Therapists in Spokane, WA

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Photo of Melanie Morlan @ Couples Therapy Spokane, Marriage & Family Therapist in Spokane, WA
Melanie Morlan @ Couples Therapy Spokane
Marriage & Family Therapist, LMFT, LMHC, NCC
Verified Verified
2 Endorsed
Spokane, WA 99201
Emotionally Focused Therapy (EFT) is an efficient and research-based protocol for helping couples recover from crisis, develop a deep soul connection, or to start with an excellent system for navigating a new relationship. EFT is my life's work. I take it very seriously and have committed my professional career to a high level of expertise and the ability to care deeply and authentically for the individuals and couples I work with. If you or your partner is struggling with any form of addiction that is not in recovery, I will refer you for additional support before starting or in addition to the work I offer.
Emotionally Focused Therapy (EFT) is an efficient and research-based protocol for helping couples recover from crisis, develop a deep soul connection, or to start with an excellent system for navigating a new relationship. EFT is my life's work. I take it very seriously and have committed my professional career to a high level of expertise and the ability to care deeply and authentically for the individuals and couples I work with. If you or your partner is struggling with any form of addiction that is not in recovery, I will refer you for additional support before starting or in addition to the work I offer.
(509) 309-0672 View (509) 309-0672
Photo of Jennifer Aske, Counselor in Spokane, WA
Jennifer Aske
Counselor, LMHC
Verified Verified
Spokane, WA 99208  (Online Only)
Life is tough. Many aspects of a person’s life can contribute to feelings of loneliness, an ongoing sense of being on edge, a lack of motivation, and extreme overwhelm. This can impact us in countless ways including a lack of boundaries, relationship challenges, day-to-day life, and a general feeling of instability in our lives. Trauma, anxiety, and depression can make it hard just to get through the day. People seek therapy for a variety of struggles. Whatever your reason is, we will work together on your destination toward self-awareness, healing, and personal growth. You do not need to go through this journey alone.
Life is tough. Many aspects of a person’s life can contribute to feelings of loneliness, an ongoing sense of being on edge, a lack of motivation, and extreme overwhelm. This can impact us in countless ways including a lack of boundaries, relationship challenges, day-to-day life, and a general feeling of instability in our lives. Trauma, anxiety, and depression can make it hard just to get through the day. People seek therapy for a variety of struggles. Whatever your reason is, we will work together on your destination toward self-awareness, healing, and personal growth. You do not need to go through this journey alone.
(509) 517-6604 View (509) 517-6604
Photo of Cassandra Nolan, Marriage & Family Therapist in Spokane, WA
Cassandra Nolan
Marriage & Family Therapist, LMFTA
Verified Verified
Spokane, WA 99202
My name is Cassandra Nolan, and I am a Marriage and Family Therapist Associate. I enjoy working with individuals and couples of various age groups, backgrounds, and identities. I work with people who attend therapy for various reasons including depression, anxiety, relational difficulties, trauma, family concerns, stress, and life changes. I work through a systemic lens and integrate attachment work with techniques from various theoretical models. My goal is to offer a safe, non-judgmental space for my clients to identify and confront patterns in their lives that are not serving them.
My name is Cassandra Nolan, and I am a Marriage and Family Therapist Associate. I enjoy working with individuals and couples of various age groups, backgrounds, and identities. I work with people who attend therapy for various reasons including depression, anxiety, relational difficulties, trauma, family concerns, stress, and life changes. I work through a systemic lens and integrate attachment work with techniques from various theoretical models. My goal is to offer a safe, non-judgmental space for my clients to identify and confront patterns in their lives that are not serving them.
(509) 245-2748 View (509) 245-2748
Photo of Erin M White, Counselor in Spokane, WA
Erin M White
Counselor, MA, LMHC
Verified Verified
1 Endorsed
Spokane, WA 99201
Not accepting new clients
Are you unable to enjoy life or achieve goals because of the pain and turmoil you feel inside? Do you feel bound by fear? Emotional, spiritual and physical pain can leave you feeling unable to cope with and enjoy life. You're not alone; I'd like to help.
Are you unable to enjoy life or achieve goals because of the pain and turmoil you feel inside? Do you feel bound by fear? Emotional, spiritual and physical pain can leave you feeling unable to cope with and enjoy life. You're not alone; I'd like to help.
