Therapists in San Francisco, CA

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Photo of Alberto Rangel, LMFT, Marriage & Family Therapist
Alberto Rangel
Marriage & Family Therapist, LMFT
Verified Verified
2 Endorsed
San Francisco, CA 94102
Since the pandemic there has been an increase in folks struggling with depression, sexuality issues, chronic illness, addiction, and having problems in relationships. I believe that therapy can help develop skills to face life's challenges. All individuals have the capacity to change and live a full life based on their core values. Therapy is a place to examine your principles and how you can use them as a compass to lead you to a life that more accurately reflects your values. Learning strong coping skills and an awareness of reactions vs responses can provide relief from chronic issues of depression and anxiety. Change happens!
Since the pandemic there has been an increase in folks struggling with depression, sexuality issues, chronic illness, addiction, and having problems in relationships. I believe that therapy can help develop skills to face life's challenges. All individuals have the capacity to change and live a full life based on their core values. Therapy is a place to examine your principles and how you can use them as a compass to lead you to a life that more accurately reflects your values. Learning strong coping skills and an awareness of reactions vs responses can provide relief from chronic issues of depression and anxiety. Change happens!
(415) 949-3865 View (415) 949-3865
Photo of Dr. Lisa Choi, PsyD, Psychologist
Dr. Lisa Choi
Psychologist, PsyD
Verified Verified
San Francisco, CA 94109  (Online Only)
Dr. Lisa Choi is a licensed Clinical Psycholgist with experience in evidence and research-driven approaches that decrease avoidance and suffering related to PTSD/trauma, help individuals with anxious or avoidant attachment move towards secure relationships, and support individuals with achieving optimal well-being while navigating high-performance careers. Dr. Choi blends psychological expertise and coaching to help individuals with purposeful decision-making.
Dr. Lisa Choi is a licensed Clinical Psycholgist with experience in evidence and research-driven approaches that decrease avoidance and suffering related to PTSD/trauma, help individuals with anxious or avoidant attachment move towards secure relationships, and support individuals with achieving optimal well-being while navigating high-performance careers. Dr. Choi blends psychological expertise and coaching to help individuals with purposeful decision-making.
(415) 949-3382 View (415) 949-3382
Photo of Taylor Eva Simon, AMFT, APCC, Marriage & Family Therapist Associate
Taylor Eva Simon
Marriage & Family Therapist Associate, AMFT, APCC
Verified Verified
2 Endorsed
San Francisco, CA 94114  (Online Only)
I work with individuals who have been harmed by toxic family dynamics and are seeking their authentic self. I want to acknowledge that beginning your journey may be an intimidating prospect. Maybe you don't know what your needs are, don't feel permission to be yourself, or feel worthy of your boundaries. Perhaps you leave family interactions with conflicting feelings of guilt, anger and shame and feel powerless to change things. I'm here to support you as you re-align with your authenticity and self-expression, processing and shedding the stories of who you are that are told by people in your life that have never truly seen you.
I work with individuals who have been harmed by toxic family dynamics and are seeking their authentic self. I want to acknowledge that beginning your journey may be an intimidating prospect. Maybe you don't know what your needs are, don't feel permission to be yourself, or feel worthy of your boundaries. Perhaps you leave family interactions with conflicting feelings of guilt, anger and shame and feel powerless to change things. I'm here to support you as you re-align with your authenticity and self-expression, processing and shedding the stories of who you are that are told by people in your life that have never truly seen you.
(415) 938-5543 View (415) 938-5543
Photo of Gina Poelke, PhD, Psychologist
Gina Poelke
Psychologist, PhD
Verified Verified
1 Endorsed
San Francisco, CA 94102  (Online Only)
Hello. I am a licensed psychologist in both California and Washington states with over 15 years of experience. I provide treatment for a host of issues including anxiety, panic, stress, depression, trauma, life transitions, grief, substance use, and severe mental illness. I will help and support you by providing brief psychotherapy to address specific problems, or provide longer term treatment to address multiple issues or long standing difficulties.
Hello. I am a licensed psychologist in both California and Washington states with over 15 years of experience. I provide treatment for a host of issues including anxiety, panic, stress, depression, trauma, life transitions, grief, substance use, and severe mental illness. I will help and support you by providing brief psychotherapy to address specific problems, or provide longer term treatment to address multiple issues or long standing difficulties.
(415) 408-7786 View (415) 408-7786
Photo of Bella Yousif, AMFT, Marriage & Family Therapist Associate
