Therapists in Spokane, WA

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Photo of Jameson C Lontz, Psychologist in Spokane, WA
Jameson C Lontz
Psychologist, PhD
Verified Verified
Spokane, WA 99201
Blue Mountain Psychology is committed to excellent therapeutic services including comprehensive forensic, neuropsychological, and psychological assessments while treating each person with dignity, integrity, and respect in a compassionate environment. Blue Mountain's mission is to maximize independence and individual accomplishments toward improved participation in society. Comprehensive, objective, unbiased forensic, neuropsychological, and psychological evaluations include testing in the areas of intelligence (IQ), memory, sensorimotor, language, academic, attention, concentration, executive, and psychosocial functions as indicated. Please visit our website for more information, to make a referral, or schedule an appointment: www.bluemountainpsychology.com
Blue Mountain Psychology is committed to excellent therapeutic services including comprehensive forensic, neuropsychological, and psychological assessments while treating each person with dignity, integrity, and respect in a compassionate environment. Blue Mountain's mission is to maximize independence and individual accomplishments toward improved participation in society. Comprehensive, objective, unbiased forensic, neuropsychological, and psychological evaluations include testing in the areas of intelligence (IQ), memory, sensorimotor, language, academic, attention, concentration, executive, and psychosocial functions as indicated. Please visit our website for more information, to make a referral, or schedule an appointment: www.bluemountainpsychology.com
(509) 724-2326 View (509) 724-2326
Photo of Maria Guadalupe Bazzell, Counselor in Spokane, WA
Maria Guadalupe Bazzell
Counselor, MA, LMHC, CMHS, NCC
Verified Verified
Spokane, WA 99201
Currently accepting Kaiser PPO or self-pay only. If you've been thinking about starting counseling but you're not sure, start today anyway. I am a licensed mental health therapist in Washington State and identify as a cisgender Latinx woman who also speaks Spanish. I have been working in the counseling field for over 8 years and have really enjoyed working with young children and their caregivers. I have specialized training and techniques that can support you and your family strengthen your family unit and build up your supports and tools you need to have better communication while strengthening your relationships.
Currently accepting Kaiser PPO or self-pay only. If you've been thinking about starting counseling but you're not sure, start today anyway. I am a licensed mental health therapist in Washington State and identify as a cisgender Latinx woman who also speaks Spanish. I have been working in the counseling field for over 8 years and have really enjoyed working with young children and their caregivers. I have specialized training and techniques that can support you and your family strengthen your family unit and build up your supports and tools you need to have better communication while strengthening your relationships.
(509) 316-2970 View (509) 316-2970
Photo of J. Zimmerman & Associates PLLC, Counselor in Spokane, WA
J. Zimmerman & Associates PLLC
Counselor, LMHCA
Verified Verified
Spokane, WA 99204
Have you experienced trauma/s that you were able to find a resolution to? Struggling to meet your goals at home, work, social situations, relationships or life in general and looking to improve your situation and ready for change? Evidence indicates that unresolved traumas can create mental & behavioral blockages that erode our sense of autonomy leaving us reliving our traumas and reacting automatically before we may even know why. At J. Zimmerman & Associates we provide EMDR psychotherapies that are observed to have reduce the effects of trauma & can help eliminate the maladaptive reactions we have to our traumatic pasts.
Have you experienced trauma/s that you were able to find a resolution to? Struggling to meet your goals at home, work, social situations, relationships or life in general and looking to improve your situation and ready for change? Evidence indicates that unresolved traumas can create mental & behavioral blockages that erode our sense of autonomy leaving us reliving our traumas and reacting automatically before we may even know why. At J. Zimmerman & Associates we provide EMDR psychotherapies that are observed to have reduce the effects of trauma & can help eliminate the maladaptive reactions we have to our traumatic pasts.
(509) 410-4650 View (509) 410-4650
Photo of Christie Champoux, Clinical Social Work/Therapist in Spokane, WA
Christie Champoux
Clinical Social Work/Therapist, MSW, LICSW, CMHS, CCATP
Verified Verified
1 Endorsed
Spokane, WA 99218
