Therapists in Polk County, IA

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Photo of Maggie Suits, Counselor, MS, LMHC
Maggie Suits
Counselor, MS, LMHC
3 Endorsed
Urbandale, IA 50322
Waitlist for new clients
Great therapy is a sacred, unique, and mutually respectful relationship. My approach is holistic in nature, seeking to balance the mind, body and spirit. There is no one approach for everyone, so I utilize many forms of therapy with clients, allowing a person-centered, humanistic, and eclectic approach. I also incorporate aspects of spirituality if desired, and am open to all beliefs. I mainly work with adults and teens. My therapy is intuitive and empathic, which invites individuality to shine.
Great therapy is a sacred, unique, and mutually respectful relationship. My approach is holistic in nature, seeking to balance the mind, body and spirit. There is no one approach for everyone, so I utilize many forms of therapy with clients, allowing a person-centered, humanistic, and eclectic approach. I also incorporate aspects of spirituality if desired, and am open to all beliefs. I mainly work with adults and teens. My therapy is intuitive and empathic, which invites individuality to shine.
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Photo of Kathleen Murray, Psychologist, Ph.D., LP
Kathleen Murray
Psychologist, Ph.D., LP
Urbandale, IA 50322
I believe meaningful change begins with connection. I work with adults who want more than surface-level coping strategies. - they want to understand themselves more deeply and find greater emotional clarity and integrity. Many of my clients feel stuck, overwhelmed or disconnected often despite being capable, thoughtful, and outwardly "high-functioning." Anxiety, depression, trauma, and complex family dynamics or relationship patterns are common concerns.
I believe meaningful change begins with connection. I work with adults who want more than surface-level coping strategies. - they want to understand themselves more deeply and find greater emotional clarity and integrity. Many of my clients feel stuck, overwhelmed or disconnected often despite being capable, thoughtful, and outwardly "high-functioning." Anxiety, depression, trauma, and complex family dynamics or relationship patterns are common concerns.
(515) 972-5715 View (515) 972-5715
Photo of Genevieve Salvato - Genevieve Salvato-Counseling for Healing&Wellness, Mental Health Counselor, MS, LMHC, CMIP, CSTS
Genevieve Salvato-Counseling for Healing&Wellness
Mental Health Counselor, MS, LMHC, CMIP, CSTS
Online Only
Have you ever asked yourself, "why am I so unhappy"? Do you find that your relationships go sour way too soon? Do you have a history of trauma? Does your anxiety and depression prevent you from enjoying life? Do you want to improve your self-confidence, self-esteem and regain a sense of purpose and meaning in your life? If so, I believe I can help. When we feel overwhelmed by past trauma experiences, we need a therapist who can navigate the complexities of prolonged trauma exposure. I believe with the right tools I can help you navigate through all of the factors that cause and exacerbate trauma.
Have you ever asked yourself, "why am I so unhappy"? Do you find that your relationships go sour way too soon? Do you have a history of trauma? Does your anxiety and depression prevent you from enjoying life? Do you want to improve your self-confidence, self-esteem and regain a sense of purpose and meaning in your life? If so, I believe I can help. When we feel overwhelmed by past trauma experiences, we need a therapist who can navigate the complexities of prolonged trauma exposure. I believe with the right tools I can help you navigate through all of the factors that cause and exacerbate trauma.
(515) 402-8486 View (515) 402-8486
Photo of Kristin Moore, Clinical Social Work/Therapist, LISW
Kristin Moore
Clinical Social Work/Therapist, LISW
Des Moines, IA 50313
Waitlist for new clients
My work is to support individuals and families facing challenges that stem from co-occurring mental health, developmental, and cognitive disabilities. I believe in partnering with you to offer individualized services that serve to enhance overall independence, resilience, and wellbeing. We will work together collaboratively, connecting and integrating both mind, body, and spirit to heal, grow, develop, and acquire new skills. I specialize in working with individuals and families to decrease maladaptive behavior and build regulation, social, and safety skills. My approach is non-judgmental, playful, educational, and supportive.
My work is to support individuals and families facing challenges that stem from co-occurring mental health, developmental, and cognitive disabilities. I believe in partnering with you to offer individualized services that serve to enhance overall independence, resilience, and wellbeing. We will work together collaboratively, connecting and integrating both mind, body, and spirit to heal, grow, develop, and acquire new skills. I specialize in working with individuals and families to decrease maladaptive behavior and build regulation, social, and safety skills. My approach is non-judgmental, playful, educational, and supportive.
