Therapists in San Francisco, CA

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Photo of Kirsten M Bauer, Psychologist in San Francisco, CA
Kirsten M Bauer
Psychologist, PsyD
Verified Verified
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) 389-1788 View (415) 389-1788
Photo of Harmony Mandela Martinez, Marriage & Family Therapist in San Francisco, CA
Harmony Mandela Martinez
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
San Francisco, CA 94121
Now offering services for Teens, couples and individuals. Therapy is a process of growth and self-discovery. In our sessions we find old patterns that do not serve you and new growth that will offer new patterns to enjoy a more fulfilling life. I will use many methods with you exploring emotions, thoughts, body sensations and behavior. I work collaboratively with you to set goals and treatment that is personal to your needs and situation in a non-judgmental environment.
Now offering services for Teens, couples and individuals. Therapy is a process of growth and self-discovery. In our sessions we find old patterns that do not serve you and new growth that will offer new patterns to enjoy a more fulfilling life. I will use many methods with you exploring emotions, thoughts, body sensations and behavior. I work collaboratively with you to set goals and treatment that is personal to your needs and situation in a non-judgmental environment.
(628) 258-6948 View (628) 258-6948
Photo of Amanda Lesky, Marriage & Family Therapist in San Francisco, CA
Amanda Lesky
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94102  (Online Only)
I assist you to develop and use your strengths to improve your relationships and yourself through self-exploration and guidance. I use an integrative Cognitive Behavioral Therapy (CBT) approach. I work with individuals that struggle with depression and anxiety related to career, athletics, interpersonal relationships, medical conditions, disease, pre/post op surgery and injuries. Through a safe and supportive environment, I believe in the importance of devising a realistic plan for treatment that is personalized for your particular symptoms and collaborate with you to improve your quality of life.
I assist you to develop and use your strengths to improve your relationships and yourself through self-exploration and guidance. I use an integrative Cognitive Behavioral Therapy (CBT) approach. I work with individuals that struggle with depression and anxiety related to career, athletics, interpersonal relationships, medical conditions, disease, pre/post op surgery and injuries. Through a safe and supportive environment, I believe in the importance of devising a realistic plan for treatment that is personalized for your particular symptoms and collaborate with you to improve your quality of life.
(628) 244-3762 View (628) 244-3762
Photo of Hilary Rosenberg, Registered Psychological Assistant in San Francisco, CA
Hilary Rosenberg
Registered Psychological Assistant, PhD
Verified Verified
1 Endorsed
San Francisco, CA 94115
My adult and couples clients seek me out for many reasons. Some want to make changes in their lives. Others feel weighed down by difficult emotions, relationships, or past experiences. Some just want to better understand themselves and how to find meaning. My work is a collaborative process, rooted in theory and research, that creates meaningful, lasting change. I've helped clients with professional stress, challenging relationships, mood difficulties (anxiety, depression), challenges adjusting to new life stages/change, medical illness, substance use, a desire to build mindfulness skills, or simply feeling “stuck” and uncreative.
My adult and couples clients seek me out for many reasons. Some want to make changes in their lives. Others feel weighed down by difficult emotions, relationships, or past experiences. Some just want to better understand themselves and how to find meaning. My work is a collaborative process, rooted in theory and research, that creates meaningful, lasting change. I've helped clients with professional stress, challenging relationships, mood difficulties (anxiety, depression), challenges adjusting to new life stages/change, medical illness, substance use, a desire to build mindfulness skills, or simply feeling “stuck” and uncreative.
(415) 612-6424 View (415) 612-6424
Photo of Rob Ashe, Marriage & Family Therapist in San Francisco, CA
Rob Ashe
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94122  (Online Only)
In your search for a therapist, you are taking an important step to explore ways to create a shift in developing healthier patterns in your life.It is my role to support you in this important process. Untangling the seeming complexity of how we perceive our experiences is a crucial element in my practice. Each one of us embodies profound gifts that are typically suppressed primarily due to years of unhealthy patterns. Our sessions are an exploration to quiet emotional discomfort and establish healthier patterns that feel authentic and sustaining.
