Photo of Amanda Spray, Psychologist in 10019, NY
Amanda Spray
Psychologist, PhD, ABPP
Verified Verified
New York, NY 10019
I am a licensed psychologist with expertise in working with adults with ADHD, anxiety, trauma, chronic pain and/or illness, insomnia, and depression. I also provide evaluation for suspected ADHD and executive functioning coaching for late teens and adults. I am board certified in Cognitive and Behavioral Therapy. I am also a Clinical Associate Professor of Psychiatry at NYU Grossman School of Medicine where I provide psychological services to veterans and family members and supervise and teach psychology trainees and psychiatry residents.
I am a licensed psychologist with expertise in working with adults with ADHD, anxiety, trauma, chronic pain and/or illness, insomnia, and depression. I also provide evaluation for suspected ADHD and executive functioning coaching for late teens and adults. I am board certified in Cognitive and Behavioral Therapy. I am also a Clinical Associate Professor of Psychiatry at NYU Grossman School of Medicine where I provide psychological services to veterans and family members and supervise and teach psychology trainees and psychiatry residents.
(929) 298-3810 View (929) 298-3810
Photo of Nancy Moyers, Licensed Master Social Worker in 10019, NY
Nancy Moyers
Licensed Master Social Worker, LMSW
Verified Verified
New York, NY 10019
Nancy specializes in working with individuals who struggle with coping and are feeling misaligned in the way they live day to day. This often looks like substance use, disordered eating, interpersonal struggles and communication, depression and anxiety, negative self-talk and self-worth, and other experiences that don’t feel supportive to the authentic self. Nancy is perfect for individuals seeking a gentle, yet direct therapeutic approach and works best with those seeking out their own definition of recovery and what healing process feels right for themselves.
Nancy specializes in working with individuals who struggle with coping and are feeling misaligned in the way they live day to day. This often looks like substance use, disordered eating, interpersonal struggles and communication, depression and anxiety, negative self-talk and self-worth, and other experiences that don’t feel supportive to the authentic self. Nancy is perfect for individuals seeking a gentle, yet direct therapeutic approach and works best with those seeking out their own definition of recovery and what healing process feels right for themselves.
(347) 851-1545 View (347) 851-1545
Photo of Zohar Fuller, Pre-Licensed Professional in 10019, NY
Zohar Fuller
Pre-Licensed Professional, LMSW
Verified Verified
1 Endorsed
New York, NY 10019
Do you want a non-judgmental space where you can show up as your full self? I'm Zohar, and I hold an MSW from Silberman School of Social Work at Hunter College and an MFA from Boston University. Therapy has helped me better understand my own behavior and has motivated me to change patterns that no longer serve me. My positive experience with therapy has inspired me to support others in exploring their own narratives, values, and actions.
Do you want a non-judgmental space where you can show up as your full self? I'm Zohar, and I hold an MSW from Silberman School of Social Work at Hunter College and an MFA from Boston University. Therapy has helped me better understand my own behavior and has motivated me to change patterns that no longer serve me. My positive experience with therapy has inspired me to support others in exploring their own narratives, values, and actions.
(212) 575-4769 View (212) 575-4769
Photo of Kelly Kyriacou, Counselor in 10019, NY
Kelly Kyriacou
Counselor, LMHC
Verified Verified
1 Endorsed
New York, NY 10019
Facing the realization that something in your life needs to change can be a challenge. Figuring out ways to make this change happen can be just as overwhelming. Through an individualized & person-centered approach, Kelly aims to provide a safe and compassionate space for clients to speak their truths without fear of judgment. Kelly will work with clients to support them in finding relief from challenging thought patterns & behaviors that ultimately leave them feeling less than their best selves. With a collaborative approach, Kelly can assist clients in identifying goals and drawing upon their personal strength to create change.
Facing the realization that something in your life needs to change can be a challenge. Figuring out ways to make this change happen can be just as overwhelming. Through an individualized & person-centered approach, Kelly aims to provide a safe and compassionate space for clients to speak their truths without fear of judgment. Kelly will work with clients to support them in finding relief from challenging thought patterns & behaviors that ultimately leave them feeling less than their best selves. With a collaborative approach, Kelly can assist clients in identifying goals and drawing upon their personal strength to create change.
