Photo of Katrina Severin, Pre-Licensed Professional in 97206, OR
Katrina Severin
Pre-Licensed Professional, MS
Verified Verified
Portland, OR 97206
Not accepting new clients
I work with individual adults of all ages, races, and genders, as well as couples and non-traditional relationships. I have experience working with Trauma, depression, anxiety, chronic pain, disability, relationship issues, boundaries, attachment, identity development, immigration issues, and much more. I enjoy working with LBGTQIA+ folks, as well as men and women who are working to liberate themselves from patriarchal roles and relationship patterns. I am committed to ongoing anti-racism work and aim to provide a space in which BIPOC clients feel safe and supported.
I work with individual adults of all ages, races, and genders, as well as couples and non-traditional relationships. I have experience working with Trauma, depression, anxiety, chronic pain, disability, relationship issues, boundaries, attachment, identity development, immigration issues, and much more. I enjoy working with LBGTQIA+ folks, as well as men and women who are working to liberate themselves from patriarchal roles and relationship patterns. I am committed to ongoing anti-racism work and aim to provide a space in which BIPOC clients feel safe and supported.
(503) 447-4618 View (503) 447-4618
Photo of Liberty Karp, Clinical Social Work/Therapist in 97206, OR
Liberty Karp
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Portland, OR 97206  (Online Only)
Whether you're searching for a thoughtful and supportive ear to talk through what's on your mind, looking to heal from something difficult, or wanting to find ways around the obstacles that are limiting your full potential, I look forward to hearing from you. My style is based in mindfulness/mind-body approaches and centers around welcoming you with a compassionate presence and a non-judgemental curiosity.
Whether you're searching for a thoughtful and supportive ear to talk through what's on your mind, looking to heal from something difficult, or wanting to find ways around the obstacles that are limiting your full potential, I look forward to hearing from you. My style is based in mindfulness/mind-body approaches and centers around welcoming you with a compassionate presence and a non-judgemental curiosity.
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Photo of Kathryn F Weymouth in 97206, OR
Kathryn F Weymouth
PhD
Verified Verified
Portland, OR 97206
My clients are high functioning individuals who want help getting unstuck in some area of their lives, are seeking direction, and want help in alleviating pain, whether it is physical, emotional, psychological, relational, or spiritual. It's not unusual for them to have tried different therapies before coming to me, and most find that the combination of approaches that I use creates a healing synergy that they have not found elsewhere. In fact, my business card says "Deep Healing for Body, Mind, and Spirit." See my website at kweymouth.com for details.
My clients are high functioning individuals who want help getting unstuck in some area of their lives, are seeking direction, and want help in alleviating pain, whether it is physical, emotional, psychological, relational, or spiritual. It's not unusual for them to have tried different therapies before coming to me, and most find that the combination of approaches that I use creates a healing synergy that they have not found elsewhere. In fact, my business card says "Deep Healing for Body, Mind, and Spirit." See my website at kweymouth.com for details.
(503) 376-8719 View (503) 376-8719
Photo of Amanda Salmick, Clinical Social Work/Therapist in 97206, OR
Amanda Salmick
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Portland, OR 97206
Not accepting new clients
I have a passion for working with individuals who are living with symptoms of trauma, PTSD, C-PTSD, borderline personality disorder, anxiety, and depression. You may be struggling with emotion regulation, feeling stuck, persistanly sad, or hopeless. I use a variety of evidence based modailites in our sessions together to include DBT, IFS, and Brainspotting. I have completed the IFS Institute's level 1 training and am a certified Brainspotting practitioner. My counseling style infuses kindness, humor, and compassion to best support you in our sessions together.
I have a passion for working with individuals who are living with symptoms of trauma, PTSD, C-PTSD, borderline personality disorder, anxiety, and depression. You may be struggling with emotion regulation, feeling stuck, persistanly sad, or hopeless. I use a variety of evidence based modailites in our sessions together to include DBT, IFS, and Brainspotting. I have completed the IFS Institute's level 1 training and am a certified Brainspotting practitioner. My counseling style infuses kindness, humor, and compassion to best support you in our sessions together.
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Photo of Jane Leng, Clinical Social Work/Therapist in 97206, OR