Bella Yousif
Marriage & Family Therapist Associate, AMFT
Verified Verified
San Francisco, CA 94102
We cannot get through life without experiencing difficult times. None of us can. Whether it's dissatisfaction in a relationship, family conflict, career predicament, trauma, or personal distress, we all experience suffering at some point. And yet, how we respond can make all the difference in our future and the future of those we love. Therapy can often be one of the first steps on a path toward a life that is fulfilling and allows you to be your authentic self. The best place to start is right where you are; the time to start is now.
We cannot get through life without experiencing difficult times. None of us can. Whether it's dissatisfaction in a relationship, family conflict, career predicament, trauma, or personal distress, we all experience suffering at some point. And yet, how we respond can make all the difference in our future and the future of those we love. Therapy can often be one of the first steps on a path toward a life that is fulfilling and allows you to be your authentic self. The best place to start is right where you are; the time to start is now.
(628) 345-2619 View (628) 345-2619
Photo of Leah K Barison, LPCC, LMHC, Counselor
Leah K Barison
Counselor, LPCC, LMHC
Verified Verified
San Francisco, CA 94109
My approach relies on a warm and trusting therapeutic relationship where we can safely engage in healing work. We will navigate the pains and challenges of today, while fostering an understanding of how the past has played a role - all while inclining toward a meaningful future. I will provide tools for immediate relief as needed to support this process.
My approach relies on a warm and trusting therapeutic relationship where we can safely engage in healing work. We will navigate the pains and challenges of today, while fostering an understanding of how the past has played a role - all while inclining toward a meaningful future. I will provide tools for immediate relief as needed to support this process.
(415) 853-2163 View (415) 853-2163
Photo of Danielle Ghilotti, MA, MFT, Marriage & Family Therapist
Danielle Ghilotti
Marriage & Family Therapist, MA, MFT
Verified Verified
San Francisco, CA 94118  (Online Only)
I am a psychotherapist specialized in working with adults, couples and families. I offer support for a wide range of issues and challenges. My approach is grounded, warm, engaged and collaborative. I work from a relational psychodynamic perspective. Our past experiences and traumas can have a significant impact on the way we relate to ourselves and others. With the exploration of this old patterning we can be empowered to make different choices. In doing so, our lives have the chance to be made anew.
I am a psychotherapist specialized in working with adults, couples and families. I offer support for a wide range of issues and challenges. My approach is grounded, warm, engaged and collaborative. I work from a relational psychodynamic perspective. Our past experiences and traumas can have a significant impact on the way we relate to ourselves and others. With the exploration of this old patterning we can be empowered to make different choices. In doing so, our lives have the chance to be made anew.
(415) 534-6021 View (415) 534-6021
Photo of Katrina Sesline, LCSW, Clinical Social Work/Therapist
Katrina Sesline
Clinical Social Work/Therapist, LCSW
Verified Verified
San Francisco, CA 94104  (Online Only)
I specialize in treating adults living with a disabling health condition, caregivers who are supporting someone with a health condition, and those grieving the loss of a loved one. Living with a serious illness or grief can bring out difficult feelings of uncertainty, anxiety, depression and fear. I use an integrative approach with elements of narrative therapy, acceptance and commitment therapy, and mindfulness. Together, let's create a safe space to help you cope while attending to your heart, mind, and body.
I specialize in treating adults living with a disabling health condition, caregivers who are supporting someone with a health condition, and those grieving the loss of a loved one. Living with a serious illness or grief can bring out difficult feelings of uncertainty, anxiety, depression and fear. I use an integrative approach with elements of narrative therapy, acceptance and commitment therapy, and mindfulness. Together, let's create a safe space to help you cope while attending to your heart, mind, and body.
(510) 616-9406 View (510) 616-9406
Photo of Leland van den Daele, MS, PhD, FACP, Psychologist
Leland van den Daele
Psychologist, MS, PhD, FACP
Verified Verified
3 Endorsed
San Francisco, CA 94115
My clients seek self-knowledge, firm identity, clear purpose, and meaning in life. They wonder “What’s it all about?”, "Is this all there is?", "How do I find a way?" They avoid cookie-cutter formulas and truisms. They seek authenticity, freedom from self-blame, doubt, anxiety, and depression, confidence during life changes, clarity of purpose, and dignity in a confused and often shallow culture. They are willing to invest in themselves to find themselves. They seek understanding of their attachment style, repressed emotions, unconscious patterns, fixations, blind spots, and defenses.
