Therapists in Boston, MA

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Photo of Allen Shamon, LICSW, Clinical Social Work/Therapist
Allen Shamon
Clinical Social Work/Therapist, LICSW
Verified Verified
Boston, MA 02114  (Online Only)
Hello, and welcome! I specialize in working with individuals working through difficult trauma, complex relationship issues, and the LGBTQ+ community. I work closely with individuals struggling with different forms of mental disorders and help my clients forge a new path forward toward healing and wholeness. My passion is in therapy, and I am humbled and grateful when people invite me to play a meaningful role in their lives.
Hello, and welcome! I specialize in working with individuals working through difficult trauma, complex relationship issues, and the LGBTQ+ community. I work closely with individuals struggling with different forms of mental disorders and help my clients forge a new path forward toward healing and wholeness. My passion is in therapy, and I am humbled and grateful when people invite me to play a meaningful role in their lives.
(339) 217-5900 View (339) 217-5900
Photo of Mia DePaolo, MA, Pre-Licensed Professional
Mia DePaolo
Pre-Licensed Professional, MA
Verified Verified
1 Endorsed
Boston, MA 02110
Accepting New Clients - Summer 2024! At this moment, you may be struggling with feelings of uncertainty, pressure, or worry. Perhaps you’d rather avoid this moment altogether. Taking this step to seek support with whatever challenges you may be facing can feel daunting, but my hope is to alleviate some of these feelings as we embark on that journey together. My goal is to support you as a whole person and hold space for your lived experiences through unconditional acceptance and non-judgement, while creating a safe therapeutic environment where you feel heard and valued.
Accepting New Clients - Summer 2024! At this moment, you may be struggling with feelings of uncertainty, pressure, or worry. Perhaps you’d rather avoid this moment altogether. Taking this step to seek support with whatever challenges you may be facing can feel daunting, but my hope is to alleviate some of these feelings as we embark on that journey together. My goal is to support you as a whole person and hold space for your lived experiences through unconditional acceptance and non-judgement, while creating a safe therapeutic environment where you feel heard and valued.
(857) 766-0265 View (857) 766-0265
Photo of Susan V Poirier, LMHC, Counselor
Susan V Poirier
Counselor, LMHC
Verified Verified
Boston, MA 02110
Accepting new clients. Are you feeling anxious or down? Are you unsure about the future of a relationship, or wondering why you find yourself repeating the same patterns and behaviors? Therapy is a collaborative process of self-discovery and personal growth. It takes a lot to reach out to a complete stranger and ask for help and you should feel proud you are considering taking this first step. I like to see my clients laugh, know what makes them happy and see them learn more about themselves through the process of therapy.
Accepting new clients. Are you feeling anxious or down? Are you unsure about the future of a relationship, or wondering why you find yourself repeating the same patterns and behaviors? Therapy is a collaborative process of self-discovery and personal growth. It takes a lot to reach out to a complete stranger and ask for help and you should feel proud you are considering taking this first step. I like to see my clients laugh, know what makes them happy and see them learn more about themselves through the process of therapy.
(617) 202-2768 View (617) 202-2768
Photo of Katie McGeough, LCSW, Clinical Social Work/Therapist
Katie McGeough
Clinical Social Work/Therapist, LCSW
Verified Verified
Boston, MA 02131
My style is based on the biopsychosocial model of therapy, which is grounded in the idea that mental health does not exist in a vacuum but is impacted by the systems we are a part of. Additionally, my therapeutic style draws from feminist theory, trauma informed therapy, acceptance and commitment therapy, and motivational interviewing. I have experience working with LGBTQIA+ individuals, victims of sexual violence, as well as individuals struggling with addiction. I am particularly interested in working with individuals that have experienced trauma around sexual violence as well as sexual and gender identity.
My style is based on the biopsychosocial model of therapy, which is grounded in the idea that mental health does not exist in a vacuum but is impacted by the systems we are a part of. Additionally, my therapeutic style draws from feminist theory, trauma informed therapy, acceptance and commitment therapy, and motivational interviewing. I have experience working with LGBTQIA+ individuals, victims of sexual violence, as well as individuals struggling with addiction. I am particularly interested in working with individuals that have experienced trauma around sexual violence as well as sexual and gender identity.
