Therapists in San Francisco, CA

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Photo of Pilar Dellano, Marriage & Family Therapist in San Francisco, CA
Pilar Dellano
Marriage & Family Therapist, MA, LMFT
Verified Verified
3 Endorsed
San Francisco, CA 94103
It may seem a world away and yet here you are; On the brink of a new day, in which courageous, interdependent, and radical connection to the life you’ve always wanted, is only an email away.
It may seem a world away and yet here you are; On the brink of a new day, in which courageous, interdependent, and radical connection to the life you’ve always wanted, is only an email away.
(415) 792-1796 View (415) 792-1796
Photo of Krystal Koop, Associate Clinical Social Worker in San Francisco, CA
Krystal Koop
Associate Clinical Social Worker, MSW, ACSW
Verified Verified
San Francisco, CA 94131  (Online Only)
Grief can be complex-sometimes our relationships with people we have lost are complicated and the process of aging and passing on is not something that many people openly talk about or acknowledge and can add to the burden of grief. Our society is also one of quick fixes, fast moves, and instant gratification, so the slow and arduous process of grieving does not typically get the space it deserves. Too often we are forced to get back to work, back to being happy, back to being "normal" when things are anything but.
Grief can be complex-sometimes our relationships with people we have lost are complicated and the process of aging and passing on is not something that many people openly talk about or acknowledge and can add to the burden of grief. Our society is also one of quick fixes, fast moves, and instant gratification, so the slow and arduous process of grieving does not typically get the space it deserves. Too often we are forced to get back to work, back to being happy, back to being "normal" when things are anything but.
(510) 369-5069 View (510) 369-5069
Photo of Dr. Joanna Renee Fassl, Marriage & Family Therapist in San Francisco, CA
Dr. Joanna Renee Fassl
Marriage & Family Therapist, Joanna Fassl, LMFT, DC, MA
Verified Verified
San Francisco, CA 94117
My clients are looking for a different type of therapy. They wish for a more enlivened and interactive approach that engages beyond words and captures the heart of one's struggle and yearning to break free. My clients oftentimes feel lost, plagued with chronic anxiety, depression or anger, and stuck in a rigidified experience of themselves. They toggle between a tired set of coping mechanisms; and the fear and distrust of branching out into the new. My work cradles the middle: lovingly chipping away at the hardened barriers while welcoming in steady, free, authentic expression. All held in grace and awe for this precious life.
My clients are looking for a different type of therapy. They wish for a more enlivened and interactive approach that engages beyond words and captures the heart of one's struggle and yearning to break free. My clients oftentimes feel lost, plagued with chronic anxiety, depression or anger, and stuck in a rigidified experience of themselves. They toggle between a tired set of coping mechanisms; and the fear and distrust of branching out into the new. My work cradles the middle: lovingly chipping away at the hardened barriers while welcoming in steady, free, authentic expression. All held in grace and awe for this precious life.
(415) 484-3881 View (415) 484-3881
Photo of Shelby McClure, Marriage & Family Therapist in San Francisco, CA
Shelby McClure
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94105  (Online Only)
I have worked in a wide variety of environments and with a wide variety of clients, including those in outpatient settings and with adolescents in a residential treatment facility. I am a strength-based therapist that works to empower her clients. I provide clients with a safe, non-judgmental space where they can more deeply examine their inner feelings and find ways to overcome life's challenges. I hope to help you along your journey of self-discovery, and to always provide you with a place where you can feel heard and understood.
I have worked in a wide variety of environments and with a wide variety of clients, including those in outpatient settings and with adolescents in a residential treatment facility. I am a strength-based therapist that works to empower her clients. I provide clients with a safe, non-judgmental space where they can more deeply examine their inner feelings and find ways to overcome life's challenges. I hope to help you along your journey of self-discovery, and to always provide you with a place where you can feel heard and understood.
(415) 630-4513 View (415) 630-4513
Photo of Jackson Doyle, Clinical Social Work/Therapist in San Francisco, CA
Jackson Doyle
Clinical Social Work/Therapist, LCSW
Verified Verified
San Francisco, CA 94110  (Online Only)
As a psychotherapist with a decade of experience in hospitals, primary care clinics, and the broader public health system, I have experience with a wide range of issues and with individuals of diverse backgrounds.
