Therapists in Iowa City, IA

Photo of Alison Coffey, Counselor in Iowa City, IA
Alison Coffey
Counselor, LMHC
Verified Verified
1 Endorsed
Iowa City, IA 52240
Not accepting new clients
As much as it can be amazing and beautiful, life can also be frustrating, stressful, lonely, overwhelming, and hard to navigate. You want it to be easier. You want to not feel so stuck, worried, sad, alone, confused, lost. You want things to be better. You want to feel better. You want meaning and connection. You're tired of being afraid. You want to live the life you see for yourself, but can't seem to reach. Maybe it's hard for you to get out there, connect, and be part of things. Maybe you feel invisible.
As much as it can be amazing and beautiful, life can also be frustrating, stressful, lonely, overwhelming, and hard to navigate. You want it to be easier. You want to not feel so stuck, worried, sad, alone, confused, lost. You want things to be better. You want to feel better. You want meaning and connection. You're tired of being afraid. You want to live the life you see for yourself, but can't seem to reach. Maybe it's hard for you to get out there, connect, and be part of things. Maybe you feel invisible.
(319) 238-4410 View (319) 238-4410
Photo of Dana Keeton, Counselor in Iowa City, IA
Dana Keeton
Counselor, ATR-BC, LMHC
Verified Verified
Iowa City, IA 52240
I provide an accepting, creative, and supportive space for clients to safely process challenges, build on strengths, and learn new skills to empower personal growth. I am a registered, board-certified art therapist, and a licensed mental health counselor. My work with clients focuses on an integrative mind-body approach rooted in trauma-informed art psychotherapy. In my sessions I incorporate art therapy, breath work, EMDR, hypnosis/hypnotherapy, mindfulness, and movement techniques.
I provide an accepting, creative, and supportive space for clients to safely process challenges, build on strengths, and learn new skills to empower personal growth. I am a registered, board-certified art therapist, and a licensed mental health counselor. My work with clients focuses on an integrative mind-body approach rooted in trauma-informed art psychotherapy. In my sessions I incorporate art therapy, breath work, EMDR, hypnosis/hypnotherapy, mindfulness, and movement techniques.
(319) 318-0148 View (319) 318-0148
Photo of Chris Loeckle, Clinical Social Work/Therapist in Iowa City, IA
Chris Loeckle
Clinical Social Work/Therapist, LISW
Verified Verified
Iowa City, IA 52246
I have a very engaging and relaxed approach to therapy. Clients often report that they appreciate my authentic style and sense of humor. In any case, the process of therapy begins and is sustained as the client feels heard and understood and can begin to feel comfortable. I come to this work with a certain reverence for what is dignified, courageous, and creative in each of us which over time has informed my life both personally and in my work in supporting others. I rely on no particular therapy framework or "treatment modality" but nonetheless bring a pretty big box of tools to the table.
I have a very engaging and relaxed approach to therapy. Clients often report that they appreciate my authentic style and sense of humor. In any case, the process of therapy begins and is sustained as the client feels heard and understood and can begin to feel comfortable. I come to this work with a certain reverence for what is dignified, courageous, and creative in each of us which over time has informed my life both personally and in my work in supporting others. I rely on no particular therapy framework or "treatment modality" but nonetheless bring a pretty big box of tools to the table.
(319) 253-2691 View (319) 253-2691
Photo of Richard A Stapleton, Counselor in Iowa City, IA
Richard A Stapleton
Counselor, EdD, LMHC, NCC, ACS, BC-TMH
Verified Verified
2 Endorsed
Iowa City, IA 52240  (Online Only)
Not accepting new clients
Shanthi is a tele-mental health practice based in Iowa City, IA, that uses a HIPAA compliant video-based system. I work with all mental health issues, but I focus a lot of my practice working with trauma, vicarious trauma, and working with medical professionals experiencing compassion fatigue or imposter syndrome. I only provide individual counseling for adults. All sessions are conducted through audio/video. I don't provide in-person sessions. You can expect that all sessions will be conducted over video and not through worksheets and text messages.
Shanthi is a tele-mental health practice based in Iowa City, IA, that uses a HIPAA compliant video-based system. I work with all mental health issues, but I focus a lot of my practice working with trauma, vicarious trauma, and working with medical professionals experiencing compassion fatigue or imposter syndrome. I only provide individual counseling for adults. All sessions are conducted through audio/video. I don't provide in-person sessions. You can expect that all sessions will be conducted over video and not through worksheets and text messages.
