Therapists in Baltimore, MD

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Photo of Dr. Moshe L. Miller, Psychologist, PsyD
Dr. Moshe L. Miller
Psychologist, PsyD
6 Endorsed
Baltimore, MD 21209
As a licensed clinical psychologist I specialize in the treatment of Anxiety and Trauma related disorders including Obsessive-Compulsive Disorder (OCD), Generalized Anxiety, Social Anxiety, Specific Phobias, and Posttraumatic Stress Disorder (PTSD). I am passionate about flexibly applying evidence-based treatments to help you live a vital and rich life. If you are looking to get unstuck and back to a meaningful life, I am excited to help you take that journey.
As a licensed clinical psychologist I specialize in the treatment of Anxiety and Trauma related disorders including Obsessive-Compulsive Disorder (OCD), Generalized Anxiety, Social Anxiety, Specific Phobias, and Posttraumatic Stress Disorder (PTSD). I am passionate about flexibly applying evidence-based treatments to help you live a vital and rich life. If you are looking to get unstuck and back to a meaningful life, I am excited to help you take that journey.
(667) 222-5581 View (667) 222-5581
Photo of Jade Marie Nesbitt, Clinical Social Work/Therapist, LCSW-C
Jade Marie Nesbitt
Clinical Social Work/Therapist, LCSW-C
1 Endorsed
Online Only
Do you feel stuck, overwhelmed, or disconnected from the life you want? My ideal client is someone navigating anxiety, depression, or life transitions—whether it’s coming out, gender identity exploration, relationship shifts, or new stages of personal growth. Many of my clients seek a non-judgmental, affirming space where they can process challenges and develop coping skills to feel more at peace with themselves. They want to feel empowered, find clarity, and build a stronger sense of self, especially when dealing with societal pressures or personal doubts.
Do you feel stuck, overwhelmed, or disconnected from the life you want? My ideal client is someone navigating anxiety, depression, or life transitions—whether it’s coming out, gender identity exploration, relationship shifts, or new stages of personal growth. Many of my clients seek a non-judgmental, affirming space where they can process challenges and develop coping skills to feel more at peace with themselves. They want to feel empowered, find clarity, and build a stronger sense of self, especially when dealing with societal pressures or personal doubts.
(443) 969-7211 View (443) 969-7211
Photo of Rebecca Lencz, Licensed Clinical Professional Counselor, LCPC, MS
Rebecca Lencz
Licensed Clinical Professional Counselor, LCPC, MS
Online Only
If you are feeling overwhelmed, anxious, or sad, know that reaching out for help is the first step towards healing. I understand that stressors, losses and transitions can easily become overwhelming, and I can help you address the anxiety and negativity brought on during challenging times. My training in trauma, grief & loss, cultural diversity and spirituality provides me with tools to help you explore what may be compounding or affecting your difficulties. I have particular interest in helping women address unique challenges complicated by societal expectations, multiple roles, and life cycle changes.
If you are feeling overwhelmed, anxious, or sad, know that reaching out for help is the first step towards healing. I understand that stressors, losses and transitions can easily become overwhelming, and I can help you address the anxiety and negativity brought on during challenging times. My training in trauma, grief & loss, cultural diversity and spirituality provides me with tools to help you explore what may be compounding or affecting your difficulties. I have particular interest in helping women address unique challenges complicated by societal expectations, multiple roles, and life cycle changes.
(410) 888-0672 View (410) 888-0672
Photo of Khyra Butterfield, Pre-Licensed Professional, MA
Khyra Butterfield
Pre-Licensed Professional, MA
1 Endorsed
Online Only
Hey! I’m Khyra. I specialize in helping teens and young adults navigate emotional challenges, family struggles, and the everyday ups and downs of life. Whether you're dealing with stress, anxiety, depression, or just trying to figure out who you are. My approach is laid-back but focused—think real talk combined with skills for regulation, communication, mindfulness, and practical strategies that work for you. I’m here to help you feel heard, understood, and empowered. I’m especially passionate about working with teens and young adults from immigrant and LGBTQIA+ communities, as well as anyone who feels stuck or misunderstood.
Hey! I’m Khyra. I specialize in helping teens and young adults navigate emotional challenges, family struggles, and the everyday ups and downs of life. Whether you're dealing with stress, anxiety, depression, or just trying to figure out who you are. My approach is laid-back but focused—think real talk combined with skills for regulation, communication, mindfulness, and practical strategies that work for you. I’m here to help you feel heard, understood, and empowered. I’m especially passionate about working with teens and young adults from immigrant and LGBTQIA+ communities, as well as anyone who feels stuck or misunderstood.
