Therapists in Las Vegas, NV

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Photo of Kristin Paragas, Clinical Social Work/Therapist in Las Vegas, NV
Kristin Paragas
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Las Vegas, NV 89117
Waitlist for new clients
I am a believer we have the power to change an ending to a story we once knew. I currently work with preteens, families, young adults, elderly and couples who deals with different problems or challenges in their lives. I am passionate working with those who are motivated & ready to face their painful emotions, break free from unhealthy or toxic patterns, heal from their past hurt from their childhood, working through grief & the loss of a loved one, relationship problems, career changes, past trauma, depression, & anxiety.
I am a believer we have the power to change an ending to a story we once knew. I currently work with preteens, families, young adults, elderly and couples who deals with different problems or challenges in their lives. I am passionate working with those who are motivated & ready to face their painful emotions, break free from unhealthy or toxic patterns, heal from their past hurt from their childhood, working through grief & the loss of a loved one, relationship problems, career changes, past trauma, depression, & anxiety.
(702) 842-2808 View (702) 842-2808
Photo of Kechia Thomas English, Marriage & Family Therapist in Las Vegas, NV
Kechia Thomas English
Marriage & Family Therapist, MA, MFT
Verified Verified
Las Vegas, NV 89129
I provide therapeutic services designed to strengthen functioning and increase emotional well-being of individual's, couple's, and family's through the means of counseling, coaching, and consultation. I am an empathic clinician who approaches client concerns in an open, honest yet straight forward manner, meeting clients where they are.
I provide therapeutic services designed to strengthen functioning and increase emotional well-being of individual's, couple's, and family's through the means of counseling, coaching, and consultation. I am an empathic clinician who approaches client concerns in an open, honest yet straight forward manner, meeting clients where they are.
(702) 829-5177 View (702) 829-5177
Photo of Trevor Milazzo, Clinical Social Work/Therapist in Las Vegas, NV
Trevor Milazzo
Clinical Social Work/Therapist, BA, MSW, LCSW
Verified Verified
Las Vegas, NV 89123  (Online Only)
Waitlist for new clients
Dually licensed in NV & UT, In my experience there is no such thing as an "ideal client". Each participant in the therapeutic process comes with their own set of unique , complexed, life experiences and current challenges. As the therapist it is my role to provide a safe container to collaborate with the participant in identifying their issues, wants, needs, goals, eventually discovering the why. I operate from systems theory
Dually licensed in NV & UT, In my experience there is no such thing as an "ideal client". Each participant in the therapeutic process comes with their own set of unique , complexed, life experiences and current challenges. As the therapist it is my role to provide a safe container to collaborate with the participant in identifying their issues, wants, needs, goals, eventually discovering the why. I operate from systems theory
(702) 718-3453 View (702) 718-3453
Photo of Michele Green, Clinical Social Work/Therapist in Las Vegas, NV
Michele Green
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Las Vegas, NV 89141  (Online Only)
Do you feel a lack of empathy from others or that they just don't understand? Life doesn't have to be this challenging. I specialize in helping clients to overcome relationship issues, anxiety, anger management, and depression, with a keen focus on PTSD, trauma, and navigating the effects of gaslighting.
Do you feel a lack of empathy from others or that they just don't understand? Life doesn't have to be this challenging. I specialize in helping clients to overcome relationship issues, anxiety, anger management, and depression, with a keen focus on PTSD, trauma, and navigating the effects of gaslighting.
(702) 475-8339 View (702) 475-8339
Photo of Darya Shahbazy, LPC Intern in Las Vegas, NV
Darya Shahbazy
LPC Intern, MA, NCC, LCPC-I
Verified Verified
1 Endorsed
Las Vegas, NV 89120
(Accepting New Clients) ——- (Offering Teletherapy) I provide therapy for individuals, couples, and families. We all experience struggles and hardships in life. You do not have to face life's challenges alone. I strive to provide a safe, empathic, nonjudgmental, and confidential atmosphere so that we can explore your concerns and overcome life’s challenges. I am certified in biofeedback and provide various modalities of treatment to meet your personal theraputic needs and development. I also have a strong understanding and training in multiculturalism and diversity consciousness.
