Therapists in Seattle, WA

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Photo of Perry Firth, Psychologist in Seattle, WA
Perry Firth
Psychologist, PhD, EdS
Verified Verified
Seattle, WA 98105
The clients I work with often feel different in some way, either because of neurodivergence, trauma, giftedness, or intense anxiety. Simply put, they process the world differently. The parents I see are doing their best to support their children's self-regulation even as they manage their own confusion and fatigue. They are looking for a guide rather than endless parenting blogs. My young adult clients are looking for ways to manage self-criticism, anxiety, and perfectionism. Frequently, they are processing trauma, striving to develop a balanced sense of self, and learning how to navigate relationships.
The clients I work with often feel different in some way, either because of neurodivergence, trauma, giftedness, or intense anxiety. Simply put, they process the world differently. The parents I see are doing their best to support their children's self-regulation even as they manage their own confusion and fatigue. They are looking for a guide rather than endless parenting blogs. My young adult clients are looking for ways to manage self-criticism, anxiety, and perfectionism. Frequently, they are processing trauma, striving to develop a balanced sense of self, and learning how to navigate relationships.
(206) 337-6381 View (206) 337-6381
Photo of Alexa Hutzenbiler, Counselor in Seattle, WA
Alexa Hutzenbiler
Counselor, MA, LMHCA
Verified Verified
Seattle, WA 98126  (Online Only)
Making the decision to come to therapy, whether for the first time or returning to it, is a choice that takes a lot of courage! I primarily work with adults with PTSD who struggle with flashbacks, intrusive thoughts, or avoidance behaviors that are impacting their quality of life and relationships with others. In looking at your patterns of thinking, I'll teach you skills to think more flexibly and to move away from feelings of blame, guilt, and shame. I have worked with a wide variety of people, including individuals with schizophrenia, bipolar disorder, Active Duty Service Members and Veterans, and folks who have legal involvement
Making the decision to come to therapy, whether for the first time or returning to it, is a choice that takes a lot of courage! I primarily work with adults with PTSD who struggle with flashbacks, intrusive thoughts, or avoidance behaviors that are impacting their quality of life and relationships with others. In looking at your patterns of thinking, I'll teach you skills to think more flexibly and to move away from feelings of blame, guilt, and shame. I have worked with a wide variety of people, including individuals with schizophrenia, bipolar disorder, Active Duty Service Members and Veterans, and folks who have legal involvement
(206) 887-9304 View (206) 887-9304
Photo of Brook Avidon, Counselor in Seattle, WA
Brook Avidon
Counselor, MA, LMHC
Verified Verified
Seattle, WA 98118  (Online Only)
Are you creative? In transition? Depressed? Different? Parenting? Re-discovering YOU? Are you wanting to make changes in your life or to heal from old wounds? Do you want to develop self-compassion? Do you want to learn how to be present for your life, to learn mindfulness to help you through the tough times? If so, let’s see if we can create a compassionate, interactive and authentic therapeutic relationship to work collaboratively towards healing. In therapy, I can help you identify your goals, look at what is and isn't working for you, explore your stories, emotions, and experiences (past and present), develop new skills, and embrace your learning styles and talents. I also provide consultation and supervision to therapists.
Are you creative? In transition? Depressed? Different? Parenting? Re-discovering YOU? Are you wanting to make changes in your life or to heal from old wounds? Do you want to develop self-compassion? Do you want to learn how to be present for your life, to learn mindfulness to help you through the tough times? If so, let’s see if we can create a compassionate, interactive and authentic therapeutic relationship to work collaboratively towards healing. In therapy, I can help you identify your goals, look at what is and isn't working for you, explore your stories, emotions, and experiences (past and present), develop new skills, and embrace your learning styles and talents. I also provide consultation and supervision to therapists.
(206) 823-0431 View (206) 823-0431
Photo of Maria Elizabeth Uchytil, Counselor in Seattle, WA
Maria Elizabeth Uchytil
Counselor, MA, LMHCA, SUDP, CC
Verified Verified
1 Endorsed
Seattle, WA 98107
I provide non-judgmental, empathetic, and person-centered approach to therapy. My goal as a licensed counselor will be to develop a collaborative relationship where each client feels empowered to act as an expert in developing healthy coping skills, manage anxiety, depression, navigate difficult life transitions, reduce stress and emotional distress, to enhance communication skills and relationships. In therapy, we can learn to become more aware of our thoughts and actions, of how negative thought patterns and behaviors may be blocking our self-awareness and making us unhappy, and how we can change.