(347) 767-5393 View (347) 767-5393
Robert A. Mead
Psychologist, PhD
Verified Verified
New York, NY 10019
I maintain an independent practice in clinical and consulting psychology. I provide therapeutic and consultative services to adults, children, families, and couples. I am an expert in a diverse range of mental health related areas including mood disorders, strategies for goal attainment, stress management, parenting skills, anger management, and relationship issues. I employ an eclectic approach that integrates insight-oriented self-exploration with practical goal-oriented strategies. Offering both long and short-term treatment modalities I have helped thousands develop effective coping/stress management skills and healthy and fulfilling lifestyles and relationships.
I maintain an independent practice in clinical and consulting psychology. I provide therapeutic and consultative services to adults, children, families, and couples. I am an expert in a diverse range of mental health related areas including mood disorders, strategies for goal attainment, stress management, parenting skills, anger management, and relationship issues. I employ an eclectic approach that integrates insight-oriented self-exploration with practical goal-oriented strategies. Offering both long and short-term treatment modalities I have helped thousands develop effective coping/stress management skills and healthy and fulfilling lifestyles and relationships.
(646) 583-2944 View (646) 583-2944
Photo of Kate Nasoff, Clinical Social Work/Therapist in 10019, NY
Kate Nasoff
Clinical Social Work/Therapist, LMSW
Verified Verified
New York, NY 10019
No matter what life stage you’re in, together we will work through symptoms of anxiety and depression, explore and strengthen interpersonal relationships and attachment, and work on self-esteem. Many of my clients also seek therapy during difficult transitions, or when it feels like something is just not working in life. My goal is to help clients gain insight and become more in touch with their thoughts and feelings while learning new ways to cope even with the uncomfortable ones. I create a safe space where you can gain deeper insight into barriers that are getting in the way of living a more satisfying life.
No matter what life stage you’re in, together we will work through symptoms of anxiety and depression, explore and strengthen interpersonal relationships and attachment, and work on self-esteem. Many of my clients also seek therapy during difficult transitions, or when it feels like something is just not working in life. My goal is to help clients gain insight and become more in touch with their thoughts and feelings while learning new ways to cope even with the uncomfortable ones. I create a safe space where you can gain deeper insight into barriers that are getting in the way of living a more satisfying life.
(347) 378-1166 View (347) 378-1166
Photo of Deborah Rinzler, Psychologist in 10019, NY
Deborah Rinzler
Psychologist, PhD
Verified Verified
New York, NY 10019
In 40 years of experience as a psychotherapist, I have learned that the most valuable thing I can do is to help my clients to accept themselves for whatever feelings and thoughts they have. I think self-rejection is the biggest block to healing. I also regard spirituality as an integral part of healing in psychotherapy. I do not use any particular theoretical framework (though I have many at my disposal), but tailor my approach to each individual's needs. My sessions are lively and interactive, and I believe that humor is an integral part of the healing process. Please see my video on Youtube where I describe the work I do.
In 40 years of experience as a psychotherapist, I have learned that the most valuable thing I can do is to help my clients to accept themselves for whatever feelings and thoughts they have. I think self-rejection is the biggest block to healing. I also regard spirituality as an integral part of healing in psychotherapy. I do not use any particular theoretical framework (though I have many at my disposal), but tailor my approach to each individual's needs. My sessions are lively and interactive, and I believe that humor is an integral part of the healing process. Please see my video on Youtube where I describe the work I do.
(646) 583-1104 View (646) 583-1104
Photo of Olga Stankovic, Counselor in 10019, NY
Olga Stankovic
Counselor, LPC
Verified Verified
New York, NY 10019  (Online Only)
As a mental health counselor, I am passionate about helping others live happier, healthier, and more authentic lives. Whether this means overcoming a specific challenge, navigating life change, or treating a specific diagnosis—my treatment approach is person-centered, collaborative, and holistic. I believe that we are "masters of our own ship", as they say; and with the power of therapeutic insight, we learn to understand and navigate turbulent emotions as we steer towards healthy change.
