Therapists in Manchester, IA

Photo of Colleen R Kuhse-Portzline, LMFT, CCTP, Marriage & Family Therapist
Colleen R Kuhse-Portzline
Marriage & Family Therapist, LMFT, CCTP
Verified Verified
1 Endorsed
Manchester, IA 52057
Waitlist for new clients
Hi. I am Colleen Kuhse-Portzline. I’m a Licensed Marriage and Family Therapist. More specifically, I’m a therapist who is passionate about helping people navigate life’s twists and turns. Are you feeling anxious, confused or maybe just “stuck”? Perhaps you’re missing the joy in life you once had or want to feel alive and thriving again. I believe in the idea of wholehearted living, of letting go of what holds us back and cultivating meaningful relationships.
Hi. I am Colleen Kuhse-Portzline. I’m a Licensed Marriage and Family Therapist. More specifically, I’m a therapist who is passionate about helping people navigate life’s twists and turns. Are you feeling anxious, confused or maybe just “stuck”? Perhaps you’re missing the joy in life you once had or want to feel alive and thriving again. I believe in the idea of wholehearted living, of letting go of what holds us back and cultivating meaningful relationships.
(563) 363-6939 View (563) 363-6939
Photo of Jenni Hentges, LMSW, Clinical Social Work/Therapist
Jenni Hentges
Clinical Social Work/Therapist, LMSW
Verified Verified
Manchester, IA 52057
It can be hard asking for help, but I am eager to get to know you and your story and help you create a positive change in your life. I serve both children and adults in need of a safe space to find the skills they need to thrive. I have a designated play room where children can express their creativity and feel comfortable talking with me. My office is also a safe, confidential environment where adults can feel empowered to share their thoughts and feelings and know their voices are heard.
It can be hard asking for help, but I am eager to get to know you and your story and help you create a positive change in your life. I serve both children and adults in need of a safe space to find the skills they need to thrive. I have a designated play room where children can express their creativity and feel comfortable talking with me. My office is also a safe, confidential environment where adults can feel empowered to share their thoughts and feelings and know their voices are heard.
(888) 330-4771 View (888) 330-4771
Photo of Stefanie Dingbaum, LISW, Clinical Social Work/Therapist
Stefanie Dingbaum
Clinical Social Work/Therapist, LISW
Verified Verified
Manchester, IA 52057
I firmly believe in order to experience true healing in life one must start by discovering the underlying root cause of their pain, stress, or trauma and ultimately working through those areas. I don’t believe in quick band-aid fixes or short-and-sweet solutions. I strive to first build a firm foundation together, built with mutual trust and commitment; knowing the path to healing is not usually linear. I also want you to believe you are resilient enough to come out of any obstacle stronger than when you started. What I strive for in every client interaction is you feeling heard, understood, and accepted just as you are.
I firmly believe in order to experience true healing in life one must start by discovering the underlying root cause of their pain, stress, or trauma and ultimately working through those areas. I don’t believe in quick band-aid fixes or short-and-sweet solutions. I strive to first build a firm foundation together, built with mutual trust and commitment; knowing the path to healing is not usually linear. I also want you to believe you are resilient enough to come out of any obstacle stronger than when you started. What I strive for in every client interaction is you feeling heard, understood, and accepted just as you are.
(563) 674-6012 View (563) 674-6012
Photo of Nicole L McGreevy, tLMHC, EFT-C, CMHC, Clinical Social Work/Therapist
Nicole L McGreevy
Clinical Social Work/Therapist, tLMHC, EFT-C, CMHC
Verified Verified
Manchester, IA 52057
Whatever challenges or life transitions you’re facing, I enjoy working with clients to help them deepen their understanding of themselves, meeting them wherever they are at, to help them learn the skills necessary to better cope with life’s stressors, and strengthen their sense of identity, meaning, and purpose, towards living healthier, more satisfying and authentic lives. It takes courage to share your story, and I provide a safe, compassionate, nonjudgmental space with a direct and genuine approach, for my clients to feel safe, valued, heard, and understood. I will work together with you to identify and work towards your goals.
Whatever challenges or life transitions you’re facing, I enjoy working with clients to help them deepen their understanding of themselves, meeting them wherever they are at, to help them learn the skills necessary to better cope with life’s stressors, and strengthen their sense of identity, meaning, and purpose, towards living healthier, more satisfying and authentic lives. It takes courage to share your story, and I provide a safe, compassionate, nonjudgmental space with a direct and genuine approach, for my clients to feel safe, valued, heard, and understood. I will work together with you to identify and work towards your goals.
(563) 208-4666 View (563) 208-4666
Photo of Brooke Martin, MA, LMHC, Counselor
Brooke Martin
Counselor, MA, LMHC
Verified Verified
Manchester, IA 52057  (Online Only)
Currently offering sessions via Telehealth (audio and video) to clients throughout the state of Iowa. I have dedicated my career to the human services field since 2008 and have been providing therapy since 2016. My clients have described my counseling approach as genuine, direct, and motivating. I utilize patience, compassion, and gentle challenging to assist you in moving through barriers and cognitive/behavioral patterns that are getting in the way of you reaching your desired outcomes in life.
Currently offering sessions via Telehealth (audio and video) to clients throughout the state of Iowa. I have dedicated my career to the human services field since 2008 and have been providing therapy since 2016. My clients have described my counseling approach as genuine, direct, and motivating. I utilize patience, compassion, and gentle challenging to assist you in moving through barriers and cognitive/behavioral patterns that are getting in the way of you reaching your desired outcomes in life.
(563) 231-7931 View (563) 231-7931

