Therapists in Presidio Heights, San Francisco, CA

Photo of Linda Michels, MA, MFT, Marriage & Family Therapist
Linda Michels
Marriage & Family Therapist, MA, MFT
Verified Verified
Presidio Heights, San Francisco, CA 94118
I think you know what would make you happy but don't know how to make it happen. This applies to both individuals and couples. People stop themselves from moving forward because they think they can't or don't deserve to get their own needs met. I can help you overcome blocks, fears, guilt, depression, and/or self-defeating behaviors so you can free yourself to be happy and more successful. It seems daunting but, with support and direction, it is possible to improve your life. This is even true for people who are suffering from more debilitating problems such as Bipolar Disorder, OCD,or Schizoaffective Disorders.
I think you know what would make you happy but don't know how to make it happen. This applies to both individuals and couples. People stop themselves from moving forward because they think they can't or don't deserve to get their own needs met. I can help you overcome blocks, fears, guilt, depression, and/or self-defeating behaviors so you can free yourself to be happy and more successful. It seems daunting but, with support and direction, it is possible to improve your life. This is even true for people who are suffering from more debilitating problems such as Bipolar Disorder, OCD,or Schizoaffective Disorders.
(415) 800-3916 View (415) 800-3916
Photo of Caleb Birkhoff, MS, LMFT, Marriage & Family Therapist
Caleb Birkhoff
Marriage & Family Therapist, MS, LMFT
Verified Verified
5 Endorsed
Presidio Heights, San Francisco, CA 94118  (Online Only)
You have friction in your relationship. You need help enhancing your connection and communication skills so you can set healthier and stronger boundaries. Maybe you're looking to get ahead of future problems before they start. It can be difficult making a change in your life, even one you want. Couples therapy is an opportunity to work on your relationship to feel closer, to build something that will last. It's also a place to understand why it just doesn't feel like it's working anymore. Come have a space to strengthen boundaries, healthy communication, and re-establish a partnership. Come try couples counseling.
You have friction in your relationship. You need help enhancing your connection and communication skills so you can set healthier and stronger boundaries. Maybe you're looking to get ahead of future problems before they start. It can be difficult making a change in your life, even one you want. Couples therapy is an opportunity to work on your relationship to feel closer, to build something that will last. It's also a place to understand why it just doesn't feel like it's working anymore. Come have a space to strengthen boundaries, healthy communication, and re-establish a partnership. Come try couples counseling.
(628) 212-6659 View (628) 212-6659
Photo of Jari Russell, Marriage & Family Therapist
Jari Russell
Marriage & Family Therapist
Verified Verified
Presidio Heights, San Francisco, CA 94118
I believe that "what has been broken in relationship must be healed in relationship." (unattributed) Often what brings us to consider therapy is some part of us that feels broken. I see my role as therapist to be a person in your life who listens with curiosity and compassion, while honestly reflecting what may be standing in your way. My hope is to walk along side you to support the journey you are on.
I believe that "what has been broken in relationship must be healed in relationship." (unattributed) Often what brings us to consider therapy is some part of us that feels broken. I see my role as therapist to be a person in your life who listens with curiosity and compassion, while honestly reflecting what may be standing in your way. My hope is to walk along side you to support the journey you are on.
(415) 619-5207 View (415) 619-5207
Photo of Laura DeSantis, LPCC, Counselor
Laura DeSantis
Counselor, LPCC
Verified Verified
2 Endorsed
Presidio Heights, San Francisco, CA 94118
As a therapist, my goal is to foster a space for you to explore what you want for yourself and your life through introspection, healing, and acceptance of self. I offer an interactive style that is engaged, compassionate, attuned to your strengths, and informed by modern neuroscience so we're getting to the root of things. This space is yours, a place where you can be heard without judgment, where vulnerability meets understanding, and where healing can truly happen.
As a therapist, my goal is to foster a space for you to explore what you want for yourself and your life through introspection, healing, and acceptance of self. I offer an interactive style that is engaged, compassionate, attuned to your strengths, and informed by modern neuroscience so we're getting to the root of things. This space is yours, a place where you can be heard without judgment, where vulnerability meets understanding, and where healing can truly happen.
(628) 241-7672 View (628) 241-7672
Photo of Julia Hammett - Sky Meets Sea Child and Family Therapy , MA, LMFT, Marriage & Family Therapist
Sky Meets Sea Child and Family Therapy
Marriage & Family Therapist, MA, LMFT
Verified Verified
