Therapists in Grand Rapids, MI

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Photo of Darlene K. Pedersen, Licensed Professional Counselor in Grand Rapids, MI
Darlene K. Pedersen
Licensed Professional Counselor, MA, LPC
Verified Verified
Grand Rapids, MI 49506  (Online Only)
Are you tired, stressed out, and and in need of change in your life? Therapy can create such change- change in the way you think, react, and behave in difficult situations. The relationship between client and therapist can provide the basis for positive change. It is imperative that the client feels safe in an environment where empathy, freedom to explore, and mutual respect abound. My goal is to provide each individual/couple the opportunity to make those changes. Working together, we will confront the issues preventing you from experiencing a more joyful life.
Are you tired, stressed out, and and in need of change in your life? Therapy can create such change- change in the way you think, react, and behave in difficult situations. The relationship between client and therapist can provide the basis for positive change. It is imperative that the client feels safe in an environment where empathy, freedom to explore, and mutual respect abound. My goal is to provide each individual/couple the opportunity to make those changes. Working together, we will confront the issues preventing you from experiencing a more joyful life.
(810) 395-5836 View (810) 395-5836
Photo of April Evans, Clinical Social Work/Therapist in Grand Rapids, MI
April Evans
Clinical Social Work/Therapist, LLMSW
Verified Verified
1 Endorsed
Grand Rapids, MI 49525
People with self-critical thoughts, perfectionists, those who find it difficult to understand their own feelings, I am not here to change your thoughts, or to get rid of them; I don't believe that's possible, even if we can sometimes ignore them for a couple hours. But I do believe we can learn to respond to those thoughts differently, in ways that acknowledge and makes space for them, but doesn't leave you getting pushed around by them, doing things that don't feel like "you."
People with self-critical thoughts, perfectionists, those who find it difficult to understand their own feelings, I am not here to change your thoughts, or to get rid of them; I don't believe that's possible, even if we can sometimes ignore them for a couple hours. But I do believe we can learn to respond to those thoughts differently, in ways that acknowledge and makes space for them, but doesn't leave you getting pushed around by them, doing things that don't feel like "you."
(616) 577-8786 View (616) 577-8786
Photo of Megan Trombka, Clinical Social Work/Therapist in Grand Rapids, MI
Megan Trombka
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Grand Rapids, MI 49525
Life is full of experiences that challenge us and shape us, often including periods of grief and loss and learning to adjust to our environment. I am confident in my over 10 years of social work experience, that together we can navigate through the challenges you are facing. Whether you are navigating a life transition, facing grief and loss, working through a complicated situation or relationship or just realizing that you need more tools for your own self-care, reaching out is the first step. Additionally, I have experience supporting people with cancer and their families, recognizing this is a unique experience.
Life is full of experiences that challenge us and shape us, often including periods of grief and loss and learning to adjust to our environment. I am confident in my over 10 years of social work experience, that together we can navigate through the challenges you are facing. Whether you are navigating a life transition, facing grief and loss, working through a complicated situation or relationship or just realizing that you need more tools for your own self-care, reaching out is the first step. Additionally, I have experience supporting people with cancer and their families, recognizing this is a unique experience.
(616) 577-8397 View (616) 577-8397
Photo of Ashlynn Lister, Clinical Social Work/Therapist in Grand Rapids, MI
Ashlynn Lister
Clinical Social Work/Therapist, LMSW
Verified Verified
Grand Rapids, MI 49546
I am Clinical Therapist with over 10 years of experience working primarily with children, teens, and young adults. I use various play techniques and engaging activities to learn about the areas of need a child may have and what kinds of behaviors those needs have impacted. I am happy to work with parents who might be needing guidance or feedback regarding their children's behaviors or mental health needs as well. In addition to working with children, I also see some adolescents and young adults struggling with life changes and other mental health needs.
I am Clinical Therapist with over 10 years of experience working primarily with children, teens, and young adults. I use various play techniques and engaging activities to learn about the areas of need a child may have and what kinds of behaviors those needs have impacted. I am happy to work with parents who might be needing guidance or feedback regarding their children's behaviors or mental health needs as well. In addition to working with children, I also see some adolescents and young adults struggling with life changes and other mental health needs.