(857) 420-7212 View (857) 420-7212
Photo of Sarah Nielsen, LICSW, PMH-C, Clinical Social Work/Therapist
Sarah Nielsen
Clinical Social Work/Therapist, LICSW, PMH-C
Verified Verified
Boston, MA 02116
For all of us, life brings transitions and challenges. We may struggle with current experiences, as well as the way we are carrying the past with us. Transitions in life are often filled with overwhelming emotions and a therapeutic relationship can provide space and a place to navigate these moments. We all possess strengths and, in our work together, we will uncover those and provide opportunities to manage challenges. My approach is trauma-informed, strengths-based and client-centered. I believe that we all benefit from a place to explore and understand our own story.
For all of us, life brings transitions and challenges. We may struggle with current experiences, as well as the way we are carrying the past with us. Transitions in life are often filled with overwhelming emotions and a therapeutic relationship can provide space and a place to navigate these moments. We all possess strengths and, in our work together, we will uncover those and provide opportunities to manage challenges. My approach is trauma-informed, strengths-based and client-centered. I believe that we all benefit from a place to explore and understand our own story.
(617) 741-5740 View (617) 741-5740
Photo of undefined - Life Balancing Acts, LLC., MS, LMHC, Counselor
Life Balancing Acts, LLC.
Counselor, MS, LMHC
Verified Verified
Boston, MA 02114  (Online Only)
We make our plans, we think we have everything covered, and suddenly Life happens. Sometimes it's an unexpected break up in a relationship; or maybe unforeseen health news for you or someone close to you; unexpected changes in your family due to immigration laws. At Life Balancing Acts, we understand the emotional stress that those circumstances may cause. CONSEJERIA/ TERAPIA EN ESPANOL INDIVIDUAL/ PAREJA.; TELETERAPIA EN ESPANOL. *** ACEPTAMOS NUEVOS CLIENTES PARA JUEVES.
We make our plans, we think we have everything covered, and suddenly Life happens. Sometimes it's an unexpected break up in a relationship; or maybe unforeseen health news for you or someone close to you; unexpected changes in your family due to immigration laws. At Life Balancing Acts, we understand the emotional stress that those circumstances may cause. CONSEJERIA/ TERAPIA EN ESPANOL INDIVIDUAL/ PAREJA.; TELETERAPIA EN ESPANOL. *** ACEPTAMOS NUEVOS CLIENTES PARA JUEVES.
(857) 399-0071 View (857) 399-0071
Photo of Samantha Loignon, LICSW, Clinical Social Work/Therapist
Samantha Loignon
Clinical Social Work/Therapist, LICSW
Verified Verified
Boston, MA 02199  (Online Only)
Hi there, I'm Samantha. Have you ever thought about what your life would look like if you were your best self? What stops you from getting there? Maybe feelings of depression, anxiety, past trauma, or relationship issues get in the way of achieving your goal? Making change is very hard, but it can be much easier when we have the right help.
Hi there, I'm Samantha. Have you ever thought about what your life would look like if you were your best self? What stops you from getting there? Maybe feelings of depression, anxiety, past trauma, or relationship issues get in the way of achieving your goal? Making change is very hard, but it can be much easier when we have the right help.
(617) 202-3866 View (617) 202-3866
Photo of Amy Sandler, PhD, LICSW, Clinical Social Work/Therapist
Amy Sandler
Clinical Social Work/Therapist, PhD, LICSW
Verified Verified
Boston, MA 02132  (Online Only)
Life is not about IF we will face difficult times, it's about preparing for WHEN. I enjoy working with adults and children who struggle with anxiety, depression, relationship difficulties, cultural demands, grief/loss, and complex life transitions (including serious illness such as cancer, etc.). I want to help you discover meaning and hope through our intentional work together. I am LGBTQ+ affirming.
Life is not about IF we will face difficult times, it's about preparing for WHEN. I enjoy working with adults and children who struggle with anxiety, depression, relationship difficulties, cultural demands, grief/loss, and complex life transitions (including serious illness such as cancer, etc.). I want to help you discover meaning and hope through our intentional work together. I am LGBTQ+ affirming.
(617) 915-3227 View (617) 915-3227
Photo of Brian Diehl, LICSW, Clinical Social Work/Therapist
Brian Diehl
Clinical Social Work/Therapist, LICSW
Verified Verified
Boston, MA 02118  (Online Only)
If your struggling with self, others or maladaptive behaviors I can assist in developing a personalized treatment plan and goals. Utilizing various trainings, beliefs and tested modalities, together we can move towards the life you want, accept the situations that we may not be able to change and weave an eclectic, psychoeducational approach designed to provide tools and develop skills to address many of your stated concerns. Using supportive language, a belief that change is possible and the inherent power of the human spirit, I will walk with you though the changes you seek.
