Therapists in 98401

Photo of John J Smith - John J. Smith, Counselor, LMHCA, MFT
John J. Smith
Counselor, LMHCA, MFT
Tacoma, WA 98401
I am a spiritual life coach. I still see clients for mental health therapy; however, my primary focus is positive change through heart focused meditative practices. I have found and feel that integrating your mind and heart is the key to personal growth and healing. We will focus on your emotional and spiritual wellbeing. Through heart focused meditative practices you will experience internal shifts. This will lead to life changing evolution rather than surface level efforts. Sincerely, John J. Smith LMHCA
I am a spiritual life coach. I still see clients for mental health therapy; however, my primary focus is positive change through heart focused meditative practices. I have found and feel that integrating your mind and heart is the key to personal growth and healing. We will focus on your emotional and spiritual wellbeing. Through heart focused meditative practices you will experience internal shifts. This will lead to life changing evolution rather than surface level efforts. Sincerely, John J. Smith LMHCA
(253) 252-5027 View (253) 252-5027
Photo of Tammy M Ferguson, Counselor, LMHC
Tammy M Ferguson
Counselor, LMHC
Tacoma, WA 98401
Hello! My name is Tammy Ferguson and I have been a psychotherapist for over twenty years. I am passionate about helping people heal and grow. I believe when we are given the proper "container" or safe space, we are more likely to be able to access our inner knowing that can potentially lead to deep healing. I like to work with individuals who are wanting help navigating relationship issues, life transitions, grief, and/or trauma. In addition, I work with people who are dealing with spiritual issues such as religious trauma, deconstruction of faith, deconversion an/or spiritual abuse.
Hello! My name is Tammy Ferguson and I have been a psychotherapist for over twenty years. I am passionate about helping people heal and grow. I believe when we are given the proper "container" or safe space, we are more likely to be able to access our inner knowing that can potentially lead to deep healing. I like to work with individuals who are wanting help navigating relationship issues, life transitions, grief, and/or trauma. In addition, I work with people who are dealing with spiritual issues such as religious trauma, deconstruction of faith, deconversion an/or spiritual abuse.
(253) 364-1709 View (253) 364-1709
Photo of Joe Njoroge, Clinical Social Work/Therapist, LSWAIC, MSW, MHP
Joe Njoroge
Clinical Social Work/Therapist, LSWAIC, MSW, MHP
1 Endorsed
Tacoma, WA 98401
My practice is centered on providing compassionate, evidence-based therapy that empowers you to achieve your goals and live a fulfilling life. I am proud to assist you with individual therapy, family therapy, art therapy, depression, anxiety and stress management.
My practice is centered on providing compassionate, evidence-based therapy that empowers you to achieve your goals and live a fulfilling life. I am proud to assist you with individual therapy, family therapy, art therapy, depression, anxiety and stress management.
(253) 352-4842 View (253) 352-4842
Photo of Qiwen Jin, Licensed Mental Health Counselor Associate , LMHCA
Qiwen Jin
Licensed Mental Health Counselor Associate , LMHCA
1 Endorsed
Tacoma, WA 98401
Life can feel overwhelming when anxiety, depression, or major changes leave you uncertain about the next step. Maybe you’re questioning your identity, navigating complicated relationships, or feeling the weight of expectations from family or culture. You want relief from constant worry and a clearer sense of who you are, but it’s hard to find a space where you can be fully understood, especially if you move between cultures or feel unseen in mainstream settings.
Life can feel overwhelming when anxiety, depression, or major changes leave you uncertain about the next step. Maybe you’re questioning your identity, navigating complicated relationships, or feeling the weight of expectations from family or culture. You want relief from constant worry and a clearer sense of who you are, but it’s hard to find a space where you can be fully understood, especially if you move between cultures or feel unseen in mainstream settings.
(206) 736-3076 View (206) 736-3076
Photo of Apryl Carlington, Counselor, MA, LMHC, MHP, CMHP
Apryl Carlington
Counselor, MA, LMHC, MHP, CMHP
1 Endorsed
Serves Area
The therapeutic relationship should empower an individual to regain ownership of their life, shifting negative self-talk and other impacts of trauma; allowing for holistic healing and growth. It is my hope to actively walk alongside my client as they work to create their peace; ultimately gaining an improvement in positive self-awareness and optimism, with a side of lasting security and emotional health.
The therapeutic relationship should empower an individual to regain ownership of their life, shifting negative self-talk and other impacts of trauma; allowing for holistic healing and growth. It is my hope to actively walk alongside my client as they work to create their peace; ultimately gaining an improvement in positive self-awareness and optimism, with a side of lasting security and emotional health.
