Therapists in 99223

Photo of Raymond Lester, Clinical Social Work/Therapist, MSW, LICSW, LCSW
Raymond Lester
Clinical Social Work/Therapist, MSW, LICSW, LCSW
1 Endorsed
Spokane, WA 99223
My ideal clients are adults, teens, or couples feeling stuck, overwhelmed, or disconnected. They may struggle with anxiety, low mood, relationships, or self-doubt and want to find clarity, balance, and purpose. They value growth and are ready to do the work to create meaningful change. Together, we build insight, strengthen confidence, and develop practical tools for a more grounded and fulfilling life.
My ideal clients are adults, teens, or couples feeling stuck, overwhelmed, or disconnected. They may struggle with anxiety, low mood, relationships, or self-doubt and want to find clarity, balance, and purpose. They value growth and are ready to do the work to create meaningful change. Together, we build insight, strengthen confidence, and develop practical tools for a more grounded and fulfilling life.
(509) 652-2188 View (509) 652-2188
Photo of Edward Deatherage, Psychologist, LCP
Edward Deatherage
Psychologist, LCP
Spokane, WA 99223
Edward Deatherage, Ph.D. Received his Doctorate in Clinical Psychology from the United States International University in San Diego, CA. A Masters Degree in Psychology at Pepperdine University, Los Angeles, CA. A bachelor's Degree in psychology at Loma Linda University, Loma Linda, CA. Clinical Psychology Internship at USAF Medical Center, Wright-Patterson AFB, Ohio
Edward Deatherage, Ph.D. Received his Doctorate in Clinical Psychology from the United States International University in San Diego, CA. A Masters Degree in Psychology at Pepperdine University, Los Angeles, CA. A bachelor's Degree in psychology at Loma Linda University, Loma Linda, CA. Clinical Psychology Internship at USAF Medical Center, Wright-Patterson AFB, Ohio
(509) 471-4523 View (509) 471-4523
Photo of James Anacker, Counselor, MA, NCC, LMHC
James Anacker
Counselor, MA, NCC, LMHC
Spokane, WA 99223
If you are struggling with depression or anxiety then I can help you. I also work with couples who want to fight less. Thirdly, I specialize in helping those deconstructing from high control and unhealthy religions. And finally, have you been traumatized? I am an advanced EMDR provider. There are a lot of choices out there for your therapist. If you work with me, then you will find someone who is down to earth and who bases their practices and techniques in research not speculation. I want to motivate you to change and show you your individualized path forward. You will feel better and your relationships will be happier again.
If you are struggling with depression or anxiety then I can help you. I also work with couples who want to fight less. Thirdly, I specialize in helping those deconstructing from high control and unhealthy religions. And finally, have you been traumatized? I am an advanced EMDR provider. There are a lot of choices out there for your therapist. If you work with me, then you will find someone who is down to earth and who bases their practices and techniques in research not speculation. I want to motivate you to change and show you your individualized path forward. You will feel better and your relationships will be happier again.
(509) 233-4974 View (509) 233-4974
Photo of Danielle Allen, Marriage & Family Therapist, LMHC, LMFT, CMHS
Danielle Allen
Marriage & Family Therapist, LMHC, LMFT, CMHS
Spokane, WA 99223
Parenting is hard. Like, really REALLY hard. I know we've all been there....feeling isolated, alone, and like we are failing ourselves and our children. But if you are here now, reading this, you are actively looking for new ways to parent and interact with your children. And that's huge! We know through decades of research that caregiver/parent self-reflection is the single greatest catalyst for positive change, in addition to feeling connected to and supported by others. That is where Circle of Security Parenting comes in! Learning how to identify and meet the emotional needs of our children, while staying balanced ourselves.
Parenting is hard. Like, really REALLY hard. I know we've all been there....feeling isolated, alone, and like we are failing ourselves and our children. But if you are here now, reading this, you are actively looking for new ways to parent and interact with your children. And that's huge! We know through decades of research that caregiver/parent self-reflection is the single greatest catalyst for positive change, in addition to feeling connected to and supported by others. That is where Circle of Security Parenting comes in! Learning how to identify and meet the emotional needs of our children, while staying balanced ourselves.
(509) 637-7235 View (509) 637-7235
Photo of Kayla Hicks, Counselor, MSW, LMHC
Kayla Hicks
Counselor, MSW, LMHC
2 Endorsed
Spokane, WA 99223