(319) 264-1603 View (319) 264-1603
Photo of B. Remi Greenbaum, Psychologist in Iowa City, IA
B. Remi Greenbaum
Psychologist, PhD
Verified Verified
Iowa City, IA 52246  (Online Only)
Waitlist for new clients
Welcome, thank you for being here. I see (many) experiences of suffering as inevitable and how we respond and care for ourselves through them matters. My work is based on a philosophy of learning to suffer well, meaning that we engage with curiosity and kindness, as we develop new ways to soothe distress and communicate with honesty and respect. Together we can tend to the roots of your suffering and make room for joy. I work from a trauma and compassion lens and integrate other EBTs. I prioritize safety, trustworthiness and transparency, collaborating and empowering your voice and choice while respecting your culture and history.
Welcome, thank you for being here. I see (many) experiences of suffering as inevitable and how we respond and care for ourselves through them matters. My work is based on a philosophy of learning to suffer well, meaning that we engage with curiosity and kindness, as we develop new ways to soothe distress and communicate with honesty and respect. Together we can tend to the roots of your suffering and make room for joy. I work from a trauma and compassion lens and integrate other EBTs. I prioritize safety, trustworthiness and transparency, collaborating and empowering your voice and choice while respecting your culture and history.
(319) 552-6523 View (319) 552-6523
Photo of Melissa Moreland, Counselor in Iowa City, IA
Melissa Moreland
Counselor, LMHC
Verified Verified
1 Endorsed
Iowa City, IA 52240  (Online Only)
Are you ready for a change, but feeling overwhelmed, tired and anxious? Intuitive holistic therapy can help you navigate anxiety, negative self-talk, or depression and begin to build a life of inner connection and meaning. I am moved by my clients’ stories and seeing them grow into their potential. With 15 years of experience working in personal growth development, I feel honored to be a companion on the journey of change—someone who offers a safe and non-judgmental environment in which to explore collaborative goals.
Are you ready for a change, but feeling overwhelmed, tired and anxious? Intuitive holistic therapy can help you navigate anxiety, negative self-talk, or depression and begin to build a life of inner connection and meaning. I am moved by my clients’ stories and seeing them grow into their potential. With 15 years of experience working in personal growth development, I feel honored to be a companion on the journey of change—someone who offers a safe and non-judgmental environment in which to explore collaborative goals.
(319) 519-4301 View (319) 519-4301
Photo of Donna Janosik, Marriage & Family Therapist in Iowa City, IA
Donna Janosik
Marriage & Family Therapist, LMFT, LMHC
Verified Verified
Iowa City, IA 52240  (Online Only)
Currently accepting new clients. Immediate openings available afternoons/evenings. 24 years experience working as a therapist: individuals, couples and families. Everyone is dealing with life's stressors, and sometimes things become overwhelming. I can help you work through these difficult feelings. I will teach you how to get rid of that negative, looping self-talk. You will gain insight by identifying triggers, and learning about coping tools to help improve functioning and decrease road blocks. I will collaborate with you on goals, and help you live life with an enhanced positive outlook. Your willingness is the key ingredient!
Currently accepting new clients. Immediate openings available afternoons/evenings. 24 years experience working as a therapist: individuals, couples and families. Everyone is dealing with life's stressors, and sometimes things become overwhelming. I can help you work through these difficult feelings. I will teach you how to get rid of that negative, looping self-talk. You will gain insight by identifying triggers, and learning about coping tools to help improve functioning and decrease road blocks. I will collaborate with you on goals, and help you live life with an enhanced positive outlook. Your willingness is the key ingredient!
(319) 224-8848 View (319) 224-8848
Photo of Emily Wofford Hurlin, Clinical Social Work/Therapist in Iowa City, IA
Emily Wofford Hurlin
Clinical Social Work/Therapist, LISW
Verified Verified
Iowa City, IA 52245
I work exclusively with couples to create a secure functioning relationship where collaboration, cooperation and communication are enhanced. I believe all decisions in the relationship must serve both the individual and the couple for mutual harmony. Too often life is challenging, my hope for all couples is they can begin to see one another as trusted allies, the one who provides shelter from the storm, and the place where they find safety and security. I work with couples seeking premarital support, communication issues, intimacy, sex, parenting, infertility, betrayal, remarriage, step-parenting, finance, or breaking up.