In your search for a therapist, you are taking an important step to explore ways to create a shift in developing healthier patterns in your life.It is my role to support you in this important process. Untangling the seeming complexity of how we perceive our experiences is a crucial element in my practice. Each one of us embodies profound gifts that are typically suppressed primarily due to years of unhealthy patterns. Our sessions are an exploration to quiet emotional discomfort and establish healthier patterns that feel authentic and sustaining.
(628) 222-2779 View (628) 222-2779
Photo of Tasha Jackson, Marriage & Family Therapist in San Francisco, CA
Tasha Jackson
Marriage & Family Therapist, MFT
Verified Verified
1 Endorsed
San Francisco, CA 94102  (Online Only)
Sometimes we all need a little support. Whether you’re struggling with work, navigating personal issues, going through a break up, or dealing with a past trauma—you are not alone. For many, it helps to talk with a professional to get a new perspective. If you’re new to therapy, my practice is a welcoming safe space for anyone who wants to “get un-stuck,” (whatever that may mean for you).
Sometimes we all need a little support. Whether you’re struggling with work, navigating personal issues, going through a break up, or dealing with a past trauma—you are not alone. For many, it helps to talk with a professional to get a new perspective. If you’re new to therapy, my practice is a welcoming safe space for anyone who wants to “get un-stuck,” (whatever that may mean for you).
(628) 313-4090 View (628) 313-4090
Photo of Kelly Lloyd, Marriage & Family Therapist in San Francisco, CA
Kelly Lloyd
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94114  (Online Only)
My approach is insight oriented, strengths-based, trauma-informed, client-centered and collaborative. I also like to incorporate practical tools to help my clients improve their daily lives. My communication style is warm, honest and direct. I encourage and value feedback from my clients. I specialize in working with people who wish to explore their gender identity and/or sexuality, are questioning their gender or are in the process of transitioning. My practice is identity affirming, fat-positive, kink-friendly and sex-worker friendly.
My approach is insight oriented, strengths-based, trauma-informed, client-centered and collaborative. I also like to incorporate practical tools to help my clients improve their daily lives. My communication style is warm, honest and direct. I encourage and value feedback from my clients. I specialize in working with people who wish to explore their gender identity and/or sexuality, are questioning their gender or are in the process of transitioning. My practice is identity affirming, fat-positive, kink-friendly and sex-worker friendly.
(415) 941-3832 View (415) 941-3832
Photo of Rebecca Cole, Psychologist in San Francisco, CA
Rebecca Cole
Psychologist, PsyD
Verified Verified
San Francisco, CA 94131
I specialize in working with youth, young adults, and their families to close the gap between where they are and where they want to be in terms of their roles as students and the many identities they are taking on as they grow and develop. I use neuropsychology to establish habits that provide a baseline for managing stress and regulating energy. I apply CBT and other evidence-based practices to support mood management and develop the mindset necessary to achieve goals, and mindfulness and relaxation strategies to sustain behavior change. I facilitate advocacy with schools to reinforce behavior change in a supportive environment.
I specialize in working with youth, young adults, and their families to close the gap between where they are and where they want to be in terms of their roles as students and the many identities they are taking on as they grow and develop. I use neuropsychology to establish habits that provide a baseline for managing stress and regulating energy. I apply CBT and other evidence-based practices to support mood management and develop the mindset necessary to achieve goals, and mindfulness and relaxation strategies to sustain behavior change. I facilitate advocacy with schools to reinforce behavior change in a supportive environment.
(341) 444-2101 View (341) 444-2101
Photo of Ali Gunsberg, Clinical Social Work/Therapist in San Francisco, CA
Ali Gunsberg
Clinical Social Work/Therapist, LCSW, MA
Verified Verified
San Francisco, CA 94114
One of the most difficult aspects of being a parent is seeing your child in pain and feeling like there is nothing that you can do to help. Whether they feel the pain of depression, anxiety, loss, trauma, divorce or social and academic pressure, my expertise is in helping children connect with their inner strength and confidence. I support families in developing the communication skills necessary to allow children to grow and move forward in healthy ways. I believe all children are unique, and my goal is to help bring out the best in your child.