Presidio Heights, San Francisco, CA 94118
Hello, I'm Julia Hammett! With a background in Fine Arts, teaching, and professional childcare, I studied Marriage and Family Therapy and Art Therapy at Notre Dame de Namur University and have been working with children and their caregivers since 2014.
Hello, I'm Julia Hammett! With a background in Fine Arts, teaching, and professional childcare, I studied Marriage and Family Therapy and Art Therapy at Notre Dame de Namur University and have been working with children and their caregivers since 2014.
(415) 429-5925 View (415) 429-5925
Photo of Nate Hinerman, PhD, MFT, Marriage & Family Therapist
Nate Hinerman
Marriage & Family Therapist, PhD, MFT
Verified Verified
Presidio Heights, San Francisco, CA 94118
Nate Hinerman, PhD, LMFT, is Dean of Undergraduate Programs at Golden Gate University, San Francisco, where he is also a tenured Professor of Psychology, as well as the Chair of the Psychology Department. He is also on the faculty at the University of San Francisco, teaching in the Nursing School, and in the Religious Studies Department. He serves as Chair of the San Francisco End of Life Network, a community-based support and education group for hospice and palliative care professionals and patients, now in its 23rd year (www.sfeol.org).
Nate Hinerman, PhD, LMFT, is Dean of Undergraduate Programs at Golden Gate University, San Francisco, where he is also a tenured Professor of Psychology, as well as the Chair of the Psychology Department. He is also on the faculty at the University of San Francisco, teaching in the Nursing School, and in the Religious Studies Department. He serves as Chair of the San Francisco End of Life Network, a community-based support and education group for hospice and palliative care professionals and patients, now in its 23rd year (www.sfeol.org).
(628) 215-8084 View (628) 215-8084
Mark Sexton
Psychologist, PhD
Verified Verified
Presidio Heights, San Francisco, CA 94118
Thank you for your interest in my practice. I am a Clinical Psychologist and Psychoanalyst. I specialize in helping patients to resolve conflictual or unsatisfying relationship patterns, problems with a sense of identify or low self-worth, and difficulties arising from navigating life challenges such as loss, divorce, or illness. I put an emphasis on establishing a trusting working relationship and typically see patients multiple times per week. This more intensive treatment approach is useful for resolving long-standing issues that may not have been addressed by past therapies.
Thank you for your interest in my practice. I am a Clinical Psychologist and Psychoanalyst. I specialize in helping patients to resolve conflictual or unsatisfying relationship patterns, problems with a sense of identify or low self-worth, and difficulties arising from navigating life challenges such as loss, divorce, or illness. I put an emphasis on establishing a trusting working relationship and typically see patients multiple times per week. This more intensive treatment approach is useful for resolving long-standing issues that may not have been addressed by past therapies.
(650) 741-3521 View (650) 741-3521
Photo of Ana Dolatabadi, PsyD, MA, Psychologist
Ana Dolatabadi
Psychologist, PsyD, MA
Verified Verified
Presidio Heights, San Francisco, CA 94118  (Online Only)
I'm Dr. Ana D. your supporter towards personal growth, resilience, and wellbeing. I serve as the Clinical Director at the EAP at UC, San Francisco, and also maintain a fulfilling private practice. My mission is to foster a authentic and empathetic environment where individuals can explore and grow in various aspects of their lives. My approach is straightforward and compassionate, centered around your personal evolution. I provide a space where you can openly express your thoughts and feelings, knowing they will be met with respect and non-judgment.
I'm Dr. Ana D. your supporter towards personal growth, resilience, and wellbeing. I serve as the Clinical Director at the EAP at UC, San Francisco, and also maintain a fulfilling private practice. My mission is to foster a authentic and empathetic environment where individuals can explore and grow in various aspects of their lives. My approach is straightforward and compassionate, centered around your personal evolution. I provide a space where you can openly express your thoughts and feelings, knowing they will be met with respect and non-judgment.
(415) 749-9296 View (415) 749-9296
Photo of Paul Beirne, MA, LPCC
Paul Beirne
Licensed Professional Clinical Counselor, MA, LPCC
Verified Verified
1 Endorsed
Presidio Heights, San Francisco, CA 94118
“Being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives.” ― Bessel A. van der Kolk. My approach to treatment helps people identify the core issues that have been avoided and pushed aside in an emotionally safe environment. Through the process of consciousness raising and self exploration, lasting changes in thought patterns are made, and overall life improvement occurs. I work with people of all ages and have a wealth of experience working with teens and young adults.
