Therapists in Boston, MA

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Photo of Carroll Foley, Clinical Social Work/Therapist in Boston, MA
Carroll Foley
Clinical Social Work/Therapist, LICSW
Verified Verified
Boston, MA 02109  (Online Only)
Not accepting new clients
I specialize in the really hard stuff life throws our way. I work with adults, college students, and teens affected by grief and loss, complex trauma (abuse and neglect) and PTSD, serious and chronic health conditions (like cancer, ALS, MS, MD), disability, and other big life changes and challenges resulting in depression and anxiety. I believe that our inability to control what happens to us is not something to be overcome. Instead, it is the reality of life that we all live within. This is where the real work of being a person begins. And this is where good, meaningful, compassionate therapy comes in. I'm glad you're here.
I specialize in the really hard stuff life throws our way. I work with adults, college students, and teens affected by grief and loss, complex trauma (abuse and neglect) and PTSD, serious and chronic health conditions (like cancer, ALS, MS, MD), disability, and other big life changes and challenges resulting in depression and anxiety. I believe that our inability to control what happens to us is not something to be overcome. Instead, it is the reality of life that we all live within. This is where the real work of being a person begins. And this is where good, meaningful, compassionate therapy comes in. I'm glad you're here.
(857) 240-4291 View (857) 240-4291
Photo of Haley Feickert, Clinical Social Work/Therapist in Boston, MA
Haley Feickert
Clinical Social Work/Therapist, LCSW
Verified Verified
Boston, MA 02130
Haley received her MSW from Boston University and has experience working with children, teens, adults, families, and groups and has worked in both school and outpatient settings. Haley's style is to hold space for her clients to explore their own patterns and interpersonal dynamics, with a goal of finding a better understanding of themselves within their relationships and families.
Haley received her MSW from Boston University and has experience working with children, teens, adults, families, and groups and has worked in both school and outpatient settings. Haley's style is to hold space for her clients to explore their own patterns and interpersonal dynamics, with a goal of finding a better understanding of themselves within their relationships and families.
(617) 380-6132 View (617) 380-6132
Photo of Natalia Villafane, Counselor in Boston, MA
Natalia Villafane
Counselor, LMHC
Verified Verified
Boston, MA 02118  (Online Only)
Not accepting new clients
There's a point in our lives when we notice our typical ways of being just aren't working for us anymore. Whether it is patterns that continue to play out, or negative thinking that keeps on putting us down, there are clinically-proven ways to help us become even greater version of ourselves. I focus on helping young adults cope with stressors typically related to self-esteem, anxiety, depression, workplace issues, interpersonal relationships, and life transitions.
There's a point in our lives when we notice our typical ways of being just aren't working for us anymore. Whether it is patterns that continue to play out, or negative thinking that keeps on putting us down, there are clinically-proven ways to help us become even greater version of ourselves. I focus on helping young adults cope with stressors typically related to self-esteem, anxiety, depression, workplace issues, interpersonal relationships, and life transitions.
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Photo of Child and Teen ADHD Coaching & Psychotherapy , Clinical Social Work/Therapist in Boston, MA
Child and Teen ADHD Coaching & Psychotherapy
Clinical Social Work/Therapist, LICSW
Verified Verified
Boston, MA 02110  (Online Only)
When children struggle with executive function challenges like ones associated with ADHD, completion of priorities and academics can be challenging. ADHD coaching and Psychotherapy can help create structured actions that help to reach daily goals. It provides the structure and planning needed to be successful with academics. We work closely creating a tactical plan using customized strategies and habit building routines that will help to maximize our time spent together. Raising healthy and happy children with ADHD can be a big job, but the good news is that you do not have to do it alone. There is a lot that can be done to help!
When children struggle with executive function challenges like ones associated with ADHD, completion of priorities and academics can be challenging. ADHD coaching and Psychotherapy can help create structured actions that help to reach daily goals. It provides the structure and planning needed to be successful with academics. We work closely creating a tactical plan using customized strategies and habit building routines that will help to maximize our time spent together. Raising healthy and happy children with ADHD can be a big job, but the good news is that you do not have to do it alone. There is a lot that can be done to help!