(515) 297-7646 View (515) 297-7646
Photo of Lauren Wright - Lauren Wright Therapy, Counselor, MS, LMHC
Lauren Wright Therapy
Counselor, MS, LMHC
2 Endorsed
Des Moines, IA 50324
Therapy can support people seeking more meaningful and connected relationships with themselves and others. My work is centered around helping my clients deepen their connection with and understanding of themselves, navigate difficult life experiences and develop helpful strategies in order to lead more fulfilling lives. I assist my clients in learning about how the past shows up in the present in order to expand their lives and establish a new future for themselves. I welcome and affirm all identities.
Therapy can support people seeking more meaningful and connected relationships with themselves and others. My work is centered around helping my clients deepen their connection with and understanding of themselves, navigate difficult life experiences and develop helpful strategies in order to lead more fulfilling lives. I assist my clients in learning about how the past shows up in the present in order to expand their lives and establish a new future for themselves. I welcome and affirm all identities.
(515) 523-6379 View (515) 523-6379
Photo of Michaela Jens, Clinical Social Work/Therapist, LISW
Michaela Jens
Clinical Social Work/Therapist, LISW
Online Only
Maybe you’re feeling stuck between who you’ve been and who you’re trying to become. You might be navigating substance use, complicated or painful family dynamics, trauma, or the uncertainty that comes with major life transitions—especially the shift into adulthood. You may feel overwhelmed, disconnected, or unsure of your direction. You want relief from old patterns, clarity about who you are, and tools to build a life that feels more stable, authentic, and meaningful.
Maybe you’re feeling stuck between who you’ve been and who you’re trying to become. You might be navigating substance use, complicated or painful family dynamics, trauma, or the uncertainty that comes with major life transitions—especially the shift into adulthood. You may feel overwhelmed, disconnected, or unsure of your direction. You want relief from old patterns, clarity about who you are, and tools to build a life that feels more stable, authentic, and meaningful.
(515) 316-5514 View (515) 316-5514
Photo of John Bigelow Jr., Psychologist, PsyD
John Bigelow Jr.
Psychologist, PsyD
West Des Moines, IA 50265
I am a licensed clinical psychologist with over 20 years of experience in community mental health. I have worked with clients with a wide range of concerns including depression, anxiety, relationship challenges, trauma and coping with stress and life challenges.
I am a licensed clinical psychologist with over 20 years of experience in community mental health. I have worked with clients with a wide range of concerns including depression, anxiety, relationship challenges, trauma and coping with stress and life challenges.
(515) 461-8981 View (515) 461-8981
Photo of Hallee Maulsby, Licensed Professional Counselor, MA, t-LMHC
Hallee Maulsby
Licensed Professional Counselor, MA, t-LMHC
2 Endorsed
West Des Moines, IA 50266
With a strong grounding in person-centered and trauma-informed care, I am committed to creating a safe, nonjudgmental space where clients feel seen, heard, and supported throughout their healing journey. My clinical interests include anxiety, depression, life transitions, self-esteem development, and chronic pain. I believe in the power of authentic connection and work collaboratively with each client to identify strengths, build resilience, and foster emotional wellness.
With a strong grounding in person-centered and trauma-informed care, I am committed to creating a safe, nonjudgmental space where clients feel seen, heard, and supported throughout their healing journey. My clinical interests include anxiety, depression, life transitions, self-esteem development, and chronic pain. I believe in the power of authentic connection and work collaboratively with each client to identify strengths, build resilience, and foster emotional wellness.
(515) 642-3665 View (515) 642-3665
Photo of Nancy K Miller, Clinical Social Work/Therapist, LISW
Nancy K Miller
Clinical Social Work/Therapist, LISW
1 Endorsed
Des Moines, IA 50312
I'm not like other therapists you may have been to. My dedication for helping others has been fueled by the adversity in my own life. I want my clients to be themselves in my space. I won't tell you what to do, but I'll walk with you while you figure out what the best route is to meet your goals for a healthy life. I enjoy working with young adults and adults who are motivated to find a solution to alleviate their depression, anxiety, ADHD, PTSD, and self-harming behaviors. I have experience working with BPD, pornography issues, infidelity and betrayal trauma, and general life transitions.