“Being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives.” ― Bessel A. van der Kolk. My approach to treatment helps people identify the core issues that have been avoided and pushed aside in an emotionally safe environment. Through the process of consciousness raising and self exploration, lasting changes in thought patterns are made, and overall life improvement occurs. I work with people of all ages and have a wealth of experience working with teens and young adults.
(415) 358-2498 View (415) 358-2498
Photo of Amelia Howard-Smith, LMFT, Marriage & Family Therapist
Amelia Howard-Smith
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Presidio Heights, San Francisco, CA 94118  (Online Only)
Are you finding it hard to express your needs in relationships or set boundaries with others? Do you often feel unworthy, putting others’ needs ahead of your own? You deserve to feel seen, heard, and understood, and that’s the core of our work together. I provide a collaborative approach tailored to your unique needs and goals, ensuring you receive the personalized support you deserve. Together, we’ll delve into your past and create a roadmap for positive change, empowering you to embrace your worth and build healthier connections.
Are you finding it hard to express your needs in relationships or set boundaries with others? Do you often feel unworthy, putting others’ needs ahead of your own? You deserve to feel seen, heard, and understood, and that’s the core of our work together. I provide a collaborative approach tailored to your unique needs and goals, ensuring you receive the personalized support you deserve. Together, we’ll delve into your past and create a roadmap for positive change, empowering you to embrace your worth and build healthier connections.
(415) 326-1841 View (415) 326-1841
Photo of Davi Weisberger, PhD, Psychologist
Davi Weisberger
Psychologist, PhD
Verified Verified
Presidio Heights, San Francisco, CA 94118
Over the past 30+ years I have helped people with a wide range of problems and challenges. These may include anxiety and worry, depression and sadness, relationship difficulties, work related stress, loss of a loved one, loss of a relationship, and difficulty with life transitions such as divorce, losing or changing jobs, becoming a parent, moving to a new city, facing an empty nest, and aging. I also see people who are struggling with old feelings from an earlier difficulty or trauma that are being triggered by some current life situation or event.
Over the past 30+ years I have helped people with a wide range of problems and challenges. These may include anxiety and worry, depression and sadness, relationship difficulties, work related stress, loss of a loved one, loss of a relationship, and difficulty with life transitions such as divorce, losing or changing jobs, becoming a parent, moving to a new city, facing an empty nest, and aging. I also see people who are struggling with old feelings from an earlier difficulty or trauma that are being triggered by some current life situation or event.
(628) 214-4749 View (628) 214-4749
Photo of Mary Kennedy, LCSW, Clinical Social Work/Therapist
Mary Kennedy
Clinical Social Work/Therapist, LCSW
Verified Verified
Presidio Heights, San Francisco, CA 94118
I am a licensed psychotherapist who is deeply committed to supporting those whose lives have been impacted by alcohol or drugs. I am compassionate, practical, engaged and genuine. If you have struggled or are still struggling, I can help. If you are worried about someone who struggles, I can help. Even if you are unsure of what you may need, I can support you. I strive to develop meaningful therapeutic relationships that allow for understanding, grieving, healing and growth. Those who find help may be teens, adult children, spouses, partners, parents, grandparents, couples, and individuals.
I am a licensed psychotherapist who is deeply committed to supporting those whose lives have been impacted by alcohol or drugs. I am compassionate, practical, engaged and genuine. If you have struggled or are still struggling, I can help. If you are worried about someone who struggles, I can help. Even if you are unsure of what you may need, I can support you. I strive to develop meaningful therapeutic relationships that allow for understanding, grieving, healing and growth. Those who find help may be teens, adult children, spouses, partners, parents, grandparents, couples, and individuals.
(415) 689-1690 View (415) 689-1690
Photo of Renu Maria Ghira Cappelli, PhD, MA, MFT, Marriage & Family Therapist
Renu Maria Ghira Cappelli
Marriage & Family Therapist, PhD, MA, MFT
Verified Verified
1 Endorsed
Presidio Heights, San Francisco, CA 94118
My psychotherapy practice aims to reveal and nurture your inner life so that you can have a more expansive experience of yourself in the world.
My psychotherapy practice aims to reveal and nurture your inner life so that you can have a more expansive experience of yourself in the world.
(628) 333-3090 View (628) 333-3090
Photo of Maureen K Fisher, MA, LMFT, Marriage & Family Therapist
Maureen K Fisher
Marriage & Family Therapist, MA, LMFT
Verified Verified
Presidio Heights, San Francisco, CA 94118
