Therapists in North Potomac, MD

Photo of Suzanne Lavoie Dell'Orfano, Clinical Social Work/Therapist in North Potomac, MD
Suzanne Lavoie Dell'Orfano
Clinical Social Work/Therapist, MSW, LCSW-C
Verified Verified
North Potomac, MD 20878
Are you experiencing feelings of anxiety and/or sadness after the birth of your child? Are you struggling with your identity after becoming a mom? Do you feel like you are suffering in silence because you are afraid to share your thoughts with others? You are not alone and I am here to help. I work with women experiencing difficulties related to postpartum depression and anxiety and the feelings of isolation that go along with it. In addition, I work with women experiencing life transitions. I have a strengths based approach to working with individuals and I will work with you toward the best outcomes.
Are you experiencing feelings of anxiety and/or sadness after the birth of your child? Are you struggling with your identity after becoming a mom? Do you feel like you are suffering in silence because you are afraid to share your thoughts with others? You are not alone and I am here to help. I work with women experiencing difficulties related to postpartum depression and anxiety and the feelings of isolation that go along with it. In addition, I work with women experiencing life transitions. I have a strengths based approach to working with individuals and I will work with you toward the best outcomes.
(240) 949-7653 View (240) 949-7653
Photo of John Danna, Psychologist in North Potomac, MD
John Danna
Psychologist, PhD
Verified Verified
1 Endorsed
North Potomac, MD 20878
It is imperative for me to provide my clients with a warm, safe, and comfortable therapeutic space in which they will be invited to share, explore, and grow. Building a healthy collaborative relationship with my clients provides a foundation for our work together. I not only seek to alleviate symptoms and foster self-understanding, but I also encourage my clients to learn from their symptoms. I have found that increasing one's sense of awareness and balance can be helpful in many situations. At the same time, I do my best to meet clients where they are in their lives and work at their pace.
It is imperative for me to provide my clients with a warm, safe, and comfortable therapeutic space in which they will be invited to share, explore, and grow. Building a healthy collaborative relationship with my clients provides a foundation for our work together. I not only seek to alleviate symptoms and foster self-understanding, but I also encourage my clients to learn from their symptoms. I have found that increasing one's sense of awareness and balance can be helpful in many situations. At the same time, I do my best to meet clients where they are in their lives and work at their pace.
(240) 297-0116 View (240) 297-0116
Photo of Birgit Cox, Licensed Clinical Professional Counselor in North Potomac, MD
Birgit Cox
Licensed Clinical Professional Counselor, PhD, LCPC
Verified Verified
1 Endorsed
North Potomac, MD 20878
I see my work with people as helping them to live happier and more fulfilling lives. Because we are all different, my services are highly individualized and I do not have a "one-size-fits-all" approach. I take a collaborative approach to working with you. Together, we will first understand your issues and then find better ways of coping, by learning and practicing skills that will allow you to make long-term changes in your life.
I see my work with people as helping them to live happier and more fulfilling lives. Because we are all different, my services are highly individualized and I do not have a "one-size-fits-all" approach. I take a collaborative approach to working with you. Together, we will first understand your issues and then find better ways of coping, by learning and practicing skills that will allow you to make long-term changes in your life.
(301) 323-8617 View (301) 323-8617
Photo of Stephanie Natter, Art Therapist in North Potomac, MD
Stephanie Natter
Art Therapist, MA, ATR-BC, CGP, LCPAT
Verified Verified
2 Endorsed
North Potomac, MD 20878
I understand that there are many things in life that influence us and take a toll on our emotional well-being. I believe that with effective support, guidance and understanding, you have the ability to not only find the answers to your problems, but the strength to make positive changes in your life. Expressive Therapy Center offers a family-focused and individualized approach that is unique to each client and his or her family's needs.
I understand that there are many things in life that influence us and take a toll on our emotional well-being. I believe that with effective support, guidance and understanding, you have the ability to not only find the answers to your problems, but the strength to make positive changes in your life. Expressive Therapy Center offers a family-focused and individualized approach that is unique to each client and his or her family's needs.
(301) 861-4416 x1 View (301) 861-4416 x1
Photo of Donna Mowry, Counselor in North Potomac, MD
Donna Mowry
Counselor, MA, MS, LCPC, NCC
Verified Verified
North Potomac, MD 20878  (Online Only)