More Therapists Nearby

Photo of Jacquelyn Schultz, LISW, Clinical Social Work/Therapist
Jacquelyn Schultz
Clinical Social Work/Therapist, LISW
Verified Verified
Masonville, IA 50654  (Online Only)
My professional experience over the past twenty-seven years has concentrated on children, teenagers, adults, couples and families including in-home and private practice. I am familiar with how individuals and families often require collaboration across settings and between service providers. My focus is on listening and finding the best approach to help someone meet their goals out of therapy. I realize that finding a therapist can be difficult. I work hard to establish a relationship in which a person feels understood and respected. I am a faith base counselor for those who are looking for that.
My professional experience over the past twenty-seven years has concentrated on children, teenagers, adults, couples and families including in-home and private practice. I am familiar with how individuals and families often require collaboration across settings and between service providers. My focus is on listening and finding the best approach to help someone meet their goals out of therapy. I realize that finding a therapist can be difficult. I work hard to establish a relationship in which a person feels understood and respected. I am a faith base counselor for those who are looking for that.
(319) 774-4674 View (319) 774-4674

Online Therapists

Photo of Patrick Harnish -Hcc - Harnish Counseling & Consulting PLC, LMHC, NCC, CCTP, CYMHS, Counselor
Harnish Counseling & Consulting PLC
Counselor, LMHC, NCC, CCTP, CYMHS
Verified Verified
Mason City, IA 50401
As a Licensed Mental Health Counselor (LMHC) and Nationally Certified Counselor, I specialize in working with adolescents (10 and up), couples, adults, and the elderly. My diverse therapeutic approach includes Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Structural Family Therapy (SBFT), Rational Emotive Behavior Therapy (REBT), Internal Family Systems (IFS), and more. I offer a range of therapies to equip you with the tools necessary to navigate life's challenges.
As a Licensed Mental Health Counselor (LMHC) and Nationally Certified Counselor, I specialize in working with adolescents (10 and up), couples, adults, and the elderly. My diverse therapeutic approach includes Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Structural Family Therapy (SBFT), Rational Emotive Behavior Therapy (REBT), Internal Family Systems (IFS), and more. I offer a range of therapies to equip you with the tools necessary to navigate life's challenges.
(641) 666-3439 View (641) 666-3439
Photo of Stacy Wilson, LMHC, NCC, Counselor
Stacy Wilson
Counselor, LMHC, NCC
Verified Verified
Waterloo, IA 50701
I consider myself a client centered therapist which means you lead where we go in session and we address what is important to you. I believe you have the power to heal yourself, and I am here to create space for and empower you to do that. For clients who seek specific interventions, I offer skills, information, and interventions informed by Acceptance and Commitment Therapy, Dialectical Behavior Therapy, CBT, and Cognitive Processing Therapy.
I consider myself a client centered therapist which means you lead where we go in session and we address what is important to you. I believe you have the power to heal yourself, and I am here to create space for and empower you to do that. For clients who seek specific interventions, I offer skills, information, and interventions informed by Acceptance and Commitment Therapy, Dialectical Behavior Therapy, CBT, and Cognitive Processing Therapy.
(319) 382-6609 View (319) 382-6609
Photo of Melissa Michelle Estes, MS, LMFT, Marriage & Family Therapist
Melissa Michelle Estes
Marriage & Family Therapist, MS, LMFT
Verified Verified
1 Endorsed
Davenport, IA 52803
Waitlist for new clients
Hello! I've been a therapist for 28 years and have had many opportunities to witness courage and resiliency. Along with their struggles and concerns, clients bring many strengths including creativity, humor, kindness, forgiveness and compassion. Being a therapist has brought meaning and fulfillment to my life. I can't imagine doing anything else. I'm most experienced and interested in working with couples working to improve their relationships at any stage of life and with individuals concerned with anxiety, life transitions, or depression.