If your struggling with self, others or maladaptive behaviors I can assist in developing a personalized treatment plan and goals. Utilizing various trainings, beliefs and tested modalities, together we can move towards the life you want, accept the situations that we may not be able to change and weave an eclectic, psychoeducational approach designed to provide tools and develop skills to address many of your stated concerns. Using supportive language, a belief that change is possible and the inherent power of the human spirit, I will walk with you though the changes you seek.
(617) 405-3495 View (617) 405-3495
Photo of Destini Kohnen, LMHC, Counselor
Destini Kohnen
Counselor, LMHC
Verified Verified
Boston, MA 02114
The ideal client is motivated to continue to work with their inner child to become grounded in the present moment. They may have anxiety, mood disorders, or personality disorders, or they may not be sure what is underlying their experience, which I can help identify as well. The ideal clients are open to trying new methods of healing, including arts and spirituality. They are willing to trust me with their feelings and express them, whether that is verbally, through the expressive arts, or both.
The ideal client is motivated to continue to work with their inner child to become grounded in the present moment. They may have anxiety, mood disorders, or personality disorders, or they may not be sure what is underlying their experience, which I can help identify as well. The ideal clients are open to trying new methods of healing, including arts and spirituality. They are willing to trust me with their feelings and express them, whether that is verbally, through the expressive arts, or both.
(781) 429-3281 View (781) 429-3281
Photo of Carolyna Mercado, LMHC, LPC, Counselor
Carolyna Mercado
Counselor, LMHC, LPC
Verified Verified
Boston, MA 02108  (Online Only)
I believe it takes courage to accept and address one's mental health needs. It is for this matter that I provide the necessary guidance and support for individuals to develop coping skills and tools that will help address the problems impacting their lives in a non-judgemental environment. I’m bilingual in Spanish-English and I have been working in the mental health field for the past 6 years. In this journey, I have enjoyed working with a wide range of individuals that struggle with anxiety, depression, stress management, life transitions, crisis intervention, substance abuse, trauma, and multicultural issues.
I believe it takes courage to accept and address one's mental health needs. It is for this matter that I provide the necessary guidance and support for individuals to develop coping skills and tools that will help address the problems impacting their lives in a non-judgemental environment. I’m bilingual in Spanish-English and I have been working in the mental health field for the past 6 years. In this journey, I have enjoyed working with a wide range of individuals that struggle with anxiety, depression, stress management, life transitions, crisis intervention, substance abuse, trauma, and multicultural issues.
(857) 420-6245 View (857) 420-6245
Photo of undefined - Integrative Psychotherapy & TMS by Dr. Ying Cao, MD, MEng
Integrative Psychotherapy & TMS by Dr. Ying Cao
MD, MEng
Not Verified Not Verified
2 Endorsed
Boston, MA 02116
Thriving in an evermore complex world can be overwhelming; mental health is key and self-actualization is a journey best undertaken with good support. Hello! I am a Harvard-affiliated psychiatrist and MIT-trained engineer with an extensive background in psychotherapy and integrative mind-body wellness care. I believe in the motto "Mind & Hand" and the transformative power of integrative care that aims to incorporate the full biopsychosocial experience of each client and actualize lasting growth through facilitating insight, addressing root-causes, shifting paradigms, upgrading skills, and implementing measurable improvements.
Thriving in an evermore complex world can be overwhelming; mental health is key and self-actualization is a journey best undertaken with good support. Hello! I am a Harvard-affiliated psychiatrist and MIT-trained engineer with an extensive background in psychotherapy and integrative mind-body wellness care. I believe in the motto "Mind & Hand" and the transformative power of integrative care that aims to incorporate the full biopsychosocial experience of each client and actualize lasting growth through facilitating insight, addressing root-causes, shifting paradigms, upgrading skills, and implementing measurable improvements.
(857) 847-5873 View (857) 847-5873
Photo of Alyssa Kull, LCSW, LICSW, Clinical Social Work/Therapist
Alyssa Kull
Clinical Social Work/Therapist, LCSW, LICSW
Verified Verified
1 Endorsed
Boston, MA 02199