(410) 824-5129 View (410) 824-5129
Photo of Lindsey Daniels, Psychologist, PsyD
Lindsey Daniels
Psychologist, PsyD
Online Only
My clients are unique individuals that become the central focus in our work together. By teaching practical application of therapeutic skills, clients are able to work on achieving personal goals in their everyday life. We collaborate to identify patterns of thought and behaviors that may underlie roadblocks to success, making desired changes to sustain achievement of your positive life goals. I integrate approaches and methods to fit your needs, working to support the development of a resilient core sense of identity, allowing you to continually and successfully address life concerns during and after treatment.
My clients are unique individuals that become the central focus in our work together. By teaching practical application of therapeutic skills, clients are able to work on achieving personal goals in their everyday life. We collaborate to identify patterns of thought and behaviors that may underlie roadblocks to success, making desired changes to sustain achievement of your positive life goals. I integrate approaches and methods to fit your needs, working to support the development of a resilient core sense of identity, allowing you to continually and successfully address life concerns during and after treatment.
(443) 552-5894 View (443) 552-5894
Photo of Paula Byrd - Living Hope LLC, Licensed Clinical Professional Counselor, LCPC
Living Hope LLC
Licensed Clinical Professional Counselor, LCPC
Baltimore, MD 21215
Finding the right words to express yourself in the midst of your many thoughts and feelings can be so challenging. The stress of feeling like there are so many things happening all at once can leave you feeling stuck and hopeless, but there is hope.
Finding the right words to express yourself in the midst of your many thoughts and feelings can be so challenging. The stress of feeling like there are so many things happening all at once can leave you feeling stuck and hopeless, but there is hope.
(443) 348-0071 View (443) 348-0071
Photo of D. Jones, Clinical Social Work/Therapist, LCSW-C , LICSW
D. Jones
Clinical Social Work/Therapist, LCSW-C , LICSW
Online Only
Not accepting new clients
Breathe. Regardless of why you are seeking therapy, acknowledge the strength and courage it has taken you to commit to working on you. I salute you! As an experienced clinician, I have worked in various settings aiding individuals on their restorative journeys with anxiety, depression, communication struggles, relational challenges, low self-esteem, and a host of other mental health diagnoses. I utilized a strengths-based perspective while combining both psychodynamic and cognitive therapy approaches to support clients while in therapy.
Breathe. Regardless of why you are seeking therapy, acknowledge the strength and courage it has taken you to commit to working on you. I salute you! As an experienced clinician, I have worked in various settings aiding individuals on their restorative journeys with anxiety, depression, communication struggles, relational challenges, low self-esteem, and a host of other mental health diagnoses. I utilized a strengths-based perspective while combining both psychodynamic and cognitive therapy approaches to support clients while in therapy.
(410) 936-3190 View (410) 936-3190
Photo of Madeline Hartley, Licensed Clinical Professional Counselor, LCPC, NCC
Madeline Hartley
Licensed Clinical Professional Counselor, LCPC, NCC
6 Endorsed
Online Only
Madeline (she/her) is a Georgia native and a Licensed Clinical Professional Counselor (LCPC) in Maryland. She has extensive experience in individual and family counseling through her work at Johns Hopkins Bayview Medical Center's adult outpatient program, as well as through community group practice. Madeline has worked with a wide range of severe mental health disorders and has earned a specialization as a Certified Trauma Professional (CTP). She works with adults and couples experiencing anxiety, depression, relationship challenges, low self-esteem, and grief/loss.
Madeline (she/her) is a Georgia native and a Licensed Clinical Professional Counselor (LCPC) in Maryland. She has extensive experience in individual and family counseling through her work at Johns Hopkins Bayview Medical Center's adult outpatient program, as well as through community group practice. Madeline has worked with a wide range of severe mental health disorders and has earned a specialization as a Certified Trauma Professional (CTP). She works with adults and couples experiencing anxiety, depression, relationship challenges, low self-esteem, and grief/loss.
(443) 727-1505 View (443) 727-1505
Photo of MacKenna Price, Clinical Social Work/Therapist, LMSW
MacKenna Price