Hello! I've been a therapist for 28 years and have had many opportunities to witness courage and resiliency. Along with their struggles and concerns, clients bring many strengths including creativity, humor, kindness, forgiveness and compassion. Being a therapist has brought meaning and fulfillment to my life. I can't imagine doing anything else. I'm most experienced and interested in working with couples working to improve their relationships at any stage of life and with individuals concerned with anxiety, life transitions, or depression.
(563) 794-4735 View (563) 794-4735
Photo of Dan Chute, MA, LMSW, Clinical Social Work/Therapist
Dan Chute
Clinical Social Work/Therapist, MA, LMSW
Verified Verified
2 Endorsed
Cedar Rapids, IA 52402
Everyone has their own story or life experiences. I assist clients with helping them process through this, challenging negative thought patterns, develop coping skills, and help resolve these previous experiences or emotions affecting them. I hope to provide a different view of the things that you are looking to address or explore in order to help you move forward in life successfully based on goals that you have set forth for yourself personally and professionally.
Everyone has their own story or life experiences. I assist clients with helping them process through this, challenging negative thought patterns, develop coping skills, and help resolve these previous experiences or emotions affecting them. I hope to provide a different view of the things that you are looking to address or explore in order to help you move forward in life successfully based on goals that you have set forth for yourself personally and professionally.
(319) 320-1646 View (319) 320-1646
Photo of Darlene Kay Fitkin - Quakerdale Family Services, L, M, S, W, Clinical Social Work/Therapist
Quakerdale Family Services
Clinical Social Work/Therapist, L, M, S, W
Verified Verified
Waterloo, IA 50703
I am a Trauma Informed Specialist. I bring to my practice a unique blend of specialized training and life experiences. It is my belief that many fears, anxiety and behaviors have some form of trauma behind them. To determine the best treatment plan, I use the client's strengths to aid in achieving their goals. I am a Christian and believe that including an individual's faith in God is important for complete healing. I am sensitive to cultural differences and work with individuals from many nations. I have experience working with: PTSD, Addiction Recovery, Family, Couple, Single Parents, Children, and Single Adults.
I am a Trauma Informed Specialist. I bring to my practice a unique blend of specialized training and life experiences. It is my belief that many fears, anxiety and behaviors have some form of trauma behind them. To determine the best treatment plan, I use the client's strengths to aid in achieving their goals. I am a Christian and believe that including an individual's faith in God is important for complete healing. I am sensitive to cultural differences and work with individuals from many nations. I have experience working with: PTSD, Addiction Recovery, Family, Couple, Single Parents, Children, and Single Adults.
(319) 271-6124 View (319) 271-6124
Photo of John F Meyer, MSW, LISW, Clinical Social Work/Therapist
John F Meyer
Clinical Social Work/Therapist, MSW, LISW
Verified Verified
Dubuque, IA 52001
I am a Licensed Independent Social Worker with varied experiences covering all ages and many conditions. I entered the field of helping others in 2003 as a Chemical Dependency Counselor. I have since worked with troubled adolescents of varied backgrounds in a residential setting; the Chronically Mentally Ill in a community supported living program. I also have extensive Crisis Management experience. I have experience working with substance abuse, depression, anxiety, anger management, social anxiety, sexual trauma, combat trauma, family relationships, physical abuse, and behavior problems.
I am a Licensed Independent Social Worker with varied experiences covering all ages and many conditions. I entered the field of helping others in 2003 as a Chemical Dependency Counselor. I have since worked with troubled adolescents of varied backgrounds in a residential setting; the Chronically Mentally Ill in a community supported living program. I also have extensive Crisis Management experience. I have experience working with substance abuse, depression, anxiety, anger management, social anxiety, sexual trauma, combat trauma, family relationships, physical abuse, and behavior problems.
(563) 538-5035 View (563) 538-5035
Photo of Abby Meyer, LMFT, Marriage & Family Therapist
Abby Meyer
Marriage & Family Therapist, LMFT
Verified Verified
2 Endorsed
Waterloo, IA 50702