(616) 585-0593 View (616) 585-0593
Photo of Justin Westerhof, Clinical Social Work/Therapist in Grand Rapids, MI
Justin Westerhof
Clinical Social Work/Therapist, LMSW, CAADC
Verified Verified
Grand Rapids, MI 49507
I have recently accepted the position as clinical director for GRCS. In this capacity, I will be available as a consultant for other clinicians here, while also setting a clinical tone for the practice. On an individual basis, I see a wide variety of clients based on my experience in substance use treatment, outpatient therapy, corrections treatment, and trauma training. I have worked also with the severe and persistent mental health population. My stance is, “Tell me what you think the issue is, and we’ll find a way to address it.”
I have recently accepted the position as clinical director for GRCS. In this capacity, I will be available as a consultant for other clinicians here, while also setting a clinical tone for the practice. On an individual basis, I see a wide variety of clients based on my experience in substance use treatment, outpatient therapy, corrections treatment, and trauma training. I have worked also with the severe and persistent mental health population. My stance is, “Tell me what you think the issue is, and we’ll find a way to address it.”
(616) 404-4209 View (616) 404-4209
Photo of Miriam Engler, Clinical Social Work/Therapist in Grand Rapids, MI
Miriam Engler
Clinical Social Work/Therapist, LMSW
Verified Verified
Grand Rapids, MI 49546
I work as a therapist because I believe we can experience real healing in our lives. The broken world in which we live frequently leaves scars and wounds. And we often wound others. As a Christian therapist I believe God heals significantly. I work with Christians and non Christians alike with respect for individual values and beliefs. Therapy begins with developing a respectful, trusting relationship. The client and therapist begin a journey to enable the client to reconcile, their past, their present, and their beliefs. It can enable them to work toward future goals successfully.
I work as a therapist because I believe we can experience real healing in our lives. The broken world in which we live frequently leaves scars and wounds. And we often wound others. As a Christian therapist I believe God heals significantly. I work with Christians and non Christians alike with respect for individual values and beliefs. Therapy begins with developing a respectful, trusting relationship. The client and therapist begin a journey to enable the client to reconcile, their past, their present, and their beliefs. It can enable them to work toward future goals successfully.
(616) 920-0891 View (616) 920-0891
Photo of Erica Springer, Clinical Social Work/Therapist in Grand Rapids, MI
Erica Springer
Clinical Social Work/Therapist, LMSW
Verified Verified
Grand Rapids, MI 49546  (Online Only)
Erica Springer is a Licensed Clinical Social Worker, Certified Clinical Trauma Professional/Certified in Grief Counseling, with 16 years of experience. Erica believes that although an individual may be affected by life challenges, those experiences need not serve as a barrier to growth. She believes in the power of therapy and faith toward helping clients nurture their strengths, accept themselves, and heal from and ultimately use life challenges as catalysts for growth. Erica owns and is a therapist at IMPACCT (Innovative Mentoring Passionate Advocacy and Creative Community-Based Treatment Techniques), treating children, teens, an
Erica Springer is a Licensed Clinical Social Worker, Certified Clinical Trauma Professional/Certified in Grief Counseling, with 16 years of experience. Erica believes that although an individual may be affected by life challenges, those experiences need not serve as a barrier to growth. She believes in the power of therapy and faith toward helping clients nurture their strengths, accept themselves, and heal from and ultimately use life challenges as catalysts for growth. Erica owns and is a therapist at IMPACCT (Innovative Mentoring Passionate Advocacy and Creative Community-Based Treatment Techniques), treating children, teens, an
(616) 379-3472 View (616) 379-3472
Photo of Greg Weichhand, Licensed Professional Counselor in Grand Rapids, MI
Greg Weichhand
Licensed Professional Counselor, LLP, LPC, CAADC
Verified Verified
Grand Rapids, MI 49546
Life is difficult. With the right tools and some effort, it does not have to be. My hope is to help you with your goals. Whether that is to feel better (less depressed, anxious or angry), improve your relationships (with a spouse, parent, child, etc.), change your behaviors (substance use, self harm, avoidance), or anything else that is important to you, I'd love the opportunity to help. I enjoy working with a number of different presenting problems. My passions are working with teens/adults, men's issues (especially navigating work and/or family life), post-partum Dad's, athletes and substance use/co-occurring disorders.
