Therapists in Portland, OR

View neighborhoods in Portland
Photo of Kathryn Bereman-Skelly, Licensed Professional Counselor in Portland, OR
Kathryn Bereman-Skelly
Licensed Professional Counselor, LPC, PMH-C
Verified Verified
1 Endorsed
Portland, OR 97213
Waitlist for new clients
Are you feeling challenged by motherhood? As a therapist who specializes in maternal mental health, I help you process and cope with the stress, anxiety, and overwhelm that surfaces during the parenting years. Relationship concerns, career transitions, exceptional children, even coping with loneliness are all common counseling topics. With very little time to process complex feelings, these issues can lead to anxiety, ambivalence, anger, even grief. I give women the space to explore their very real feelings, while fostering confidence in, and compassion for, themselves through this intense season of life.
Are you feeling challenged by motherhood? As a therapist who specializes in maternal mental health, I help you process and cope with the stress, anxiety, and overwhelm that surfaces during the parenting years. Relationship concerns, career transitions, exceptional children, even coping with loneliness are all common counseling topics. With very little time to process complex feelings, these issues can lead to anxiety, ambivalence, anger, even grief. I give women the space to explore their very real feelings, while fostering confidence in, and compassion for, themselves through this intense season of life.
(971) 234-9531 View (971) 234-9531
Photo of Jessica Simonetti, Psychologist in Portland, OR
Jessica Simonetti
Psychologist, PhD
Verified Verified
Portland, OR 97227
I am a clinical psychologist in the state of Oregon and primarily serve the adult population. I completed my doctoral training at Palo Alto University (APA accredited), internship at the Long Beach VA and residency at the West LA VA. I work with those suffering with depression, anxiety, shame, self-criticism, and identity or purpose-related struggles such as new transitions, or clarifying goals, values, and direction, I also help those struggling with chronic stress, sleep challenges such as insomnia, and personal relationship challenges. I have vast experience in and specialize in working with LGBTQ folx and LGBTQ relevant issues.
I am a clinical psychologist in the state of Oregon and primarily serve the adult population. I completed my doctoral training at Palo Alto University (APA accredited), internship at the Long Beach VA and residency at the West LA VA. I work with those suffering with depression, anxiety, shame, self-criticism, and identity or purpose-related struggles such as new transitions, or clarifying goals, values, and direction, I also help those struggling with chronic stress, sleep challenges such as insomnia, and personal relationship challenges. I have vast experience in and specialize in working with LGBTQ folx and LGBTQ relevant issues.
(971) 257-5395 View (971) 257-5395
Photo of Brooke A White, Clinical Social Work/Therapist in Portland, OR
Brooke A White
Clinical Social Work/Therapist, LCSW
Verified Verified
Portland, OR 97232
Not accepting new clients
Human minds and bodies are creative and our systems find ways to keep us functioning safely through extraordinary and difficult circumstances. There often comes a time, however, when the tools and skills we have relied on to keep us safe are no longer working and we need to find new ways to move through the world as we build the life we want to live.
Human minds and bodies are creative and our systems find ways to keep us functioning safely through extraordinary and difficult circumstances. There often comes a time, however, when the tools and skills we have relied on to keep us safe are no longer working and we need to find new ways to move through the world as we build the life we want to live.
(503) 773-6923 View (503) 773-6923
Photo of Randy H Zasloff, Licensed Professional Counselor in Portland, OR
Randy H Zasloff
Licensed Professional Counselor, LPC, CADCI, NCC
Verified Verified
3 Endorsed
Portland, OR 97210  (Online Only)
Not accepting new clients
Do you feel overwhelmed, confused, or stuck? You have more days when it's all you can do to drag yourself out of bed? You have trouble falling asleep because you can't stop worry about what's going to happen? Or you wake up from nightmares that make no sense? Counseling can help. I truly believe everyone has the ability to heal. First, we will develop a safe and respectful relationship. Then, dependent on what works best for you we put together a plan to address your goals. Often I incorporate 'experiential' therapies to complement 'talk' therapy.
Do you feel overwhelmed, confused, or stuck? You have more days when it's all you can do to drag yourself out of bed? You have trouble falling asleep because you can't stop worry about what's going to happen? Or you wake up from nightmares that make no sense? Counseling can help. I truly believe everyone has the ability to heal. First, we will develop a safe and respectful relationship. Then, dependent on what works best for you we put together a plan to address your goals. Often I incorporate 'experiential' therapies to complement 'talk' therapy.
