Therapists in Saint Louis, MO

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Photo of Dr. Caleb S Reese, Psychologist in Saint Louis, MO
Dr. Caleb S Reese
Psychologist, PsyD, LP, DBT-LBC
Verified Verified
Saint Louis, MO 63146
Waitlist for new clients
I believe obstacles can be paths and hope to be of service to those who are struggling. The willingness to ask for help requires courage. I strive to provide guidance and support as we explore your inner strengths. I do not ask my clients to do anything that I would not do. I recognize my own fallibilities because I am human, too. Through collaborative work and a desire to push towards change, my goal is to aid in recognizing what you have control over in order to make the most of your time.
I believe obstacles can be paths and hope to be of service to those who are struggling. The willingness to ask for help requires courage. I strive to provide guidance and support as we explore your inner strengths. I do not ask my clients to do anything that I would not do. I recognize my own fallibilities because I am human, too. Through collaborative work and a desire to push towards change, my goal is to aid in recognizing what you have control over in order to make the most of your time.
(314) 804-6951 View (314) 804-6951
Photo of Ayelet Gottesman, Psychologist in Saint Louis, MO
Ayelet Gottesman
Psychologist, PsyD
Verified Verified
Saint Louis, MO 63144
My approach to therapy stems from the belief that feeling truly seen and understood is a basic human need. I aim to provide a safe and reflective space where you can bring your whole self without fear of judgment. We will work together in a collaborative process to understand your unique experiences and how they've impacted you, figure out where you may be stuck, and help you take back the reins. I work with people, not diagnoses, and take a strengths-based approach to help individuals of all ages gain self-awareness, curiosity, inspiration and hope.
My approach to therapy stems from the belief that feeling truly seen and understood is a basic human need. I aim to provide a safe and reflective space where you can bring your whole self without fear of judgment. We will work together in a collaborative process to understand your unique experiences and how they've impacted you, figure out where you may be stuck, and help you take back the reins. I work with people, not diagnoses, and take a strengths-based approach to help individuals of all ages gain self-awareness, curiosity, inspiration and hope.
(314) 671-0714 View (314) 671-0714
Betty J Hopkins
Licensed Professional Counselor, MEd, LPC, NCC
Verified Verified
Saint Louis, MO 63108
Are you stuck? Life's challenges keep getting you down? Feel like you can't move beyond past disappointments and hurts? You are not alone. Therapy can help "renew you, renew life".
Are you stuck? Life's challenges keep getting you down? Feel like you can't move beyond past disappointments and hurts? You are not alone. Therapy can help "renew you, renew life".
(314) 488-2295 View (314) 488-2295
Photo of Zane Shetler, Clinical Social Work/Therapist in Saint Louis, MO
Zane Shetler
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
2 Endorsed
Saint Louis, MO 63117
Are you seeking to live a fuller life less encumbered by stress, anxiety, loneliness, or self-doubt? Psychodynamic and emotion-focused therapy is a supportive and nonjudgmental process that allows us to develop a deeper understanding of how our thoughts, feelings, and behaviors are influenced by our experiences. Through this work we can foster greater self-awareness, enhance our ability to tune into and regulate our emotions, and become more empowered to live authentically and purposefully in the present, enriching our lives and relationships along the way.
Are you seeking to live a fuller life less encumbered by stress, anxiety, loneliness, or self-doubt? Psychodynamic and emotion-focused therapy is a supportive and nonjudgmental process that allows us to develop a deeper understanding of how our thoughts, feelings, and behaviors are influenced by our experiences. Through this work we can foster greater self-awareness, enhance our ability to tune into and regulate our emotions, and become more empowered to live authentically and purposefully in the present, enriching our lives and relationships along the way.
(314) 682-4618 View (314) 682-4618
Photo of Riott Kochman, Clinical Social Work/Therapist in Saint Louis, MO
Riott Kochman
Clinical Social Work/Therapist, LCSW
Verified Verified
Saint Louis, MO 63104
The systems we live within (capitalism, colonialism, anti-fatness, etc.) and our early attachment experiences can leave us feeling disconnected from others, our bodies, our values, and our authentic selves. I offer a compassionate space to explore the ways these systems have impacted you. Together, we’ll develop resources, skills, and insights to make your life and relationships more manageable and meaningful.
