Therapists in San Francisco, CA

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Photo of Gilbert A. Woo, Marriage & Family Therapist in San Francisco, CA
Gilbert A. Woo
Marriage & Family Therapist, MS, MFT
Verified Verified
San Francisco, CA 94117
Gilbert received his M.S. in Clinical Psychology from San Francisco State University with internships at UCSF and SFGH Psychiatry Departments. For 7 years, he was the Mental Health Director at UCSF Epilepsy Center. He has been working with individuals with seizures since 2004 and has provided psychotherapy in a variety of settings, including child adolescent services and LGBT community clinics. He is also an Adjunct Professor in the Department of Psychology at the University of San Francisco.
Gilbert received his M.S. in Clinical Psychology from San Francisco State University with internships at UCSF and SFGH Psychiatry Departments. For 7 years, he was the Mental Health Director at UCSF Epilepsy Center. He has been working with individuals with seizures since 2004 and has provided psychotherapy in a variety of settings, including child adolescent services and LGBT community clinics. He is also an Adjunct Professor in the Department of Psychology at the University of San Francisco.
(415) 449-1667 View (415) 449-1667
Photo of Elaine Shelub, Clinical Social Work/Therapist in San Francisco, CA
Elaine Shelub
Clinical Social Work/Therapist, MA, LCSW
Verified Verified
San Francisco, CA 94127
Having a safe and supportive space where one can talk openly, is so very important. Feeling understood and listened to promotes growth and change. I am warm and understanding as well as insightful and objective, bringing experience and honesty to my work. Together we will talk about what’s going on now, past events and relationships, and how they might be affecting you. I will work to develop a trusting, supportive relationship to more clearly understand what is troubling you. My clients have enjoyed success in overcoming anxiety and depression, connecting with others, defining and attaining goals, and increasing self-esteem.
Having a safe and supportive space where one can talk openly, is so very important. Feeling understood and listened to promotes growth and change. I am warm and understanding as well as insightful and objective, bringing experience and honesty to my work. Together we will talk about what’s going on now, past events and relationships, and how they might be affecting you. I will work to develop a trusting, supportive relationship to more clearly understand what is troubling you. My clients have enjoyed success in overcoming anxiety and depression, connecting with others, defining and attaining goals, and increasing self-esteem.
(415) 682-6708 View (415) 682-6708
Photo of Chris S. Doorley, Marriage & Family Therapist Associate in San Francisco, CA
Chris S. Doorley
Marriage & Family Therapist Associate, AMFT, MA
Verified Verified
1 Endorsed
San Francisco, CA 94114  (Online Only)
Many of my clients tend to be curious about discovery, growth and change, often expressing a desire to re-enliven their own natural ways of being.
Many of my clients tend to be curious about discovery, growth and change, often expressing a desire to re-enliven their own natural ways of being.
(415) 417-0943 View (415) 417-0943
Photo of Elizabeth Owens, Associate Clinical Social Worker in San Francisco, CA
Elizabeth Owens
Associate Clinical Social Worker, ACSW
Verified Verified
1 Endorsed
San Francisco, CA 94102
I enjoy working with an array of different types of individuals. Some of the people I work with are looking to gain tangible skills to overcome particular challenges in their lives, such as social anxiety, phobias, and OCD. Others seek out therapy with me because they are navigating life transitions, experiencing relationship difficulties, or looking to better understand themselves. My hope would be that throughout the course of therapy, their goals might evolve as they experience some relief from their symptoms and would shift to exploring their own values, identity, and spirituality.
I enjoy working with an array of different types of individuals. Some of the people I work with are looking to gain tangible skills to overcome particular challenges in their lives, such as social anxiety, phobias, and OCD. Others seek out therapy with me because they are navigating life transitions, experiencing relationship difficulties, or looking to better understand themselves. My hope would be that throughout the course of therapy, their goals might evolve as they experience some relief from their symptoms and would shift to exploring their own values, identity, and spirituality.
(628) 203-7796 View (628) 203-7796
Photo of Bernice (Niki) Berkowitz, Marriage & Family Therapist in San Francisco, CA
Bernice (Niki) Berkowitz
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94105  (Online Only)
Putting off your mental health any longer is not an option. Enroll as a client today! WellPsyche providers can help you regain control of your life and function at your best. WellPsyche is a telehealth practice only. All WellPsyche provider appointments are via Zoom, ensuring you can receive medication management and psychotherapy from the comfort of home.
