Therapists in Saint Louis, MO

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Photo of Kara Shaughnessy, Clinical Social Work/Therapist in Saint Louis, MO
Kara Shaughnessy
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Saint Louis, MO 63128
Not accepting new clients
Some people have intense or overwhelming emotions, feeling stressed or just “stuck” in life. While we all try to do the best we can to problem solve and manage life stressors, sometimes what we’ve been doing is no longer working for us. I am skilled in helping clients untangle strong emotions and thoughts by balancing the “see-saw” of acceptance of what won't change in life while also empowering clients to use new skills to change. In doing so, we identify unhelpful behaviors that are no longer serving a purpose and work toward more healthy behaviors that are relevant to people’s goals to figure out the problems in their lives.
Some people have intense or overwhelming emotions, feeling stressed or just “stuck” in life. While we all try to do the best we can to problem solve and manage life stressors, sometimes what we’ve been doing is no longer working for us. I am skilled in helping clients untangle strong emotions and thoughts by balancing the “see-saw” of acceptance of what won't change in life while also empowering clients to use new skills to change. In doing so, we identify unhelpful behaviors that are no longer serving a purpose and work toward more healthy behaviors that are relevant to people’s goals to figure out the problems in their lives.
(314) 207-4999 View (314) 207-4999
Photo of Cadence Hodes, Licensed Professional Counselor in Saint Louis, MO
Cadence Hodes
Licensed Professional Counselor, LPC, MEd, NCC
Verified Verified
Saint Louis, MO 63139
Therapy is a unique experience. It provides the opportunity to show up exactly as you are and explore your thoughts, feelings, identities, and relationships without fear of judgement; and to feel heard, accepted, and cared for in return. Life is increasingly hard, and my goal is to provide space to decompress, navigate hardships together, and celebrate your growth and successes. We might be a good fit if you are in a life transition, experiencing anxiety or depression, struggling with body image, have specific goals you'd like to work towards (or would like to identify some!), or simply believe you could be happier.
Therapy is a unique experience. It provides the opportunity to show up exactly as you are and explore your thoughts, feelings, identities, and relationships without fear of judgement; and to feel heard, accepted, and cared for in return. Life is increasingly hard, and my goal is to provide space to decompress, navigate hardships together, and celebrate your growth and successes. We might be a good fit if you are in a life transition, experiencing anxiety or depression, struggling with body image, have specific goals you'd like to work towards (or would like to identify some!), or simply believe you could be happier.
(314) 408-2772 View (314) 408-2772
Photo of Brittany N. Murphy, Licensed Professional Counselor in Saint Louis, MO
Brittany N. Murphy
Licensed Professional Counselor, PhD, LPC, NCC, BC-TMH
Verified Verified
4 Endorsed
Saint Louis, MO 63117  (Online Only)
You're in the right place! You're ready for your mood and motivation to improve, your relationships to be better, your work to be more enjoyable, and your life to feel more meaningful. I work well with people who feel stuck or that things aren't as they could or should be. My clients want clarity about their experiences, their relationships, and the direction of their lives.
You're in the right place! You're ready for your mood and motivation to improve, your relationships to be better, your work to be more enjoyable, and your life to feel more meaningful. I work well with people who feel stuck or that things aren't as they could or should be. My clients want clarity about their experiences, their relationships, and the direction of their lives.
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Photo of Michelle Perotta, Pre-Licensed Professional in Saint Louis, MO
Michelle Perotta
Pre-Licensed Professional, LMSW
Verified Verified
3 Endorsed
Saint Louis, MO 63131
Michelle earned her Masters of Social Work degree from Saint Louis University & her Licensed Master of Social Work License 2011. Michelle has worked with a diverse population over the years, primarily focusing on children, teenagers, & families, as well as individuals facing trauma. Michelle believes that all individuals wish to be heard, accepted & understood, but when faced with stressful & challenging situations life can seem overwhelming, unmanageable, and out of control, but therapy can help bring you peace, or "calm the chaos" as she frequently says.