You're tired of feeling stressed, burntout and overwhelmed. You're ready to put the past behind you and feel grounded, energetic and content. I'm passionate about treating the whole person, which starts with good mental health. My practice is designed to encompass your entire journey with compassion, education, and strategies to achieve your optimal wellness goals. Collaboration on your needs and strengths is the goal of treatment to achieve your best outcomes. Whether its the past or present barriers getting in your way, I'm ready to help you unlock your full potential.
You're tired of feeling stressed, burntout and overwhelmed. You're ready to put the past behind you and feel grounded, energetic and content. I'm passionate about treating the whole person, which starts with good mental health. My practice is designed to encompass your entire journey with compassion, education, and strategies to achieve your optimal wellness goals. Collaboration on your needs and strengths is the goal of treatment to achieve your best outcomes. Whether its the past or present barriers getting in your way, I'm ready to help you unlock your full potential.
(509) 359-1424 View (509) 359-1424
Photo of Nicole Prasch, Clinical Social Work/Therapist, LSWAIC
Nicole Prasch
Clinical Social Work/Therapist, LSWAIC
5 Endorsed
Spokane, WA 99223
Whatever brings you here, you deserve compassion and support as you navigate it. Are you carrying anxiety, depression, stress, or the weight of past experiences that feel hard to shake? Maybe you’re tired of feeling overwhelmed or disconnected and are looking for a place to sort through what’s happening inside. You may be hoping for clarity, steadiness, or simply a space where your emotions are understood and taken seriously. You deserve support and understanding. Your immense courage will be respected and honored. Your vision for life is valid and good. We will work towards that life you envision. You can heal and be happy again.
Whatever brings you here, you deserve compassion and support as you navigate it. Are you carrying anxiety, depression, stress, or the weight of past experiences that feel hard to shake? Maybe you’re tired of feeling overwhelmed or disconnected and are looking for a place to sort through what’s happening inside. You may be hoping for clarity, steadiness, or simply a space where your emotions are understood and taken seriously. You deserve support and understanding. Your immense courage will be respected and honored. Your vision for life is valid and good. We will work towards that life you envision. You can heal and be happy again.
(509) 800-5752 View (509) 800-5752
Photo of Kathy Jo M Avery, Clinical Social Work/Therapist, BSN, MA, CHT
Kathy Jo M Avery
Clinical Social Work/Therapist, BSN, MA, CHT
Spokane, WA 99223
Are you tried of feeling anxious, afraid, depressed, overwhelmed or haunted by your past such as abuse and trauma? With good coping/life skills, trauma recovery and operating in harmony with all 3 minds you possess, you can do ANYTHING! Consider hypnotherapy or counseling done in a heartfelt, client centered, strengths perspective. YOU are more powerful than you know! Call me at (509) 448-5660.
Are you tried of feeling anxious, afraid, depressed, overwhelmed or haunted by your past such as abuse and trauma? With good coping/life skills, trauma recovery and operating in harmony with all 3 minds you possess, you can do ANYTHING! Consider hypnotherapy or counseling done in a heartfelt, client centered, strengths perspective. YOU are more powerful than you know! Call me at (509) 448-5660.
(509) 731-4966 View (509) 731-4966
Photo of Ginger M Johnson - Relationship Advantage, MA
Relationship Advantage
Verified Verified
Spokane, WA 99223
Are issues like communication around money, sex, or intimacy creating distance in your relationship? Do you feel like you are drifting apart? Has there been a violation of trust? These are the challenges many relationships face and Relationship Advantage provides opportunity to develop skills to not just cope but grow! Give us a call!
Are issues like communication around money, sex, or intimacy creating distance in your relationship? Do you feel like you are drifting apart? Has there been a violation of trust? These are the challenges many relationships face and Relationship Advantage provides opportunity to develop skills to not just cope but grow! Give us a call!
(509) 213-0821 View (509) 213-0821
Photo of McKenna Janae Dean-Davis, Clinical Social Work/Therapist, MSW, LICSW
McKenna Janae Dean-Davis
Clinical Social Work/Therapist, MSW, LICSW
2 Endorsed
Spokane, WA 99223
Since I was young mental health was always a topic in my home, so becoming a 3rd generation therapist was not surprising to those around me. When I realized prioritizing self-care, setting boundaries, & naming feelings were not normal dinner table topics, I wanted to change that. I am passionate about destigmatizing mental health and making tools more accessible. My goal is to empower my clients to use their innate gifts and strengths to conquer anything that comes their way. Taking the first step is brave, but continuing to show up and work towards your goals is courageous.