Putting off your mental health any longer is not an option. Enroll as a client today! WellPsyche providers can help you regain control of your life and function at your best. WellPsyche is a telehealth practice only. All WellPsyche provider appointments are via Zoom, ensuring you can receive medication management and psychotherapy from the comfort of home.
(415) 687-0980 View (415) 687-0980
Photo of Tracy Vadakumchery, Licensed Professional Clinical Counselor in San Francisco, CA
Tracy Vadakumchery
Licensed Professional Clinical Counselor, LPCC, LMHC
Verified Verified
San Francisco, CA 94115  (Online Only)
For Indian and South Asian Americans who’ve been told that you’re “bad” for not following cultural norms, for questioning these rules, for honoring your needs and desires, for forging your own path, and for challenging the rulebook: doing these things do not make you a “Bad South Asian”; they make you a more genuine and authentic one. You’re HEALING intergenerational curses. You might get messages from South Asians who tell you otherwise, but many of these “norms” are actually trauma responses. That more “cultured” South Asian person you know does not inherently know more than you. You know enough and you ARE enough.
For Indian and South Asian Americans who’ve been told that you’re “bad” for not following cultural norms, for questioning these rules, for honoring your needs and desires, for forging your own path, and for challenging the rulebook: doing these things do not make you a “Bad South Asian”; they make you a more genuine and authentic one. You’re HEALING intergenerational curses. You might get messages from South Asians who tell you otherwise, but many of these “norms” are actually trauma responses. That more “cultured” South Asian person you know does not inherently know more than you. You know enough and you ARE enough.
(415) 301-4613 View (415) 301-4613
Photo of Julia Forberg, Marriage & Family Therapist in San Francisco, CA
Julia Forberg
Marriage & Family Therapist, MA, MFT
Verified Verified
1 Endorsed
San Francisco, CA 94118
Are you a woman struggling in your relationships? Pregnant or a new mom? I help women who feel hopeless and anxious about their lives feel more empowered. Perhaps you've been stuck in the same patterns in your relationships. Or you are navigating new motherhood and are understandably impacted by the massive changes happening. Together, we'll help you learn the tools to understand the meaning underneath your emotions and move beyond feeling stuck and overwhelmed. Using both talk therapy and somatic (body-based) tools, therapy is a place for you to heal, grow, and explore your inner world in a compassionate and non-judgmental space.
Are you a woman struggling in your relationships? Pregnant or a new mom? I help women who feel hopeless and anxious about their lives feel more empowered. Perhaps you've been stuck in the same patterns in your relationships. Or you are navigating new motherhood and are understandably impacted by the massive changes happening. Together, we'll help you learn the tools to understand the meaning underneath your emotions and move beyond feeling stuck and overwhelmed. Using both talk therapy and somatic (body-based) tools, therapy is a place for you to heal, grow, and explore your inner world in a compassionate and non-judgmental space.
(415) 841-2737 View (415) 841-2737
Photo of Khawaja Saad Haye, Licensed Professional Counselor in San Francisco, CA
Khawaja Saad Haye
Licensed Professional Counselor, LPC, LPCC, CCTP
Verified Verified
3 Endorsed
San Francisco, CA 94115  (Online Only)
Khawaja Saad Haye (call him Saad) is a Trauma & PTSD Specialist. He acquired specialty certifications in clinical trauma. He has helped clients who experienced trauma from childhood, sexual assaults, war, and racial trauma. His approach is strengths based, skills based and solution focused. Saad helps his client's understand their visceral reactions and will support them in the moment to attend to themselves in an effective manner. It is not uncommon for Saad to point out physical shifts in session to help the client be more aware of how their mind-body are interconnected.
Khawaja Saad Haye (call him Saad) is a Trauma & PTSD Specialist. He acquired specialty certifications in clinical trauma. He has helped clients who experienced trauma from childhood, sexual assaults, war, and racial trauma. His approach is strengths based, skills based and solution focused. Saad helps his client's understand their visceral reactions and will support them in the moment to attend to themselves in an effective manner. It is not uncommon for Saad to point out physical shifts in session to help the client be more aware of how their mind-body are interconnected.
(415) 729-1998 View (415) 729-1998
Photo of Carol Winetsky, Psychologist in San Francisco, CA
Carol Winetsky
Psychologist, PhD
Verified Verified
San Francisco, CA 94118
