Therapists in Merrimack, NH

Photo of Gary G McAree, Counselor in Merrimack, NH
Gary G McAree
Counselor, LCMHC, MLADAC, IDSP, RPh
Verified Verified
Merrimack, NH 03054
Life brings many Challenges. Are you Feeling Overwhelmed? Fearful? Do you feel broken? Are you struggling with PTSD? Are you suffering from anxiety and depression? Are you having problems with your relationships? Are you using substances to cope? You may be struggling to manage or stop behaviors that create shame, guilt or ongoing regret. Well these things can throw you off balance. Make the first step! And let me help…… My goal is to provide a safe, nonjudgmental space for you to discuss your concerns. We will work together to discover your strengths and learn new coping strategies. I utilize various therapeutic approaches.
Life brings many Challenges. Are you Feeling Overwhelmed? Fearful? Do you feel broken? Are you struggling with PTSD? Are you suffering from anxiety and depression? Are you having problems with your relationships? Are you using substances to cope? You may be struggling to manage or stop behaviors that create shame, guilt or ongoing regret. Well these things can throw you off balance. Make the first step! And let me help…… My goal is to provide a safe, nonjudgmental space for you to discuss your concerns. We will work together to discover your strengths and learn new coping strategies. I utilize various therapeutic approaches.
(603) 825-4523 View (603) 825-4523
Photo of Cheryl Sutherland, Clinical Social Work/Therapist in Merrimack, NH
Cheryl Sutherland
Clinical Social Work/Therapist, LICSW
Verified Verified
Merrimack, NH 03054  (Online Only)
Licensed in MA and NH. COUPLES only practice! If you want to change the "dance" (repeated negative cycle) you have with your significant other, Emotionally Focused Therapy can help. In fact, we have a roadmap to do just that. EFT is the only couple therapy with an effectiveness rating of over 90% (www.iceeft.com). As a Certified EFT therapist & ICEEFT-approved Clinical Supervisor-in-Training, I have advanced training in this scientifically-proven treatment for repairing a couple's relationship.
Licensed in MA and NH. COUPLES only practice! If you want to change the "dance" (repeated negative cycle) you have with your significant other, Emotionally Focused Therapy can help. In fact, we have a roadmap to do just that. EFT is the only couple therapy with an effectiveness rating of over 90% (www.iceeft.com). As a Certified EFT therapist & ICEEFT-approved Clinical Supervisor-in-Training, I have advanced training in this scientifically-proven treatment for repairing a couple's relationship.
(978) 616-3240 View (978) 616-3240
Photo of Brian Bedard, Counselor in Merrimack, NH
Brian Bedard
Counselor, MA, LCMHC
Verified Verified
Merrimack, NH 03054
I enjoy working with professional adults and motivated older adolescents who are struggling with mental disorders and life challenges. I have been working in the mental health field for over 22 years. I specialize in treating ADHD, Anxiety, and Depression. I have the dual benefit of historically working in medical, hospital and institutional settings and approaching the practice of psychotherapy from a holistic perspective (mind, body and spirit). I especially enjoy approaching psychotherapy from a Cognitive Behavioral Perspective as well using mindfulness to assist patients who are struggling.
I enjoy working with professional adults and motivated older adolescents who are struggling with mental disorders and life challenges. I have been working in the mental health field for over 22 years. I specialize in treating ADHD, Anxiety, and Depression. I have the dual benefit of historically working in medical, hospital and institutional settings and approaching the practice of psychotherapy from a holistic perspective (mind, body and spirit). I especially enjoy approaching psychotherapy from a Cognitive Behavioral Perspective as well using mindfulness to assist patients who are struggling.
(603) 606-3070 View (603) 606-3070
Photo of Lila Ivanoff Valdez, Counselor in Merrimack, NH
Lila Ivanoff Valdez
Counselor, MA, LCMHC, LLC
Verified Verified
Merrimack, NH 03054
Waitlist for new clients
Hello! I would like to support you to discover your strengths, resiliency, and to feel empowered in your life. In a warm, safe, collaborative environment, we create a positive path together towards your well-being. Utilizing your inherent strengths and coping strategies with skills and approaches, we will uncover negative thought patterns or behaviors, stuck places, and create new paths forward. Reconnecting with your healthy self, we will navigate through present transitions, pain, or loss in order to transform your connection with yourself and others.
Hello! I would like to support you to discover your strengths, resiliency, and to feel empowered in your life. In a warm, safe, collaborative environment, we create a positive path together towards your well-being. Utilizing your inherent strengths and coping strategies with skills and approaches, we will uncover negative thought patterns or behaviors, stuck places, and create new paths forward. Reconnecting with your healthy self, we will navigate through present transitions, pain, or loss in order to transform your connection with yourself and others.