Jane Leng
Clinical Social Work/Therapist, LCSW
Verified Verified
Portland, OR 97206
As a certified trauma therapist, I specialize in working with adults who suffer from the symptoms of traumatic stress or post traumatic stress disorder. The symptoms of trauma often include, panic attacks, anxiety, depression, sleep disturbances, nightmares and flashbacks, lack of concentration, ADD, binge eating and negative body image. All of these symptoms may be a result of unprocessed trauma that has become stuck in the mind and the body. There is a tremendous amount of promise in mental health healing available through trauma treatment.
As a certified trauma therapist, I specialize in working with adults who suffer from the symptoms of traumatic stress or post traumatic stress disorder. The symptoms of trauma often include, panic attacks, anxiety, depression, sleep disturbances, nightmares and flashbacks, lack of concentration, ADD, binge eating and negative body image. All of these symptoms may be a result of unprocessed trauma that has become stuck in the mind and the body. There is a tremendous amount of promise in mental health healing available through trauma treatment.
(503) 782-9069 View (503) 782-9069
Photo of Julia Perretta, Marriage & Family Therapist in 97206, OR
Julia Perretta
Marriage & Family Therapist, MS, LMFT
Verified Verified
Portland, OR 97206  (Online Only)
I specialize in providing emotion focused therapy for couples who are interested in working on issues related to communication, trust, infidelity, connection, and intimacy. I also work with individuals who are looking to heal their relationship with food, body image, stress, anxiety, substance use, depression, and manage responses to complex trauma. I welcome folx of all types, including LGBTQI and poly/ENM identifying individuals and couples. People who work with me enjoy integrating mindfulness and humor into the therapeutic tableau.
I specialize in providing emotion focused therapy for couples who are interested in working on issues related to communication, trust, infidelity, connection, and intimacy. I also work with individuals who are looking to heal their relationship with food, body image, stress, anxiety, substance use, depression, and manage responses to complex trauma. I welcome folx of all types, including LGBTQI and poly/ENM identifying individuals and couples. People who work with me enjoy integrating mindfulness and humor into the therapeutic tableau.
(503) 213-6255 View (503) 213-6255
Photo of Lila Derickson in 97206, OR
Lila Derickson
ND, MS
Verified Verified
1 Endorsed
Portland, OR 97206  (Online Only)
Not accepting new clients
Do you think you might have ADHD, be autistic, or both? Maybe you've had a sense that some things are a lot more difficult for you than for other people. Maybe you've felt like everyone else got the manual on how to be a person, but they forgot to give you one. Or you've just felt like you were different somehow. If this sounds like you and you're wondering if undiagnosed ADHD or autism could be the reason, I can help.
Do you think you might have ADHD, be autistic, or both? Maybe you've had a sense that some things are a lot more difficult for you than for other people. Maybe you've felt like everyone else got the manual on how to be a person, but they forgot to give you one. Or you've just felt like you were different somehow. If this sounds like you and you're wondering if undiagnosed ADHD or autism could be the reason, I can help.
(971) 717-7828 View (971) 717-7828
Photo of Grace Nguyen, Licensed Professional Counselor in 97206, OR
Grace Nguyen
Licensed Professional Counselor, LPC
Verified Verified
Portland, OR 97206  (Online Only)
Life can be hard sometimes. Even when we have the best intentions, try our best, and do all we can, it just doesn't feel like it's enough. The stuckness continues to be present. We want the relationships with our loved ones to work, other areas of our life, like work, to go smoothly, and life doesn't seem too heavy to live. It is very human to want these things, and we all deserve to live such a life, maybe not problem-free, but a wholesome enough one that it feels like there's meaning and reasons worth living it.
Life can be hard sometimes. Even when we have the best intentions, try our best, and do all we can, it just doesn't feel like it's enough. The stuckness continues to be present. We want the relationships with our loved ones to work, other areas of our life, like work, to go smoothly, and life doesn't seem too heavy to live. It is very human to want these things, and we all deserve to live such a life, maybe not problem-free, but a wholesome enough one that it feels like there's meaning and reasons worth living it.
(971) 328-3359 View (971) 328-3359
Photo of Jennifer Gray Counseling, Licensed Professional Counselor in 97206, OR
Jennifer Gray Counseling
Licensed Professional Counselor, LPC
Verified Verified
Portland, OR 97206  (Online Only)
