Therapists in Tacoma, WA

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Photo of Emelie Nelson, Counselor in Tacoma, WA
Emelie Nelson
Counselor, LMHCA, MEd
Verified Verified
Tacoma, WA 98402
Welcome! I'm so glad you are here. There are many reasons why someone may seek counseling, and it is a step that takes courage and vulnerability. I primarily work with individuals who want support with the following: negative thinking and self-criticism; low self-esteem; difficulties developing and maintaining meaningful relationships; identifying and removing barriers to success in the workplace. I strive to ensure that when clients speak with me, they know they are safe, respected, feel heard, and are empowered to make positive changes.
Welcome! I'm so glad you are here. There are many reasons why someone may seek counseling, and it is a step that takes courage and vulnerability. I primarily work with individuals who want support with the following: negative thinking and self-criticism; low self-esteem; difficulties developing and maintaining meaningful relationships; identifying and removing barriers to success in the workplace. I strive to ensure that when clients speak with me, they know they are safe, respected, feel heard, and are empowered to make positive changes.
(253) 881-8825 View (253) 881-8825
Photo of Douglas W. Lane, Psychologist in Tacoma, WA
Douglas W. Lane
Psychologist, PhD, ABPP
Verified Verified
Tacoma, WA 98402
Not accepting new clients
I provide care to adults and older adults using standard, well-established approaches to psychotherapy. I am board certified in the specialties of Clinical Psychology and Geriatric Psychology by the American Board of Professional Psychology. These are the highest credentials a psychologist can earn in these specialties. I also hold an appointment as a Clinical Professor in the Department of Psychiatry of the University of Washington School of Medicine. My areas of focus include general mental health needs such as depression and anxiety, as well as promoting resilience, and coping with medical illnesses such as dementia.
I provide care to adults and older adults using standard, well-established approaches to psychotherapy. I am board certified in the specialties of Clinical Psychology and Geriatric Psychology by the American Board of Professional Psychology. These are the highest credentials a psychologist can earn in these specialties. I also hold an appointment as a Clinical Professor in the Department of Psychiatry of the University of Washington School of Medicine. My areas of focus include general mental health needs such as depression and anxiety, as well as promoting resilience, and coping with medical illnesses such as dementia.
(253) 478-8497 View (253) 478-8497
Photo of Lizzie Munday, Counselor in Tacoma, WA
Lizzie Munday
Counselor, MEd, LMHC
Verified Verified
3 Endorsed
Tacoma, WA 98408
Therapy and the process of change can be daunting but, YOU ARE WORTH IT! My focus and goal in my work with you is to help navigate through your personal process of growth and change. I use a strength based, client centered and cognitive/behavioral approach to help develop techniques and coping skills to get you to where you want to be to feel solace and peace in your life. The most important step in the process is establishing a client/therapist relationship based on mutual respect and integrity.
Therapy and the process of change can be daunting but, YOU ARE WORTH IT! My focus and goal in my work with you is to help navigate through your personal process of growth and change. I use a strength based, client centered and cognitive/behavioral approach to help develop techniques and coping skills to get you to where you want to be to feel solace and peace in your life. The most important step in the process is establishing a client/therapist relationship based on mutual respect and integrity.
(253) 444-2946 View (253) 444-2946
Photo of Helen Janean Stepp, Clinical Social Work/Therapist in Tacoma, WA
Helen Janean Stepp
Clinical Social Work/Therapist, LICSW
Verified Verified
Tacoma, WA 98445
My name is Janean Stepp, and I am a Licensed Clinical Social Worker. I provide telehealth therapy to individuals age 10+. I have worked with clients with a wide range of issues including serious mental illness, behavioral issues, grief and loss, trauma, crisis situations, and major life changes and transitions. One of the most important aspects of providing therapy is forming a relationship based on empathy, trust, and a safe environment. I believe you are the expert on yourself, and I want to help you identify your strengths and the coping strategies that work best for you.
My name is Janean Stepp, and I am a Licensed Clinical Social Worker. I provide telehealth therapy to individuals age 10+. I have worked with clients with a wide range of issues including serious mental illness, behavioral issues, grief and loss, trauma, crisis situations, and major life changes and transitions. One of the most important aspects of providing therapy is forming a relationship based on empathy, trust, and a safe environment. I believe you are the expert on yourself, and I want to help you identify your strengths and the coping strategies that work best for you.