Life is difficult. With the right tools and some effort, it does not have to be. My hope is to help you with your goals. Whether that is to feel better (less depressed, anxious or angry), improve your relationships (with a spouse, parent, child, etc.), change your behaviors (substance use, self harm, avoidance), or anything else that is important to you, I'd love the opportunity to help. I enjoy working with a number of different presenting problems. My passions are working with teens/adults, men's issues (especially navigating work and/or family life), post-partum Dad's, athletes and substance use/co-occurring disorders.
(616) 947-3503 View (616) 947-3503
Photo of Kate Smaller, Clinical Social Work/Therapist in Grand Rapids, MI
Kate Smaller
Clinical Social Work/Therapist, PhD, LCSW, MEd
Verified Verified
Grand Rapids, MI 49503
Do you feel stuck? Do you wish your relationships could feel more fulfilling? Are you tired of feeling bogged down by your past? While we are all unique and come from unique circumstances, we all have one thing in common: A desire to move forward. My approach to therapy allows you to do just that.
Do you feel stuck? Do you wish your relationships could feel more fulfilling? Are you tired of feeling bogged down by your past? While we are all unique and come from unique circumstances, we all have one thing in common: A desire to move forward. My approach to therapy allows you to do just that.
(269) 231-8404 View (269) 231-8404
Photo of Cindy L. Haner-Velzen, Clinical Social Work/Therapist in Grand Rapids, MI
Cindy L. Haner-Velzen
Clinical Social Work/Therapist, LMSW, LLC
Verified Verified
1 Endorsed
Grand Rapids, MI 49546
Waitlist for new clients
I am dedicated to using my education, specialized training and extensive clinical expertise to guide clients in creating the life they desire and deserve to live. I am passionate about collaborating with clients and using evidenced based practices to increase healthy connections to self, life and others. Using Interactive Practices for Healing We, together, design a effective "blue print" for living which restores relationships, increases joy and decreases suffering.
I am dedicated to using my education, specialized training and extensive clinical expertise to guide clients in creating the life they desire and deserve to live. I am passionate about collaborating with clients and using evidenced based practices to increase healthy connections to self, life and others. Using Interactive Practices for Healing We, together, design a effective "blue print" for living which restores relationships, increases joy and decreases suffering.
(616) 918-3422 View (616) 918-3422
Photo of Aaron Reider, Counselor in Grand Rapids, MI
Aaron Reider
Counselor, LPC
Verified Verified
8 Endorsed
Grand Rapids, MI 49503
What would you do tomorrow if you woke up free from that little voice of doubt, anxiety, and self-loathing? As a therapist, I love to explore the answer to that question with you. It’s my belief that we all are deserving of living into our greatest selves, but that this voice and its irrational nature prevent us from doing so. In an effort to change its narrative, we work together to explore, challenge, and reframe the negative core beliefs at the root of your suffering. It is the dual process of building self-awareness through empathetic exploration of blind-spots and the development of a strong therapeutic connection.
What would you do tomorrow if you woke up free from that little voice of doubt, anxiety, and self-loathing? As a therapist, I love to explore the answer to that question with you. It’s my belief that we all are deserving of living into our greatest selves, but that this voice and its irrational nature prevent us from doing so. In an effort to change its narrative, we work together to explore, challenge, and reframe the negative core beliefs at the root of your suffering. It is the dual process of building self-awareness through empathetic exploration of blind-spots and the development of a strong therapeutic connection.
(616) 326-2832 View (616) 326-2832
Photo of Natalie DeVries, Licensed Professional Counselor in Grand Rapids, MI
Natalie DeVries
Licensed Professional Counselor, MA, LLPC
Verified Verified
Grand Rapids, MI 49508
I enjoy working with people of various backgrounds, especially adults and teens in the LGBTQ+ community and individuals with trauma history. Using a mix of evidence-based interventions like EMDR, Internal Family Systems, along with a somatic, multicultural and feminist lens, I aim to provide a safe, supportive environment where you can explore all the parts of yourself. I believe the key to progress in therapy is curiosity and commitment to change, and my goal as your therapist is to walk alongside you as you discover your own personal power.
I enjoy working with people of various backgrounds, especially adults and teens in the LGBTQ+ community and individuals with trauma history. Using a mix of evidence-based interventions like EMDR, Internal Family Systems, along with a somatic, multicultural and feminist lens, I aim to provide a safe, supportive environment where you can explore all the parts of yourself. I believe the key to progress in therapy is curiosity and commitment to change, and my goal as your therapist is to walk alongside you as you discover your own personal power.