As a psychotherapist with a decade of experience in hospitals, primary care clinics, and the broader public health system, I have experience with a wide range of issues and with individuals of diverse backgrounds.
(510) 800-9801 View (510) 800-9801
Photo of Nina Atanassova, Marriage & Family Therapist in San Francisco, CA
Nina Atanassova
Marriage & Family Therapist, MFT
Verified Verified
San Francisco, CA 94112  (Online Only)
In my practice, I believe that the process of change requires an approach that is tailored to each individual's unique style and needs. I strive to create a collaborative, caring, and supportive atmosphere that will assist you in identifying and changing the thoughts, the behaviors, and the interpersonal styles that are no longer effective for you. I offer confidential, supportive and caring environment free of judgment that will facilitate your journey through difficulties and challenges.
In my practice, I believe that the process of change requires an approach that is tailored to each individual's unique style and needs. I strive to create a collaborative, caring, and supportive atmosphere that will assist you in identifying and changing the thoughts, the behaviors, and the interpersonal styles that are no longer effective for you. I offer confidential, supportive and caring environment free of judgment that will facilitate your journey through difficulties and challenges.
(628) 244-9011 View (628) 244-9011
Photo of Brooke Ferragamo, Psychologist in San Francisco, CA
Brooke Ferragamo
Psychologist, PhD
Verified Verified
1 Endorsed
San Francisco, CA 94118
I offer a grounded, warm, and personalized approach to help adolescents and adults cope with life transitions, chronic distress, trauma, and other mental health challenges such as depression and anxiety. I am passionate about serving adolescents who are struggling to find their place in our rapidly changing world, members of the LGBTQ+ community, and any folks who feel as though they have difficulty fitting into society's prescribed norms. Some folks reach out with a specific goal in mind, while just as many enter therapy with more of a feeling that something is not quite right. In either case, you are welcome here.
I offer a grounded, warm, and personalized approach to help adolescents and adults cope with life transitions, chronic distress, trauma, and other mental health challenges such as depression and anxiety. I am passionate about serving adolescents who are struggling to find their place in our rapidly changing world, members of the LGBTQ+ community, and any folks who feel as though they have difficulty fitting into society's prescribed norms. Some folks reach out with a specific goal in mind, while just as many enter therapy with more of a feeling that something is not quite right. In either case, you are welcome here.
(415) 639-4075 View (415) 639-4075
Photo of Debbie Grace P Lugtu, Marriage & Family Therapist in San Francisco, CA
Debbie Grace P Lugtu
Marriage & Family Therapist, LMFT, MA
Verified Verified
San Francisco, CA 94108  (Online Only)
Are you looking to deep dive with a therapist you feel safe with and collaboratively works with you and encourages you along the way? My ideal client is reflective as I ask questions to deep dive and explore underlying issues and themes to help them gain insight. I work from a narrative therapy approach, believing that every person has a story to share and has the power to re-author their stories or create their own narrative. I am strength-based and use encouraging language in session, while following your lead. In our sessions, you will also learn Mindfulness, CBT and DBT skills to help you manage emotions and stress.
Are you looking to deep dive with a therapist you feel safe with and collaboratively works with you and encourages you along the way? My ideal client is reflective as I ask questions to deep dive and explore underlying issues and themes to help them gain insight. I work from a narrative therapy approach, believing that every person has a story to share and has the power to re-author their stories or create their own narrative. I am strength-based and use encouraging language in session, while following your lead. In our sessions, you will also learn Mindfulness, CBT and DBT skills to help you manage emotions and stress.
(949) 732-0074 View (949) 732-0074
Photo of Caroline Cretti, Psychologist in San Francisco, CA
Caroline Cretti
Psychologist, PsyD
Verified Verified
San Francisco, CA 94104
I am a licensed clinical psychologist, registered with the California Board of Psychology. I have been a therapist in the Bay Area for over 5 years. My goal in therapy is to provide space for clients to better understand themselves and the different dynamics that have created specific patterns of relationships, behaviors, and anxieties. I approach therapy and each client from a psychodynamic and humanistic framework. As a clinical psychologist, I have experience working with trauma, mood and anxiety disorders, family and relationship issues, obsessive compulsive disorders, and serious mental illness.