At times the challenges life puts before us can become overwhelming. I believe that by working together we can overcome these challenges. I have had over 25 years experience working with children, adolescents, young adults and families. I have focused on depression, anxiety, grief/loss, obsessive compulsive disorders, stress management, PTSD and a variety of other behavioral and emotional issues. In my practice I utilize a variety of modalities including Cognitive Behavioral Therapy, Mindfulness Based Cognitive Behavioral Therapy and Trauma Focused Cognitive Behavioral Therapy. In addition I am a Certified Anxiety Specialist.
At times the challenges life puts before us can become overwhelming. I believe that by working together we can overcome these challenges. I have had over 25 years experience working with children, adolescents, young adults and families. I have focused on depression, anxiety, grief/loss, obsessive compulsive disorders, stress management, PTSD and a variety of other behavioral and emotional issues. In my practice I utilize a variety of modalities including Cognitive Behavioral Therapy, Mindfulness Based Cognitive Behavioral Therapy and Trauma Focused Cognitive Behavioral Therapy. In addition I am a Certified Anxiety Specialist.
(509) 941-2419 View (509) 941-2419
Photo of Billie Tyler, Marriage & Family Therapist in Spokane, WA
Billie Tyler
Marriage & Family Therapist, PhD, LMFT
Verified Verified
4 Endorsed
Spokane, WA 99204
We are all involved in relationships, with others and ourselves. These relationships evolve and change over time. At times, we can feel frustrated, unappreciated, misunderstood, or just on different pages. I offer an open, warm, and engaging environment. Through a process of thoughtful discovery we will focus on strengths and build from there. Often, we already have what we need to find satisfying and fulfilling bonds. For couples this may be seeking more intimacy, for families we may work on communication, for parents of younger children we may work on growing parenting skills and increasing positive behavior from children. The possibilities are endless.
We are all involved in relationships, with others and ourselves. These relationships evolve and change over time. At times, we can feel frustrated, unappreciated, misunderstood, or just on different pages. I offer an open, warm, and engaging environment. Through a process of thoughtful discovery we will focus on strengths and build from there. Often, we already have what we need to find satisfying and fulfilling bonds. For couples this may be seeking more intimacy, for families we may work on communication, for parents of younger children we may work on growing parenting skills and increasing positive behavior from children. The possibilities are endless.
(509) 792-3487 View (509) 792-3487
Photo of Jordan McCann, Counselor in Spokane, WA
Jordan McCann
Counselor, LMHC
Verified Verified
1 Endorsed
Spokane, WA 99218
My experience is primarily with children, young adults and couples. I also work with depression, anxiety and traumatic experiences. I am trained in Cognitive Behavioral Therapy and Dialectical Behavior Therapy and have extensive training in couples counseling techniques. I enjoy humor and like to use it in therapy when appropriate.
My experience is primarily with children, young adults and couples. I also work with depression, anxiety and traumatic experiences. I am trained in Cognitive Behavioral Therapy and Dialectical Behavior Therapy and have extensive training in couples counseling techniques. I enjoy humor and like to use it in therapy when appropriate.
(509) 414-7999 View (509) 414-7999
Photo of Lisa Lester, Counselor in Spokane, WA
Lisa Lester
Counselor, MA, LMHC, SUDP
Verified Verified
1 Endorsed
Spokane, WA 99218
Not accepting new clients
I am experienced in individual and family therapy and utilize evidence based practices along with empathy, collaboration and humor to address your unique concerns, needs and circumstances. I have a wide range of experience with many different issues, including depression, anxiety, substance use disorders, trauma, grief and loss, relationship struggles, behavioral issues and parenting skills. I primarily work with clients from school age to middle adulthood.
I am experienced in individual and family therapy and utilize evidence based practices along with empathy, collaboration and humor to address your unique concerns, needs and circumstances. I have a wide range of experience with many different issues, including depression, anxiety, substance use disorders, trauma, grief and loss, relationship struggles, behavioral issues and parenting skills. I primarily work with clients from school age to middle adulthood.
(509) 245-2212 View (509) 245-2212
Photo of Janice M Huston, Counselor in Spokane, WA
Janice M Huston
Counselor, MA, LMHC, LPCC
Verified Verified
Spokane, WA 99208  (Online Only)
Waitlist for new clients
I work with teens and adults who are in search of relief from stress, anxiety, panic, anger, low-self-esteem, depression, and relationship issues such as codependency. In my practice, I recognize that being human is complex. Big and small traumas can hold someone back from taking care of themselves, seeing their potential, forming meaningful relationships, taking aligned risks, and living an authentic life. If you are interested in getting to the root of lifelong patterns and emotional triggers that are keeping you from living your best life, then I would love to join you on your healing journey.
