Therapists in Northampton, MA

Photo of Alessandra Urbano, Psychologist in Northampton, MA
Alessandra Urbano
Psychologist, PhD, CGP
Verified Verified
Northampton, MA 01060
I’m a licensed psychologist who helps adults of all identities to feel more secure in themselves, satisfied in their relationships, and resilient through uncertainty, change and loss. I specialize in helping: a) those who feel anxious, sensitive, misunderstood, or emotionally overwhelmed to increase comfort with themselves, their feelings and needs, and others; b) individuals/couples/families to develop healthier attachments and change hurtful relational patterns; and c) aspiring and current parents throughout the complex family planning & adjustment process, including grief and loss.
I’m a licensed psychologist who helps adults of all identities to feel more secure in themselves, satisfied in their relationships, and resilient through uncertainty, change and loss. I specialize in helping: a) those who feel anxious, sensitive, misunderstood, or emotionally overwhelmed to increase comfort with themselves, their feelings and needs, and others; b) individuals/couples/families to develop healthier attachments and change hurtful relational patterns; and c) aspiring and current parents throughout the complex family planning & adjustment process, including grief and loss.
(617) 580-3370 View (617) 580-3370
Photo of Robin Weingarten, Clinical Social Work/Therapist in Northampton, MA
Robin Weingarten
Clinical Social Work/Therapist, LICSW
Verified Verified
Northampton, MA 01060  (Online Only)
Not accepting new clients
With curiosity, compassion and creativity, I explore and honor your unique strengths, needs and challenges. Together, we'll develop your goals for change, and work toward them while building your capacity for both self-acceptance and growth. With a focus on understanding and transforming beliefs and behaviors to become more in alignment with your goals, I will guide you to develop a new relationship with your past, enhance your tools and resources to live more fully in the present, and increase your clarity and confidence to create the future you desire.
With curiosity, compassion and creativity, I explore and honor your unique strengths, needs and challenges. Together, we'll develop your goals for change, and work toward them while building your capacity for both self-acceptance and growth. With a focus on understanding and transforming beliefs and behaviors to become more in alignment with your goals, I will guide you to develop a new relationship with your past, enhance your tools and resources to live more fully in the present, and increase your clarity and confidence to create the future you desire.
(413) 372-8133 View (413) 372-8133
Photo of Stephen D Sacco, Clinical Social Work/Therapist in Northampton, MA
Stephen D Sacco
Clinical Social Work/Therapist, LICSW
Verified Verified
Northampton, MA 01060
What is your preferred future? Have you allowed yourself to consider your best hopes and believe that your life can be different? Therapy is an opportunity for you to create and realize your preferred future. There is no one size fits all approach as all individuals have their own specific wants, needs, strengths and barriers. I strive to ensure focus on YOUR specific wants and needs and instill confidence in your capacity to meet them.
What is your preferred future? Have you allowed yourself to consider your best hopes and believe that your life can be different? Therapy is an opportunity for you to create and realize your preferred future. There is no one size fits all approach as all individuals have their own specific wants, needs, strengths and barriers. I strive to ensure focus on YOUR specific wants and needs and instill confidence in your capacity to meet them.
(413) 923-6045 View (413) 923-6045
Photo of Brenda Martin-Tousignant, Psychologist in Northampton, MA
Brenda Martin-Tousignant
Psychologist, PsyD
Verified Verified
Northampton, MA 01060
I’m a licensed psychologist who specializes in women’s and parental mental health. Juggling all the needs of self, children, partners, work, & daily life demands can result in an overwhelming loss of control and losing one’s “self,” which takes a toll on social, physical, & emotional wellbeing. Whether you’re trying to find your new normal after the newest addition to your family, dealing with relationship challenges, experiencing postpartum depression or anxiety, trying to process a traumatic birth or NICU experience, or struggling with grief or family trauma, I’m here to help.
I’m a licensed psychologist who specializes in women’s and parental mental health. Juggling all the needs of self, children, partners, work, & daily life demands can result in an overwhelming loss of control and losing one’s “self,” which takes a toll on social, physical, & emotional wellbeing. Whether you’re trying to find your new normal after the newest addition to your family, dealing with relationship challenges, experiencing postpartum depression or anxiety, trying to process a traumatic birth or NICU experience, or struggling with grief or family trauma, I’m here to help.
