede, MD, MD, MPH
I treat depression, anxiety, bipolar disease and related mood disorders, insomnia, ADD, PTSD; addictions to opiates and opiate-like drugs (such as kratom and tianeptine), stimulants, cannabis, alcohol, nicotine, etc; and overweight in the context of other medical and mental health issues. I use a combination of the latest medications and psychotherapy to treat most patients, and think the therapeutic relationship lies at the heart of successful treatment. Together we will find ways to enhance your mindfulness, sound sleep, nutrition, and exercise. See details (including a link to online reviews), on the web at The Bluestone Clinic.
I treat depression, anxiety, bipolar disease and related mood disorders, insomnia, ADD, PTSD; addictions to opiates and opiate-like drugs (such as kratom and tianeptine), stimulants, cannabis, alcohol, nicotine, etc; and overweight in the context of other medical and mental health issues. I use a combination of the latest medications and psychotherapy to treat most patients, and think the therapeutic relationship lies at the heart of successful treatment. Together we will find ways to enhance your mindfulness, sound sleep, nutrition, and exercise. See details (including a link to online reviews), on the web at The Bluestone Clinic.
(971) 277-4111 View (971) 277-4111
Photo of Bella Perea, Clinical Social Work Associate, MSW, CSWA
Bella Perea
Clinical Social Work Associate, MSW, CSWA
Portland, OR 97204
Are you ready to build deeper, more authentic connections with yourself and those around you? Do you often hold back your emotions or needs, unsure of what’s keeping you from speaking your truth? Are you done repeating the same patterns, and ready to break free from what no longer serves you? If any of this resonates, you're not alone—and you don’t have to navigate it on your own. I support adults and adolescents facing anxiety, depression, eating disorders, trauma, identity exploration, grief, and life transitions. I'm also deeply committed to supporting those impacted by the legal system, whether directly or through a loved one.
Are you ready to build deeper, more authentic connections with yourself and those around you? Do you often hold back your emotions or needs, unsure of what’s keeping you from speaking your truth? Are you done repeating the same patterns, and ready to break free from what no longer serves you? If any of this resonates, you're not alone—and you don’t have to navigate it on your own. I support adults and adolescents facing anxiety, depression, eating disorders, trauma, identity exploration, grief, and life transitions. I'm also deeply committed to supporting those impacted by the legal system, whether directly or through a loved one.
(971) 251-4701 View (971) 251-4701
Photo of Kathryn Hoover - EMDR Therapy in the City of Roses, Licensed Professional Counselor, MS, LPC
EMDR Therapy in the City of Roses
Licensed Professional Counselor, MS, LPC
Portland, OR 97204
Accepting new clients as of 11/25/25 Welcome! My name is Kathryn Hoover and my heart's work is connecting with people, holding space for their hurt, and empowering them to reach towards a connected, integrated life. My ideal client is someone who is curious about WHY troubling symptoms exist in the first place; someone who is ready to either step into therapy for the first time (hurrah!) or to step away from traditional talk therapy and begin deeper, more profound healing from the bottom up instead of the top down; someone who is wanting to feel more connected to themselves and others, and to feel more joy.
Accepting new clients as of 11/25/25 Welcome! My name is Kathryn Hoover and my heart's work is connecting with people, holding space for their hurt, and empowering them to reach towards a connected, integrated life. My ideal client is someone who is curious about WHY troubling symptoms exist in the first place; someone who is ready to either step into therapy for the first time (hurrah!) or to step away from traditional talk therapy and begin deeper, more profound healing from the bottom up instead of the top down; someone who is wanting to feel more connected to themselves and others, and to feel more joy.
(503) 406-6572 View (503) 406-6572
Photo of Brandt Hueser, Clinical Social Work/Therapist, LCSW
Brandt Hueser
Clinical Social Work/Therapist, LCSW
Portland, OR 97204
