Therapists in Fresno County, CA

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Photo of April Taylor-Salery, Marriage & Family Therapist in Fresno County, CA
April Taylor-Salery
Marriage & Family Therapist, MA, LMFT
Verified
Fresno, CA 93720
I am a licensed marriage and family therapist who enjoys working with individuals, couples and families; while providing a safe and affirming environment. As a therapist I have worked with a wide range of populations such as at risk youth, substance abuse and recovery, individuals with severe mental illness, families, couples, anxiety, depression, ADHD, OCD, interpersonal relationships, and the LGBTQ+ community. I have worked with individuals ranging in age from 8 years old to 70 years old.
I am a licensed marriage and family therapist who enjoys working with individuals, couples and families; while providing a safe and affirming environment. As a therapist I have worked with a wide range of populations such as at risk youth, substance abuse and recovery, individuals with severe mental illness, families, couples, anxiety, depression, ADHD, OCD, interpersonal relationships, and the LGBTQ+ community. I have worked with individuals ranging in age from 8 years old to 70 years old.
(559) 364-9503 View (559) 364-9503
Photo of Christie Dooley, Marriage & Family Therapist in Fresno County, CA
Christie Dooley
Marriage & Family Therapist, LMFT
Verified
Fresno, CA 93720  (Online Only)
Hi, I’m Christie Dooley, a Licensed Marriage and Family Therapist. I’ve learned sometimes we must experience discomfort to meet growth. Beginning that journey can be a heavy step to take, but rest assured, I’m here to provide you with a safe, supportive space, where you're free to be yourself to gain the clarity you deserve and become the person you’re meant to be. My Master of Arts Degree in Psychology has allowed me the opportunities to work in the private practice sector and substance abuse treatment facilities, where I gained experience working with; Anxiety, Adjustment Disorders, Addiction, Communication Issues, Grief/Loss
Hi, I’m Christie Dooley, a Licensed Marriage and Family Therapist. I’ve learned sometimes we must experience discomfort to meet growth. Beginning that journey can be a heavy step to take, but rest assured, I’m here to provide you with a safe, supportive space, where you're free to be yourself to gain the clarity you deserve and become the person you’re meant to be. My Master of Arts Degree in Psychology has allowed me the opportunities to work in the private practice sector and substance abuse treatment facilities, where I gained experience working with; Anxiety, Adjustment Disorders, Addiction, Communication Issues, Grief/Loss
(559) 236-6139 View (559) 236-6139
Photo of Mahtab Kaeni, Psychologist in Fresno County, CA
Mahtab Kaeni
Psychologist, PsyD
Verified
Fresno, CA 93711
Do you want a more healthy, productive and satisfying life? Sometimes, people may feel overwhelmed by what is happening in their lives and need help sorting out their feelings, finding solutions to their problems, or just feeling better. I am a licensed clinical psychologist at Transcendence Psychological Services and can help by providing a safe and non-judgmental therapeutic experience. I strive to help people find a new perspective on their problems and provide tools to help them change old patterns so they can increase the joy and peace in their lives.
Do you want a more healthy, productive and satisfying life? Sometimes, people may feel overwhelmed by what is happening in their lives and need help sorting out their feelings, finding solutions to their problems, or just feeling better. I am a licensed clinical psychologist at Transcendence Psychological Services and can help by providing a safe and non-judgmental therapeutic experience. I strive to help people find a new perspective on their problems and provide tools to help them change old patterns so they can increase the joy and peace in their lives.
(559) 708-4110 View (559) 708-4110
Judith Ann Dickey
Marriage & Family Therapist, LMFT, PhD
Verified
Fresno, CA 93704
I believe that it takes courage and wisdom to ask for help. Giving yourself the time and space to work things through is a gift to yourself and your relationships. Therapy is also a partnership for growth. I work with individuals, couples, families to help them achieve healthier relationships and to add more meaning and purpose to their lives. We live in an era of change. People often need help to move through transitions, cope with their anxieties, and work they way through depression. I like to help clients build emotional stamina, clearer thinking, claim intuition, and make soulful connections.
I believe that it takes courage and wisdom to ask for help. Giving yourself the time and space to work things through is a gift to yourself and your relationships. Therapy is also a partnership for growth. I work with individuals, couples, families to help them achieve healthier relationships and to add more meaning and purpose to their lives. We live in an era of change. People often need help to move through transitions, cope with their anxieties, and work they way through depression. I like to help clients build emotional stamina, clearer thinking, claim intuition, and make soulful connections.
