Therapists in San Diego, CA

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Marion Herzog
Marriage & Family Therapist Associate, AMFT
1 Endorsed
San Diego, CA 92108
Hello! I commend you for taking this step. I typically work with clients who are experiencing anxiety, depression, identity work/exploration, and how all of this can impact community and societal views. I strongly believe that the client is the expert of their own life, and I hope to make therapy a collaborative process as opposed to the therapist being seen as the sole person with all the answers. I also strongly believe that society has an impact on how we view ourselves in the world. This can often not alight with our own beliefs or how we identify. As a result, we often have conversations regarding deconstructing societal ideas.
Hello! I commend you for taking this step. I typically work with clients who are experiencing anxiety, depression, identity work/exploration, and how all of this can impact community and societal views. I strongly believe that the client is the expert of their own life, and I hope to make therapy a collaborative process as opposed to the therapist being seen as the sole person with all the answers. I also strongly believe that society has an impact on how we view ourselves in the world. This can often not alight with our own beliefs or how we identify. As a result, we often have conversations regarding deconstructing societal ideas.
(858) 771-8792 View (858) 771-8792
Erin Chan
Marriage & Family Therapist, LMFT, MS
3 Endorsed
San Diego, CA 92103
I specialize in working with couples and individuals who are looking for deeper, more intentional relationships - with themselves and with others. Together, we explore how culture, emotional patterns, attachment dynamics, and past experiences shape how you show up in connection. My approach is warm, collaborative, and insight-oriented. I bring powerful emotional attunement to you, as well as levity and humanness to the therapeutic relationship, while effectively helping you build practical tools for communication, emotional regulation, and repair. I also support adolescents navigating anxiety, self-esteem, and peer/family dynamics.
I specialize in working with couples and individuals who are looking for deeper, more intentional relationships - with themselves and with others. Together, we explore how culture, emotional patterns, attachment dynamics, and past experiences shape how you show up in connection. My approach is warm, collaborative, and insight-oriented. I bring powerful emotional attunement to you, as well as levity and humanness to the therapeutic relationship, while effectively helping you build practical tools for communication, emotional regulation, and repair. I also support adolescents navigating anxiety, self-esteem, and peer/family dynamics.
(619) 489-9925 View (619) 489-9925
Ava Swanson
Marriage & Family Therapist, LMFT
3 Endorsed
San Diego, CA 92131
If you are running on empty, and looking for a place to land: welcome. I support perfectionists, empaths, and high achievers facing complex trauma, PTSD, unrelenting anxiety, chronic stress, & attachment challenges. I often work with college students, new parents, healthcare workers, and specialize in working with survivors of sexual trauma. Clients I support often excel at showing up for others, sometimes to the point of losing themselves. In the absence of a safe place to land, we can learn to ignore our own needs and "stuff" our deepest pain. This survival and belonging strategy can serve us well, until it doesn't.
If you are running on empty, and looking for a place to land: welcome. I support perfectionists, empaths, and high achievers facing complex trauma, PTSD, unrelenting anxiety, chronic stress, & attachment challenges. I often work with college students, new parents, healthcare workers, and specialize in working with survivors of sexual trauma. Clients I support often excel at showing up for others, sometimes to the point of losing themselves. In the absence of a safe place to land, we can learn to ignore our own needs and "stuff" our deepest pain. This survival and belonging strategy can serve us well, until it doesn't.
(858) 682-1463 View (858) 682-1463
Athena Morrisette
Clinical Social Work/Therapist, LCSW
Online Only
Depression, anxiety, and trauma can make it hard to trust your own read on things, second guessing decisions that used to feel obvious. I'm Athena Morrisette, a Licensed Clinical Social Worker with a Master's in Social Work from the University of Southern California. I work with adults 18 and older, and I've seen how much clearer things can get once someone has real support in their corner.
Depression, anxiety, and trauma can make it hard to trust your own read on things, second guessing decisions that used to feel obvious. I'm Athena Morrisette, a Licensed Clinical Social Worker with a Master's in Social Work from the University of Southern California. I work with adults 18 and older, and I've seen how much clearer things can get once someone has real support in their corner.
(858) 544-2494 View (858) 544-2494