I treat clients whose daily functioning, self image and way of relating to others has been negatively impacted by anxiety, depression, and various external or situational stressors. Compassion and collaboration are crucial in facilitating healing and creating a functional therapeutic rapport that allows for increasingly greater presence of mind. Education and 15 years of clinical experience underscore my belief that people can feel better as they practice more adaptive thinking and behavior in the present.
I treat clients whose daily functioning, self image and way of relating to others has been negatively impacted by anxiety, depression, and various external or situational stressors. Compassion and collaboration are crucial in facilitating healing and creating a functional therapeutic rapport that allows for increasingly greater presence of mind. Education and 15 years of clinical experience underscore my belief that people can feel better as they practice more adaptive thinking and behavior in the present.
(415) 423-1152 View (415) 423-1152
Photo of Lauren Mizock, PhD, Psychologist
Lauren Mizock
Psychologist, PhD
Verified Verified
3 Endorsed
Presidio Heights, San Francisco, CA 94118
My goal is to create an empowering space to draw from your strengths in overcoming current challenges. I work collaboratively with clients to establish ongoing, flexible goals for therapy to make our sessions most effective. I individualize therapy to each person using a range of techniques and approaches. I am particularly interested in the stories we tell about our lives and the meaning we make of them. My clients describe me as warm, positive, and insightful.
My goal is to create an empowering space to draw from your strengths in overcoming current challenges. I work collaboratively with clients to establish ongoing, flexible goals for therapy to make our sessions most effective. I individualize therapy to each person using a range of techniques and approaches. I am particularly interested in the stories we tell about our lives and the meaning we make of them. My clients describe me as warm, positive, and insightful.
(415) 843-8560 View (415) 843-8560
Photo of Adrienne Elizabeth Amundsen, PhD, Psychologist
Adrienne Elizabeth Amundsen
Psychologist, PhD
Verified Verified
Presidio Heights, San Francisco, CA 94118
Because everyone comes with their own needs, goals, and styles, I am flexible in my approach. I can be practical and problem-focused, but much of my work is deeper, and deals with emotional patterns developed early in life, I work a lot with trauma and loss. Attending to the therapy relationship is also important for learning about relationship patterns and trust. I bring my love of creativity to my work as well. Working with dreams and imagery, I find, can bring surprising insight. When therapy really takes off, I find that clients often discover their own creativity and a sense of life purpose.
Because everyone comes with their own needs, goals, and styles, I am flexible in my approach. I can be practical and problem-focused, but much of my work is deeper, and deals with emotional patterns developed early in life, I work a lot with trauma and loss. Attending to the therapy relationship is also important for learning about relationship patterns and trust. I bring my love of creativity to my work as well. Working with dreams and imagery, I find, can bring surprising insight. When therapy really takes off, I find that clients often discover their own creativity and a sense of life purpose.
(415) 423-2642 View (415) 423-2642
Photo of Rhys Mason, PsyD, Psychologist
Rhys Mason
Psychologist, PsyD
Verified Verified
1 Endorsed
Presidio Heights, San Francisco, CA 94118
Are you struggling and longing for a change? Perhaps you put a great deal of effort into your relationships and work, but it seems that no one extends that same care and attention to you. Although you crave connection and meaning, you might feel weighed down by loneliness, hopelessness, and a pervading sense of disempowerment. You may feel that no one sees or values who you really are. In fact, you may be your own harshest critic, unsure of your purpose and certain you are falling short of your potential. Like so many others, you might be searching for the tools needed to live with greater confidence, satisfaction, and ease.
Are you struggling and longing for a change? Perhaps you put a great deal of effort into your relationships and work, but it seems that no one extends that same care and attention to you. Although you crave connection and meaning, you might feel weighed down by loneliness, hopelessness, and a pervading sense of disempowerment. You may feel that no one sees or values who you really are. In fact, you may be your own harshest critic, unsure of your purpose and certain you are falling short of your potential. Like so many others, you might be searching for the tools needed to live with greater confidence, satisfaction, and ease.
(415) 612-6391 View (415) 612-6391
Photo of Whitney Lynch, PsyD, Psychologist
Whitney Lynch
Psychologist, PsyD
Verified Verified
Presidio Heights, San Francisco, CA 94118
Perhaps you are seeking healthier ways to cope with stressful life experiences or want to make more enduring changes to how you relate to yourself and others. In my work, I aim to not only help you feel better but provide you the tools to lead a more meaningful life. I help clients recognize and harness their own personal strengths while learning new ways to challenge negative thought patterns and unhealthy behaviors that can keep us feeling stuck, depressed, and anxious.