Michelle earned her Masters of Social Work degree from Saint Louis University & her Licensed Master of Social Work License 2011. Michelle has worked with a diverse population over the years, primarily focusing on children, teenagers, & families, as well as individuals facing trauma. Michelle believes that all individuals wish to be heard, accepted & understood, but when faced with stressful & challenging situations life can seem overwhelming, unmanageable, and out of control, but therapy can help bring you peace, or "calm the chaos" as she frequently says.
(314) 582-5126 View (314) 582-5126
Photo of Dana Boyland, Clinical Social Work/Therapist in Saint Louis, MO
Dana Boyland
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
2 Endorsed
Saint Louis, MO 63132
Accepting New Clients! - As an older adult you know that life has a way of throwing you curve balls in way of events or circumstances that make you anxious and may weigh you down emotionally. Do you have a new medical diagnosis? A life-limiting disease or illness? Have physical challenges affected your most important relationships? Did retirement not turn out the way you'd expected? Are you experiencing loss of independence, even loss of control if others are making decisions for you and you're not ready. You may be thinking, “This is unfair, life was not supposed to turn out this way.” Aging is not for the faint of heart!
Accepting New Clients! - As an older adult you know that life has a way of throwing you curve balls in way of events or circumstances that make you anxious and may weigh you down emotionally. Do you have a new medical diagnosis? A life-limiting disease or illness? Have physical challenges affected your most important relationships? Did retirement not turn out the way you'd expected? Are you experiencing loss of independence, even loss of control if others are making decisions for you and you're not ready. You may be thinking, “This is unfair, life was not supposed to turn out this way.” Aging is not for the faint of heart!
(314) 701-7496 View (314) 701-7496
Photo of Kelly S Diller, Licensed Professional Counselor in Saint Louis, MO
Kelly S Diller
Licensed Professional Counselor, LPC, MAC
Verified Verified
Saint Louis, MO 63131
Waitlist for new clients
Kelly brings deep compassion and understanding to the counseling experience and walks with her clients through changes that are meaningful and long-lasting. She is passionate about helping women heal from abuse and betrayal, and she recognizes the importance of instilling hope for desired change with regard to relationships and other goals. She loves to work with relationships, anxiety, self-esteem, family counseling, adolescents, identity issues, grief, trauma, depression, anger, and spiritual struggles. Kelly assists her clients in understanding the full context of their situations and she speaks truth in love.
Kelly brings deep compassion and understanding to the counseling experience and walks with her clients through changes that are meaningful and long-lasting. She is passionate about helping women heal from abuse and betrayal, and she recognizes the importance of instilling hope for desired change with regard to relationships and other goals. She loves to work with relationships, anxiety, self-esteem, family counseling, adolescents, identity issues, grief, trauma, depression, anger, and spiritual struggles. Kelly assists her clients in understanding the full context of their situations and she speaks truth in love.
(314) 219-1724 View (314) 219-1724
Photo of Aya B Kawasaki, Clinical Social Work/Therapist in Saint Louis, MO
Aya B Kawasaki
Clinical Social Work/Therapist, LCSW
Verified Verified
Saint Louis, MO 63139
My clients are very diverse in age, ethnicity, social economic status, and gender/sexual identity. I would like to be culturally humble and honor your background and identity.
My clients are very diverse in age, ethnicity, social economic status, and gender/sexual identity. I would like to be culturally humble and honor your background and identity.
(314) 804-1545 View (314) 804-1545
Photo of Hannah Campbell, Marriage & Family Therapist in Saint Louis, MO
Hannah Campbell
Marriage & Family Therapist, MA, LMFT, LPCC
Verified Verified
Saint Louis, MO 63130
I'm glad you're here: you have taken a courageous and healing step by seeking support. I provide an integrative, resiliency-focused approach to therapy, pulling from your strengths and values to guide our work and help you regain a sense of mastery, meaning, and connection in your life. My perspective is that we are built to survive and often develop ways of relating which once helped us get by, but may no longer be helpful to a current situation. My goal is to form a safe connection to explore these factors that may contribute to ongoing difficulties, re-process experiences, and ultimately co-create your next chapter.
I'm glad you're here: you have taken a courageous and healing step by seeking support. I provide an integrative, resiliency-focused approach to therapy, pulling from your strengths and values to guide our work and help you regain a sense of mastery, meaning, and connection in your life. My perspective is that we are built to survive and often develop ways of relating which once helped us get by, but may no longer be helpful to a current situation. My goal is to form a safe connection to explore these factors that may contribute to ongoing difficulties, re-process experiences, and ultimately co-create your next chapter.