Robert Lee Teel
Psychologist, PhD
1 Endorsed
San Diego, CA 92123
I specialize in helping teens and adults detach from impulsive electronic use, including video games, social media, online gambling, pornography addiction, and the unique mental health challenges of being a social influencer. Electronic addictions are often a result of deeper struggles such as depression, anxiety, identity, social concerns, trauma, and other obstacles in your daily life, which will also be explored and addressed during our time together.
I specialize in helping teens and adults detach from impulsive electronic use, including video games, social media, online gambling, pornography addiction, and the unique mental health challenges of being a social influencer. Electronic addictions are often a result of deeper struggles such as depression, anxiety, identity, social concerns, trauma, and other obstacles in your daily life, which will also be explored and addressed during our time together.
(619) 853-5803 View (619) 853-5803
Eva Smith
Marriage & Family Therapist, MS, LMFT, PMH-C
1 Endorsed
San Diego, CA 92119
Sometimes we feel like our minds are in a constant state of overwhelm between responsibilities to ourselves, jobs, caring for loved ones, etc. The competing roles, running to-do list, expectations keep us up at night, making the days feel like survival mode: Will I ever feel normal again? When will I ever be able to catch up? Will I ever be able to reset and find calm? You feel it in your bones that you need a break to re-evaluate, but you can’t ever seem to make the time. Maybe you hold yourself to expectations that no longer fit your life, or maybe they never did. It's time to freedom in who you are now.
Sometimes we feel like our minds are in a constant state of overwhelm between responsibilities to ourselves, jobs, caring for loved ones, etc. The competing roles, running to-do list, expectations keep us up at night, making the days feel like survival mode: Will I ever feel normal again? When will I ever be able to catch up? Will I ever be able to reset and find calm? You feel it in your bones that you need a break to re-evaluate, but you can’t ever seem to make the time. Maybe you hold yourself to expectations that no longer fit your life, or maybe they never did. It's time to freedom in who you are now.
(619) 614-7556 View (619) 614-7556
Nathan Aish Evidenced-Based and Client Centered
Clinical Social Work/Therapist, LCSW, MSW, MPH, PPS
Online Only
Hello! I'm Nathan Aish, a Licensed Clinical Social Worker, with over 28 years of healthcare leadership experience, including 10 years providing therapy to individuals, couples, and families. I hold a Master of Public Health (MPH) degree from The Ohio State University, and a Master of Social Work (MSW) degree from San Diego State University. I am also certified to work as a K-12 school social worker. My core values are servitude and continuous improvement, and my approach to care integrates person-centered, trauma-informed, strength-based, harm-reduction, gender-responsive, and cultural humility practices.
Hello! I'm Nathan Aish, a Licensed Clinical Social Worker, with over 28 years of healthcare leadership experience, including 10 years providing therapy to individuals, couples, and families. I hold a Master of Public Health (MPH) degree from The Ohio State University, and a Master of Social Work (MSW) degree from San Diego State University. I am also certified to work as a K-12 school social worker. My core values are servitude and continuous improvement, and my approach to care integrates person-centered, trauma-informed, strength-based, harm-reduction, gender-responsive, and cultural humility practices.
(619) 375-4689 View (619) 375-4689
Hearthomes Healing
Verified Verified
San Diego, CA 92116
I am currently accepting private clients for individual grief support sessions. I offer a range of support topics including substance-use disorder loss, anticipatory grief related to illness, accident, and substance use, and disenfranchised loss related to murder, suicide, or substance use. In addition, I offer support for other types of loss that may not be recognized by traditional therapies, such as the loss of a pet, job, co-worker, or dear friend. Sessions are ongoing and are offered via phone or Zoom. For Individual sessions, I work on a sliding scale fee. For more information: hearthomeshealingdotgmaildotcom
I am currently accepting private clients for individual grief support sessions. I offer a range of support topics including substance-use disorder loss, anticipatory grief related to illness, accident, and substance use, and disenfranchised loss related to murder, suicide, or substance use. In addition, I offer support for other types of loss that may not be recognized by traditional therapies, such as the loss of a pet, job, co-worker, or dear friend. Sessions are ongoing and are offered via phone or Zoom. For Individual sessions, I work on a sliding scale fee. For more information: hearthomeshealingdotgmaildotcom
(619) 777-5431 View (619) 777-5431
Ben Yalom