(559) 475-8963 x559222 View (559) 475-8963 x559222
Photo of Danell Black, Counselor in Fresno County, CA
Danell Black
Counselor, LPCC
Verified
Fresno, CA 93720
Hello, I'm Danell. Do you ever feel your past getting in the way of your future? Is it hard to be positive? As a counselor, my role is to provide support and guidance to help individuals make positive changes in their lives. I’m ready to listen to your thoughts, fears, and concerns without judgment.
Hello, I'm Danell. Do you ever feel your past getting in the way of your future? Is it hard to be positive? As a counselor, my role is to provide support and guidance to help individuals make positive changes in their lives. I’m ready to listen to your thoughts, fears, and concerns without judgment.
(858) 758-7760 View (858) 758-7760
Photo of Mirian Cardenas, Marriage & Family Therapist in Fresno County, CA
Mirian Cardenas
Marriage & Family Therapist, MS, LMFT
Verified
1 Endorsed
Fresno, CA 93711
Not accepting new clients
Life can get complicated and there is no handbook on how to handle things like depression, anxiety, trauma, and relationship problems. It is important to know two things: 1. you are not alone, 2. challenges are always opportunities to grow and change your life. You are probably here because it's time to "do something different." Let me help guide you through this journey!
Life can get complicated and there is no handbook on how to handle things like depression, anxiety, trauma, and relationship problems. It is important to know two things: 1. you are not alone, 2. challenges are always opportunities to grow and change your life. You are probably here because it's time to "do something different." Let me help guide you through this journey!
(559) 272-5275 View (559) 272-5275
Photo of Nicki Trevino, Marriage & Family Therapist in Fresno County, CA
Nicki Trevino
Marriage & Family Therapist, LMFT
Verified
Fresno, CA 93720
Therapy is a big step and can sometimes feel scary, and I want you to know that you are not alone. I am passionate about meeting you where you are and coming alongside you in your own unique journey. I believe that finding a therapist that is right for you is one of the most important parts of successful therapy. In my work, I provide a safe and empathetic place that fosters insight, understanding, and self-compassion. I recognize that each client has their own individual needs and I come from a place of warmth and acceptance.
Therapy is a big step and can sometimes feel scary, and I want you to know that you are not alone. I am passionate about meeting you where you are and coming alongside you in your own unique journey. I believe that finding a therapist that is right for you is one of the most important parts of successful therapy. In my work, I provide a safe and empathetic place that fosters insight, understanding, and self-compassion. I recognize that each client has their own individual needs and I come from a place of warmth and acceptance.
(559) 634-3025 View (559) 634-3025
Photo of Kathleen Chavoor Bergen, Marriage & Family Therapist in Fresno County, CA
Kathleen Chavoor Bergen
Marriage & Family Therapist, MA, LMFT
Verified
3 Endorsed
Fresno, CA 93711
Kathleen Chavoor-Bergen, M.A., is a Licensed Marriage and Family Therapist with a focus on Jungian and Depth psychology. Currently pursuing a Ph.D. in Depth Psychology, Kathleen possesses a unique skill set to engage with dreams, symbols, active imagination, myths, and play therapy. As a Depth therapist, Kathleen understands how individuals can become entangled in challenging behaviors, thoughts, and emotions that impact relationships and perpetuate personal distress. These recurring patterns often trace back to generational and behavioral blueprints influenced by cultural, societal, and familial histories.
Kathleen Chavoor-Bergen, M.A., is a Licensed Marriage and Family Therapist with a focus on Jungian and Depth psychology. Currently pursuing a Ph.D. in Depth Psychology, Kathleen possesses a unique skill set to engage with dreams, symbols, active imagination, myths, and play therapy. As a Depth therapist, Kathleen understands how individuals can become entangled in challenging behaviors, thoughts, and emotions that impact relationships and perpetuate personal distress. These recurring patterns often trace back to generational and behavioral blueprints influenced by cultural, societal, and familial histories.
(559) 597-8658 View (559) 597-8658
Photo of Carol G Kim (Sheher), Clinical Social Work/Therapist in Fresno County, CA
Carol G Kim (Sheher)
Clinical Social Work/Therapist, LCSW
Verified
Fresno, CA 93720