One of the most difficult aspects of being a parent is seeing your child in pain and feeling like there is nothing that you can do to help. Whether they feel the pain of depression, anxiety, loss, trauma, divorce or social and academic pressure, my expertise is in helping children connect with their inner strength and confidence. I support families in developing the communication skills necessary to allow children to grow and move forward in healthy ways. I believe all children are unique, and my goal is to help bring out the best in your child.
(415) 295-4664 View (415) 295-4664
Photo of Blanca Amaya, Clinical Social Work/Therapist in San Francisco, CA
Blanca Amaya
Clinical Social Work/Therapist, LCSW
Verified Verified
San Francisco, CA 94105  (Online Only)
I have been in the helping profession for over 10 years, working with adults using evidence-based and alternative practices. I work under a multicultural and trauma-informed lens that allows me to understand your individual needs and meet you where you are in your journey. Together we will focus on your currents needs and goals to help create trust within the therapeutic relationship. I specialize in helping individuals heal from trauma, PTSD, anxiety, and depression.
I have been in the helping profession for over 10 years, working with adults using evidence-based and alternative practices. I work under a multicultural and trauma-informed lens that allows me to understand your individual needs and meet you where you are in your journey. Together we will focus on your currents needs and goals to help create trust within the therapeutic relationship. I specialize in helping individuals heal from trauma, PTSD, anxiety, and depression.
(415) 329-3753 View (415) 329-3753
Photo of Jose E Trejo, Clinical Social Work/Therapist in San Francisco, CA
Jose E Trejo
Clinical Social Work/Therapist, Jose E , Trejo, LCSW
Verified Verified
San Francisco, CA 94110  (Online Only)
If it’s your sexual functioning, infidelity, relationship discord, divorce, communication or stressors in life (transitions, work, health, life direction, etc.), I can help. I bring 18 years of experience and passion into the work we do. My focus is on sex therapy, couples and life stress. Our work is fulfilled when; you have a healthy, fulfilling and rewarding sex life, your relationships are energizing and rewarding, or when the stressors in your life are manageable and no longer the focus in your life. We will work to identify and then develop and create the life you want to live.
If it’s your sexual functioning, infidelity, relationship discord, divorce, communication or stressors in life (transitions, work, health, life direction, etc.), I can help. I bring 18 years of experience and passion into the work we do. My focus is on sex therapy, couples and life stress. Our work is fulfilled when; you have a healthy, fulfilling and rewarding sex life, your relationships are energizing and rewarding, or when the stressors in your life are manageable and no longer the focus in your life. We will work to identify and then develop and create the life you want to live.
(415) 430-9121 View (415) 430-9121
Photo of George Kolcun, Marriage & Family Therapist in San Francisco, CA
George Kolcun
Marriage & Family Therapist, MFT
Verified Verified
1 Endorsed
San Francisco, CA 94114
George Kolcun, MFT provides psychotherapy sessions for individuals, couples and adolescents to address a wide variety of challenges, with specific expertise in parenting support and couples work. George is licensed by the state of California as a Marriage and Family Therapist and is an adjunct professor of psychology at the University of San Francisco. George works in private practice in the Noe Valley neighborhood of San Francisco and central Marin County.
George Kolcun, MFT provides psychotherapy sessions for individuals, couples and adolescents to address a wide variety of challenges, with specific expertise in parenting support and couples work. George is licensed by the state of California as a Marriage and Family Therapist and is an adjunct professor of psychology at the University of San Francisco. George works in private practice in the Noe Valley neighborhood of San Francisco and central Marin County.
(415) 689-9442 View (415) 689-9442
Photo of Laurel Anderson Khurana, Psychologist in San Francisco, CA
Laurel Anderson Khurana
Psychologist, PsyD
Verified Verified
San Francisco, CA 94104