(314) 675-7902 View (314) 675-7902
Photo of Nicole Neace, Licensed Professional Counselor in Saint Louis, MO
Nicole Neace
Licensed Professional Counselor, MEd, LPC
Verified Verified
Saint Louis, MO 63139  (Online Only)
It is never too late to begin deep and meaningful work reimagining how traumas or other experiences can become integrated, meaningful parts of our lives and ourselves, rather than barriers or obstacles. The key to this important work is the recognition that your story and has deep and significant meaning.  No detail is ultimately insignificant, if we can but muster the courage, patience, and presence required.  I will help you!  I am so eager to understand and explore with you, and help create a safe space that ultimately facilitates not just growth and transition, but true healing and transformation.
It is never too late to begin deep and meaningful work reimagining how traumas or other experiences can become integrated, meaningful parts of our lives and ourselves, rather than barriers or obstacles. The key to this important work is the recognition that your story and has deep and significant meaning.  No detail is ultimately insignificant, if we can but muster the courage, patience, and presence required.  I will help you!  I am so eager to understand and explore with you, and help create a safe space that ultimately facilitates not just growth and transition, but true healing and transformation.
(314) 370-1039 View (314) 370-1039
Photo of Brady Sullivan, Licensed Professional Counselor in Saint Louis, MO
Brady Sullivan
Licensed Professional Counselor, PhD, LPC-S, NCC
Verified Verified
2 Endorsed
Saint Louis, MO 63118
Waitlist for new clients
*Yes, I am gay :)* I believe that therapy is for everyone, because everyone deserves this sacred space to look into the mirror and see themselves. Sometimes the reflection isn’t pretty. Sometimes there are things we wish we didn’t see. However, witnessing and recognizing the pain and sadness is the first part of moving through it. That’s where the therapist comes in, to stand by patiently and point out the behaviors, beliefs, thoughts, and feelings that are causing us pain. They are the person who helps us shed everything that is holding us back so that we can finally become the person we always knew we could be.
*Yes, I am gay :)* I believe that therapy is for everyone, because everyone deserves this sacred space to look into the mirror and see themselves. Sometimes the reflection isn’t pretty. Sometimes there are things we wish we didn’t see. However, witnessing and recognizing the pain and sadness is the first part of moving through it. That’s where the therapist comes in, to stand by patiently and point out the behaviors, beliefs, thoughts, and feelings that are causing us pain. They are the person who helps us shed everything that is holding us back so that we can finally become the person we always knew we could be.
(314) 208-2434 View (314) 208-2434
Photo of Fred Hudson, Counselor in Saint Louis, MO
Fred Hudson
Counselor, LPC
Verified Verified
Saint Louis, MO 63122
Fred Hudson is a Licensed Professional Counselor (Missouri) and National Certified Counselor who has been practicing since 2007. He graduated from Webster University in St. Louis, Missouri with a Master of Arts degree in Counseling.
Fred Hudson is a Licensed Professional Counselor (Missouri) and National Certified Counselor who has been practicing since 2007. He graduated from Webster University in St. Louis, Missouri with a Master of Arts degree in Counseling.
(314) 860-7915 View (314) 860-7915
Photo of Therapy Nest Accepting New Clients!, Licensed Professional Counselor in Saint Louis, MO
Therapy Nest Accepting New Clients!
Licensed Professional Counselor, LPC , LCSW, LMFT, CSAT, LMT
Verified Verified
1 Endorsed
Saint Louis, MO 63132
Accepting new clients! We are a diverse group of licensed wellness professionals that have come together to help those in need. We are knowledgeable, compassionate and honored to help Individuals, couples and families. If you are a practicum internship student looking for a site inquire today!
Accepting new clients! We are a diverse group of licensed wellness professionals that have come together to help those in need. We are knowledgeable, compassionate and honored to help Individuals, couples and families. If you are a practicum internship student looking for a site inquire today!
(314) 907-3135 View (314) 907-3135
Photo of Rita Skiba-Mathews, Clinical Social Work/Therapist in Saint Louis, MO
Rita Skiba-Mathews
Clinical Social Work/Therapist, LCSW
Verified Verified
Saint Louis, MO 63108