Since I was young mental health was always a topic in my home, so becoming a 3rd generation therapist was not surprising to those around me. When I realized prioritizing self-care, setting boundaries, & naming feelings were not normal dinner table topics, I wanted to change that. I am passionate about destigmatizing mental health and making tools more accessible. My goal is to empower my clients to use their innate gifts and strengths to conquer anything that comes their way. Taking the first step is brave, but continuing to show up and work towards your goals is courageous.
(509) 571-2548 View (509) 571-2548
Photo of Bobbi Kizer, Psychologist, PhD
Bobbi Kizer
Psychologist, PhD
Spokane, WA 99223
I recently opened an in-person office in Portland, Oregon; continuing to take new and ongoing virtual patients in Washington. Louisiana, and throughout Oregon. I believe that healing can happen through the process of empathic and supportive counseling. I work with mood issues, personality disorders, trauma, grief, substance use and more. I utilize a culturally sensitive and holistic psychodynamic style of therapy. This approach encourages development in all areas of life, and pays special attention to unconscious factors, childhood upbringing, trauma, and cultural identity (race, religion, sexuality, gender, disability, etc).
I recently opened an in-person office in Portland, Oregon; continuing to take new and ongoing virtual patients in Washington. Louisiana, and throughout Oregon. I believe that healing can happen through the process of empathic and supportive counseling. I work with mood issues, personality disorders, trauma, grief, substance use and more. I utilize a culturally sensitive and holistic psychodynamic style of therapy. This approach encourages development in all areas of life, and pays special attention to unconscious factors, childhood upbringing, trauma, and cultural identity (race, religion, sexuality, gender, disability, etc).
(504) 226-7035 View (504) 226-7035
Photo of Victoria Carding, Clinical Social Work/Therapist, LICSW, MSW
Victoria Carding
Clinical Social Work/Therapist, LICSW, MSW
1 Endorsed
Spokane, WA 99223
Hello, and welcome. I’m glad you’re here—it takes courage to reach out for support. Together, we’ll explore what’s keeping you feeling stuck and find practical ways to create more balance and satisfaction in your life. My style is genuine, curious, and down-to-earth, with room for humor when it helps.
Hello, and welcome. I’m glad you’re here—it takes courage to reach out for support. Together, we’ll explore what’s keeping you feeling stuck and find practical ways to create more balance and satisfaction in your life. My style is genuine, curious, and down-to-earth, with room for humor when it helps.
(509) 269-2304 View (509) 269-2304
Photo of A Denise Ashcroft Ms, Counselor, MS, OrgLead, Art, Therapy
A Denise Ashcroft Ms
Counselor, MS, OrgLead, Art, Therapy
Spokane, WA 99223
You’ve spent your life trying to ‘fit in’, MASKING your energy, organizing your CHAOS, managing your ANXIETY & wondering why it always feels harder than it should. You’re not “too much, lazy, disorganized.” You’re a high-achieving neurodivergent person trying to thrive in a neurotypical world. I help adults, partners & parents of (ADHD, Anxiety, NeuroAtypical) rebuild confidence, release shame, & navigate life with greater ease & self-trust. Therapy helps you understand your wiring, stop fighting your brain, and start working with it — so you can THRIVE, not just SURVIVE. Therapy isn’t about fixing you — it’s about FREEING you!
You’ve spent your life trying to ‘fit in’, MASKING your energy, organizing your CHAOS, managing your ANXIETY & wondering why it always feels harder than it should. You’re not “too much, lazy, disorganized.” You’re a high-achieving neurodivergent person trying to thrive in a neurotypical world. I help adults, partners & parents of (ADHD, Anxiety, NeuroAtypical) rebuild confidence, release shame, & navigate life with greater ease & self-trust. Therapy helps you understand your wiring, stop fighting your brain, and start working with it — so you can THRIVE, not just SURVIVE. Therapy isn’t about fixing you — it’s about FREEING you!
(206) 202-8098 View (206) 202-8098
Photo of Lindy Turner, Marriage & Family Therapist, MA, LMFT
Lindy Turner
Marriage & Family Therapist, MA, LMFT
Serves Area
Life can take many a difficult turn. A sudden tragedy, abrupt life change, or physical loss can leave us not knowing how to handle the emotional distress. Sometimes we find ourselves struggling to cope in a relationship that once was beautiful. A new couple struggles to lovingly blend their families. The anxiety and depression we feel because of past neglect, abuse, or trauma can become overwhelming even years after the fact. Some of us feel like we have always been broken. Good news! There is healing. There is hope. There is a brighter tomorrow with a new, joyful, and positive outlook on life.