(509) 941-2389 View (509) 941-2389
Photo of Kelly Peck, Counselor in Tacoma, WA
Kelly Peck
Counselor, MA, LMHC
Verified Verified
Tacoma, WA 98402
Everyone goes through challenging situations in life, and while you may have successfully navigated through other difficulties you've faced, there's nothing wrong with seeking out extra support when you need it. I believe that children, adolescents, adults, couples and families can and deserve symptom relief, peace, harmony and greater satisfaction in their personal life, marriage, job, school, and interpersonal relationships. I provide a safe, warm and confidential therapeutic environment to achieve these goals with you.
Everyone goes through challenging situations in life, and while you may have successfully navigated through other difficulties you've faced, there's nothing wrong with seeking out extra support when you need it. I believe that children, adolescents, adults, couples and families can and deserve symptom relief, peace, harmony and greater satisfaction in their personal life, marriage, job, school, and interpersonal relationships. I provide a safe, warm and confidential therapeutic environment to achieve these goals with you.
(253) 292-5139 View (253) 292-5139
Photo of Christel Wilder, Marriage & Family Therapist in Tacoma, WA
Christel Wilder
Marriage & Family Therapist, MS, LMFT
Verified Verified
1 Endorsed
Tacoma, WA 98402
Are you tired of the same argument, different day? Each argument results in one person shutting down, the other person feeling alone, and both partners feeling misunderstood and hurt. Things don't have to be this way. I assist couples in developing safety and vulnerability to strengthen the relationship bond and learn how to talk about the complex issues of the relationship. Many of us never learned how to have our emotional needs met, or how to respond to someone's emotional needs. It can feel like speaking a foreign language.
Are you tired of the same argument, different day? Each argument results in one person shutting down, the other person feeling alone, and both partners feeling misunderstood and hurt. Things don't have to be this way. I assist couples in developing safety and vulnerability to strengthen the relationship bond and learn how to talk about the complex issues of the relationship. Many of us never learned how to have our emotional needs met, or how to respond to someone's emotional needs. It can feel like speaking a foreign language.
(253) 893-6058 View (253) 893-6058
Photo of Jenn Parretta - Relationship And Sex Therapist, Marriage & Family Therapist Associate in Tacoma, WA
Jenn Parretta - Relationship And Sex Therapist
Marriage & Family Therapist Associate, MA, LMFTA, ABS, ATR-P
Verified Verified
9 Endorsed
Tacoma, WA 98402
Now Accepting New Clients! - Ready to start on a journey of self-discovery, understanding, and fulfillment? Specializing in the intricate intersections of mental health, sexuality, and creativity, I guide individuals through the process of connecting with their desires. I’ll guide you through the challenges of understanding your needs, fostering healthy relationships, and unlocking your true passions. In our safe and supportive space, we'll work together to enhance communication, embrace authenticity, and build newfound confidence that will allow you to prioritize pleasure and your wellbeing.
Now Accepting New Clients! - Ready to start on a journey of self-discovery, understanding, and fulfillment? Specializing in the intricate intersections of mental health, sexuality, and creativity, I guide individuals through the process of connecting with their desires. I’ll guide you through the challenges of understanding your needs, fostering healthy relationships, and unlocking your true passions. In our safe and supportive space, we'll work together to enhance communication, embrace authenticity, and build newfound confidence that will allow you to prioritize pleasure and your wellbeing.
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Photo of Keziah Grindeland, Marriage & Family Therapist Associate in Tacoma, WA
Keziah Grindeland
Marriage & Family Therapist Associate, MA, LMFTA
Verified Verified
2 Endorsed
Tacoma, WA 98402  (Online Only)
Waitlist for new clients
I specialize in working with adult individuals navigating ADHD, depression, anxiety, and the impacts of trauma. I feel honored to walk alongside clients searching for connection and healing within themselves and their relationships. My therapeutic approach is grounded in Narrative and Solution-Focused modalities, and I tailor my approach to fit each individual client. Additionally, I am trained in Cognitive Processing Therapy, a 12-week manualized therapy designed to assist clients in healing from PTSD.
I specialize in working with adult individuals navigating ADHD, depression, anxiety, and the impacts of trauma. I feel honored to walk alongside clients searching for connection and healing within themselves and their relationships. My therapeutic approach is grounded in Narrative and Solution-Focused modalities, and I tailor my approach to fit each individual client. Additionally, I am trained in Cognitive Processing Therapy, a 12-week manualized therapy designed to assist clients in healing from PTSD.