(616) 236-6443 x11 View (616) 236-6443 x11
Photo of Wesley G Morgan, Licensed Professional Counselor in Grand Rapids, MI
Wesley G Morgan
Licensed Professional Counselor, MA, LPC
Verified Verified
8 Endorsed
Grand Rapids, MI 49506  (Online Only)
Waitlist for new clients
I believe life is a process. Many things occur during this process. The challenge is our perspective and how we chose to look at life. There are times when the lenses through which we use to view life are clouded, but with the proper adjustments our vision can be much clearer.
I believe life is a process. Many things occur during this process. The challenge is our perspective and how we chose to look at life. There are times when the lenses through which we use to view life are clouded, but with the proper adjustments our vision can be much clearer.
(616) 604-4090 View (616) 604-4090
Photo of Carolyn Madry, Licensed Professional Counselor in Grand Rapids, MI
Carolyn Madry
Licensed Professional Counselor, LPC, MS
Verified Verified
5 Endorsed
Grand Rapids, MI 49546
A wise philosopher once said that the journey of a thousand miles begins with a single step. Small changes, even increasing self-awareness, can collect and snowball into life-changing transformations. These changes and transformations currently may be hard to imagine or fully believe, and we can still choose to bravely take that step. Whatever length your journey, I offer support along the road and a safe space for exploration, expression, insight, and transformation.
A wise philosopher once said that the journey of a thousand miles begins with a single step. Small changes, even increasing self-awareness, can collect and snowball into life-changing transformations. These changes and transformations currently may be hard to imagine or fully believe, and we can still choose to bravely take that step. Whatever length your journey, I offer support along the road and a safe space for exploration, expression, insight, and transformation.
(616) 207-1592 View (616) 207-1592
Photo of Tacia Knoper, Counselor in Grand Rapids, MI
Tacia Knoper
Counselor, MS, LPC
Verified Verified
2 Endorsed
Grand Rapids, MI 49503
I understand that starting the therapy process can be daunting. Finding the right person to meet with, knowing what you want to work on and finding a way to explain it to another person takes courage and determination. I hope to provide a safe and supportive environment for you to explore what is getting in your way and how to develop the tools for you to move forward.
I understand that starting the therapy process can be daunting. Finding the right person to meet with, knowing what you want to work on and finding a way to explain it to another person takes courage and determination. I hope to provide a safe and supportive environment for you to explore what is getting in your way and how to develop the tools for you to move forward.
(616) 594-0986 View (616) 594-0986
Photo of Jessica Rose Hoekstra, Limited Licensed Psychologist in Grand Rapids, MI
Jessica Rose Hoekstra
Limited Licensed Psychologist, LLP
Verified Verified
1 Endorsed
Grand Rapids, MI 49525
As a therapist, I believe that building a relationship is the most important part of the therapeutic process. From that relationship, it becomes possible to examine difficult areas of your life in order to experience growth and security within yourself. The therapeutic setting provides a unique opportunity to pause the busyness of everyday life and sort through present or past concerns that may be affecting you and your family.
As a therapist, I believe that building a relationship is the most important part of the therapeutic process. From that relationship, it becomes possible to examine difficult areas of your life in order to experience growth and security within yourself. The therapeutic setting provides a unique opportunity to pause the busyness of everyday life and sort through present or past concerns that may be affecting you and your family.
(616) 528-9132 View (616) 528-9132
Photo of Vida Holistic Therapy, Clinical Social Work/Therapist in Grand Rapids, MI
Vida Holistic Therapy
Clinical Social Work/Therapist, LCSW, LMSW, LAC
Verified Verified
Grand Rapids, MI 49508
My name is Rebeca Davila, and Vida Holistic Therapy provides an integrated therapy approach for your mental health needs that combines talk therapy with somatic therapies such as full-body acupuncture, acupressure, breathing exercises, and meditation. As a Licensed Clinician and a Licensed Acupuncturist, I offer a unique treatment model, the only one of its kind in the State of Michigan & Illinois. Integrated therapies have significant results in healing. If you are experiencing anxiety, depression, a difficult life transition, have unresolved trauma, or want to find more meaning in your life, I am here to support you.