Overwhelmed and exhausted with your business, you're now prepared to courageously reinvent a life you're absolutely passionate about! You aim to break free from the trap of comparison and perfectionism. You're eager to restore self-belief and break the chains of destructive cycles. You want authentic connections in every role. You wish to replace anxiety with strength and calm within. You aspire to be audacious and bold in a financially secure and liberating career. You're ready to revive your true essence: lively and inspired. You can go from Uncertain to Confident, Anxious to Calm, and Wanting to Fulfilled.
Overwhelmed and exhausted with your business, you're now prepared to courageously reinvent a life you're absolutely passionate about! You aim to break free from the trap of comparison and perfectionism. You're eager to restore self-belief and break the chains of destructive cycles. You want authentic connections in every role. You wish to replace anxiety with strength and calm within. You aspire to be audacious and bold in a financially secure and liberating career. You're ready to revive your true essence: lively and inspired. You can go from Uncertain to Confident, Anxious to Calm, and Wanting to Fulfilled.
(503) 461-1607 View (503) 461-1607
Photo of DANIEL Nishina, Licensed Professional Counselor in 97206, OR
DANIEL Nishina
Licensed Professional Counselor, LPC
Verified Verified
Portland, OR 97206
A person considering counseling is already making the first step of trying to achieve, or return to, a healthier and happier equilibrium. I believe that “loosening up” and releasing the many things we hold, particularly unconsciously, allow us to activate that capacity and return to, or discover, a healthier state of being. Top-down, this would involve uncovering our various thought patterns, reactions, and story that we have about ourselves. Bottom-up, it involves noticing and feeling - the various ways our body is in relation to how we are mentally.
A person considering counseling is already making the first step of trying to achieve, or return to, a healthier and happier equilibrium. I believe that “loosening up” and releasing the many things we hold, particularly unconsciously, allow us to activate that capacity and return to, or discover, a healthier state of being. Top-down, this would involve uncovering our various thought patterns, reactions, and story that we have about ourselves. Bottom-up, it involves noticing and feeling - the various ways our body is in relation to how we are mentally.
(503) 455-7871 View (503) 455-7871
Photo of Lorin Jonathan Pritts, Marriage & Family Therapist in 97206, OR
Lorin Jonathan Pritts
Marriage & Family Therapist, LMFT
Verified Verified
Portland, OR 97206
My goal is to empower those who often find themselves in the margins in our society. My work often focuses on identity issues with LGBTQ individuals, couples or moresomes, and I work with folks in an affirming way that integrates principles of justice and equity. I utilize Narrative and Emotionally Focused systemic approaches in therapy to help my clients celebrate aspects of their identity that are often marginalized by society.
My goal is to empower those who often find themselves in the margins in our society. My work often focuses on identity issues with LGBTQ individuals, couples or moresomes, and I work with folks in an affirming way that integrates principles of justice and equity. I utilize Narrative and Emotionally Focused systemic approaches in therapy to help my clients celebrate aspects of their identity that are often marginalized by society.
(971) 800-2364 View (971) 800-2364
Photo of Robyn Migliorini, Psychologist in 97206, OR
Robyn Migliorini
Psychologist, PhD
Verified Verified
Portland, OR 97206  (Online Only)
I specialize in telehealth therapy for adult ADHD, executive functioning concerns, and anxiety. As a neuropsychologist, I appreciate the complex interactions between our brains, our behaviors, and our environments. I view symptoms and their potential remedies through a scientific lens, with a focus on evidence-based strategies -- practical tools that can make a difference in your everyday life. I also believe treatment should be collaborative, creative, and tailored for your specific needs. I try to approach therapy with curiosity, determination, openness, and humor, and I invite my clients to do the same.
I specialize in telehealth therapy for adult ADHD, executive functioning concerns, and anxiety. As a neuropsychologist, I appreciate the complex interactions between our brains, our behaviors, and our environments. I view symptoms and their potential remedies through a scientific lens, with a focus on evidence-based strategies -- practical tools that can make a difference in your everyday life. I also believe treatment should be collaborative, creative, and tailored for your specific needs. I try to approach therapy with curiosity, determination, openness, and humor, and I invite my clients to do the same.
(781) 288-5141 View (781) 288-5141