I'm not like other therapists you may have been to. My dedication for helping others has been fueled by the adversity in my own life. I want my clients to be themselves in my space. I won't tell you what to do, but I'll walk with you while you figure out what the best route is to meet your goals for a healthy life. I enjoy working with young adults and adults who are motivated to find a solution to alleviate their depression, anxiety, ADHD, PTSD, and self-harming behaviors. I have experience working with BPD, pornography issues, infidelity and betrayal trauma, and general life transitions.
(515) 575-2540 View (515) 575-2540
Photo of Travis David Wentworth, Clinical Social Work/Therapist, LISW, MACM
Travis David Wentworth
Clinical Social Work/Therapist, LISW, MACM
1 Endorsed
West Des Moines, IA 50266
My desire is to meet my clients where they are at. I want them to know that no matter what they’ve been through, there is healing and hope available to them. My goal is to build a strong therapeutic relationship with clients and utilize a variety of techniques in the therapy process to meet the needs of each client. I will integrate faith into the therapeutic process for clients who communicate a desire for this, but I will gladly meet with any client regardless of their background.
My desire is to meet my clients where they are at. I want them to know that no matter what they’ve been through, there is healing and hope available to them. My goal is to build a strong therapeutic relationship with clients and utilize a variety of techniques in the therapy process to meet the needs of each client. I will integrate faith into the therapeutic process for clients who communicate a desire for this, but I will gladly meet with any client regardless of their background.
(515) 585-8469 View (515) 585-8469
Photo of Heather Conover, Counselor, MS, LMHC, C-PD, CCATP, CCTP
Heather Conover
Counselor, MS, LMHC, C-PD, CCATP, CCTP
1 Endorsed
West Des Moines, IA 50265
As a clinical therapist, my foremost commitment is to provide a safe and non-judgmental space for individuals seeking support in managing a wide array of mental health issues. Facing challenges such as anxiety, depression, trauma, bipolar disorder, or personality disorders, my focus is on providing comprehensive treatment tailored to your specific needs. You can trust that I am committed to walking alongside you, offering evidence-based interventions aimed at fostering positive change and promoting your overall well-being.
As a clinical therapist, my foremost commitment is to provide a safe and non-judgmental space for individuals seeking support in managing a wide array of mental health issues. Facing challenges such as anxiety, depression, trauma, bipolar disorder, or personality disorders, my focus is on providing comprehensive treatment tailored to your specific needs. You can trust that I am committed to walking alongside you, offering evidence-based interventions aimed at fostering positive change and promoting your overall well-being.
(515) 373-4756 View (515) 373-4756
Photo of Eric Williamson, Pre-Licensed Professional, tLMHC
Eric Williamson
Pre-Licensed Professional, tLMHC
1 Endorsed
Online Only
If you are reading this, you are most likely considering getting in touch with a therapist. Regardless of the reason or reasons, I believe that it is important for you to recognize and honor your strength in reaching this point. I know that it can be difficult to ask for help, but if you are ready, I am here. Creating an environment that is judgment-free and unwaveringly supportive is exceptionally important to me. My desire is to work with clients who feel that there is something preventing them from living their best and most fulfilling life.
If you are reading this, you are most likely considering getting in touch with a therapist. Regardless of the reason or reasons, I believe that it is important for you to recognize and honor your strength in reaching this point. I know that it can be difficult to ask for help, but if you are ready, I am here. Creating an environment that is judgment-free and unwaveringly supportive is exceptionally important to me. My desire is to work with clients who feel that there is something preventing them from living their best and most fulfilling life.
(515) 461-8595 View (515) 461-8595
Photo of Laura Taggart, Counselor, t-LMHC
Laura Taggart
Counselor, t-LMHC
1 Endorsed
Online Only
A mother’s well-being and mental health have a large impact on not only herself but on her children and family. My passion is supporting women as they navigate the internal and external challenges that come with motherhood and growing a family. We’ll work together to navigate the situations of your choosing. You are the expert of your life and I feel honored to be here to support you and your therapeutic goals, as healing can be a hard thing to do by ourselves. Whether your situation or symptoms are past or present, an individualized approach can help you on your path to personal growth, healing, and mental wellness in the present.