Change is difficult. Whatever problem you are experiencing - relationship difficulties, anxiety, depressed mood, feeling stuck - there are good reasons you have not been able to solve these on your own. I would be honored to help you create positive change. As a Certified Level 4 T.E.A.M therapist, I practice state-of-the-art therapy, which has innovative and powerful tools that are designed to radically improve ways of coping and viewing yourself and others. My patient and I are a TEAM - working to overcome anxiety, panic,depression, habits, &/or relationship problems. .
Change is difficult. Whatever problem you are experiencing - relationship difficulties, anxiety, depressed mood, feeling stuck - there are good reasons you have not been able to solve these on your own. I would be honored to help you create positive change. As a Certified Level 4 T.E.A.M therapist, I practice state-of-the-art therapy, which has innovative and powerful tools that are designed to radically improve ways of coping and viewing yourself and others. My patient and I are a TEAM - working to overcome anxiety, panic,depression, habits, &/or relationship problems. .
(559) 472-0195 View (559) 472-0195
Photo of Jennifer Her, Marriage & Family Therapist in Fresno County, CA
Jennifer Her
Marriage & Family Therapist, MS, LMFT
Verified
1 Endorsed
Fresno, CA 93710
If you are going through a difficult time or need support in working through life challenges, I welcome you into my practice to explore, repair and heal. Whether you are struggling with depression, anxiety, postpartum, parenting, relationships, family conflict, or racial trauma, no one flourishes in isolation. If you are ready to engage in a therapeutic experience to nurture, reflect and process opportunities of change and growth, I am here to help and support you.
If you are going through a difficult time or need support in working through life challenges, I welcome you into my practice to explore, repair and heal. Whether you are struggling with depression, anxiety, postpartum, parenting, relationships, family conflict, or racial trauma, no one flourishes in isolation. If you are ready to engage in a therapeutic experience to nurture, reflect and process opportunities of change and growth, I am here to help and support you.
(559) 549-0083 View (559) 549-0083
Photo of Tammy Lee Anderson, Marriage & Family Therapist in Fresno County, CA
Tammy Lee Anderson
Marriage & Family Therapist, MS, LMFT
Verified
Clovis, CA 93612  (Online Only)
Online Video Appointments only. Wellness Counseling. Focused on Personal Empowerment. Grief, Stress Reduction, Life coaching, Mindfulness practice, and Hypnotherapy are some of what I offer. Stress reduction strategies, management of depression, anxiety, PTSD, Loss and Grief, physical pain management and overall general well-being. Contact me through email: balance93612@gmail.com
Online Video Appointments only. Wellness Counseling. Focused on Personal Empowerment. Grief, Stress Reduction, Life coaching, Mindfulness practice, and Hypnotherapy are some of what I offer. Stress reduction strategies, management of depression, anxiety, PTSD, Loss and Grief, physical pain management and overall general well-being. Contact me through email: balance93612@gmail.com
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Photo of Bryan Van Ravenhorst, Pre-Licensed Professional in Fresno County, CA
Bryan Van Ravenhorst
Pre-Licensed Professional, ASW
Verified
1 Endorsed
Fresno, CA 93711
Life is hard. Keeping up with everything that’s going on around us can sometimes make it difficult for us to recognize and deal with what is going on within us. Perhaps you are struggling to manage stress, navigate relationships (with partners, family members, friends, coworkers, etc.), or adjust to changing life circumstances. Or maybe you are feeling stuck, overwhelmed, and looking for a change.
Life is hard. Keeping up with everything that’s going on around us can sometimes make it difficult for us to recognize and deal with what is going on within us. Perhaps you are struggling to manage stress, navigate relationships (with partners, family members, friends, coworkers, etc.), or adjust to changing life circumstances. Or maybe you are feeling stuck, overwhelmed, and looking for a change.
(559) 370-3027 View (559) 370-3027
Photo of Link Care Foundation, Psychologist in Fresno County, CA
Link Care Foundation
Psychologist, PsyD
Verified
Fresno, CA 93711
Link Care seeks to bring together a firm commitment to the Christian faith and the practical, professional psychological discipline. We are comprised of a highly professional group of clinicians including Psychologists, Licensed Marriage & Family Therapists, Licensed Clinical Social Worker, MFT Associates, MFT trainees, and Pastoral counselors. We exist to help people overcome and recover from hurtful events, gain tools for successful relationships, & become more effective in daily life. As a Christian Counseling Center, Link Care serves both Christians & non-Christians in its mission to provide excellent, professional counseling.
