Therapists in West Des Moines, IA

Photo of Carlos Canales, Psychologist in West Des Moines, IA
Carlos Canales
Psychologist, PsyD, CGP, FAGPA
Verified Verified
8 Endorsed
West Des Moines, IA 50266
I believe therapy is a way to enrich life in general, to enhance the enjoyable, and to understand and move through the painful. I think life is better in supportive company and that is why I am a therapist. I am fascinated with the multilayer complexity of life; in integrating the mind, body, heart, and spirit, as well as the richness of people and culture. I enjoy building connections with clients and exploring what brought them to therapy, how their history informs their present situation, and how needs and emotions are communicated. In essence, I’m thoughtful about how life is experienced, assimilated, digested and observed.
I believe therapy is a way to enrich life in general, to enhance the enjoyable, and to understand and move through the painful. I think life is better in supportive company and that is why I am a therapist. I am fascinated with the multilayer complexity of life; in integrating the mind, body, heart, and spirit, as well as the richness of people and culture. I enjoy building connections with clients and exploring what brought them to therapy, how their history informs their present situation, and how needs and emotions are communicated. In essence, I’m thoughtful about how life is experienced, assimilated, digested and observed.
(515) 393-2921 View (515) 393-2921
Photo of Denise Kelley Edwards, Clinical Social Work/Therapist in West Des Moines, IA
Denise Kelley Edwards
Clinical Social Work/Therapist, MSW, LISW
Verified Verified
West Des Moines, IA 50266  (Online Only)
The relationship between therapist and client is central to a positive therapeutic experience, therefore, it is important to find a therapist you feel comfortable with. My role as therapist is to help each client improve the quality of their lives as they learn to navigate difficult issues and situations or learn to manage a mental illness. In addition, each client and each issue presented require an individualized approach. To achieve appropriate treatment plans I use a variety of treatment modalities including CBT, DBT, psychoeducation and psychotherapy. I work mainly with women. I work with adult women in all stages of life.
The relationship between therapist and client is central to a positive therapeutic experience, therefore, it is important to find a therapist you feel comfortable with. My role as therapist is to help each client improve the quality of their lives as they learn to navigate difficult issues and situations or learn to manage a mental illness. In addition, each client and each issue presented require an individualized approach. To achieve appropriate treatment plans I use a variety of treatment modalities including CBT, DBT, psychoeducation and psychotherapy. I work mainly with women. I work with adult women in all stages of life.
(515) 329-7951 View (515) 329-7951
Photo of Megan Cecil, Counselor in West Des Moines, IA
Megan Cecil
Counselor, LMHC, CADC
Verified Verified
West Des Moines, IA 50266
Greetings! I am a dedicated and compassionate counselor with a firm belief in the power of a flexible and integrative approach to therapy. My goal is to tailor sessions to the unique needs and objectives of each individual, meeting them where they are on their journey. In my practice, creating a nurturing and understanding environment is paramount. I'm committed to helping individuals discover their inherent strengths and fostering curiosity about their lives and thought patterns, all while building a foundation of self-compassion.
Greetings! I am a dedicated and compassionate counselor with a firm belief in the power of a flexible and integrative approach to therapy. My goal is to tailor sessions to the unique needs and objectives of each individual, meeting them where they are on their journey. In my practice, creating a nurturing and understanding environment is paramount. I'm committed to helping individuals discover their inherent strengths and fostering curiosity about their lives and thought patterns, all while building a foundation of self-compassion.
(515) 461-7767 View (515) 461-7767
Photo of Kim Comer, Clinical Social Work/Therapist in West Des Moines, IA
Kim Comer
Clinical Social Work/Therapist, LISW
Verified Verified
West Des Moines, IA 50265
I am currently accepting new clients. I have been practicing for 20 years and have been in the field for over 40. I have an I am currently accepting new clients. I have been practicing for 20 years. Are you having a tough time adjusting to life? Whether that be problems with depression, anxiety, or other life Stressors? Possibly you’ve experienced a lot of trauma in your life, or abuse, or you are wondering if your child has been sexually abused? I am here to help you through these difficult times. I also love working with adults who are trying to manage their issues one day at a time.
