Therapists in Androscoggin County, ME

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Photo of Nate Miller, Clinical Social Work/Therapist in Androscoggin County, ME
Nate Miller
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Lewiston, ME 04240
I enjoy working with people from all walks of life and throughout the lifespan. I tailor evidence-based therapeutic approaches to meet the needs, expectations, and goals of my clients. I use client centered methods grounded in Cognitive Behavioral Therapy, focusing on strengths, positive psychology, gratitude, mindfulness, relationships, choices, and solutions. I offer individual therapy and I co-facilitate a teen art therapy group in Lewiston on Saturday mornings. I am also certified for Ketamine Assisted Psychotherapy.
I enjoy working with people from all walks of life and throughout the lifespan. I tailor evidence-based therapeutic approaches to meet the needs, expectations, and goals of my clients. I use client centered methods grounded in Cognitive Behavioral Therapy, focusing on strengths, positive psychology, gratitude, mindfulness, relationships, choices, and solutions. I offer individual therapy and I co-facilitate a teen art therapy group in Lewiston on Saturday mornings. I am also certified for Ketamine Assisted Psychotherapy.
(207) 389-7784 View (207) 389-7784
Photo of Wendy Lynne Frayer, Clinical Social Work/Therapist in Androscoggin County, ME
Wendy Lynne Frayer
Clinical Social Work/Therapist, LCSW
Verified Verified
Lewiston, ME 04240  (Online Only)
Not accepting new clients
Have you been feeling overwhelmed, stuck, and/or unsupported in your life? Has getting along with others kept you distant and feeling alone? Are you plagued by negative and/or worrisome thoughts that keep you from making decisions? It can be scary to begin the process of therapy and wondering if it can help you. Imagine feeling more confident in yourself and your choices. Maybe you would like to feel more connected to self and others. Together, we will develop safety and trust in the relationship that allows for insight and collaboration into your healing journey.
Have you been feeling overwhelmed, stuck, and/or unsupported in your life? Has getting along with others kept you distant and feeling alone? Are you plagued by negative and/or worrisome thoughts that keep you from making decisions? It can be scary to begin the process of therapy and wondering if it can help you. Imagine feeling more confident in yourself and your choices. Maybe you would like to feel more connected to self and others. Together, we will develop safety and trust in the relationship that allows for insight and collaboration into your healing journey.
(207) 203-6949 View (207) 203-6949
Photo of Lacey Marie Graffam, Counselor in Androscoggin County, ME
Lacey Marie Graffam
Counselor, LCPC
Verified Verified
2 Endorsed
Auburn, ME 04211  (Online Only)
Waitlist for new clients
Have you experienced difficulty in your past that you feel impacts you presently? Would you benefit from having someone in your corner while you navigate this stage of your life? I would love to explore whether I might be a good fit to help you move forward towards positive change. The therapeutic space I provide for my clients is non-judgmental, confidential, and built upon empathic understanding. We collaborate as a team to understand your struggles, process potential roots, and apply appropriate coping strategies suited for you individually.
Have you experienced difficulty in your past that you feel impacts you presently? Would you benefit from having someone in your corner while you navigate this stage of your life? I would love to explore whether I might be a good fit to help you move forward towards positive change. The therapeutic space I provide for my clients is non-judgmental, confidential, and built upon empathic understanding. We collaborate as a team to understand your struggles, process potential roots, and apply appropriate coping strategies suited for you individually.
(207) 218-0509 View (207) 218-0509
Photo of Emily Ellis, Counselor in Androscoggin County, ME
Emily Ellis
Counselor, LCPC, NCC, CADC
Verified Verified
Auburn, ME 04210
Thank you for your interest in learning about my practice. Are you feeling stuck in life's ruts and unsure of a way out? Together, we will build a safe partnership and work toward a greater sense of clarity and balance. I will strive to better understand how your challenges and conflicts interfere with your daily functioning. Using my person-centered approach, I will help you explore, rediscover your strengths, resources and goals and how th can be channeled to help you feel more in control and confident.
Thank you for your interest in learning about my practice. Are you feeling stuck in life's ruts and unsure of a way out? Together, we will build a safe partnership and work toward a greater sense of clarity and balance. I will strive to better understand how your challenges and conflicts interfere with your daily functioning. Using my person-centered approach, I will help you explore, rediscover your strengths, resources and goals and how th can be channeled to help you feel more in control and confident.