(253) 785-2675 View (253) 785-2675
Photo of Hailey Clum, Pre-Licensed Professional in Tacoma, WA
Hailey Clum
Pre-Licensed Professional
Verified Verified
9 Endorsed
Tacoma, WA 98405  (Online Only)
Not accepting new clients
Please note: I am not accepting new clients, as my caseload is full, but will have spots in Summer 2024. Therapy can be a challenging and fulfilling experience that caters to each person’s needs. Knowing that there may be a variety of influences and obstacles you are navigating, it is my hope and aspiration to collaborate with you. I intend to provide a brave space that fosters a supportive and welcoming environment for you to share experiences, thoughts, and emotions. Leading with empathy, affirmation, and earnest listening are my goals when working with clients. My hope is you walk away feeling understood and encouraged.
Please note: I am not accepting new clients, as my caseload is full, but will have spots in Summer 2024. Therapy can be a challenging and fulfilling experience that caters to each person’s needs. Knowing that there may be a variety of influences and obstacles you are navigating, it is my hope and aspiration to collaborate with you. I intend to provide a brave space that fosters a supportive and welcoming environment for you to share experiences, thoughts, and emotions. Leading with empathy, affirmation, and earnest listening are my goals when working with clients. My hope is you walk away feeling understood and encouraged.
(206) 758-5435 View (206) 758-5435
Photo of Leslie Hendrix, Counselor in Tacoma, WA
Leslie Hendrix
Counselor, LMHCA
Verified Verified
Tacoma, WA 98409
Leslie Hendrix is a Licensed Mental Health Counselor Associate in Washington who has been practicing since 2023. Leslie provides bilingual sessions available in conversational Spanish. She is able to offer a multi-cultural lens to sessions. Outside of work, Leslie enjoys reading, crafting, and spending time with her four dogs and young son.
Leslie Hendrix is a Licensed Mental Health Counselor Associate in Washington who has been practicing since 2023. Leslie provides bilingual sessions available in conversational Spanish. She is able to offer a multi-cultural lens to sessions. Outside of work, Leslie enjoys reading, crafting, and spending time with her four dogs and young son.
(253) 553-2822 View (253) 553-2822
Photo of Psychological Health Consultants & Services, LLC, Counselor in Tacoma, WA
Psychological Health Consultants & Services, LLC
Counselor, EdD, LMHC, CCTP
Verified Verified
Tacoma, WA 98409  (Online Only)
I am a retired Senior Leader of the US Army. I consider myself an eclectic therapist with a sense of humor and do not believe one size fits all. I draw from various theories and use different therapeutic approaches such as Cognitive Behavior Therapy, Exposure Therapy, Family Systems Theories, Solution Focused, Brief Solution Focused as well as Behavior Activation techniques. I use the client center approach and use resources and support systems available for the client. I also assist with providing resources and connecting clients to their community. My specialization is in narcissist abuse education and recovery.
I am a retired Senior Leader of the US Army. I consider myself an eclectic therapist with a sense of humor and do not believe one size fits all. I draw from various theories and use different therapeutic approaches such as Cognitive Behavior Therapy, Exposure Therapy, Family Systems Theories, Solution Focused, Brief Solution Focused as well as Behavior Activation techniques. I use the client center approach and use resources and support systems available for the client. I also assist with providing resources and connecting clients to their community. My specialization is in narcissist abuse education and recovery.
(253) 259-3315 View (253) 259-3315
Photo of Mark R Ferrer, Marriage & Family Therapist in Tacoma, WA
Mark R Ferrer
Marriage & Family Therapist, MBA, MA, LMFT
Verified Verified
1 Endorsed
Tacoma, WA 98402
In my work as a therapist and organizational consultant over the last 35+ years, I have assisted youth, adults, families, and organizations in reducing barriers to and facilitating elements of healthy growth, functioning, and the achievement of goals. I work collaboratively with clients for I don't feel that I'm an expert on someone else life. We learn together what will work for you as the therapy progresses and by the work you do in therapy, it is hoped that you will reach the goals that you set for yourself at the very first appointment.
In my work as a therapist and organizational consultant over the last 35+ years, I have assisted youth, adults, families, and organizations in reducing barriers to and facilitating elements of healthy growth, functioning, and the achievement of goals. I work collaboratively with clients for I don't feel that I'm an expert on someone else life. We learn together what will work for you as the therapy progresses and by the work you do in therapy, it is hoped that you will reach the goals that you set for yourself at the very first appointment.
