Therapists in Tacoma, WA

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Photo of Paul Hunziker, Marriage & Family Therapist in Tacoma, WA
Paul Hunziker
Marriage & Family Therapist, MA, LMFT, SUDP
Verified Verified
1 Endorsed
Tacoma, WA 98403
My ideal clients are couples in early recovery from substance use disorders or other addictions. Early recovery can be a critical time for both partners to quickly gain the skills needed to be successful and stay strong as a couple. I also have extensive experience working with youth and young adults with substance use and mental health challenges.
My ideal clients are couples in early recovery from substance use disorders or other addictions. Early recovery can be a critical time for both partners to quickly gain the skills needed to be successful and stay strong as a couple. I also have extensive experience working with youth and young adults with substance use and mental health challenges.
(253) 237-8351 View (253) 237-8351
Photo of Erin Manning, Marriage & Family Therapist in Tacoma, WA
Erin Manning
Marriage & Family Therapist, MA, LMFT
Verified Verified
Tacoma, WA 98406
As a Licensed Marriage and Family Therapist, I strive to create a space for individuals and families to feel safe and open as we work through some of life's hardest challenges. It can feel overwhelming considering where to start and what to tackle first. Seeking guidance takes a lot of strength and courage.
As a Licensed Marriage and Family Therapist, I strive to create a space for individuals and families to feel safe and open as we work through some of life's hardest challenges. It can feel overwhelming considering where to start and what to tackle first. Seeking guidance takes a lot of strength and courage.
(253) 793-0858 View (253) 793-0858
Photo of Anne Mauro, Marriage & Family Therapist in Tacoma, WA
Anne Mauro
Marriage & Family Therapist, LMFT, DHS, CST, CSE, CST-S
Verified Verified
46 Endorsed
Tacoma, WA 98406  (Online Only)
Are you frustrated with your sexual relationship(s)? Are you struggling with breakdowns in communication around sex? Are you feeling distance from your partner(s) and feel the loneliness creeping in? People normally see me when they need support in the "bedroom". If intimacy is a concern, seeking assistance through sex therapy can be a transformative journey. Sex therapy can help you move past barriers and teach you new skills that will enhance your relationship and improve sex life. Together, we can process concerns and work towards creating realistic and sustainable change. My clients include adult individuals and relationships.
Are you frustrated with your sexual relationship(s)? Are you struggling with breakdowns in communication around sex? Are you feeling distance from your partner(s) and feel the loneliness creeping in? People normally see me when they need support in the "bedroom". If intimacy is a concern, seeking assistance through sex therapy can be a transformative journey. Sex therapy can help you move past barriers and teach you new skills that will enhance your relationship and improve sex life. Together, we can process concerns and work towards creating realistic and sustainable change. My clients include adult individuals and relationships.
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Photo of Melissa Shivers, Counselor in Tacoma, WA
Melissa Shivers
Counselor, LMHC
Verified Verified
Tacoma, WA 98467
Not accepting new clients
I am not currently accepting new clients. I offer either in-person appointments or telehealth appointments for those who prefer to stay home. I am thankful to be able to help people through their challenging seasons. I enjoy working with individuals and have a special interest in working with those struggling with anxiety and depression. I am also passionate about providing Christian counseling for those who are struggling with faith-based issues.
I am not currently accepting new clients. I offer either in-person appointments or telehealth appointments for those who prefer to stay home. I am thankful to be able to help people through their challenging seasons. I enjoy working with individuals and have a special interest in working with those struggling with anxiety and depression. I am also passionate about providing Christian counseling for those who are struggling with faith-based issues.
(253) 292-9645 View (253) 292-9645
Photo of Shauri Coleman-Brown, Counselor in Tacoma, WA
Shauri Coleman-Brown
Counselor, LMHC, MHP, MS
Verified Verified
Tacoma, WA 98402
Waitlist for new clients
People prioritize therapy when it is necessary or important to them. I want to make therapy flexible enough for your busy life, with evening appointments, telehealth, and in-person options. Therapy works best if you have a trusting relationship with your therapist, and I aim to provide that setting, getting to know who you are and what you need, as you are the expert on your life. I hope to help you with the skills that will be useful throughout your life.