Clinical Social Work/Therapist, LMSW
1 Endorsed
Online Only
I am devoted to providing a warm, curious, and radically accepting space for clients to feel seen and heard in their entirety. It is an honor and a privilege to walk beside clients in their healing journeys. My holistic approach aims to normalize rather than pathologize whenever possible, and tenderly offer support wherever you feel called towards growth. Oftentimes, we get stuck in a tough season of life and discomfort becomes the norm. My hope is to empower you to return to an emotional space where safety and security are the norm again.
I am devoted to providing a warm, curious, and radically accepting space for clients to feel seen and heard in their entirety. It is an honor and a privilege to walk beside clients in their healing journeys. My holistic approach aims to normalize rather than pathologize whenever possible, and tenderly offer support wherever you feel called towards growth. Oftentimes, we get stuck in a tough season of life and discomfort becomes the norm. My hope is to empower you to return to an emotional space where safety and security are the norm again.
(443) 733-4665 View (443) 733-4665
Photo of Vamsi Tummalachetty, Psychologist, MA, PsyD
Vamsi Tummalachetty
Psychologist, MA, PsyD
Baltimore, MD 21224
Have trouble expressing your feelings or feel like you do not fit in or no one understands you? Does your family ned a nudge to live together more positively? When you receive care at our clinic, we do not only look at your condition(s); we look at you as an individual or family trying to improve your quality of life. Therefore, our approaches revolve around helping you to overcome your personal hurdles and thrive with a newfound sense of mental peace. We also focus on establishing affection and warmth in your relationship with your child in order to equip you in dealing with your child's struggles confidently.
Have trouble expressing your feelings or feel like you do not fit in or no one understands you? Does your family ned a nudge to live together more positively? When you receive care at our clinic, we do not only look at your condition(s); we look at you as an individual or family trying to improve your quality of life. Therefore, our approaches revolve around helping you to overcome your personal hurdles and thrive with a newfound sense of mental peace. We also focus on establishing affection and warmth in your relationship with your child in order to equip you in dealing with your child's struggles confidently.
(410) 709-7574 View (410) 709-7574
Photo of Oluremi Momodu - Caring Hands Behavioral Health Center, PMHNP, LCPC, LCSW-C, LMSW
Caring Hands Behavioral Health Center
Verified Verified
1 Endorsed
Baltimore, MD 21218
Our ideal client is someone struggling with emotional or mental health challenges like anxiety, depression, or difficulty managing daily life. They may feel isolated, overwhelmed, or stuck—and they need support they can trust. They rely on Medicaid and seek affordable, accessible care. Their goals include feeling more stable, improving daily functioning, building confidence, and finding peace. They want to be heard, supported, and equipped with tools to manage life more effectively. Most of all, they want to feel better and know they’re not alone on the journey.
Our ideal client is someone struggling with emotional or mental health challenges like anxiety, depression, or difficulty managing daily life. They may feel isolated, overwhelmed, or stuck—and they need support they can trust. They rely on Medicaid and seek affordable, accessible care. Their goals include feeling more stable, improving daily functioning, building confidence, and finding peace. They want to be heard, supported, and equipped with tools to manage life more effectively. Most of all, they want to feel better and know they’re not alone on the journey.
(443) 298-2625 x101 View (443) 298-2625 x101
Photo of Jennifer Pritchett - Ready To Thrive Counseling, Clinical Social Work/Therapist, MSW, LCSW-C
Ready To Thrive Counseling
Clinical Social Work/Therapist, MSW, LCSW-C
Online Only
Congratulations on taking the first step towards growth and healing. My name is Jennifer, I am a clinical social worker with 7 years as a licensed therapist. I provide a safe, nonjudgmental space for you to discuss concerns or areas you would like to grow while using evidenced based methods. It would be my pleasure to help you along in your journey of living a life that thrives.
Congratulations on taking the first step towards growth and healing. My name is Jennifer, I am a clinical social worker with 7 years as a licensed therapist. I provide a safe, nonjudgmental space for you to discuss concerns or areas you would like to grow while using evidenced based methods. It would be my pleasure to help you along in your journey of living a life that thrives.
(443) 258-5702 View (443) 258-5702
Photo of Dr. Xiaoying Amber Wu, Psychologist, PsyD
Dr. Xiaoying Amber Wu
Psychologist, PsyD
1 Endorsed
Online Only