(503) 610-5039 View (503) 610-5039
Photo of Cassandra Gardner, Licensed Professional Counselor in Portland, OR
Cassandra Gardner
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Portland, OR 97212  (Online Only)
When working with clients I prioritize the therapeutic relationship. We become a team working toward your goals, and I place significant value on honesty, authenticity, humor, compassion, validation, and accountability into our work together. Since starting my counseling practice I have worked with people of all ages and backgrounds experiencing various challenges including but not limited to anxiety, depression, OCD, trauma, gender dysphoria, grief, interpersonal issues, life transitions, adoption, self-esteem, bipolar II disorder, and more.
When working with clients I prioritize the therapeutic relationship. We become a team working toward your goals, and I place significant value on honesty, authenticity, humor, compassion, validation, and accountability into our work together. Since starting my counseling practice I have worked with people of all ages and backgrounds experiencing various challenges including but not limited to anxiety, depression, OCD, trauma, gender dysphoria, grief, interpersonal issues, life transitions, adoption, self-esteem, bipolar II disorder, and more.
(503) 966-8721 View (503) 966-8721
Photo of John Lenkin, LPC Intern in Portland, OR
John Lenkin
LPC Intern, SEP
Verified Verified
Portland, OR 97202
Hi I'm Lincoln. I appreciate that you reading this is a reflection of your own curiosity and showing up for yourself! Therapy is a safe, collaborative, and respectful space to work with you towards lessening your struggles and achieving your goals. Our work together is an opportunity to shift from scripts, wounding and habit patterns of your past and more fully enter the present moment with clarity, belief in yourself, and strength to act. Ultimately, our work together can decrease your stress, cultivate a more comfortable relationship with yourself and others, and overall lead to more possibilities and self-empowerment.
Hi I'm Lincoln. I appreciate that you reading this is a reflection of your own curiosity and showing up for yourself! Therapy is a safe, collaborative, and respectful space to work with you towards lessening your struggles and achieving your goals. Our work together is an opportunity to shift from scripts, wounding and habit patterns of your past and more fully enter the present moment with clarity, belief in yourself, and strength to act. Ultimately, our work together can decrease your stress, cultivate a more comfortable relationship with yourself and others, and overall lead to more possibilities and self-empowerment.
(971) 224-7397 View (971) 224-7397
Photo of Zaida Gomez, Marriage & Family Therapist in Portland, OR
Zaida Gomez
Marriage & Family Therapist, MS, LMFT
Verified Verified
Portland, OR 97232  (Online Only)
Are you struggling to find your way while dealing with family expectations and pressure? Is it hard to feel like what you’re doing is “enough”? Maybe you’re struggling with anxious thoughts or conflict with important people in your life. I am here to help in creating healthy boundaries and to help you feel confident in the life you want to live.
Are you struggling to find your way while dealing with family expectations and pressure? Is it hard to feel like what you’re doing is “enough”? Maybe you’re struggling with anxious thoughts or conflict with important people in your life. I am here to help in creating healthy boundaries and to help you feel confident in the life you want to live.
(503) 382-8762 View (503) 382-8762
Photo of Teeshawna Tee Amor-Mashino, Professional Counselor Associate in Portland, OR
Teeshawna Tee Amor-Mashino
Professional Counselor Associate, MA, QMHP
Verified Verified
1 Endorsed
Portland, OR 97221  (Online Only)
I am currently accepting clients. I am passionate about and have experience working with individuals in marginalized populations, individuals wanting to manage their anxiety, depression, trauma, and helping individuals through DV/IPV.
I am currently accepting clients. I am passionate about and have experience working with individuals in marginalized populations, individuals wanting to manage their anxiety, depression, trauma, and helping individuals through DV/IPV.
(503) 400-3877 View (503) 400-3877
Photo of Susanna Heger, Marriage & Family Therapist in Portland, OR
Susanna Heger
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Portland, OR 97213
Not accepting new clients
