Therapists in Washington, DC

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Photo of Ariel VanDoren, Licensed Professional Counselor, MA, LPC
Ariel VanDoren
Licensed Professional Counselor, MA, LPC
2 Endorsed
Washington, DC 20036
Therapy is a choice that may allow for insight, personal awareness and change. Therapy allows you to increase self-awareness so that you can be accountable for you thoughts, feelings, and actions and learn to avoid triggering situations, unhelpful patterns of behavior and overcome challenges you are facing. I firmly believe in a person's potential for growth by integrating aspects of their past into the present in an effort to heal. As you learn to externalize parts of your self, it is my hope that you become more comfortable with vulnerability and present in your daily life.
Therapy is a choice that may allow for insight, personal awareness and change. Therapy allows you to increase self-awareness so that you can be accountable for you thoughts, feelings, and actions and learn to avoid triggering situations, unhelpful patterns of behavior and overcome challenges you are facing. I firmly believe in a person's potential for growth by integrating aspects of their past into the present in an effort to heal. As you learn to externalize parts of your self, it is my hope that you become more comfortable with vulnerability and present in your daily life.
(202) 471-1507 View (202) 471-1507
Photo of Dr. Ryan Hinojosa, Psychologist, PhD
Dr. Ryan Hinojosa
Psychologist, PhD
2 Endorsed
Washington, DC 20001
My therapy practice is ideal for individuals wanting support and guidance as they navigate general life stressors. I work with neurotypical, neurodivergent, and LGBTQ+ clients alike who are wrestling with clinical concerns as well, including depressive symptoms, anxiety, and executive functioning differences. Clients struggling to build self-confidence, develop their identity, achieve consistency in pursuit of their goals, and manage their emotional wellness are met with compassion, patience, solutions, and integrated strategies backed by research. Contact me for more information about in-person neuropsychological testing.
My therapy practice is ideal for individuals wanting support and guidance as they navigate general life stressors. I work with neurotypical, neurodivergent, and LGBTQ+ clients alike who are wrestling with clinical concerns as well, including depressive symptoms, anxiety, and executive functioning differences. Clients struggling to build self-confidence, develop their identity, achieve consistency in pursuit of their goals, and manage their emotional wellness are met with compassion, patience, solutions, and integrated strategies backed by research. Contact me for more information about in-person neuropsychological testing.
(202) 759-8878 View (202) 759-8878
Photo of Madelyn Keefe, Clinical Social Work/Therapist, LICSW
Madelyn Keefe
Clinical Social Work/Therapist, LICSW
Online Only
Madelyn is a clinical social worker in Washington, DC, with experience providing therapy to clients living with depression, anxiety, and other mood-related disorders. She has clinical experience working with clients who have faced grief and loss, struggled with life stressors, and experienced trauma. Madelyn has a passion of supporting neurodivergent individuals and is committed to providing neurodiversity-affirming care. Madelyn believes in a strengths-based, client-centered approach that recognizes and celebrates each individual’s unique way of experiencing the world.
Madelyn is a clinical social worker in Washington, DC, with experience providing therapy to clients living with depression, anxiety, and other mood-related disorders. She has clinical experience working with clients who have faced grief and loss, struggled with life stressors, and experienced trauma. Madelyn has a passion of supporting neurodivergent individuals and is committed to providing neurodiversity-affirming care. Madelyn believes in a strengths-based, client-centered approach that recognizes and celebrates each individual’s unique way of experiencing the world.
(202) 949-6913 View (202) 949-6913
Photo of Elizabeth Quirch, Counselor, MA , LGPC
Elizabeth Quirch
Counselor, MA , LGPC
3 Endorsed
Washington, DC 20006
Hello! My name is Elizabeth and I am a native Spanish speaking therapist with Arelis Perez Psychotherapy Services LLC. My professional background encompasses working in diverse settings including nonprofit community-based organizations, DCPS schools, and a juvenile corrections facility. I have extensive experience working with adolescents and adults going through Life-Transitions, Depression, Anxiety, and Trauma. Whether you find yourself struggling with anxiety, depression, or navigating the ups and downs of life, I am here to guide you towards developing effective strategies and gaining valuable insights.
