Therapists in Tacoma, WA

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Photo of Jessica Aarsvold, Counselor in Tacoma, WA
Jessica Aarsvold
Counselor, MA, LMHCA
Verified Verified
Tacoma, WA 98406  (Online Only)
Do you find yourself feeling stuck in the same cycles and patterns? Are you wishing for movement in your life but find yourself unable to let go of old stories, feelings, and thoughts? Maybe you are unsure of where to start but know that the way things are, is not how you want them to be. Often times our lives can become dictated by past wounds and, coping with the feelings that arise from these moments, can be difficult. Healing from the past and staying present in the now is possible, and you do not have to do it alone.
Do you find yourself feeling stuck in the same cycles and patterns? Are you wishing for movement in your life but find yourself unable to let go of old stories, feelings, and thoughts? Maybe you are unsure of where to start but know that the way things are, is not how you want them to be. Often times our lives can become dictated by past wounds and, coping with the feelings that arise from these moments, can be difficult. Healing from the past and staying present in the now is possible, and you do not have to do it alone.
(253) 215-8565 View (253) 215-8565
Photo of Erin Riggio, Counselor in Tacoma, WA
Erin Riggio
Counselor, MEd, LMHCA
Verified Verified
5 Endorsed
Tacoma, WA 98403
Not accepting new clients
Do you feel like nobody really sees you? Are you afraid that if they do, they’ll turn away? Sometimes we find ourselves putting on a “perfect” face because inside, we feel anything but. We lash out at the people close to us and then we feel confused and guilty. Maybe you’ve begun to notice some relationship patterns that no longer serve you. Maybe anxiety is holding you back from living a full life. Or maybe unprocessed trauma or grief are showing up in distressing ways. Therapy can help you get unstuck and move from feeling overwhelmed, disconnected, and not-enough to balanced, engaged, and whole. I’ve got you.
Do you feel like nobody really sees you? Are you afraid that if they do, they’ll turn away? Sometimes we find ourselves putting on a “perfect” face because inside, we feel anything but. We lash out at the people close to us and then we feel confused and guilty. Maybe you’ve begun to notice some relationship patterns that no longer serve you. Maybe anxiety is holding you back from living a full life. Or maybe unprocessed trauma or grief are showing up in distressing ways. Therapy can help you get unstuck and move from feeling overwhelmed, disconnected, and not-enough to balanced, engaged, and whole. I’ve got you.
(253) 893-8457 View (253) 893-8457
Photo of Tanya Larson, Counselor in Tacoma, WA
Tanya Larson
Counselor, MA, LMHC
Verified Verified
2 Endorsed
Tacoma, WA 98402
Are you feeling overwhelmed? Everyday stressors and relationship losses can leave you feeling disconnected from others, anxious or depressed. Whatever you are going through, I am here to help empower you with support, acceptance, and empathy. Let me help you align with your strengths, confront old patterns that impede your progress, learn new ways to interact in relationships, and deepen your self-understanding.
Are you feeling overwhelmed? Everyday stressors and relationship losses can leave you feeling disconnected from others, anxious or depressed. Whatever you are going through, I am here to help empower you with support, acceptance, and empathy. Let me help you align with your strengths, confront old patterns that impede your progress, learn new ways to interact in relationships, and deepen your self-understanding.
(253) 259-3042 View (253) 259-3042
Photo of Sara Elkington, Counselor in Tacoma, WA
Sara Elkington
Counselor, MA, LMHC
Verified Verified
Tacoma, WA 98403
Sara Elkington MA, LMHC is a licensed mental health therapist currently building a practice in Tacoma, Washington. She has specialized in working with individuals struggling with anxiety, depression, dissociative symptoms, post-trauma reactions, intimate partner abuse recovery, ADHD-related concerns, and those living with a life-changing medical condition or chronic illness. She firmly believes in the power of therapy to promote self-growth and resilience. Sara is committed to providing a safe, supportive, and judgment-free space for her clients to explore their experiences and foster healing.
Sara Elkington MA, LMHC is a licensed mental health therapist currently building a practice in Tacoma, Washington. She has specialized in working with individuals struggling with anxiety, depression, dissociative symptoms, post-trauma reactions, intimate partner abuse recovery, ADHD-related concerns, and those living with a life-changing medical condition or chronic illness. She firmly believes in the power of therapy to promote self-growth and resilience. Sara is committed to providing a safe, supportive, and judgment-free space for her clients to explore their experiences and foster healing.
(206) 973-7804 View (206) 973-7804