(360) 625-6911 View (360) 625-6911
Photo of Brittany Steffen, Marriage & Family Therapist, MS, LMFT, AASECT
Brittany Steffen
Marriage & Family Therapist, MS, LMFT, AASECT
39 Endorsed
Serves Area
Accepting new clients! I work with anyone who is feeling stuck in their life- helping them feel seen, heard, and understood, as we approach problems with curiosity and empathy. While we can't control what happens to us, we can control how we respond- and therapy is the best way to get all the tools you need to respond to life's ups and downs. If you're motivated and engaged in the process, therapy can give you the set of tools you need to improve (or completely change) your life. My background includes in-depth therapeutic training, 12 years of experience as a therapist, as well as 7 years of supervising associate therapists.
Accepting new clients! I work with anyone who is feeling stuck in their life- helping them feel seen, heard, and understood, as we approach problems with curiosity and empathy. While we can't control what happens to us, we can control how we respond- and therapy is the best way to get all the tools you need to respond to life's ups and downs. If you're motivated and engaged in the process, therapy can give you the set of tools you need to improve (or completely change) your life. My background includes in-depth therapeutic training, 12 years of experience as a therapist, as well as 7 years of supervising associate therapists.
(206) 535-1787 View (206) 535-1787
Photo of Lucy Porter, Pre-Licensed Professional
Lucy Porter
Pre-Licensed Professional
Serves Area
Hi, I’m Lucy. Thank you for being here — everyone who seeks therapy has their own, important reason. You might be dealing with anxiety, unresolved trauma, people-pleasing, or a sense of hopelessness. Maybe you’re struggling to connect—in your relationship or within yourself. My role as a therapist is to help you identify, explore and access all the paths available to you—whether you’re seeking change, acceptance, or both.
Hi, I’m Lucy. Thank you for being here — everyone who seeks therapy has their own, important reason. You might be dealing with anxiety, unresolved trauma, people-pleasing, or a sense of hopelessness. Maybe you’re struggling to connect—in your relationship or within yourself. My role as a therapist is to help you identify, explore and access all the paths available to you—whether you’re seeking change, acceptance, or both.
(206) 207-5404 View (206) 207-5404
Photo of Kristi Neubauer, Counselor, MA, LMHCA
Kristi Neubauer
Counselor, MA, LMHCA
Serves Area
Being neurodivergent, especially when you have gone much of your life not knowing it, can leave you feeling broken, confused, and lonely. For many this means struggling with anxiety, depression, trauma, disordered eating, and other symptoms as a result of masking and living in a world not designed for you. You’re sensitive and curious and you desire increased understanding of yourself and your experiences in order to move through the world more confidently, authentically, and regulated. Together we will explore your unique needs, hopes, and struggles, and work to get you closer to the life you want.
Being neurodivergent, especially when you have gone much of your life not knowing it, can leave you feeling broken, confused, and lonely. For many this means struggling with anxiety, depression, trauma, disordered eating, and other symptoms as a result of masking and living in a world not designed for you. You’re sensitive and curious and you desire increased understanding of yourself and your experiences in order to move through the world more confidently, authentically, and regulated. Together we will explore your unique needs, hopes, and struggles, and work to get you closer to the life you want.
(425) 629-0733 View (425) 629-0733
Photo of Todd Wilson, Social Worker Associate, LICASW, MSW, BSW
Todd Wilson
Social Worker Associate, LICASW, MSW, BSW
1 Endorsed
Serves Area
Hello, I am accepting new clients! Seasonal changes got you feeling down, or trauma experiences keep you triggered, and you need to process this with a trusting therapist strength-based and solution-focused, based on your goals. As someone who has experienced physical and emotional trauma, I combine my knowledge with life experiences as a therapist. I work with you to provide the tools needed to heal, grow and thrive. Together, we make goals while working through challenges and emotions with empathy and understanding. I see teens and adults specifically, using a wide variety of therapies based on your needs currently and the future.
Hello, I am accepting new clients! Seasonal changes got you feeling down, or trauma experiences keep you triggered, and you need to process this with a trusting therapist strength-based and solution-focused, based on your goals. As someone who has experienced physical and emotional trauma, I combine my knowledge with life experiences as a therapist. I work with you to provide the tools needed to heal, grow and thrive. Together, we make goals while working through challenges and emotions with empathy and understanding. I see teens and adults specifically, using a wide variety of therapies based on your needs currently and the future.
