Therapists in Cincinnati, OH

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Photo of Emily Kim, Licensed Professional Counselor in Cincinnati, OH
Emily Kim
Licensed Professional Counselor, LPC
Verified Verified
Cincinnati, OH 45242
I am a full-time Middle School Counselor and am very passionate about education. I am a life-long learner and am eager to grow my knowledge. I enjoy working with all groups of people; specifically adolescents and young adults. I utilize many different modalities, and place a strong emphasis on helping others find strengths and solutions to help them identify aspects within themselves that can be used to help overcome whatever their presenting challenge may be. I believe that we all can use the strengths we possess to make positive changes in our lives. I applaud your bravery in taking the first step in seeking out support.
I am a full-time Middle School Counselor and am very passionate about education. I am a life-long learner and am eager to grow my knowledge. I enjoy working with all groups of people; specifically adolescents and young adults. I utilize many different modalities, and place a strong emphasis on helping others find strengths and solutions to help them identify aspects within themselves that can be used to help overcome whatever their presenting challenge may be. I believe that we all can use the strengths we possess to make positive changes in our lives. I applaud your bravery in taking the first step in seeking out support.
(513) 845-3519 View (513) 845-3519
Photo of Meghan Kelsey, Clinical Social Work/Therapist in Cincinnati, OH
Meghan Kelsey
Clinical Social Work/Therapist, LPCC
Verified Verified
Cincinnati, OH 45236  (Online Only)
Meghan Kelsey, LPCC Meghan Kelsey received her master’s degree from Xavier University in clinical mental health counseling and her bachelor’s degree from The Ohio State University in psychology. She is a licensed professional clinical counselor and has been providing therapy since 2018. Meghan has been trained in providing trauma informed care for both adults and children/adolescents, understanding the impact on both individual experiences and family systems.
Meghan Kelsey, LPCC Meghan Kelsey received her master’s degree from Xavier University in clinical mental health counseling and her bachelor’s degree from The Ohio State University in psychology. She is a licensed professional clinical counselor and has been providing therapy since 2018. Meghan has been trained in providing trauma informed care for both adults and children/adolescents, understanding the impact on both individual experiences and family systems.
(513) 540-1132 View (513) 540-1132
Photo of Candida Crasto, Marriage & Family Therapist Intern in Cincinnati, OH
Candida Crasto
Marriage & Family Therapist Intern, MFT-TRN
Verified Verified
Cincinnati, OH 45242
My choice to become a therapist is based on my personal experience with therapy as well as my belief that everyone has the potential to uncover and enjoy their authentic selves. I have spent time understanding the construct of identity as it relates to self-acceptance, self- worth, and self-actualization. These themes are not only core to the self, but also integral parts of our interpersonal relationships - partners, children, friends, and communities. Trauma, belief systems, and life experiences create a default mode of operation. Undoing these is a gentle process of vulnerability and self-trust.
My choice to become a therapist is based on my personal experience with therapy as well as my belief that everyone has the potential to uncover and enjoy their authentic selves. I have spent time understanding the construct of identity as it relates to self-acceptance, self- worth, and self-actualization. These themes are not only core to the self, but also integral parts of our interpersonal relationships - partners, children, friends, and communities. Trauma, belief systems, and life experiences create a default mode of operation. Undoing these is a gentle process of vulnerability and self-trust.
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Photo of Maddy Campbell, Licensed Professional Counselor in Cincinnati, OH
Maddy Campbell
Licensed Professional Counselor, BA, MA, LPC
Verified Verified
5 Endorsed
Cincinnati, OH 45208
What makes you...you? If you've ever struggled with this question, welcome to Skyway Counseling. Your story is unique and I am grateful you’re choosing to share it with me. I believe that the counseling relationship should be honest, encouraging, nonjudgemental, and collaborative. I know you are capable of navigating these obstacles, whether you’re dealing with depression, anxiety, stress, or trauma. In addition to the previous list, I also specialize working with transracial adult adoptees and marginalized people through trauma and identity work. My goal is to help you build your own skyway to connect all the parts of you together.