(207) 494-4956 View (207) 494-4956
Photo of Christine Audet, Clinical Social Work/Therapist in Androscoggin County, ME
Christine Audet
Clinical Social Work/Therapist, LCSW, LADC, PMH-C
Verified Verified
Lewiston, ME 04240
Not accepting new clients
Many of us are working through challenging phases in our lives. Challenges such as past trauma, relationship issues, or having unhealthy ways to cope that can lead to unwelcoming thoughts, feelings and behaviors. Reaching out for help is the first step in the process of healing, letting go and learning how to find our own personal strength to move forward. My role as your therapist will be to help you identify goals that will support you in achieving success in whatever areas of life you are struggling with. I will guide you in your own unique process of understanding where you are and where you would like to be.
Many of us are working through challenging phases in our lives. Challenges such as past trauma, relationship issues, or having unhealthy ways to cope that can lead to unwelcoming thoughts, feelings and behaviors. Reaching out for help is the first step in the process of healing, letting go and learning how to find our own personal strength to move forward. My role as your therapist will be to help you identify goals that will support you in achieving success in whatever areas of life you are struggling with. I will guide you in your own unique process of understanding where you are and where you would like to be.
(207) 481-4606 View (207) 481-4606
Photo of Rose Heikkinen, Counselor in Androscoggin County, ME
Rose Heikkinen
Counselor, LCPC
Verified Verified
Lewiston, ME 04240
Waitlist for new clients
At times an individual may want extra support to talk about and or explore areas in their life that are causing stress: It can lead to anxiety, depression, mood changes, substance use, compulsive behaviors, and anger. If anyone of these emotional or behavioral issues become significant it can affect relationships, education, finances or day to day functioning. In session, the individual will examine past, present and future experiences that impact thoughts, behaviors, and emotions. There are appropriate and inappropriate ways to better cope with stressors in our life and in session the client will examine which strategies work best.
At times an individual may want extra support to talk about and or explore areas in their life that are causing stress: It can lead to anxiety, depression, mood changes, substance use, compulsive behaviors, and anger. If anyone of these emotional or behavioral issues become significant it can affect relationships, education, finances or day to day functioning. In session, the individual will examine past, present and future experiences that impact thoughts, behaviors, and emotions. There are appropriate and inappropriate ways to better cope with stressors in our life and in session the client will examine which strategies work best.
(207) 506-0247 View (207) 506-0247
Photo of Bryce Libby, Clinical Social Work/Therapist in Androscoggin County, ME
Bryce Libby
Clinical Social Work/Therapist, LCSW, LADC, CCS
Verified Verified
Lewiston, ME 04240
Not accepting new clients
You have strengths you already use, perhaps without realizing it. Together, we will work to identify and build on those strengths as well as develop new skills so you can reach the goals you set. The greatest insight and learning result from action! We typically start with small actions, which allow mastery of new skills and build confidence while working toward the bigger changes you want to make. My approach is strength-based and relational. Grounded in CBT and especially ACT, I incorporate strategies from other therapy models based on the needs and learning styles of the individual.
You have strengths you already use, perhaps without realizing it. Together, we will work to identify and build on those strengths as well as develop new skills so you can reach the goals you set. The greatest insight and learning result from action! We typically start with small actions, which allow mastery of new skills and build confidence while working toward the bigger changes you want to make. My approach is strength-based and relational. Grounded in CBT and especially ACT, I incorporate strategies from other therapy models based on the needs and learning styles of the individual.
(833) 961-1326 View (833) 961-1326
Photo of Julia Waltman, Counselor in Androscoggin County, ME
Julia Waltman
Counselor, LCPC-C
Verified Verified
Durham, ME 04222
Not accepting new clients
**No openings available** If you are struggling in any aspect of your life, please consider seeking support. My goal as a counselor is to empower you to find balance and fulfillment, and to facilitate meaningful change and personal growth. I offer a safe and non judgmental space allowing you to explore the various issues or patterns that have brought you to therapy. My hope is to help you gain insight and awareness as well as new skills to make navigating life's hurdles a little bit easier.
**No openings available** If you are struggling in any aspect of your life, please consider seeking support. My goal as a counselor is to empower you to find balance and fulfillment, and to facilitate meaningful change and personal growth. I offer a safe and non judgmental space allowing you to explore the various issues or patterns that have brought you to therapy. My hope is to help you gain insight and awareness as well as new skills to make navigating life's hurdles a little bit easier.
(207) 406-9659 View (207) 406-9659