(603) 435-2387 View (603) 435-2387
Photo of LS Associates, LLC, Psychologist in Merrimack, NH
LS Associates, LLC
Psychologist, PhD
Verified Verified
Merrimack, NH 03054
Not accepting new clients
LS Associates, LLC provides treatment services exclusively to the first responder community/LEOs. We understand the challenges, pressures, and demands of the lifestyle. With that in mind, we tailor our approach to meet the officer/responder where they are and get them where they want to go. Whether you are seeking short term/symptom focused therapy, longer term treatment that addresses ingrained patterns, or aren't sure what would best serve you, we can help you figure it out and start a plan of action.
LS Associates, LLC provides treatment services exclusively to the first responder community/LEOs. We understand the challenges, pressures, and demands of the lifestyle. With that in mind, we tailor our approach to meet the officer/responder where they are and get them where they want to go. Whether you are seeking short term/symptom focused therapy, longer term treatment that addresses ingrained patterns, or aren't sure what would best serve you, we can help you figure it out and start a plan of action.
(844) 689-0244 View (844) 689-0244
Photo of Kathy Simon, Clinical Social Work/Therapist in Merrimack, NH
Kathy Simon
Clinical Social Work/Therapist, LICSW
Verified Verified
Merrimack, NH 03054  (Online Only)
Life provides a wonderful opporunity for joy, connection and love. But the reality is that life also offers us stress and anxiety in every level of our lives (world events, work stress, relationships). How do we manage? How do we get by? Is it possible to actually thrive with all that we have going on inside of us and around us? Yes, it's possible. If you have felt ready to take action to feel better and make things better for yourself, let's connect. If you wonder why you are so stressed and what to do about it, let's connect. If you want to know what it feels like to truly love yourself and be at peace with yourself, let's connect
Life provides a wonderful opporunity for joy, connection and love. But the reality is that life also offers us stress and anxiety in every level of our lives (world events, work stress, relationships). How do we manage? How do we get by? Is it possible to actually thrive with all that we have going on inside of us and around us? Yes, it's possible. If you have felt ready to take action to feel better and make things better for yourself, let's connect. If you wonder why you are so stressed and what to do about it, let's connect. If you want to know what it feels like to truly love yourself and be at peace with yourself, let's connect
(978) 226-8383 View (978) 226-8383
Photo of Merrimack Valley Counseling, Psychologist in Merrimack, NH
Merrimack Valley Counseling
Psychologist
Verified Verified
Merrimack, NH 03054
Dr. Flynn is a licensed psychologist in New Hampshire and Massachusetts. He received his master's degree and Certificate of Advanced Graduate Studies from Assumption College, Massachusetts, and his doctorate degree in counseling psychology from Boston University. His professional background includes several years of full-time undergraduate and graduate teaching and counseling experience at Franklin Pierce University, River College, Northeastern University, University of Massachusetts at Lowell, Antioch New England Graduate School, Notre Dame College, and the University of New Hampshire. He has completed internships at Boston University and University of Massachusetts Medical Center at Worcester.
Dr. Flynn is a licensed psychologist in New Hampshire and Massachusetts. He received his master's degree and Certificate of Advanced Graduate Studies from Assumption College, Massachusetts, and his doctorate degree in counseling psychology from Boston University. His professional background includes several years of full-time undergraduate and graduate teaching and counseling experience at Franklin Pierce University, River College, Northeastern University, University of Massachusetts at Lowell, Antioch New England Graduate School, Notre Dame College, and the University of New Hampshire. He has completed internships at Boston University and University of Massachusetts Medical Center at Worcester.
(603) 678-4343 View (603) 678-4343
Photo of Erin O'Toole, Counselor in Merrimack, NH
Erin O'Toole
Counselor, MS, LMHC
Verified Verified
2 Endorsed
Merrimack, NH 03054  (Online Only)
Waitlist for new clients
Hi, I’m Erin! While life can be absolutely beautiful, it can also be difficult to feel contentment and notice the joy when you are overwhelmed with anxiety, doubt, and negative beliefs about yourself. It can feel comfortable to stay stuck in a pattern that is not serving you, but I’m betting that you’re becoming more uncomfortable with staying the same than you have in the past. While working together, you will learn how to navigate difficult thoughts that promote hard feelings. You will obtain skills to self regulate and accept things outside of your control, while becoming familiar with healthy boundaries that promote balance.