I am a licensed clinical psychologist with over thirty years of experience. I have helped people navigate a variety of different life transitions such as divorce and separation, job loss, leaving home, starting a family or new career or both, as well as end-of-life issues. I have helped children deal with school and peer issues as well as parental loss and separation. My therapy style is interactive and psychodynamic and may entail short or long-term therapy, individual psychotherapy or couples work.
I am a licensed clinical psychologist with over thirty years of experience. I have helped people navigate a variety of different life transitions such as divorce and separation, job loss, leaving home, starting a family or new career or both, as well as end-of-life issues. I have helped children deal with school and peer issues as well as parental loss and separation. My therapy style is interactive and psychodynamic and may entail short or long-term therapy, individual psychotherapy or couples work.
(415) 236-2948 View (415) 236-2948
Photo of Hector Saavedra, Marriage & Family Therapist in San Francisco, CA
Hector Saavedra
Marriage & Family Therapist, LMFT
Verified Verified
2 Endorsed
San Francisco, CA 94104  (Online Only)
I am a dedicated and committed LMFT who is dedicated to guiding clients in their therapeutic journey. I am a graduate of the MFT program at the University of Southern California. In the past, I have worked in various settings such as universities, schools, and clinics; in these settings, I have worked with those struggling with depression, anxiety, ADHD, addiction, and many other issues.
I am a dedicated and committed LMFT who is dedicated to guiding clients in their therapeutic journey. I am a graduate of the MFT program at the University of Southern California. In the past, I have worked in various settings such as universities, schools, and clinics; in these settings, I have worked with those struggling with depression, anxiety, ADHD, addiction, and many other issues.
(415) 275-6420 View (415) 275-6420
Photo of Arthur Scappaticci Psychotherapy, Marriage & Family Therapist in San Francisco, CA
Arthur Scappaticci Psychotherapy
Marriage & Family Therapist, MS, LMFT
Verified Verified
San Francisco, CA 94118
Realizing our potential challenges the very essence of who we are: belief, self-esteem, identity. I have a comprehensive approach that will help unlock problematic thought and behavioral patterns, maximizing the resources available to you as you embark on a journey of self discovery and self worth. Identifying and understanding the obstacles that keep you stuck and hold you back are at the heart of personal and professional growth. Recovering from past wounds clears the way towards a wholesome self, reaffirms personal power, and ultimately leads to a greater sense of worth and self-acceptance.
Realizing our potential challenges the very essence of who we are: belief, self-esteem, identity. I have a comprehensive approach that will help unlock problematic thought and behavioral patterns, maximizing the resources available to you as you embark on a journey of self discovery and self worth. Identifying and understanding the obstacles that keep you stuck and hold you back are at the heart of personal and professional growth. Recovering from past wounds clears the way towards a wholesome self, reaffirms personal power, and ultimately leads to a greater sense of worth and self-acceptance.
(628) 265-8349 View (628) 265-8349
Photo of Janelle De Veyra, Marriage & Family Therapist in San Francisco, CA
Janelle De Veyra
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94114
Do you struggle with depression, anxiety, and trauma? Do you experience difficulties managing family and relationship issues? I believe that healing happens when we pay attention to all the parts that make us whole—our mind, body, and soul. The subconscious mind controls most of our reality and choices, so building awareness and active presence can improve the quality of daily living and assist in not only surviving but thriving through life. As an intuitive & holistic therapist, I will assist you in strengthening your inner psyche and developing new tools to manage negative feelings and thoughts.
Do you struggle with depression, anxiety, and trauma? Do you experience difficulties managing family and relationship issues? I believe that healing happens when we pay attention to all the parts that make us whole—our mind, body, and soul. The subconscious mind controls most of our reality and choices, so building awareness and active presence can improve the quality of daily living and assist in not only surviving but thriving through life. As an intuitive & holistic therapist, I will assist you in strengthening your inner psyche and developing new tools to manage negative feelings and thoughts.
(415) 877-4918 View (415) 877-4918
Photo of Julie A Wolfert, Psychologist in San Francisco, CA
Julie A Wolfert
Psychologist, PsyD
Verified Verified
2 Endorsed
San Francisco, CA 94123