Photo of Ashley Parkinson, Clinical Social Work/Therapist in 97206, OR
Ashley Parkinson
Clinical Social Work/Therapist, LCSW, CADC-I
Verified Verified
1 Endorsed
Portland, OR 97206
Mid-life can be deeply rewarding, but it can also feel like a never-ending pile of stress. It's not surprising that you’re feeling the weight of the world on your shoulders. You may be navigating complex relationships, career and caregiving responsibilities, finances, and health issues, not to mention a pandemic or the multitude of systemic oppressive forces alive in our country today! On top of it all, you may notice that your tools for managing stress (alcohol, food, pushing yourself to the max) aren’t really cutting it anymore and may even be causing harm. The pressure is overwhelming, and you're not sure how to handle it all.
Mid-life can be deeply rewarding, but it can also feel like a never-ending pile of stress. It's not surprising that you’re feeling the weight of the world on your shoulders. You may be navigating complex relationships, career and caregiving responsibilities, finances, and health issues, not to mention a pandemic or the multitude of systemic oppressive forces alive in our country today! On top of it all, you may notice that your tools for managing stress (alcohol, food, pushing yourself to the max) aren’t really cutting it anymore and may even be causing harm. The pressure is overwhelming, and you're not sure how to handle it all.
(503) 994-1156 View (503) 994-1156
Photo of Kate Bentley, Clinical Social Work/Therapist in 97206, OR
Kate Bentley
Clinical Social Work/Therapist, LCSW, CADC 1
Verified Verified
Portland, OR 97206  (Online Only)
Hello and welcome. I am a queer identified therapist, who is person centered, relational and utilize practices from the following modalities: Brainspotting, Mindfulness, Somatic Awareness, Motivational Interviewing, Parts Work, The Invitation to Change Approach, 12 step, Harm Reduction and Self Compassion. I bring a unique perspective and have a relaxed, kind demeanor that typically puts people at ease. I have both training and lived experience in the following areas: Substance Use Disorders, navigating relationship with folks with SUD's, traumatic grief, trauma, LGBTQIA2S+ issues, mood d/o. I am kink, ENM and sex positive.
Hello and welcome. I am a queer identified therapist, who is person centered, relational and utilize practices from the following modalities: Brainspotting, Mindfulness, Somatic Awareness, Motivational Interviewing, Parts Work, The Invitation to Change Approach, 12 step, Harm Reduction and Self Compassion. I bring a unique perspective and have a relaxed, kind demeanor that typically puts people at ease. I have both training and lived experience in the following areas: Substance Use Disorders, navigating relationship with folks with SUD's, traumatic grief, trauma, LGBTQIA2S+ issues, mood d/o. I am kink, ENM and sex positive.
(503) 893-4237 View (503) 893-4237
Photo of Maya M Lubin, Professional Counselor Associate in 97206, OR
Maya M Lubin
Professional Counselor Associate, MA
Verified Verified
1 Endorsed
Portland, OR 97206
Now Accepting OHP - Care Oregon insurance (HealthShare, Jackson Care Connect, and Columbia Pacific). My approach to therapy is holistic, providing support that nurtures the complex being you are, and acknowledging that physical, social, and spiritual wellness all contribute to positive mental health and personal growth. I focus on helping clients build resilience, hone their strengths, and become more attuned to their inner wisdom.
Now Accepting OHP - Care Oregon insurance (HealthShare, Jackson Care Connect, and Columbia Pacific). My approach to therapy is holistic, providing support that nurtures the complex being you are, and acknowledging that physical, social, and spiritual wellness all contribute to positive mental health and personal growth. I focus on helping clients build resilience, hone their strengths, and become more attuned to their inner wisdom.
(503) 741-8728 View (503) 741-8728
Photo of Kara Busse, Clinical Social Work/Therapist in 97206, OR
Kara Busse
Clinical Social Work/Therapist, LCSW
Verified Verified
Portland, OR 97206  (Online Only)
Reaching out for support is a strength and it brings me great joy to offer my support to you.Through a trauma informed lens I bring compassion, curiosity, and heartfelt acceptance to my work with teens, young adults and parents. Depression, anxiety, healing unresolved trauma, relationship challenges, grief, school issues and difficulty navigating life transitions are common themes clients bring in. Together we aim to identify concerns,develop healthy coping skills, build inner trust, and address and integrate trauma with care. Clients notice reduced stress, more agency, energy, improved self esteem and more fulfilling relationships.