Hi, I’m Erin! While life can be absolutely beautiful, it can also be difficult to feel contentment and notice the joy when you are overwhelmed with anxiety, doubt, and negative beliefs about yourself. It can feel comfortable to stay stuck in a pattern that is not serving you, but I’m betting that you’re becoming more uncomfortable with staying the same than you have in the past. While working together, you will learn how to navigate difficult thoughts that promote hard feelings. You will obtain skills to self regulate and accept things outside of your control, while becoming familiar with healthy boundaries that promote balance.
(585) 643-8844 View (585) 643-8844
Photo of Deborah Sturm, Psychologist in Merrimack, NH
Deborah Sturm
Psychologist, PhD
Verified Verified
Merrimack, NH 03054
Hi. I am a licensed psychologist lucky enough to love what I do. I have a thriving private practice working exclusively with adults in individual and couples/marital therapy. Whether you want help with personal/emotional struggles, relationships, stresses of everyday life, or a life crisis, I can help you feel more settled and confident about yourself and your life. Rooted in the present or past, issues including anxiety, depression and self-esteem may be interfering with your happiness and effectiveness. My approach varies with your particular needs but is always rooted in a safe and caring relationship and dedicated to promoting positive change.
Hi. I am a licensed psychologist lucky enough to love what I do. I have a thriving private practice working exclusively with adults in individual and couples/marital therapy. Whether you want help with personal/emotional struggles, relationships, stresses of everyday life, or a life crisis, I can help you feel more settled and confident about yourself and your life. Rooted in the present or past, issues including anxiety, depression and self-esteem may be interfering with your happiness and effectiveness. My approach varies with your particular needs but is always rooted in a safe and caring relationship and dedicated to promoting positive change.
(855) 890-6759 View (855) 890-6759
Photo of David Brower, Pastoral Counselor in Merrimack, NH
David Brower
Pastoral Counselor, MDiv, STM, PhD
Verified Verified
Merrimack, NH 03054
Personal crisis recovery, whether due to divorce, child/family disruption, death of loved one(s) ; personal identity development, pastoral counseling and spiritual development. Interpersonal relationship concerns : man to woman, parent to child, parent about child, man to man, woman to woman. I will walk the woods with you until a clearing is gained. It's all about the journey. Certified training as a life/ career coach at UNH, the only university based coaching training in the country. Coaching inquiries are welcomed.
Personal crisis recovery, whether due to divorce, child/family disruption, death of loved one(s) ; personal identity development, pastoral counseling and spiritual development. Interpersonal relationship concerns : man to woman, parent to child, parent about child, man to man, woman to woman. I will walk the woods with you until a clearing is gained. It's all about the journey. Certified training as a life/ career coach at UNH, the only university based coaching training in the country. Coaching inquiries are welcomed.
(603) 899-7586 View (603) 899-7586
Photo of Richard J DiNapoli, Psychologist in Merrimack, NH
Richard J DiNapoli
Psychologist, EdD
Verified Verified
Merrimack, NH 03054
Relationship concerns? Our relationships with others define us in many ways. Whether its marriage or other intimate relationships, co-workers, friends, or family members, we live in a world of connection with others. I can help you better understand yourself as a relational being and turn that understanding into improved satisfaction with yourself and those you are involved with. After all, isn't it the quality of our relationships that determines the quality of our lives for most of us?
Relationship concerns? Our relationships with others define us in many ways. Whether its marriage or other intimate relationships, co-workers, friends, or family members, we live in a world of connection with others. I can help you better understand yourself as a relational being and turn that understanding into improved satisfaction with yourself and those you are involved with. After all, isn't it the quality of our relationships that determines the quality of our lives for most of us?
(603) 952-3239 View (603) 952-3239
Photo of Barton W Bryant, Psychologist in Merrimack, NH
Barton W Bryant
Psychologist, PhD
Verified Verified
Merrimack, NH 03054
I love my work. You may want a quiet, protected space where you can think out loud - with the freedom to follow your thoughts to their own (surprising?) conclusions. Or you may want a more active interaction, a back-and-forth exchange to wrestle with difficult emotions and come out the other side feeling more settled and self-directed in your life. My first job is to meet you wherever you are - wanting help with an immediate crisis, or wishing to explore a past experience that continues to haunt you.