(253) 518-3476 View (253) 518-3476
Photo of Issy Kleiman, Marriage & Family Therapist, MA, LMFT, AAMFT, CD
Issy Kleiman
Marriage & Family Therapist, MA, LMFT, AAMFT, CD
4 Endorsed
Serves Area
Accepting New Clients for Therapy & Medication Management! I know how critical finding the right provider is for your mental health journey and I recognize how hard it is to take the first step. You've got this. My mission as Clinical Director is to provide vital support to those seeking top-tier mental healthcare. I empower my clients to "go within" and gain profound insights into their strengths and weaknesses while developing effective coping mechanisms and communication skills. However, life often presents us with unexpected challenges, leaving us feeling unprepared. Message me to connect today!
Accepting New Clients for Therapy & Medication Management! I know how critical finding the right provider is for your mental health journey and I recognize how hard it is to take the first step. You've got this. My mission as Clinical Director is to provide vital support to those seeking top-tier mental healthcare. I empower my clients to "go within" and gain profound insights into their strengths and weaknesses while developing effective coping mechanisms and communication skills. However, life often presents us with unexpected challenges, leaving us feeling unprepared. Message me to connect today!
(206) 745-4691 View (206) 745-4691
Photo of Susan M Ross - Susan Ross & Associates, Clinical Social Work/Therapist, LICSW
Susan Ross & Associates
Clinical Social Work/Therapist, LICSW
Serves Area
Maybe you’ve just read “The Body Keeps the Score,” and are curious about trauma treatment. Possibly you feel overwhelmed. Addictions may have added to the mix. Shame, guilt, and suffering interfere with the life you imagine. I get it. My treatment approach is designed to help you release your restrictive heaviness and wounds in a timely manner. I offer neurofeedback and EMDR as well as talk therapy. When clients are offered these methods together, breakthroughs happen. We use cutting edge neuroscience with heart-centered therapy to help your brain and body align. Our treatment effectively works with all of you.
Maybe you’ve just read “The Body Keeps the Score,” and are curious about trauma treatment. Possibly you feel overwhelmed. Addictions may have added to the mix. Shame, guilt, and suffering interfere with the life you imagine. I get it. My treatment approach is designed to help you release your restrictive heaviness and wounds in a timely manner. I offer neurofeedback and EMDR as well as talk therapy. When clients are offered these methods together, breakthroughs happen. We use cutting edge neuroscience with heart-centered therapy to help your brain and body align. Our treatment effectively works with all of you.
(206) 489-3508 View (206) 489-3508
Photo of Kira Mogue, Counselor, MA, LMHC, LPC
Kira Mogue
Counselor, MA, LMHC, LPC
Serves Area
Healing happens through experience, and having a consistent, non-judgmental ear can help you see things in a new light. Together we may talk, move, create and explore your feelings. I will guide you through your depths so that you can reconnect to the source, get to know yourself, and come to terms with the past. Maybe you've hit a wall with talk therapy. Perhaps you want to be more present, bolster your own practice, or stop engaging in patterns that cause you pain. I approach you as a human being and help you grow into a fuller version of yourself.
Healing happens through experience, and having a consistent, non-judgmental ear can help you see things in a new light. Together we may talk, move, create and explore your feelings. I will guide you through your depths so that you can reconnect to the source, get to know yourself, and come to terms with the past. Maybe you've hit a wall with talk therapy. Perhaps you want to be more present, bolster your own practice, or stop engaging in patterns that cause you pain. I approach you as a human being and help you grow into a fuller version of yourself.
(206) 887-9312 View (206) 887-9312
Photo of Misha Speck, Counselor, LMHCA
Misha Speck
Counselor, LMHCA
2 Endorsed
Serves Area
I enjoy working with people within the LGBTQ+ community, specifically people in early adulthood. I love working with first generation Americans and learning about the experiences growing up as a third culture kid. My ideal client is someone seeking support around their experiences, identity, and where they see themselves in the world, a common theme among younger LGBTQ adults. I love working with clients who feel in conflict or "out of step" with the world, as I strongly believe pressure to conform and "fit in" are often ways in which marginalized experiences are devalued.