I am a licensed clinical psychologist, registered with the California Board of Psychology. I have been a therapist in the Bay Area for over 5 years. My goal in therapy is to provide space for clients to better understand themselves and the different dynamics that have created specific patterns of relationships, behaviors, and anxieties. I approach therapy and each client from a psychodynamic and humanistic framework. As a clinical psychologist, I have experience working with trauma, mood and anxiety disorders, family and relationship issues, obsessive compulsive disorders, and serious mental illness.
(628) 265-8969 View (628) 265-8969
Photo of Dr. Paula B. Holt, Clinical Social Work/Therapist in San Francisco, CA
Dr. Paula B. Holt
Clinical Social Work/Therapist, LCSW, ACSW, PhD
Verified Verified
San Francisco, CA 94117
We find unique healing in your own path for change, expansion, and self assurance. My best source is your own psychology. We find the tools within you for our work. We will seek clarification for yourself and understanding of others. Good psychotherapy provides not only a safe haven to relieve anxiety, depression, or any psychological pain, but also provides tools for your continuing growth. We add the richness of Jung to insights from psychoanalytically based psychotherapy. Also note that I have an additional practice in support of conscious dying.
We find unique healing in your own path for change, expansion, and self assurance. My best source is your own psychology. We find the tools within you for our work. We will seek clarification for yourself and understanding of others. Good psychotherapy provides not only a safe haven to relieve anxiety, depression, or any psychological pain, but also provides tools for your continuing growth. We add the richness of Jung to insights from psychoanalytically based psychotherapy. Also note that I have an additional practice in support of conscious dying.
(415) 799-7680 View (415) 799-7680
Photo of Dr. Runa Korde, Psychologist in San Francisco, CA
Dr. Runa Korde
Psychologist, PhD, MS, MA
Verified Verified
San Francisco, CA 94121  (Online Only)
At Human, my focus is to create a space where my clients feel safe and welcome with all their strengths and weakness and all their experiences - a space where they can just 'be'. Life brings us all kinds of experiences and some of those can be hard to cope with as is. My goal is to help you find the strength you already have within to learn and grow from these experiences as you continue to process them.
At Human, my focus is to create a space where my clients feel safe and welcome with all their strengths and weakness and all their experiences - a space where they can just 'be'. Life brings us all kinds of experiences and some of those can be hard to cope with as is. My goal is to help you find the strength you already have within to learn and grow from these experiences as you continue to process them.
(628) 265-4054 View (628) 265-4054
Photo of Cathy Trenary, Associate Professional Clinical Counselor in San Francisco, CA
Cathy Trenary
Associate Professional Clinical Counselor, APCC
Verified Verified
San Francisco, CA 94114
Our life experiences can lead us to question our identity and purpose in the world we live in. This can lead us to anxiety, depression, and trauma. Do you want to improve how you face challenges, function in your relationships, and face overwhelming feelings? I place heavy importance on addressing trauma. Trauma disintegrates the parts that make up your whole self, which can leave aspects of who you are hidden from your awareness. Left unaddressed, anxiety and depression can worsen, which can rob you of the necessary connection that all human beings need to thrive. I aim to help you process unresolved trauma.
Our life experiences can lead us to question our identity and purpose in the world we live in. This can lead us to anxiety, depression, and trauma. Do you want to improve how you face challenges, function in your relationships, and face overwhelming feelings? I place heavy importance on addressing trauma. Trauma disintegrates the parts that make up your whole self, which can leave aspects of who you are hidden from your awareness. Left unaddressed, anxiety and depression can worsen, which can rob you of the necessary connection that all human beings need to thrive. I aim to help you process unresolved trauma.
(415) 870-3417 View (415) 870-3417
Photo of Amanda Murray, Psychologist in San Francisco, CA
Amanda Murray
Psychologist, PhD
Verified Verified
San Francisco, CA 94114
If you feel anxious, odd, or out of place I want to help you connect with what matters to you. I work with autistic adults, other neurodivergent folks, and individuals experiencing anxiety. We all deserve a life where we can truly be ourselves. I will support you in harnessing your strengths to pursue the goals you care about. Goals might include building more supportive relationships, combating self-stigma, alleviating burnout, or better understanding and communicating your needs.