(509) 774-5833 View (509) 774-5833
Photo of Taylor Svetlichny, Marriage & Family Therapist in Spokane, WA
Taylor Svetlichny
Marriage & Family Therapist, MA, LMFTA
Verified Verified
Spokane, WA 99202  (Online Only)
Not accepting new clients
You are constantly questioning yourself, relying on validation from other people to feel good enough. Sometimes, you don’t know who you are, and you find yourself thinking about others and their needs before your own. Your mind races with thoughts about what others might think of you or how they might react, which leaves you wondering, “Why do I feel this way? I’m just not enough.” You sense yourself shutting down with feelings of fear, anxiety, worry, and dread… It might be time to take the next steps to discover how you can more fully engage in your life and the lives of others with greater ease and with greater joy.
You are constantly questioning yourself, relying on validation from other people to feel good enough. Sometimes, you don’t know who you are, and you find yourself thinking about others and their needs before your own. Your mind races with thoughts about what others might think of you or how they might react, which leaves you wondering, “Why do I feel this way? I’m just not enough.” You sense yourself shutting down with feelings of fear, anxiety, worry, and dread… It might be time to take the next steps to discover how you can more fully engage in your life and the lives of others with greater ease and with greater joy.
(509) 253-1181 View (509) 253-1181
Photo of Shoba M. Nishek, Clinical Social Work/Therapist in Spokane, WA
Shoba M. Nishek
Clinical Social Work/Therapist, LICSW, MHP, CMHS
Verified Verified
Spokane, WA 99223
Greetings! As a Licensed Independent Clinical Social Worker, MHP, CMHS, I believe building a healthy therapeutic relationship is cultivated by implementing comprehensive, person-centered, trauma informed, evidence-based clinical approaches! When personally motivated for intrinsic change, therapy can provide a secure setting inviting self-examination while exploring multi-generational systemic and family trauma. To sustain improved healthy symptom changes, engaging in consistent treatment clinically proven to restructure negative cognitions directly impacting personal emotional regulation and negative behavioral patterns, is crucial.
Greetings! As a Licensed Independent Clinical Social Worker, MHP, CMHS, I believe building a healthy therapeutic relationship is cultivated by implementing comprehensive, person-centered, trauma informed, evidence-based clinical approaches! When personally motivated for intrinsic change, therapy can provide a secure setting inviting self-examination while exploring multi-generational systemic and family trauma. To sustain improved healthy symptom changes, engaging in consistent treatment clinically proven to restructure negative cognitions directly impacting personal emotional regulation and negative behavioral patterns, is crucial.
(509) 204-5704 View (509) 204-5704
Photo of Kamala Keller Brickey, Clinical Social Work/Therapist in Spokane, WA
Kamala Keller Brickey
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Spokane, WA 99201
I have been a social worker for over 20 years having been honored by people who have shared their lives with me. I believe everyone has the "answers" within themselves. When one's positive capacities are supported, one is more likely to act on their strengths. I would like to help you bring out your strengths and "answers" in yourself.
I have been a social worker for over 20 years having been honored by people who have shared their lives with me. I believe everyone has the "answers" within themselves. When one's positive capacities are supported, one is more likely to act on their strengths. I would like to help you bring out your strengths and "answers" in yourself.
(509) 401-8648 View (509) 401-8648
Photo of Cathlene Dunlap, Counselor in Spokane, WA
Cathlene Dunlap
Counselor, MS, LMHC, MHP
Verified Verified
1 Endorsed
Spokane, WA 99218  (Online Only)
Waitlist for new clients
I deeply enjoy being a therapist and working with all types of people. Relationship issues and eating disorders are a couple of areas that I specialize. I have an attachment focused approach that integrates several interventions such as ACT, DBT and mindfulness.
I deeply enjoy being a therapist and working with all types of people. Relationship issues and eating disorders are a couple of areas that I specialize. I have an attachment focused approach that integrates several interventions such as ACT, DBT and mindfulness.
(509) 215-2035 View (509) 215-2035
Photo of Maggie M Evans, Counselor in Spokane, WA
Maggie M Evans
Counselor, MA, LMHC, ATR-BC
Verified Verified
3 Endorsed
Spokane, WA 99201