I love working with young adults who are experiencing relationship issues, family issues, depression, anxiety, and life transitions. I've also worked with older adults for 10+ years and really enjoy helping them work through issues that tend to appear later in life like loneliness, isolation, loss, grief, and illness. After establishing trust and a strong therapeutic bond, my clients want to be as open and vulnerable as possible so they can process their feelings and work on improving their lives.
I love working with young adults who are experiencing relationship issues, family issues, depression, anxiety, and life transitions. I've also worked with older adults for 10+ years and really enjoy helping them work through issues that tend to appear later in life like loneliness, isolation, loss, grief, and illness. After establishing trust and a strong therapeutic bond, my clients want to be as open and vulnerable as possible so they can process their feelings and work on improving their lives.
(267) 214-4151 View (267) 214-4151
Photo of Robert Haas, LICSW, MSW, MA, Clinical Social Work/Therapist
Robert Haas
Clinical Social Work/Therapist, LICSW, MSW, MA
Verified Verified
1 Endorsed
Boston, MA 02116  (Online Only)
Not accepting new clients
I specialize in CBT (cognitive-behavior therapy), ACT (acceptance & commitment therapy), MINDFULNESS and psychodynamic therapies. I help you clarify your values and goals, and then encourage you to live life based on those values and goals. I teach you how to best connect with self and others, and believe such connection increases your capacity and possibility for living a life of ease, contentment and passion. Connection leads to better health and well-being. Once you feel safe in connection the possibilities are endless.
I specialize in CBT (cognitive-behavior therapy), ACT (acceptance & commitment therapy), MINDFULNESS and psychodynamic therapies. I help you clarify your values and goals, and then encourage you to live life based on those values and goals. I teach you how to best connect with self and others, and believe such connection increases your capacity and possibility for living a life of ease, contentment and passion. Connection leads to better health and well-being. Once you feel safe in connection the possibilities are endless.
(617) 262-6269 View (617) 262-6269
Photo of undefined - Insights Psychological Services, PLLC, PsyD, Psychologist
Insights Psychological Services, PLLC
Psychologist, PsyD
Verified Verified
Boston, MA 02115  (Online Only)
Welcome! We are a telehealth group practice comprised of relationally oriented clinicians serving college students, graduate students, professionals, and couples. We provide treatment for symptoms of stress, anxiety, depression, low self-esteem, and relationship issues. We offer guidance with building effective communication skills and strategies, so clients feel empowered and are able to convey their needs and wants to others.
Welcome! We are a telehealth group practice comprised of relationally oriented clinicians serving college students, graduate students, professionals, and couples. We provide treatment for symptoms of stress, anxiety, depression, low self-esteem, and relationship issues. We offer guidance with building effective communication skills and strategies, so clients feel empowered and are able to convey their needs and wants to others.
(781) 332-4058 View (781) 332-4058
Photo of Seth Boynton, LICSW, Clinical Social Work/Therapist
Seth Boynton
Clinical Social Work/Therapist, LICSW
Verified Verified
Boston, MA 02114  (Online Only)
Taking care of ourselves physically, emotionally and socially is my top priority. I've been a Licensed Clinical Social Worker since 2004, helping my clients throughout all stages of their life. The essence of my work is to facilitate self-growth by helping you identify the core challenges and setbacks in your life, so that you can overcome them with confidence. I specialize in creating personalized plans and providing tools to guide you forward and achieve your desired goals. I have earned certificates in Applied Behavioral Analysis, Health Psychology and Nutritional Psychology. I can help you WHERE you are and WHEN you need it. I
Taking care of ourselves physically, emotionally and socially is my top priority. I've been a Licensed Clinical Social Worker since 2004, helping my clients throughout all stages of their life. The essence of my work is to facilitate self-growth by helping you identify the core challenges and setbacks in your life, so that you can overcome them with confidence. I specialize in creating personalized plans and providing tools to guide you forward and achieve your desired goals. I have earned certificates in Applied Behavioral Analysis, Health Psychology and Nutritional Psychology. I can help you WHERE you are and WHEN you need it. I
(781) 619-3434 View (781) 619-3434
Photo of Caleb Brooks Licsw Anxiety Adhd Addiction Specialized Therapist, LICSW, Clinical Social Work/Therapist
Caleb Brooks Licsw Anxiety Adhd Addiction Specialized Therapist
Clinical Social Work/Therapist, LICSW