What makes you...you? If you've ever struggled with this question, welcome to Skyway Counseling. Your story is unique and I am grateful you’re choosing to share it with me. I believe that the counseling relationship should be honest, encouraging, nonjudgemental, and collaborative. I know you are capable of navigating these obstacles, whether you’re dealing with depression, anxiety, stress, or trauma. In addition to the previous list, I also specialize working with transracial adult adoptees and marginalized people through trauma and identity work. My goal is to help you build your own skyway to connect all the parts of you together.
(513) 654-6986 View (513) 654-6986
Photo of La'Keyta Inez Hoffmann, Counselor in Cincinnati, OH
La'Keyta Inez Hoffmann
Counselor, MA, LPCC-S, LMHC, LPCC
Verified Verified
3 Endorsed
Cincinnati, OH 45219
Hello, I am Keyta and welcome to Light & Hope Counseling. We are here to help you as you take this big leap toward being seen, heard, and healed! We work with individuals and couples impacted by trauma, anxiety, and depression. We are experienced mental health therapists who partner with you to hear your story. In this journey, we will understand and eliminate dysfunctional, disruptive behaviors and thoughts while improving relationships. We look forward to working with you during this new chapter of your life, and we can attest that our therapeutic approach and skills are effective at helping people reach their desired goals.
Hello, I am Keyta and welcome to Light & Hope Counseling. We are here to help you as you take this big leap toward being seen, heard, and healed! We work with individuals and couples impacted by trauma, anxiety, and depression. We are experienced mental health therapists who partner with you to hear your story. In this journey, we will understand and eliminate dysfunctional, disruptive behaviors and thoughts while improving relationships. We look forward to working with you during this new chapter of your life, and we can attest that our therapeutic approach and skills are effective at helping people reach their desired goals.
(513) 496-1795 View (513) 496-1795
Photo of Ebony Peak, Clinical Social Work/Therapist in Cincinnati, OH
Ebony Peak
Clinical Social Work/Therapist, MSW , LISW-S
Verified Verified
1 Endorsed
Cincinnati, OH 45231
Want to learn coping skills, and build confidence so that you feel empowered to set and attain your goals? If so, I am the therapist for you! Passionate about my work, I believe in the transformative power of therapy to heal, empower, and bring about positive change. I approach each client with a client-centered, strengths-based perspective, tailoring my therapeutic approach to meet individual needs.
Want to learn coping skills, and build confidence so that you feel empowered to set and attain your goals? If so, I am the therapist for you! Passionate about my work, I believe in the transformative power of therapy to heal, empower, and bring about positive change. I approach each client with a client-centered, strengths-based perspective, tailoring my therapeutic approach to meet individual needs.
(513) 756-7751 View (513) 756-7751
Photo of Kristen Pribanich, Licensed Professional Counselor in Cincinnati, OH
Kristen Pribanich
Licensed Professional Counselor, MA, LPC
Verified Verified
Cincinnati, OH 45202  (Online Only)
Waitlist for new clients
We're all seeking a balance between work and life; but what happens when those lines start to get blurry? Perhaps, difficult life situations are impacting your work. Maybe you are feeling disengaged in your day-to-day tasks at work and it is causing high levels of stress and uncertainty about your future. Toxic work environment causing a deterioration of mental health? New or growing responsibilities at home causing you to rethink how you work? Are you finding it hard to create or hold boundaries at work? Maybe you know you're ready for a change but are unsure where to start? If any of this sounds familiar to you, keep reading.
We're all seeking a balance between work and life; but what happens when those lines start to get blurry? Perhaps, difficult life situations are impacting your work. Maybe you are feeling disengaged in your day-to-day tasks at work and it is causing high levels of stress and uncertainty about your future. Toxic work environment causing a deterioration of mental health? New or growing responsibilities at home causing you to rethink how you work? Are you finding it hard to create or hold boundaries at work? Maybe you know you're ready for a change but are unsure where to start? If any of this sounds familiar to you, keep reading.
(234) 218-4399 View (234) 218-4399
Photo of Meg Rose, Clinical Social Work/Therapist in Cincinnati, OH
Meg Rose
Clinical Social Work/Therapist, LISW
Verified Verified
2 Endorsed
Cincinnati, OH 45209
Our journey together is rooted in a collaborative and compassionate approach. Together, we'll set objectives that align with your values. Our sessions will be tailored to your unique needs, whether we're navigating the complexities of your past, building coping skills for the present, or envisioning a brighter future. This partnership will be trauma-informed, guided by understanding, empathy, and a shared commitment to your well-being. Together, we'll embark on a transformative journey towards healing, growth, and discovering the strength within you.