I enjoy working with people within the LGBTQ+ community, specifically people in early adulthood. I love working with first generation Americans and learning about the experiences growing up as a third culture kid. My ideal client is someone seeking support around their experiences, identity, and where they see themselves in the world, a common theme among younger LGBTQ adults. I love working with clients who feel in conflict or "out of step" with the world, as I strongly believe pressure to conform and "fit in" are often ways in which marginalized experiences are devalued.
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Photo of Leo Lowe, Licensed Mental Health Counselor, MS, LMHC
Leo Lowe
Licensed Mental Health Counselor, MS, LMHC
2 Endorsed
Serves Area
You've felt different your entire life. You never felt like you fit in with what was expected. Because of this you never really got to learn who you really are. You never had a chance to create meaning, joy, and grow into your potential. Often you feel responsible for the demands and needs of others. You are exhausted and it feels like you have to fight every day just for others to see and recognize you for the person you are. You just want to be able to see yourself as who you truly are.
You've felt different your entire life. You never felt like you fit in with what was expected. Because of this you never really got to learn who you really are. You never had a chance to create meaning, joy, and grow into your potential. Often you feel responsible for the demands and needs of others. You are exhausted and it feels like you have to fight every day just for others to see and recognize you for the person you are. You just want to be able to see yourself as who you truly are.
(509) 463-5737 View (509) 463-5737
Photo of Sarah J Kyle, Marriage & Family Therapist, MA, LMFT
Sarah J Kyle
Marriage & Family Therapist, MA, LMFT
7 Endorsed
Serves Area
I specialize in couples therapy, where I help partners work toward relational repair after infidelity, betrayal, or ongoing conflict. I also work with individuals who want to work through attachment and relationship issues, identity development, spirituality, trauma, anxiety, and depression. Therapy is work that asks a great deal from us, but it also holds potential for meaningful change: to awaken to your own life, to make strides toward repairing broken bonds, and to imagine new possibilities and new ways of being, for yourself and for your relationships.
I specialize in couples therapy, where I help partners work toward relational repair after infidelity, betrayal, or ongoing conflict. I also work with individuals who want to work through attachment and relationship issues, identity development, spirituality, trauma, anxiety, and depression. Therapy is work that asks a great deal from us, but it also holds potential for meaningful change: to awaken to your own life, to make strides toward repairing broken bonds, and to imagine new possibilities and new ways of being, for yourself and for your relationships.
(206) 339-4277 View (206) 339-4277
Neil Kirkpatrick
Psychologist, PhD
1 Endorsed
Serves Area
I believe that every person deserves the highest quality of care and that treatment decisions should be based on more than just opinion. I make an ongoing effort to keep up with the latest scientific research and offer only scientifically evaluated treatments, known as Evidence Based Practices (EBP). I place a high value on developing a warm, collaborative relationship between client and therapist and implementing EBPs in a way that honors the values and preferences of the client and family. I believe that well researched treatments provided by a skilled and engaging therapist will result in the most effective treatments.
I believe that every person deserves the highest quality of care and that treatment decisions should be based on more than just opinion. I make an ongoing effort to keep up with the latest scientific research and offer only scientifically evaluated treatments, known as Evidence Based Practices (EBP). I place a high value on developing a warm, collaborative relationship between client and therapist and implementing EBPs in a way that honors the values and preferences of the client and family. I believe that well researched treatments provided by a skilled and engaging therapist will result in the most effective treatments.
(253) 299-8298 View (253) 299-8298
Photo of Karina Johnson, Clinical Social Work/Therapist, MSW, LICSW
Karina Johnson
Clinical Social Work/Therapist, MSW, LICSW
Serves Area
'Hope' (noun): To desire with expectation of obtainment or fulfillment; to expect with confidence. What do you hope for? I think deep down we all hope for similar things; peace, joy, love, excitement, and fulfilling relationships. When we experience depression, anxiety, trauma, stressful life circumstances, parenting challenges or relationship difficulties we can end up feeling hopeless and alone. My goal as a therapist is to help you rediscover your hopes and dreams and make a plan to achieve them! I will do this by providing a safe space to process what has gotten in your way and helping you identify what changes can be made.