Photo of Deborah Lopez, Counselor in Tacoma, WA
Deborah Lopez
Counselor, MA
Verified Verified
Tacoma, WA 98446
Taking new clients in person for equine assisted psychotherapy, outside and socially distant sessions, and/or more traditional solution focused and cognitive behavioral therapy. If you are dealing with life changes or struggling with anxiety and/or depression I can help. I am a designated Mental Health Professional and Children's Mental Health Specialist . Licensed MH counselor in the Washington. I work with families individuals and couples toward goals that we identify together. Services to military veterans and family members at no cost through a contract with the Department of Veterans affairs.
Taking new clients in person for equine assisted psychotherapy, outside and socially distant sessions, and/or more traditional solution focused and cognitive behavioral therapy. If you are dealing with life changes or struggling with anxiety and/or depression I can help. I am a designated Mental Health Professional and Children's Mental Health Specialist . Licensed MH counselor in the Washington. I work with families individuals and couples toward goals that we identify together. Services to military veterans and family members at no cost through a contract with the Department of Veterans affairs.
(253) 243-3346 View (253) 243-3346
Photo of Kelley Kohlwes, Marriage & Family Therapist in Tacoma, WA
Kelley Kohlwes
Marriage & Family Therapist, LMFT, MHP, CMHS
Verified Verified
8 Endorsed
Tacoma, WA 98406
Working from a relational-narrative perspective, I am committed to supporting you in your life journey. If you are feeling unhappy within your relationship, personal experiences or simply feel “stuck”, I’m here to help support you in the pursuit of your preferred way of living. I am passionate about working with individuals experiencing life transitions and couples in any relational stage, offering support to all gender identities and sexual orientations.
Working from a relational-narrative perspective, I am committed to supporting you in your life journey. If you are feeling unhappy within your relationship, personal experiences or simply feel “stuck”, I’m here to help support you in the pursuit of your preferred way of living. I am passionate about working with individuals experiencing life transitions and couples in any relational stage, offering support to all gender identities and sexual orientations.
(253) 666-6954 View (253) 666-6954
Photo of Full Circle Psychotherapy, Counselor in Tacoma, WA
Full Circle Psychotherapy
Counselor, MA, LMHC
Verified Verified
5 Endorsed
Tacoma, WA 98403
My therapeutic philosophy rests on the premise that entering into a therapy relationship is a sacred act, and should be treated accordingly. It takes courage to challenge the limiting beliefs accumulated along life's journey, and I hold deep respect for those who are willing to do so. I provide a safe and respectful environment where you can explore the patterns keeping you from living a more authentic life.
My therapeutic philosophy rests on the premise that entering into a therapy relationship is a sacred act, and should be treated accordingly. It takes courage to challenge the limiting beliefs accumulated along life's journey, and I hold deep respect for those who are willing to do so. I provide a safe and respectful environment where you can explore the patterns keeping you from living a more authentic life.
(253) 358-2310 View (253) 358-2310
Photo of Lonnie Renteria Counseling, PLLC, Counselor in Tacoma, WA
Lonnie Renteria Counseling, PLLC
Counselor, MA, LMHC, CCTP, CTMH
Verified Verified
Tacoma, WA 98402  (Online Only)
Waitlist for new clients
I provide a safe, supportive space for couples and individuals. We negotiate together how to optimize your experience of living life, your relationships, your work, and we continue to build on that. I believe that we all have the capacity to heal and build the life that we want to live.
I provide a safe, supportive space for couples and individuals. We negotiate together how to optimize your experience of living life, your relationships, your work, and we continue to build on that. I believe that we all have the capacity to heal and build the life that we want to live.
(206) 258-6420 View (206) 258-6420
Photo of Janna Bushaw, Counselor in Tacoma, WA
Janna Bushaw
Counselor, MBA, MA, LMHC, NCC
Verified Verified
1 Endorsed
Tacoma, WA 98406
Waitlist for new clients
There are universal experiences that can cause us to question everything we have learned about who we are within ourselves and in connection to others. It’s in these times it can be difficult to meet life on life’s terms; when looking on the bright side, persistence and grit no longer get us through the day. This has been especially true this past couple of years. The most profound change being our ability to be connected to each other and having shared experiences to look forward to.