Life can take many a difficult turn. A sudden tragedy, abrupt life change, or physical loss can leave us not knowing how to handle the emotional distress. Sometimes we find ourselves struggling to cope in a relationship that once was beautiful. A new couple struggles to lovingly blend their families. The anxiety and depression we feel because of past neglect, abuse, or trauma can become overwhelming even years after the fact. Some of us feel like we have always been broken. Good news! There is healing. There is hope. There is a brighter tomorrow with a new, joyful, and positive outlook on life.
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Photo of Mariann “Annie” Kinkle, Marriage & Family Therapist Associate, MA, LMFTA
Mariann “Annie” Kinkle
Marriage & Family Therapist Associate, MA, LMFTA
1 Endorsed
Serves Area
My approach is person-centered and tailored to your unique needs. I support clients in building confidence and emotional strength while navigating life transitions, relationship challenges, anxiety, depression, and healing from past trauma in a supportive, collaborative space.
My approach is person-centered and tailored to your unique needs. I support clients in building confidence and emotional strength while navigating life transitions, relationship challenges, anxiety, depression, and healing from past trauma in a supportive, collaborative space.
(509) 341-0723 View (509) 341-0723
Photo of Max Manix, Counselor, LMHC, NCC, MA
Max Manix
Counselor, LMHC, NCC, MA
Serves Area
I am passionate about Sports Performance Therapy and bring both training and experience in applying sports psychology skills with athletes of all ages and competitive levels. My focus is on helping athletes identify, address, and overcome struggles related to performance and overall mental health. By drawing on motivators such as meaning and purpose, I aim to help clients not only perform at their best in sport but also thrive in relationships and everyday life. I provide guidance in relaxation techniques, self-talk, and the development of coping tools to manage the pressures of competition, relationships, and life challenges.
I am passionate about Sports Performance Therapy and bring both training and experience in applying sports psychology skills with athletes of all ages and competitive levels. My focus is on helping athletes identify, address, and overcome struggles related to performance and overall mental health. By drawing on motivators such as meaning and purpose, I aim to help clients not only perform at their best in sport but also thrive in relationships and everyday life. I provide guidance in relaxation techniques, self-talk, and the development of coping tools to manage the pressures of competition, relationships, and life challenges.
(509) 800-5365 View (509) 800-5365
Photo of Jina Doggett, Drug & Alcohol Counselor, SUDP
Jina Doggett
Drug & Alcohol Counselor, SUDP
Serves Area
Are you concerned about your current relationship with substances but finding it difficult to manage on your own? Achieving long-term sobriety is challenging, but our program is designed to provide the structure, support, and tools needed to build and maintain a sober lifestyle. We offer both Partial Hospitalization (PHP), Intensive Outpatient (IOP), and outpatient treatment programs that include group and individual therapy for adults affected by substance use disorders. Participation in both group and individual sessions is an essential part of the recovery process.
Are you concerned about your current relationship with substances but finding it difficult to manage on your own? Achieving long-term sobriety is challenging, but our program is designed to provide the structure, support, and tools needed to build and maintain a sober lifestyle. We offer both Partial Hospitalization (PHP), Intensive Outpatient (IOP), and outpatient treatment programs that include group and individual therapy for adults affected by substance use disorders. Participation in both group and individual sessions is an essential part of the recovery process.
(509) 404-0278 View (509) 404-0278
Photo of Lyndsey Klein, Pre-Licensed Professional
Lyndsey Klein
Pre-Licensed Professional
2 Endorsed
Serves Area
Hello, I’m Lyndsey Klein and I am a graduate student at Gonzaga University working towards my Master's degree in Marriage and Family Therapy. My passion lies in helping clients build healthier relationships, deepen self-understanding, and create lives that feel authentic and fulfilling. Being a human can be challenging, and sometimes we all need an extra hand, or even a life jacket to stay afloat. My goal is to help you not just survive but thrive - creating the life you envision for yourself.