Reaching out for support is a strength and it brings me great joy to offer my support to you.Through a trauma informed lens I bring compassion, curiosity, and heartfelt acceptance to my work with teens, young adults and parents. Depression, anxiety, healing unresolved trauma, relationship challenges, grief, school issues and difficulty navigating life transitions are common themes clients bring in. Together we aim to identify concerns,develop healthy coping skills, build inner trust, and address and integrate trauma with care. Clients notice reduced stress, more agency, energy, improved self esteem and more fulfilling relationships.
(971) 216-5904 View (971) 216-5904
Photo of Shelly Nicol, Psychologist in 97206, OR
Shelly Nicol
Psychologist, PsyD
Verified Verified
Portland, OR 97206  (Online Only)
Not accepting new clients
I have more information on my website: shellynicolpsyd.com
I have more information on my website: shellynicolpsyd.com
(503) 832-4759 View (503) 832-4759
Photo of Lena Crandell in 97206, OR
Lena Crandell
WHNP-BC, CSC
Verified Verified
Portland, OR 97206  (Online Only)
Waitlist for new clients
My goal is to help you have a happier and more satisfying sex life, without pain, distress or shame. With over a decade of experience as a Nurse Practitioner in the field of sexual health, my biopsychosocial approach to your care will include advice about both physiological and psychological factors that may be contributing to your sexual concerns. I am happy see clients of all genders and sexual orientations and I am supportive of all relationship styles.
My goal is to help you have a happier and more satisfying sex life, without pain, distress or shame. With over a decade of experience as a Nurse Practitioner in the field of sexual health, my biopsychosocial approach to your care will include advice about both physiological and psychological factors that may be contributing to your sexual concerns. I am happy see clients of all genders and sexual orientations and I am supportive of all relationship styles.
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Photo of Sally Foster Rudolph, Art Therapist in 97206, OR
Sally Foster Rudolph
Art Therapist, LCAT, ART-BC
Verified Verified
Portland, OR 97206
Do you seek emotional healing, spiritual transformation, or support through your grief? Perhaps you feel stuck in sadness, anger or anxiety, and need a way to express yourself and integrate your experiences. Perhaps you have lost a loved one, or your health, or a job, or an important relationship. Maybe the past is not allowing you to move forward. As a therapist, I strive to provide an accepting, genuine, creative, and hands-on way to process confusion, loss and trauma. I offer individual therapy, as well as grief groups.
Do you seek emotional healing, spiritual transformation, or support through your grief? Perhaps you feel stuck in sadness, anger or anxiety, and need a way to express yourself and integrate your experiences. Perhaps you have lost a loved one, or your health, or a job, or an important relationship. Maybe the past is not allowing you to move forward. As a therapist, I strive to provide an accepting, genuine, creative, and hands-on way to process confusion, loss and trauma. I offer individual therapy, as well as grief groups.
(503) 832-5061 View (503) 832-5061
Photo of George Lewis, Professional Counselor Associate in 97206, OR
George Lewis
Professional Counselor Associate, MA
Verified Verified
1 Endorsed
Portland, OR 97206
People seek therapy for many reasons, but one thing just about everyone entering therapy has in common is a feeling that something needs to change for life to become more fulfilling. Whether you’re encountering difficulties in personal relationships, grief and loss, work-related stress, a life transition, low self-esteem, the emotional impacts of traumatic experiences, or struggling with constellations of symptoms commonly referred to as “depression” or “anxiety,” I honor your individuality and tailor my approach to meeting your unique needs.
People seek therapy for many reasons, but one thing just about everyone entering therapy has in common is a feeling that something needs to change for life to become more fulfilling. Whether you’re encountering difficulties in personal relationships, grief and loss, work-related stress, a life transition, low self-esteem, the emotional impacts of traumatic experiences, or struggling with constellations of symptoms commonly referred to as “depression” or “anxiety,” I honor your individuality and tailor my approach to meeting your unique needs.
(503) 893-8055 View (503) 893-8055

How does your Therapist compare?

Number of Therapists in 97206

100+

Average cost per session

$150

Therapists in 97206 who prioritize treating:

94% Anxiety
83% Depression
77% Relationship Issues
77% Self Esteem
70% Trauma and PTSD
70% Stress
67% Grief

Average years in practice

11 Years

Top 3 insurances accepted

58% PacificSource
45% Aetna
43% BlueCross and BlueShield

How Therapists in 97206 see their clients

64% In Person and Online
36% Online Only

Gender breakdown

73% Female
23% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 97206?

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.