Our journey together is rooted in a collaborative and compassionate approach. Together, we'll set objectives that align with your values. Our sessions will be tailored to your unique needs, whether we're navigating the complexities of your past, building coping skills for the present, or envisioning a brighter future. This partnership will be trauma-informed, guided by understanding, empathy, and a shared commitment to your well-being. Together, we'll embark on a transformative journey towards healing, growth, and discovering the strength within you.
(513) 450-3923 View (513) 450-3923
Photo of Teresa Lawhead, Counselor in Cincinnati, OH
Teresa Lawhead
Counselor, MA , LPCC-S
Verified Verified
Cincinnati, OH 45230
Current Openings! I am here to empower your child to learn how to navigate feeling, thoughts, and behaviors. When children enter the play room, they are able to build skills and process through challenges through play or sharing. I support children through this growth ages 3-12years old.
Current Openings! I am here to empower your child to learn how to navigate feeling, thoughts, and behaviors. When children enter the play room, they are able to build skills and process through challenges through play or sharing. I support children through this growth ages 3-12years old.
(513) 434-6302 View (513) 434-6302
Photo of A Sound Mind Counseling Service, Counselor in Cincinnati, OH
A Sound Mind Counseling Service
Counselor, PhD, PCC, LSW
Verified Verified
Cincinnati, OH 45216
The therapists at A Sound Mind Counseling Service understand life challenges, trauma and pain. We are here to help and that is why we specialize in variety of issues such as: Anger, Anxiety, Depression, Marriage Counseling, Addictions, ADHD, Bipolar Disorder, Children, Christian Counseling, Mens and Womens Issues, Sexual Addiction, Pre and Post Marital Issues, Teens and Groups for Teens and Women. We have therapist who specialize in multicultural issues and American Sign Language. We also have interns who offer probono sessions.
The therapists at A Sound Mind Counseling Service understand life challenges, trauma and pain. We are here to help and that is why we specialize in variety of issues such as: Anger, Anxiety, Depression, Marriage Counseling, Addictions, ADHD, Bipolar Disorder, Children, Christian Counseling, Mens and Womens Issues, Sexual Addiction, Pre and Post Marital Issues, Teens and Groups for Teens and Women. We have therapist who specialize in multicultural issues and American Sign Language. We also have interns who offer probono sessions.
(513) 899-6412 View (513) 899-6412
Photo of Ashley Nicole Scott, Licensed Professional Counselor in Cincinnati, OH
Ashley Nicole Scott
Licensed Professional Counselor, MS, LPC
Verified Verified
1 Endorsed
Cincinnati, OH 45229  (Online Only)
Wellness for the culture isn’t just a catchphrase; it is my form of activism. I am committed to nurturing the mental, emotional, and spiritual well-being of Black people, particularly women and femmes. I understand the unique challenges you face - from code switching to grappling with the “strong Black woman” syndrome that often silences your pain. My vision is for you to achieve your definition of success without sacrificing your well-being. To build a relationship with yourself that embodies exquisite care, compassion, and consideration without shame. I want to help you learn how to prioritize rest and pleasure, without guilt.
Wellness for the culture isn’t just a catchphrase; it is my form of activism. I am committed to nurturing the mental, emotional, and spiritual well-being of Black people, particularly women and femmes. I understand the unique challenges you face - from code switching to grappling with the “strong Black woman” syndrome that often silences your pain. My vision is for you to achieve your definition of success without sacrificing your well-being. To build a relationship with yourself that embodies exquisite care, compassion, and consideration without shame. I want to help you learn how to prioritize rest and pleasure, without guilt.
(513) 866-3254 View (513) 866-3254
Photo of Candace S Johnson, Psychologist in Cincinnati, OH
Candace S Johnson
Psychologist
Verified Verified
1 Endorsed
Cincinnati, OH 45231
Are you facing a significant life transition and in need of support? Are you feeling overwhelmed as a caregiver for a loved one? Have you noticed that spending time with others has become less enjoyable? Are you dealing with low self-esteem and harsh self-judgments? Have you experienced an unexpected loss and finding it hard to adjust. Do you need help with identifying coping skills to improve your daily functioning? If so, these are common reasons to seek psychotherapy. You are deserving of being the best version of yourself. I am here to create a safe space that will support personal growth and self-expression without judgment.