(253) 785-0451 View (253) 785-0451
Photo of Gabriela Raisl, Marriage & Family Therapist Associate in Tacoma, WA
Gabriela Raisl
Marriage & Family Therapist Associate, MA, LMFTA
Verified Verified
Tacoma, WA 98403
I specialize in working with couples that are needing help creating a new path for connection and emotional safety within their relationship. Some areas include parenting, infidelity, repairing ruptures and needing to strengthen communication. I work with individuals who are experiencing anxiety, depression, life transition and wanting to take a deep look inward. I offer a few spots for whole families who are wanting to connect and create secure attachments, creating a family system that feels in sync and united.
I specialize in working with couples that are needing help creating a new path for connection and emotional safety within their relationship. Some areas include parenting, infidelity, repairing ruptures and needing to strengthen communication. I work with individuals who are experiencing anxiety, depression, life transition and wanting to take a deep look inward. I offer a few spots for whole families who are wanting to connect and create secure attachments, creating a family system that feels in sync and united.
(253) 553-3206 View (253) 553-3206
Photo of Jennifer Olley, Clinical Social Work/Therapist in Tacoma, WA
Jennifer Olley
Clinical Social Work/Therapist, LICSW
Verified Verified
1 Endorsed
Tacoma, WA 98405  (Online Only)
Do you long to feel more alive, awake, and connected? Do you want to live with passion and purpose? Are you interested in honoring what your heart is longing for and willing to listen to what your body is communicating to you? Can you imagine making all of your decisions based on your intuition? Don’t get me wrong, I’m not suggesting that we won’t address your current circumstances. Your circumstances, and your feelings about your circumstances, they are all valid and belong. But they do not define you. Nor should they confine you. You are so much more than your diagnosis, your past experiences, or your fears about the future.
Do you long to feel more alive, awake, and connected? Do you want to live with passion and purpose? Are you interested in honoring what your heart is longing for and willing to listen to what your body is communicating to you? Can you imagine making all of your decisions based on your intuition? Don’t get me wrong, I’m not suggesting that we won’t address your current circumstances. Your circumstances, and your feelings about your circumstances, they are all valid and belong. But they do not define you. Nor should they confine you. You are so much more than your diagnosis, your past experiences, or your fears about the future.
(206) 561-7119 View (206) 561-7119
Photo of Anna Elizabeth Johnson, Counselor in Tacoma, WA
Anna Elizabeth Johnson
Counselor, MA, LMHC, EMDR
Verified Verified
Tacoma, WA 98402  (Online Only)
Hello, I am Anna. As a mom, mental health professional, and disabled individual, I know how difficult the world and life can be and how hard it can be to ask for help. I see counseling as coming beside a person and assisting them to best help themselves. Counseling should be a partnership where the person is open, determined and willing to work and the clinician, in collaboration with them, directs the ship and supports them with the tools they need. Are you having a tough time with anxiety? Has your past held you back from your goals? Do feel lost trying to fill your life with "stuff" that never seems to help? Change is possible.
Hello, I am Anna. As a mom, mental health professional, and disabled individual, I know how difficult the world and life can be and how hard it can be to ask for help. I see counseling as coming beside a person and assisting them to best help themselves. Counseling should be a partnership where the person is open, determined and willing to work and the clinician, in collaboration with them, directs the ship and supports them with the tools they need. Are you having a tough time with anxiety? Has your past held you back from your goals? Do feel lost trying to fill your life with "stuff" that never seems to help? Change is possible.
(509) 779-6738 View (509) 779-6738
Photo of Lucas Brown, Clinical Social Work/Therapist in Tacoma, WA
Lucas Brown
Clinical Social Work/Therapist, LICSW
Verified Verified
Tacoma, WA 98445  (Online Only)
If you're looking to improve your relationship with food and body image, navigate anxiety and stress, find yourself after trauma, develop the comfort to start making and maintaining boundaries, or are seeking a safe space as you work through other difficulties, I'd be happy to partner with you in your journey. I like to provide an inclusive, affirming, non-judgmental, space to support the insight and self-compassion that are valuable for growth and healing, and I like to be actively engaged by doing my part to better equip and empower you. If you're motivated to do therapy for you, I'm here!