I work with teens and adults who are in search of relief from stress, anxiety, panic, anger, low-self-esteem, depression, and relationship issues such as codependency. In my practice, I recognize that being human is complex. Big and small traumas can hold someone back from taking care of themselves, seeing their potential, forming meaningful relationships, taking aligned risks, and living an authentic life. If you are interested in getting to the root of lifelong patterns and emotional triggers that are keeping you from living your best life, then I would love to join you on your healing journey.
(509) 778-5290 View (509) 778-5290
Heidi C. Neddo
Counselor, LMHC, MHP, CMHS
Verified Verified
1 Endorsed
Spokane, WA 99218
Are you concerned with a personal issue, overwhelmed by stress or worries, burdened by depression or anxiety? Are you trying to deal with a traumatic event in your life, past sexual abuse or emotional abuse? Are you struggling with family or relationship conflicts? Everyone encounters situations when one feels lost, unable to cope, or needs support and guidance. If you're looking for relief from pain; compassionate, nonjudgmental support and guidance; hope for improvement; and lasting change, counseling can help! Research shows that therapy can lead to increased happiness, productive coping mechanisms, fulfilling relationships and improved physical health.
Are you concerned with a personal issue, overwhelmed by stress or worries, burdened by depression or anxiety? Are you trying to deal with a traumatic event in your life, past sexual abuse or emotional abuse? Are you struggling with family or relationship conflicts? Everyone encounters situations when one feels lost, unable to cope, or needs support and guidance. If you're looking for relief from pain; compassionate, nonjudgmental support and guidance; hope for improvement; and lasting change, counseling can help! Research shows that therapy can lead to increased happiness, productive coping mechanisms, fulfilling relationships and improved physical health.
(509) 424-5180 View (509) 424-5180
Photo of Kimberly Lemus, Clinical Social Work/Therapist in Spokane, WA
Kimberly Lemus
Clinical Social Work/Therapist, Lcswa
Verified Verified
Spokane, WA 99201  (Online Only)
I have worked with every population ranging from 4 years old to 60. I specialize in working on reducing stress, understanding triggers, working on dealing with everyday life issues. I have experience on anxiety, depression, suicidal ideation, divorce, and post partum depression. I am a very empathetic and understanding person, I work at your pace and help you set the goals you want for your therapy. This is about what YOU want for yourself.
I have worked with every population ranging from 4 years old to 60. I specialize in working on reducing stress, understanding triggers, working on dealing with everyday life issues. I have experience on anxiety, depression, suicidal ideation, divorce, and post partum depression. I am a very empathetic and understanding person, I work at your pace and help you set the goals you want for your therapy. This is about what YOU want for yourself.
(509) 397-7639 View (509) 397-7639
Photo of Oscar G Haupt, Clinical Social Work/Therapist in Spokane, WA
Oscar G Haupt
Clinical Social Work/Therapist, LCSW
Verified Verified
Spokane, WA 99201
My name is Oscar and I have been helping people for over three decades. Over the years and in my own personal life, I have discovered that life is a long journey. During this journey, we experience ups and downs, darkness and lightness, silence and loudness. At times, the journey feels effortless. Other times it feels very taxing.
My name is Oscar and I have been helping people for over three decades. Over the years and in my own personal life, I have discovered that life is a long journey. During this journey, we experience ups and downs, darkness and lightness, silence and loudness. At times, the journey feels effortless. Other times it feels very taxing.
(509) 337-4904 View (509) 337-4904
Photo of Jillian Jessup, Counselor in Spokane, WA
Jillian Jessup
Counselor, MS, LMHCA
Verified Verified
1 Endorsed
Spokane, WA 99203
Welcome! I'm dedicated to fostering a compassionate, authentic, & supportive environment for individuals seeking healing and personal growth. Life's journey can present challenges that feel overwhelming, but I firmly believe that with support, we can navigate these obstacles & emerge stronger. With over 12 years of experience spanning across children, adolescents, and adults, my approach is tailored to meet each client's unique needs and goals. While specializing in anxiety & depressive disorders, I also have extensive experience supporting clients through various challenges, including relationship difficulties, & life transitions.