Hello! My name is Elizabeth and I am a native Spanish speaking therapist with Arelis Perez Psychotherapy Services LLC. My professional background encompasses working in diverse settings including nonprofit community-based organizations, DCPS schools, and a juvenile corrections facility. I have extensive experience working with adolescents and adults going through Life-Transitions, Depression, Anxiety, and Trauma. Whether you find yourself struggling with anxiety, depression, or navigating the ups and downs of life, I am here to guide you towards developing effective strategies and gaining valuable insights.
(202) 951-9028 View (202) 951-9028
Photo of Dr. L. Blair Simmons, Psychological Associate, PhD
Dr. L. Blair Simmons
Psychological Associate, PhD
1 Endorsed
Online Only
Hi! I'm Dr. Simmons. As a Black and White Biracial woman, wife, and mother, my personal and professional identities inform my passion for supporting individuals, couples, and families with diverse and intersecting identities. Due to my training and expertise, I might be a good fit for you if you identify as Black, Biracial, or Bicultural or are in an interracial or intercultural relationship. If you are having concerns related to trauma, anxiety, depression, family dynamics, relationships, or racial identity, I will help you to navigate challenges, discover your inner strengths, and achieve meaningful growth.
Hi! I'm Dr. Simmons. As a Black and White Biracial woman, wife, and mother, my personal and professional identities inform my passion for supporting individuals, couples, and families with diverse and intersecting identities. Due to my training and expertise, I might be a good fit for you if you identify as Black, Biracial, or Bicultural or are in an interracial or intercultural relationship. If you are having concerns related to trauma, anxiety, depression, family dynamics, relationships, or racial identity, I will help you to navigate challenges, discover your inner strengths, and achieve meaningful growth.
(855) 448-9179 View (855) 448-9179
Photo of Nikki Ford, Clinical Social Work/Therapist, LCSW, LCSW-C, LICSW, MPH
Nikki Ford
Clinical Social Work/Therapist, LCSW, LCSW-C, LICSW, MPH
Washington, DC 20009
As a clinical social worker, I work from a strengths-based, person-centered, and deeply collaborative perspective. We become a team in your therapy journey. My approach to therapy is integrative, and I draw from cognitive-behavioral, psychodynamic, and humanistic frameworks to support individual needs and goals. I also believe humor can play an important role in the therapeutic process. Clients work hard in therapy, and moments of levity can help reframe and normalize struggles in a positive or relieving manner.
As a clinical social worker, I work from a strengths-based, person-centered, and deeply collaborative perspective. We become a team in your therapy journey. My approach to therapy is integrative, and I draw from cognitive-behavioral, psychodynamic, and humanistic frameworks to support individual needs and goals. I also believe humor can play an important role in the therapeutic process. Clients work hard in therapy, and moments of levity can help reframe and normalize struggles in a positive or relieving manner.
(202) 972-6801 View (202) 972-6801
Photo of Annie Bollini, Psychologist, PhD
Annie Bollini
Psychologist, PhD
Online Only
Current Telehealth Openings: Do you feel stressed, overwhelmed, or dissatisfied with life? Are you trying to adjust to a change (e.g., break up, job change, grief)? Are you haunted by trauma or experiencing PTSD symptoms? Any of these can make daily life incredibly challenging and emotionally painful or lead to numbness. Perhaps you’ve tried different strategies on your own but still don’t feel better. I can help you work through your situation so that you feel less overwhelmed, more at peace and in control, and better able to focus on the best path forward for you. We can work together to help you feel better. www.anniebollini.com
Current Telehealth Openings: Do you feel stressed, overwhelmed, or dissatisfied with life? Are you trying to adjust to a change (e.g., break up, job change, grief)? Are you haunted by trauma or experiencing PTSD symptoms? Any of these can make daily life incredibly challenging and emotionally painful or lead to numbness. Perhaps you’ve tried different strategies on your own but still don’t feel better. I can help you work through your situation so that you feel less overwhelmed, more at peace and in control, and better able to focus on the best path forward for you. We can work together to help you feel better. www.anniebollini.com
(202) 804-2909 View (202) 804-2909
Photo of Donna Reid-Washington, Licensed Professional Counselor, LPC
Donna Reid-Washington
Licensed Professional Counselor, LPC
Online Only
I am a Licensed Professional Counselor with over 20 years of experience in guiding others to broaden their perspectives. After over 30 years in the Public Schools I retired to focus full time on my Practice "Love First", emphasizing love as life's core value. My mission is to help individuals cultivate self-love, retrain their minds, and navigate life's challenges positively.