People prioritize therapy when it is necessary or important to them. I want to make therapy flexible enough for your busy life, with evening appointments, telehealth, and in-person options. Therapy works best if you have a trusting relationship with your therapist, and I aim to provide that setting, getting to know who you are and what you need, as you are the expert on your life. I hope to help you with the skills that will be useful throughout your life.
(253) 264-0960 View (253) 264-0960
Photo of Geoff Ashmun, Counselor in Tacoma, WA
Geoff Ashmun
Counselor, MA, LPCC
Verified Verified
4 Endorsed
Tacoma, WA 98416  (Online Only)
I work primarily with two types of clients: 1) Transition age youth and young adults (17-25) identifying as LGBTQIA+ and/or neurodivergent who are seeking to solidify their identity and find a footing in the emerging world of "adulthood." 2) Adult women (26-50) who struggle with depression and anxiety, often as an expression of a lack of authority in their lives be it in relation to their their marriages and partnerships, their role as a parent/caregiver, their family of origin, and their workplace. Additionally, I have extensive experience with adult children of alcoholics and I am equipped to work with clients on religious trauma.
I work primarily with two types of clients: 1) Transition age youth and young adults (17-25) identifying as LGBTQIA+ and/or neurodivergent who are seeking to solidify their identity and find a footing in the emerging world of "adulthood." 2) Adult women (26-50) who struggle with depression and anxiety, often as an expression of a lack of authority in their lives be it in relation to their their marriages and partnerships, their role as a parent/caregiver, their family of origin, and their workplace. Additionally, I have extensive experience with adult children of alcoholics and I am equipped to work with clients on religious trauma.
(206) 483-2245 View (206) 483-2245
Photo of Meg Bohman Houbrick, Counselor in Tacoma, WA
Meg Bohman Houbrick
Counselor, MA, LMHC, MHP
Verified Verified
5 Endorsed
Tacoma, WA 98406
I am a mental health counselor, trained to work with individuals, couples, and families. I believe that every human being is fundamentally capable of experiencing the joyful and fulfilling lives they seek - sometimes, life makes that difficult. Maybe you are experiencing grief, conflict in relationships, or loss of self. Maybe you’ve noticed yourself feeling depressed, anxious, or withdrawn. No matter what may bring you to therapy, I am honored to walk along with you as we explore opportunities for healing and growth.
I am a mental health counselor, trained to work with individuals, couples, and families. I believe that every human being is fundamentally capable of experiencing the joyful and fulfilling lives they seek - sometimes, life makes that difficult. Maybe you are experiencing grief, conflict in relationships, or loss of self. Maybe you’ve noticed yourself feeling depressed, anxious, or withdrawn. No matter what may bring you to therapy, I am honored to walk along with you as we explore opportunities for healing and growth.
(253) 201-2307 View (253) 201-2307
Photo of Brittany Tillman, Counselor in Tacoma, WA
Brittany Tillman
Counselor, LMHCA
Verified Verified
Tacoma, WA 98446
Welcome! I am so glad you are here. My primary focus as a licensed mental health counselor associate is on anxiety-related disorders, and I have worked extensively with clients facing a range of challenges, from generalized anxiety or specific phobias, to perfectionism or insecure attachment styles. I understand that each person's experience with anxiety is unique, and I tailor my therapeutic approach to meet individual needs. Whether that involves use of common evidence-based practices like cognitive-behavioral therapy (CBT), or traditional talk therapy, we will find what works best for you.
Welcome! I am so glad you are here. My primary focus as a licensed mental health counselor associate is on anxiety-related disorders, and I have worked extensively with clients facing a range of challenges, from generalized anxiety or specific phobias, to perfectionism or insecure attachment styles. I understand that each person's experience with anxiety is unique, and I tailor my therapeutic approach to meet individual needs. Whether that involves use of common evidence-based practices like cognitive-behavioral therapy (CBT), or traditional talk therapy, we will find what works best for you.
(509) 519-1420 View (509) 519-1420
Photo of Jesalyn Kimura, Counselor in Tacoma, WA
Jesalyn Kimura
Counselor, MA, LMHC
Verified Verified
Tacoma, WA 98403
Sometimes in life, we can feel lost, stuck or even desperate. We do the same things over and over again without finding any solutions to our problems. Life often becomes painful when our past experiences have no words to describe them or clarity to bring them to understanding. Using a variety of approaches my clients and I explore their current pain and concerns, while considering the picture of their past experience. With support and compassion we map out a plan to discover ways to become unstuck and move in new directions.