I provide non-judgmental, empathetic, and person-centered approach to therapy. My goal as a licensed counselor will be to develop a collaborative relationship where each client feels empowered to act as an expert in developing healthy coping skills, manage anxiety, depression, navigate difficult life transitions, reduce stress and emotional distress, to enhance communication skills and relationships. In therapy, we can learn to become more aware of our thoughts and actions, of how negative thought patterns and behaviors may be blocking our self-awareness and making us unhappy, and how we can change.
(206) 460-1622 View (206) 460-1622
Photo of Bobby Martin, Marriage & Family Therapist Associate in Seattle, WA
Bobby Martin
Marriage & Family Therapist Associate, MACP, LMHCA
Verified Verified
4 Endorsed
Seattle, WA 98112
My therapeutic orientation is psychodynamic in nature, and based on the observation that people are often unaware of unconscious influences that determine their thoughts and actions.  Lack of awareness can often lead to behavior that constrains their ability to fully comprehend or work through the difficulties they are facing.  My hope is to help remove problematic symptoms that prohibit individuals from participating in meaningful relationships with themselves and others, while working toward leading a full and productive life as an active and positive contributor to their community.
My therapeutic orientation is psychodynamic in nature, and based on the observation that people are often unaware of unconscious influences that determine their thoughts and actions.  Lack of awareness can often lead to behavior that constrains their ability to fully comprehend or work through the difficulties they are facing.  My hope is to help remove problematic symptoms that prohibit individuals from participating in meaningful relationships with themselves and others, while working toward leading a full and productive life as an active and positive contributor to their community.
(206) 339-6835 View (206) 339-6835
Photo of Jennifer Schulz, Counselor in Seattle, WA
Jennifer Schulz
Counselor, MA, LMHC, PhD
Verified Verified
Seattle, WA 98118
I work with individual adult clients and couples who are facing anxiety, depression, life transitions, loss, trauma, and challenges at work or in relationships. Since 2002, I have counseled adults, couples, and groups in community mental health and medical clinics, as well as in my private practice. I have also conducted in-depth research on trauma, hopelessness, empathy, and intimacy. Above all, I believe that my clients, not I, hold the key to their growth and that emotional pain and anxiety, when given respect and non-judgmental attention, can often provide some of the best opportunities for learning.
I work with individual adult clients and couples who are facing anxiety, depression, life transitions, loss, trauma, and challenges at work or in relationships. Since 2002, I have counseled adults, couples, and groups in community mental health and medical clinics, as well as in my private practice. I have also conducted in-depth research on trauma, hopelessness, empathy, and intimacy. Above all, I believe that my clients, not I, hold the key to their growth and that emotional pain and anxiety, when given respect and non-judgmental attention, can often provide some of the best opportunities for learning.
(206) 395-3354 View (206) 395-3354
Photo of Beck Pazdral, Counselor in Seattle, WA
Beck Pazdral
Counselor, MA, DEd, LMHC
Verified Verified
Seattle, WA 98118  (Online Only)
I work with people throughout the state of Washington via telehealth. I have experience with people ages 11 and older of all genders and from a range of lifestyles. I enjoy working with people going through life transitions, working through hurdles that have come up and building tools to work towards a better life and their goals for the future. I specialize in working with neurodiverse people, LGBTQ+, kink and poly populations, as well as people living with disabilities and chronic health conditions. I bring my feminist, sex-positive, healthy at every size philosophy to help empower others to work towards living their best life.
I work with people throughout the state of Washington via telehealth. I have experience with people ages 11 and older of all genders and from a range of lifestyles. I enjoy working with people going through life transitions, working through hurdles that have come up and building tools to work towards a better life and their goals for the future. I specialize in working with neurodiverse people, LGBTQ+, kink and poly populations, as well as people living with disabilities and chronic health conditions. I bring my feminist, sex-positive, healthy at every size philosophy to help empower others to work towards living their best life.
(206) 875-2636 View (206) 875-2636
Photo of Amanda M Speer, Counselor in Seattle, WA
Amanda M Speer
Counselor, LMHC, CPC
Verified Verified