If you feel anxious, odd, or out of place I want to help you connect with what matters to you. I work with autistic adults, other neurodivergent folks, and individuals experiencing anxiety. We all deserve a life where we can truly be ourselves. I will support you in harnessing your strengths to pursue the goals you care about. Goals might include building more supportive relationships, combating self-stigma, alleviating burnout, or better understanding and communicating your needs.
(415) 802-0627 View (415) 802-0627
Photo of Christina Papanestor, Clinical Social Work/Therapist in San Francisco, CA
Christina Papanestor
Clinical Social Work/Therapist, LCSW, BCD
Verified Verified
8 Endorsed
San Francisco, CA 94114
Many of us hold on to what is familiar, routine and predictable, even when what we cling to is no longer serving us. Letting go of what is known is one of the hardest parts of growth. Change and growth are possible when a sense of security, safety, and genuine understanding is present. I provide individualized, culturally-attuned and effective psychotherapy. You might have tried psychotherapy before, and perhaps it brought you through a stormy time, but ultimately left you to find yourself repeating well-worn patterns and feeling the same insecurities that led you to seek help initially.
Many of us hold on to what is familiar, routine and predictable, even when what we cling to is no longer serving us. Letting go of what is known is one of the hardest parts of growth. Change and growth are possible when a sense of security, safety, and genuine understanding is present. I provide individualized, culturally-attuned and effective psychotherapy. You might have tried psychotherapy before, and perhaps it brought you through a stormy time, but ultimately left you to find yourself repeating well-worn patterns and feeling the same insecurities that led you to seek help initially.
(415) 295-1561 View (415) 295-1561
Photo of Gay Therapy Center, Marriage & Family Therapist in San Francisco, CA
Gay Therapy Center
Marriage & Family Therapist, MFT
Verified Verified
San Francisco, CA 94114
It's very important in therapy to know for sure that your therapist really "gets" you. At GTC, we’re LGBTQ therapists for LGBTQ people. I founded the Gay Therapy Center in 2015 because I believe in the healing power of LGBTQ people working with LGBTQ therapists. We've now grown to become the largest private LGBTQ therapy provider in the country with therapists in DC, NYC, SF, LA, and online. We personally match you to the therapist we think will be particularly good for you! You won’t have to deal with waiting lists, sifting through profiles, or matching by algorithms.
It's very important in therapy to know for sure that your therapist really "gets" you. At GTC, we’re LGBTQ therapists for LGBTQ people. I founded the Gay Therapy Center in 2015 because I believe in the healing power of LGBTQ people working with LGBTQ therapists. We've now grown to become the largest private LGBTQ therapy provider in the country with therapists in DC, NYC, SF, LA, and online. We personally match you to the therapist we think will be particularly good for you! You won’t have to deal with waiting lists, sifting through profiles, or matching by algorithms.
(628) 600-1822 View (628) 600-1822
Photo of Giulia P. Davis, Marriage & Family Therapist Associate in San Francisco, CA
Giulia P. Davis
Marriage & Family Therapist Associate, MA, AMFT
Verified Verified
1 Endorsed
San Francisco, CA 94117  (Online Only)
Are you rocking that 'got-it-together' facade, but deep down you're really falling apart? You're not alone. Life's throwing punches, and the struggle is real. You're seeking direction and clarity, but you feel stuck, caught in self-doubt, and trapped in "stay or leave" dilemmas. The uncertainty is unsettling and you start questioning everything about your relationship…and yourself. Whether it's your marriage, career, or the sheer weight of everything around you—I get it. It's like having a hundred tabs open in your mind at once, making it hard to think straight and perform as you envision. You're exhausted. It's time for a change.
Are you rocking that 'got-it-together' facade, but deep down you're really falling apart? You're not alone. Life's throwing punches, and the struggle is real. You're seeking direction and clarity, but you feel stuck, caught in self-doubt, and trapped in "stay or leave" dilemmas. The uncertainty is unsettling and you start questioning everything about your relationship…and yourself. Whether it's your marriage, career, or the sheer weight of everything around you—I get it. It's like having a hundred tabs open in your mind at once, making it hard to think straight and perform as you envision. You're exhausted. It's time for a change.
(415) 692-3541 View (415) 692-3541
Photo of Scott Altamirano, Marriage & Family Therapist in San Francisco, CA
Scott Altamirano
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94103  (Online Only)
Accepting clients Apr 2024. I help clients have happier and more fulfilling lives by overcoming their anxieties to create happy and healthy relationships. Let me help you learn to invest in yourself and your overall wellbeing through habit building, dating, socializing, and improving our overall self esteem!