(Accepting New Clients) ——- (Offering Teletherapy) I provide therapy for individuals, couples, and families. We all experience struggles and hardships in life. You do not have to face life's challenges alone. I strive to provide a safe, empathic, nonjudgmental, and confidential atmosphere so that we can explore your concerns and overcome life’s challenges. I am certified in biofeedback and provide various modalities of treatment to meet your personal theraputic needs and development. I also have a strong understanding and training in multiculturalism and diversity consciousness.
(702) 872-2349 View (702) 872-2349
Photo of Jennifer Tripp-Herring, Pre-Licensed Professional in Las Vegas, NV
Jennifer Tripp-Herring
Pre-Licensed Professional, MS, MFT-I
Verified Verified
1 Endorsed
Las Vegas, NV 89144
Now accepting clients Mondays at 2pm & Tuesdays at 5pm! “The only evidence of life is growth." Is life bringing growth in the form of overwhelming change/ challenges? I hear you. Here, you are offered a truly unique space: one of empathy, acceptance, and growth! We'll explore your experience to create a plan that leads to the clarity and well-being you deserve. You CAN attain peace and progress! All this and more is gained through validating support and empowering solutions tailored to you. Even good changes can seem intimidating; I commend you for a courageous first step of venturing into this expressive and progressive journey...
Now accepting clients Mondays at 2pm & Tuesdays at 5pm! “The only evidence of life is growth." Is life bringing growth in the form of overwhelming change/ challenges? I hear you. Here, you are offered a truly unique space: one of empathy, acceptance, and growth! We'll explore your experience to create a plan that leads to the clarity and well-being you deserve. You CAN attain peace and progress! All this and more is gained through validating support and empowering solutions tailored to you. Even good changes can seem intimidating; I commend you for a courageous first step of venturing into this expressive and progressive journey...
(702) 291-9576 View (702) 291-9576
Photo of Brittany Chapman, Pre-Licensed Professional in Las Vegas, NV
Brittany Chapman
Pre-Licensed Professional, Student
Verified Verified
1 Endorsed
Las Vegas, NV 89144
Evening and Telehealth Availability. Brittany is a graduate level student therapist with a passion for providing compassionate support for those who are struggling. Life can be difficult, and Brittany is committed to creating a safe and nonjudgemental space where children, teens, individuals, and families can be heard. Areas of focus include substance abuse, eating disorders, addictions, anxiety, depression, trauma, and stress.
Evening and Telehealth Availability. Brittany is a graduate level student therapist with a passion for providing compassionate support for those who are struggling. Life can be difficult, and Brittany is committed to creating a safe and nonjudgemental space where children, teens, individuals, and families can be heard. Areas of focus include substance abuse, eating disorders, addictions, anxiety, depression, trauma, and stress.
(725) 444-7927 View (725) 444-7927
Photo of Core Strength Wellness, Clinical Social Work/Therapist in Las Vegas, NV
Core Strength Wellness
Clinical Social Work/Therapist, MSW, LCSW, LCADC
Verified Verified
Las Vegas, NV 89148
Core Strength is a safe space created for those interested in deepening their understanding of the whole self. We believe that through holistic therapy clients can begin to feel balanced and centered, and our approach will help you to feel safe as you encounter change. Holistic therapy explores the interactions between your thoughts, emotions, and behavior from a whole-person perspective. Our goal is to assist clients in recognizing their strengths while developing new ways of thinking, feeling, and acting to increase their overall happiness and satisfaction with life.
Core Strength is a safe space created for those interested in deepening their understanding of the whole self. We believe that through holistic therapy clients can begin to feel balanced and centered, and our approach will help you to feel safe as you encounter change. Holistic therapy explores the interactions between your thoughts, emotions, and behavior from a whole-person perspective. Our goal is to assist clients in recognizing their strengths while developing new ways of thinking, feeling, and acting to increase their overall happiness and satisfaction with life.
(725) 696-9117 View (725) 696-9117
Photo of Naomi Wilborn, Clinical Professional Counselor in Las Vegas, NV
Naomi Wilborn
Clinical Professional Counselor, MS, LCPC, NCC
Verified Verified
Las Vegas, NV 89113  (Online Only)
Not accepting new clients
Hi, my name is Naomi Wilborn, I am human and also a Licensed Clinical Professional Counselor. I am currently serving clients in the state of Nevada through my private practice Unparalleled Therapy LLC. I believe in being true to yourself and celebrating your individuality, even if that does not align with the predetermined limits of society. I have been in the mental health field for nearly a decade and have had the opportunity to work with people from many different walks of life.