A mother’s well-being and mental health have a large impact on not only herself but on her children and family. My passion is supporting women as they navigate the internal and external challenges that come with motherhood and growing a family. We’ll work together to navigate the situations of your choosing. You are the expert of your life and I feel honored to be here to support you and your therapeutic goals, as healing can be a hard thing to do by ourselves. Whether your situation or symptoms are past or present, an individualized approach can help you on your path to personal growth, healing, and mental wellness in the present.
(515) 855-6970 View (515) 855-6970
Photo of Monica R Wentworth - Healing Collective Counseling, Counselor, MA, LMHC
Healing Collective Counseling
Counselor, MA, LMHC
4 Endorsed
West Des Moines, IA 50266
Immediate openings for telehealth & in person starting 10/13! If you are feeling overwhelmed by anxiety, weighed down by depression, or struggling to make sense of past trauma, you are not alone. Maybe you are a parent seeking compassionate support for your child, or someone who wants to build practical coping skills in a safe, affirming space. You want to feel heard and understood without judgment, and to move toward healing at your own pace. Your hope is to regain control, find peace, and create a life where you can thrive emotionally and authentically.
Immediate openings for telehealth & in person starting 10/13! If you are feeling overwhelmed by anxiety, weighed down by depression, or struggling to make sense of past trauma, you are not alone. Maybe you are a parent seeking compassionate support for your child, or someone who wants to build practical coping skills in a safe, affirming space. You want to feel heard and understood without judgment, and to move toward healing at your own pace. Your hope is to regain control, find peace, and create a life where you can thrive emotionally and authentically.
(515) 679-3416 View (515) 679-3416
Photo of Kathleen Matthews - Perennial Pathways, Psychologist, PhD
Perennial Pathways
Psychologist, PhD
West Des Moines, IA 50266
We work with individuals experiencing confirmed or suspected Alzheimer’s disease and related dementias, as well as the care partners who support them in day‑to‑day life. Many families seek our help to understand changes in their loved one’s thinking, behavior, or functioning and what these shifts mean for identity, daily life, and the future. With more than 15 years of geropsychology experience, we provide compassionate, person‑centered assessment, clear explanations, and evidence‑based strategies that reduce distress, build resilience, and strengthen meaningful connection throughout the dementia journey.
We work with individuals experiencing confirmed or suspected Alzheimer’s disease and related dementias, as well as the care partners who support them in day‑to‑day life. Many families seek our help to understand changes in their loved one’s thinking, behavior, or functioning and what these shifts mean for identity, daily life, and the future. With more than 15 years of geropsychology experience, we provide compassionate, person‑centered assessment, clear explanations, and evidence‑based strategies that reduce distress, build resilience, and strengthen meaningful connection throughout the dementia journey.
(515) 368-9671 View (515) 368-9671
Photo of Keimara Roby, Clinical Social Work/Therapist, LMSW
Keimara Roby
Clinical Social Work/Therapist, LMSW
Des Moines, IA 50311
I'm passionate about supporting teens and young adults as they navigate life’s challenges. Whether you're facing anxiety that feels overwhelming, depression that makes it hard to get through the day, or unresolved trauma that’s impacting your ability to move forward, I’m here to meet you where you are and walk alongside you. I strive to create a warm and open environment where you can reflect, process your experiences, and begin working toward meaningful, lasting change.
I'm passionate about supporting teens and young adults as they navigate life’s challenges. Whether you're facing anxiety that feels overwhelming, depression that makes it hard to get through the day, or unresolved trauma that’s impacting your ability to move forward, I’m here to meet you where you are and walk alongside you. I strive to create a warm and open environment where you can reflect, process your experiences, and begin working toward meaningful, lasting change.
(515) 882-5218 View (515) 882-5218
Photo of Erin Sawhill, Clinical Social Work/Therapist, MSW, LISW, PMH-C
Erin Sawhill
Clinical Social Work/Therapist, MSW, LISW, PMH-C
4 Endorsed
West Des Moines, IA 50266
My belief, self-care is paramount. It is my goal to assist in all areas of life, in order for you to feel balanced & motivated. I work with individuals 16yrs old through adulthood. Whether struggling at home, school, or work I see my role as assisting you & your important others to identify goals, reflect on barriers, & build resources through your own strengths as well as the supports around you. I have earned a certification in Perinatal Mental Health and Gottman Level I. I have personal interest in the Enneagram Types and find significant value in its use to raise insight on an individual & relational level.