Seattle, WA 98119  (Online Only)
My primary focus is to help clients discover the best version of themselves in a safe, non-judgmental environment. "Only when we are brave enough to explore the darkness will we discover the infinite power of our light"-Bene Brown.
My primary focus is to help clients discover the best version of themselves in a safe, non-judgmental environment. "Only when we are brave enough to explore the darkness will we discover the infinite power of our light"-Bene Brown.
(702) 919-7080 View (702) 919-7080
Photo of Dylan Tizon, Counselor in Seattle, WA
Dylan Tizon
Counselor, MA, LMHCA
Verified Verified
5 Endorsed
Seattle, WA 98115  (Online Only)
Waitlist for new clients
Someone casually asked, “How are you?” when you were out running errands. You're tired of this empty question and a part of you wanted to tell the truth. Honestly, you're f-cking exhausted. Struggling to juggle your grief/anger about the current state of the world, the demands of work, your relationships, and self-care... while also trying to heal from trauma and break toxic generational cycles. It's a LOT. Instead, you answered, “I’m good. You?" This is your life now; pretending everything's fine while, deep down, you know you've got parts of yourself you still don't understand and negative patterns you're ready to leave behind.
Someone casually asked, “How are you?” when you were out running errands. You're tired of this empty question and a part of you wanted to tell the truth. Honestly, you're f-cking exhausted. Struggling to juggle your grief/anger about the current state of the world, the demands of work, your relationships, and self-care... while also trying to heal from trauma and break toxic generational cycles. It's a LOT. Instead, you answered, “I’m good. You?" This is your life now; pretending everything's fine while, deep down, you know you've got parts of yourself you still don't understand and negative patterns you're ready to leave behind.
(206) 678-0889 View (206) 678-0889
Photo of Alexandra Grissom, Marriage & Family Therapist in Seattle, WA
Alexandra Grissom
Marriage & Family Therapist, MS, LMFT
Verified Verified
Seattle, WA 98108  (Online Only)
I am so excited that you have come across AIG Therapy PLLC! My name is Alexandra (she/her) and I am a Licensed Marriage & Family Therapist (LMFT) providing individual therapy services to adults who are: struggling with anxiety, experiencing a life transition, struggle with self-doubt & people pleasing, looking to increase self-esteem & confidence and looking to create sustainable boundaries and balance in life.
I am so excited that you have come across AIG Therapy PLLC! My name is Alexandra (she/her) and I am a Licensed Marriage & Family Therapist (LMFT) providing individual therapy services to adults who are: struggling with anxiety, experiencing a life transition, struggle with self-doubt & people pleasing, looking to increase self-esteem & confidence and looking to create sustainable boundaries and balance in life.
(206) 457-1312 View (206) 457-1312
Photo of Lisa Fann, Counselor in Seattle, WA
Lisa Fann
Counselor, LMHC, MA
Verified Verified
Seattle, WA 98115  (Online Only)
I love working with people who have come to a place in their lives where they want to make changes. Something is not working and they want to create a life with more joy, freedom, love, and integrity. Perhaps they are struggling with depression and anxiety, traumatic memories, difficult relationships, or grief, or perhaps they simply have the sense that they are not living fully. I work with my clients to establish a trusting relationship where they can speak honestly of the matters that most impact them and the events where they have felt anger, fear, grief, and shame.
I love working with people who have come to a place in their lives where they want to make changes. Something is not working and they want to create a life with more joy, freedom, love, and integrity. Perhaps they are struggling with depression and anxiety, traumatic memories, difficult relationships, or grief, or perhaps they simply have the sense that they are not living fully. I work with my clients to establish a trusting relationship where they can speak honestly of the matters that most impact them and the events where they have felt anger, fear, grief, and shame.
(206) 887-9378 View (206) 887-9378
Photo of Candice M Small, Psychologist in Seattle, WA
Candice M Small
Psychologist, PhD
Verified Verified
Seattle, WA 98105
Candice M. Small, PhD, is a licensed psychologist specializing in providing evidence-based treatments for anxiety, depression, and trauma exposure in children and adolescents. She strives to work collaboratively with caregivers and families to identify strengths and challenges in order to help every child succeed. Dr. Small also specializes in comprehensive therapeutic psychological assessment, including diagnostic assessment for Mood Disorders, Learning Disabilities, Attention-Deficit/Hyperactivity Disorder (ADHD), and other learning or executive functioning concerns.