(413) 287-1782 View (413) 287-1782
Photo of Peter Pruyn, Counselor in Northampton, MA
Peter Pruyn
Counselor, LMHC, MA, EdM
Verified Verified
Northampton, MA 01060
Looking for a therapist can be challenging. For those looking for the first time, I'd like to offer some thoughts on finding one who's right for you. While credentials and experience have their place, at the end of the day the most important thing is fit. I encourage you to "go with your gut." Do a phone consult. Did they give you space to talk? Did you feel heard? Sometimes what we need is feeling supported by someone who "gets" us. Other times we grow from someone who is able to challenge us in just the right way.
Looking for a therapist can be challenging. For those looking for the first time, I'd like to offer some thoughts on finding one who's right for you. While credentials and experience have their place, at the end of the day the most important thing is fit. I encourage you to "go with your gut." Do a phone consult. Did they give you space to talk? Did you feel heard? Sometimes what we need is feeling supported by someone who "gets" us. Other times we grow from someone who is able to challenge us in just the right way.
(413) 320-4240 View (413) 320-4240
Photo of Dr. Jennifer Bryan, Psychologist in Northampton, MA
Dr. Jennifer Bryan
Psychologist, PhD
Verified Verified
Northampton, MA 01061  (Online Only)
Do you work in PreK-12 Education as a teacher, administrator or staff person? After the past four years of Covid-impacted schooling, do you find yourself depleted, with big questions about what your job has become, the needs of your students, the expectations of parents, and the future of the profession? Perhaps you wonder if anyone really understands what it is like to work in a school today. If this sounds at all like you, I can help.
Do you work in PreK-12 Education as a teacher, administrator or staff person? After the past four years of Covid-impacted schooling, do you find yourself depleted, with big questions about what your job has become, the needs of your students, the expectations of parents, and the future of the profession? Perhaps you wonder if anyone really understands what it is like to work in a school today. If this sounds at all like you, I can help.
(413) 675-5282 View (413) 675-5282
Photo of Joel Coburn, Clinical Social Work/Therapist in Northampton, MA
Joel Coburn
Clinical Social Work/Therapist, LICSW
Verified Verified
2 Endorsed
Northampton, MA 01060
Not accepting new clients
I'm not accepting clients at this time. Best of luck in your search and take good care.
I'm not accepting clients at this time. Best of luck in your search and take good care.
(413) 634-4267 View (413) 634-4267
Photo of Max Ehrnfelt, Clinical Social Work/Therapist in Northampton, MA
Max Ehrnfelt
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Northampton, MA 01060  (Online Only)
Waitlist for new clients
Are you hoping to practice clear and effective communication with others about your wants, needs, or boundaries? Are you thinking about breaking a pattern or stopping a behavior that no longer serves you? Are you searching for a supportive, collaborative space to reflect on your past, to stay grounded in the present, or to explore what you want for your future?
Are you hoping to practice clear and effective communication with others about your wants, needs, or boundaries? Are you thinking about breaking a pattern or stopping a behavior that no longer serves you? Are you searching for a supportive, collaborative space to reflect on your past, to stay grounded in the present, or to explore what you want for your future?
(413) 287-1780 View (413) 287-1780
Photo of Liam Lattrell, Clinical Social Work/Therapist in Northampton, MA
Liam Lattrell
Clinical Social Work/Therapist, LICSW, MSW, MA
Verified Verified
Northampton, MA 01060  (Online Only)
Life can be difficult--sometimes, unnecessarily hard. People do their best to cope with challenges, but often these coping strategies are destructive, hindering our emotional health and interpersonal relations. I specialize in depression, relationship issues, anxiety, and substance and behavioral addictions. Ideally, I can help you find your true self, and through this journey you can begin to discover what you truly deserve in life.
Life can be difficult--sometimes, unnecessarily hard. People do their best to cope with challenges, but often these coping strategies are destructive, hindering our emotional health and interpersonal relations. I specialize in depression, relationship issues, anxiety, and substance and behavioral addictions. Ideally, I can help you find your true self, and through this journey you can begin to discover what you truly deserve in life.
(413) 251-5027 View (413) 251-5027
Photo of Seniors, Adults, Caregivers Illness, Grief, LGBTQ, Clinical Social Work/Therapist in Northampton, MA
Seniors, Adults, Caregivers Illness, Grief, LGBTQ
Clinical Social Work/Therapist, LICSW
Verified Verified
Northampton, MA 01062