Photo of Lorraine O Wight, Clinical Social Work/Therapist in Androscoggin County, ME
Lorraine O Wight
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Lewiston, ME 04240
Not accepting new clients
The treatments I use help people to identify goals closest to their own values. Goals are then easier to achieve because they are already close to who you are and what you hold to be important. I can assist with reshaping challenging thoughts into productive actions and more positive behaviors. I work in a group practice in Lewiston founded as a diverse holistic group that with the pandemic has evolved into a practice of experienced mental health practictioners.
The treatments I use help people to identify goals closest to their own values. Goals are then easier to achieve because they are already close to who you are and what you hold to be important. I can assist with reshaping challenging thoughts into productive actions and more positive behaviors. I work in a group practice in Lewiston founded as a diverse holistic group that with the pandemic has evolved into a practice of experienced mental health practictioners.
(207) 518-7572 View (207) 518-7572
Photo of Michelle Heieren, Counselor in Androscoggin County, ME
Michelle Heieren
Counselor, LCPC
Verified Verified
Auburn, ME 04210
Not accepting new clients
You were not made to be alone in your struggles. Your mind and body want to heal; sometimes it just takes a little help along the way. Perhaps you find yourself feeling stuck in the same old pattern of unhelpful behaviors or replaying the endless cycle of negative thoughts in your mind. You feel desperate for change but don’t know where to even begin. When you feel overwhelmed with stress, sometimes it is so much easier to just push the pain away. But when the root of our pain remains buried in the past, it becomes more difficult to live a life of meaning and value.
You were not made to be alone in your struggles. Your mind and body want to heal; sometimes it just takes a little help along the way. Perhaps you find yourself feeling stuck in the same old pattern of unhelpful behaviors or replaying the endless cycle of negative thoughts in your mind. You feel desperate for change but don’t know where to even begin. When you feel overwhelmed with stress, sometimes it is so much easier to just push the pain away. But when the root of our pain remains buried in the past, it becomes more difficult to live a life of meaning and value.
(207) 864-1801 View (207) 864-1801
Photo of Nichelle Gardner, Counselor in Androscoggin County, ME
Nichelle Gardner
Counselor, LCPC, CADC
Verified Verified
Lewiston, ME 04240
I believe truly understanding a person’s journey begins with a compassionate heart. Each person is beautifully unique, harbors inner strengths, and is on a developmental journey, no matter what their age. I work collaboratively and creatively to identify these strengths and explore developmental perspective. During our work together, it is my goal to create a private and safe place in which to explore, heal, and grow.
I believe truly understanding a person’s journey begins with a compassionate heart. Each person is beautifully unique, harbors inner strengths, and is on a developmental journey, no matter what their age. I work collaboratively and creatively to identify these strengths and explore developmental perspective. During our work together, it is my goal to create a private and safe place in which to explore, heal, and grow.
(207) 387-7963 View (207) 387-7963
Photo of Christina Pizzo, Counselor in Androscoggin County, ME
Christina Pizzo
Counselor, LCPC, LADC
Verified Verified
Auburn, ME 04211  (Online Only)
Congratulations on your journey of peace and wellness. Whether you are new to therapy, or continuing a mission of self-reflection, remember to take time to acknowledge your efforts. Self improvement can be a lifelong adventure filled with incredible experiences.
Congratulations on your journey of peace and wellness. Whether you are new to therapy, or continuing a mission of self-reflection, remember to take time to acknowledge your efforts. Self improvement can be a lifelong adventure filled with incredible experiences.
(207) 481-4270 View (207) 481-4270
Photo of Lise M. Carrier-Pelletier, Counselor in Androscoggin County, ME
Lise M. Carrier-Pelletier
Counselor, LADC, CCS, CSOTP, NCACII, SAP
Verified Verified
Lewiston, ME 04240