(617) 958-6021 View (617) 958-6021
Photo of Shelana A Simon, Clinical Social Work/Therapist in Boston, MA
Shelana A Simon
Clinical Social Work/Therapist, LICSW, MSW, PhD(c)
Verified Verified
1 Endorsed
Boston, MA 02115
Welcoming NEW patients! I understand that that taking steps towards receiving mental health treatment requires tremendous strength. I aim to foster collaborative relationships with my clients as they move towards their unique goals. I am highly skilled and dedicated Licensed Independent Clinical Social Worker, and I currently practice in the Boston area. I obtained my Master of Social Work from Wheelock College, where I also obtained a certificate in Military counselling. I bring a comprehensive educational background to my role as my clinical experience is extensive. I am looking forward to collaborating with you on your care.
Welcoming NEW patients! I understand that that taking steps towards receiving mental health treatment requires tremendous strength. I aim to foster collaborative relationships with my clients as they move towards their unique goals. I am highly skilled and dedicated Licensed Independent Clinical Social Worker, and I currently practice in the Boston area. I obtained my Master of Social Work from Wheelock College, where I also obtained a certificate in Military counselling. I bring a comprehensive educational background to my role as my clinical experience is extensive. I am looking forward to collaborating with you on your care.
(351) 333-1695 View (351) 333-1695
Photo of Tricia Coffey, Clinical Social Work/Therapist in Boston, MA
Tricia Coffey
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Boston, MA 02215  (Online Only)
Balance in life can only be achieved when we start taking care of both our mental and physical health. I take an integrative approach to address clients' cognitive, emotional and physical needs. Whether that is challenging your anxious/negative thoughts, addressing your chronic pain, changing disruptive relationship patterns, avoiding work burnout or taking steps towards better nutrition and physical routines, we will address the whole you each session. I have worked in the therapy field for eleven years and have experience treating a variety of conditions including; anxiety, depression, life- transitions and trauma responses.
Balance in life can only be achieved when we start taking care of both our mental and physical health. I take an integrative approach to address clients' cognitive, emotional and physical needs. Whether that is challenging your anxious/negative thoughts, addressing your chronic pain, changing disruptive relationship patterns, avoiding work burnout or taking steps towards better nutrition and physical routines, we will address the whole you each session. I have worked in the therapy field for eleven years and have experience treating a variety of conditions including; anxiety, depression, life- transitions and trauma responses.
(857) 214-5422 View (857) 214-5422
Photo of Amy West, Clinical Social Work/Therapist in Boston, MA
Amy West
Clinical Social Work/Therapist, MSW, LMSW
Verified Verified
Boston, MA 02199
Amy is a therapist focusing on the needs of children, parents, and their families. She specializes in trauma: particularly trauma related to attachment, foster care, adoption, and medical conditions. Amy engages in a variety of therapeutic modalities as she supports her clients, including: CBT, DBT, SFBT, TF-CBT, etc. That alphabet soup can really be read as an indication of Amy's commitment to blending a variety of approaches to suit each unique client's situation. Amy is passionate about co-regulation and relational neuroscience, using these tools to support clients as they seek joyful connection and feel-safety in their lives.
Amy is a therapist focusing on the needs of children, parents, and their families. She specializes in trauma: particularly trauma related to attachment, foster care, adoption, and medical conditions. Amy engages in a variety of therapeutic modalities as she supports her clients, including: CBT, DBT, SFBT, TF-CBT, etc. That alphabet soup can really be read as an indication of Amy's commitment to blending a variety of approaches to suit each unique client's situation. Amy is passionate about co-regulation and relational neuroscience, using these tools to support clients as they seek joyful connection and feel-safety in their lives.
(571) 475-8912 View (571) 475-8912
Photo of Jenai Wu Steinkeller, Ph.D. , Psychologist in Boston, MA
Jenai Wu Steinkeller, Ph.D.
Psychologist, PhD
Verified Verified
Boston, MA 02110  (Online Only)
I am a highly credentialed and experienced psychologist working as a personal and executive coach. As an organizational psychologist & psychoanalyst, my approach melds deep-listening inner exploration with focus & goal-orientation that is grounded in the reality and challenges of your particular situation. While I am a licensed clinical psychologist in MA, after COVID I live part-time out of state & focus exclusively on personal and executive coaching. My coaching process is about change & growth, through increasing self-awareness & insight, expanded emotional openness & deepened perspective & understanding about your own psychology