Are you facing a significant life transition and in need of support? Are you feeling overwhelmed as a caregiver for a loved one? Have you noticed that spending time with others has become less enjoyable? Are you dealing with low self-esteem and harsh self-judgments? Have you experienced an unexpected loss and finding it hard to adjust. Do you need help with identifying coping skills to improve your daily functioning? If so, these are common reasons to seek psychotherapy. You are deserving of being the best version of yourself. I am here to create a safe space that will support personal growth and self-expression without judgment.
(513) 334-1021 View (513) 334-1021
Photo of Stephanie Gainer, Clinical Social Work/Therapist in Cincinnati, OH
Stephanie Gainer
Clinical Social Work/Therapist, LISW-S
Verified Verified
Cincinnati, OH 45202  (Online Only)
Congratulations on taking the first on your healing journey! I am passionate about empowering individuals. I aim to join you in successfully reaching your goals of resolving conflicts, lessening distress and emotional pain, solving problems, and enhancing your overall well-being. I work hard to create a safe, calm place where my clients feel heard.
Congratulations on taking the first on your healing journey! I am passionate about empowering individuals. I aim to join you in successfully reaching your goals of resolving conflicts, lessening distress and emotional pain, solving problems, and enhancing your overall well-being. I work hard to create a safe, calm place where my clients feel heard.
(513) 647-5327 View (513) 647-5327
Photo of Jill Chiara, Clinical Social Work/Therapist in Cincinnati, OH
Jill Chiara
Clinical Social Work/Therapist, LISW, LCSW
Verified Verified
Cincinnati, OH 45219
I have been treating adult individuals who have been struggling with anxiety and depression for 23 years. Issues that I have experience working with are relational conflicts, job stress, parenting, and trauma. My approach to treatment is psychodynamic, and I use EMDR and CBT as well when it can be beneficial for the therapy.
I have been treating adult individuals who have been struggling with anxiety and depression for 23 years. Issues that I have experience working with are relational conflicts, job stress, parenting, and trauma. My approach to treatment is psychodynamic, and I use EMDR and CBT as well when it can be beneficial for the therapy.
(513) 773-3276 View (513) 773-3276
Photo of Gary W Jacobs, Clinical Social Work/Therapist in Cincinnati, OH
Gary W Jacobs
Clinical Social Work/Therapist, DMin, MDiv, LISW
Verified Verified
Cincinnati, OH 45255
Lifeline Counseling LLC is a faith-based provider offering direct care in individual, pre-marital, and marriage counseling. Whether the concerns are related to personal, social, academic, or occupational functioning and well-being, Dr. Gary Jacobs uses an integrated, solution-focused approach best suited to each person's intellectual, physical, and spiritual strengths. With an emphasis on enhancing strengths, providing tools, and building skills, this client-driven approach is best suited to meet each person's particular goals for living and feeling well.
Lifeline Counseling LLC is a faith-based provider offering direct care in individual, pre-marital, and marriage counseling. Whether the concerns are related to personal, social, academic, or occupational functioning and well-being, Dr. Gary Jacobs uses an integrated, solution-focused approach best suited to each person's intellectual, physical, and spiritual strengths. With an emphasis on enhancing strengths, providing tools, and building skills, this client-driven approach is best suited to meet each person's particular goals for living and feeling well.
(513) 283-8150 View (513) 283-8150
Photo of Helen Farrah-McGrail, Clinical Social Work/Therapist in Cincinnati, OH
Helen Farrah-McGrail
Clinical Social Work/Therapist, LCISW
Verified Verified
Cincinnati, OH 45202  (Online Only)
Hi! I am a licensed clinical social worker and therapist (LICSW) based in West Virginia. In particular, I enjoy working with clients who are both eager and excited to learn and to better their lives. My clients are those who want to change their lives and better themselves. In this way, I am helping them to experience life at its fullest potential.
Hi! I am a licensed clinical social worker and therapist (LICSW) based in West Virginia. In particular, I enjoy working with clients who are both eager and excited to learn and to better their lives. My clients are those who want to change their lives and better themselves. In this way, I am helping them to experience life at its fullest potential.
(304) 403-7705 View (304) 403-7705
P. Stephen Long
Clinical Social Work/Therapist, MSW, LISW-S, NBCFCH
Verified Verified
Cincinnati, OH 45211