Marriage & Family Therapist Associate, AMFT, MFA
1 Endorsed
San Diego, CA 92117
I am deeply invested in helping individuals and couples work through the challenging issues that life throws at all of us. I believe it is possible for us all to pursue meaningful goals, in open partnership with the people we love (or will love), in ways that resonate with our deepest values. I am co-author, with Dr. Irvin Yalom, of Hour of the Heart.
I am deeply invested in helping individuals and couples work through the challenging issues that life throws at all of us. I believe it is possible for us all to pursue meaningful goals, in open partnership with the people we love (or will love), in ways that resonate with our deepest values. I am co-author, with Dr. Irvin Yalom, of Hour of the Heart.
(619) 389-2805 View (619) 389-2805
Paola Berg
Clinical Social Work/Therapist, LCSW
San Diego, CA 92103
I am devoted to providing a safe place for individuals seeking to learn to practice self-compassion and self-acceptance. My goal is to be a strong support for you by providing therapy through a trauma informed lens. I will work alongside you, as you explore your strengths, values, and maximize your potential to live your true authentic self. I have experience working with survivors of intimate partner violence, as well as those newly diagnosed with HIV, and those adapting to new life changes.
I am devoted to providing a safe place for individuals seeking to learn to practice self-compassion and self-acceptance. My goal is to be a strong support for you by providing therapy through a trauma informed lens. I will work alongside you, as you explore your strengths, values, and maximize your potential to live your true authentic self. I have experience working with survivors of intimate partner violence, as well as those newly diagnosed with HIV, and those adapting to new life changes.
(760) 624-3899 View (760) 624-3899
Patricia C Kantzavelos
Clinical Social Work/Therapist, LCSW, MLIS, MSW
1 Endorsed
Online Only
Welcome! I’m so glad you’re here. I specialize in supporting people living with chronic and complex health conditions and trauma, which I understand firsthand. Conditions such as dysautonomia/POTS, EDS, Lyme disease, Bartonella, IBS, fibromyalgia, ME/CFS, Hashimoto’s, MCAS, CIRS, autoimmune disease, chronic pain, migraine, Celiac disease, long COVID, endometriosis, PCOS, and other complex conditions can affect every part of your life, bringing fear, anxiety, grief, medical trauma, relationship changes, and uncertainty about the future. I also work with neurodivergence, ADHD, autism, and CPTSD.
Welcome! I’m so glad you’re here. I specialize in supporting people living with chronic and complex health conditions and trauma, which I understand firsthand. Conditions such as dysautonomia/POTS, EDS, Lyme disease, Bartonella, IBS, fibromyalgia, ME/CFS, Hashimoto’s, MCAS, CIRS, autoimmune disease, chronic pain, migraine, Celiac disease, long COVID, endometriosis, PCOS, and other complex conditions can affect every part of your life, bringing fear, anxiety, grief, medical trauma, relationship changes, and uncertainty about the future. I also work with neurodivergence, ADHD, autism, and CPTSD.
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Jennifer Lara
Associate Clinical Social Worker, ASW
San Diego, CA 92103
Childhood trauma can cripple us, it creates overpowering ‘intense’ emotions such as anxiety, depression, and anger when left unattended which begins to create physical symptoms to defend our bodies from the internal wounds. Has there ever been a time in your life where you have experienced this reaction? Are you experiencing these feelings based on current or past trauma from childhood, early teens, adolescence, adulthood, or as a senior? I aim to utilize a variety of actionable techniques to help reduce trauma related symptoms and make lasting changes in life.
Childhood trauma can cripple us, it creates overpowering ‘intense’ emotions such as anxiety, depression, and anger when left unattended which begins to create physical symptoms to defend our bodies from the internal wounds. Has there ever been a time in your life where you have experienced this reaction? Are you experiencing these feelings based on current or past trauma from childhood, early teens, adolescence, adulthood, or as a senior? I aim to utilize a variety of actionable techniques to help reduce trauma related symptoms and make lasting changes in life.
(760) 214-9581 View (760) 214-9581
Shawnee Brew
Psychologist, PsyD
1 Endorsed
Online Only
I’m a licensed clinical psychologist providing evidence-based therapy for adults. My approach is humanistic, affirmative, and centered on holistic wellness. Within an often harsh and exclusive healthcare system, I aim to nurture, validate, and honor your value so you can safely explore and heal. I bring curiosity, authenticity, and humor to my work, integrating humanistic and behavioral techniques. I specialize in working with queer, neurodiverse, and disabled folks. I have spent my career learning to help manage anxiety, trauma, OCD, relational stressors, life transitions, and identity development.