I am a licensed clinical social worker specializing in working with children, adolescents, and adults. After graduating with a Masters in Social Work from the University of Michigan in 2003, I have provided both home based and outpatient therapy to at risk youth and families. I specialize in working with children, adolescents and adults dealing with a wide range of issues. I believe that small shifts at any level, i.e. personal, environmental, or within relationships, can affect positive change within any individual and system.
I am a licensed clinical social worker specializing in working with children, adolescents, and adults. After graduating with a Masters in Social Work from the University of Michigan in 2003, I have provided both home based and outpatient therapy to at risk youth and families. I specialize in working with children, adolescents and adults dealing with a wide range of issues. I believe that small shifts at any level, i.e. personal, environmental, or within relationships, can affect positive change within any individual and system.
(971) 205-2936 View (971) 205-2936
Photo of Alexis L Washam, Pre-Licensed Professional, MSW, CSWA
Alexis L Washam
Pre-Licensed Professional, MSW, CSWA
1 Endorsed
Portland, OR 97204
Starting therapy can feel like a big leap—especially if you're used to managing things on your own. Whether you're dealing with chronic anxiety, navigating a recent loss, exploring neurodivergence, or just feeling stuck in old patterns, I offer a space where we can slow things down and make sense of what’s happening. Before I became a therapist, I spent nearly two decades as a book editor. That work trained me to listen closely—not just for what’s said, but for what’s under the surface. I bring that same attentiveness and care to my clinical work today.
Starting therapy can feel like a big leap—especially if you're used to managing things on your own. Whether you're dealing with chronic anxiety, navigating a recent loss, exploring neurodivergence, or just feeling stuck in old patterns, I offer a space where we can slow things down and make sense of what’s happening. Before I became a therapist, I spent nearly two decades as a book editor. That work trained me to listen closely—not just for what’s said, but for what’s under the surface. I bring that same attentiveness and care to my clinical work today.
(971) 626-1678 View (971) 626-1678
Photo of Sophie Anderson, R8285, MA, LMHCA
Sophie Anderson
R8285, MA, LMHCA
Portland, OR 97204
I prefer to provide clear and honest mental health counseling and will include you on the process of your therapy every step of the way: your diagnosis, my observations, and your treatment goals. I also love teaching folks living with ADHD skills-based learning derived from Cognitive Behavioral Therapy and have an eclectic mix of other theories which I can draw from to help you make progress. I provide individual adult therapy for those who come from many different backgrounds, ethnicities/cultures, and identities, ages 18 to 64, including those diagnosed with MDD, GAD, ADHD, ASD, Bipolar II Disorder, and PTSD.
I prefer to provide clear and honest mental health counseling and will include you on the process of your therapy every step of the way: your diagnosis, my observations, and your treatment goals. I also love teaching folks living with ADHD skills-based learning derived from Cognitive Behavioral Therapy and have an eclectic mix of other theories which I can draw from to help you make progress. I provide individual adult therapy for those who come from many different backgrounds, ethnicities/cultures, and identities, ages 18 to 64, including those diagnosed with MDD, GAD, ADHD, ASD, Bipolar II Disorder, and PTSD.
(971) 290-4260 View (971) 290-4260
Photo of Andrea M Frasca, Professional Counselor Associate, MA
Andrea M Frasca
Professional Counselor Associate, MA
Portland, OR 97204
Hello! I am a professional counselor associate who works with adults struggling with depression, and anxiety, and those navigating stressful life changes and circumstances (relationships, parenting, divorce, death of a loved one, financial issues, etc.), and those experiencing issues related to over-control. My primary goal is to partner with my clients to initiate and achieve positive change in their lives, develop resilience, and persevere through life’s many challenges.
Hello! I am a professional counselor associate who works with adults struggling with depression, and anxiety, and those navigating stressful life changes and circumstances (relationships, parenting, divorce, death of a loved one, financial issues, etc.), and those experiencing issues related to over-control. My primary goal is to partner with my clients to initiate and achieve positive change in their lives, develop resilience, and persevere through life’s many challenges.