I am a Licensed Professional Counselor with over 20 years of experience in guiding others to broaden their perspectives. After over 30 years in the Public Schools I retired to focus full time on my Practice "Love First", emphasizing love as life's core value. My mission is to help individuals cultivate self-love, retrain their minds, and navigate life's challenges positively.
(202) 519-1208 View (202) 519-1208
Photo of Dr. Alicia M Moran, Licensed Professional Counselor, PhD, LPC, ACS, MAC
Dr. Alicia M Moran
Licensed Professional Counselor, PhD, LPC, ACS, MAC
Online Only
Guided by the wisdom of Jung's words, "There can be no transforming of darkness into light, without emotion," I specialize in unraveling the intricate threads of emotional intelligence. Grounded in a profound understanding of belief systems, my training delves into the core, where past ideologies shape your present reality. Embracing emotional intelligence is not just a skill; it's a transformative state-of-mind that shapes thoughts and heightens emotional awareness. I advocate not for change but for understanding and acceptance.
Guided by the wisdom of Jung's words, "There can be no transforming of darkness into light, without emotion," I specialize in unraveling the intricate threads of emotional intelligence. Grounded in a profound understanding of belief systems, my training delves into the core, where past ideologies shape your present reality. Embracing emotional intelligence is not just a skill; it's a transformative state-of-mind that shapes thoughts and heightens emotional awareness. I advocate not for change but for understanding and acceptance.
(866) 730-5841 View (866) 730-5841
Photo of Frances Rekrut, Psychologist, MA, PhD
Frances Rekrut
Psychologist, MA, PhD
12 Endorsed
Washington, DC 20036
Compassionate therapy has the power to help people reflect, grow, and change. Using a warm and engaging approach, I collaborate with clients to develop treatment strategies that work based on research-based techniques. I specialize in working with clients struggling with relationship issues, OCD, grief and loss, and difficult life transitions, including changes in roles or identity.
Compassionate therapy has the power to help people reflect, grow, and change. Using a warm and engaging approach, I collaborate with clients to develop treatment strategies that work based on research-based techniques. I specialize in working with clients struggling with relationship issues, OCD, grief and loss, and difficult life transitions, including changes in roles or identity.
(202) 759-7878 View (202) 759-7878
Photo of Tandra Brown, Clinical Social Work/Therapist, LICSW, LCSW-C, CCTP I, CMIP
Tandra Brown
Clinical Social Work/Therapist, LICSW, LCSW-C, CCTP I, CMIP
Online Only
I am honored to have the opportunity to partner with you on a therapeutic journey to self discovery, healing and emotional wellness. Utilizing a multi-modal approach, we will work together to uncover underlying concerns, identify damaging thought patterns and balance responses to improve your quality of life. I am also board certified to provide clinical supervision in the state of Maryland and in Washington, DC.
I am honored to have the opportunity to partner with you on a therapeutic journey to self discovery, healing and emotional wellness. Utilizing a multi-modal approach, we will work together to uncover underlying concerns, identify damaging thought patterns and balance responses to improve your quality of life. I am also board certified to provide clinical supervision in the state of Maryland and in Washington, DC.
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Photo of Tina J Rutherford, Clinical Social Work/Therapist, MSW, LCSW, LICSW
Tina J Rutherford
Clinical Social Work/Therapist, MSW, LCSW, LICSW
1 Endorsed
Online Only
Breathe! I got you...In a world filled with constant change and uncertainty it is easy to forget to breathe, slow down and check-in with yourself. The daily grind, career dissatisfaction, family demands, strained relationships, past and current trauma, self-doubt…the list goes on. Let me be your guide on a journey into true freedom and overall satisfaction in all areas of your life. We will explore your historical blueprint and recreate a design that is authentically yours. A blueprint guided by fearlessness and healing rather than fear, self-doubt and recycled patterns that no longer serve you.
Breathe! I got you...In a world filled with constant change and uncertainty it is easy to forget to breathe, slow down and check-in with yourself. The daily grind, career dissatisfaction, family demands, strained relationships, past and current trauma, self-doubt…the list goes on. Let me be your guide on a journey into true freedom and overall satisfaction in all areas of your life. We will explore your historical blueprint and recreate a design that is authentically yours. A blueprint guided by fearlessness and healing rather than fear, self-doubt and recycled patterns that no longer serve you.
(202) 998-6511 View (202) 998-6511
Photo of Joanne Zucchetto, Clinical Social Work/Therapist, LICSW, LCSW-C
Joanne Zucchetto
Clinical Social Work/Therapist, LICSW, LCSW-C