The systems we live within (capitalism, colonialism, anti-fatness, etc.) and our early attachment experiences can leave us feeling disconnected from others, our bodies, our values, and our authentic selves. I offer a compassionate space to explore the ways these systems have impacted you. Together, we’ll develop resources, skills, and insights to make your life and relationships more manageable and meaningful.
(314) 501-5645 View (314) 501-5645
Photo of Brittany N. Murphy, Licensed Professional Counselor in Saint Louis, MO
Brittany N. Murphy
Licensed Professional Counselor, PhD, LPC, NCC, BC-TMH
Verified Verified
4 Endorsed
Saint Louis, MO 63117  (Online Only)
You're in the right place! You're ready for your mood and motivation to improve, your relationships to be better, your work to be more enjoyable, and your life to feel more meaningful. I work well with people who feel stuck or that things aren't as they could or should be. My clients want clarity about their experiences, their relationships, and the direction of their lives.
You're in the right place! You're ready for your mood and motivation to improve, your relationships to be better, your work to be more enjoyable, and your life to feel more meaningful. I work well with people who feel stuck or that things aren't as they could or should be. My clients want clarity about their experiences, their relationships, and the direction of their lives.
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Photo of Esther Boguszewski, Clinical Social Work/Therapist in Saint Louis, MO
Esther Boguszewski
Clinical Social Work/Therapist, LMSW
Verified Verified
Saint Louis, MO 63139
Not accepting new clients
Esther is a Licensed Master of Social Work who provides therapy services to teens and adults (15-years-old and up) at Ellie Mental Health in St. Louis. Esther strives to create a safe space where clients can feel free to be their most vulnerable selves, without fear of judgement. Reaching out by email is the best way to get in contact regarding therapy inquiries. Esther accepts Medicaid MO (HealthNet), Carelon, Optum, BCBS, and Cigna (Evernorth).
Esther is a Licensed Master of Social Work who provides therapy services to teens and adults (15-years-old and up) at Ellie Mental Health in St. Louis. Esther strives to create a safe space where clients can feel free to be their most vulnerable selves, without fear of judgement. Reaching out by email is the best way to get in contact regarding therapy inquiries. Esther accepts Medicaid MO (HealthNet), Carelon, Optum, BCBS, and Cigna (Evernorth).
(314) 675-7907 View (314) 675-7907
Photo of Deborah R Meyerson, Clinical Social Work/Therapist in Saint Louis, MO
Deborah R Meyerson
Clinical Social Work/Therapist, LCSW
Verified Verified
Saint Louis, MO 63105
My professional strengths include a solid theoretical base, strong interpersonal skills and a thorough understanding of human behavior. Intelligence, experience, humor and humanity are all qualities which make me a very effective therapist. Clients and colleagues tell me I have an unusual degree of insight. I offer my insights to help individuals generate insights of their own. I actively address a client's presenting concerns with directness and support. When appropriate, I encourage deeper examination. My experience is that client self awareness reinforced with behavioral strategies accelerate therapy,helping people achieve greater and more immediate mastery.
My professional strengths include a solid theoretical base, strong interpersonal skills and a thorough understanding of human behavior. Intelligence, experience, humor and humanity are all qualities which make me a very effective therapist. Clients and colleagues tell me I have an unusual degree of insight. I offer my insights to help individuals generate insights of their own. I actively address a client's presenting concerns with directness and support. When appropriate, I encourage deeper examination. My experience is that client self awareness reinforced with behavioral strategies accelerate therapy,helping people achieve greater and more immediate mastery.
(833) 553-0362 View (833) 553-0362
Photo of Matt Anderson, Pre-Licensed Professional in Saint Louis, MO
Matt Anderson
Pre-Licensed Professional, MEd, PLPC
Verified Verified
Saint Louis, MO 63139
I know what it’s like to feel helpless, alone, frustrated, confused, unseen, unheard, and unsupported. Also, I know that it’s possible to transform these experiences into something deeply meaningful. The path to this transformation involves time and intention, and the courage to look deeply at oneself. As we learn to understand and relinquish old patterns, new ways of being give forth new hope and possibility. And not just for ourselves, but for everyone around us. What a wondrous experience!