I love my work. You may want a quiet, protected space where you can think out loud - with the freedom to follow your thoughts to their own (surprising?) conclusions. Or you may want a more active interaction, a back-and-forth exchange to wrestle with difficult emotions and come out the other side feeling more settled and self-directed in your life. My first job is to meet you wherever you are - wanting help with an immediate crisis, or wishing to explore a past experience that continues to haunt you.
(603) 673-1661 View (603) 673-1661
Photo of Robert Sibley, Counselor in Merrimack, NH
Robert Sibley
Counselor, LCMHC
Verified Verified
1 Endorsed
Merrimack, NH 03054
Are you experiencing stress from home, work, school, or do you feel less joy in your everyday life? It can be intimidating to need or ask for help, but sometimes we need to work through our own struggles, with the help from others. I will help you to build new and effective coping skills that are tailored to your situation. These methods are designed to work through your thoughts, feelings, and behaviors. together we can get control back in your life.
Are you experiencing stress from home, work, school, or do you feel less joy in your everyday life? It can be intimidating to need or ask for help, but sometimes we need to work through our own struggles, with the help from others. I will help you to build new and effective coping skills that are tailored to your situation. These methods are designed to work through your thoughts, feelings, and behaviors. together we can get control back in your life.
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Photo of Robert Glejzer, Counselor in Merrimack, NH
Robert Glejzer
Counselor, MA, LCMHC
Verified Verified
2 Endorsed
Merrimack, NH 03054
Whether you are interested in therapeutic services for yourself or the entire family, we will be with you shoulder to shoulder throughout your process of change, growth, and development.
Whether you are interested in therapeutic services for yourself or the entire family, we will be with you shoulder to shoulder throughout your process of change, growth, and development.
(603) 819-5578 View (603) 819-5578
Photo of Stacie Siwik, Clinical Social Work/Therapist in Merrimack, NH
Stacie Siwik
Clinical Social Work/Therapist, LICSW
Verified Verified
Merrimack, NH 03054  (Online Only)
Not accepting new clients
Are you feeling overwhelmed in your daily life, have difficulty shutting your brain off, or find yourself worrying about almost anything? Counseling may be the right step for you. Counseling is a collaborative effort between you and me to help identify the thoughts that interfere with your life in a negative way. With work, you can gain better control over unhelpful thoughts. Everyone has the ability to change, my job is to guide and support you through the process. I believe in creating a safe and judgement free experience for you to explore what you want to change and what gets in the way.
Are you feeling overwhelmed in your daily life, have difficulty shutting your brain off, or find yourself worrying about almost anything? Counseling may be the right step for you. Counseling is a collaborative effort between you and me to help identify the thoughts that interfere with your life in a negative way. With work, you can gain better control over unhelpful thoughts. Everyone has the ability to change, my job is to guide and support you through the process. I believe in creating a safe and judgement free experience for you to explore what you want to change and what gets in the way.
(855) 694-6157 View (855) 694-6157
William J Manseau
Pastoral Counselor, DMin, LPP
Verified Verified
Merrimack, NH 03054
If you realize that you are feeling perplexed, down or anxious or in a transition and could use someone to talk with I believe that I may be able to help. I am a Roman Catholic priest who transitioned into marriage as a priest and learned a lot about new beginnings and human growth in the process. My wife and I have been married for almost 43 years. I'm learning a lot. My training as a mental health clinician able to help a person integrate their own spiritual values in their relationships and life decisions has been valuable.
If you realize that you are feeling perplexed, down or anxious or in a transition and could use someone to talk with I believe that I may be able to help. I am a Roman Catholic priest who transitioned into marriage as a priest and learned a lot about new beginnings and human growth in the process. My wife and I have been married for almost 43 years. I'm learning a lot. My training as a mental health clinician able to help a person integrate their own spiritual values in their relationships and life decisions has been valuable.
(603) 952-3073 View (603) 952-3073
Photo of Denise Gaertner, Counselor in Merrimack, NH
Denise Gaertner
Counselor, MA, LCMHC
Verified Verified
Merrimack, NH 03054