You don't have to go it alone. Are you an older adult or the caregiver for a parent or spouse? Struggling to keep your balance while dealing with chronic illness or pain? Have you lost a loved one or had a major life change? All of these challenges bring fatigue, isolation, loneliness, and feelings of loss. With help, you can better understand your feelings and better meet your challenge. If you are stressed and feeling burnt out, depressed, or weighed down by anxiety, reach out for help. In therapy, you can get the support that you need to build on your strengths and thrive. Serving adults of all ages and the LGBTQ+ community
You don't have to go it alone. Are you an older adult or the caregiver for a parent or spouse? Struggling to keep your balance while dealing with chronic illness or pain? Have you lost a loved one or had a major life change? All of these challenges bring fatigue, isolation, loneliness, and feelings of loss. With help, you can better understand your feelings and better meet your challenge. If you are stressed and feeling burnt out, depressed, or weighed down by anxiety, reach out for help. In therapy, you can get the support that you need to build on your strengths and thrive. Serving adults of all ages and the LGBTQ+ community
(413) 722-5553 View (413) 722-5553
Photo of Celia Mackinnon, Marriage & Family Therapist in Northampton, MA
Celia Mackinnon
Marriage & Family Therapist, LMHC, LMFT
Verified Verified
Northampton, MA 01060
Waitlist for new clients
Thank you for considering my profile. I am licensed both as a Mental Health Counseler and a Marriage and Family Therapist. A guiding belief in my work is an unconditional regard for the individual value of each person. I have a variety of training (Pyschodynamic, cognitive behavioral, relational EFT, EMDR etc.)and use an ecelectic approach. I have been working with children and their families in a varity of settings, for almost 30 years. I have extensive experience working with a variety of diagnosis. I also have a bachelor degree in working with Young Children with Special Needs.
Thank you for considering my profile. I am licensed both as a Mental Health Counseler and a Marriage and Family Therapist. A guiding belief in my work is an unconditional regard for the individual value of each person. I have a variety of training (Pyschodynamic, cognitive behavioral, relational EFT, EMDR etc.)and use an ecelectic approach. I have been working with children and their families in a varity of settings, for almost 30 years. I have extensive experience working with a variety of diagnosis. I also have a bachelor degree in working with Young Children with Special Needs.
(413) 758-1973 View (413) 758-1973
Photo of Justine Sheffler, Psychologist in Northampton, MA
Justine Sheffler
Psychologist, PsyD
Verified Verified
1 Endorsed
Northampton, MA 01062  (Online Only)
As a humanistic therapist, I believe that healing is both a universal capacity and a profoundly personal process. My goal is to help you discover and expand your unique healing process, and to release the blocks that prevent you from realizing your potential. I have ten years’ experience in the mental health field, supporting clients in coping with depression, anxiety, grief, relationship challenges, difficulties with trust and self-esteem, life transitions, trauma, and a myriad of other challenges.
As a humanistic therapist, I believe that healing is both a universal capacity and a profoundly personal process. My goal is to help you discover and expand your unique healing process, and to release the blocks that prevent you from realizing your potential. I have ten years’ experience in the mental health field, supporting clients in coping with depression, anxiety, grief, relationship challenges, difficulties with trust and self-esteem, life transitions, trauma, and a myriad of other challenges.
(617) 819-0957 View (617) 819-0957
Photo of Elizabeth Donahue, Clinical Social Work/Therapist in Northampton, MA
Elizabeth Donahue
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Northampton, MA 01060
Waitlist for new clients
I know that seeking out a new therapist or starting therapy can be an overwhelming and scary process, and my goal is to offer a compassionate and thoughtful space for you to engage in this important work. I have experience working with people who are experiencing depression, anxiety, trauma, body image and food-related issues, grief, sexual trauma, issues around identity development, big life transitions, and the general overwhelm that comes with existing as a human at this moment in time! I also have many years of experience working specifically with college students.
I know that seeking out a new therapist or starting therapy can be an overwhelming and scary process, and my goal is to offer a compassionate and thoughtful space for you to engage in this important work. I have experience working with people who are experiencing depression, anxiety, trauma, body image and food-related issues, grief, sexual trauma, issues around identity development, big life transitions, and the general overwhelm that comes with existing as a human at this moment in time! I also have many years of experience working specifically with college students.