Hello, I’m Lyndsey Klein and I am a graduate student at Gonzaga University working towards my Master's degree in Marriage and Family Therapy. My passion lies in helping clients build healthier relationships, deepen self-understanding, and create lives that feel authentic and fulfilling. Being a human can be challenging, and sometimes we all need an extra hand, or even a life jacket to stay afloat. My goal is to help you not just survive but thrive - creating the life you envision for yourself.
(509) 210-6793 View (509) 210-6793
Photo of Justin Van Elsberg, Counselor, LMHCA
Justin Van Elsberg
Counselor, LMHCA
2 Endorsed
Serves Area
Welcome. My name is Justin Van Elsberg, and I work with individuals, couples, and communities who are navigating life complexities of all kinds and supporting their movement toward something that feels more whole. If you are encountering grief, conflict, alienation, transition, longing, fear, or uncertainty, I am honored to walk beside you and provide the therapeutic space for what is needed. My approach is rooted in relationship. This includes learning about your world and the many systems you are a part of: family, culture, body, imagination, environment, and the future you are growing into.
Welcome. My name is Justin Van Elsberg, and I work with individuals, couples, and communities who are navigating life complexities of all kinds and supporting their movement toward something that feels more whole. If you are encountering grief, conflict, alienation, transition, longing, fear, or uncertainty, I am honored to walk beside you and provide the therapeutic space for what is needed. My approach is rooted in relationship. This includes learning about your world and the many systems you are a part of: family, culture, body, imagination, environment, and the future you are growing into.
(509) 285-9599 View (509) 285-9599
Photo of Claire Roman, Mental Health Counselor, LMHC
Claire Roman
Mental Health Counselor, LMHC
1 Endorsed
Serves Area
I am passionate about relational and trauma healing and hold a trauma-informed, attachment- centered lens when working with individuals or families. In therapy, I aim to help clients identify, understand, and heal emotional wounds. As I get to know you and your needs more, I integrate techniques from several counseling theories to best support your therapeutic goals. My therapeutic approaches pull from CBT, EFT, IFS techniques, play therapy and attachment theory. I have specialized experience working with children and families in the foster and adoption system.
I am passionate about relational and trauma healing and hold a trauma-informed, attachment- centered lens when working with individuals or families. In therapy, I aim to help clients identify, understand, and heal emotional wounds. As I get to know you and your needs more, I integrate techniques from several counseling theories to best support your therapeutic goals. My therapeutic approaches pull from CBT, EFT, IFS techniques, play therapy and attachment theory. I have specialized experience working with children and families in the foster and adoption system.
(509) 287-4559 View (509) 287-4559
Photo of Kimberly Brady, Counselor, MS, MHP, LMHC
Kimberly Brady
Counselor, MS, MHP, LMHC
2 Endorsed
Serves Area
I am passionate about working with clients challenged by anxiety, unwanted, intrusive thoughts and fears that prevent them from participating in activities they value, reaching goals, or sustaining satisfying relationships. Clients often come to me when worries have become unmanageable. Anxiety is a life thief, it targets what you value. Often clients find their world has become small, ruled by behaviors they feel driven to do to feel safe. They may have rigid rules, unrealistic expectations or patterns of perfectionism. Some find themselves avoiding situations or people out of fear.
I am passionate about working with clients challenged by anxiety, unwanted, intrusive thoughts and fears that prevent them from participating in activities they value, reaching goals, or sustaining satisfying relationships. Clients often come to me when worries have become unmanageable. Anxiety is a life thief, it targets what you value. Often clients find their world has become small, ruled by behaviors they feel driven to do to feel safe. They may have rigid rules, unrealistic expectations or patterns of perfectionism. Some find themselves avoiding situations or people out of fear.
(509) 260-2890 View (509) 260-2890

See more therapy options for 99223

How does your Therapist compare?

Number of Therapists in 99223

90+

Average cost per session

$150

Therapists in 99223 who prioritize treating:

92% Anxiety
76% Relationship Issues
76% Stress
75% Depression
75% Self Esteem
71% Trauma and PTSD
61% Grief

Average years in practice

13 Years

Top 3 insurances accepted

87% Premera Blue Cross
78% Aetna
74% BlueCross and BlueShield

How Therapists in 99223 see their clients

63% In Person and Online
37% Online Only

Gender breakdown

81% Female
18% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 99223?

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.