I have over ten years of experience working with families, adolescents, children, and individuals alike. I have additional trainings in multiple modalities such as Systems-Based Approaches, Emotion Focused Therapy, Structural, Experiential, Brief, and Parent Child Interaction Therapy. I am a strong believer in tailoring my therapeutic approach to each individual and/or family's needs with warmth and humor.
I have over ten years of experience working with families, adolescents, children, and individuals alike. I have additional trainings in multiple modalities such as Systems-Based Approaches, Emotion Focused Therapy, Structural, Experiential, Brief, and Parent Child Interaction Therapy. I am a strong believer in tailoring my therapeutic approach to each individual and/or family's needs with warmth and humor.
(503) 966-2984 View (503) 966-2984
Photo of Wendy Forrester, Marriage & Family Therapist in Portland, OR
Wendy Forrester
Marriage & Family Therapist, MA, LMFT, ATR
Verified Verified
Portland, OR 97239
Does life seem too challenging and uncertain? Awake at 3am unable to quiet your mind. Overwhelmed by anxiety? Immobilized by depression? Possibly you abandon your feelings to defer to others. You may be outwardly successful yet that doesn't ease your inner distress. A voice in your mind reminds you of perceived shortcomings leaving you feeling inadequate. Discouraged from trying to move forward but feel stuck? Whatever you're experiencing you don’t have to face it alone. You’re a woman seeking a deeper understanding of yourself—in relationships, beyond responsibilities & self-defeating patterns which create barriers to intimacy.
Does life seem too challenging and uncertain? Awake at 3am unable to quiet your mind. Overwhelmed by anxiety? Immobilized by depression? Possibly you abandon your feelings to defer to others. You may be outwardly successful yet that doesn't ease your inner distress. A voice in your mind reminds you of perceived shortcomings leaving you feeling inadequate. Discouraged from trying to move forward but feel stuck? Whatever you're experiencing you don’t have to face it alone. You’re a woman seeking a deeper understanding of yourself—in relationships, beyond responsibilities & self-defeating patterns which create barriers to intimacy.
(971) 251-1173 View (971) 251-1173
Photo of Amanda Helmers, Psychologist in Portland, OR
Amanda Helmers
Psychologist, PhD
Verified Verified
1 Endorsed
Portland, OR 97210
I am a Clinical Psychologist licensed in Oregon and New York providing individual psychotherapy for adolescents & adults. I enjoy the collaborative and creative process of therapy and offer support around topics including emotional difficulties, relationship problems, life and role transitions, trauma, and perinatal mental health concerns. I focus on building a therapeutic relationship grounded in warmth, respect and authenticity.
I am a Clinical Psychologist licensed in Oregon and New York providing individual psychotherapy for adolescents & adults. I enjoy the collaborative and creative process of therapy and offer support around topics including emotional difficulties, relationship problems, life and role transitions, trauma, and perinatal mental health concerns. I focus on building a therapeutic relationship grounded in warmth, respect and authenticity.
(503) 837-3494 View (503) 837-3494
Photo of Elisa Miranda, LPC Intern in Portland, OR
Elisa Miranda
LPC Intern
Verified Verified
1 Endorsed
Portland, OR 97219  (Online Only)
I offer bilingual therapy in Spanish and english. Yo ofrezco terapia bilingue, en español y en inglés. I believe that every individual has the power and capability to seek help, find healing, restore, and work on their mental health and their overall well-being to have a profound life. Having a healthy mental health and a positive mind set, is key to experience a positive sense of self and a meaningful lifestyle. My goal is to help my clients reach their full potential in emotional and personal growth so they can find and embrace individual strength.
I offer bilingual therapy in Spanish and english. Yo ofrezco terapia bilingue, en español y en inglés. I believe that every individual has the power and capability to seek help, find healing, restore, and work on their mental health and their overall well-being to have a profound life. Having a healthy mental health and a positive mind set, is key to experience a positive sense of self and a meaningful lifestyle. My goal is to help my clients reach their full potential in emotional and personal growth so they can find and embrace individual strength.
(971) 268-5559 View (971) 268-5559
Photo of Eileen B Summit, Clinical Social Work/Therapist in Portland, OR
Eileen B Summit
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Portland, OR 97213  (Online Only)
I work with women, 21-101, who are facing life transitions, health issues and loss. I specialize in working with women who are experiencing anxiety or depression, struggling to overcome negative thought patterns and interactions, or facing serious health issues, caregiving issues or loss of a loved one   I believe each woman has the inner strength needed to heal and take steps toward life-giving goals.