I work exclusively with couples to create a secure functioning relationship where collaboration, cooperation and communication are enhanced. I believe all decisions in the relationship must serve both the individual and the couple for mutual harmony. Too often life is challenging, my hope for all couples is they can begin to see one another as trusted allies, the one who provides shelter from the storm, and the place where they find safety and security. I work with couples seeking premarital support, communication issues, intimacy, sex, parenting, infertility, betrayal, remarriage, step-parenting, finance, or breaking up.
(319) 220-0675 View (319) 220-0675
Photo of Christina Sowers, Counselor in Iowa City, IA
Christina Sowers
Counselor
Verified Verified
1 Endorsed
Iowa City, IA 52240
Do you struggle with anxiety, depression, or substance use that affects your day to day life? In my practice I start with understanding where you are now and the challenges you are facing. I help you put a plan in place to help you move forward in the direction you want to go. I can also offer a safe space with in-person and virtual appointments on a confidential platform.
Do you struggle with anxiety, depression, or substance use that affects your day to day life? In my practice I start with understanding where you are now and the challenges you are facing. I help you put a plan in place to help you move forward in the direction you want to go. I can also offer a safe space with in-person and virtual appointments on a confidential platform.
(319) 469-8262 View (319) 469-8262
Photo of Monica McWilliams, Clinical Social Work/Therapist in Iowa City, IA
Monica McWilliams
Clinical Social Work/Therapist, MSW, LMSW
Verified Verified
Iowa City, IA 52245  (Online Only)
Waitlist for new clients
I’m passionate about helping women, couples, and parents who want to decrease stress, anxiety, fear, anger, and overwhelm, break cycles, understand and heal past wounds, increase confidence and connection to self and others, and create a thriving life. Together we explore how past wounds and attachment trauma impact present day relationships and endeavors. My approach is holistic and designed to cultivate lasting change for adult individuals and partners navigating relationship challenges seeking to integrate mind, body, and lived experiences for overall life satisfaction and improved mental wellness.
I’m passionate about helping women, couples, and parents who want to decrease stress, anxiety, fear, anger, and overwhelm, break cycles, understand and heal past wounds, increase confidence and connection to self and others, and create a thriving life. Together we explore how past wounds and attachment trauma impact present day relationships and endeavors. My approach is holistic and designed to cultivate lasting change for adult individuals and partners navigating relationship challenges seeking to integrate mind, body, and lived experiences for overall life satisfaction and improved mental wellness.
(319) 448-3957 View (319) 448-3957
Photo of Ece Akbay, Counselor in Iowa City, IA
Ece Akbay
Counselor, MEd , LMHC
Verified Verified
5 Endorsed
Iowa City, IA 52240  (Online Only)
Not accepting new clients
Whether you are feeling anxious, helpless, stuck or depressed, you do not have to overcome the challenges of life alone. I work collaboratively with my clients to help them identify ways to improve their quality of life. I believe that humans are resilient and have the resources to face obstacles in life. I appreciate each individual's unique personality and background. Contact me to learn more about my services and/or set up an initial appointment.
Whether you are feeling anxious, helpless, stuck or depressed, you do not have to overcome the challenges of life alone. I work collaboratively with my clients to help them identify ways to improve their quality of life. I believe that humans are resilient and have the resources to face obstacles in life. I appreciate each individual's unique personality and background. Contact me to learn more about my services and/or set up an initial appointment.
(319) 220-0747 View (319) 220-0747
Photo of Julia Foster, Marriage & Family Therapist in Iowa City, IA
Julia Foster
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Iowa City, IA 52240
My clients describe me as laid back and non-judgmental, and I aim to provide an atmosphere where anyone can feel safe to explore feelings and experiences they may never have shared before. I’m also a strong believer in the importance of humor to a productive therapeutic relationship.
My clients describe me as laid back and non-judgmental, and I aim to provide an atmosphere where anyone can feel safe to explore feelings and experiences they may never have shared before. I’m also a strong believer in the importance of humor to a productive therapeutic relationship.
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Photo of Christine Vincent, Clinical Social Work/Therapist in Iowa City, IA
Christine Vincent
Clinical Social Work/Therapist, LISW
Verified Verified
Iowa City, IA 52246