Hi, my name is Naomi Wilborn, I am human and also a Licensed Clinical Professional Counselor. I am currently serving clients in the state of Nevada through my private practice Unparalleled Therapy LLC. I believe in being true to yourself and celebrating your individuality, even if that does not align with the predetermined limits of society. I have been in the mental health field for nearly a decade and have had the opportunity to work with people from many different walks of life.
(702) 827-4868 View (702) 827-4868
Photo of Brainwaves & Counseling, Counselor in Las Vegas, NV
Brainwaves & Counseling
Counselor, LCPC, BSN
Verified Verified
1 Endorsed
Las Vegas, NV 89123
Brainwaves & Counseling specializes in enhancing the brain and mind collectively! We believe the combination of neurofeedback and counseling services provides a positive and efficient result to our clients. Neurofeedback is a safe, non-invasive brain training procedure which allows client to self regulate their physiology and self regulate their symptoms. Our clients become aware of what area(s) of the Brain need training. The client is watching a movie, playing brain games or listening to music; while the training is in progress; the clinician relates the results to clients behavior, feelings or thought patterns.
Brainwaves & Counseling specializes in enhancing the brain and mind collectively! We believe the combination of neurofeedback and counseling services provides a positive and efficient result to our clients. Neurofeedback is a safe, non-invasive brain training procedure which allows client to self regulate their physiology and self regulate their symptoms. Our clients become aware of what area(s) of the Brain need training. The client is watching a movie, playing brain games or listening to music; while the training is in progress; the clinician relates the results to clients behavior, feelings or thought patterns.
(702) 903-1256 View (702) 903-1256
Photo of Bree Mullin, Psychologist in Las Vegas, NV
Bree Mullin
Psychologist, PsyD
Verified Verified
Las Vegas, NV 89120
Every person is an individual and every individual has unique strengths and weaknesses, supports and challenges. Depression, anxiety, and relationship issues can feel debilitating, and are more common than we think, yet they do not have to govern our lives. Specializing in children, adolescents, and families, I support people in using their strengths and support s to overcome adversity and improve life effectiveness. My goals are to help you reach your goals. How? By employing scientifically-driven, evidence-based interventions to improve communication, relationships, emotional functioning, and overall life satisfaction.
Every person is an individual and every individual has unique strengths and weaknesses, supports and challenges. Depression, anxiety, and relationship issues can feel debilitating, and are more common than we think, yet they do not have to govern our lives. Specializing in children, adolescents, and families, I support people in using their strengths and support s to overcome adversity and improve life effectiveness. My goals are to help you reach your goals. How? By employing scientifically-driven, evidence-based interventions to improve communication, relationships, emotional functioning, and overall life satisfaction.
(702) 903-2693 View (702) 903-2693
Photo of Holly Priscu, Licensed Professional Counselor in Las Vegas, NV
Holly Priscu
Licensed Professional Counselor, JD, LCPC, CFMHE, CCTP-II
Verified Verified
Las Vegas, NV 89113  (Online Only)
Our human brains are fascinating in what they allow us to accomplish, but sometimes they can be our own worst enemy! Overwhelming emotions and unhelpful thoughts can interfere with our lives and cause significant distress. I created my practice to help people "be okay when things are not okay." This is done using a person-centered dialectical-behavior therapy (DBT) approach to help you gain insight into yourself while providing you with the tools and encouragement to thrive instead of just survive. I want you to leave each session feeling validated and more confident in your ability to cope with life's challenges!
Our human brains are fascinating in what they allow us to accomplish, but sometimes they can be our own worst enemy! Overwhelming emotions and unhelpful thoughts can interfere with our lives and cause significant distress. I created my practice to help people "be okay when things are not okay." This is done using a person-centered dialectical-behavior therapy (DBT) approach to help you gain insight into yourself while providing you with the tools and encouragement to thrive instead of just survive. I want you to leave each session feeling validated and more confident in your ability to cope with life's challenges!
(702) 541-9331 View (702) 541-9331
Photo of Patti J. Barkell, Licensed Professional Counselor in Las Vegas, NV
Patti J. Barkell
Licensed Professional Counselor, MS, CPC, LCPC
Verified Verified
1 Endorsed
Las Vegas, NV 89123
I believe that the foundation of the therapeutic relationship begins with the connection between myself and you. Trust and safety must be present in order for you to express your concerns and to achieve your goals. It is important to me that you feel accepted while sharing the unexpected challenges of life. You are not alone, you don't have to stay stuck, and you can be a better version of yourself once those burdens have been lifted.