I work collaboratively with patients in individual therapy and while conducting neuropsychological, psychodiagnostic, and psychoeducational assessments. I provide information regarding patients' limitations, capabilities, cognitive functioning and diagnostic considerations. My interests and experience have contributed to my specializing in diagnosing and treating neuropsychological and educational disabilities (including ADHD/ADD) as well as working with individuals experiencing mood, adjustment and anxiety disorders. I assist people in the development of academic, professional and personal skills and the building of confidence in order to support reaching their highest potential. I provide behavioral pain management and work with patients who are adjusting to various disabilities.
I work collaboratively with patients in individual therapy and while conducting neuropsychological, psychodiagnostic, and psychoeducational assessments. I provide information regarding patients' limitations, capabilities, cognitive functioning and diagnostic considerations. My interests and experience have contributed to my specializing in diagnosing and treating neuropsychological and educational disabilities (including ADHD/ADD) as well as working with individuals experiencing mood, adjustment and anxiety disorders. I assist people in the development of academic, professional and personal skills and the building of confidence in order to support reaching their highest potential. I provide behavioral pain management and work with patients who are adjusting to various disabilities.
(415) 935-4901 View (415) 935-4901
Photo of Alexis Monnier, Marriage & Family Therapist in San Francisco, CA
Alexis Monnier
Marriage & Family Therapist, MA
Verified Verified
13 Endorsed
San Francisco, CA 94115
Many couples work so hard to resolve conflict on thier own and end up getting stuck over and over. Though each couple has hot topics they can often argue over something as simple as the toilet paper roll. They try to resolve repetitive conflicts on their own and get stuck. There are specific tools and perspectives that are key to having a successful relationship. Learning these tools can deepen a relationship and build a foundation for a potential future family.
Many couples work so hard to resolve conflict on thier own and end up getting stuck over and over. Though each couple has hot topics they can often argue over something as simple as the toilet paper roll. They try to resolve repetitive conflicts on their own and get stuck. There are specific tools and perspectives that are key to having a successful relationship. Learning these tools can deepen a relationship and build a foundation for a potential future family.
(415) 801-0354 View (415) 801-0354
Photo of Yin J. Li, Marriage & Family Therapist in San Francisco, CA
Yin J. Li
Marriage & Family Therapist, MA, LMFT
Verified Verified
1 Endorsed
San Francisco, CA 94110  (Online Only)
You are “highly functioning”. You have succeeded in most of the ways that were expected of you. Most people look to you for direction, leadership, and support. And, you have a different internal life. You feel resentful of all the obligations put on you. You struggle with intimacy. You feel alone despite having a large social network. You worry a lot. You have a hard time knowing what you need. You feel disconnected from yourself. You feel tired. You want more.
You are “highly functioning”. You have succeeded in most of the ways that were expected of you. Most people look to you for direction, leadership, and support. And, you have a different internal life. You feel resentful of all the obligations put on you. You struggle with intimacy. You feel alone despite having a large social network. You worry a lot. You have a hard time knowing what you need. You feel disconnected from yourself. You feel tired. You want more.
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Photo of Allison Broennimann, Psychologist in San Francisco, CA
Allison Broennimann
Psychologist, PhD
Verified Verified
1 Endorsed
San Francisco, CA 94109
Therapy is about helping you with your unique challenges. Supporting you over the short or long term. My primary goal includes offering hope and a safe space in which to explore difficulties and solutions. Obstacles can vary over the lifespan, and many different types of symptoms or events can change your ability to manage your relationships or work stress levels.
Therapy is about helping you with your unique challenges. Supporting you over the short or long term. My primary goal includes offering hope and a safe space in which to explore difficulties and solutions. Obstacles can vary over the lifespan, and many different types of symptoms or events can change your ability to manage your relationships or work stress levels.
(844) 362-2891 View (844) 362-2891
Photo of Dr Jonathon Gray MFT, Marriage & Family Therapist in San Francisco, CA
Dr Jonathon Gray MFT
Marriage & Family Therapist, MFT
Verified Verified
San Francisco, CA 94110
The most important thing in working with me is your positive desire to change. Given that I'll bring you into the office, we will discuss your issues of concern and design and implement suggestions to create growth , understanding and lasting solutions. Many clients see me once for behavior change through hypnotherapy. Others see me for ongoing psychotherapy appointments. Some clients combine both modalities to insure continued growth and change. I am optimistic about the possibilities of health and healing through our work together. After forty years in practice I remain committed to my clients and their work with me