Are you feeling stuck as if you'd like to make changes but just can't seem to do so? Or maybe you're not sure which direction to head? Together, let's locate where you are today so you can make intentional movement. Over the past decade, I've come to learn again and again that there are legitimate reasons why we feel what we do, why we do what we do, and also why it's difficult to make changes we want make. When we really understand and acknowledge what is causing the discomfort (e.g. feeling stuck, sad, anxious, fearful), lasting change can occur. This process is unique for each person and I'd love to join you on your journey.
Are you feeling stuck as if you'd like to make changes but just can't seem to do so? Or maybe you're not sure which direction to head? Together, let's locate where you are today so you can make intentional movement. Over the past decade, I've come to learn again and again that there are legitimate reasons why we feel what we do, why we do what we do, and also why it's difficult to make changes we want make. When we really understand and acknowledge what is causing the discomfort (e.g. feeling stuck, sad, anxious, fearful), lasting change can occur. This process is unique for each person and I'd love to join you on your journey.
(415) 799-1657 View (415) 799-1657
Photo of Ellen B Klyce, Marriage & Family Therapist in San Francisco, CA
Ellen B Klyce
Marriage & Family Therapist, MA, LMFT
Verified Verified
1 Endorsed
San Francisco, CA 94123
I mostly treat couples who are navigating parenting and communication. But I work with individual clients too, Bay area residents who have multiple responsibilities and many demands placed on them daily. I help clients ease their doubt in social situations, calm down the inner critic. In my sessions we explore new ways to connect in many different circumstances. If you have fallen into negative thinking patterns, this constant worry may wear you down. I am there to be your collaborator, to find the best solution for you.
I mostly treat couples who are navigating parenting and communication. But I work with individual clients too, Bay area residents who have multiple responsibilities and many demands placed on them daily. I help clients ease their doubt in social situations, calm down the inner critic. In my sessions we explore new ways to connect in many different circumstances. If you have fallen into negative thinking patterns, this constant worry may wear you down. I am there to be your collaborator, to find the best solution for you.
(510) 768-7175 View (510) 768-7175
Photo of David Brown, Marriage & Family Therapist in San Francisco, CA
David Brown
Marriage & Family Therapist, MA, LMFT
Verified Verified
12 Endorsed
San Francisco, CA 94102
As a licensed therapist based in San Francisco, I help individuals, couples, and families dive beneath the surface-level issues to discover the underlying causes of their distress. Many men, women, and non-binary individuals who choose to work with me are at the grips of anxiety, depression, addiction, grief, or relationship challenges. Many are highly motivated professionals who are self-reliant and achievement-focused but often struggle with self-defeating thoughts and patterns that keep them stuck.
As a licensed therapist based in San Francisco, I help individuals, couples, and families dive beneath the surface-level issues to discover the underlying causes of their distress. Many men, women, and non-binary individuals who choose to work with me are at the grips of anxiety, depression, addiction, grief, or relationship challenges. Many are highly motivated professionals who are self-reliant and achievement-focused but often struggle with self-defeating thoughts and patterns that keep them stuck.
(415) 967-5261 View (415) 967-5261
Photo of Ilene Ava Serlin, Psychologist in San Francisco, CA
Ilene Ava Serlin
Psychologist, PhD, ADTR
Verified Verified
1 Endorsed
San Francisco, CA 94123
Not accepting new clients
I'm a very experienced psychotherapist with over 30 years experience in many settings. I'm warm and compassionate, but also practical. I work from a growth model that helps you access your own wisdom and make a commitment to change. My background in the arts and Jungian psychology attunes me to the dreams and imagery that can inform you about your life course, but I also help you bring these dreams into action. My experience with mind/body can help you prepare for and recover from surgery, develop resilience, stress reduction, confront mortality and life changes, find meaningful work, and appreciate relationships.
I'm a very experienced psychotherapist with over 30 years experience in many settings. I'm warm and compassionate, but also practical. I work from a growth model that helps you access your own wisdom and make a commitment to change. My background in the arts and Jungian psychology attunes me to the dreams and imagery that can inform you about your life course, but I also help you bring these dreams into action. My experience with mind/body can help you prepare for and recover from surgery, develop resilience, stress reduction, confront mortality and life changes, find meaningful work, and appreciate relationships.
(415) 594-4898 View (415) 594-4898