I am currently accepting new clients. I have been practicing for 20 years and have been in the field for over 40. I have an I am currently accepting new clients. I have been practicing for 20 years. Are you having a tough time adjusting to life? Whether that be problems with depression, anxiety, or other life Stressors? Possibly you’ve experienced a lot of trauma in your life, or abuse, or you are wondering if your child has been sexually abused? I am here to help you through these difficult times. I also love working with adults who are trying to manage their issues one day at a time.
(515) 303-2689 View (515) 303-2689
Photo of Kayli Winchester, Clinical Social Work/Therapist in West Des Moines, IA
Kayli Winchester
Clinical Social Work/Therapist, LISW
Verified Verified
West Des Moines, IA 50265
I have worked as a school-based mental health therapist for over five years serving elementary-aged children. I currently work as a child therapist serving primarily children ages 5-11 years old with a variety of presenting concerns, such as defiance, anxiety, anger, depression, and trauma. I work closely with both the child and their caregiver(s) to meet the goals we establish at the start of services.
I have worked as a school-based mental health therapist for over five years serving elementary-aged children. I currently work as a child therapist serving primarily children ages 5-11 years old with a variety of presenting concerns, such as defiance, anxiety, anger, depression, and trauma. I work closely with both the child and their caregiver(s) to meet the goals we establish at the start of services.
(515) 495-6327 View (515) 495-6327
Photo of Amy DeMoney, Clinical Social Work/Therapist in West Des Moines, IA
Amy DeMoney
Clinical Social Work/Therapist, LISW
Verified Verified
West Des Moines, IA 50266
I strongly believe in working with clients to develop trust and empower them to address difficult subjects. I work to assist clients with identifying their strengths and how to best utilize those strenghts to develop coping strategies. I have over 20 years of experiences as a therapist working with children, adolescents, adults and families. My primary therapeutic approach is Cognitive Behavioral Therapy.
I strongly believe in working with clients to develop trust and empower them to address difficult subjects. I work to assist clients with identifying their strengths and how to best utilize those strenghts to develop coping strategies. I have over 20 years of experiences as a therapist working with children, adolescents, adults and families. My primary therapeutic approach is Cognitive Behavioral Therapy.
(515) 758-7881 View (515) 758-7881
Photo of Erica Hecht Kehrberg, Clinical Social Work/Therapist in West Des Moines, IA
Erica Hecht Kehrberg
Clinical Social Work/Therapist, LISW
Verified Verified
2 Endorsed
West Des Moines, IA 50266
Waitlist for new clients
Seeking help with life challenges can be intimidating. I believe in creating a safe, nonjudgmental space where people feel comfortable to explore their struggles, reach their goals and find hope that leads to healing. Over the years in a variety of social service roles assisting children and families, I have learned that it is essential to find the right person with whom you can build an authentic connection and from whom you can receive support. I believe we can find that connection together.
Seeking help with life challenges can be intimidating. I believe in creating a safe, nonjudgmental space where people feel comfortable to explore their struggles, reach their goals and find hope that leads to healing. Over the years in a variety of social service roles assisting children and families, I have learned that it is essential to find the right person with whom you can build an authentic connection and from whom you can receive support. I believe we can find that connection together.
(515) 498-3940 View (515) 498-3940
Photo of Sarah L Bowen, Clinical Social Work/Therapist in West Des Moines, IA
Sarah L Bowen
Clinical Social Work/Therapist, LISW
Verified Verified
1 Endorsed
West Des Moines, IA 50266
I have a passion for working with teenagers and adults, specifically on issues related to attachment, behavior, anxiety, stress, relationship building, communication, professional growth, and career and college planning. Client goals should be focused on challenging distorted thinking and creating plans in order to have a healthier and more productive lifestyle.
I have a passion for working with teenagers and adults, specifically on issues related to attachment, behavior, anxiety, stress, relationship building, communication, professional growth, and career and college planning. Client goals should be focused on challenging distorted thinking and creating plans in order to have a healthier and more productive lifestyle.
(515) 375-0687 View (515) 375-0687
Photo of Dr. Kathleen (Katy) Laurin, Psychologist in West Des Moines, IA
Dr. Kathleen (Katy) Laurin
Psychologist, PhD
Verified Verified
West Des Moines, IA 50266  (Online Only)