My name is Abby Meyer (she/her) and I’m a Licensed Marriage and Family Therapist in Waterloo, IA with experience working with individuals, families and children. I strive to provide an environment dedicated to instilling hope and building client strengths. Using a Systems Theory lens, my goal is to work with each client system to create everlasting change.
My name is Abby Meyer (she/her) and I’m a Licensed Marriage and Family Therapist in Waterloo, IA with experience working with individuals, families and children. I strive to provide an environment dedicated to instilling hope and building client strengths. Using a Systems Theory lens, my goal is to work with each client system to create everlasting change.
(319) 251-2424 View (319) 251-2424
Photo of Alyssa Anne Drury, MA, LMHC, Counselor
Alyssa Anne Drury
Counselor, MA, LMHC
Verified Verified
Iowa City, IA 52240
All of us have some hard and difficult times in life and we need some help. Although this can be humbling, it usually pays off in the end. I am a very flexible and laid back person and am here to help you with whatever it is you are struggling with. There will be no judgment and we will work on what only you want to work on. I believe there is no magic answer to everything and not everything works for everybody, so it is you and I trying to figure out what works best for you.
All of us have some hard and difficult times in life and we need some help. Although this can be humbling, it usually pays off in the end. I am a very flexible and laid back person and am here to help you with whatever it is you are struggling with. There will be no judgment and we will work on what only you want to work on. I believe there is no magic answer to everything and not everything works for everybody, so it is you and I trying to figure out what works best for you.
(319) 820-0382 View (319) 820-0382
Photo of Kristin B Bowers, MA, LPC, BCN, Licensed Professional Counselor
Kristin B Bowers
Licensed Professional Counselor, MA, LPC, BCN
Verified Verified
2 Endorsed
Mount Vernon, IA 52314  (Online Only)
My 15 year of expertise lies in individual therapy for teens and adults, with a focus on evidence-based practices, such as EMDR. If you’re in Texas or Iowa and seeking professional support, consider connecting with Kristin for virtual counseling sessions. Her commitment to evidence-based methods ensures quality care.
My 15 year of expertise lies in individual therapy for teens and adults, with a focus on evidence-based practices, such as EMDR. If you’re in Texas or Iowa and seeking professional support, consider connecting with Kristin for virtual counseling sessions. Her commitment to evidence-based methods ensures quality care.
(512) 706-9327 View (512) 706-9327
Photo of Mackenzie Behof, MSW, LISW, PMH-C, Clinical Social Work/Therapist
Mackenzie Behof
Clinical Social Work/Therapist, MSW, LISW, PMH-C
Verified Verified
2 Endorsed
Cedar Rapids, IA 52402
I recognize that making the decision to come to therapy can be overwhelming and unfamiliar. I strive to create a safe, non-judgmental, and supportive environment for my clients to explore their thoughts, emotions, and experiences. I use a combination of approaches to best fit the needs of my clients including Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT) and Motivational Interviewing.
I recognize that making the decision to come to therapy can be overwhelming and unfamiliar. I strive to create a safe, non-judgmental, and supportive environment for my clients to explore their thoughts, emotions, and experiences. I use a combination of approaches to best fit the needs of my clients including Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT) and Motivational Interviewing.
(319) 458-5138 View (319) 458-5138
Photo of Josie Jones, LMSW, Clinical Social Work/Therapist
Josie Jones
Clinical Social Work/Therapist, LMSW
Verified Verified
4 Endorsed
Cedar Falls, IA 50613
I work with children and teens providing a safe space to process traumatic events, explore emotions and build self esteem. Working to create a positive therapeutic relationship is the goal with every client that steps into my office. I work with children who struggle to self-regulate, are unsure of how to express their emotions in a healthy way, or those who have experienced some type of trauma. I also utilize body-based trauma processing skills with teens and young adults who have experienced traumatic events.
I work with children and teens providing a safe space to process traumatic events, explore emotions and build self esteem. Working to create a positive therapeutic relationship is the goal with every client that steps into my office. I work with children who struggle to self-regulate, are unsure of how to express their emotions in a healthy way, or those who have experienced some type of trauma. I also utilize body-based trauma processing skills with teens and young adults who have experienced traumatic events.