I believe that the foundation of the therapeutic relationship begins with the connection between myself and you. Trust and safety must be present in order for you to express your concerns and to achieve your goals. It is important to me that you feel accepted while sharing the unexpected challenges of life. You are not alone, you don't have to stay stuck, and you can be a better version of yourself once those burdens have been lifted.
(406) 412-3719 View (406) 412-3719
Photo of Andrea Call, Clinical Social Work/Therapist in Las Vegas, NV
Andrea Call
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Las Vegas, NV 89123
I have been in practice since 2010. I have a background in successfully treating a variety of complex and co-occurring mental health issues including mood disorders, trauma, anxiety, social struggles, and depression. I have experience helping individuals, couples and families navigate difficult family dynamics and resolve conflict. My years of practice have allowed me to work with various populations and age ranges. My unique treatment style includes humor and solution-focused interventions which allows me to be direct and make progress quickly.
I have been in practice since 2010. I have a background in successfully treating a variety of complex and co-occurring mental health issues including mood disorders, trauma, anxiety, social struggles, and depression. I have experience helping individuals, couples and families navigate difficult family dynamics and resolve conflict. My years of practice have allowed me to work with various populations and age ranges. My unique treatment style includes humor and solution-focused interventions which allows me to be direct and make progress quickly.
(702) 500-1959 View (702) 500-1959
Photo of Hana Olivia Gutierrez, Marriage & Family Therapist Intern in Las Vegas, NV
Hana Olivia Gutierrez
Marriage & Family Therapist Intern, MFT-I
Verified Verified
1 Endorsed
Las Vegas, NV 89146
Deciding to come to therapy can be an intimidating decision. It is the first step in a journey of vulnerability, discovery, and self love. Because of the magnitude of this journey it is important to select a therapist that understands your needs and supports your journey. I strive to be authentic and provide a safe environment for clients that acknowledges the vulnerable space you are putting yourself in by initiating therapy. I support clients in cultivating their strengths and acknowledging how the daily ups and downs of life can affect the therapeutic process.
Deciding to come to therapy can be an intimidating decision. It is the first step in a journey of vulnerability, discovery, and self love. Because of the magnitude of this journey it is important to select a therapist that understands your needs and supports your journey. I strive to be authentic and provide a safe environment for clients that acknowledges the vulnerable space you are putting yourself in by initiating therapy. I support clients in cultivating their strengths and acknowledging how the daily ups and downs of life can affect the therapeutic process.
(702) 819-7506 View (702) 819-7506
Photo of Ericka Albert, Marriage & Family Therapist in Las Vegas, NV
Ericka Albert
Marriage & Family Therapist, MS, LMFT
Verified Verified
2 Endorsed
Las Vegas, NV 89123
I am passionate about mental health and it is my goal to assist my clients with improving their quality of life. I have over ten years of experience as a Marriage and Family Therapist working with a variety of mental health concerns including improving self-esteem, working through trauma, and managing symptoms of anxiety and depression. I genuinely care about the well-being of my clients and am dedicated to assisting them in navigating challenges and achieving personal growth.
I am passionate about mental health and it is my goal to assist my clients with improving their quality of life. I have over ten years of experience as a Marriage and Family Therapist working with a variety of mental health concerns including improving self-esteem, working through trauma, and managing symptoms of anxiety and depression. I genuinely care about the well-being of my clients and am dedicated to assisting them in navigating challenges and achieving personal growth.
(702) 751-4721 View (702) 751-4721
Hilary E Katz
Psychologist, PhD
Verified Verified
Las Vegas, NV 89128
I specialize in neuropsychology testing and assessment for school age children and adolescents. When children are having difficulty in school or at home it is important to evaluate cognitive, educational, emotional, and social functioning. Your child may find school difficult due to a learning disability, ADHD, or another factor which may be interfering with learning. On the other hand, your child may find school boring and "too easy". A neuropsychological assessment will help you better understand your child's needs in school and at home and start you on the path to better meeting those needs.