I have been working with substance use disorders and families and friends affected by it since 1983. I have years of experience and an interest in helping you succeed. Addictions/Use disorders/Affected Family Members are my focus. Intergenerational issues from this disorder impact children, grandchildren - older or younger - the patterns of behavior are the same. Feeling Isolated? Feeling you are not good enough? People say you are Oversensitive? Tired of using your Charm to "get by"? Need to be Perfect? Helping Others vs. helping yourself? Feel the Need to Change? Call Me!
I have been working with substance use disorders and families and friends affected by it since 1983. I have years of experience and an interest in helping you succeed. Addictions/Use disorders/Affected Family Members are my focus. Intergenerational issues from this disorder impact children, grandchildren - older or younger - the patterns of behavior are the same. Feeling Isolated? Feeling you are not good enough? People say you are Oversensitive? Tired of using your Charm to "get by"? Need to be Perfect? Helping Others vs. helping yourself? Feel the Need to Change? Call Me!
(207) 386-3058 View (207) 386-3058
Photo of Bruce H Webber, Clinical Social Work/Therapist in Androscoggin County, ME
Bruce H Webber
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Lewiston, ME 04240
Not accepting new clients
Whether the issue is addictions, depression, relationships or behavior at school, sometimes we get stuck in patterns that prevent us from being healthy and happy. In general, I view the therapeutic process as a means to help my clients get themselves unstuck. I enjoy incorporating your spiritual or religious practice into the therapeutic process, working with different ethnic groups and welcome LGBTQ clients.
Whether the issue is addictions, depression, relationships or behavior at school, sometimes we get stuck in patterns that prevent us from being healthy and happy. In general, I view the therapeutic process as a means to help my clients get themselves unstuck. I enjoy incorporating your spiritual or religious practice into the therapeutic process, working with different ethnic groups and welcome LGBTQ clients.
(207) 747-1080 View (207) 747-1080
Photo of Tany Walker, Clinical Social Work/Therapist in Androscoggin County, ME
Tany Walker
Clinical Social Work/Therapist, LCSW
Verified Verified
Auburn, ME 04210  (Online Only)
For many of us, 2020 was a catalyst year starting with the pandemic, political conflict, grief and loss issues across the nation. It was a collective impact. For so many individuals, including myself, lives were uprooted, and the adjustment period was difficult and disconcerting as nothing seemed familiar anymore. Many have been dealing with relationships and marriages ending, loss of jobs, loss of homes, losing loved ones who have passed on, physical health deteriorating and so much more. Old traumas seemed to have resurfaced, depression/anxiety increasing, loneliness, and finding balance or a sense of self seems to evade us.
For many of us, 2020 was a catalyst year starting with the pandemic, political conflict, grief and loss issues across the nation. It was a collective impact. For so many individuals, including myself, lives were uprooted, and the adjustment period was difficult and disconcerting as nothing seemed familiar anymore. Many have been dealing with relationships and marriages ending, loss of jobs, loss of homes, losing loved ones who have passed on, physical health deteriorating and so much more. Old traumas seemed to have resurfaced, depression/anxiety increasing, loneliness, and finding balance or a sense of self seems to evade us.
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Photo of Sara Poulin, Counselor in Androscoggin County, ME
Sara Poulin
Counselor, LCPC
Verified Verified
Auburn, ME 04210
Not accepting new clients
Accepting new clients in July2024 Congratulations on taking the first step toward wellness and thank you for considering me to be part of your journey. The idea of sharing your personal story can be overwhelming but you are not alone. I am an energetic, relatable, compassionate therapist who enjoys working with adolescents, adults and families.  I encourage active participation, creativity and flexible thinking.
Accepting new clients in July2024 Congratulations on taking the first step toward wellness and thank you for considering me to be part of your journey. The idea of sharing your personal story can be overwhelming but you are not alone. I am an energetic, relatable, compassionate therapist who enjoys working with adolescents, adults and families.  I encourage active participation, creativity and flexible thinking.
View
Photo of Sean Douglas, Clinical Social Work/Therapist in Androscoggin County, ME
Sean Douglas
Clinical Social Work/Therapist, LCSW
Verified Verified
Auburn, ME 04210
Not accepting new clients
I work with individuals and couples seeking a sense of balance and wellness in mind, body and spirit as well as those feeling sidetracked by the challenges of emotional and physical distress. By identifying the obstacles that support distress and building on your personal values/abilities that support wellness, we will identify different ways of thinking, feeling and doing.