Candice M. Small, PhD, is a licensed psychologist specializing in providing evidence-based treatments for anxiety, depression, and trauma exposure in children and adolescents. She strives to work collaboratively with caregivers and families to identify strengths and challenges in order to help every child succeed. Dr. Small also specializes in comprehensive therapeutic psychological assessment, including diagnostic assessment for Mood Disorders, Learning Disabilities, Attention-Deficit/Hyperactivity Disorder (ADHD), and other learning or executive functioning concerns.
(206) 258-6957 View (206) 258-6957
Photo of Shannon Wittevrongel, Counselor in Seattle, WA
Shannon Wittevrongel
Counselor, MA, LMHC
Verified Verified
2 Endorsed
Seattle, WA 98121
I specialize in eating disorders, dissociative disorders & complex trauma, anxiety, depression, and life transitions. Our bodies hold deep wisdom but for many, as a result of trauma, emotional and physical distress, and systemic oppression, to name a few, the connection to this wisdom has been disrupted and damaged. I will meet you where ever you are at in the process as we learn to listen to what your body and story hold.
I specialize in eating disorders, dissociative disorders & complex trauma, anxiety, depression, and life transitions. Our bodies hold deep wisdom but for many, as a result of trauma, emotional and physical distress, and systemic oppression, to name a few, the connection to this wisdom has been disrupted and damaged. I will meet you where ever you are at in the process as we learn to listen to what your body and story hold.
(206) 203-9799 View (206) 203-9799
Photo of Dr. Gary Bell, Marriage & Family Therapist in Seattle, WA
Dr. Gary Bell
Marriage & Family Therapist, Ed D, LMFT
Verified Verified
Seattle, WA 98115
I have worked with tens of thousands of clients with issues ranging from trauma, relationship issues, anxiety, depression, communication, parenting, work frustrations, suicidality, sudden life change, and more. My goal is for you to experience peace in your life, stop merely coping, and start thriving in the present. I believe in the importance of living in this moment that we’ve been given, and I want you to experience the abundant joy and freedom that comes from God. Don’t wait another day; invest in yourself today. I look forward to working with you to overcome past barriers so you can fully enjoy your life each moment.
I have worked with tens of thousands of clients with issues ranging from trauma, relationship issues, anxiety, depression, communication, parenting, work frustrations, suicidality, sudden life change, and more. My goal is for you to experience peace in your life, stop merely coping, and start thriving in the present. I believe in the importance of living in this moment that we’ve been given, and I want you to experience the abundant joy and freedom that comes from God. Don’t wait another day; invest in yourself today. I look forward to working with you to overcome past barriers so you can fully enjoy your life each moment.
(206) 426-0376 View (206) 426-0376
Photo of Meagan M. Hyde, Marriage & Family Therapist in Seattle, WA
Meagan M. Hyde
Marriage & Family Therapist, MS, LMFT
Verified Verified
2 Endorsed
Seattle, WA 98105  (Online Only)
Are you struggling with communication and unable to resolve conflict in your relationship? Do you feel stuck, misunderstood, unappreciated or dismissed? Uncertain whether things can actually change? If so, I can help. As an empathic advocate for you and your relationship, I help you to explore and expand perspectives, hear different sides, learn and practice communication skills for more productive conversations and be able to resolve gridlocked conflict more effectively. We work together to set goals and create a roadmap for making progress, and I provide support and feedback about what it will take to reach your goals.
Are you struggling with communication and unable to resolve conflict in your relationship? Do you feel stuck, misunderstood, unappreciated or dismissed? Uncertain whether things can actually change? If so, I can help. As an empathic advocate for you and your relationship, I help you to explore and expand perspectives, hear different sides, learn and practice communication skills for more productive conversations and be able to resolve gridlocked conflict more effectively. We work together to set goals and create a roadmap for making progress, and I provide support and feedback about what it will take to reach your goals.
(425) 374-0852 View (425) 374-0852
Photo of Cary Terra, Marriage & Family Therapist in Seattle, WA
Cary Terra
Marriage & Family Therapist, MA, LMFT
Verified Verified
Seattle, WA 98116
My practice is limited to working with adults on the spectrum and adults with symptoms of trauma.
My practice is limited to working with adults on the spectrum and adults with symptoms of trauma.
(206) 890-4858 View (206) 890-4858
Photo of Inner Peace Counseling, Psychologist in Seattle, WA
Inner Peace Counseling
Psychologist, PsyD
Verified Verified
Seattle, WA 98101  (Online Only)