Not accepting new clients
Life isn't always easy! Sometimes, even the strongest people amongst us need a little bit of help to work through some of life's more challenging problems. Everyone has battles to fight and hurdles to overcome at some point. Whether you struggle with depression, anxiety, self-esteem, difficult life transitions, trauma, or any other issue, you should know that there is hope for a better tomorrow. I view my role as the therapist as being a conduit of light that gently guides you to discover a life fully lived --- with more happiness, purpose, and passion.
Life isn't always easy! Sometimes, even the strongest people amongst us need a little bit of help to work through some of life's more challenging problems. Everyone has battles to fight and hurdles to overcome at some point. Whether you struggle with depression, anxiety, self-esteem, difficult life transitions, trauma, or any other issue, you should know that there is hope for a better tomorrow. I view my role as the therapist as being a conduit of light that gently guides you to discover a life fully lived --- with more happiness, purpose, and passion.
(301) 822-2361 View (301) 822-2361
Photo of Marci Michelle Fenton, Clinical Social Work/Therapist in North Potomac, MD
Marci Michelle Fenton
Clinical Social Work/Therapist, LCSW-C
Verified Verified
North Potomac, MD 20878
I take an eclectic approach when working with a diversity of clients who primarily experience anxiety disorders, relationship challenges, and depression. Likewise, I implement creative strategies to help my clients achieve their goals through assigned work outside of the office.
I take an eclectic approach when working with a diversity of clients who primarily experience anxiety disorders, relationship challenges, and depression. Likewise, I implement creative strategies to help my clients achieve their goals through assigned work outside of the office.
(301) 660-4473 View (301) 660-4473
Photo of Veronica L Tunon, Clinical Social Work/Therapist in North Potomac, MD
Veronica L Tunon
Clinical Social Work/Therapist, LCSW-C
Verified Verified
6 Endorsed
North Potomac, MD 20878
Not accepting new clients
I specialize in working with adult clients to offer a collaborative, strengths-based perspective to encourage positive growth and empowerment for my clients. My goal is to create a safe, respectful, non-judgmental environment which helps clients thrive. I have additional experience working with families to navigate the challenge--and rewards--of raising a child with special needs.
I specialize in working with adult clients to offer a collaborative, strengths-based perspective to encourage positive growth and empowerment for my clients. My goal is to create a safe, respectful, non-judgmental environment which helps clients thrive. I have additional experience working with families to navigate the challenge--and rewards--of raising a child with special needs.
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Photo of Debra L Caplan, Licensed Clinical Professional Counselor in North Potomac, MD
Debra L Caplan
Licensed Clinical Professional Counselor, MS, LCPC
Verified Verified
North Potomac, MD 20878  (Online Only)
Is this the life you imagined you'd have? Do you suffer from depression, loneliness, anxiety, relationship or self-esteem problems, work or family difficulties? I work with adults going through transitions and with people who would like to understand how their past affects them today.
Is this the life you imagined you'd have? Do you suffer from depression, loneliness, anxiety, relationship or self-esteem problems, work or family difficulties? I work with adults going through transitions and with people who would like to understand how their past affects them today.
(240) 266-3247 View (240) 266-3247
Photo of Gunjan Gotra, Counselor in North Potomac, MD
Gunjan Gotra
Counselor, LCPC
Verified Verified
North Potomac, MD 20878  (Online Only)
I am a Licensed Professional Counselor with 8-10 years of experience working with children, teens, adults and families. I completed my Masters in Mental Health Counseling from Boston University School of Medicine in 2009. I have experience working with individuals struggling with stress, depression, anxiety, trauma, divorce, substance abuse, family conflict, infertility, ADHD and more. I am a first-generation immigrant who enjoys learning about and working with individuals from different cultures.
I am a Licensed Professional Counselor with 8-10 years of experience working with children, teens, adults and families. I completed my Masters in Mental Health Counseling from Boston University School of Medicine in 2009. I have experience working with individuals struggling with stress, depression, anxiety, trauma, divorce, substance abuse, family conflict, infertility, ADHD and more. I am a first-generation immigrant who enjoys learning about and working with individuals from different cultures.
(240) 556-2780 View (240) 556-2780
Photo of Ellen L Levin, Clinical Social Work/Therapist in North Potomac, MD
Ellen L Levin
Clinical Social Work/Therapist, MSW, LICSW, LCSW-C
Verified Verified
North Potomac, MD 20878  (Online Only)