There are universal experiences that can cause us to question everything we have learned about who we are within ourselves and in connection to others. It’s in these times it can be difficult to meet life on life’s terms; when looking on the bright side, persistence and grit no longer get us through the day. This has been especially true this past couple of years. The most profound change being our ability to be connected to each other and having shared experiences to look forward to.
(253) 262-0681 View (253) 262-0681
Photo of Allie Peyton, Marriage & Family Therapist Associate in Tacoma, WA
Allie Peyton
Marriage & Family Therapist Associate, LMFTA
Verified Verified
3 Endorsed
Tacoma, WA 98403
Struggling with how to make your relationship and sex satisfying? Our relationships and sex in them can be fulfilling and pleasurable. I see intimacy and sex as layered. I work to enhance strengths, improve communication via attachment work and redefine what works for you/the relationship. Each of us changes in different ways as we grow. With changes in our sexuality, relationship or identity, I also hold space for the grief that we each individually or together experience for what we expected sex would look like or how things used to be. I bring laughter, safety and nonjudgement to each of my clients in our work together.
Struggling with how to make your relationship and sex satisfying? Our relationships and sex in them can be fulfilling and pleasurable. I see intimacy and sex as layered. I work to enhance strengths, improve communication via attachment work and redefine what works for you/the relationship. Each of us changes in different ways as we grow. With changes in our sexuality, relationship or identity, I also hold space for the grief that we each individually or together experience for what we expected sex would look like or how things used to be. I bring laughter, safety and nonjudgement to each of my clients in our work together.
(253) 201-4340 View (253) 201-4340
Photo of Dr. Kathleen King, Psychologist in Tacoma, WA
Dr. Kathleen King
Psychologist, PhD
Verified Verified
5 Endorsed
Tacoma, WA 98402  (Online Only)
Not accepting new clients
I specialize in working with adults, who struggle with building and maintaining healthy/happy relationships. Many of my clients feel a lot of pain in their romantic and/or familial relationships. Some clients feel unsupported, unappreciated, or invalidated and struggle with communicating with their loved ones. Others feel unsafe with their partner because of their own past trauma, anxiety, or depression. Some of the individuals I work with have been diagnosed with ADHD or have a partner with that diagnosis. They may have a difficult time connecting with one another and understanding each other's experiences.
I specialize in working with adults, who struggle with building and maintaining healthy/happy relationships. Many of my clients feel a lot of pain in their romantic and/or familial relationships. Some clients feel unsupported, unappreciated, or invalidated and struggle with communicating with their loved ones. Others feel unsafe with their partner because of their own past trauma, anxiety, or depression. Some of the individuals I work with have been diagnosed with ADHD or have a partner with that diagnosis. They may have a difficult time connecting with one another and understanding each other's experiences.
(425) 364-6604 View (425) 364-6604
Photo of Tatyana A Kincaid, Counselor in Tacoma, WA
Tatyana A Kincaid
Counselor, MA, LMHC
Verified Verified
1 Endorsed
Tacoma, WA 98403
My specialty is helping clients understand why certain patterns have emerged in their lives. By fully appreciating our unwanted patterns we can gain clarity about how to change them. I believe lasting change comes from an awareness of our beliefs and values coupled with habit change. Some unique issues I work with in addition to the listed concerns are; difficulty relaxing, grief and loss, feeling others' feelings, and perfectionism.
My specialty is helping clients understand why certain patterns have emerged in their lives. By fully appreciating our unwanted patterns we can gain clarity about how to change them. I believe lasting change comes from an awareness of our beliefs and values coupled with habit change. Some unique issues I work with in addition to the listed concerns are; difficulty relaxing, grief and loss, feeling others' feelings, and perfectionism.
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Photo of Meaghan Trezza, Counselor in Tacoma, WA
Meaghan Trezza
Counselor, LMHC, MS, NCC
Verified Verified
Tacoma, WA 98405
I am a Licensed Mental Health Therapist with a passion for helping individuals connect with themselves, their strengths, and joy to live a more balanced and fulfilling life. In my practice, I utilize a combination of person-centered, Somatic Experiencing, existential, self-compassion work, and mindfulness-based interventions. My approach is multicultural and intersectional, utilizing my degree in political science to take into account the impact that oppressive systems have on mental health. My approach is relational, trauma-informed, and showing up genuine, authentic, and curious in our space together.