Sometimes in life, we can feel lost, stuck or even desperate. We do the same things over and over again without finding any solutions to our problems. Life often becomes painful when our past experiences have no words to describe them or clarity to bring them to understanding. Using a variety of approaches my clients and I explore their current pain and concerns, while considering the picture of their past experience. With support and compassion we map out a plan to discover ways to become unstuck and move in new directions.
(253) 220-6990 View (253) 220-6990
Photo of Kelsey Schank, Marriage & Family Therapist in Tacoma, WA
Kelsey Schank
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Tacoma, WA 98403
Therapy is a place to feel heard, validated and offer growth and change to your life.  I am here to support your needs whether you are looking as an individual, couple or family. Every person holds a unique story and experiences; it is my goal to work collaboratively with you to achieve personal goals and growth throughout the therapy experience. I work with teens, adults, couples and families and bring a systemic focus on each individual’s needs in session. Traditional and non-traditional families are welcome.
Therapy is a place to feel heard, validated and offer growth and change to your life.  I am here to support your needs whether you are looking as an individual, couple or family. Every person holds a unique story and experiences; it is my goal to work collaboratively with you to achieve personal goals and growth throughout the therapy experience. I work with teens, adults, couples and families and bring a systemic focus on each individual’s needs in session. Traditional and non-traditional families are welcome.
(253) 676-9397 View (253) 676-9397
Photo of Psychological Health Consultants & Services, LLC, Counselor in Tacoma, WA
Psychological Health Consultants & Services, LLC
Counselor, EdD, LMHC, CCTP
Verified Verified
Tacoma, WA 98409  (Online Only)
I am a retired Senior Leader of the US Army. I consider myself an eclectic therapist with a sense of humor and do not believe one size fits all. I draw from various theories and use different therapeutic approaches such as Cognitive Behavior Therapy, Exposure Therapy, Family Systems Theories, Solution Focused, Brief Solution Focused as well as Behavior Activation techniques. I use the client center approach and use resources and support systems available for the client. I also assist with providing resources and connecting clients to their community. My specialization is in narcissist abuse education and recovery.
I am a retired Senior Leader of the US Army. I consider myself an eclectic therapist with a sense of humor and do not believe one size fits all. I draw from various theories and use different therapeutic approaches such as Cognitive Behavior Therapy, Exposure Therapy, Family Systems Theories, Solution Focused, Brief Solution Focused as well as Behavior Activation techniques. I use the client center approach and use resources and support systems available for the client. I also assist with providing resources and connecting clients to their community. My specialization is in narcissist abuse education and recovery.
(253) 259-3315 View (253) 259-3315
Photo of Machelle Miller, Counselor in Tacoma, WA
Machelle Miller
Counselor, MS, LMHCA
Verified Verified
1 Endorsed
Tacoma, WA 98402  (Online Only)
I understand the importance of finding a counselor with whom you connect. When you reach out for help, you might be feeling overwhelmed and vulnerable. My approach to the therapeutic relationship is to collaborate with my clients in ways that support their values and goals while honoring who they are and their experiences. While we are all doing the best we can with the skills and experiences we have, sometimes we need some extra support navigating life and relationships, to learn new skills, or to have a safe space in which to process experiences, explore who we are, gain insights, or rebuild our sense of self and meaning.
I understand the importance of finding a counselor with whom you connect. When you reach out for help, you might be feeling overwhelmed and vulnerable. My approach to the therapeutic relationship is to collaborate with my clients in ways that support their values and goals while honoring who they are and their experiences. While we are all doing the best we can with the skills and experiences we have, sometimes we need some extra support navigating life and relationships, to learn new skills, or to have a safe space in which to process experiences, explore who we are, gain insights, or rebuild our sense of self and meaning.
(360) 800-3069 x1 View (360) 800-3069 x1
Photo of Philip A Bower, Clinical Social Work/Therapist in Tacoma, WA
Philip A Bower
Clinical Social Work/Therapist, MSW, LSWAIC, MHP
Verified Verified
5 Endorsed
Tacoma, WA 98402
Are you overwhelmed by worries, feeling disconnected, or struggling to find your true self? I specialize in helping individuals aged 25-70 navigate life's challenges using holistic approaches. I integrate Mindfulness, Polyvagal Theory, Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and spiritually informed techniques to support your journey toward healing and self-discovery. Together, we'll work to cultivate inner peace, build resilience, and foster a deeper connection to yourself and the world around you. You don't have to navigate this journey alone. Let's embark on the path to healing together.