Are you seeking a therapist who is committed to providing a safe and affirming environment where your experiences, feelings, and identity are respected and valued? Perhaps you have experienced hardship or traumas and feel stuck in a loop of past memories. Or maybe you are finding it challenging to be effective in your day to day life. If something about this resonates with you, I think we might be a good fit! I hope to provide a comfortable and nonjudgemental environment where you can safely show up as your authentic self to work on treatment goals that fit your current struggles.
Are you seeking a therapist who is committed to providing a safe and affirming environment where your experiences, feelings, and identity are respected and valued? Perhaps you have experienced hardship or traumas and feel stuck in a loop of past memories. Or maybe you are finding it challenging to be effective in your day to day life. If something about this resonates with you, I think we might be a good fit! I hope to provide a comfortable and nonjudgemental environment where you can safely show up as your authentic self to work on treatment goals that fit your current struggles.
(314) 804-7725 View (314) 804-7725
Photo of Meghan Gaffney, Pre-Licensed Professional in Saint Louis, MO
Meghan Gaffney
Pre-Licensed Professional, MA, PLPC
Verified Verified
Saint Louis, MO 63118
As someone who values genuineness, compassion, and transparency, I aim to create a space where clients can be vulnerable and authentically themselves. I feel healing occurs when client’s feel seen, supported, and validated. You can expect curiosity, passion, and informality to show up in my approach. I believe in meeting each client at where they're at in their journey. I have experience working with anxiety, depression, traumatic experiences, communication problems, and adjustment issues.
As someone who values genuineness, compassion, and transparency, I aim to create a space where clients can be vulnerable and authentically themselves. I feel healing occurs when client’s feel seen, supported, and validated. You can expect curiosity, passion, and informality to show up in my approach. I believe in meeting each client at where they're at in their journey. I have experience working with anxiety, depression, traumatic experiences, communication problems, and adjustment issues.
(314) 310-1870 View (314) 310-1870
Photo of Didi Lombardo in Saint Louis, MO
Didi Lombardo
MA, LPC
Verified Verified
Saint Louis, MO 63146  (Online Only)
Hello and welcome! Are you feeling as though you've been spinning your wheels with no direction or reward? Do you want to take steps to improve your current behavior patterns or routine, or have you been feeling overwhelmed with some of life's challenges and transitions? I am here to help you. Together we will work to create the goals that you would like to achieve to improve your current situation, and hopefully you'll even find joy in working to achieve them.
Hello and welcome! Are you feeling as though you've been spinning your wheels with no direction or reward? Do you want to take steps to improve your current behavior patterns or routine, or have you been feeling overwhelmed with some of life's challenges and transitions? I am here to help you. Together we will work to create the goals that you would like to achieve to improve your current situation, and hopefully you'll even find joy in working to achieve them.
(314) 526-3958 View (314) 526-3958
Photo of Megan MacKenzie, Clinical Social Work/Therapist in Saint Louis, MO
Megan MacKenzie
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Saint Louis, MO 63108
As a relationship, sex, and gender therapist, I help couples, relationships, and individuals explore identities, navigate non-monogamy, and experience greater pleasure and intimacy. I am passionate about supporting LGBTQ+ folks in exploring and healing from the negative impacts of internalized homophobia, transphobia, and racism as they often manifest in shame, guilt, and low self-esteem.
As a relationship, sex, and gender therapist, I help couples, relationships, and individuals explore identities, navigate non-monogamy, and experience greater pleasure and intimacy. I am passionate about supporting LGBTQ+ folks in exploring and healing from the negative impacts of internalized homophobia, transphobia, and racism as they often manifest in shame, guilt, and low self-esteem.
(314) 626-0543 View (314) 626-0543
Photo of Kelly Larkin, Licensed Professional Counselor in Saint Louis, MO
Kelly Larkin
Licensed Professional Counselor, MA, LPC
Verified Verified
Saint Louis, MO 63127
I believe my clients deserve to be understood, valued, and given the opportunity to gain the tools for a more fulfilling life. When working as a team, we use our strengths to achieve the best outcome. I believe clients are the professionals on themselves and I offer the professional knowledge and therapeutic tools. Together we can identify the problem areas and find solutions for success and relief. My goal is to help my clients not feel alone with their struggles and to feel competent to deal with whatever life throws their way.