Photo of Ivette Huerta, Marriage & Family Therapist in San Francisco, CA
Ivette Huerta
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94105  (Online Only)
I have been working with the adults, parents, and families for over 20 years. I want to provide helping hands through your journey with the goal of you finding your self-worth and self-awareness. Life causes anxiety and frustrations, but with my guidance you will develop and strengthen yourself into a healthy individual. Through practical individual therapy, a change in your relationship will unfold before your eyes. I believe in creating a safe space for a client and taking time for self-care. I have worked with adults and families who've struggled with depression, anxiety, and trauma.
I have been working with the adults, parents, and families for over 20 years. I want to provide helping hands through your journey with the goal of you finding your self-worth and self-awareness. Life causes anxiety and frustrations, but with my guidance you will develop and strengthen yourself into a healthy individual. Through practical individual therapy, a change in your relationship will unfold before your eyes. I believe in creating a safe space for a client and taking time for self-care. I have worked with adults and families who've struggled with depression, anxiety, and trauma.
(415) 729-2474 View (415) 729-2474
Photo of Susan Allen, Marriage & Family Therapist in San Francisco, CA
Susan Allen
Marriage & Family Therapist, MA, LMFT
Verified Verified
San Francisco, CA 94115
I support women and couples through the emotional challenges of infertility, pregnancy and postpartum, and the parenting transition. My approach to therapy is warm, engaged and interactive with a focus on helping people to process and cope with the complex emotions of these life stressors.
I support women and couples through the emotional challenges of infertility, pregnancy and postpartum, and the parenting transition. My approach to therapy is warm, engaged and interactive with a focus on helping people to process and cope with the complex emotions of these life stressors.
(415) 505-3541 View (415) 505-3541
Photo of Sophia Reinders, Marriage & Family Therapist in San Francisco, CA
Sophia Reinders
Marriage & Family Therapist, PhD, MFT, REAT
Verified Verified
6 Endorsed
San Francisco, CA 94118
Are you longing for healing, transformation or a more trusting sense of self and more fulfilling life? My approach to counseling and psychotherapy with individuals and couples is holistic, creative and embodied, within a framework of Jungian psychology and creative arts therapy. With 20 plus years of clinical experience, I welcome individuals and couples struggling with life transitions, relationships, family matters, career or low self-worth, or who suffer from anxiety, depression, loss and grieving, questions of meaning or their intimate sense of spirituality. Having grown up in France and Germany, I also enjoy working with those whose mother tongue is German or French.
Are you longing for healing, transformation or a more trusting sense of self and more fulfilling life? My approach to counseling and psychotherapy with individuals and couples is holistic, creative and embodied, within a framework of Jungian psychology and creative arts therapy. With 20 plus years of clinical experience, I welcome individuals and couples struggling with life transitions, relationships, family matters, career or low self-worth, or who suffer from anxiety, depression, loss and grieving, questions of meaning or their intimate sense of spirituality. Having grown up in France and Germany, I also enjoy working with those whose mother tongue is German or French.
(415) 968-2450 View (415) 968-2450
Photo of John Kim, Marriage & Family Therapist in San Francisco, CA
John Kim
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94105  (Online Only)
I treat depression, anxiety, couple conflicts, motivation issues, and career issues. I hope to help you get from getting by to getting well, to get from mere coping to full on thriving.
I treat depression, anxiety, couple conflicts, motivation issues, and career issues. I hope to help you get from getting by to getting well, to get from mere coping to full on thriving.
(415) 991-6471 View (415) 991-6471

See more therapy options for San Francisco

How does your Therapist compare?

Number of Therapists in San Francisco, CA

3,000+

Average cost per session

$189

Therapists in San Francisco, CA who prioritize treating:

93% Anxiety
87% Depression
81% Relationship Issues
75% Self Esteem
70% Trauma and PTSD
68% Stress
66% Life Transitions

Average years in practice

12 Years

Top 3 insurances accepted

69% Aetna
55% UnitedHealthcare UHC | UBH
54% Cigna and Evernorth

How Therapists in San Francisco, CA see their clients

55% In Person and Online
45% Online Only

Gender breakdown

75% Female
23% 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.