I have been providing psychotherapy to adults and children since 1997. My expertise includes the treatment of depression, anxiety, grief and trauma. I have advanced training in EMDR, which is used to treat traumatic stress. I see therapy as the building of a relationship which focuses on the goals of growth and healing. I view my clients as persons who possess limitless potential for change, problem solving and wholeness. My role is to help clients learn about themselves as well as develop new perspectives and skills for living a more balanced and fulfilling life.
I have been providing psychotherapy to adults and children since 1997. My expertise includes the treatment of depression, anxiety, grief and trauma. I have advanced training in EMDR, which is used to treat traumatic stress. I see therapy as the building of a relationship which focuses on the goals of growth and healing. I view my clients as persons who possess limitless potential for change, problem solving and wholeness. My role is to help clients learn about themselves as well as develop new perspectives and skills for living a more balanced and fulfilling life.
(319) 774-4143 x2 View (319) 774-4143 x2
Photo of Rebecca McMurray, Clinical Social Work/Therapist in Iowa City, IA
Rebecca McMurray
Clinical Social Work/Therapist, LISW
Verified Verified
Iowa City, IA 52246
As you or your loved one’s mental health provider, I promise to always be creative, fun, positive, honest and persistent. No matter your circumstance, I will provide you with unconditional positive regard and focus on your strengths. I have a a heart for healing that is part of my DNA. I also happen to be a lover of all things circus (just ask my three pet chickens). One day, I hope to spend part of my time as a clown doctor providing hope and healing through humor.
As you or your loved one’s mental health provider, I promise to always be creative, fun, positive, honest and persistent. No matter your circumstance, I will provide you with unconditional positive regard and focus on your strengths. I have a a heart for healing that is part of my DNA. I also happen to be a lover of all things circus (just ask my three pet chickens). One day, I hope to spend part of my time as a clown doctor providing hope and healing through humor.
(319) 408-8786 View (319) 408-8786
Photo of Tim P Grady, Counselor in Iowa City, IA
Tim P Grady
Counselor, LMHC
Verified Verified
Iowa City, IA 52240
Waitlist for new clients
I have had the honor of working with many diverse communities in my professional life, including: LGBTQ+ people, the Transgender/Non-binary community, survivors of sexual exploitation and trafficking, people living with HIV, communities of color, and people in recovery from drugs and alcohol.
I have had the honor of working with many diverse communities in my professional life, including: LGBTQ+ people, the Transgender/Non-binary community, survivors of sexual exploitation and trafficking, people living with HIV, communities of color, and people in recovery from drugs and alcohol.
(319) 519-4359 View (319) 519-4359
Photo of Alyssa Anne Drury, Counselor in Iowa City, IA
Alyssa Anne Drury
Counselor, MA, LMHC
Verified Verified
Iowa City, IA 52240
All of us have some hard and difficult times in life and we need some help. Although this can be humbling, it usually pays off in the end. I am a very flexible and laid back person and am here to help you with whatever it is you are struggling with. There will be no judgment and we will work on what only you want to work on. I believe there is no magic answer to everything and not everything works for everybody, so it is you and I trying to figure out what works best for you.
All of us have some hard and difficult times in life and we need some help. Although this can be humbling, it usually pays off in the end. I am a very flexible and laid back person and am here to help you with whatever it is you are struggling with. There will be no judgment and we will work on what only you want to work on. I believe there is no magic answer to everything and not everything works for everybody, so it is you and I trying to figure out what works best for you.
(319) 820-0382 View (319) 820-0382
Photo of Stephanie De Roo, Counselor in Iowa City, IA
Stephanie De Roo
Counselor, LMHC, NCC, MS
Verified Verified
Iowa City, IA 52240
Waitlist for new clients
Welcome! Working through depression, anxiety, relationship issues, life transitions, and other mental health concerns can be difficult and intimidating to do alone. Therapy can be a helpful tool if you are feeling stuck and looking for a change. I work to provide non-judgmental insight, while recognizing that each client is their expert of their own experiences.
Welcome! Working through depression, anxiety, relationship issues, life transitions, and other mental health concerns can be difficult and intimidating to do alone. Therapy can be a helpful tool if you are feeling stuck and looking for a change. I work to provide non-judgmental insight, while recognizing that each client is their expert of their own experiences.