My clients seek self-knowledge, firm identity, clear purpose, and meaning in life. They wonder “What’s it all about?”, "Is this all there is?", "How do I find a way?" They avoid cookie-cutter formulas and truisms. They seek authenticity, freedom from self-blame, doubt, anxiety, and depression, confidence during life changes, clarity of purpose, and dignity in a confused and often shallow culture. They are willing to invest in themselves to find themselves. They seek understanding of their attachment style, repressed emotions, unconscious patterns, fixations, blind spots, and defenses.
(628) 210-3285 View (628) 210-3285
Photo of Melissa Ciappetta, MA, MFT, Marriage & Family Therapist
Melissa Ciappetta
Marriage & Family Therapist, MA, MFT
Verified Verified
2 Endorsed
San Francisco, CA 94109
I offer a therapeutic approach that is warm, non-judgmental, calm and engages the client. I am a compassionate and seasoned therapist who has treated clients with a range of clinical issues for over 20 years. My approach provides a safe way to deal with major life changes. I can help you find the patterns and identify the connections between thoughts, feelings and behaviors. My direct New York style , softened by my California vibe, will provide you with thoughtful reflection needed to help you find the path toward healing.
I offer a therapeutic approach that is warm, non-judgmental, calm and engages the client. I am a compassionate and seasoned therapist who has treated clients with a range of clinical issues for over 20 years. My approach provides a safe way to deal with major life changes. I can help you find the patterns and identify the connections between thoughts, feelings and behaviors. My direct New York style , softened by my California vibe, will provide you with thoughtful reflection needed to help you find the path toward healing.
(415) 936-7326 View (415) 936-7326
Photo of Beth Myler, LCSW, JD, Clinical Social Work/Therapist
Beth Myler
Clinical Social Work/Therapist, LCSW, JD
Verified Verified
San Francisco, CA 94123  (Online Only)
Currently accepting new clients in California and Texas. In addition to psychotherapy for anxiety and depression, I also provide counseling and coaching to clients managing various kinds of change in their lives. I help clients navigate challenges presented by relationships, career, and changes in their health status due to aging, illness or injury. I trained as a psychotherapist after a long career as a lawyer and enjoy helping clients focus on pragmatic goals as well as developing insight and personal growth.
Currently accepting new clients in California and Texas. In addition to psychotherapy for anxiety and depression, I also provide counseling and coaching to clients managing various kinds of change in their lives. I help clients navigate challenges presented by relationships, career, and changes in their health status due to aging, illness or injury. I trained as a psychotherapist after a long career as a lawyer and enjoy helping clients focus on pragmatic goals as well as developing insight and personal growth.
(415) 200-3465 View (415) 200-3465
Photo of Sarah Voynow Berman, MS, LMFT, Marriage & Family Therapist
Sarah Voynow Berman
Marriage & Family Therapist, MS, LMFT
Verified Verified
San Francisco, CA 94114  (Online Only)
Are you having any mental blocks stemming from stress? Would you like to learn creative, evidence-based practical skills that can facilitate positive lasting change? As an active psychotherapist and professional musician I work with motivated clients who want to obtain greater self compassion, acceptance and productive strategies to assist in establishing a healthy balance in their professional and personal lives.
Are you having any mental blocks stemming from stress? Would you like to learn creative, evidence-based practical skills that can facilitate positive lasting change? As an active psychotherapist and professional musician I work with motivated clients who want to obtain greater self compassion, acceptance and productive strategies to assist in establishing a healthy balance in their professional and personal lives.
(415) 578-5358 View (415) 578-5358
Photo of Miya G Yung, ACSW, MSW, Pre-Licensed Professional
Miya G Yung
Pre-Licensed Professional, ACSW, MSW
Verified Verified
1 Endorsed
San Francisco, CA 94102
Hi, I'm Miya! I specialize in working with LGBTQ+, Asian American & Pacific Islander, and other POC/immigrant communities. I support clients who are exploring their identities, processing trauma and grief, making sense of family patterns and cultural influences, struggling with anxiety or depression, or just wanting to become a better version of themselves.
Hi, I'm Miya! I specialize in working with LGBTQ+, Asian American & Pacific Islander, and other POC/immigrant communities. I support clients who are exploring their identities, processing trauma and grief, making sense of family patterns and cultural influences, struggling with anxiety or depression, or just wanting to become a better version of themselves.
(628) 345-5836 View (628) 345-5836
Photo of Jamie David, LMFT, Marriage & Family Therapist
Jamie David
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94105  (Online Only)