Are you overwhelmed by worries, feeling disconnected, or struggling to find your true self? I specialize in helping individuals aged 25-70 navigate life's challenges using holistic approaches. I integrate Mindfulness, Polyvagal Theory, Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and spiritually informed techniques to support your journey toward healing and self-discovery. Together, we'll work to cultivate inner peace, build resilience, and foster a deeper connection to yourself and the world around you. You don't have to navigate this journey alone. Let's embark on the path to healing together.
(253) 525-5618 View (253) 525-5618
Photo of Joel Hencken, Psychologist in Tacoma, WA
Joel Hencken
Psychologist, PsyD
Verified Verified
Tacoma, WA 98467
I feel very fortunate that in clinical psychology I have found a field where I have been glad to go to work since I saw my first client in 1974. My training has been "˜eclectic'. My undergrad work was in philosophy of science at University of Michigan. After a short stint in medical school, I went to San Diego State University, where my professors were Rogerians, cognitivists and behaviorists (that was before the latter two got hyphenated and finally acronym-ized into CBT), plus one crypto-Freudian who spoke little but offered the most amazing insights. I also had some years of personal psychoanalysis.
I feel very fortunate that in clinical psychology I have found a field where I have been glad to go to work since I saw my first client in 1974. My training has been "˜eclectic'. My undergrad work was in philosophy of science at University of Michigan. After a short stint in medical school, I went to San Diego State University, where my professors were Rogerians, cognitivists and behaviorists (that was before the latter two got hyphenated and finally acronym-ized into CBT), plus one crypto-Freudian who spoke little but offered the most amazing insights. I also had some years of personal psychoanalysis.
(253) 364-4308 View (253) 364-4308
Photo of Winona Wallace, Counselor in Tacoma, WA
Winona Wallace
Counselor, LMHC
Verified Verified
Tacoma, WA 98405
Winona enjoys working with adolescents and adults of all ages. She works with clients dealing with mood disorders, personality disorders, anxiety, self-esteem issues, PTSD, grief and loss, and those facing other life challenges. In addition, she has worked with clients experiencing domestic violence. Her objective is to help individuals heal, and then find and build on their strengths in order to achieve their goals and become their very best selves. Winona enjoys working with clients and assisting them in developing coping skills that they can use for the rest of their lives.
Winona enjoys working with adolescents and adults of all ages. She works with clients dealing with mood disorders, personality disorders, anxiety, self-esteem issues, PTSD, grief and loss, and those facing other life challenges. In addition, she has worked with clients experiencing domestic violence. Her objective is to help individuals heal, and then find and build on their strengths in order to achieve their goals and become their very best selves. Winona enjoys working with clients and assisting them in developing coping skills that they can use for the rest of their lives.
(253) 523-2311 View (253) 523-2311
Photo of Trenecsia Wilson, Counselor in Tacoma, WA
Trenecsia Wilson
Counselor, LMHC, MHP, NCC, EMMHS-A, BC-TMH
Verified Verified
Tacoma, WA 98409
I work with individuals, couples, and families. My primary objective is to facilitate and support the next level of growth and development for individuals and families that I work with. This means something different for everyone, so I focus on building a therapeutic relationship that lends to the understanding and accomplishing of identified goals. There are a number of things that contribute to diminished mental wellness and I am here to help you find out what that is for you and to support you on taking action.
I work with individuals, couples, and families. My primary objective is to facilitate and support the next level of growth and development for individuals and families that I work with. This means something different for everyone, so I focus on building a therapeutic relationship that lends to the understanding and accomplishing of identified goals. There are a number of things that contribute to diminished mental wellness and I am here to help you find out what that is for you and to support you on taking action.
(206) 260-0448 View (206) 260-0448
Photo of Jessica Malley, Psychologist in Tacoma, WA
Jessica Malley
Psychologist, PsyD
Verified Verified
Tacoma, WA 98405
Dr. Malley has provided consultative, evaluative, therapeutic, school and home-based intervention services to children and families impacted by Autism, developmental and learning disabilities, emotional and behavioral disorders. She has developed and consulted with an array of school-based programs for students with Autism Spectrum Disorders, emotional, and behavioral disorders. She has also provided individual, group, and family-based counseling to those with autism and other developmental disabilities.