Link Care seeks to bring together a firm commitment to the Christian faith and the practical, professional psychological discipline. We are comprised of a highly professional group of clinicians including Psychologists, Licensed Marriage & Family Therapists, Licensed Clinical Social Worker, MFT Associates, MFT trainees, and Pastoral counselors. We exist to help people overcome and recover from hurtful events, gain tools for successful relationships, & become more effective in daily life. As a Christian Counseling Center, Link Care serves both Christians & non-Christians in its mission to provide excellent, professional counseling.
(559) 315-0570 x145 View (559) 315-0570 x145
James A Powroznik
Marriage & Family Therapist, LMFT
Verified
Fresno, CA 93704
As a family systems therapist, my goal is to help you uncover your true potential and lead a life that is worth celebrating. While we can't change difficult situations of the past, we can work together to better understand how the past has affected your life and resolve challenges in your life by resolving the past, We will unearth long-standing behavior patterns or negative perceptions. Through joural writing and autobiographical work, we can unraval the past, so the future is for you to make. In couples work, unravaling the personal past of each person in the relationship, can be the solution to a fuller and richer relationship.
As a family systems therapist, my goal is to help you uncover your true potential and lead a life that is worth celebrating. While we can't change difficult situations of the past, we can work together to better understand how the past has affected your life and resolve challenges in your life by resolving the past, We will unearth long-standing behavior patterns or negative perceptions. Through joural writing and autobiographical work, we can unraval the past, so the future is for you to make. In couples work, unravaling the personal past of each person in the relationship, can be the solution to a fuller and richer relationship.
(559) 358-4837 View (559) 358-4837
Photo of Karen D Wood, Clinical Social Work/Therapist in Fresno County, CA
Karen D Wood
Clinical Social Work/Therapist, MSW, LCSW
Verified
Fresno, CA 93720
Not accepting new clients
I invite people to be curious about their brains, to understand why they do, how they think! Addicted? Anxious? Angry? A relationship in trouble? All are about the brain. Learning about the amygdala and how it is connected to the rest of the brain, the alert it keeps us at, has everything to do with learning about doing life differently from here forward. Learning how visceral tension response on the body is a clue to what is going on in the mind, gives a sense of control in any situation, giving the balance between frontal lobe executive thinking and limbic system emotional reactivity.
I invite people to be curious about their brains, to understand why they do, how they think! Addicted? Anxious? Angry? A relationship in trouble? All are about the brain. Learning about the amygdala and how it is connected to the rest of the brain, the alert it keeps us at, has everything to do with learning about doing life differently from here forward. Learning how visceral tension response on the body is a clue to what is going on in the mind, gives a sense of control in any situation, giving the balance between frontal lobe executive thinking and limbic system emotional reactivity.
(559) 366-6747 View (559) 366-6747
Photo of Johnny Dell Simmons, Marriage & Family Therapist in Fresno County, CA
Johnny Dell Simmons
Marriage & Family Therapist, LMFT
Verified
1 Endorsed
Fresno, CA 93703
Do you ever find yourself feeling worried all of the time? Do you feel sad and/or feel as if you have little to no energy? Do you find it difficult to interact with others? Have you experienced trauma and feel things are still unresolved? Do you ever just feel "stuck" in life? As captains of our journeys, things can become overwhelming. Anxiety, depression and so many other issues can arise and cause us to feel debilitated. Let us learn how to develop the skills and techniques to be the captains we choose to be. Let us embark on the journey of life together.
Do you ever find yourself feeling worried all of the time? Do you feel sad and/or feel as if you have little to no energy? Do you find it difficult to interact with others? Have you experienced trauma and feel things are still unresolved? Do you ever just feel "stuck" in life? As captains of our journeys, things can become overwhelming. Anxiety, depression and so many other issues can arise and cause us to feel debilitated. Let us learn how to develop the skills and techniques to be the captains we choose to be. Let us embark on the journey of life together.
(323) 642-6703 View (323) 642-6703
Photo of Maria Elena Nunez, Marriage & Family Therapist Associate in Fresno County, CA
Maria Elena Nunez
Marriage & Family Therapist Associate, MA, AMFT
Verified
1 Endorsed
Fresno, CA 93710