I work with anyone who is experiencing a wide range of social and emotional difficulties including sadness, anxiety, phobias, family and life transitions and friendships. I provide individual therapy, family therapy and parent coaching in a warm, safe and non-judgmental environment in order to address individual needs and concerns. In addition, I provide support and guidance in promoting additional understanding of family dynamics and facilitating a better channel of communication between family members. I enjoy working collaboratively with families to find unique ways to help their children or themselves to progress and heal.
I work with anyone who is experiencing a wide range of social and emotional difficulties including sadness, anxiety, phobias, family and life transitions and friendships. I provide individual therapy, family therapy and parent coaching in a warm, safe and non-judgmental environment in order to address individual needs and concerns. In addition, I provide support and guidance in promoting additional understanding of family dynamics and facilitating a better channel of communication between family members. I enjoy working collaboratively with families to find unique ways to help their children or themselves to progress and heal.
(301) 761-5871 View (301) 761-5871
Photo of Robert Shugoll, Psychologist in North Potomac, MD
Robert Shugoll
Psychologist, PhD
Verified Verified
North Potomac, MD 20878  (Online Only)
Not accepting new clients
People seek psychotherapy for a variety of reasons.  You may be challenged by specific anxieties, depression, relationship issues or have an interest in self-growth.  As an experienced Ph.D. psychologist I will tune into how you experience your concerns and help you move towards your goals. I have a relaxed manner and will work with you collaboratively. We will build on existing personal strengths and determine ways of getting freed up from the negative patterns and experiences which have caused distress.
People seek psychotherapy for a variety of reasons.  You may be challenged by specific anxieties, depression, relationship issues or have an interest in self-growth.  As an experienced Ph.D. psychologist I will tune into how you experience your concerns and help you move towards your goals. I have a relaxed manner and will work with you collaboratively. We will build on existing personal strengths and determine ways of getting freed up from the negative patterns and experiences which have caused distress.
(301) 485-6667 View (301) 485-6667
Photo of Lisa Makstein, Clinical Social Work/Therapist in North Potomac, MD
Lisa Makstein
Clinical Social Work/Therapist, LCSW-C, LICSW
Verified Verified
North Potomac, MD 20878  (Online Only)
As a psychotherapist for the past 30+ years, I feel passionate about helping people experience more joy and contentment in their relationships and in their lives. I believe that every crisis or problem that arises also provides an opportunity for healing and growth. Whether you are depressed, anxious, having marital conflicts, parenting difficulties, recovering from a traumatic experience, or in the midst of a life transition, we can problem-solve together and discover new possibilities for you. My style can best be described as interactive and engaging. I am a supportive listener, yet give honest feedback and offer suggestions for positive actions.
As a psychotherapist for the past 30+ years, I feel passionate about helping people experience more joy and contentment in their relationships and in their lives. I believe that every crisis or problem that arises also provides an opportunity for healing and growth. Whether you are depressed, anxious, having marital conflicts, parenting difficulties, recovering from a traumatic experience, or in the midst of a life transition, we can problem-solve together and discover new possibilities for you. My style can best be described as interactive and engaging. I am a supportive listener, yet give honest feedback and offer suggestions for positive actions.
(301) 485-6939 View (301) 485-6939
Photo of Brenda L Yuen, Counselor in North Potomac, MD
Brenda L Yuen
Counselor, LCPC, NCC
Verified Verified
1 Endorsed
North Potomac, MD 20878  (Online Only)
Are you a teenager (or young adult) who struggles with cultural and racial identity due to immigration, parental or familial immigration, or international/inter-racial adoption? Or are you a teen (15 to 18) or adult of any age with anxiety, depression, self-esteem, anger, and/or struggling with life adjustments? Because education is power, we will touch on MH concepts through psycho-educational information and focus on other personal tools to help you learn new ways of relating with, changing, or living along side your struggles. Hope comes from willingness to change and grow! As of October, 2023, I have a few openings.
Are you a teenager (or young adult) who struggles with cultural and racial identity due to immigration, parental or familial immigration, or international/inter-racial adoption? Or are you a teen (15 to 18) or adult of any age with anxiety, depression, self-esteem, anger, and/or struggling with life adjustments? Because education is power, we will touch on MH concepts through psycho-educational information and focus on other personal tools to help you learn new ways of relating with, changing, or living along side your struggles. Hope comes from willingness to change and grow! As of October, 2023, I have a few openings.