Accepting clients Apr 2024. I help clients have happier and more fulfilling lives by overcoming their anxieties to create happy and healthy relationships. Let me help you learn to invest in yourself and your overall wellbeing through habit building, dating, socializing, and improving our overall self esteem!
(682) 582-8683 View (682) 582-8683
Photo of Patricia E Lund, Psychologist in San Francisco, CA
Patricia E Lund
Psychologist, PhD
Verified Verified
San Francisco, CA 94122
Have you recently received a medical diagnosis that has thrown you "off your path?" Do you have an upcoming surgical procedure that has you frightened, and you want to be as prepared as possible? Are you scheduling an elective procedure that will make your life better, but that has inherent risks? Or perhaps you need help in healing from a disturbing medical procedure? One of my specialties as a psychotherapist is to help you manage and heal from such events. I have spent 30 years helping people diagnosed with breast cancer, other forms of cancer, and medical crises as well as life transitions, depression, anxiety, PTSD, and grief.
Have you recently received a medical diagnosis that has thrown you "off your path?" Do you have an upcoming surgical procedure that has you frightened, and you want to be as prepared as possible? Are you scheduling an elective procedure that will make your life better, but that has inherent risks? Or perhaps you need help in healing from a disturbing medical procedure? One of my specialties as a psychotherapist is to help you manage and heal from such events. I have spent 30 years helping people diagnosed with breast cancer, other forms of cancer, and medical crises as well as life transitions, depression, anxiety, PTSD, and grief.
(415) 592-6893 View (415) 592-6893
Photo of Vanessa Vertin, Marriage & Family Therapist in San Francisco, CA
Vanessa Vertin
Marriage & Family Therapist, PhD, LMFT
Verified Verified
1 Endorsed
San Francisco, CA 94115  (Online Only)
Dr. Vertin specializes in modern-day relationships with self and others. Her work helps people thrive by revolutionizing how people think about health and relationship and thus, how they function. Vanessa's specializations are integral health, coupling relationships, and life transitions/stress. Other areas in which she has extensive training and therapeutic experience include: freedom and intimacy dynamics, marriage and other relationship forms, survivors of abuse, anxiety and depression, issues of elders and their families, aging & death, developmental issues, PTSD, and women’s issues.
Dr. Vertin specializes in modern-day relationships with self and others. Her work helps people thrive by revolutionizing how people think about health and relationship and thus, how they function. Vanessa's specializations are integral health, coupling relationships, and life transitions/stress. Other areas in which she has extensive training and therapeutic experience include: freedom and intimacy dynamics, marriage and other relationship forms, survivors of abuse, anxiety and depression, issues of elders and their families, aging & death, developmental issues, PTSD, and women’s issues.
(650) 262-3687 View (650) 262-3687
Photo of Beth A Mitchner, Psychologist in San Francisco, CA
Beth A Mitchner
Psychologist, PsyD
Verified Verified
San Francisco, CA 94122
Not accepting new clients
I believe that we heal and grow best in a welcoming and supportive environment. My goal is to create a safe space where we can explore together your thoughts and feelings and guide you to a place of deeper self-understanding of your strengths and challenges. Often, this process will enable you to find new ways for dealing with problems, experience more fulfilling relationships, and be more effective in recognizing and meeting your needs, and realizing your desires, and aspirations. These changes reduce discomfort and stress and allow you to feel more alive and fulfilled.
I believe that we heal and grow best in a welcoming and supportive environment. My goal is to create a safe space where we can explore together your thoughts and feelings and guide you to a place of deeper self-understanding of your strengths and challenges. Often, this process will enable you to find new ways for dealing with problems, experience more fulfilling relationships, and be more effective in recognizing and meeting your needs, and realizing your desires, and aspirations. These changes reduce discomfort and stress and allow you to feel more alive and fulfilled.
(628) 210-3586 View (628) 210-3586

See more therapy options for San Francisco

How does your Therapist compare?

Number of Therapists in San Francisco, CA

3,000+

Average cost per session

$189

Therapists in San Francisco, CA who prioritize treating:

93% Anxiety
87% Depression
81% Relationship Issues
75% Self Esteem
70% Trauma and PTSD
68% Stress
66% Life Transitions

Average years in practice

12 Years

Top 3 insurances accepted

69% Aetna
55% UnitedHealthcare UHC | UBH
54% Cigna and Evernorth

How Therapists in San Francisco, CA see their clients

55% In Person and Online
45% Online Only

Gender breakdown

75% Female
23% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in San Francisco?

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.