I believe my clients deserve to be understood, valued, and given the opportunity to gain the tools for a more fulfilling life. When working as a team, we use our strengths to achieve the best outcome. I believe clients are the professionals on themselves and I offer the professional knowledge and therapeutic tools. Together we can identify the problem areas and find solutions for success and relief. My goal is to help my clients not feel alone with their struggles and to feel competent to deal with whatever life throws their way.
(314) 762-6476 View (314) 762-6476
Jean Caine
Clinical Social Work/Therapist, LCSW, LMFT
Verified Verified
Saint Louis, MO 63117
Jean Stanton Caine, LCSW, LMFT, a Menninger trained family therapist, specializes in many issues affecting individuals and families i.e.: grief, illness, sexual and physical abuse, marital stress, child and adolescent problems. She has an eclectic researched approach in her family practice using both short term and long-term therapy. Jean has been in practice for 25 years. She has been past president on St. Louis MAMFT board and the Missouri board of Family Therapy. She has taught for 20 years at Washington University. Jean does accept most insurance plans.
Jean Stanton Caine, LCSW, LMFT, a Menninger trained family therapist, specializes in many issues affecting individuals and families i.e.: grief, illness, sexual and physical abuse, marital stress, child and adolescent problems. She has an eclectic researched approach in her family practice using both short term and long-term therapy. Jean has been in practice for 25 years. She has been past president on St. Louis MAMFT board and the Missouri board of Family Therapy. She has taught for 20 years at Washington University. Jean does accept most insurance plans.
(314) 828-2601 View (314) 828-2601
Photo of Cathy Luebbering, Clinical Social Work/Therapist in Saint Louis, MO
Cathy Luebbering
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Saint Louis, MO 63117
I work with those who are courageously facing pain and trauma in their lives. Perhaps you wonder if you can look at your own experiences... Maybe you fear being overwhelmed if you dare look. You may be thinking anxiety will overwhelm you. It need not be this way. Allow me to journey with you as you explore the questions tugging at you. You need not face them alone. Support is here; it is real. You CAN face these challenges, and you need not face them alone in the silence of your heart. Reach out now for the support you deserve.
I work with those who are courageously facing pain and trauma in their lives. Perhaps you wonder if you can look at your own experiences... Maybe you fear being overwhelmed if you dare look. You may be thinking anxiety will overwhelm you. It need not be this way. Allow me to journey with you as you explore the questions tugging at you. You need not face them alone. Support is here; it is real. You CAN face these challenges, and you need not face them alone in the silence of your heart. Reach out now for the support you deserve.
(314) 309-3431 View (314) 309-3431
Photo of Danielle High, Licensed Professional Counselor in Saint Louis, MO
Danielle High
Licensed Professional Counselor, MEd, LPC
Verified Verified
Saint Louis, MO 63112
Waitlist for new clients
I know reaching out for help can be daunting and overwhelming. I am here to make this process easier for you. I have worked with individuals and families from differing backgrounds, experiences, and concerns. My counseling style is strength-based, meaning I like to focus on the many positive traits you already possess and work collaboratively to reach the goals you would like to achieve. We are all searching for acceptance and understanding. I am here to help. I have extensive experience working with individuals that have experienced trauma, depression, anxiety, phobias, LGBTQIA+ related concerns, and non-monogamous relationships.
I know reaching out for help can be daunting and overwhelming. I am here to make this process easier for you. I have worked with individuals and families from differing backgrounds, experiences, and concerns. My counseling style is strength-based, meaning I like to focus on the many positive traits you already possess and work collaboratively to reach the goals you would like to achieve. We are all searching for acceptance and understanding. I am here to help. I have extensive experience working with individuals that have experienced trauma, depression, anxiety, phobias, LGBTQIA+ related concerns, and non-monogamous relationships.
(314) 270-1294 View (314) 270-1294

How does your Therapist compare?

Number of Therapists in Saint Louis, MO

1,000+

Average cost per session

$125

Therapists in Saint Louis, MO who prioritize treating:

91% Anxiety
86% Depression
77% Relationship Issues
74% Self Esteem
70% Trauma and PTSD
67% Stress
66% Coping Skills

Average years in practice

11 Years

Top 3 insurances accepted

74% UnitedHealthcare UHC | UBH
71% Aetna
71% Cigna and Evernorth

How Therapists in Saint Louis, MO see their clients

75% In Person and Online
25% Online Only

Gender breakdown

78% Female
20% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Saint Louis?

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.