Washington, DC 20015
My belief that the therapeutic relationship is the key element of successful treatment informs my practice. This working relationship, based on mutual trust and shared goals, allows for self-exploration and ultimately personal growth. In working with individuals, couples, families and/or groups I think that connecting the dots between past and present allows the client to have a better grasp on what is influencing her/his feelings and life choices leading to greater empowerment and life satisfaction.
My belief that the therapeutic relationship is the key element of successful treatment informs my practice. This working relationship, based on mutual trust and shared goals, allows for self-exploration and ultimately personal growth. In working with individuals, couples, families and/or groups I think that connecting the dots between past and present allows the client to have a better grasp on what is influencing her/his feelings and life choices leading to greater empowerment and life satisfaction.
(410) 988-2167 View (410) 988-2167
Photo of Dr. Erica M. Davis, Clinical Social Work/Therapist, DSW, LICSW
Dr. Erica M. Davis
Clinical Social Work/Therapist, DSW, LICSW
1 Endorsed
Online Only
As a Licensed Independent Clinical Social Worker with a Doctorate in Clinical Social Work, I am passionate about actively listening to human experiences. I understand that many people deeply desire to be heard, honored, and feel connected. I emphasize the importance of honoring clients' stories. I believe everyone has a unique story that shapes their experiences and views.
As a Licensed Independent Clinical Social Worker with a Doctorate in Clinical Social Work, I am passionate about actively listening to human experiences. I understand that many people deeply desire to be heard, honored, and feel connected. I emphasize the importance of honoring clients' stories. I believe everyone has a unique story that shapes their experiences and views.
(877) 845-7849 View (877) 845-7849
Photo of Dr. Abby Brown, Psychologist, PhD
Dr. Abby Brown
Psychologist, PhD
2 Endorsed
Online Only
I specialize in working with adults with eating disorders and disordered eating, and the conditions that often co-occur with eating concerns such as anxiety, depression, relationship difficulties, and trauma. I also have an extensive research background in chronic fatigue syndrome (sometimes called myalgic encephalomyelitis or ME/CFS) and have worked on multiple NIH-funded studies; I am aware of the unique challenges faced by individuals living with ME/CFS and other poorly understood, stigmatized health conditions. I provide evidence-based interventions that are tailored to my client’s needs and progress.
I specialize in working with adults with eating disorders and disordered eating, and the conditions that often co-occur with eating concerns such as anxiety, depression, relationship difficulties, and trauma. I also have an extensive research background in chronic fatigue syndrome (sometimes called myalgic encephalomyelitis or ME/CFS) and have worked on multiple NIH-funded studies; I am aware of the unique challenges faced by individuals living with ME/CFS and other poorly understood, stigmatized health conditions. I provide evidence-based interventions that are tailored to my client’s needs and progress.
(703) 215-3275 View (703) 215-3275
Photo of Tara Devineni, Clinical Social Work/Therapist, LCSW
Tara Devineni
Clinical Social Work/Therapist, LCSW
8 Endorsed
Washington, DC 20007
Everyone needs support during difficult times in their lives, whether they are dealing with a loss, relationship issues, stress at home or work, or feelings of depression and anxiety with or without a clear cause. It is during times like these that therapy can help. Through our work together I will provide a safe space for painful memories and emotions to be explored and work with you to gain a deeper understanding of how these experiences continue to shape you today. Together we will work to help you develop new coping skills and bring an enhanced level of self-awareness to your life.
Everyone needs support during difficult times in their lives, whether they are dealing with a loss, relationship issues, stress at home or work, or feelings of depression and anxiety with or without a clear cause. It is during times like these that therapy can help. Through our work together I will provide a safe space for painful memories and emotions to be explored and work with you to gain a deeper understanding of how these experiences continue to shape you today. Together we will work to help you develop new coping skills and bring an enhanced level of self-awareness to your life.
(484) 424-7218 View (484) 424-7218
Photo of Kia Batiste, Clinical Social Work/Therapist, LICSW
Kia Batiste
Clinical Social Work/Therapist, LICSW
Online Only
Welcome, I'm Kia! Life can present you with a million and one ups, downs, flips, and turns. All of this, understandably so, can take toll on your mental health and relationships. Although we have these challenges, seeking support can be difficult. So, congrats on taking this step! You deserve a safe space to express yourself, heal, and grow to your full potential.