I work with women, 21-101, who are facing life transitions, health issues and loss. I specialize in working with women who are experiencing anxiety or depression, struggling to overcome negative thought patterns and interactions, or facing serious health issues, caregiving issues or loss of a loved one   I believe each woman has the inner strength needed to heal and take steps toward life-giving goals.
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Photo of Sarah Bord, Licensed Professional Counselor in Portland, OR
Sarah Bord
Licensed Professional Counselor, MA, LPC, CADC I
Verified Verified
1 Endorsed
Portland, OR 97236
I work with clients struggling with trauma, anxiety, depression, substance abuse, burnout, compassion fatigue, and socioeconomical, environmental and climate concerns. I work with individuals that want to put the work into improving the quality of their lives and finding balance within their core values, beliefs, self-worth, interpersonal relationships, work/college, leisure time, time outdoors, and lifestyle. I work with individuals on identifying the disruption in these areas of their lives.
I work with clients struggling with trauma, anxiety, depression, substance abuse, burnout, compassion fatigue, and socioeconomical, environmental and climate concerns. I work with individuals that want to put the work into improving the quality of their lives and finding balance within their core values, beliefs, self-worth, interpersonal relationships, work/college, leisure time, time outdoors, and lifestyle. I work with individuals on identifying the disruption in these areas of their lives.
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Photo of Steven Bo O'Dell, Clinical Social Work/Therapist in Portland, OR
Steven Bo O'Dell
Clinical Social Work/Therapist, MSW, LCSW, BCD, CHT
Verified Verified
1 Endorsed
Portland, OR 97214
Not accepting new clients
It doesn't interest me what you do for a living, how old you are, or how much money you have, whom you know or how you came to be here. I want to know what you ache for, and if you dare to dream of meeting your heart's longing..." ~~ from "The Invitation" by Elder Oriah Mountain Dreamer. I enjoy working with people who want to understand themselves in a deeper way, who want to uncover and heal the patterns of behavior that have kept them from living their dreams.
It doesn't interest me what you do for a living, how old you are, or how much money you have, whom you know or how you came to be here. I want to know what you ache for, and if you dare to dream of meeting your heart's longing..." ~~ from "The Invitation" by Elder Oriah Mountain Dreamer. I enjoy working with people who want to understand themselves in a deeper way, who want to uncover and heal the patterns of behavior that have kept them from living their dreams.
(503) 567-1318 View (503) 567-1318
Photo of Christine Salas, Clinical Social Work/Therapist in Portland, OR
Christine Salas
Clinical Social Work/Therapist, LCSW, HTCP
Verified Verified
Portland, OR 97215  (Online Only)
Are you feeling overwhelmed by stress, anxiety, depression, or relationship challenges? I believe in your inherent strengths and abilities, and I'm committed to helping you achieve your goals of finding inner peace, emotional well-being, and greater fulfillment in life. As a Licensed Clinical Social Worker (LCSW) and Healing Touch Certified Practitioner/Energy Healer (HTCP), I provide a unique, compassionate, non-judgemental, safe space where you can freely express yourself. Let's work together as a team towards your healing and growth, and create positive change in your life.
Are you feeling overwhelmed by stress, anxiety, depression, or relationship challenges? I believe in your inherent strengths and abilities, and I'm committed to helping you achieve your goals of finding inner peace, emotional well-being, and greater fulfillment in life. As a Licensed Clinical Social Worker (LCSW) and Healing Touch Certified Practitioner/Energy Healer (HTCP), I provide a unique, compassionate, non-judgemental, safe space where you can freely express yourself. Let's work together as a team towards your healing and growth, and create positive change in your life.
(503) 867-8550 View (503) 867-8550
Photo of Dr. Danette A Buchanan, Licensed Professional Counselor in Portland, OR
Dr. Danette A Buchanan
Licensed Professional Counselor, PhD, LPC, NCC
Verified Verified
4 Endorsed
Portland, OR 97223
Not accepting new clients
I am a Clinical Pastoral Counselor who practices in Tigard, (Portland), Oregon. I am a Licensed Professional Counselor and a graduate of Liberty University (Ph.D, 2022) and Loyola University (M.S., 2009). ​I recently transitioned to teaching and have reduced my client load to a minimum. I am unable to accept new clients at this time.