'Hope' (noun): To desire with expectation of obtainment or fulfillment; to expect with confidence. What do you hope for? I think deep down we all hope for similar things; peace, joy, love, excitement, and fulfilling relationships. When we experience depression, anxiety, trauma, stressful life circumstances, parenting challenges or relationship difficulties we can end up feeling hopeless and alone. My goal as a therapist is to help you rediscover your hopes and dreams and make a plan to achieve them! I will do this by providing a safe space to process what has gotten in your way and helping you identify what changes can be made.
(253) 367-3147 View (253) 367-3147
Photo of Leah Cantor, Licensed Mental Health Counselor Associate, LMHCA, MEd
Leah Cantor
Licensed Mental Health Counselor Associate, LMHCA, MEd
1 Endorsed
Serves Area
My approach to therapy is authentic, warm, and honest. I use a collaborative and non-judgmental approach with my clients to support them in discovering their goals for therapy, finding new perspectives, and disrupting harmful patterns that may be showing up. I draw from a number of evidence-based treatment styles and tailor my approach to each individual but am inherently person-centered and strengths-based.
My approach to therapy is authentic, warm, and honest. I use a collaborative and non-judgmental approach with my clients to support them in discovering their goals for therapy, finding new perspectives, and disrupting harmful patterns that may be showing up. I draw from a number of evidence-based treatment styles and tailor my approach to each individual but am inherently person-centered and strengths-based.
(425) 437-3301 View (425) 437-3301
Photo of Mayra Toscano Reveles, Marriage & Family Therapist Associate, LMFTA
Mayra Toscano Reveles
Marriage & Family Therapist Associate, LMFTA
1 Endorsed
Serves Area
Hola, I’m Mayra (she/her/ella), a couple and family therapist and founder of Jardín Wellness Therapy. I specialize in working with (adult) children of immigrant families, BIPOC individuals, queer and trans folks, and neurodiverse individuals and families. Some areas of focus include cultural and racial identity exploration, trauma, family-of-origin and childhood issues, grief & loss, and life transitions. In our work together, we will consider your intersecting identities and experiences. Additionally, we will integrate cultural traditions and values that are important to you.
Hola, I’m Mayra (she/her/ella), a couple and family therapist and founder of Jardín Wellness Therapy. I specialize in working with (adult) children of immigrant families, BIPOC individuals, queer and trans folks, and neurodiverse individuals and families. Some areas of focus include cultural and racial identity exploration, trauma, family-of-origin and childhood issues, grief & loss, and life transitions. In our work together, we will consider your intersecting identities and experiences. Additionally, we will integrate cultural traditions and values that are important to you.
(425) 434-9260 View (425) 434-9260
Photo of Adam David Kaufman, Counselor, MSEd, LMHCA
Adam David Kaufman
Counselor, MSEd, LMHCA
1 Endorsed
Serves Area
Currently accepting new clients. Adam Kaufman is a Licensed Mental Health Counselor Associate with a Master of Science in Education (MSEd) in Mental Health Counseling from CUNY Hunter College. His therapeutic approach blends depth-oriented psychodynamic principles with the structured, skills-based methods of CBT, allowing him to flexibly adapt to each client’s unique needs. With experience in addressing a variety of mental health challenges—such as depression, anxiety, stress, trauma, and relationship issues—Adam provides a safe and supportive environment for meaningful exploration and growth.
Currently accepting new clients. Adam Kaufman is a Licensed Mental Health Counselor Associate with a Master of Science in Education (MSEd) in Mental Health Counseling from CUNY Hunter College. His therapeutic approach blends depth-oriented psychodynamic principles with the structured, skills-based methods of CBT, allowing him to flexibly adapt to each client’s unique needs. With experience in addressing a variety of mental health challenges—such as depression, anxiety, stress, trauma, and relationship issues—Adam provides a safe and supportive environment for meaningful exploration and growth.
(253) 400-2184 View (253) 400-2184

See more therapy options for 98401

How does your Therapist compare?

Number of Therapists in 98401

200+

Average cost per session

$150

Therapists in 98401 who prioritize treating:

94% Anxiety
85% Depression
78% Relationship Issues
78% Trauma and PTSD
73% Self Esteem
72% Stress
68% Life Transitions

Average years in practice

7 Years

Top 3 insurances accepted

81% Premera Blue Cross
75% Aetna
74% Regence

How Therapists in 98401 see their clients

61% Online Only
39% In Person and Online

Gender breakdown

70% Female
21% Male
9% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 98401?

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.