I know what it’s like to feel helpless, alone, frustrated, confused, unseen, unheard, and unsupported. Also, I know that it’s possible to transform these experiences into something deeply meaningful. The path to this transformation involves time and intention, and the courage to look deeply at oneself. As we learn to understand and relinquish old patterns, new ways of being give forth new hope and possibility. And not just for ourselves, but for everyone around us. What a wondrous experience!
(314) 408-6966 View (314) 408-6966
Photo of Herzog-Borowiak Counseling LLC, Licensed Professional Counselor in Saint Louis, MO
Herzog-Borowiak Counseling LLC
Licensed Professional Counselor, MA, LPC, NAMP, NCC
Verified Verified
Saint Louis, MO 63141
Congratulations you took the first step in becoming a healthier you.! I have a personal mission of helping people reach their highest potential! I am an experienced therapist, educator, counselor, school psychologist, and advocate with 30+ years experience in the helping field. My counseling services are provided to children, adolescents, adults, couples, and families across a wide spectrum of issues. I will support you as you process feelings, face difficult decisions, talk through available options, strengthen your current relationships, learn cognitive behavioral techniques and develop coping strategies! Through this process you will learn ways to reach your highest potential.
Congratulations you took the first step in becoming a healthier you.! I have a personal mission of helping people reach their highest potential! I am an experienced therapist, educator, counselor, school psychologist, and advocate with 30+ years experience in the helping field. My counseling services are provided to children, adolescents, adults, couples, and families across a wide spectrum of issues. I will support you as you process feelings, face difficult decisions, talk through available options, strengthen your current relationships, learn cognitive behavioral techniques and develop coping strategies! Through this process you will learn ways to reach your highest potential.
(314) 736-3716 View (314) 736-3716
Photo of Diana Dee-Williams, Licensed Professional Counselor in Saint Louis, MO
Diana Dee-Williams
Licensed Professional Counselor, MA, LPC
Verified Verified
Saint Louis, MO 63125
Not accepting new clients
My name is Diana Dee-Williams, I am a Licensed professional counselor in the State of MO. My focus is to create a safe sense of comfort for clients to build rapport while helping them solve their life challenges. I am psychotherapist who believes in helping individuals explore their inner thoughts, feelings, behaviors behind their significant life challenges as well help him or her move toward Self-Achievement and Self-Growth. The goal is for the therapist and individuals to work together in maintaining stability with the intentional plan to work through those circumstances and reach a positive balance and purpose in life.
My name is Diana Dee-Williams, I am a Licensed professional counselor in the State of MO. My focus is to create a safe sense of comfort for clients to build rapport while helping them solve their life challenges. I am psychotherapist who believes in helping individuals explore their inner thoughts, feelings, behaviors behind their significant life challenges as well help him or her move toward Self-Achievement and Self-Growth. The goal is for the therapist and individuals to work together in maintaining stability with the intentional plan to work through those circumstances and reach a positive balance and purpose in life.
(314) 408-2838 View (314) 408-2838
Photo of Cristina Marie Smugala, Licensed Professional Counselor in Saint Louis, MO
Cristina Marie Smugala
Licensed Professional Counselor, MA, LPC
Verified Verified
3 Endorsed
Saint Louis, MO 63127  (Online Only)
My passion is to empathetically guide and support transformation of traumatic experience. I will empower you to face your fears, unburden toxic shame, heal traumatic wounds and help you reclaim the courage that you know is inside of you. The ability to have love, compassion and acceptance for yourself are powerful healing forces that I strive to ignite, recover and unlock in my clients. Through EMDR and Somatic Experiencing I focus on restoring a sense of calm, centered connectedness within the brain and body. I work to inspire courage, promote healing so you can embody radical acceptance, release fear and embrace authenticity.
My passion is to empathetically guide and support transformation of traumatic experience. I will empower you to face your fears, unburden toxic shame, heal traumatic wounds and help you reclaim the courage that you know is inside of you. The ability to have love, compassion and acceptance for yourself are powerful healing forces that I strive to ignite, recover and unlock in my clients. Through EMDR and Somatic Experiencing I focus on restoring a sense of calm, centered connectedness within the brain and body. I work to inspire courage, promote healing so you can embody radical acceptance, release fear and embrace authenticity.