I enjoy working with children, teens, young adults, and adults, with a special interest in trauma, men’s issues, women’s issues, BIPOC, mood disorders and grief. I have experience in working with adults struggling with depression, anxiety, grief, life transitions, relational conflicts and trauma. I am especially sensitive to the experience of marginalized groups and am passionate about working with clients from diverse backgrounds, cultures and sexual orientations. I provide a safe and fun space for children to identify, explore and process their emotions through the use of gentle directive approaches and non-directive play.
I enjoy working with children, teens, young adults, and adults, with a special interest in trauma, men’s issues, women’s issues, BIPOC, mood disorders and grief. I have experience in working with adults struggling with depression, anxiety, grief, life transitions, relational conflicts and trauma. I am especially sensitive to the experience of marginalized groups and am passionate about working with clients from diverse backgrounds, cultures and sexual orientations. I provide a safe and fun space for children to identify, explore and process their emotions through the use of gentle directive approaches and non-directive play.
(559) 314-2700 View (559) 314-2700
Photo of Lisa Whitmore, Clinical Social Work/Therapist in Fresno County, CA
Lisa Whitmore
Clinical Social Work/Therapist, LCSW
Verified
Sanger, CA 93657
Lisa Whitmore, Licensed Clinical Social Worker I have been a Licensed Clinical Social Worker (LCSW) since 2019, and I provide counselling to California clients via telehealth. I have focused on older adults, families of older adults, and immigrants to the United States. I work collaboratively with clients to reach a mutual understanding of stressors and use cultural competence and eclectic professional expertise to support you in the challenges you are facing.
Lisa Whitmore, Licensed Clinical Social Worker I have been a Licensed Clinical Social Worker (LCSW) since 2019, and I provide counselling to California clients via telehealth. I have focused on older adults, families of older adults, and immigrants to the United States. I work collaboratively with clients to reach a mutual understanding of stressors and use cultural competence and eclectic professional expertise to support you in the challenges you are facing.
(559) 354-6140 View (559) 354-6140
Photo of Reynaldo T Manalo, Marriage & Family Therapist Associate in Fresno County, CA
Reynaldo T Manalo
Marriage & Family Therapist Associate, MA
Verified
1 Endorsed
Fresno, CA 93720  (Online Only)
I specialize working with individuals and couples going through difficult life-transitions and overwhelming stressors that are impacting their quality of life. Individuals: depression, anxiety, and personal life-transition. Couples: inter-relationship conflict, life-transition. I have worked with individuals in exploration of authentic-selves and brainstorm with clients for methods of treatments. I find joy working with couples as they navigate through their relationship, finding their own methods of how their relationship works, and for them to strengthen their abilities to convey both their feelings and intentions to one another.
I specialize working with individuals and couples going through difficult life-transitions and overwhelming stressors that are impacting their quality of life. Individuals: depression, anxiety, and personal life-transition. Couples: inter-relationship conflict, life-transition. I have worked with individuals in exploration of authentic-selves and brainstorm with clients for methods of treatments. I find joy working with couples as they navigate through their relationship, finding their own methods of how their relationship works, and for them to strengthen their abilities to convey both their feelings and intentions to one another.
(559) 234-4959 View (559) 234-4959
Photo of Alejandra Vega, Clinical Social Work/Therapist in Fresno County, CA
Alejandra Vega
Clinical Social Work/Therapist, LCSW
Verified
Clovis, CA 93612
Hello, My name is Alejandra Vega, LCSW. I am a Latina therapist who enjoys incorporating laughter into sessions. I meet the client where they are on their path toward better days and understanding.
Hello, My name is Alejandra Vega, LCSW. I am a Latina therapist who enjoys incorporating laughter into sessions. I meet the client where they are on their path toward better days and understanding.
(559) 608-3906 View (559) 608-3906

See more therapy options for Fresno County

How does your Therapist compare?

Number of Therapists in Fresno County, CA

1,000+

Average cost per session

$140

Therapists in Fresno County, CA who prioritize treating:

90% Anxiety
87% Depression
73% Coping Skills
70% Self Esteem
63% Trauma and PTSD
58% Grief
55% Stress

Average years in practice

10 Years

Top 3 insurances accepted

79% UnitedHealthcare UHC | UBH
77% Optum
71% Aetna

How Therapists in Fresno County, CA see their clients

64% In Person and Online
36% Online Only

Gender breakdown

81% Female
18% Male
1% Non-Binary

FAQs - About Therapy and Counseling

How can I find a therapist in Fresno County?

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.