(413) 216-4553 View (413) 216-4553
Photo of Sarah A Briggs, Counselor in Northampton, MA
Sarah A Briggs
Counselor, LMHC, MA
Verified Verified
Northampton, MA 01060  (Online Only)
Not accepting new clients
People often seek therapy during times of crisis, when they’re feeling particularly vulnerable and raw. Many people turn to psychotherapy to work through anxiety, depression, or trauma, or because they want to establish, repair, or deepen their relationships. Sometimes they want support adjusting to life transitions, or help developing personal insight and self-awareness. There may be clearly identifiable short-term goals that rise to the top during a crisis and are resolved in a relatively short period of time, but some people also like the process of self-exploration and growth that comes with the practice of more in-depth work.
People often seek therapy during times of crisis, when they’re feeling particularly vulnerable and raw. Many people turn to psychotherapy to work through anxiety, depression, or trauma, or because they want to establish, repair, or deepen their relationships. Sometimes they want support adjusting to life transitions, or help developing personal insight and self-awareness. There may be clearly identifiable short-term goals that rise to the top during a crisis and are resolved in a relatively short period of time, but some people also like the process of self-exploration and growth that comes with the practice of more in-depth work.
(413) 252-0050 View (413) 252-0050
Photo of Brooks Bull, Marriage & Family Therapist in Northampton, MA
Brooks Bull
Marriage & Family Therapist, PhD, LMFT
Verified Verified
Northampton, MA 01060
Not accepting new clients
I provide trauma-informed, socially just therapy to people of all genders. The lingering effects of living in a racist, misogynist and transphobic culture can manifest for many people as depression, anxiety, and panic. I see the connection between the external world and our internal experiences as central to the therapy process. Individuals as well as people in relationships of all configurations are welcome: couples, triads, and any and all open configurations. I trained at Northampton Sex Therapy Associates for 2 years and enjoy working with sexual issues and problems in therapy.
I provide trauma-informed, socially just therapy to people of all genders. The lingering effects of living in a racist, misogynist and transphobic culture can manifest for many people as depression, anxiety, and panic. I see the connection between the external world and our internal experiences as central to the therapy process. Individuals as well as people in relationships of all configurations are welcome: couples, triads, and any and all open configurations. I trained at Northampton Sex Therapy Associates for 2 years and enjoy working with sexual issues and problems in therapy.
(413) 923-6344 View (413) 923-6344
Photo of Nikki Gamache, Counselor in Northampton, MA
Nikki Gamache
Counselor, MA, LMHC, CGT
Verified Verified
Northampton, MA 01060
Unhealed trauma and loss can significantly impact our lives, making it challenging to experience happiness, clarity, compassion, and joy. These experiences can trap us in cycles of negative thoughts, behaviors, and feelings. You may yearn to break free from this cycle, but hopelessness and feeling trapped can be common. Trauma therapy can help! I specialize in intensive trauma therapy with weekly 90-minute sessions designed to help you address past traumas and break free from these cycles.
Unhealed trauma and loss can significantly impact our lives, making it challenging to experience happiness, clarity, compassion, and joy. These experiences can trap us in cycles of negative thoughts, behaviors, and feelings. You may yearn to break free from this cycle, but hopelessness and feeling trapped can be common. Trauma therapy can help! I specialize in intensive trauma therapy with weekly 90-minute sessions designed to help you address past traumas and break free from these cycles.
(413) 304-2253 View (413) 304-2253
Photo of Chadbourne F Gillette, Clinical Social Work/Therapist in Northampton, MA
Chadbourne F Gillette
Clinical Social Work/Therapist, LICSW
Verified Verified
Northampton, MA 01060
I provide psychotherapy and psychoanalysis to adults in a thoughtful, warm, compassionate atmosphere. I treat a spectrum of issues ranging from the commonly practical to the loftily complex, including trauma, depression, anxiety, self-esteem, grief, loss, sexuality, gender, LGBTQ, family, relationships, marriage, professional, identity, existential and spiritual confusion. My therapeutic approach is rooted in psychoanalytic and contemplative theories of human development, function, and dysfunction. I am dedicated to helping my clients grow through their issues in a safe, comfortable, confidential space.