I am a Licensed Mental Health Therapist with a passion for helping individuals connect with themselves, their strengths, and joy to live a more balanced and fulfilling life. In my practice, I utilize a combination of person-centered, Somatic Experiencing, existential, self-compassion work, and mindfulness-based interventions. My approach is multicultural and intersectional, utilizing my degree in political science to take into account the impact that oppressive systems have on mental health. My approach is relational, trauma-informed, and showing up genuine, authentic, and curious in our space together.
(253) 352-3476 View (253) 352-3476
Photo of Spirit Springs Holistic Healing, LLC, Pre-Licensed Professional in Tacoma, WA
Spirit Springs Holistic Healing, LLC
Pre-Licensed Professional, MS, LMHCA, SUDPt
Verified Verified
Tacoma, WA 98406
Waitlist for new clients
First off, I am so proud that you have taken the first (or 1000th) step on this journey of reconnecting with your authentic self! I firmly believe that each client has the potential to access everything they need within themselves, with supportive and nurturing guidance. We will work together to identify limitations and barriers and build the tools necessary to move through them with grace and compassion. Your primary goal is self-empowerment and energetic centering and I am hopeful to help you get there. If you are interested in a holistic approach to your mental health, I would love to be a part of your journey.
First off, I am so proud that you have taken the first (or 1000th) step on this journey of reconnecting with your authentic self! I firmly believe that each client has the potential to access everything they need within themselves, with supportive and nurturing guidance. We will work together to identify limitations and barriers and build the tools necessary to move through them with grace and compassion. Your primary goal is self-empowerment and energetic centering and I am hopeful to help you get there. If you are interested in a holistic approach to your mental health, I would love to be a part of your journey.
(253) 785-2105 View (253) 785-2105
Photo of Ivey West, Counselor in Tacoma, WA
Ivey West
Counselor, MEd, LMHC
Verified Verified
Tacoma, WA 98405
Not accepting new clients
Renowned therapist Virginia Satir said: "Life is not what it is supposed to be. It's what it is. The way you cope with it is what makes the difference." It sums up my philosophy of therapy. Life is hard. Coping is hard. Effective coping strategies can bring peace and satisfaction no matter your history, your current challenges, or your future unknowns. How to cope.
Renowned therapist Virginia Satir said: "Life is not what it is supposed to be. It's what it is. The way you cope with it is what makes the difference." It sums up my philosophy of therapy. Life is hard. Coping is hard. Effective coping strategies can bring peace and satisfaction no matter your history, your current challenges, or your future unknowns. How to cope.
(253) 655-0947 View (253) 655-0947
Photo of Andre St. Hilaire, Counselor in Tacoma, WA
Andre St. Hilaire
Counselor, MEd, LMHCA
Verified Verified
4 Endorsed
Tacoma, WA 98403
Current openings for outdoor and online therapy sessions! Is the toxic stress you are experiencing showing up as anxiety, dread or avoidance? Does the gap between what you want out of life and where you are at currently leave you feeling symptoms of burnout or depression? When stress is overwhelming it can impact our self esteem and ability to move forward. Whether it's finding a sense of calm and being more present, building a better relationship with yourself, or figuring out the changes you want to work towards therapy can restore hope. Together we can explore what you want for the road ahead-it's time to rediscover you!
Current openings for outdoor and online therapy sessions! Is the toxic stress you are experiencing showing up as anxiety, dread or avoidance? Does the gap between what you want out of life and where you are at currently leave you feeling symptoms of burnout or depression? When stress is overwhelming it can impact our self esteem and ability to move forward. Whether it's finding a sense of calm and being more present, building a better relationship with yourself, or figuring out the changes you want to work towards therapy can restore hope. Together we can explore what you want for the road ahead-it's time to rediscover you!
(253) 796-8413 View (253) 796-8413
Photo of Winona Wallace, Counselor in Tacoma, WA
Winona Wallace
Counselor, LMHC
Verified Verified
Tacoma, WA 98405
Winona enjoys working with adolescents and adults of all ages. She works with clients dealing with mood disorders, personality disorders, anxiety, self-esteem issues, PTSD, grief and loss, and those facing other life challenges. In addition, she has worked with clients experiencing domestic violence. Her objective is to help individuals heal, and then find and build on their strengths in order to achieve their goals and become their very best selves. Winona enjoys working with clients and assisting them in developing coping skills that they can use for the rest of their lives.