I am a Licensed Clinical Psychologist who specializes in working with adults and older adults who are experiencing emotional distress and/or who are concerned about age-related cognitive changes. I believe early assessment of memory or other suspected changes reduces anxiety, provides information that can improve brain health, and helps clients and their loved ones prepare for the future. Cognitive evaluations include interview, testing, review of results, and a report to you and/or your healthcare provider.
I am a Licensed Clinical Psychologist who specializes in working with adults and older adults who are experiencing emotional distress and/or who are concerned about age-related cognitive changes. I believe early assessment of memory or other suspected changes reduces anxiety, provides information that can improve brain health, and helps clients and their loved ones prepare for the future. Cognitive evaluations include interview, testing, review of results, and a report to you and/or your healthcare provider.
(515) 310-4466 View (515) 310-4466
Photo of Ian Adams, Counselor in West Des Moines, IA
Ian Adams
Counselor, tLMHC, MS
Verified Verified
3 Endorsed
West Des Moines, IA 50266
I have extended my schedule and am now accepting new clients, high school age and older - I accept all major insurance. I specialize in helping those struggling with trauma, depression, anxiety, and addiction to unhealthy cycles; especially lesser thought-of issues such as addictions to toxic relationships, pornography, sex, gaming, health, and social media. I'm also a philosophy buff and love working with those looking to gain a sense of belonging or purpose in life.
I have extended my schedule and am now accepting new clients, high school age and older - I accept all major insurance. I specialize in helping those struggling with trauma, depression, anxiety, and addiction to unhealthy cycles; especially lesser thought-of issues such as addictions to toxic relationships, pornography, sex, gaming, health, and social media. I'm also a philosophy buff and love working with those looking to gain a sense of belonging or purpose in life.
(515) 516-6858 View (515) 516-6858
Photo of Lindsey Olsen, Marriage & Family Therapist in West Des Moines, IA
Lindsey Olsen
Marriage & Family Therapist, MS, LMFT
Verified Verified
2 Endorsed
West Des Moines, IA 50266
Waitlist for new clients
Hi! I am a Licensed Marriage and Family Therapist, and I am passionate about working with individuals, couples, and families to meet their desired goals. I have an interest in working with clients who have experienced trauma and/or PTSD. I am a certified therapist in Eye Movement Desensitization Reprocessing (EMDR). EMDR is a type of therapy that enables people to heal from symptoms and/or emotional distress that can result from disturbing life experiences. I also work with clients experiencing somatic (body) issues from traumatic experiences. Please do not hesitate to ask questions about specific issues you would like to address.
Hi! I am a Licensed Marriage and Family Therapist, and I am passionate about working with individuals, couples, and families to meet their desired goals. I have an interest in working with clients who have experienced trauma and/or PTSD. I am a certified therapist in Eye Movement Desensitization Reprocessing (EMDR). EMDR is a type of therapy that enables people to heal from symptoms and/or emotional distress that can result from disturbing life experiences. I also work with clients experiencing somatic (body) issues from traumatic experiences. Please do not hesitate to ask questions about specific issues you would like to address.
(515) 505-1833 View (515) 505-1833
Photo of Amy M Tiefenthaler, Counselor in West Des Moines, IA
Amy M Tiefenthaler
Counselor, LMHC
Verified Verified
1 Endorsed
West Des Moines, IA 50266
Serving Children and Families in the Des Moines Area for over 9 years. Specializing in Youth, Adolescent ages, and pre/post natal parenting.
Serving Children and Families in the Des Moines Area for over 9 years. Specializing in Youth, Adolescent ages, and pre/post natal parenting.
(515) 361-7309 View (515) 361-7309
Photo of Ali Dotson, Clinical Social Work/Therapist in West Des Moines, IA
Ali Dotson
Clinical Social Work/Therapist, MA, LMHC
Verified Verified
West Des Moines, IA 50266  (Online Only)
I am so glad you're here! Seeking out therapy when feeling overwhelmed or stuck is an act of courage. As a therapist with 10 years of experience, I am committed to providing a safe space to talk through your roadblocks, life transitions, and adverse experiences. I not only trust you are an expert of your own life, but also give you the opportunity to challenge deeply-held beliefs that may no longer serve purpose in your present life. My areas of expertise include perinatal mood disorders, anxiety, depression, trauma, grief and loss, and relationships.
I am so glad you're here! Seeking out therapy when feeling overwhelmed or stuck is an act of courage. As a therapist with 10 years of experience, I am committed to providing a safe space to talk through your roadblocks, life transitions, and adverse experiences. I not only trust you are an expert of your own life, but also give you the opportunity to challenge deeply-held beliefs that may no longer serve purpose in your present life. My areas of expertise include perinatal mood disorders, anxiety, depression, trauma, grief and loss, and relationships.