(314) 888-5212 x3 View (314) 888-5212 x3
Photo of Daeton DeGrant, Licensed Professional Counselor in Saint Louis, MO
Daeton DeGrant
Licensed Professional Counselor, MA, MS, LPC
Verified Verified
1 Endorsed
Saint Louis, MO 63103  (Online Only)
The journey to wellness starts with the choice to hope that there is the possibility for tomorrow to be a better day. Our mission is to assist others in finding hope on their journey to wellness by providing practical solution focused options, including therapy, psychological assessment, life coaching, education, information, professional development trainings and more.
The journey to wellness starts with the choice to hope that there is the possibility for tomorrow to be a better day. Our mission is to assist others in finding hope on their journey to wellness by providing practical solution focused options, including therapy, psychological assessment, life coaching, education, information, professional development trainings and more.
(314) 470-9794 View (314) 470-9794
Photo of Pete Sandoval, Licensed Professional Counselor in Saint Louis, MO
Pete Sandoval
Licensed Professional Counselor, LPC, NCC, CCTP
Verified Verified
1 Endorsed
Saint Louis, MO 63114  (Online Only)
Today is a new day! Having someone to listen without judgment is a tremendous gift. It can remove the loneliness and despair that can happen when life gets to be too much to bear. Perhaps you've had therapy before but something's still missing. You've done everything you can think of or that your previous therapist told you. You are dedicated to your personal growth. You engage in regular practices and are committed to do whatever it takes to be your best self. Despite some real progress, the deeper relief you've been looking for hasn't occurred just yet.
Today is a new day! Having someone to listen without judgment is a tremendous gift. It can remove the loneliness and despair that can happen when life gets to be too much to bear. Perhaps you've had therapy before but something's still missing. You've done everything you can think of or that your previous therapist told you. You are dedicated to your personal growth. You engage in regular practices and are committed to do whatever it takes to be your best self. Despite some real progress, the deeper relief you've been looking for hasn't occurred just yet.
(314) 462-2696 View (314) 462-2696
Photo of Chris Elliott, Clinical Social Work/Therapist in Saint Louis, MO
Chris Elliott
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Saint Louis, MO 63116
I am a Licensed Clinical Social Worker (LCSW) with over 20 years of experience in the field of mental health. I believe that therapy is a powerful tool for achieving a healthy and balanced life. I utilize various therapeutic approaches, including mindfulness, community-based interventions, trauma-focused therapy, and cognitive behavioral therapy, to provide individualized care for each client. As a North St. Louis-bred and St. Louis University-educated professional, I understand the struggles associated with limited resources and the traumas they can bring. This knowledge is used to support clients' growth.
I am a Licensed Clinical Social Worker (LCSW) with over 20 years of experience in the field of mental health. I believe that therapy is a powerful tool for achieving a healthy and balanced life. I utilize various therapeutic approaches, including mindfulness, community-based interventions, trauma-focused therapy, and cognitive behavioral therapy, to provide individualized care for each client. As a North St. Louis-bred and St. Louis University-educated professional, I understand the struggles associated with limited resources and the traumas they can bring. This knowledge is used to support clients' growth.
(314) 648-8388 View (314) 648-8388
Photo of Matthew James Murtaugh, Licensed Professional Counselor in Saint Louis, MO
Matthew James Murtaugh
Licensed Professional Counselor, LPC, MA
Verified Verified
1 Endorsed
Saint Louis, MO 63104  (Online Only)
I am looking forward to meeting you. Sometimes life is confusing and hard. Maybe you need more understanding of yourself. We can add coping skills to help. You might have trouble navigating your emotions. There could be trauma that is hindering your growth. Let us work together to improve your life!
I am looking forward to meeting you. Sometimes life is confusing and hard. Maybe you need more understanding of yourself. We can add coping skills to help. You might have trouble navigating your emotions. There could be trauma that is hindering your growth. Let us work together to improve your life!
(314) 501-7516 View (314) 501-7516
Photo of Annie Carrera, Pre-Licensed Professional in Saint Louis, MO
Annie Carrera
Pre-Licensed Professional, MA, PLPC
Verified Verified
Saint Louis, MO 63131