The most important thing in working with me is your positive desire to change. Given that I'll bring you into the office, we will discuss your issues of concern and design and implement suggestions to create growth , understanding and lasting solutions. Many clients see me once for behavior change through hypnotherapy. Others see me for ongoing psychotherapy appointments. Some clients combine both modalities to insure continued growth and change. I am optimistic about the possibilities of health and healing through our work together. After forty years in practice I remain committed to my clients and their work with me
(415) 630-5741 View (415) 630-5741
Photo of Hope Czbas, Licensed Professional Clinical Counselor in San Francisco, CA
Hope Czbas
Licensed Professional Clinical Counselor, LPCC
Verified Verified
San Francisco, CA 94118
Hey Y’all! My name is Hope Czbas and I’m a Licensed Professional Clinical Counselor (LPCC). My approach to therapy is initially one that is client centered; I believe it is important to first meet a client where they are at with that of compassion and understanding. I have a wide array of training within the mental health field but have the most experience supporting those healing through trauma, identity issues and emotional distress & regulation skills.
Hey Y’all! My name is Hope Czbas and I’m a Licensed Professional Clinical Counselor (LPCC). My approach to therapy is initially one that is client centered; I believe it is important to first meet a client where they are at with that of compassion and understanding. I have a wide array of training within the mental health field but have the most experience supporting those healing through trauma, identity issues and emotional distress & regulation skills.
(415) 687-5443 View (415) 687-5443
Photo of Dr. Dyan Savery, Psychologist in San Francisco, CA
Dr. Dyan Savery
Psychologist, PhD
Verified Verified
San Francisco, CA 94104  (Online Only)
Dr. Savery, PhD is a Licensed Clinical Psychologist with over twenty years of experience helping individuals improve their lives. She focuses on holistic yet specific and tailored treatment based on the individual needs of each person. If you have depression, anxiety or are unsure how you feel, Dr. Savery specializes in helping you understand your thoughts and feelings that are getting in the way of your happiness. You will work together to approach what the obstacles to your happiness are and how to effectively cope with life’s demands.
Dr. Savery, PhD is a Licensed Clinical Psychologist with over twenty years of experience helping individuals improve their lives. She focuses on holistic yet specific and tailored treatment based on the individual needs of each person. If you have depression, anxiety or are unsure how you feel, Dr. Savery specializes in helping you understand your thoughts and feelings that are getting in the way of your happiness. You will work together to approach what the obstacles to your happiness are and how to effectively cope with life’s demands.
(628) 265-8503 View (628) 265-8503
Photo of Brad Dolin, Marriage & Family Therapist Associate in San Francisco, CA
Brad Dolin
Marriage & Family Therapist Associate, MA, AMFT, APCC
Verified Verified
San Francisco, CA 94129  (Online Only)
Modern life can feel like a paradox. Surrounded by technology meant to bring connection, ease, and order to our lives, you may instead feel isolated, anxious, and overwhelmed. Bombarded by reminders about the value of purpose, meaning, and contentment, you may find yourself feeling disoriented, distracted, and insufficient. You are far from alone. There is a path toward feeling whole. And I encourage you to nourish the seed of hope that brought you to search for a therapist.
Modern life can feel like a paradox. Surrounded by technology meant to bring connection, ease, and order to our lives, you may instead feel isolated, anxious, and overwhelmed. Bombarded by reminders about the value of purpose, meaning, and contentment, you may find yourself feeling disoriented, distracted, and insufficient. You are far from alone. There is a path toward feeling whole. And I encourage you to nourish the seed of hope that brought you to search for a therapist.
(415) 761-4087 View (415) 761-4087

See more therapy options for San Francisco

How does your Therapist compare?

Number of Therapists in San Francisco, CA

3,000+

Average cost per session

$189

Therapists in San Francisco, CA who prioritize treating:

93% Anxiety
87% Depression
81% Relationship Issues
75% Self Esteem
70% Trauma and PTSD
68% Stress
66% Life Transitions

Average years in practice

12 Years

Top 3 insurances accepted

69% Aetna
55% UnitedHealthcare UHC | UBH
54% Cigna and Evernorth

How Therapists in San Francisco, CA see their clients

55% In Person and Online
45% Online Only

Gender breakdown

75% Female
23% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in San Francisco?

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.