The most important relationship we have is the one with ourselves. I provide a safe space for my clients to be themselves. From there, we can allow the parts of self that have been abandoned to be seen, leading to a place of wholeness. As a therapist and mother who had her son during the pandemic, I understand the challenges that parents face. I am passionate about helping moms navigate the identity shift that often accompanies motherhood. Whether you're struggling with postpartum anxiety or depression, grief, loss, or simply need support, I am here. My approach is integrative and holistic, based on your specific needs.
The most important relationship we have is the one with ourselves. I provide a safe space for my clients to be themselves. From there, we can allow the parts of self that have been abandoned to be seen, leading to a place of wholeness. As a therapist and mother who had her son during the pandemic, I understand the challenges that parents face. I am passionate about helping moms navigate the identity shift that often accompanies motherhood. Whether you're struggling with postpartum anxiety or depression, grief, loss, or simply need support, I am here. My approach is integrative and holistic, based on your specific needs.
(415) 498-1345 View (415) 498-1345
Photo of Emily Johnson, LMFT, Marriage & Family Therapist
Emily Johnson
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94116
My name is Emily Johnson and I am a Licensed Marriage and Family Therapist in the state of California. I work with adults, specializing in relationship issues, grief, and managing anger. I use Emotionally Focused and Attachment Theory lenses to help you process pain and develop insight as well as incorporate Dialectical Behavior Therapy and Solution Focused techniques to help you develop skills. I understand that therapy is an investment and I want to work with you to develop meaningful goals so that you get what you want out of therapy.
My name is Emily Johnson and I am a Licensed Marriage and Family Therapist in the state of California. I work with adults, specializing in relationship issues, grief, and managing anger. I use Emotionally Focused and Attachment Theory lenses to help you process pain and develop insight as well as incorporate Dialectical Behavior Therapy and Solution Focused techniques to help you develop skills. I understand that therapy is an investment and I want to work with you to develop meaningful goals so that you get what you want out of therapy.
(415) 909-3124 View (415) 909-3124
Photo of Norah McHenry-Uy, LCSW, Clinical Social Work/Therapist
Norah McHenry-Uy
Clinical Social Work/Therapist, LCSW
Verified Verified
San Francisco, CA 94105  (Online Only)
As a Licensed Clinical Social Worker I help clients process their experiences with the whole picture in mind; considering their history, culture, identity, and underlying systems of privilege and oppression. I take a therapeutic approach that is both kind and challenging, motivating clients to reach their goals. Over the past decade, I have collaborated with individuals to confront a wide range of barriers holding them back from living the life they desire. My specialties include providing the appropriate coping skills to treat problematic response patterns ranging from perfectionism to codependency.
As a Licensed Clinical Social Worker I help clients process their experiences with the whole picture in mind; considering their history, culture, identity, and underlying systems of privilege and oppression. I take a therapeutic approach that is both kind and challenging, motivating clients to reach their goals. Over the past decade, I have collaborated with individuals to confront a wide range of barriers holding them back from living the life they desire. My specialties include providing the appropriate coping skills to treat problematic response patterns ranging from perfectionism to codependency.
(415) 966-3124 View (415) 966-3124
Photo of Levana Adato, LCSW, Clinical Social Work/Therapist
Levana Adato
Clinical Social Work/Therapist, LCSW
Verified Verified
San Francisco, CA 94105  (Online Only)
I became a therapist because I believe in making the world a better place, helping one person at a time. From a very young age, I learned the value of social justice and helping others from my family. I volunteered a lot growing up, helping the elderly and my community. My therapy style includes Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Dialectical Behavioral Therapy, Mindfulness, Solution Focused, culturally sensitive, Family Systems, grief, humanistic, integrative, interpersonal, life coaching, multicultural, person-centered, reality therapy, Strength-Based, and Trauma-Focused.
I became a therapist because I believe in making the world a better place, helping one person at a time. From a very young age, I learned the value of social justice and helping others from my family. I volunteered a lot growing up, helping the elderly and my community. My therapy style includes Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Dialectical Behavioral Therapy, Mindfulness, Solution Focused, culturally sensitive, Family Systems, grief, humanistic, integrative, interpersonal, life coaching, multicultural, person-centered, reality therapy, Strength-Based, and Trauma-Focused.