I am a highly credentialed and experienced psychologist working as a personal and executive coach. As an organizational psychologist & psychoanalyst, my approach melds deep-listening inner exploration with focus & goal-orientation that is grounded in the reality and challenges of your particular situation. While I am a licensed clinical psychologist in MA, after COVID I live part-time out of state & focus exclusively on personal and executive coaching. My coaching process is about change & growth, through increasing self-awareness & insight, expanded emotional openness & deepened perspective & understanding about your own psychology
(617) 682-9200 View (617) 682-9200
Photo of Rebecca La Prade, Psychologist in Boston, MA
Rebecca La Prade
Psychologist, PhD
Verified Verified
Boston, MA 02127  (Online Only)
Does it feel like anxiety or other emotions hold you hostage? Or do you, your teen, or your college-aged child struggle to make sense of your emotions or feel like emotions (or running from emotions) drive your decisions? Emotions are beautiful and challenging, and I love helping teens, young adults, and adults navigate the storm. I completed my post-doc training at McLean Hospital and Harvard Medical School in the 3East Intensive Program providing adherent DBT therapy to adolescents. I have experience in a range of settings including community mental health, IOP, PHP, and Residential Treatment.
Does it feel like anxiety or other emotions hold you hostage? Or do you, your teen, or your college-aged child struggle to make sense of your emotions or feel like emotions (or running from emotions) drive your decisions? Emotions are beautiful and challenging, and I love helping teens, young adults, and adults navigate the storm. I completed my post-doc training at McLean Hospital and Harvard Medical School in the 3East Intensive Program providing adherent DBT therapy to adolescents. I have experience in a range of settings including community mental health, IOP, PHP, and Residential Treatment.
(617) 410-5538 View (617) 410-5538
Photo of Jill Stanzler-Katz, Clinical Social Work/Therapist in Boston, MA
Jill Stanzler-Katz
Clinical Social Work/Therapist, LICSW
Verified Verified
Boston, MA 02132  (Online Only)
Waitlist for new clients
You may be here because your life is feeling pretty messy right now, overwhelming, and hard. Or maybe you’re feeling stuck and you don’t know how to get unstuck. Or past experiences and past trauma affect your daily life and your relationships. Or perhaps your relationship is not where you want it to be, and you long for it to be better..but you don’t know what to do next. Would you like to finally feel less overwhelmed and actually experience getting unstuck, so that you can see yourself in a different light? With a clearer perspective, that feels empowering, accepting and self-loving, with more calmness, balance and ease?
You may be here because your life is feeling pretty messy right now, overwhelming, and hard. Or maybe you’re feeling stuck and you don’t know how to get unstuck. Or past experiences and past trauma affect your daily life and your relationships. Or perhaps your relationship is not where you want it to be, and you long for it to be better..but you don’t know what to do next. Would you like to finally feel less overwhelmed and actually experience getting unstuck, so that you can see yourself in a different light? With a clearer perspective, that feels empowering, accepting and self-loving, with more calmness, balance and ease?
(617) 958-5390 View (617) 958-5390
Photo of Katie Lee Loatman, Psychologist in Boston, MA
Katie Lee Loatman
Psychologist, PhD
Verified Verified
Boston, MA 02116  (Online Only)
I offer compassionate, non-judgmental treatment for adolescents and adults struggling with anxiety, depression, OCD and substance use issues. Using research-based techniques, I help clients create a toolbox of skills to use in times of distress, and provide a warm and supportive environment for self-exploration and growth. I am an Assistant Psychologist and Instructor in Psychology at McLean Hospital/Harvard Medical School.
I offer compassionate, non-judgmental treatment for adolescents and adults struggling with anxiety, depression, OCD and substance use issues. Using research-based techniques, I help clients create a toolbox of skills to use in times of distress, and provide a warm and supportive environment for self-exploration and growth. I am an Assistant Psychologist and Instructor in Psychology at McLean Hospital/Harvard Medical School.
(914) 229-9738 View (914) 229-9738
Photo of Elizabeth Hammond, Clinical Social Work/Therapist in Boston, MA
Elizabeth Hammond
Clinical Social Work/Therapist, LICSW
Verified Verified
Boston, MA 02109  (Online Only)