I specialize in neuropsychology testing and assessment for school age children and adolescents. When children are having difficulty in school or at home it is important to evaluate cognitive, educational, emotional, and social functioning. Your child may find school difficult due to a learning disability, ADHD, or another factor which may be interfering with learning. On the other hand, your child may find school boring and "too easy". A neuropsychological assessment will help you better understand your child's needs in school and at home and start you on the path to better meeting those needs.
(702) 800-2547 View (702) 800-2547
Photo of Anna Cuffee, LPC Intern in Las Vegas, NV
Anna Cuffee
LPC Intern, CPC-I, MA Ed
Verified Verified
2 Endorsed
Las Vegas, NV 89148
Do you struggle with “feeling like yourself” again since having kids? Do you and your partner or spouse have trouble seeing eye-to-eye? Has intimacy changed since becoming parents? Have you experienced a recent traumatic birth experience? Many women (and men) choose not to seek the help that they need because these issues are not talked about enough in our society. Issues in the perinatal period can also look like rage or increased irritability, low motivation, feeling "stuck", not feeling connected to your partner/spouse, kids, or even yourself.
Do you struggle with “feeling like yourself” again since having kids? Do you and your partner or spouse have trouble seeing eye-to-eye? Has intimacy changed since becoming parents? Have you experienced a recent traumatic birth experience? Many women (and men) choose not to seek the help that they need because these issues are not talked about enough in our society. Issues in the perinatal period can also look like rage or increased irritability, low motivation, feeling "stuck", not feeling connected to your partner/spouse, kids, or even yourself.
(725) 208-5951 View (725) 208-5951
Photo of E. Michele Sprole, Counselor in Las Vegas, NV
E. Michele Sprole
Counselor, MA, LCPC, NCC
Verified Verified
Las Vegas, NV 89123
There are times in life that you need someone you can trust to provide a safe and caring space for you to grow. I can help you create a positive future for yourself and help you integrate the experiences from your past into your present. I am a Licensed Clinical Professional Counselor. I use cognitive behavioral and solution focused therapy to help you realize your full potential. At your initial visit we will explore what it is that brings you to therapy and we will determine a path together that will move you forward in your life.
There are times in life that you need someone you can trust to provide a safe and caring space for you to grow. I can help you create a positive future for yourself and help you integrate the experiences from your past into your present. I am a Licensed Clinical Professional Counselor. I use cognitive behavioral and solution focused therapy to help you realize your full potential. At your initial visit we will explore what it is that brings you to therapy and we will determine a path together that will move you forward in your life.
(702) 472-8516 View (702) 472-8516
Photo of Nikki Luu, Clinical Social Work/Therapist in Las Vegas, NV
Nikki Luu
Clinical Social Work/Therapist, LCSW
Verified Verified
Las Vegas, NV 89148
You've taken an important first step in your journey to self-awareness and self-healing. You may be looking for additional support because you've tried other solutions which either haven't worked, was only a temporary fix, or you might have not taken the next step yet, because frankly, change is not easy. At this point in your journey, you might be feeling tired, overwhelmed, stuck, or even lost. Often when healing doesn't occur, the cycle inevitably continues which can lead to distress, feelings of anxiousness, fear, burnout, and irritability.
You've taken an important first step in your journey to self-awareness and self-healing. You may be looking for additional support because you've tried other solutions which either haven't worked, was only a temporary fix, or you might have not taken the next step yet, because frankly, change is not easy. At this point in your journey, you might be feeling tired, overwhelmed, stuck, or even lost. Often when healing doesn't occur, the cycle inevitably continues which can lead to distress, feelings of anxiousness, fear, burnout, and irritability.
(725) 213-9284 View (725) 213-9284

Nearby Searches for Las Vegas

How does your Therapist compare?

Number of Therapists in Las Vegas, NV

1,000+

Average cost per session

$130

Therapists in Las Vegas, NV who prioritize treating:

91% Anxiety
88% Depression
77% Self Esteem
76% Trauma and PTSD
75% Relationship Issues
71% Coping Skills
71% Stress

Average years in practice

9 Years

Top 3 insurances accepted

70% Aetna
61% Cigna and Evernorth
59% UnitedHealthcare UHC | UBH

How Therapists in Las Vegas, NV see their clients

67% In Person and Online
33% Online Only

Gender breakdown

81% Female
18% Male
1% Non-Binary

FAQs - About Therapy and Counseling

How can I find a therapist in Las Vegas?

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.