Verified Verified
Boston, MA 02116  (Online Only)
Caleb Brooks, LICSW, is an award-winning therapist with over 3,500 hours of specialized training and continuing education focused on Anxiety, ADHD, and Addiction. Recognized for his expertise, Caleb employs a compassionate and evidence-based approach to empower clients to navigate challenges and improve their mental health. His methods are tailored to each individual, ensuring that therapy is both personal and effective. Caleb's commitment to professional growth and excellence is evident in his active engagement with ongoing learning and practice development.
Caleb Brooks, LICSW, is an award-winning therapist with over 3,500 hours of specialized training and continuing education focused on Anxiety, ADHD, and Addiction. Recognized for his expertise, Caleb employs a compassionate and evidence-based approach to empower clients to navigate challenges and improve their mental health. His methods are tailored to each individual, ensuring that therapy is both personal and effective. Caleb's commitment to professional growth and excellence is evident in his active engagement with ongoing learning and practice development.
(617) 958-6021 View (617) 958-6021
Photo of undefined - Virtual Wellness Solutions, LLC, LMHC, Counselor
Virtual Wellness Solutions, LLC
Counselor, LMHC
Verified Verified
1 Endorsed
Boston, MA 02108  (Online Only)
Welcome to Virtual Wellness Solutions! We are here to revolutionize mental health support through our innovative online clinic. Our mission is to seamlessly blend progress, compassion, and genuine connection to help you address anxiety, depression, stress, relationship issues, and addiction. At Virtual Wellness Solutions, we believe in a compassionate yet effective approach to treatment, meeting you where you are and empowering you to move forward.
Welcome to Virtual Wellness Solutions! We are here to revolutionize mental health support through our innovative online clinic. Our mission is to seamlessly blend progress, compassion, and genuine connection to help you address anxiety, depression, stress, relationship issues, and addiction. At Virtual Wellness Solutions, we believe in a compassionate yet effective approach to treatment, meeting you where you are and empowering you to move forward.
(781) 207-9822 View (781) 207-9822
Photo of Jenny A Reed, LMHC, ATR, Counselor
Jenny A Reed
Counselor, LMHC, ATR
Verified Verified
Boston, MA 02132  (Online Only)
I work with clients who have various life challenges from struggling with depression and anxiety to chronic mental illness. They seek an emotional outlet to express and process troubling emotions. I collaborate with clients to develop healthy coping skills, manage triggers, and improve their mood. Clients are able to embrace their authentic self and become the best version of themself.
I work with clients who have various life challenges from struggling with depression and anxiety to chronic mental illness. They seek an emotional outlet to express and process troubling emotions. I collaborate with clients to develop healthy coping skills, manage triggers, and improve their mood. Clients are able to embrace their authentic self and become the best version of themself.
(857) 267-3824 View (857) 267-3824
Photo of Laci Gonzalez, MSW
Laci Gonzalez
MSW
Verified Verified
Boston, MA 02109
Hello! My name is Laci. I am a compassionate, dedicated, analytical, and team oriented therapist with a lifelong passion towards helping and uplifting others. My passion stems from my own childhood and my difficulties with my mental health and self confidence. I believe that everyone is capable of positive change no matter a person’s age, race, sexual orientation, ethnicity, and overall background. It is up to those in the helping professions, like myself, to assist in lighting that spark for change.
Hello! My name is Laci. I am a compassionate, dedicated, analytical, and team oriented therapist with a lifelong passion towards helping and uplifting others. My passion stems from my own childhood and my difficulties with my mental health and self confidence. I believe that everyone is capable of positive change no matter a person’s age, race, sexual orientation, ethnicity, and overall background. It is up to those in the helping professions, like myself, to assist in lighting that spark for change.
(857) 847-3871 View (857) 847-3871

How does your Therapist compare?

Number of Therapists in Boston, MA

3,000+

Average cost per session

$154

Therapists in Boston, MA who prioritize treating:

93% Anxiety
86% Depression
76% Relationship Issues
74% Self Esteem
70% Stress
68% Trauma and PTSD
68% Coping Skills

Average years in practice

11 Years

Top 3 insurances accepted

78% BlueCross and BlueShield
61% Aetna
61% UnitedHealthcare UHC | UBH

How Therapists in Boston, MA see their clients

61% Online Only
39% In Person and Online

Gender breakdown

79% Female
19% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Boston?

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.