I am a Clinical Pastoral Counselor who practices in Tigard, (Portland), Oregon. I am a Licensed Professional Counselor and a graduate of Liberty University (Ph.D, 2022) and Loyola University (M.S., 2009). ​I recently transitioned to teaching and have reduced my client load to a minimum. I am unable to accept new clients at this time.
(971) 299-7901 View (971) 299-7901
Photo of Peter Skutt, Pre-Licensed Professional in Portland, OR
Peter Skutt
Pre-Licensed Professional, MA
Verified Verified
1 Endorsed
Portland, OR 97209
Sometimes the act of verbalizing our experiences can be very challenging. Art can be a great way to begin the therapeutic process and to further explore the unseen and unsaid aspects of our lives. My approach focuses primarily on the combination of art therapy and internal family systems therapy, to help my clients gain a deeper understanding of their different parts and how those parts show up in the world. I try to be very collaborative and transparent with my clients to create a more equal dynamic in our sessions.
Sometimes the act of verbalizing our experiences can be very challenging. Art can be a great way to begin the therapeutic process and to further explore the unseen and unsaid aspects of our lives. My approach focuses primarily on the combination of art therapy and internal family systems therapy, to help my clients gain a deeper understanding of their different parts and how those parts show up in the world. I try to be very collaborative and transparent with my clients to create a more equal dynamic in our sessions.
(971) 571-5217 View (971) 571-5217
Photo of Jeanne V Bjorklund, Marriage & Family Therapist in Portland, OR
Jeanne V Bjorklund
Marriage & Family Therapist, MA, LMFT-CA
Verified Verified
1 Endorsed
Portland, OR 97239
Most folks can handle the ups and downs of life unless their closest relationships are in trouble. That's what brings people to me. With over two decades as facilitator of personal and relational growth in individuals, couples and families, I am psycho-dynamic (seek to 'peel back the layers') with individuals, helping them to become free from the emotional baggage of childhood. I offer a systems-oriention with couples and families along with some Gottman tools and Prepare and Enrich. I developed a therapeutic program for a children's home in CA and served as their therapist and staff trainer for 5 years.
Most folks can handle the ups and downs of life unless their closest relationships are in trouble. That's what brings people to me. With over two decades as facilitator of personal and relational growth in individuals, couples and families, I am psycho-dynamic (seek to 'peel back the layers') with individuals, helping them to become free from the emotional baggage of childhood. I offer a systems-oriention with couples and families along with some Gottman tools and Prepare and Enrich. I developed a therapeutic program for a children's home in CA and served as their therapist and staff trainer for 5 years.
(503) 987-3367 View (503) 987-3367
Photo of Jay Hopkins, Licensed Professional Counselor in Portland, OR
Jay Hopkins
Licensed Professional Counselor, MA, LPC
Verified Verified
Portland, OR 97217
We all get stuck sometimes; and we suffer. Life often feels messy and chaotic, and in the midst of "the daily grind" we experience ourselves as unbalanced, fragmented, and "all over the place." Life is perpetually full of transition and change; and our habituated ways of being in the world are often at odds with the ebb and flow of life's events, and we experience stress, conflict and pain. Despite our resources, strategies and efforts to cope with challenges, we often get stuck; and end up feeling dissatisfied with ourselves, disenchanted with others, and disconnected from life, vitality, joy.
We all get stuck sometimes; and we suffer. Life often feels messy and chaotic, and in the midst of "the daily grind" we experience ourselves as unbalanced, fragmented, and "all over the place." Life is perpetually full of transition and change; and our habituated ways of being in the world are often at odds with the ebb and flow of life's events, and we experience stress, conflict and pain. Despite our resources, strategies and efforts to cope with challenges, we often get stuck; and end up feeling dissatisfied with ourselves, disenchanted with others, and disconnected from life, vitality, joy.
(503) 577-8115 View (503) 577-8115

How does your Therapist compare?

Number of Therapists in Portland, OR

3,000+

Average cost per session

$160

Therapists in Portland, OR who prioritize treating:

91% Anxiety
85% Depression
78% Relationship Issues
76% Self Esteem
73% Trauma and PTSD
70% Stress
67% Life Transitions

Average years in practice

11 Years

Top 3 insurances accepted

54% PacificSource
47% Aetna
38% BlueCross and BlueShield

How Therapists in Portland, OR see their clients

57% In Person and Online
43% Online Only

Gender breakdown

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

How can I find a therapist in Portland?

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.