Your relationship with food and your body has taken over your life, and you’re tired of feeling overwhelmed, disconnected, and alone. You may be fed up with the shame, tired of having no control, or sick of feeling isolated. You might not even remember a time things didn’t feel this way. But one thing is for sure: you’re ready for some relief. You’re ready to leave the eating disorder behind. You want to feel confident and in control of your emotions. Most of all, you’re ready to reconnect with yourself.
Your relationship with food and your body has taken over your life, and you’re tired of feeling overwhelmed, disconnected, and alone. You may be fed up with the shame, tired of having no control, or sick of feeling isolated. You might not even remember a time things didn’t feel this way. But one thing is for sure: you’re ready for some relief. You’re ready to leave the eating disorder behind. You want to feel confident and in control of your emotions. Most of all, you’re ready to reconnect with yourself.
(857) 214-2413 View (857) 214-2413
Photo of Janelle Patrick, Clinical Social Work/Therapist in Boston, MA
Janelle Patrick
Clinical Social Work/Therapist, LICSW
Verified Verified
Boston, MA 02114
I'm not sure I believe in an Ideal client; I think all clients are Ideal, no matter their life circumstances. Life is like a rollercoaster, and when you're going down, you may need someone to be there and help talk you through it. However, If I had to choose, it would be a client having difficulty with self-esteem, self-worth, and depressive symptoms and needing additional assistance building coping skills but expressing readiness to change.
I'm not sure I believe in an Ideal client; I think all clients are Ideal, no matter their life circumstances. Life is like a rollercoaster, and when you're going down, you may need someone to be there and help talk you through it. However, If I had to choose, it would be a client having difficulty with self-esteem, self-worth, and depressive symptoms and needing additional assistance building coping skills but expressing readiness to change.
(781) 650-3608 View (781) 650-3608
Photo of Sam Leary, Licensed Professional Counselor in Boston, MA
Sam Leary
Licensed Professional Counselor, LMHC
Verified Verified
1 Endorsed
Boston, MA 02113  (Online Only)
You've braved the first, and often most difficult step by reaching out. My name is Sam and I help clients ages 18 and up struggling with anxiety, depression, life stressors/ transitions and men's mental health. I truly believe that the therapeutic process is a place for self-exploration and that you have all the knowledge within yourself to reach your goals. As a therapist, my goal is to create a collaborative and comfortable environment for you to explore your treatment needs.
You've braved the first, and often most difficult step by reaching out. My name is Sam and I help clients ages 18 and up struggling with anxiety, depression, life stressors/ transitions and men's mental health. I truly believe that the therapeutic process is a place for self-exploration and that you have all the knowledge within yourself to reach your goals. As a therapist, my goal is to create a collaborative and comfortable environment for you to explore your treatment needs.
(413) 357-1090 View (413) 357-1090
Photo of Karen Grimes, Counselor in Boston, MA
Karen Grimes
Counselor, MA, LMHC
Verified Verified
2 Endorsed
Boston, MA 02131  (Online Only)
When we experience inner conflict or are unsure of our life's direction,talking with a therapist can help explore and resolve stressful issues as well as help restore balance to our lives. As a licensed therapist in Boston ,I view counseling in a holistic way, valuing all aspects of a person. My therapeutic approach is client centered and collaborative. My view of therapy is that it provides an opportunity for people to gain insight into their lives, and assists them in making positive change.
When we experience inner conflict or are unsure of our life's direction,talking with a therapist can help explore and resolve stressful issues as well as help restore balance to our lives. As a licensed therapist in Boston ,I view counseling in a holistic way, valuing all aspects of a person. My therapeutic approach is client centered and collaborative. My view of therapy is that it provides an opportunity for people to gain insight into their lives, and assists them in making positive change.
(617) 855-6476 View (617) 855-6476
Photo of Through the Forest Counseling Inc., Counselor in Boston, MA
Through the Forest Counseling Inc.
Counselor, LMHC
Verified Verified
1 Endorsed
Boston, MA 02114  (Online Only)
Yes, we are accepting new clients please email for an appointment!!! Phone calls will be returned Friday and Saturdays! Life is a journey that we are all on. While on this journey we can sometimes get turned around. This happens to many of us at one point or another. Sometimes it feels like a rut other times it feels overwhelming but clarity is ahead! At Through The Forest Counseling, we specialize in brief solution focus therapies that will assist you in getting to the root of the issue and start healing.