(301) 329-6090 View (301) 329-6090
Photo of Raymond McLaughlin, Clinical Social Work/Therapist in North Potomac, MD
Raymond McLaughlin
Clinical Social Work/Therapist, LCSW-C, NBCCH
Verified Verified
North Potomac, MD 20878  (Online Only)
Not accepting new clients
We started our company, ABC Therapeutic Solutions, with the goal of providing the best quality evidenced based therapy possible. Dealing with stress, depression, anxiety, impulsivity, family or relationship conflict and other mental health symptoms, can have a serious impact on your health. Our mission is to approach treatment from a total health perspective to help you find a balance that meets your emotional, psychological and physical needs.
We started our company, ABC Therapeutic Solutions, with the goal of providing the best quality evidenced based therapy possible. Dealing with stress, depression, anxiety, impulsivity, family or relationship conflict and other mental health symptoms, can have a serious impact on your health. Our mission is to approach treatment from a total health perspective to help you find a balance that meets your emotional, psychological and physical needs.
(301) 701-4803 View (301) 701-4803
Photo of Emily Pavlick, Clinical Social Work/Therapist in North Potomac, MD
Emily Pavlick
Clinical Social Work/Therapist, LCSW-C, MA
Verified Verified
North Potomac, MD 20878  (Online Only)
Authenticity, genuineness, and deep empathy form the foundation for the way I find connection with my clients. I come from a client-centered approach where unconditional positive regard drives the work we will do. I’ve always believed that people are as different on the inside as they look on the outside and it is my job to connect with that special uniqueness to best support your growth. I approach therapy with compassion, warmth, a sense of humor, and without judgement. My goal is to provide a safe and comforting space for you to process any struggles, big and small, while learning to increase happiness and decrease pain.
Authenticity, genuineness, and deep empathy form the foundation for the way I find connection with my clients. I come from a client-centered approach where unconditional positive regard drives the work we will do. I’ve always believed that people are as different on the inside as they look on the outside and it is my job to connect with that special uniqueness to best support your growth. I approach therapy with compassion, warmth, a sense of humor, and without judgement. My goal is to provide a safe and comforting space for you to process any struggles, big and small, while learning to increase happiness and decrease pain.
(301) 215-3765 View (301) 215-3765
Photo of Nicole Jackson, Clinical Social Work/Therapist in North Potomac, MD
Nicole Jackson
Clinical Social Work/Therapist, LCSW-C, MSW
Verified Verified
North Potomac, MD 20878  (Online Only)
I believe that effective therapy is built on trust and unconditional empathy. My treatment approach is rooted in the importance of the individual, using methods such as Cognitive Behavioral Therapy (CBT), Strength-Based Therapy, and Somatic skills. In our sessions, you can expect a warm, judgment free space where you can openly express your thoughts and feelings. I am dedicated to taking the time to truly get to know you, so that I can incorporate your interests into treatment in creative ways. I want you to not only process your past, but be equipped with practical tools to fuel your future.
I believe that effective therapy is built on trust and unconditional empathy. My treatment approach is rooted in the importance of the individual, using methods such as Cognitive Behavioral Therapy (CBT), Strength-Based Therapy, and Somatic skills. In our sessions, you can expect a warm, judgment free space where you can openly express your thoughts and feelings. I am dedicated to taking the time to truly get to know you, so that I can incorporate your interests into treatment in creative ways. I want you to not only process your past, but be equipped with practical tools to fuel your future.
(301) 591-6086 View (301) 591-6086
Photo of Mia Joelsson, Clinical Social Work/Therapist in North Potomac, MD
Mia Joelsson
Clinical Social Work/Therapist, MSW, LCSW-C, LCSW
Verified Verified
5 Endorsed
North Potomac, MD 20878
Are you experiencing a reproductive issue (like infertility, pregnancy, postpartum adjustment, pregnancy loss, parenting challenges) that is affecting you emotionally? Are you trying to be strong on the outside, but inside you feel like you are falling apart? Maybe you are pregnant or had a baby recently and just don't feel like yourself? Or getting pregnant is harder than you expected it to be? Have you tried talking to family or friends but no one understands? I understand. You don't have to do this alone any more. Working together, we will help you feel better. There is hope.