I’m a licensed clinical psychologist providing evidence-based therapy for adults. My approach is humanistic, affirmative, and centered on holistic wellness. Within an often harsh and exclusive healthcare system, I aim to nurture, validate, and honor your value so you can safely explore and heal. I bring curiosity, authenticity, and humor to my work, integrating humanistic and behavioral techniques. I specialize in working with queer, neurodiverse, and disabled folks. I have spent my career learning to help manage anxiety, trauma, OCD, relational stressors, life transitions, and identity development.
(619) 730-7975 View (619) 730-7975
Yu-An Chien
Clinical Social Work/Therapist, LCSW, MSSA
2 Endorsed
Online Only
Waitlist for new clients
Waitlist till Dec. 2026 -Life is a journey full of change, and sometimes with uncertainty. During life hardships, we may want to talk to someone, get a helping hand, take a break and rest our soul to prepare us for the growth. I provide Bilingual English/Mandarin-Chinese therapy to adults and family who need a teammate. I specialize in treating trauma, mood-related disorder, cultural and identity difficulties, adjustment in life transitions, and chronic stress. I help individuals and families work through challenges and adversities, gain courage, understanding of self, and skills to grow a meaningful, purposeful life.
Waitlist till Dec. 2026 -Life is a journey full of change, and sometimes with uncertainty. During life hardships, we may want to talk to someone, get a helping hand, take a break and rest our soul to prepare us for the growth. I provide Bilingual English/Mandarin-Chinese therapy to adults and family who need a teammate. I specialize in treating trauma, mood-related disorder, cultural and identity difficulties, adjustment in life transitions, and chronic stress. I help individuals and families work through challenges and adversities, gain courage, understanding of self, and skills to grow a meaningful, purposeful life.
(858) 683-8726 View (858) 683-8726
Dr. Avery Morrison
Psychologist, PsyD
2 Endorsed
San Diego, CA 92102
I approach therapy in a personalized developed treatment plan for each client. I consider your upbringing, cultural background, intersectionality, and current symptoms. Therapy can be scary; it may the first time you’re processing experiences, discussing emotions you haven’t uncovered, or coming to difficult conclusions regarding life decisions. This is why it’s of the upmost importance to me that you are met with a warm, nonjudgemental environment.
I approach therapy in a personalized developed treatment plan for each client. I consider your upbringing, cultural background, intersectionality, and current symptoms. Therapy can be scary; it may the first time you’re processing experiences, discussing emotions you haven’t uncovered, or coming to difficult conclusions regarding life decisions. This is why it’s of the upmost importance to me that you are met with a warm, nonjudgemental environment.
(858) 682-0143 View (858) 682-0143
Kristin Donaldson
Clinical Social Work/Therapist, LCSW
1 Endorsed
Online Only
I know it's hard to find a therapist. If you are someone seeking a safe and supportive space to explore your feelings, thoughts, and experiences, I may be able to help you unpack some of that weight you've been carrying on your shoulders.
I know it's hard to find a therapist. If you are someone seeking a safe and supportive space to explore your feelings, thoughts, and experiences, I may be able to help you unpack some of that weight you've been carrying on your shoulders.
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Miyoung Son
Marriage & Family Therapist, MA, LMFT
1 Endorsed
Online Only
Reaching out for help can be challenging for many. As psychotherapy aims at positive changes you desire, I am honored to provide a safe place for your self-exploration and reflection in which you can gain your inner peace and change you long for. Being specialized in trauma, PTSD, sexual abuse and domestic violence, I can offer some resolution in your trauma work. Trauma can penetrate not only your emotional well-being but also almost every facet of your life. My warm and peaceful presence would guide you through an effective treatment you deserve. My other specialties include performance anxiety, and psychological impotence (ED).
Reaching out for help can be challenging for many. As psychotherapy aims at positive changes you desire, I am honored to provide a safe place for your self-exploration and reflection in which you can gain your inner peace and change you long for. Being specialized in trauma, PTSD, sexual abuse and domestic violence, I can offer some resolution in your trauma work. Trauma can penetrate not only your emotional well-being but also almost every facet of your life. My warm and peaceful presence would guide you through an effective treatment you deserve. My other specialties include performance anxiety, and psychological impotence (ED).
(619) 485-6056 View (619) 485-6056
Sarah Chun
Psychological Associate, PhD