(319) 552-4321 View (319) 552-4321
Photo of Brad VanGorkom, LISW, Clinical Social Work/Therapist
Brad VanGorkom
Clinical Social Work/Therapist, LISW
Verified Verified
1 Endorsed
Cedar Rapids, IA 52402
Over 20 years of experience with child mental health needs including direct work with issues such as developmental delays, early childhood traumatic illness, childhood victims of abuse neglect and crime, foster care and adoption, autism spectrum, grief and loss, anxiety and depression, academic and behavioral issues in school, sibling and parent/child relationship difficulties.
Over 20 years of experience with child mental health needs including direct work with issues such as developmental delays, early childhood traumatic illness, childhood victims of abuse neglect and crime, foster care and adoption, autism spectrum, grief and loss, anxiety and depression, academic and behavioral issues in school, sibling and parent/child relationship difficulties.
(319) 220-0174 x1 View (319) 220-0174 x1
Photo of Megan Conrad, LMHC, Counselor
Megan Conrad
Counselor, LMHC
Verified Verified
Cedar Rapids, IA 52402
Have you ever woken up and felt like getting out of bed was like trying to climb Mount Everest, but no one understood? Ever just thought about work and felt fear clawing at your chest and throat? Have you been told you were not “trying hard enough” or were just “unmotivated” or “lazy” when behind the scenes you try so hard it overwhelmed you? I have, and you are not alone. Now imagine waking up, jumping out of bed, feeling refreshed. Imagine knowing that despite the challenges you face you can succeed and it “fills you with determination”. Imagine that, even on the worse days, you know “this too shall pass”.
Have you ever woken up and felt like getting out of bed was like trying to climb Mount Everest, but no one understood? Ever just thought about work and felt fear clawing at your chest and throat? Have you been told you were not “trying hard enough” or were just “unmotivated” or “lazy” when behind the scenes you try so hard it overwhelmed you? I have, and you are not alone. Now imagine waking up, jumping out of bed, feeling refreshed. Imagine knowing that despite the challenges you face you can succeed and it “fills you with determination”. Imagine that, even on the worse days, you know “this too shall pass”.
(319) 895-1704 View (319) 895-1704
Photo of Erika Bandilla, MSW, LISW, Clinical Social Work/Therapist
Erika Bandilla
Clinical Social Work/Therapist, MSW, LISW
Verified Verified
1 Endorsed
Waterloo, IA 50701
My ideal client is someone who recognizes the importance of their mental health and is ready to embark on a journey of self-discovery and growth. They may be struggling with a variety of issues: anxiety, depression, relationship difficulties, or low self-esteem. They have a genuine desire to understand themselves better, improve their well-being, and live a more fulfilling life. Ultimately, my ideal client wants to experience a sense of empowerment, self-acceptance, and achievement. They understand that investing in their mental health is a valuable and transformative endeavor, and they are committed to the process of growth.
My ideal client is someone who recognizes the importance of their mental health and is ready to embark on a journey of self-discovery and growth. They may be struggling with a variety of issues: anxiety, depression, relationship difficulties, or low self-esteem. They have a genuine desire to understand themselves better, improve their well-being, and live a more fulfilling life. Ultimately, my ideal client wants to experience a sense of empowerment, self-acceptance, and achievement. They understand that investing in their mental health is a valuable and transformative endeavor, and they are committed to the process of growth.
(319) 408-8705 View (319) 408-8705

See more therapy options for Manchester

How does your Therapist compare?

Number of Therapists in Manchester, IA

< 10

Therapists in Manchester, IA who prioritize treating:

100% Relationship Issues
100% Depression
100% Anxiety
100% Trauma and PTSD
100% Coping Skills
100% Self Esteem
100% Life Transitions

Average years in practice

6 Years

Top 3 insurances accepted

100% UnitedHealthcare UHC | UBH
80% BlueCross and BlueShield
60% Medicaid

How Therapists in Manchester, IA see their clients

80% In Person and Online
20% Online Only

Gender breakdown

100% Female
FAQs - About Therapy and Counseling

How can I find a therapist in Manchester?

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.