I think of my practice as a magnifying glass, one that zooms in on feelings and beliefs that are daunting to examine but painfully hold us captive every day. Too often, we are left feeling cyclically, if not perpetually, disconnected, confused, stagnant, and dissatisfied. I strive to create a collaborative and compassionate space for you to access those vulnerable parts of yourself. I also believe in the power of relationships – ones we have with others and ourselves. In addition to examining your pains in relational terms across time, we will likely explore your needs and values and the realistic ways to fulfill and embody them.
I think of my practice as a magnifying glass, one that zooms in on feelings and beliefs that are daunting to examine but painfully hold us captive every day. Too often, we are left feeling cyclically, if not perpetually, disconnected, confused, stagnant, and dissatisfied. I strive to create a collaborative and compassionate space for you to access those vulnerable parts of yourself. I also believe in the power of relationships – ones we have with others and ourselves. In addition to examining your pains in relational terms across time, we will likely explore your needs and values and the realistic ways to fulfill and embody them.
(410) 929-4439 View (410) 929-4439
Photo of Shawn Smith, Counselor, MA, LCPC
Shawn Smith
Counselor, MA, LCPC
Baltimore, MD 21209
Hello - I am a licensed clinical professional counselor (L.C.P.C.), and a licensed clinical alcohol and drug counselor (L.C.A.D.C.). I've been assisting individuals with mental health and behavioral health disorders, in addition to substance use disorders, in and around the Baltimore, Maryland area for the past 23-years. I believe that a solid therapeutic relationship and a good sense of humor are critical to exploring some of life's greatest challenges and obstacles. With a little effort and guidance, almost anyone can accomplish almost anything!
Hello - I am a licensed clinical professional counselor (L.C.P.C.), and a licensed clinical alcohol and drug counselor (L.C.A.D.C.). I've been assisting individuals with mental health and behavioral health disorders, in addition to substance use disorders, in and around the Baltimore, Maryland area for the past 23-years. I believe that a solid therapeutic relationship and a good sense of humor are critical to exploring some of life's greatest challenges and obstacles. With a little effort and guidance, almost anyone can accomplish almost anything!
(410) 559-9293 View (410) 559-9293
Photo of Andrew J Burns, Psychologist, PhD
Andrew J Burns
Psychologist, PhD
Baltimore, MD 21208
Choosing a child psychologist is not an easy task. I have been working as a licensed psychologist for over a decade, helping children, teens, young adults, and families cope with many of the difficulties they face. Primarily a specialist in Cognitive-Behavioral Therapy, I also use Behavior Therapy, Family Therapy, and traditional Individual/Interpersonal Therapy to help reach your goals. Also, I can perform psychological/psychoeducational evaluations to help guide a plan to improved grades and overall performance. Please feel free to call to discuss how I can help!
Choosing a child psychologist is not an easy task. I have been working as a licensed psychologist for over a decade, helping children, teens, young adults, and families cope with many of the difficulties they face. Primarily a specialist in Cognitive-Behavioral Therapy, I also use Behavior Therapy, Family Therapy, and traditional Individual/Interpersonal Therapy to help reach your goals. Also, I can perform psychological/psychoeducational evaluations to help guide a plan to improved grades and overall performance. Please feel free to call to discuss how I can help!
(410) 501-5015 View (410) 501-5015
Photo of Janet Moos, Clinical Social Work/Therapist, LCSW-C
Janet Moos
Clinical Social Work/Therapist, LCSW-C
4 Endorsed
Baltimore, MD 21210
Not accepting new clients
Being able to provide good therapy requires that the therapist has a strong knowledge base and a good set of skills. My education and training and 30 years of experience in the field are central to my ability to help you. I have degrees from Harvard University and University of Michigan. I also have experience with Mindfulness-Based Stress Reduction and training in family and couples therapy through the Philadelphia Child Guidance Clinic. In addition, I completed a Fellowship at the Baltimore-Washington Psychoanalytic Institute.
Being able to provide good therapy requires that the therapist has a strong knowledge base and a good set of skills. My education and training and 30 years of experience in the field are central to my ability to help you. I have degrees from Harvard University and University of Michigan. I also have experience with Mindfulness-Based Stress Reduction and training in family and couples therapy through the Philadelphia Child Guidance Clinic. In addition, I completed a Fellowship at the Baltimore-Washington Psychoanalytic Institute.