I offer individual therapy to older adolescents and adults in a small private practice setting which allows me to personalize my service to you. I specialize in working with those who have problems as a result of having suffered trauma at some time in their lives, whether during childhood or more recently. I am able to offer help regulating difficult emotions, such as depression, anxiety and anger. I can also work with you to strengthen your sense of self-worth and relationships with others. I most enjoy helping people gain greater self-knowledge for a more fulfilling life.
I offer individual therapy to older adolescents and adults in a small private practice setting which allows me to personalize my service to you. I specialize in working with those who have problems as a result of having suffered trauma at some time in their lives, whether during childhood or more recently. I am able to offer help regulating difficult emotions, such as depression, anxiety and anger. I can also work with you to strengthen your sense of self-worth and relationships with others. I most enjoy helping people gain greater self-knowledge for a more fulfilling life.
(603) 685-3705 View (603) 685-3705
Photo of Kirby Gardner, Counselor in Merrimack, NH
Kirby Gardner
Counselor, MA, CAGS, LCMHC
Verified Verified
3 Endorsed
Merrimack, NH 03054
Making the decision to begin counseling can be intimidating and also rewarding. I am here to support you on this journey with a genuine, compassionate, and curious mind. I have been licensed for 10 years in NH and recently added VT for telehealth appointments only. I provide a solution-focused, person-centered approach to therapy. I specialize in topics such as anxious worry, self-esteem, interpersonal relationships, and stress/emotion management.
Making the decision to begin counseling can be intimidating and also rewarding. I am here to support you on this journey with a genuine, compassionate, and curious mind. I have been licensed for 10 years in NH and recently added VT for telehealth appointments only. I provide a solution-focused, person-centered approach to therapy. I specialize in topics such as anxious worry, self-esteem, interpersonal relationships, and stress/emotion management.
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Photo of Jessica Bennett, Drug & Alcohol Counselor in Merrimack, NH
Jessica Bennett
Drug & Alcohol Counselor, LCMHC, LADC
Verified Verified
Merrimack, NH 03054
I am a Licensed Clinical Mental Health Counselor as well as a Licensed Alcohol and Drug Counselor with over 11 years of experience working with individuals, families, and couples. I have a passion for helping people of all ages learn to manage their day to day stressors. Through the use of Cognitive Behavioral Therapy (CBT) and Motivational Interviewing my clients learn appropriate coping skills. I provide a safe environment free of judgment while also fostering a therapeutic relationship with my clients.
I am a Licensed Clinical Mental Health Counselor as well as a Licensed Alcohol and Drug Counselor with over 11 years of experience working with individuals, families, and couples. I have a passion for helping people of all ages learn to manage their day to day stressors. Through the use of Cognitive Behavioral Therapy (CBT) and Motivational Interviewing my clients learn appropriate coping skills. I provide a safe environment free of judgment while also fostering a therapeutic relationship with my clients.
(978) 883-3021 View (978) 883-3021
Photo of Patricia Blaze Hugenberger, Clinical Social Work/Therapist in Merrimack, NH
Patricia Blaze Hugenberger
Clinical Social Work/Therapist, Psya, D, LICSW
Verified Verified
Merrimack, NH 03054
Not accepting new clients
People seek counseling or therapy because of distress, conflict and perhaps anxiety or malaise. Many are facing a life stressor. Each person is unique in who they are, how they experience the world and how they deal with stress. My strength is working with the individual where they discover the tools to have more control of their lives and get what they want.
People seek counseling or therapy because of distress, conflict and perhaps anxiety or malaise. Many are facing a life stressor. Each person is unique in who they are, how they experience the world and how they deal with stress. My strength is working with the individual where they discover the tools to have more control of their lives and get what they want.
(603) 769-4425 View (603) 769-4425

How does your Therapist compare?

Number of Therapists in Merrimack, NH

40+

Average cost per session

$140

Therapists in Merrimack, NH who prioritize treating:

91% Anxiety
88% Depression
70% Relationship Issues
70% Self Esteem
65% Coping Skills
60% Stress
58% Trauma and PTSD

Average years in practice

15 Years

Top 3 insurances accepted

86% Harvard Pilgrim
86% Anthem | Elevance
81% UnitedHealthcare UHC | UBH

How Therapists in Merrimack, NH see their clients

84% In Person and Online
16% Online Only

Gender breakdown

80% Female
20% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Merrimack?

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.