Yes, we are accepting new clients please email for an appointment!!! Phone calls will be returned Friday and Saturdays! Life is a journey that we are all on. While on this journey we can sometimes get turned around. This happens to many of us at one point or another. Sometimes it feels like a rut other times it feels overwhelming but clarity is ahead! At Through The Forest Counseling, we specialize in brief solution focus therapies that will assist you in getting to the root of the issue and start healing.
(617) 393-5436 View (617) 393-5436
Photo of Brittany Silva, Clinical Social Work/Therapist in Boston, MA
Brittany Silva
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
1 Endorsed
Boston, MA 02127  (Online Only)
Change is difficult and life can feel quite daunting at times! We often need someone to validate our struggles and nudge us in a positive direction.
Change is difficult and life can feel quite daunting at times! We often need someone to validate our struggles and nudge us in a positive direction.
(857) 420-6229 View (857) 420-6229
Photo of Jane Lo, Counselor in Boston, MA
Jane Lo
Counselor, MA, LMHC
Verified Verified
Boston, MA 02110
Email preferred. Does life ever feel like a maze, with a dead end around every corner? Does it ever feel like the more you try to untangle the threads of your mind, the tighter the knots become? I compare my role as therapist to be a guide, someone who listens carefully and guides you through your unique maze, pointing out potential pitfalls and celebrating scenic views. I offer a calm space to allow you to open up, process your experiences, and take steps forward. For years I’ve worked with people who wrestled with grief over various losses such as death, divorce, chronic illness, unemployment and estranged relationships.
Email preferred. Does life ever feel like a maze, with a dead end around every corner? Does it ever feel like the more you try to untangle the threads of your mind, the tighter the knots become? I compare my role as therapist to be a guide, someone who listens carefully and guides you through your unique maze, pointing out potential pitfalls and celebrating scenic views. I offer a calm space to allow you to open up, process your experiences, and take steps forward. For years I’ve worked with people who wrestled with grief over various losses such as death, divorce, chronic illness, unemployment and estranged relationships.
(857) 597-3843 View (857) 597-3843
Photo of Vesper Jingxuan Yang, Clinical Social Work/Therapist in Boston, MA
Vesper Jingxuan Yang
Clinical Social Work/Therapist, LCSW
Verified Verified
Boston, MA 02109  (Online Only)
The desire to know and to be known is a normal human experience. I value the trauma-informed safety and client-centered connection we collaboratively create through a systematic lens. I am particularly sensitive to diversity in culture and self-identity, including with respect to race, gender and sexuality. I believe the importance of affirming the unique individual experience with cultural humility. Through compassion, sensitivity, and empowerment, we will work together respectfully to acknowledge vulnerability, unearth patterns, attend complexity, and gain ownership change to achieve the most authentic and expansive self.
The desire to know and to be known is a normal human experience. I value the trauma-informed safety and client-centered connection we collaboratively create through a systematic lens. I am particularly sensitive to diversity in culture and self-identity, including with respect to race, gender and sexuality. I believe the importance of affirming the unique individual experience with cultural humility. Through compassion, sensitivity, and empowerment, we will work together respectfully to acknowledge vulnerability, unearth patterns, attend complexity, and gain ownership change to achieve the most authentic and expansive self.
(508) 413-2256 View (508) 413-2256
Photo of Chapdelaine Consulting Services, Clinical Social Work/Therapist in Boston, MA
Chapdelaine Consulting Services
Clinical Social Work/Therapist, MSW, LICSW, JD, LLM
Verified Verified
Boston, MA 02116
Please feel free to call if you are looking for support or therapy. I am available to work with anyone who resides in Massachusetts. All sessions will take place online using a telehealth devise utilizing communication on a computer, tablet or phone.
Please feel free to call if you are looking for support or therapy. I am available to work with anyone who resides in Massachusetts. All sessions will take place online using a telehealth devise utilizing communication on a computer, tablet or phone.
(617) 390-8811 View (617) 390-8811

How does your Therapist compare?

Number of Therapists in Boston, MA

3,000+

Average cost per session

$160

Therapists in Boston, MA who prioritize treating:

93% Anxiety
86% Depression
76% Relationship Issues
74% Self Esteem
70% Stress
68% Trauma and PTSD
68% Coping Skills

Average years in practice

11 Years

Top 3 insurances accepted

78% BlueCross and BlueShield
61% UnitedHealthcare UHC | UBH
58% Aetna

How Therapists in Boston, MA see their clients

60% Online Only
40% In Person and Online

Gender breakdown

79% Female
19% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Boston?

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.