The daily struggles of life, loss, relationships, and health are real. But we are not supposed to face them alone. We may not choose the pain that comes our way, but we can choose how we respond. Inner peace and strength are gifts from God — gifts that are within our reach. I will partner with you in your journey toward healing, providing the resources and space you need to apply faith and skill in everyday life.
The daily struggles of life, loss, relationships, and health are real. But we are not supposed to face them alone. We may not choose the pain that comes our way, but we can choose how we respond. Inner peace and strength are gifts from God — gifts that are within our reach. I will partner with you in your journey toward healing, providing the resources and space you need to apply faith and skill in everyday life.
(206) 208-0278 View (206) 208-0278
Photo of Michelle Jones, Counselor in Seattle, WA
Michelle Jones
Counselor, MA, LMHC
Verified Verified
Seattle, WA 98104  (Online Only)
Are you a new mother who is juggling life with young kids? Are just now coming up for air after the complex newborn months? Are you yearning to get reoriented? The fact that you’re here highlights that you are both suffering deeply and deeply resourceful. I believe you are wiser than you know, and I trust that with some support, you can reconnect to your deep knowing. I would be honored to partner with you in discovering what is no longer serving you and exploring subtle shifts in how you want to relate to yourself and others. Even though your outside world may not change, your experience can be different. You can flourish.
Are you a new mother who is juggling life with young kids? Are just now coming up for air after the complex newborn months? Are you yearning to get reoriented? The fact that you’re here highlights that you are both suffering deeply and deeply resourceful. I believe you are wiser than you know, and I trust that with some support, you can reconnect to your deep knowing. I would be honored to partner with you in discovering what is no longer serving you and exploring subtle shifts in how you want to relate to yourself and others. Even though your outside world may not change, your experience can be different. You can flourish.
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Photo of Cynthia Wilson, Counselor in Seattle, WA
Cynthia Wilson
Counselor, MA, LMHC
Verified Verified
Seattle, WA 98115
The life you want is already inside you, so I invite you to discover what you might need to change and accept in order to heal and grow. Patterns of relationship or ideas about yourself that helped you survive in the past may be limiting how you engage with the world today. Re-finding the parts of ourselves that haven’t been welcomed can bring a profound new sense of wellbeing. My goal as a therapist is to create the safe, accepting relationship in which that deeply satisfying life can grow.
The life you want is already inside you, so I invite you to discover what you might need to change and accept in order to heal and grow. Patterns of relationship or ideas about yourself that helped you survive in the past may be limiting how you engage with the world today. Re-finding the parts of ourselves that haven’t been welcomed can bring a profound new sense of wellbeing. My goal as a therapist is to create the safe, accepting relationship in which that deeply satisfying life can grow.
(206) 385-5698 View (206) 385-5698
Photo of Annette Ramos-Miranda, Counselor in Seattle, WA
Annette Ramos-Miranda
Counselor, PhD, LMHC, MHP
Verified Verified
Seattle, WA 98101  (Online Only)
As human being, I know that life situations could be difficult to manage by our own. However, past traumas, bad relationships (toxic/domestic abuse), stress, divorces, financial struggles, mental health disorders, depression, grieves...DON"T have to determine our life moving forward. IT IS POSSIBLE to recover from those big stones that we find in our life path! I love to work with my clients from a healing/recovery perspective and none judgmental attitude to help them get a better quality of life.
As human being, I know that life situations could be difficult to manage by our own. However, past traumas, bad relationships (toxic/domestic abuse), stress, divorces, financial struggles, mental health disorders, depression, grieves...DON"T have to determine our life moving forward. IT IS POSSIBLE to recover from those big stones that we find in our life path! I love to work with my clients from a healing/recovery perspective and none judgmental attitude to help them get a better quality of life.
(253) 215-1986 View (253) 215-1986

How does your Therapist compare?

Number of Therapists in Seattle, WA

3,000+

Average cost per session

$150

Therapists in Seattle, WA who prioritize treating:

93% Anxiety
86% Depression
79% Relationship Issues
76% Self Esteem
72% Trauma and PTSD
71% Stress
69% Life Transitions

Average years in practice

9 Years

Top 3 insurances accepted

70% Premera
53% Aetna
47% Regence

How Therapists in Seattle, WA see their clients

51% Online Only
49% In Person and Online

Gender breakdown

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

How can I find a therapist in Seattle?

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.