My belief, self-care is paramount. It is my goal to assist in all areas of life, in order for you to feel balanced & motivated. I work with individuals 16yrs old through adulthood. Whether struggling at home, school, or work I see my role as assisting you & your important others to identify goals, reflect on barriers, & build resources through your own strengths as well as the supports around you. I have earned a certification in Perinatal Mental Health and Gottman Level I. I have personal interest in the Enneagram Types and find significant value in its use to raise insight on an individual & relational level.
(515) 393-4057 View (515) 393-4057
Photo of Sarah Cammoun-Myers, Counselor, LMHC
Sarah Cammoun-Myers
Counselor, LMHC
1 Endorsed
Urbandale, IA 50322
At Sage Counseling and Wellness, I believe that healing can occur to develop a fulfilling and harmonious life filled with meaningful connections. I strive to help clients discover and feel comfortable with their authentic self and empower them to have the courage to bring that authenticity into their relationships. I believe in the importance of maintaining a supportive and affirming environment throughout the therapeutic process. I welcome people from all walks of life, including but not limited to: LGBTQIA+, BIPOC, and individuals with disabilities by providing a safe and affirming environment to all.
At Sage Counseling and Wellness, I believe that healing can occur to develop a fulfilling and harmonious life filled with meaningful connections. I strive to help clients discover and feel comfortable with their authentic self and empower them to have the courage to bring that authenticity into their relationships. I believe in the importance of maintaining a supportive and affirming environment throughout the therapeutic process. I welcome people from all walks of life, including but not limited to: LGBTQIA+, BIPOC, and individuals with disabilities by providing a safe and affirming environment to all.
(515) 679-5247 View (515) 679-5247
Photo of Emma Sakanovic, Counselor, MS, tLMHC
Emma Sakanovic
Counselor, MS, tLMHC
4 Endorsed
West Des Moines, IA 50266
I believe that therapy is a sacred place where my clients will feel safe, welcome, and heard. Our lives can bring adversity and tribulations that shake us to our core, leaving us lost and alone. With me, you don’t have to be alone in your journey. With 20+ years of experience working with adults in the criminal justice system, I bring patience, empathy, understanding, and a nonjudgmental stance. I am grateful for the opportunity to help you grow and reach your full potential. While we can’t change the past, together we can gain clarity, build healthier coping strategies, and create meaningful change so you can move forward.
I believe that therapy is a sacred place where my clients will feel safe, welcome, and heard. Our lives can bring adversity and tribulations that shake us to our core, leaving us lost and alone. With me, you don’t have to be alone in your journey. With 20+ years of experience working with adults in the criminal justice system, I bring patience, empathy, understanding, and a nonjudgmental stance. I am grateful for the opportunity to help you grow and reach your full potential. While we can’t change the past, together we can gain clarity, build healthier coping strategies, and create meaningful change so you can move forward.
(515) 824-2443 View (515) 824-2443
Photo of Kaylee Wilson, Pre-Licensed Professional, Intern
Kaylee Wilson
Pre-Licensed Professional, Intern
Ankeny, IA 50023
Waitlist for new clients
Hi, I'm Kaylee! I am a Master of Social Work student through the University of Iowa. As part of my clinical training, I’m completing my internship at Thrive Counseling Center under the supervision of Amy Halls, LMFT, and Taylar Aldrich, LISW. I offer free or reduced-price therapy sessions (I do not work with insurance). I work with clients of a variety of backgrounds, ages, and walks of life.
Hi, I'm Kaylee! I am a Master of Social Work student through the University of Iowa. As part of my clinical training, I’m completing my internship at Thrive Counseling Center under the supervision of Amy Halls, LMFT, and Taylar Aldrich, LISW. I offer free or reduced-price therapy sessions (I do not work with insurance). I work with clients of a variety of backgrounds, ages, and walks of life.
(515) 373-2351 View (515) 373-2351

See more therapy options for Polk County

How does your Therapist compare?

Number of Therapists in Polk County, IA

1,000+

Average cost per session

$174

Therapists in Polk County, IA who prioritize treating:

94% Anxiety
87% Depression
74% Relationship Issues
74% Trauma and PTSD
74% Self Esteem
73% Stress
61% Grief

Average years in practice

9 Years

Top 3 insurances accepted

83% BlueCross and BlueShield
76% Wellmark BCBS
59% UnitedHealthcare UHC | UBH

How Therapists in Polk County, IA see their clients

76% In Person and Online
24% Online Only

Gender breakdown

80% Female
18% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Polk County?

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.