Are you experiencing a reproductive issue (like infertility, pregnancy, postpartum adjustment, pregnancy loss, parenting challenges) that is affecting you emotionally? Are you trying to be strong on the outside, but inside you feel like you are falling apart? Maybe you are pregnant or had a baby recently and just don't feel like yourself? Or getting pregnant is harder than you expected it to be? Have you tried talking to family or friends but no one understands? I understand. You don't have to do this alone any more. Working together, we will help you feel better. There is hope.
(240) 696-7438 View (240) 696-7438
Photo of Amy Henry, Licensed Professional Counselor in North Potomac, MD
Amy Henry
Licensed Professional Counselor, LCPC
Verified Verified
1 Endorsed
North Potomac, MD 20878  (Online Only)
Licensed in MD, DC, VA, NJ. If you’re reading this, then you’ve already taken the first step toward healing. If you are struggling with anxiety, depression, bipolar disorder, eating disorder, trauma, or other challenges, I can help you forge a path forward. I will work collaboratively with you to establish personalized therapy goals tailored to your specific needs. I will work diligently to foster an environment in which you feel safe, accepted, seen, heard, and never judged. In our work together, you can expect me to be compassionate, honest, and real; I will be patient and encourage you to confront the deeper, underlying issues.
Licensed in MD, DC, VA, NJ. If you’re reading this, then you’ve already taken the first step toward healing. If you are struggling with anxiety, depression, bipolar disorder, eating disorder, trauma, or other challenges, I can help you forge a path forward. I will work collaboratively with you to establish personalized therapy goals tailored to your specific needs. I will work diligently to foster an environment in which you feel safe, accepted, seen, heard, and never judged. In our work together, you can expect me to be compassionate, honest, and real; I will be patient and encourage you to confront the deeper, underlying issues.
(410) 612-3808 View (410) 612-3808
Photo of Beth Ann Smith, Clinical Social Work/Therapist in North Potomac, MD
Beth Ann Smith
Clinical Social Work/Therapist, LCSW-C
Verified Verified
North Potomac, MD 20878
Are you interested in therapy that gets you off of the couch or out of the office? Do you want to actively participate in your growth? Reflect In Motion therapy is a great tool for this! I offer a wellness model that combines traditional talk therapy with walking in the outdoors. Evidence-based research has confirmed that this combination can help you open up more quickly and comfortably, increase your energy, sharpen your focus and concentration, positively change your mood and behavior, and help you cope with daily life stressors. Being in nature calms the mind and promotes feelings of peacefulness and tranquility.
Are you interested in therapy that gets you off of the couch or out of the office? Do you want to actively participate in your growth? Reflect In Motion therapy is a great tool for this! I offer a wellness model that combines traditional talk therapy with walking in the outdoors. Evidence-based research has confirmed that this combination can help you open up more quickly and comfortably, increase your energy, sharpen your focus and concentration, positively change your mood and behavior, and help you cope with daily life stressors. Being in nature calms the mind and promotes feelings of peacefulness and tranquility.
(240) 219-8169 View (240) 219-8169
Photo of New Chapter Counseling:Adult &Senior Mental Health, Clinical Social Work/Therapist in North Potomac, MD
New Chapter Counseling:Adult &Senior Mental Health
Clinical Social Work/Therapist, LCSW-C
Verified Verified
North Potomac, MD 20878
As a clinician , I try to create a supportive, safe and collaborative environment for my clients to improve their strengths ,widen their resources and create usable coping skills to help navigate their current challenges. I have extra training in the treatment of aging, anxiety, depression, trauma, senior and elder care issues, grief and loss
As a clinician , I try to create a supportive, safe and collaborative environment for my clients to improve their strengths ,widen their resources and create usable coping skills to help navigate their current challenges. I have extra training in the treatment of aging, anxiety, depression, trauma, senior and elder care issues, grief and loss
(240) 774-2750 View (240) 774-2750

See more therapy options for North Potomac

How does your Therapist compare?

Number of Therapists in North Potomac, MD

70+

Average cost per session

$150

Therapists in North Potomac, MD who prioritize treating:

97% Anxiety
96% Depression
93% Relationship Issues
84% Self Esteem
78% Grief
77% Coping Skills
73% Family Conflict

Average years in practice

15 Years

Top 3 insurances accepted

91% BlueCross and BlueShield
83% CareFirst
74% Cigna and Evernorth

How Therapists in North Potomac, MD see their clients

65% In Person and Online
35% Online Only

Gender breakdown

88% Female
12% Male

FAQs - About Therapy and Counseling

How can I find a therapist in North Potomac?

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.