Welcome, I'm Kia! Life can present you with a million and one ups, downs, flips, and turns. All of this, understandably so, can take toll on your mental health and relationships. Although we have these challenges, seeking support can be difficult. So, congrats on taking this step! You deserve a safe space to express yourself, heal, and grow to your full potential.
(202) 946-1193 View (202) 946-1193
Photo of Tiffany Burt, Clinical Social Work/Therapist, LICSW
Tiffany Burt
Clinical Social Work/Therapist, LICSW
Online Only
My name is Tiffany Burt and I am born and raised in Michigan. I am a licensed independent clinical social worker. My main therapeutic approach is Solution-Focused Cognitive Behavioral Therapy (CBT), Trauma Focused CBT, and CBT. I believe you are the expert in your life and I believe in developing a plan with you as the driver in the therapeutic approach. My goal is to create a space, using evidence based approach, to make improvements in your life.
My name is Tiffany Burt and I am born and raised in Michigan. I am a licensed independent clinical social worker. My main therapeutic approach is Solution-Focused Cognitive Behavioral Therapy (CBT), Trauma Focused CBT, and CBT. I believe you are the expert in your life and I believe in developing a plan with you as the driver in the therapeutic approach. My goal is to create a space, using evidence based approach, to make improvements in your life.
(202) 519-4322 View (202) 519-4322
Photo of Dr. Chad D. Olle, Psychologist, PhD, MS
Dr. Chad D. Olle
Psychologist, PhD, MS
1 Endorsed
Washington, DC 20036
Therapy can help you engage in your life more fully by reducing hypersensitivity to disappointment and other injuries while also reconnecting you to your strengths. I have experience working with a wide variety of histories, presentations, and severities, many of which add up to some form of anxiety and/or depression. Some clients struggle with major disruptions to their normal functioning while others are functioning well enough but are looking to “raise the bar” and live a more rewarding life. I also have experience working with a diverse clientele, and all backgrounds and identities are welcome.
Therapy can help you engage in your life more fully by reducing hypersensitivity to disappointment and other injuries while also reconnecting you to your strengths. I have experience working with a wide variety of histories, presentations, and severities, many of which add up to some form of anxiety and/or depression. Some clients struggle with major disruptions to their normal functioning while others are functioning well enough but are looking to “raise the bar” and live a more rewarding life. I also have experience working with a diverse clientele, and all backgrounds and identities are welcome.
(202) 899-8990 View (202) 899-8990
Photo of Mollie Dee, Psychologist, PsyD
Mollie Dee
Psychologist, PsyD
4 Endorsed
Washington, DC 20009
Not accepting new clients
I am licensed in DC and Maryland. I specialize in providing services to children, adolescents, and adults who are experiencing academic, emotional, behavioral, and/or interpersonal challenges. I currently work in private practice, but also have extensive experience working in schools with students and their families. I have a strong background in assessment, and frequently complete evaluations for a variety of concerns including: screening for Attention-Deficits, assessing social and emotional functioning, exploring cognitive and academic strengths and weaknesses, clarifying symptoms and diagnosis, and aiding in treatment planning.
I am licensed in DC and Maryland. I specialize in providing services to children, adolescents, and adults who are experiencing academic, emotional, behavioral, and/or interpersonal challenges. I currently work in private practice, but also have extensive experience working in schools with students and their families. I have a strong background in assessment, and frequently complete evaluations for a variety of concerns including: screening for Attention-Deficits, assessing social and emotional functioning, exploring cognitive and academic strengths and weaknesses, clarifying symptoms and diagnosis, and aiding in treatment planning.
(202) 759-7821 View (202) 759-7821
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How does your Therapist compare?

Number of Therapists in Washington, DC

3,000+

Average cost per session

$180

Therapists in Washington, DC who prioritize treating:

93% Anxiety
87% Depression
78% Relationship Issues
74% Self Esteem
69% Stress
68% Trauma and PTSD
65% Life Transitions

Average years in practice

13 Years

Top 3 insurances accepted

62% Aetna
62% Cigna and Evernorth
57% BlueCross and BlueShield

How Therapists in Washington, DC see their clients

50% In Person and Online
50% Online Only

Gender breakdown

81% Female
18% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Washington?

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.