You're pretty much a survival-mode expert. You take pride in your robust ability to show up and take care of the shitty parts of life. You've managed and masked well until now. Suddenly your quirks have become magnified, old wounds re-triggered, and the shame and blame intensified; you can't hold it together much longer. Time’s passed and your ability to cope has too - only secretly.  You’ve got no one left to talk to because you’ve convinced everyone you’re “fine”.  You find yourself escaping to the bathroom to cry because you feel so overwhelmed. You're lost, stuck, sad, and lonely. You wonder how to take any kind of action...
You're pretty much a survival-mode expert. You take pride in your robust ability to show up and take care of the shitty parts of life. You've managed and masked well until now. Suddenly your quirks have become magnified, old wounds re-triggered, and the shame and blame intensified; you can't hold it together much longer. Time’s passed and your ability to cope has too - only secretly.  You’ve got no one left to talk to because you’ve convinced everyone you’re “fine”.  You find yourself escaping to the bathroom to cry because you feel so overwhelmed. You're lost, stuck, sad, and lonely. You wonder how to take any kind of action...
(509) 285-1589 View (509) 285-1589
Photo of Erin LeVan, Counselor in Spokane, WA
Erin LeVan
Counselor, MEd LMHC
Verified Verified
Spokane, WA 99202
I provide hope when life is challenging. I am a Licensed Mental Health Counselor specializing in treating women and young adults. I have a diversity of experience working with all ages in a variety of settings. I work with clients to set treatment goals and assist them in achieving their goals.
I provide hope when life is challenging. I am a Licensed Mental Health Counselor specializing in treating women and young adults. I have a diversity of experience working with all ages in a variety of settings. I work with clients to set treatment goals and assist them in achieving their goals.
(509) 260-7439 x306 View (509) 260-7439 x306
Photo of Mark A Fuqua, Clinical Social Work/Therapist in Spokane, WA
Mark A Fuqua
Clinical Social Work/Therapist, LMSW, MSW, ThM
Verified Verified
1 Endorsed
Spokane, WA 99201
Not accepting new clients
Do you feel "stuck?" In other words, you are at a point of change, something HAS to change, and sometimes you have no clue what change to make. And, on top of that . . . you are afraid of change. Life's shows us that change is inevitable, whether the change is planned or not. Often along with that change come some very strong emotions, stress in our relationships, trauma, and usually we are confronted with some decisions we have to make. Hopefully, the challenge we face also presents us with the possibility of new dreams and maybe brings us closer to achieving long held goals.
Do you feel "stuck?" In other words, you are at a point of change, something HAS to change, and sometimes you have no clue what change to make. And, on top of that . . . you are afraid of change. Life's shows us that change is inevitable, whether the change is planned or not. Often along with that change come some very strong emotions, stress in our relationships, trauma, and usually we are confronted with some decisions we have to make. Hopefully, the challenge we face also presents us with the possibility of new dreams and maybe brings us closer to achieving long held goals.
(615) 845-4834 x7009 View (615) 845-4834 x7009
Photo of Tye L Sheller, Clinical Social Work/Therapist in Spokane, WA
Tye L Sheller
Clinical Social Work/Therapist, LSWAIC
Verified Verified
Spokane, WA 99223
Welcome! I am a dedicated psychotherapist with a Master of Social Work (MSW) degree from Eastern Washington University. My professional journey led me to social work because I firmly believe in the profound impact of one's environment on their personal development and well-being. Everyone’s unique experiences shape their present circumstances, and it is my commitment to meet you exactly where you are on your journey, supporting you in reaching your desired destination. With a comprehensive understanding of social work principles and a passion for empowering individuals, I am equipped to provide compassionate and effective therapy.
Welcome! I am a dedicated psychotherapist with a Master of Social Work (MSW) degree from Eastern Washington University. My professional journey led me to social work because I firmly believe in the profound impact of one's environment on their personal development and well-being. Everyone’s unique experiences shape their present circumstances, and it is my commitment to meet you exactly where you are on your journey, supporting you in reaching your desired destination. With a comprehensive understanding of social work principles and a passion for empowering individuals, I am equipped to provide compassionate and effective therapy.
(509) 778-5137 View (509) 778-5137
Photo of Natalie A Martinez, Clinical Social Work/Therapist in Spokane, WA
Natalie A Martinez
Clinical Social Work/Therapist, LSWAIC
Verified Verified
Spokane, WA 99201  (Online Only)