(410) 433-3129 View (410) 433-3129
Photo of Patricia Cobb, MS
Patricia Cobb
Verified Verified
Baltimore, MD 21210
My ideal client is someone who has been through some of life’s unexpected and difficult turns—like the loss of a loved one, a painful breakup, career burnout, family tension, major disappointments, or goals that never quite came to life. These experiences may have left them feeling stuck, anxious, disconnected, or questioning their worth and direction. They may look like they’re holding it together on the outside but feel overwhelmed, unseen, or exhausted on the inside. Deep down they know they can feel better. They come to me because they’re ready for change, and to heal in a way that feels deep, grounded, and lasting.
My ideal client is someone who has been through some of life’s unexpected and difficult turns—like the loss of a loved one, a painful breakup, career burnout, family tension, major disappointments, or goals that never quite came to life. These experiences may have left them feeling stuck, anxious, disconnected, or questioning their worth and direction. They may look like they’re holding it together on the outside but feel overwhelmed, unseen, or exhausted on the inside. Deep down they know they can feel better. They come to me because they’re ready for change, and to heal in a way that feels deep, grounded, and lasting.
(443) 658-5048 View (443) 658-5048
Photo of Tia L Blue - LoveTalks LLC, Clinical Social Work/Therapist, LCSW-C
LoveTalks LLC
Clinical Social Work/Therapist, LCSW-C
Online Only
My ideal clients are professional women experiencing relationship challenges in their personal and professional relationships. These woman are successful in certain aspects of their lives but struggle with anxiety, unhappiness, loneliness and trust issues in their relationships. They want inner peace, self acceptance and healthy relationships with themselves and others. This will allow them to confidently pursue their professional goals and life purpose.
My ideal clients are professional women experiencing relationship challenges in their personal and professional relationships. These woman are successful in certain aspects of their lives but struggle with anxiety, unhappiness, loneliness and trust issues in their relationships. They want inner peace, self acceptance and healthy relationships with themselves and others. This will allow them to confidently pursue their professional goals and life purpose.
(443) 399-2978 View (443) 399-2978
Photo of Carmen Pendleton, Licensed Clinical Professional Counselor, LCPC
Carmen Pendleton
Licensed Clinical Professional Counselor, LCPC
Online Only
I am a straightforward, honest and solution oriented therapist. I specialize in the treatment of anxiety related issues. My approach is eclectic but majority person centered.
I am a straightforward, honest and solution oriented therapist. I specialize in the treatment of anxiety related issues. My approach is eclectic but majority person centered.
(443) 351-6253 View (443) 351-6253
Photo of Amber M Reed, Clinical Social Work/Therapist, LCSW-C
Amber M Reed
Clinical Social Work/Therapist, LCSW-C
Online Only
Life sometimes comes at us hard but I am here to support & encourage you to find your voice (you ever scream in the shower or car? Try it). I will support & challenge you to say "NO" (trust me it's not a cuss word). I will support you in finding & stepping into your power (put on some boots, we bout to kick life back HARD). I will support & celebrate your worth (Shine Bright Like a Diamond). I will support & embrace your magic (Yes, I do have & carry a wand). I will support & honor your heart work (Healing Vibes - with a dope playlist). I am rooting for YOU..
Life sometimes comes at us hard but I am here to support & encourage you to find your voice (you ever scream in the shower or car? Try it). I will support & challenge you to say "NO" (trust me it's not a cuss word). I will support you in finding & stepping into your power (put on some boots, we bout to kick life back HARD). I will support & celebrate your worth (Shine Bright Like a Diamond). I will support & embrace your magic (Yes, I do have & carry a wand). I will support & honor your heart work (Healing Vibes - with a dope playlist). I am rooting for YOU..
(410) 755-5084 View (410) 755-5084

See more therapy options for Baltimore

How does your Therapist compare?

Number of Therapists in Baltimore, MD

2,000+

Average cost per session

$150

Therapists in Baltimore, MD who prioritize treating:

93% Anxiety
88% Depression
70% Relationship Issues
70% Self Esteem
69% Stress
67% Trauma and PTSD
65% Coping Skills

Average years in practice

10 Years

Top 3 insurances accepted

74% Cigna and Evernorth
71% BlueCross and BlueShield
67% CareFirst

How Therapists in Baltimore, MD see their clients

55% Online Only
45% In Person and Online

Gender breakdown

78% Female
19% Male
3% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Baltimore?

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.