San Diego, CA 92108
I am a Registered Psychological Associate under supervision at Aloha Psych Associates. I am inspired by the “aloha spirit,” drawing on Hawaiian concepts like ‘alo’ (presence), ‘ha’ (breath of life), ‘mana’ (healing energy), and ‘ohana’ (family and connectedness). I have training working with clients of all ages in multiple settings, including primary care clinics, partial hospitalization programs, outpatient settings, and college counseling centers. My approach to therapy is warm, genuine, and collaborative.
I am a Registered Psychological Associate under supervision at Aloha Psych Associates. I am inspired by the “aloha spirit,” drawing on Hawaiian concepts like ‘alo’ (presence), ‘ha’ (breath of life), ‘mana’ (healing energy), and ‘ohana’ (family and connectedness). I have training working with clients of all ages in multiple settings, including primary care clinics, partial hospitalization programs, outpatient settings, and college counseling centers. My approach to therapy is warm, genuine, and collaborative.
(619) 567-1901 View (619) 567-1901
Stacey D Downing
Marriage & Family Therapist, LMFT, MA
1 Endorsed
Online Only
We are here to thrive, not just survive. As a licensed therapist, Shamanic practitioner and former bodyworker, I am here to help the soul searchers, truth seekers, and those on a quest to rediscover their authentic selves towards overall health and healing. I will support you on your journey to shed the layers of fear, shame, trauma and pain. I will help you on your spiritual or self healing journey, providing additional support as you encounter life's challenges. When the walls come down, and the truth of the authentic self begins to emerge, it may be difficult, but we will move through it together. We will identify triggers and blockages, and look into things such as unhealthy attachments, cognitive distortions (negative thoughts) and belief systems. It doesn’t matter whether they came from trauma in childhood, abuse, unhealthy relationships, grief or loss, I am here to help. By identifying, processing, and releasing that which no longer serves you will allow the true healing to finally begin and set your feet on the path you were meant to walk.
We are here to thrive, not just survive. As a licensed therapist, Shamanic practitioner and former bodyworker, I am here to help the soul searchers, truth seekers, and those on a quest to rediscover their authentic selves towards overall health and healing. I will support you on your journey to shed the layers of fear, shame, trauma and pain. I will help you on your spiritual or self healing journey, providing additional support as you encounter life's challenges. When the walls come down, and the truth of the authentic self begins to emerge, it may be difficult, but we will move through it together. We will identify triggers and blockages, and look into things such as unhealthy attachments, cognitive distortions (negative thoughts) and belief systems. It doesn’t matter whether they came from trauma in childhood, abuse, unhealthy relationships, grief or loss, I am here to help. By identifying, processing, and releasing that which no longer serves you will allow the true healing to finally begin and set your feet on the path you were meant to walk.
(858) 251-1074 View (858) 251-1074
Abigail Weisman
Clinical Social Work/Therapist, LCSW
Online Only
Hi, my name is Abby. I recognize how difficult it can be to ask for help, so congrats on taking this first, brave step towards feeling better. I'm a Licensed Clinical Social Worker, with over 8 years of experience supporting individuals, couples, and families. I aim to provide clients a safe space to be their most authentic selves without fear of judgment. I believe we all have inherent strengths and capabilities, and I hope we can use our time together identifying how to maximize yours.
Hi, my name is Abby. I recognize how difficult it can be to ask for help, so congrats on taking this first, brave step towards feeling better. I'm a Licensed Clinical Social Worker, with over 8 years of experience supporting individuals, couples, and families. I aim to provide clients a safe space to be their most authentic selves without fear of judgment. I believe we all have inherent strengths and capabilities, and I hope we can use our time together identifying how to maximize yours.
(619) 650-5764 View (619) 650-5764

See more therapy options for San Diego

How does your Therapist compare?

Number of Therapists in San Diego, CA

3,000+

Average cost per session

$170

Therapists in San Diego, CA who prioritize treating:

93% Anxiety
93% Social Anxiety
93% Health Anxiety
93% Driving Anxiety
86% Depression
73% Relationship Issues
70% Relationship Anxiety

Average years in practice

11 Years

Top 3 insurances accepted

89% Aetna
72% Cigna and Evernorth
57% UnitedHealthcare UHC | UBH

How Therapists in San Diego, CA see their clients

56% Online Only
44% In Person and Online

Gender breakdown

80% Female
18% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in San Diego?

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.