My caring knowledge as an esteemed therapist is that I am committed to guide clients to realize their greatest potential, I will lead you on a transforming journey toward self-discovery and personal improvement. I provide my clients with a secure and caring environment in which they can explore their inner worlds and deal with life's issues by combining evidence-based therapeutic techniques with a warm, compassionate, and trauma informed approach.
My caring knowledge as an esteemed therapist is that I am committed to guide clients to realize their greatest potential, I will lead you on a transforming journey toward self-discovery and personal improvement. I provide my clients with a secure and caring environment in which they can explore their inner worlds and deal with life's issues by combining evidence-based therapeutic techniques with a warm, compassionate, and trauma informed approach.
(509) 316-2930 View (509) 316-2930
Photo of ACT Services, Counselor in Spokane, WA
ACT Services
Counselor, LMHC, LICSW, MHP, CMHS
Verified Verified
2 Endorsed
Spokane, WA 99205  (Online Only)
Now accepting NEW clients! We all experience difficulties in life: breakups, divorce, grief and loss as well as trouble with school or work performance. We believe quality mental health services should be available when inevitable events knock us off course and we can't "fix" it ourselves. Most people try several remedies before therapy, but sometimes extra help is needed. We also recognize that everyone wants privacy, ranging from children to lawyers to other medical professionals. We were founded with you in mind. Your privacy is important to us, and shouldn't be a barrier to quality care.
Now accepting NEW clients! We all experience difficulties in life: breakups, divorce, grief and loss as well as trouble with school or work performance. We believe quality mental health services should be available when inevitable events knock us off course and we can't "fix" it ourselves. Most people try several remedies before therapy, but sometimes extra help is needed. We also recognize that everyone wants privacy, ranging from children to lawyers to other medical professionals. We were founded with you in mind. Your privacy is important to us, and shouldn't be a barrier to quality care.
(509) 631-8240 View (509) 631-8240
Photo of Britney Strey, On the Brink Therapy Studio, PLLC, Counselor in Spokane, WA
Britney Strey, On the Brink Therapy Studio, PLLC
Counselor, MS, LMHCA
Verified Verified
Spokane, WA 99201  (Online Only)
It is my priority to provide clients with an authentic and safe environment to express vulnerable feelings which may be painful or difficult to navigate alone. Seeking therapy can be a vulnerable and courageous step in the process of self-growth. I offer a non-judgmental and empathetic environment for individuals and couples to work through the complex emotional experiences that come with life.
It is my priority to provide clients with an authentic and safe environment to express vulnerable feelings which may be painful or difficult to navigate alone. Seeking therapy can be a vulnerable and courageous step in the process of self-growth. I offer a non-judgmental and empathetic environment for individuals and couples to work through the complex emotional experiences that come with life.
(509) 348-4761 View (509) 348-4761
Photo of Nate Wareham, Counselor in Spokane, WA
Nate Wareham
Counselor, LMHC, MS
Verified Verified
Spokane, WA 99204
Not accepting new clients
Therapy is a very individual process with each person having their own concerns and challenges that they are looking for help with. Maybe it feels like you’re constantly unsure and struggling while everyone around you is doing fine? Or like there are an overwhelming number of issues in the world that worry you and you don’t know what to do? Maybe your life feels like something isn’t working but what that is isn’t clear? Regardless of what you’re struggling with, my overall goal in therapy is to work with you to build up the skills, confidence, and support you need to move into a life that works better for you.
Therapy is a very individual process with each person having their own concerns and challenges that they are looking for help with. Maybe it feels like you’re constantly unsure and struggling while everyone around you is doing fine? Or like there are an overwhelming number of issues in the world that worry you and you don’t know what to do? Maybe your life feels like something isn’t working but what that is isn’t clear? Regardless of what you’re struggling with, my overall goal in therapy is to work with you to build up the skills, confidence, and support you need to move into a life that works better for you.
(509) 341-0190 View (509) 341-0190
Photo of Blaine P. Bart, Counselor in Spokane, WA
Blaine P. Bart
Counselor, MS, LMHC
Verified Verified
Spokane, WA 99208
Not accepting new clients