I provide psychotherapy and psychoanalysis to adults in a thoughtful, warm, compassionate atmosphere. I treat a spectrum of issues ranging from the commonly practical to the loftily complex, including trauma, depression, anxiety, self-esteem, grief, loss, sexuality, gender, LGBTQ, family, relationships, marriage, professional, identity, existential and spiritual confusion. My therapeutic approach is rooted in psychoanalytic and contemplative theories of human development, function, and dysfunction. I am dedicated to helping my clients grow through their issues in a safe, comfortable, confidential space.
(617) 519-1806 View (617) 519-1806
Photo of Kelly Crowell, Clinical Social Work/Therapist in Northampton, MA
Kelly Crowell
Clinical Social Work/Therapist, LICSW
Verified Verified
1 Endorsed
Northampton, MA 01060
Asking for help is not easy, and finding the right therapist can be even more difficult. I am passionate about helping individuals and families move towards a path of well-being and health. In a safe and caring environment, I work with clients who struggle with a range of issues: anxiety, trauma, depression, relationship difficulties, separation and loss, low self-esteem, lack of motivation, family conflict and parenting. My work is trauma informed and strengths-based. It is important to me that clients feel heard and valued.
Asking for help is not easy, and finding the right therapist can be even more difficult. I am passionate about helping individuals and families move towards a path of well-being and health. In a safe and caring environment, I work with clients who struggle with a range of issues: anxiety, trauma, depression, relationship difficulties, separation and loss, low self-esteem, lack of motivation, family conflict and parenting. My work is trauma informed and strengths-based. It is important to me that clients feel heard and valued.
(413) 299-2721 View (413) 299-2721
Photo of Dean Colpack, Clinical Social Work/Therapist in Northampton, MA
Dean Colpack
Clinical Social Work/Therapist, LICSW
Verified Verified
Northampton, MA 01060
Not accepting new clients
Clients and myself are on a journey, to explore and notice the things that bubble up, the things that stay stuck beneath, the parts of themselves that enter the therapy room: the grieving parts, the sad and scared parts, the joyful ones. I work with clients who are seeking for meaning and understanding in their responses to the relationships in their lives: those with family, with partners, with spirituality, with creativity, with work and life's purpose, and beyond.
Clients and myself are on a journey, to explore and notice the things that bubble up, the things that stay stuck beneath, the parts of themselves that enter the therapy room: the grieving parts, the sad and scared parts, the joyful ones. I work with clients who are seeking for meaning and understanding in their responses to the relationships in their lives: those with family, with partners, with spirituality, with creativity, with work and life's purpose, and beyond.
(413) 308-6945 View (413) 308-6945
Photo of Moonbeam Counseling LLC, Clinical Social Work/Therapist in Northampton, MA
Moonbeam Counseling LLC
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
8 Endorsed
Northampton, MA 01060
Not accepting new clients
The world can be an unsafe place at times, posing many challenges for all of us. Looking for help to navigate life stressors can be difficult when you might already be experiencing grief, isolation, and anxiety. It can be easy to feel lost, disconnected, and even helpless. I provide a warm-hearted safe space and am confident in treating many psychological concerns. My goal in therapy is to help you find solutions to your problems and illuminate resources already available to you. I am especially helpful in areas of life transition, trauma, and grief and loss. You don’t have to do this alone.
The world can be an unsafe place at times, posing many challenges for all of us. Looking for help to navigate life stressors can be difficult when you might already be experiencing grief, isolation, and anxiety. It can be easy to feel lost, disconnected, and even helpless. I provide a warm-hearted safe space and am confident in treating many psychological concerns. My goal in therapy is to help you find solutions to your problems and illuminate resources already available to you. I am especially helpful in areas of life transition, trauma, and grief and loss. You don’t have to do this alone.
(413) 889-8559 View (413) 889-8559

How does your Therapist compare?

Number of Therapists in Northampton, MA

500+

Average cost per session

$150

Therapists in Northampton, MA who prioritize treating:

91% Anxiety
87% Depression
81% Relationship Issues
73% Trauma and PTSD
73% Self Esteem
66% Grief
65% Life Transitions

Average years in practice

14 Years

Top 3 insurances accepted

89% BlueCross and BlueShield
47% Optum
46% UnitedHealthcare UHC | UBH

How Therapists in Northampton, MA see their clients

61% In Person and Online
39% Online Only

Gender breakdown

72% Female
23% Male
5% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Northampton?

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.