My name is Rebeca Davila, and Vida Holistic Therapy provides an integrated therapy approach for your mental health needs that combines talk therapy with somatic therapies such as full-body acupuncture, acupressure, breathing exercises, and meditation. As a Licensed Clinician and a Licensed Acupuncturist, I offer a unique treatment model, the only one of its kind in the State of Michigan & Illinois. Integrated therapies have significant results in healing. If you are experiencing anxiety, depression, a difficult life transition, have unresolved trauma, or want to find more meaning in your life, I am here to support you.
(616) 441-3866 View (616) 441-3866
Photo of Julia Cunningham, Psychologist in Grand Rapids, MI
Julia Cunningham
Psychologist, PsyD
Verified Verified
Grand Rapids, MI 49546
I have a very simple approach to therapy. I believe clients seek out therapy already equipped with the tools and qualities necessary to have a successful and happy life. Sometimes, these skills are clouded by grief, depression, stress, anxiety, etc. Maybe you are scared by the future, or stuck in the past. My job is to help you work through those issues, and assist in tapping into those natural strengths. As you become more aware of your strengths, you become more confident in yourself. Then, amazing things can happen.
I have a very simple approach to therapy. I believe clients seek out therapy already equipped with the tools and qualities necessary to have a successful and happy life. Sometimes, these skills are clouded by grief, depression, stress, anxiety, etc. Maybe you are scared by the future, or stuck in the past. My job is to help you work through those issues, and assist in tapping into those natural strengths. As you become more aware of your strengths, you become more confident in yourself. Then, amazing things can happen.
(616) 528-4721 View (616) 528-4721
Photo of Courtney Kozarian, Clinical Social Work/Therapist in Grand Rapids, MI
Courtney Kozarian
Clinical Social Work/Therapist, LMSW
Verified Verified
Grand Rapids, MI 49505
I believe every person has a unique story, influenced by all of the situations and life experiences that have led up to this moment. My goal as a therapist is to build a warm and trusting relationship with you in order to support and encourage your personal growth and change. With both my personal and professional experience with blended families, non-monogamous relationships and anxiety/depression, I understand how difficult it can be to find a therapist who can provide a non-judgmental space to navigate your deepest thoughts and feelings. It is my goal to provide a space that is safe and welcoming for every client.
I believe every person has a unique story, influenced by all of the situations and life experiences that have led up to this moment. My goal as a therapist is to build a warm and trusting relationship with you in order to support and encourage your personal growth and change. With both my personal and professional experience with blended families, non-monogamous relationships and anxiety/depression, I understand how difficult it can be to find a therapist who can provide a non-judgmental space to navigate your deepest thoughts and feelings. It is my goal to provide a space that is safe and welcoming for every client.
(616) 580-1857 View (616) 580-1857
Photo of David Schroeder, Clinical Social Work/Therapist in Grand Rapids, MI
David Schroeder
Clinical Social Work/Therapist, LMSW, CPC
Verified Verified
Grand Rapids, MI 49525
As a therapist and life coach, my goal is to assist you in finding the wisdom and answers to your struggles. I offer therapies and approaches that can get to the core of your struggles, empowering you to transform your life from the inside-out. With support, I help you find those repeated patterns of thinking and behaviors that block your happiness and potential. My 25 years of experience offers the latest in psychotherapy and body, mind, spirit approaches; helping to resolve emotional blockages. If you are ready, I offer holistic approaches that create life changing results.
As a therapist and life coach, my goal is to assist you in finding the wisdom and answers to your struggles. I offer therapies and approaches that can get to the core of your struggles, empowering you to transform your life from the inside-out. With support, I help you find those repeated patterns of thinking and behaviors that block your happiness and potential. My 25 years of experience offers the latest in psychotherapy and body, mind, spirit approaches; helping to resolve emotional blockages. If you are ready, I offer holistic approaches that create life changing results.
(616) 577-1052 View (616) 577-1052

See more therapy options for Grand Rapids

How does your Therapist compare?

Number of Therapists in Grand Rapids, MI

1,000+

Average cost per session

$150

Therapists in Grand Rapids, MI who prioritize treating:

92% Anxiety
89% Depression
77% Self Esteem
76% Relationship Issues
72% Trauma and PTSD
71% Coping Skills
70% Stress

Average years in practice

10 Years

Top 3 insurances accepted

95% BlueCross and BlueShield
69% Priority Health
63% Aetna

How Therapists in Grand Rapids, MI 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 Grand Rapids?

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.