(319) 209-9349 View (319) 209-9349
Photo of JoAnna Romero Cartaya, Psychologist in Iowa City, IA
JoAnna Romero Cartaya
Psychologist, PhD
Verified Verified
Iowa City, IA 52240
Accepting new therapy clients for Fall 2023! I enjoy meeting with high school/college/graduate students and professionals who want to live life with authenticy, courage, and purpose and who are seeking ways to recharge and reconnect to themselves. Although experiences of life, including trauma, anxiety, or depression as well as changes or expansions of our responsibilities may impact how we think, feel, and behave these life experiences, while overwhelming at times, can also lead to the greatest growth, discovery, and reclaiming confidence and perhaps above all discovering that life is truly meaningful even while imperfect.
Accepting new therapy clients for Fall 2023! I enjoy meeting with high school/college/graduate students and professionals who want to live life with authenticy, courage, and purpose and who are seeking ways to recharge and reconnect to themselves. Although experiences of life, including trauma, anxiety, or depression as well as changes or expansions of our responsibilities may impact how we think, feel, and behave these life experiences, while overwhelming at times, can also lead to the greatest growth, discovery, and reclaiming confidence and perhaps above all discovering that life is truly meaningful even while imperfect.
(319) 774-8237 View (319) 774-8237
Photo of Jennifer L Adrian, Clinical Social Work/Therapist in Iowa City, IA
Jennifer L Adrian
Clinical Social Work/Therapist, MFA, LISW
Verified Verified
3 Endorsed
Iowa City, IA 52245
**NO OPENINGS AT THIS TIME** I enjoy helping clients create rich and meaningful lives. I specialize in individual therapy with adults and adolescents struggling with anxiety, depression, addiction, trauma, eating disorders, adjustments to life stressors, and more. I also love working with artists and creative people. I primarily use the Acceptance Commitment Therapy (ACT) Model with clients, an evidence-based model that stems out of cognitive behavioral therapy, and the idea that our thoughts, emotions and behaviors are closely connected. Clients learn many skills related to mindfulness, radical acceptance, and self-compassion.
**NO OPENINGS AT THIS TIME** I enjoy helping clients create rich and meaningful lives. I specialize in individual therapy with adults and adolescents struggling with anxiety, depression, addiction, trauma, eating disorders, adjustments to life stressors, and more. I also love working with artists and creative people. I primarily use the Acceptance Commitment Therapy (ACT) Model with clients, an evidence-based model that stems out of cognitive behavioral therapy, and the idea that our thoughts, emotions and behaviors are closely connected. Clients learn many skills related to mindfulness, radical acceptance, and self-compassion.
(319) 774-8524 View (319) 774-8524
Photo of Fannie K Hungerford, Marriage & Family Therapist in Iowa City, IA
Fannie K Hungerford
Marriage & Family Therapist, MA, tLMFT, RYT-500
Verified Verified
8 Endorsed
Iowa City, IA 52240
I welcome you as you are. Leading with authenticity and connection as core values, I endeavor to bring truth and heartfelt engagement to each therapeutic encounter. Working with somatic based practices, creative exploration, inquiry, and collaborative dialogue, I am committed to supporting individuals and couples in leading more integrated and easeful lives. Normalizing the full-spectrum of the human experience and emotional field, my approach to psychotherapy is one guided by honesty, existential query, love, and the wisdom of the body so we may more fully inhabit the present moment.
I welcome you as you are. Leading with authenticity and connection as core values, I endeavor to bring truth and heartfelt engagement to each therapeutic encounter. Working with somatic based practices, creative exploration, inquiry, and collaborative dialogue, I am committed to supporting individuals and couples in leading more integrated and easeful lives. Normalizing the full-spectrum of the human experience and emotional field, my approach to psychotherapy is one guided by honesty, existential query, love, and the wisdom of the body so we may more fully inhabit the present moment.
(319) 696-6241 View (319) 696-6241

How does your Therapist compare?

Number of Therapists in Iowa City, IA

300+

Average cost per session

$157

Therapists in Iowa City, IA who prioritize treating:

96% Anxiety
93% Depression
78% Relationship Issues
78% Self Esteem
74% Trauma and PTSD
73% Coping Skills
73% Stress

Average years in practice

10 Years

Top 3 insurances accepted

86% BlueCross and BlueShield
70% Wellmark BCBS
44% Blue Cross

How Therapists in Iowa City, IA see their clients

74% In Person and Online
26% Online Only

Gender breakdown

78% Female
21% Male
1% Non-Binary

FAQs - About Therapy and Counseling

How can I find a therapist in Iowa City?

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.