(415) 851-6896 View (415) 851-6896
Photo of Jeannine McAdams, PsyD, Psychologist
Jeannine McAdams
Psychologist, PsyD
Verified Verified
San Francisco, CA 94102
Dr. Jeannine McAdams is a Psychologist in California who has been practicing since 2024. Dr. McAdams supports client to become more selfaware, manage and move through distressing symptoms and mood states, set and reach goals, heal and manage depression, anxiety, PTSD, bipolar, and other mental health issues. Dr. McAdams offers nonjudgmental, heart centered assessment and psychotherapy. Adults, adolescents, couples, families, neurodivergent and LQBTQ+ welcome. In her free time, Dr. McAdams loves to be outdoors, snowboard and surf, garden, and hike. She loves dogs and camping under the stars.
Dr. Jeannine McAdams is a Psychologist in California who has been practicing since 2024. Dr. McAdams supports client to become more selfaware, manage and move through distressing symptoms and mood states, set and reach goals, heal and manage depression, anxiety, PTSD, bipolar, and other mental health issues. Dr. McAdams offers nonjudgmental, heart centered assessment and psychotherapy. Adults, adolescents, couples, families, neurodivergent and LQBTQ+ welcome. In her free time, Dr. McAdams loves to be outdoors, snowboard and surf, garden, and hike. She loves dogs and camping under the stars.
(628) 244-8227 View (628) 244-8227
Photo of Marion Swenson, LMFT, Marriage & Family Therapist
Marion Swenson
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94110
My name is Marion Swenson. I am a licensed marriage and family therapist. My approach to therapy is to discover who my client is and how I may help them. My focus is to listen deeply to the heart of my client and to walk with them while on their healing journey. My approach to therapy is simply listening to my client and collaborating with them to attain their goal/goals. The theoretical approaches utilized in my practice are CBT, attachment-based, and family systems.
My name is Marion Swenson. I am a licensed marriage and family therapist. My approach to therapy is to discover who my client is and how I may help them. My focus is to listen deeply to the heart of my client and to walk with them while on their healing journey. My approach to therapy is simply listening to my client and collaborating with them to attain their goal/goals. The theoretical approaches utilized in my practice are CBT, attachment-based, and family systems.
(415) 715-1707 View (415) 715-1707
Photo of Kimberly Wheeler Rich, MFT, Marriage & Family Therapist
Kimberly Wheeler Rich
Marriage & Family Therapist, MFT
Verified Verified
San Francisco, CA 94129  (Online Only)
The stress of our fast-paced lives can challenge our most import relationships. Families are juggling so many responsibilities that its easy to let relationships take a back seat. Don't let stressful times derail you from living the life you always envisioned. I work with clients to manage stress, learn new problem solving tools, improve their relationships with loved ones and be the partner and/or parent you always wanted to be.
The stress of our fast-paced lives can challenge our most import relationships. Families are juggling so many responsibilities that its easy to let relationships take a back seat. Don't let stressful times derail you from living the life you always envisioned. I work with clients to manage stress, learn new problem solving tools, improve their relationships with loved ones and be the partner and/or parent you always wanted to be.
(650) 643-5319 View (650) 643-5319
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How does your Therapist compare?

Number of Therapists in San Francisco, CA

3,000+

Average cost per session

$190

Therapists in San Francisco, CA who prioritize treating:

93% Anxiety
86% Depression
81% Relationship Issues
74% Self Esteem
69% Trauma and PTSD
67% Stress
66% Life Transitions

Average years in practice

11 Years

Top 3 insurances accepted

71% Aetna
56% Cigna and Evernorth
54% UnitedHealthcare UHC | UBH

How Therapists in San Francisco, CA see their clients

54% In Person and Online
46% Online Only

Gender breakdown

76% Female
22% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in San Francisco?

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

Learn more about how to find a therapist

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

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

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

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

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

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

What type of therapy is right for me?

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

How much does therapy cost?

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

What are more affordable or low cost therapy solutions?

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

Is online therapy cheaper than in-person therapy?

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

Is online therapy a good option?

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

Are therapy sessions confidential?

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