Winona enjoys working with adolescents and adults of all ages. She works with clients dealing with mood disorders, personality disorders, anxiety, self-esteem issues, PTSD, grief and loss, and those facing other life challenges. In addition, she has worked with clients experiencing domestic violence. Her objective is to help individuals heal, and then find and build on their strengths in order to achieve their goals and become their very best selves. Winona enjoys working with clients and assisting them in developing coping skills that they can use for the rest of their lives.
(253) 523-2311 View (253) 523-2311
Photo of Stanford Stringham, Mental Health Counselor in Tacoma, WA
Stanford Stringham
Mental Health Counselor
Verified Verified
Tacoma, WA 98405
S. Todd Stringham, LMHC, received his Master of Science in Mental Health Counseling from Walden University in 2016, and has been working for Comprehensive Life Resources as a therapist in Tacoma. Todd's eclectic style draws from a variety of techniques that include: (ACT) Acceptance and Commitment Therapy, (DBT) Dialectical Behavior Therapy, (EMDR) Eye Movement Desensitization and Reprocessing, and (MI) Motivational Interview. He works with adults suffering from anxiety disorders including phobias and OCD, depression, trauma, stress and adjustment disorder.
S. Todd Stringham, LMHC, received his Master of Science in Mental Health Counseling from Walden University in 2016, and has been working for Comprehensive Life Resources as a therapist in Tacoma. Todd's eclectic style draws from a variety of techniques that include: (ACT) Acceptance and Commitment Therapy, (DBT) Dialectical Behavior Therapy, (EMDR) Eye Movement Desensitization and Reprocessing, and (MI) Motivational Interview. He works with adults suffering from anxiety disorders including phobias and OCD, depression, trauma, stress and adjustment disorder.
(253) 364-4695 View (253) 364-4695
Photo of Brittany Tillman, Counselor in Tacoma, WA
Brittany Tillman
Counselor, LMHCA
Verified Verified
Tacoma, WA 98446
Welcome! I am so glad you are here. My primary focus as a licensed mental health counselor associate is on anxiety-related disorders, and I have worked extensively with clients facing a range of challenges, from generalized anxiety or specific phobias, to perfectionism or insecure attachment styles. I understand that each person's experience with anxiety is unique, and I tailor my therapeutic approach to meet individual needs. Whether that involves use of common evidence-based practices like cognitive-behavioral therapy (CBT), or traditional talk therapy, we will find what works best for you.
Welcome! I am so glad you are here. My primary focus as a licensed mental health counselor associate is on anxiety-related disorders, and I have worked extensively with clients facing a range of challenges, from generalized anxiety or specific phobias, to perfectionism or insecure attachment styles. I understand that each person's experience with anxiety is unique, and I tailor my therapeutic approach to meet individual needs. Whether that involves use of common evidence-based practices like cognitive-behavioral therapy (CBT), or traditional talk therapy, we will find what works best for you.
(509) 519-1420 View (509) 519-1420
Photo of Loving Kindness Family Counseling Services, Counselor in Tacoma, WA
Loving Kindness Family Counseling Services
Counselor, LMHC
Verified Verified
Tacoma, WA 98409
There are times in our lives that sometimes we just need a listening ear. There are other times when life comes at you fast with experiences and challenges that can be difficult to face alone. I am 100% committed to helping you find that extra help you need. My goal is to provide a safe, non-judgmental and compassionate place for you to feel comfortable in sharing and expressing yourself.
There are times in our lives that sometimes we just need a listening ear. There are other times when life comes at you fast with experiences and challenges that can be difficult to face alone. I am 100% committed to helping you find that extra help you need. My goal is to provide a safe, non-judgmental and compassionate place for you to feel comfortable in sharing and expressing yourself.
(253) 655-2265 View (253) 655-2265

How does your Therapist compare?

Number of Therapists in Tacoma, WA

1,000+

Average cost per session

$150

Therapists in Tacoma, WA who prioritize treating:

93% Anxiety
88% Depression
76% Trauma and PTSD
75% Relationship Issues
75% Self Esteem
70% Stress
67% Coping Skills

Average years in practice

9 Years

Top 3 insurances accepted

78% Premera
66% Regence
61% Aetna

How Therapists in Tacoma, WA see their clients

50% In Person and Online
50% Online Only

Gender breakdown

75% Female
21% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Tacoma?

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.