I enjoy working with people. The process of meeting others where they’re at in support of a collaborative effort to create positive change is the meaning of my work. My evidence-based training lies primarily in CBT, ACT, and DBT-Mindfulness. Beyond the evidence-based models I incorporate their philosophical underpinnings within existentialism, stoicism, and eastern philosophies. I have deep love, respect and compassion for the human condition. I am a father, husband, Veteran, clinician and human being. My personal philosophy involves an approach of education, meditation and application. Like others, I'm a "work in progress."
I enjoy working with people. The process of meeting others where they’re at in support of a collaborative effort to create positive change is the meaning of my work. My evidence-based training lies primarily in CBT, ACT, and DBT-Mindfulness. Beyond the evidence-based models I incorporate their philosophical underpinnings within existentialism, stoicism, and eastern philosophies. I have deep love, respect and compassion for the human condition. I am a father, husband, Veteran, clinician and human being. My personal philosophy involves an approach of education, meditation and application. Like others, I'm a "work in progress."
(509) 775-6616 View (509) 775-6616
Photo of LaBre Roy, Pre-Licensed Professional in Spokane, WA
LaBre Roy
Pre-Licensed Professional, LPC, LMHCA, RMHC-I
Verified Verified
Spokane, WA 99201  (Online Only)
Greetings! I’ve endured some wonderful and difficult experiences that have shaped who I am and how I help. My professional and personal journey has provided me with unique clinical knowledge that includes trauma, PTSD, anxiety, hopeless depression, cycles of substance abuse, and severe mental illnesses such as borderline personality disorder, bipolar, and schizophrenia.. By working with diverse (BIPOC) populations I have been successful in helping clients develop interpersonal communication skills, healthy coping strategies, and promoting optimal mental health.
Greetings! I’ve endured some wonderful and difficult experiences that have shaped who I am and how I help. My professional and personal journey has provided me with unique clinical knowledge that includes trauma, PTSD, anxiety, hopeless depression, cycles of substance abuse, and severe mental illnesses such as borderline personality disorder, bipolar, and schizophrenia.. By working with diverse (BIPOC) populations I have been successful in helping clients develop interpersonal communication skills, healthy coping strategies, and promoting optimal mental health.
(509) 519-1646 View (509) 519-1646
Photo of Karen Brown, Counselor in Spokane, WA
Karen Brown
Counselor, MA, LMHC, CMHS
Verified Verified
Spokane, WA 99201  (Online Only)
Karen Brown, M.A. is a Licensed Mental Health Counselor (LMHC) who has provided crisis-intervention and -management, Cognitive Behavioral Therapy, Motivational Interviewing, and Eye Movement Desensitization and Reprocessing (EMDR), among other specialized services. She also holds certification as a Child Mental Health Specialist. Karen has helped a diversity of adults, children (ages 6+), & adolescents who have a variety of mental health needs. In-person & virtual (Telehealth) sessions are available.
Karen Brown, M.A. is a Licensed Mental Health Counselor (LMHC) who has provided crisis-intervention and -management, Cognitive Behavioral Therapy, Motivational Interviewing, and Eye Movement Desensitization and Reprocessing (EMDR), among other specialized services. She also holds certification as a Child Mental Health Specialist. Karen has helped a diversity of adults, children (ages 6+), & adolescents who have a variety of mental health needs. In-person & virtual (Telehealth) sessions are available.
(509) 233-4815 View (509) 233-4815
Matt Woods
Counselor, LMHC, LCPC
Verified Verified
Spokane, WA 99209  (Online Only)
The initial meeting we'll get a feel for each other and we'll determine whether future sessions will likely be fruitful. If your initial impression of me is you feel I am trustworthy, sincere, and genuine then we are off to a great start! Finding a counselor that is the right fit can feel daunting, but once you do, the potential benefits can be huge.
The initial meeting we'll get a feel for each other and we'll determine whether future sessions will likely be fruitful. If your initial impression of me is you feel I am trustworthy, sincere, and genuine then we are off to a great start! Finding a counselor that is the right fit can feel daunting, but once you do, the potential benefits can be huge.
(509) 519-1332 View (509) 519-1332

How does your Therapist compare?

Number of Therapists in Spokane, WA

1,000+

Average cost per session

$135

Therapists in Spokane, WA who prioritize treating:

92% Anxiety
87% Depression
76% Self Esteem
74% Trauma and PTSD
73% Stress
72% Relationship Issues
71% Coping Skills

Average years in practice

8 Years

Top 3 insurances accepted

74% Premera
72% Aetna
58% Regence

How Therapists in Spokane, WA see their clients

52% In Person and Online
48% Online Only

Gender breakdown

80% Female
19% Male
1% Non-Binary

FAQs - About Therapy and Counseling

How can I find a therapist in Spokane?

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.