If you're looking to improve your relationship with food and body image, navigate anxiety and stress, find yourself after trauma, develop the comfort to start making and maintaining boundaries, or are seeking a safe space as you work through other difficulties, I'd be happy to partner with you in your journey. I like to provide an inclusive, affirming, non-judgmental, space to support the insight and self-compassion that are valuable for growth and healing, and I like to be actively engaged by doing my part to better equip and empower you. If you're motivated to do therapy for you, I'm here!
(253) 201-1623 View (253) 201-1623
Photo of Renate Schultz, Psychologist in Tacoma, WA
Renate Schultz
Psychologist, PsyD
Verified Verified
Tacoma, WA 98407
Waitlist for new clients
Often people come to therapy because they feel lost or stuck in their lives. They may sense that they are repeating patterns or facing the same struggles at work, in their homes, or in relationships without really knowing why or being able to imagine how things could be different.
Often people come to therapy because they feel lost or stuck in their lives. They may sense that they are repeating patterns or facing the same struggles at work, in their homes, or in relationships without really knowing why or being able to imagine how things could be different.
(707) 309-7641 View (707) 309-7641
Photo of Emily Pico, Pre-Licensed Professional in Tacoma, WA
Emily Pico
Pre-Licensed Professional, MCN
Verified Verified
Tacoma, WA 98406
Have you found that talk therapy isn't successful for you? Micro Current Neurofeedback uses micro current stimulation that allows for the release of stuck patterns and disentrains the brain where needed. The result is a shifted brainwave state and a much greater ability for the brain and nervous system to regulate itself. Utilizing the brain’s own neuroplasticity, individuals experience a more symptom-free, fulling, positive life.
Have you found that talk therapy isn't successful for you? Micro Current Neurofeedback uses micro current stimulation that allows for the release of stuck patterns and disentrains the brain where needed. The result is a shifted brainwave state and a much greater ability for the brain and nervous system to regulate itself. Utilizing the brain’s own neuroplasticity, individuals experience a more symptom-free, fulling, positive life.
(253) 559-0532 View (253) 559-0532
Photo of Saltwater Supervision & Consulting, Clinical Social Work/Therapist in Tacoma, WA
Saltwater Supervision & Consulting
Clinical Social Work/Therapist, LICSW
Verified Verified
Tacoma, WA 98402
Are you looking for high quality, low cost group supervision hours? I am starting clinical social work supervision groups in May that will meet for four hours one weekend a month. We will divide the time into seminar-style learning, case presentation and discussion, guest speakers and test prep.
Are you looking for high quality, low cost group supervision hours? I am starting clinical social work supervision groups in May that will meet for four hours one weekend a month. We will divide the time into seminar-style learning, case presentation and discussion, guest speakers and test prep.
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Photo of Jennae Phillippe, Clinical Social Work/Therapist in Tacoma, WA
Jennae Phillippe
Clinical Social Work/Therapist, MSSW, LCSW
Verified Verified
2 Endorsed
Tacoma, WA 98465  (Online Only)
Asking for help may be the hardest and most courageous thing any of us can do. Utilizing Narrative Therapy, I help clients identify their values and skills to help them effectively confront current and future problems. I want to help people challenge and change the scripts that hold them back from self-compassion, curiosity, and creativity. My ultimate goal is to help people cultivate joy in their lives so that they can feel connected to the moments and people that matter to them most.
Asking for help may be the hardest and most courageous thing any of us can do. Utilizing Narrative Therapy, I help clients identify their values and skills to help them effectively confront current and future problems. I want to help people challenge and change the scripts that hold them back from self-compassion, curiosity, and creativity. My ultimate goal is to help people cultivate joy in their lives so that they can feel connected to the moments and people that matter to them most.
(253) 364-1109 View (253) 364-1109

How does your Therapist compare?

Number of Therapists in Tacoma, WA

1,000+

Average cost per session

$150

Therapists in Tacoma, WA who prioritize treating:

93% Anxiety
88% Depression
76% Trauma and PTSD
75% Relationship Issues
75% Self Esteem
70% Stress
67% Coping Skills

Average years in practice

9 Years

Top 3 insurances accepted

78% Premera
66% Regence
61% Aetna

How Therapists in Tacoma, WA see their clients

50% In Person and Online
50% Online Only

Gender breakdown

75% Female
21% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Tacoma?

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.