Perhaps you are seeking healthier ways to cope with stressful life experiences or want to make more enduring changes to how you relate to yourself and others. In my work, I aim to not only help you feel better but provide you the tools to lead a more meaningful life. I help clients recognize and harness their own personal strengths while learning new ways to challenge negative thought patterns and unhealthy behaviors that can keep us feeling stuck, depressed, and anxious.
(415) 243-7249 View (415) 243-7249
Photo of Kirsten M Bauer, PsyD, Psychologist
Kirsten M Bauer
Psychologist, PsyD
Verified Verified
Presidio Heights, San Francisco, CA 94118
As a child and adult therapist I am fortunate to witness the entire developmental span. With this unique window into the lifespan, I help children, parents, adults and couples gain insight into the patterns being created and already created in the mind of how they relate to and with the world i.e.how they relate to themselves and others. By first developing a safe and respectful relationship with my patients, we can begin to understand and uncover these complicated yet reflexive patterns that at some point served them, by protecting their self integrity, but along the way began to cause more harm then good.
As a child and adult therapist I am fortunate to witness the entire developmental span. With this unique window into the lifespan, I help children, parents, adults and couples gain insight into the patterns being created and already created in the mind of how they relate to and with the world i.e.how they relate to themselves and others. By first developing a safe and respectful relationship with my patients, we can begin to understand and uncover these complicated yet reflexive patterns that at some point served them, by protecting their self integrity, but along the way began to cause more harm then good.
(415) 304-8860 View (415) 304-8860
Photo of Julia Forberg, MA, MFT, Marriage & Family Therapist
Julia Forberg
Marriage & Family Therapist, MA, MFT
Verified Verified
1 Endorsed
Presidio Heights, San Francisco, CA 94118
Waitlist for new clients
Are you a woman struggling in your relationships? Pregnant or a new mom? I help women who feel hopeless and anxious about their lives feel more empowered. Perhaps you've been stuck in the same patterns in your relationships. Or you are navigating new motherhood and are understandably impacted by the massive changes happening. Together, we'll help you learn the tools to understand the meaning underneath your emotions and move beyond feeling stuck and overwhelmed. Using both talk therapy and somatic (body-based) tools, therapy is a place for you to heal, grow, and explore your inner world in a compassionate and non-judgmental space.
Are you a woman struggling in your relationships? Pregnant or a new mom? I help women who feel hopeless and anxious about their lives feel more empowered. Perhaps you've been stuck in the same patterns in your relationships. Or you are navigating new motherhood and are understandably impacted by the massive changes happening. Together, we'll help you learn the tools to understand the meaning underneath your emotions and move beyond feeling stuck and overwhelmed. Using both talk therapy and somatic (body-based) tools, therapy is a place for you to heal, grow, and explore your inner world in a compassionate and non-judgmental space.
(415) 841-2737 View (415) 841-2737
1

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How does your Therapist compare?

Number of Therapists in Presidio Heights, San Francisco, CA

100+

Average cost per session

$210

Therapists in Presidio Heights, San Francisco, CA who prioritize treating:

95% Anxiety
90% Relationship Issues
88% Depression
80% Self Esteem
69% Grief
69% Trauma and PTSD
64% Life Transitions

Average years in practice

15 Years

Top 3 insurances accepted

66% Aetna
47% Other
38% UnitedHealthcare UHC | UBH

How Therapists in Presidio Heights, San Francisco, CA see their clients

73% In Person and Online
27% Online Only

Gender breakdown

83% Female
17% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Presidio Heights, San Francisco?

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

Learn more about how to find a therapist

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

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

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

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

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

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

What type of therapy is right for me?

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

How much does therapy cost?

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

What are more affordable or low cost therapy solutions?

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

Is online therapy cheaper than in-person therapy?

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

Is online therapy a good option?

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

Are therapy sessions confidential?

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