Welcome! I'm dedicated to fostering a compassionate, authentic, & supportive environment for individuals seeking healing and personal growth. Life's journey can present challenges that feel overwhelming, but I firmly believe that with support, we can navigate these obstacles & emerge stronger. With over 12 years of experience spanning across children, adolescents, and adults, my approach is tailored to meet each client's unique needs and goals. While specializing in anxiety & depressive disorders, I also have extensive experience supporting clients through various challenges, including relationship difficulties, & life transitions.
(509) 285-1768 View (509) 285-1768
Photo of Andria Nicolle Hollingshead, Counselor in Spokane, WA
Andria Nicolle Hollingshead
Counselor, NCC, LIMHP, SUD, LPC, LADC
Verified Verified
1 Endorsed
Spokane, WA 99208
Hello, I am a licensed therapist and substance abuse counselor in Washington, Nebraska and by telehealth in Idaho; I have been doing therapy with veterans at the Veteran Affairs for 10 years decided it was time to take a step into the private practice sector. I am trained in the top 3 trauma therapies (EMDR, PE and CPT), all of my practice is grounded in somatics, neuroscience and strengths based. I use humor within therapy when appropriate, I believe I learn as much you as you might from me. I have primary experience and formalized supervision in doing trauma, addiction, anxiety therapies.
Hello, I am a licensed therapist and substance abuse counselor in Washington, Nebraska and by telehealth in Idaho; I have been doing therapy with veterans at the Veteran Affairs for 10 years decided it was time to take a step into the private practice sector. I am trained in the top 3 trauma therapies (EMDR, PE and CPT), all of my practice is grounded in somatics, neuroscience and strengths based. I use humor within therapy when appropriate, I believe I learn as much you as you might from me. I have primary experience and formalized supervision in doing trauma, addiction, anxiety therapies.
(509) 412-3645 View (509) 412-3645
Photo of Harvey Caine, Counselor in Spokane, WA
Harvey Caine
Counselor, CC, LMP
Verified Verified
Spokane, WA 99202
I specialize in helping the whole person, body, mind and spirit. I offer non traditional approaches to counseling, focused on identifying and healing the underlying causes to problems.With over 30 years experience as an intuitive counselor and massage therapist I also utilize my expertise in the mind-body connection to help you transform your life and reach your goals efficiently.
I specialize in helping the whole person, body, mind and spirit. I offer non traditional approaches to counseling, focused on identifying and healing the underlying causes to problems.With over 30 years experience as an intuitive counselor and massage therapist I also utilize my expertise in the mind-body connection to help you transform your life and reach your goals efficiently.
(509) 572-3833 View (509) 572-3833
Photo of Cathlene Dunlap, Counselor in Spokane, WA
Cathlene Dunlap
Counselor, MS, LMHC, MHP
Verified Verified
1 Endorsed
Spokane, WA 99218  (Online Only)
Waitlist for new clients
I deeply enjoy being a therapist and working with all types of people. Relationship issues and eating disorders are a couple of areas that I specialize. I have an attachment focused approach that integrates several interventions such as ACT, DBT and mindfulness.
I deeply enjoy being a therapist and working with all types of people. Relationship issues and eating disorders are a couple of areas that I specialize. I have an attachment focused approach that integrates several interventions such as ACT, DBT and mindfulness.
(509) 215-2035 View (509) 215-2035
Photo of Rooted In Hope Counseling, Marriage & Family Therapist in Spokane, WA
Rooted In Hope Counseling
Marriage & Family Therapist
Verified Verified
Spokane, WA 99202
Rooted in Hope Counseling is a small private group practice. All of our therapists are at varying stages of life both professionally and personally making finding the right fit for you possible. We seek to meet clients where they are at in their own life journey and support them with whatever it is they are currently desiring to work on, through, or towards.
Rooted in Hope Counseling is a small private group practice. All of our therapists are at varying stages of life both professionally and personally making finding the right fit for you possible. We seek to meet clients where they are at in their own life journey and support them with whatever it is they are currently desiring to work on, through, or towards.
(509) 257-4551 View (509) 257-4551
Photo of Ray William Smith, Counselor in Spokane, WA
Ray William Smith
Counselor, EdD, DMin
Verified Verified
Spokane, WA 99218
Do You Want the Pain to Stop? From time to time, life gives us difficult issues. Having someone who will listen, and who has the ability to offer useful guidance, can be helpful. We work together to end your turmoil and pain in as brief amount of time as possible. Gaining new insights and skills can help resolve tough issues, even long-standing ones. - Please Share Your Story With Me - The issues in our lives that cause us emotional pain or that we struggle with fall into some general categories.