This is a common pattern in many couples’ relationships and maybe this describes you: prior to getting married, you had a dream. A dream that your relationship would be like the ones portrayed in romantic movies, a life of bliss because you found your perfect person. Then, at some point in your marriage, you asked this question: “How did we get here?” Instead of a foundation of joy and security, you and your spouse find yourselves stuck in conflict cycles that leave you feeling bitter, distant, and hopeless.
This is a common pattern in many couples’ relationships and maybe this describes you: prior to getting married, you had a dream. A dream that your relationship would be like the ones portrayed in romantic movies, a life of bliss because you found your perfect person. Then, at some point in your marriage, you asked this question: “How did we get here?” Instead of a foundation of joy and security, you and your spouse find yourselves stuck in conflict cycles that leave you feeling bitter, distant, and hopeless.
(314) 474-7228 View (314) 474-7228
Photo of Austin E Wilmot, Clinical Social Work/Therapist in Saint Louis, MO
Austin E Wilmot
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
4 Endorsed
Saint Louis, MO 63124
I have experience treating all ages with an in-depth approach, beginning with meeting you and working to understand the difficulties you are facing. I offer a space that fosters fuller experiencing and understanding of your inner emotional life, including feelings, thoughts, dreams and fantasies. In connection with me, your symptoms and problematic patterns can become understood in new ways, leading to emotional growth and a greater capacity to make meaningful changes in your life. I provide dynamic therapy in-office and by videoconference to people whose location or commitments make it difficult to attend in-person meetings.
I have experience treating all ages with an in-depth approach, beginning with meeting you and working to understand the difficulties you are facing. I offer a space that fosters fuller experiencing and understanding of your inner emotional life, including feelings, thoughts, dreams and fantasies. In connection with me, your symptoms and problematic patterns can become understood in new ways, leading to emotional growth and a greater capacity to make meaningful changes in your life. I provide dynamic therapy in-office and by videoconference to people whose location or commitments make it difficult to attend in-person meetings.
(314) 907-3197 View (314) 907-3197
Photo of Travis Munnerlyn, Psychologist in Saint Louis, MO
Travis Munnerlyn
Psychologist, PsyD
Verified Verified
Saint Louis, MO 63139
For many of us, childhood was mentally and emotionally confusing. And we may find that these experiences impact us even now — they season how we relate to others, how we interact with our worlds, and even how we conceive of our future. Making sense of all of this requires a respect for very human needs like safety, stability, and positive and corrective emotional experiences. Therapy is often the single most helpful and effective intervention to those ends—it certainly has been healing for me. I hold a deep respect and honor for those who are able to show up to do this work.
For many of us, childhood was mentally and emotionally confusing. And we may find that these experiences impact us even now — they season how we relate to others, how we interact with our worlds, and even how we conceive of our future. Making sense of all of this requires a respect for very human needs like safety, stability, and positive and corrective emotional experiences. Therapy is often the single most helpful and effective intervention to those ends—it certainly has been healing for me. I hold a deep respect and honor for those who are able to show up to do this work.
(314) 947-5910 View (314) 947-5910
Photo of Yasmira Emofor, Licensed Professional Counselor in Saint Louis, MO
Yasmira Emofor
Licensed Professional Counselor, LPC, CCDP-D
Verified Verified
Saint Louis, MO 63108
Have you felt like you are missing out on life? Have you felt like you are in a slump that you can’t dig yourself out off? Like you been struggling for so long without a break from the stress of it all? Whether your struggle is depression, anxiety, phobias or trauma, I am here to offer a safe space for you. What you want to feel is empowered, capable and resilient to handle the challenge; or ready to face down any fear. I've helped countless individuals! Let me help you reclaim your resiliency today!
Have you felt like you are missing out on life? Have you felt like you are in a slump that you can’t dig yourself out off? Like you been struggling for so long without a break from the stress of it all? Whether your struggle is depression, anxiety, phobias or trauma, I am here to offer a safe space for you. What you want to feel is empowered, capable and resilient to handle the challenge; or ready to face down any fear. I've helped countless individuals! Let me help you reclaim your resiliency today!
(314) 742-8208 View (314) 742-8208