(515) 203-2872 View (515) 203-2872
Photo of Carter DeVary, Marriage & Family Therapist in West Des Moines, IA
Carter DeVary
Marriage & Family Therapist, LMFT
Verified Verified
3 Endorsed
West Des Moines, IA 50266
I provide an open and accepting environment that empowers clients to share their concerns without judgment. From a systemic perspective, I focus on helping individuals, couples and families develop a greater sense of self within their relationships, leading clients to develop and maintain healthy and sustainable relationships beyond therapy. I work with a broad range of clients including individual teenagers to older adults, couples and families, with a diverse set of problems and needs including anxiety, depression, grief, trauma, couple and marital issues, blended family problems, and many more.
I provide an open and accepting environment that empowers clients to share their concerns without judgment. From a systemic perspective, I focus on helping individuals, couples and families develop a greater sense of self within their relationships, leading clients to develop and maintain healthy and sustainable relationships beyond therapy. I work with a broad range of clients including individual teenagers to older adults, couples and families, with a diverse set of problems and needs including anxiety, depression, grief, trauma, couple and marital issues, blended family problems, and many more.
(515) 393-6791 View (515) 393-6791
Photo of Integrative Counseling Solutions, Clinical Social Work/Therapist in West Des Moines, IA
Integrative Counseling Solutions
Clinical Social Work/Therapist, LMSW
Verified Verified
West Des Moines, IA 50266
We are an interdisciplinary team made up of Licensed Therapists and Social Workers. Together we are able to provide a comprehensive and holistic approach to mental health treatment which includes; mental health assessment, counseling, referral, skill development, play therapy, sand tray therapy, and substance use. We serve children, teens, adults, couples and families at our Polk and Marion County offices, along with school locations throughout Central Iowa. We have offices in Ankeny, Knoxville and West Des Moines.
We are an interdisciplinary team made up of Licensed Therapists and Social Workers. Together we are able to provide a comprehensive and holistic approach to mental health treatment which includes; mental health assessment, counseling, referral, skill development, play therapy, sand tray therapy, and substance use. We serve children, teens, adults, couples and families at our Polk and Marion County offices, along with school locations throughout Central Iowa. We have offices in Ankeny, Knoxville and West Des Moines.
(515) 267-1340 View (515) 267-1340
Photo of Ellen Petersen, Clinical Social Work/Therapist in West Des Moines, IA
Ellen Petersen
Clinical Social Work/Therapist, LISW
Verified Verified
West Des Moines, IA 50266
Happiness appears to us to be achievement driven. If we just graduate, get married, buy a house, have 2 children, surely we’ll be happy then…right? What happens when we’re several achievements deep and we have yet to actually reach any sort of lasting joy? Did we do it wrong? For you and I, it means we have the beautiful opportunity to sift through the daily noise in your life and find what truly brings you joy. Feelings of listlessness, anxiety, depression for the status of our life are all of our warning signals that life is currently so far what we truly want, that we need to steer the ship back towards the life you want to live.
Happiness appears to us to be achievement driven. If we just graduate, get married, buy a house, have 2 children, surely we’ll be happy then…right? What happens when we’re several achievements deep and we have yet to actually reach any sort of lasting joy? Did we do it wrong? For you and I, it means we have the beautiful opportunity to sift through the daily noise in your life and find what truly brings you joy. Feelings of listlessness, anxiety, depression for the status of our life are all of our warning signals that life is currently so far what we truly want, that we need to steer the ship back towards the life you want to live.
(515) 605-7595 View (515) 605-7595
Photo of Barbara Petersen-Fox, Clinical Social Work/Therapist in West Des Moines, IA
Barbara Petersen-Fox
Clinical Social Work/Therapist, LISW
Verified Verified
8 Endorsed
West Des Moines, IA 50266
Not accepting new clients
Are you feeling frustrated and stressed with your relationships or your job? Are you experiencing transitions that are causing you anxiety or feelings of depression? My goal is to help you find clarity and develop positive behavior changes, so that you can lead a more fulfilling life. We will examine all aspects of your self: psychological, biological, social, and spiritual. You will develop new perspectives, insights, and effective strategies to improve your life and overcome obstacles that have gotten in your way.