I see people for all kinds of everyday life problems including: life and work stress; depression; anxiety; phobias/fears; obsessive-compulsive disorder; bipolar disorder; marital/couples issues; divorce; behavior problems; parenting; ADHD/ADD; clinical hypnosis; stress and anger management; smoking cessation; habit control; employee asssistance; alcohol/drug evaluations; codependence; post traumatic stress; minorities; spiritual/faith issues: and grief/loss. I provide employee assistance services to employees after traumatizing experiences like bank robberies, job injuries or coworker deaths.
I see people for all kinds of everyday life problems including: life and work stress; depression; anxiety; phobias/fears; obsessive-compulsive disorder; bipolar disorder; marital/couples issues; divorce; behavior problems; parenting; ADHD/ADD; clinical hypnosis; stress and anger management; smoking cessation; habit control; employee asssistance; alcohol/drug evaluations; codependence; post traumatic stress; minorities; spiritual/faith issues: and grief/loss. I provide employee assistance services to employees after traumatizing experiences like bank robberies, job injuries or coworker deaths.
(513) 334-2233 View (513) 334-2233
Photo of Integrative Counseling Solutions in Cincinnati, OH
Integrative Counseling Solutions
MS, LPCC, S
Verified Verified
4 Endorsed
Cincinnati, OH 45255
Integrative Counseling Solutions promotes the mental health and well-being of individuals who seek a better existence and personal growth. ICS integrates flexible counseling options in order to accommodate our clients and their individual needs. We do this by incorporating therapeutic skills with unique and individualized techniques.
Integrative Counseling Solutions promotes the mental health and well-being of individuals who seek a better existence and personal growth. ICS integrates flexible counseling options in order to accommodate our clients and their individual needs. We do this by incorporating therapeutic skills with unique and individualized techniques.
(513) 342-3756 View (513) 342-3756
Photo of Darcy Jack, Counselor in Cincinnati, OH
Darcy Jack
Counselor, MA, LPCC
Verified Verified
Cincinnati, OH 45206
In a supportive atmosphere, Darcy assists clients through challenges to create the relationships they long for. Learning to see troubling differences as opportunities to grow, clients develop skills that improve all relationships, with partners/spouses, family, children, friends, colleagues and perhaps most importantly, with themselves. People of all races, ethnicities, ages, spiritual perspectives, sexual and gender expression are warmly welcomed.
In a supportive atmosphere, Darcy assists clients through challenges to create the relationships they long for. Learning to see troubling differences as opportunities to grow, clients develop skills that improve all relationships, with partners/spouses, family, children, friends, colleagues and perhaps most importantly, with themselves. People of all races, ethnicities, ages, spiritual perspectives, sexual and gender expression are warmly welcomed.
(513) 201-7096 View (513) 201-7096
Photo of Shana Cronican, Clinical Social Work/Therapist in Cincinnati, OH
Shana Cronican
Clinical Social Work/Therapist, MA, MSW, LISW-S
Verified Verified
Cincinnati, OH 45227
Are you struggling with current and/or past issues that are not allowing you to live richly and connect deeply to others? Clients experience hope, empowerment and an heightened sense of well-being through a trauma focused, holistic and client centered lens. I connect with clients through kindness, care and empathy. I also possess expertise in gender-based violence and the short and long term effects of trauma. Clients feel supported and develop positive coping skills through the use of evidence based tools to heal and recover from daily stress, past and current trauma/abuse & relationship issues in order to live their best life.
Are you struggling with current and/or past issues that are not allowing you to live richly and connect deeply to others? Clients experience hope, empowerment and an heightened sense of well-being through a trauma focused, holistic and client centered lens. I connect with clients through kindness, care and empathy. I also possess expertise in gender-based violence and the short and long term effects of trauma. Clients feel supported and develop positive coping skills through the use of evidence based tools to heal and recover from daily stress, past and current trauma/abuse & relationship issues in order to live their best life.
(513) 822-5294 View (513) 822-5294

How does your Therapist compare?

Number of Therapists in Cincinnati, OH

1,000+

Average cost per session

$125

Therapists in Cincinnati, OH who prioritize treating:

91% Anxiety
87% Depression
72% Self Esteem
71% Trauma and PTSD
69% Relationship Issues
66% Coping Skills
62% Stress

Average years in practice

10 Years

Top 3 insurances accepted

77% UnitedHealthcare UHC | UBH
74% Aetna
64% Optum

How Therapists in Cincinnati, OH see their clients

66% In Person and Online
34% Online Only

Gender breakdown

79% Female
20% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Cincinnati?

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.