I work with individuals and couples seeking a sense of balance and wellness in mind, body and spirit as well as those feeling sidetracked by the challenges of emotional and physical distress. By identifying the obstacles that support distress and building on your personal values/abilities that support wellness, we will identify different ways of thinking, feeling and doing.
(207) 420-2255 View (207) 420-2255
Photo of Vincent P Carrier, Counselor in Androscoggin County, ME
Vincent P Carrier
Counselor, MS, LCPC, ILADC
Verified Verified
3 Endorsed
Lewiston, ME 04240
The focus of therapy is to identify early life influences and/or learned behaviors that lead to problem behaviors. Behaviors can include: anger, physical/emotional/sexual abuse. In addition family/relationship conflict, anxiety/depression, mood swings, drug & alcohol & compulsive behaviors. The sub conscious mind is programed from infancy with positive & negative beliefs & destructive coping skills, programmed survival skills. In therapy we identify old habits/behaviors & poor coping strategies. In therapy, we work to replace self destructive habits/behaviors with functional habits & beliefs. Anxiety & Depression are relieved.
The focus of therapy is to identify early life influences and/or learned behaviors that lead to problem behaviors. Behaviors can include: anger, physical/emotional/sexual abuse. In addition family/relationship conflict, anxiety/depression, mood swings, drug & alcohol & compulsive behaviors. The sub conscious mind is programed from infancy with positive & negative beliefs & destructive coping skills, programmed survival skills. In therapy we identify old habits/behaviors & poor coping strategies. In therapy, we work to replace self destructive habits/behaviors with functional habits & beliefs. Anxiety & Depression are relieved.
(207) 742-7350 View (207) 742-7350
Photo of Jamie Folker Lcsw, Clinical Social Work/Therapist in Androscoggin County, ME
Jamie Folker Lcsw
Clinical Social Work/Therapist, LCSW
Verified Verified
Lewiston, ME 04240
Not accepting new clients
I am excited at the potential opportunity to work with yourself, or a loved one. Durning therapy I gain an understanding of an individuals perspective in which they see themselves, others, and life’s conditions. I work with the individual to identifying specific problems or issues in your daily life, become aware of unproductive thought patterns and how they can impact your life. I work to identify negative thinking and reshape it in a way that changes how you feel, as well as learn new behaviors and put them into practice. Please note, recently I have had a few daytime openings open up, I do not have any openings past 2pm.
I am excited at the potential opportunity to work with yourself, or a loved one. Durning therapy I gain an understanding of an individuals perspective in which they see themselves, others, and life’s conditions. I work with the individual to identifying specific problems or issues in your daily life, become aware of unproductive thought patterns and how they can impact your life. I work to identify negative thinking and reshape it in a way that changes how you feel, as well as learn new behaviors and put them into practice. Please note, recently I have had a few daytime openings open up, I do not have any openings past 2pm.
(207) 250-4315 x1 View (207) 250-4315 x1
Photo of Ryan P. Shannon, Clinical Social Work/Therapist in Androscoggin County, ME
Ryan P. Shannon
Clinical Social Work/Therapist, LCSW, MSW
Verified Verified
Lewiston, ME 04240  (Online Only)
The thought "I need someone to talk to" can be challenging, and finding the "right" person to speak with can be overwhelming. I make it my mission to create a judgment-free, open, calming space for you to explore those parts of your life where you'd welcome change, and contemplate what change means for you. Let's work together to create more balance in your life! Email contact is preferred as I can respond faster than a telephone call.
The thought "I need someone to talk to" can be challenging, and finding the "right" person to speak with can be overwhelming. I make it my mission to create a judgment-free, open, calming space for you to explore those parts of your life where you'd welcome change, and contemplate what change means for you. Let's work together to create more balance in your life! Email contact is preferred as I can respond faster than a telephone call.
(207) 520-2160 View (207) 520-2160

See more therapy options for Androscoggin County

How does your Therapist compare?

Number of Therapists in Androscoggin County, ME

100+

Average cost per session

$125

Therapists in Androscoggin County, ME who prioritize treating:

91% Anxiety
85% Depression
74% Trauma and PTSD
72% Relationship Issues
70% Coping Skills
69% Stress
66% Self Esteem

Average years in practice

13 Years

Top 3 insurances accepted

71% Anthem | Elevance
69% Aetna
66% BlueCross and BlueShield

How Therapists in Androscoggin County, ME see their clients

63% In Person and Online
37% Online Only

Gender breakdown

72% Female
28% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Androscoggin County?

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.