Are you feeling frustrated and stressed with your relationships or your job? Are you experiencing transitions that are causing you anxiety or feelings of depression? My goal is to help you find clarity and develop positive behavior changes, so that you can lead a more fulfilling life. We will examine all aspects of your self: psychological, biological, social, and spiritual. You will develop new perspectives, insights, and effective strategies to improve your life and overcome obstacles that have gotten in your way.
(515) 619-6544 View (515) 619-6544
Photo of Shelly Johnson, Counselor in West Des Moines, IA
Shelly Johnson
Counselor, LMHC, CIFST
Verified Verified
1 Endorsed
West Des Moines, IA 50265  (Online Only)
Waitlist for new clients
Life is a journey that we are all navigating through in an effort to find who we really are, what our passions are, & what we truly desire; this is necessary to have an embodied experience of authentic healing, self-expression, and living. My ‘deepest’ intention for my clients is that they feel uplifted & more closely aligned w/ their hearts’ true desires. I encourage clients to cultivate a genuine & authentic approach to life, regardless of earlier life experiences, beliefs, or messaging. Are you ready to take that inner journey of exploration & discovery, without having to do it alone?
Life is a journey that we are all navigating through in an effort to find who we really are, what our passions are, & what we truly desire; this is necessary to have an embodied experience of authentic healing, self-expression, and living. My ‘deepest’ intention for my clients is that they feel uplifted & more closely aligned w/ their hearts’ true desires. I encourage clients to cultivate a genuine & authentic approach to life, regardless of earlier life experiences, beliefs, or messaging. Are you ready to take that inner journey of exploration & discovery, without having to do it alone?
(515) 446-7351 View (515) 446-7351
Photo of Kathleen Alexander, LMFT, CMPE, Marriage & Family Therapist in West Des Moines, IA
Kathleen Alexander, LMFT, CMPE
Marriage & Family Therapist, LMFT, CMPE
Verified Verified
West Des Moines, IA 50266
I am a licensed Marriage and Family Therapist (LMFT). I am passionate about helping individuals, couples, and families meet their desired goals. The atmosphere in my sessions is warm, collaborative and purposeful. I provide practical feedback, including suggestions for new ways of thinking, assessing relationships and improving well-being outside of sessions.
I am a licensed Marriage and Family Therapist (LMFT). I am passionate about helping individuals, couples, and families meet their desired goals. The atmosphere in my sessions is warm, collaborative and purposeful. I provide practical feedback, including suggestions for new ways of thinking, assessing relationships and improving well-being outside of sessions.
(515) 497-2249 View (515) 497-2249
Photo of Angela La Luzerne, Clinical Social Work/Therapist in West Des Moines, IA
Angela La Luzerne
Clinical Social Work/Therapist, LISW
Verified Verified
1 Endorsed
West Des Moines, IA 50266
Ever wonder, "why is this so hard?" "How did I find myself here?" "What do I do now?" You may feel hopeless or stuck. The desire to get unstuck - to make changes and show up for life in a happier, healthier way - is a noble one. The therapeutic relationship provides a safe, sacred space for you to explore new possibilities, especially as the journey may feel overwhelming at times. We often uncover thoughts, beliefs and behaviors that no longer serve you well. Through a variety of interventions, tailored to your individual needs, change IS possible! It is never too late to start caring for ourselves and others more effectively.
Ever wonder, "why is this so hard?" "How did I find myself here?" "What do I do now?" You may feel hopeless or stuck. The desire to get unstuck - to make changes and show up for life in a happier, healthier way - is a noble one. The therapeutic relationship provides a safe, sacred space for you to explore new possibilities, especially as the journey may feel overwhelming at times. We often uncover thoughts, beliefs and behaviors that no longer serve you well. Through a variety of interventions, tailored to your individual needs, change IS possible! It is never too late to start caring for ourselves and others more effectively.
(515) 523-7354 View (515) 523-7354

See more therapy options for West Des Moines

How does your Therapist compare?

Number of Therapists in West Des Moines, IA

300+

Average cost per session

$155

Therapists in West Des Moines, IA who prioritize treating:

96% Anxiety
90% Depression
79% Relationship Issues
78% Self Esteem
74% Trauma and PTSD
74% Stress
71% Coping Skills

Average years in practice

11 Years

Top 3 insurances accepted

87% BlueCross and BlueShield
84% Wellmark BCBS
49% UnitedHealthcare UHC | UBH

How Therapists in West Des Moines, IA see their clients

88% In Person and Online
12% Online Only

Gender breakdown

78% Female
21% Male
1% Non-Binary

FAQs - About Therapy and Counseling

How can I find a therapist in West Des Moines?

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.