Dr. Malley has provided consultative, evaluative, therapeutic, school and home-based intervention services to children and families impacted by Autism, developmental and learning disabilities, emotional and behavioral disorders. She has developed and consulted with an array of school-based programs for students with Autism Spectrum Disorders, emotional, and behavioral disorders. She has also provided individual, group, and family-based counseling to those with autism and other developmental disabilities.
(253) 499-7986 View (253) 499-7986
Photo of Andrew Martin Knight, Counselor in Tacoma, WA
Andrew Martin Knight
Counselor, MAC, LMHCA
Verified Verified
Tacoma, WA 98402  (Online Only)
I can help clients when they are at a difficult moment dealing with complex life transitions and experiencing grief, anxiety, stress, and anger. I prefer to help clients with existential methods that invoke depth orientated psychological approaches from Jung, Gestalt, and stoicism. Clients that are able to receive homework assignments for mindfulness and reflect on the challenges they are having will be the best equipped to look at introspection and navigate their mood disturbances with assistance in the therapeutic relationship.
I can help clients when they are at a difficult moment dealing with complex life transitions and experiencing grief, anxiety, stress, and anger. I prefer to help clients with existential methods that invoke depth orientated psychological approaches from Jung, Gestalt, and stoicism. Clients that are able to receive homework assignments for mindfulness and reflect on the challenges they are having will be the best equipped to look at introspection and navigate their mood disturbances with assistance in the therapeutic relationship.
(253) 528-7350 View (253) 528-7350
Photo of Right Now! Counseling, Counselor in Tacoma, WA
Right Now! Counseling
Counselor, MA, LMHC
Verified Verified
Tacoma, WA 98407  (Online Only)
Not accepting new clients
Do you feel out of control? Are you searching for answers? Ever wonder why every day seems hard to get through? Overwhelmed by the smallest things? Wonder why you haven't accomplished what you know you can? I will work with you to create new ways of handling challenges in your daily life. My training, compassion, life experience, and insight offer you a unique opportunity to get started right now on realizing your full potential. PLEASE TEXT to schedule your appointment.
Do you feel out of control? Are you searching for answers? Ever wonder why every day seems hard to get through? Overwhelmed by the smallest things? Wonder why you haven't accomplished what you know you can? I will work with you to create new ways of handling challenges in your daily life. My training, compassion, life experience, and insight offer you a unique opportunity to get started right now on realizing your full potential. PLEASE TEXT to schedule your appointment.
(253) 248-7707 View (253) 248-7707
Photo of Kim Butler, Counselor in Tacoma, WA
Kim Butler
Counselor, MA, LMHCA
Verified Verified
2 Endorsed
Tacoma, WA 98406
I am a person-centered therapist accepting new clients. I aim to provide a collaborative safe space for clients to process at their own pace. I welcome couples, adult, and adolescent clients who are seeking support in deepening their understanding of emotions, mental processes, and behaviors, as well as those wanting help navigating through difficult life adjustments, painful pasts, stress management, coping strategies, relationship struggles, and mind-body health and wellness. I am passionate about honoring diversity and providing therapy from a multicultural and global perspective.
I am a person-centered therapist accepting new clients. I aim to provide a collaborative safe space for clients to process at their own pace. I welcome couples, adult, and adolescent clients who are seeking support in deepening their understanding of emotions, mental processes, and behaviors, as well as those wanting help navigating through difficult life adjustments, painful pasts, stress management, coping strategies, relationship struggles, and mind-body health and wellness. I am passionate about honoring diversity and providing therapy from a multicultural and global perspective.
(253) 338-8760 View (253) 338-8760

How does your Therapist compare?

Number of Therapists in Tacoma, WA

1,000+

Average cost per session

$150

Therapists in Tacoma, WA who prioritize treating:

93% Anxiety
87% Depression
76% Trauma and PTSD
75% Relationship Issues
75% Self Esteem
70% Stress
67% Coping Skills

Average years in practice

9 Years

Top 3 insurances accepted

78% Premera
66% Regence
61% Aetna

How Therapists in Tacoma, WA see their clients

50% In Person and Online
50% Online Only

Gender breakdown

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

How can I find a therapist in Tacoma?

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.