(971) 626-4383 View (971) 626-4383
Photo of Ry Brown, Licensed Professional Counselor, MA, LPC
Ry Brown
Licensed Professional Counselor, MA, LPC
Portland, OR 97204
Being human isn't easy. My name is Ryan. I’m an existential-humanistic psychotherapist, and I help people navigate the deep questions of life with clarity, presence, and compassion. I work with individuals facing depression, anxiety, major life transitions, relationship and family challenges, career struggles, grief, burnout, and
Being human isn't easy. My name is Ryan. I’m an existential-humanistic psychotherapist, and I help people navigate the deep questions of life with clarity, presence, and compassion. I work with individuals facing depression, anxiety, major life transitions, relationship and family challenges, career struggles, grief, burnout, and
(503) 647-4213 View (503) 647-4213
Photo of Brian McLanahan, Clinical Social Work/Therapist, LCSW
Brian McLanahan
Clinical Social Work/Therapist, LCSW
Portland, OR 97204
Are you overwhelmed by negative self-talk? Maybe you feel that no matter how hard you try, you somehow seem to miss the mark you set for yourself. Are you struggling with a sense of overwhelming anxiety, and your usual methods of coping are just not working anymore? Perhaps you've been hesitant to seek professional advice because you had a bad experience with a therapist, or you simply dislike labels. I am here to lend a hand. I strive to practice in a way that is most comfortable for my clients. For some, a diagnosis feels like validation; for others, it's a prison. I am happy to provide the service that best suits your needs.
Are you overwhelmed by negative self-talk? Maybe you feel that no matter how hard you try, you somehow seem to miss the mark you set for yourself. Are you struggling with a sense of overwhelming anxiety, and your usual methods of coping are just not working anymore? Perhaps you've been hesitant to seek professional advice because you had a bad experience with a therapist, or you simply dislike labels. I am here to lend a hand. I strive to practice in a way that is most comfortable for my clients. For some, a diagnosis feels like validation; for others, it's a prison. I am happy to provide the service that best suits your needs.
(971) 265-6136 View (971) 265-6136
Photo of Liz Ortland, Marriage & Family Therapist, LMFT
Liz Ortland
Marriage & Family Therapist, LMFT
Portland, OR 97204
I am passionate about supporting clients on their journey towards more connected, authentic, and fulfilling lives. I take a non-pathologizing stance that sees you as a whole person interacting with a complex world, not just a diagnosis or set of symptoms. My goal is to help you to deepen your self-knowledge, improve your relationship to self and others, and take responsibility for your life choices. Don’t expect quick fixes or advice giving here—creating lasting change requires commitment and hard work! I see therapy as a partnership, and we will build a genuine trusting relationship so you feel safe to explore the unknown together.
I am passionate about supporting clients on their journey towards more connected, authentic, and fulfilling lives. I take a non-pathologizing stance that sees you as a whole person interacting with a complex world, not just a diagnosis or set of symptoms. My goal is to help you to deepen your self-knowledge, improve your relationship to self and others, and take responsibility for your life choices. Don’t expect quick fixes or advice giving here—creating lasting change requires commitment and hard work! I see therapy as a partnership, and we will build a genuine trusting relationship so you feel safe to explore the unknown together.
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How does your Therapist compare?

Number of Therapists in 97204

100+

Average cost per session

$165

Therapists in 97204 who prioritize treating:

88% Anxiety
82% Depression
76% Relationship Issues
74% Trauma and PTSD
73% Stress
72% Self Esteem
71% Life Transitions

Average years in practice

10 Years

Top 3 insurances accepted

66% Aetna
56% BlueCross and BlueShield
53% Cigna and Evernorth

How Therapists in 97204 see their clients

50% In Person and Online
50% Online Only

Gender breakdown

75% Female
22% Male
3% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 97204?

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.