How does your Therapist compare?

Number of Therapists in Saint Louis, MO

1,000+

Average cost per session

$125

Therapists in Saint Louis, MO who prioritize treating:

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

Average years in practice

11 Years

Top 3 insurances accepted

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

How Therapists in Saint Louis, MO see their clients

75% In Person and Online
25% Online Only

Gender breakdown

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

How can I find a therapist in Saint Louis?

Search for nearby therapists or counselors by inputting your city, town, or suburb; or zip code; or a provider’s name into the search bar. From there, you can filter providers by the issues they treat, cost, insurance, gender, and other factors to find providers who are well-suited to your needs. To navigate between locations within the same country, enter a new city or zip code into the search bar.

Learn more about how to find a therapist

Is everyone in the Psychology Today Therapy Directory a licensed therapist?

The Psychology Today directory lists providers who offer legitimate mental health services to the public, including psychologists, psychiatrists, social workers, and counselors.

Many have been licensed by the country or state where they practice; providers whose license or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Some clinicians or organizations provide services for which their state or country does not offer licenses, such as pastoral counseling. They may be selectively included without the “Verified” seal.

What’s the difference between a psychologist, a therapist, and a counselor?

Therapists, psychologists, and counselors are all licensed mental health professionals. In the US, psychologists have earned a doctoral degree. The terms “therapist” and “counselor” are used somewhat interchangeably, but generally therapists offer longer-term, mental health care, while counselors offer shorter-term care that may focus on one domain, such as marriage, career, or academic challenges.

Clients should consider factors such as insurance coverage and their primary reason(s) for seeking therapy to determine the type of professional best suited to their needs. Someone struggling with mental health challenges such as depression or anxiety, for example, may wish to seek out a clinical psychologist or therapist, while someone navigating career obstacles or marital upheaval may benefit from seeing a counselor who can offer short-term, targeted support.

What type of therapy is right for me?

The type of therapy best suited to a particular individual depends on several factors, including their primary reason for seeking therapy, their preferred timeline (some therapy types last for a set number of sessions, while others are open-ended), and their personality and preferences—some may prefer a more structured approach. For many individuals, multiple types of therapy could provide a good fit.

How much does therapy cost?

The cost of therapy depends on a number of variables, including location and the therapist’s experience and training. On average, a therapy session in the United States could cost between $100 and $200 or more. If you have insurance, the expense of mental health care is typically lower, but it varies based on your insurance plan details and whether you choose an in-network or out-of-network mental healthcare provider.

What are more affordable or low cost therapy solutions?

Many therapists offer sliding scale payments, usually on a limited number of slots, which consists in an agreement between the therapist and a client to pay a reduced rate. Therapists who provide such arrangements often consider the client's income or ability to pay, but the extent of the discount is ultimately at the therapist's discretion. Furthermore, while group therapy may have different goals and benefits compared to individual therapy, it can be a more affordable solution to address certain types of issues.

Is online therapy cheaper than in-person therapy?

Many therapists charge the same amount for online therapy as they do for in-person therapy—though clients may still find this cost-effective if it cuts down on their transportation costs. Health insurance plans often offer equivalent coverage for online and in-person therapy; indeed, in many places, they are legally required to do so. Text-based or on-demand therapy apps may be cheaper than traditional one-on-one psychotherapy; however, the practice may be less effective and is not likely to be covered by insurance.

Is online therapy a good option?

Therapy conducted online can be just as effective as in-person therapy, as long as there is a strong alliance between the client and the therapist. To find a therapist who provides telehealth services to clients in your area, click “Online Therapy” on the directory homepage and search by your city or town or your zip code.

Are therapy sessions confidential?

Confidentiality is a crucial part of the therapeutic relationship. Therapists in the United States are bound by the regulations set out by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which aims to protect sensitive health information. With very few exceptions, a therapist will only discuss their client with others when the client has given their written permission. The instances in which a therapist would be required to disclose personal information are: if a client poses a danger to themselves or others, if the therapist suspects the abuse of a child or an elderly or otherwise dependent adult, or if they are legally forced to by court order. These exceptions to the confidentiality agreement are usually discussed with a client before their first session.