Do You Want the Pain to Stop? From time to time, life gives us difficult issues. Having someone who will listen, and who has the ability to offer useful guidance, can be helpful. We work together to end your turmoil and pain in as brief amount of time as possible. Gaining new insights and skills can help resolve tough issues, even long-standing ones. - Please Share Your Story With Me - The issues in our lives that cause us emotional pain or that we struggle with fall into some general categories.
(509) 293-9795 x1 View (509) 293-9795 x1
Photo of Traverse Therapy Services, Clinical Social Work/Therapist in Spokane, WA
Traverse Therapy Services
Clinical Social Work/Therapist, LCSWAA
Verified Verified
Spokane, WA 99216
I'm Yasmin often I hear from those I work with that they just don't feel like themselves anymore, feeling like they are just going through the motions of life; does this resonate with you? Our mental wellness and our journey in achieving it can be challenging, confusing and maybe even scary, but finding relief and becoming the version of yourself you long to be does not have to be done alone. Whether it is a life shift like welcoming a new baby or just being ready to address past trauma. My approach is multi-dimensional and client centered; what works for you is unique and dependent on your needs and reflective of your unique needs.
I'm Yasmin often I hear from those I work with that they just don't feel like themselves anymore, feeling like they are just going through the motions of life; does this resonate with you? Our mental wellness and our journey in achieving it can be challenging, confusing and maybe even scary, but finding relief and becoming the version of yourself you long to be does not have to be done alone. Whether it is a life shift like welcoming a new baby or just being ready to address past trauma. My approach is multi-dimensional and client centered; what works for you is unique and dependent on your needs and reflective of your unique needs.
(509) 400-5416 View (509) 400-5416
Photo of Nick Mehrnoosh, Counselor in Spokane, WA
Nick Mehrnoosh
Counselor, MS, LMHC
Verified Verified
Spokane, WA 99201
In the therapeutic process, my core belief is that everyone should feel a sense of trust and respect, with the autonomy to make their own decisions. Thus, my role is to empower and enable my clients to achieve their goals in improving their quality of life. The process can be difficult and disheartening, but the path is far from impossible to forge. My practice integrates empirical research and clinical interventions through a person-centered approach. From this perspective, the client and therapist create a collaborative atmosphere of trust and respect that envisions the client’s best possible treatment trajectory.
In the therapeutic process, my core belief is that everyone should feel a sense of trust and respect, with the autonomy to make their own decisions. Thus, my role is to empower and enable my clients to achieve their goals in improving their quality of life. The process can be difficult and disheartening, but the path is far from impossible to forge. My practice integrates empirical research and clinical interventions through a person-centered approach. From this perspective, the client and therapist create a collaborative atmosphere of trust and respect that envisions the client’s best possible treatment trajectory.
(509) 519-1627 View (509) 519-1627
Photo of Alita Crosby, Marriage & Family Therapist Associate in Spokane, WA
Alita Crosby
Marriage & Family Therapist Associate, MA, LMFTA
Verified Verified
2 Endorsed
Spokane, WA 99208
I work with teens, adults, couples and families to strengthen self-love, navigate challenging personal and professional relationships, and increase connections that align with your value system. These and other stressors such as anxiety, trauma, abuse, and marital, family or work-place strife can weaken the body's ability to be as effective in life. My goal is to help explore what events or dynamics affect you and how that impacts your well-being.
I work with teens, adults, couples and families to strengthen self-love, navigate challenging personal and professional relationships, and increase connections that align with your value system. These and other stressors such as anxiety, trauma, abuse, and marital, family or work-place strife can weaken the body's ability to be as effective in life. My goal is to help explore what events or dynamics affect you and how that impacts your well-being.
(509) 402-1945 View (509) 402-1945

How does your Therapist compare?

Number of Therapists in Spokane, WA

1,000+

Average cost per session

$135

Therapists in Spokane, WA who prioritize treating:

92% Anxiety
87% Depression
77% Self Esteem
74% Trauma and PTSD
73% Relationship Issues
73% Stress
71% Coping Skills

Average years in practice

8 Years

Top 3 insurances accepted

73% Premera
72% Aetna
58% Regence

How Therapists in Spokane, WA see their clients

52% In Person and Online
48% Online Only

Gender breakdown

80% Female
19% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Spokane?

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.