As a mental health counselor, I am passionate about helping others live happier, healthier, and more authentic lives. Whether this means overcoming a specific challenge, navigating life change, or treating a specific diagnosis—my treatment approach is person-centered, collaborative, and holistic. I believe that we are "masters of our own ship", as they say; and with the power of therapeutic insight, we learn to understand and navigate turbulent emotions as we steer towards healthy change.
(646) 736-4355 View (646) 736-4355
Photo of Laura Young, LCSW Counseling Services PC, Clinical Social Work/Therapist in 10019, NY
Laura Young, LCSW Counseling Services PC
Clinical Social Work/Therapist, LCSW-R, CGP
Verified Verified
New York, NY 10019
Relationships are the origin of our greatest growth, yet can also be the source of our greatest challenges. My goal in our work together is to help you as an Individual, Couple, or Family to better understand these multifaceted relationships. Often these complicated relationships come intertwined with other issues which we can also examine together. As your therapist, I will provide empathy, compassion and guidance to help you and/or your family work through your challenges. Please check out my website and 2-minute introductory video: www.LLYoung.com. Thank you.
Relationships are the origin of our greatest growth, yet can also be the source of our greatest challenges. My goal in our work together is to help you as an Individual, Couple, or Family to better understand these multifaceted relationships. Often these complicated relationships come intertwined with other issues which we can also examine together. As your therapist, I will provide empathy, compassion and guidance to help you and/or your family work through your challenges. Please check out my website and 2-minute introductory video: www.LLYoung.com. Thank you.
(646) 351-1801 View (646) 351-1801
Photo of Alan Harvey, Licensed Master Social Worker in 10019, NY
Alan Harvey
Licensed Master Social Worker, LMSW
Verified Verified
New York, NY 10019
Being queer in today’s world can be TOUGH, and constantly having to explain your identity to your therapist definitely doesn’t make it any easier. As a fellow queer, I am passionate about working within the LGBTQ+ community. You may be struggling to find your place in the community or find a support system that feels safe and validating. You may be struggling to figure out your relationships- maybe you are overwhelmed at the thought of finding a partner, maintaining your relationship(s), or managing conflicting sex drives. Or maybe you need an outlet to talk about how much the world can suck and process what that means for you.
Being queer in today’s world can be TOUGH, and constantly having to explain your identity to your therapist definitely doesn’t make it any easier. As a fellow queer, I am passionate about working within the LGBTQ+ community. You may be struggling to find your place in the community or find a support system that feels safe and validating. You may be struggling to figure out your relationships- maybe you are overwhelmed at the thought of finding a partner, maintaining your relationship(s), or managing conflicting sex drives. Or maybe you need an outlet to talk about how much the world can suck and process what that means for you.
(347) 970-5143 View (347) 970-5143
Photo of Rachel Boelter Psychotherapist, Art Therapist in 10019, NY
Rachel Boelter Psychotherapist
Art Therapist, MA, LCAT, RDT
Verified Verified
1 Endorsed
New York, NY 10019  (Online Only)
Waitlist for new clients
I’m a licensed psychotherapist currently working with adults and teens who are experiencing anxiety, disconnection, and depression as a result of trauma, family of origin wounds, or other life stressors. As a creative arts therapist with a background in theatre and the arts; I offer creative solutions to each individual’s specific needs. I meet each client where they are and will utilize as much or as little expressive arts based work as each client wants or needs. The tools and techniques chosen for each client will be different and unique, as each individual is unique. I’m also known to use humor and playfulness when appropriate.
I’m a licensed psychotherapist currently working with adults and teens who are experiencing anxiety, disconnection, and depression as a result of trauma, family of origin wounds, or other life stressors. As a creative arts therapist with a background in theatre and the arts; I offer creative solutions to each individual’s specific needs. I meet each client where they are and will utilize as much or as little expressive arts based work as each client wants or needs. The tools and techniques chosen for each client will be different and unique, as each individual is unique. I’m also known to use humor and playfulness when appropriate.
(929) 224-7864 View (929) 224-7864
Photo of Enya Pfeiffer in 10019, NY
Enya Pfeiffer
MHC-LP
Verified Verified
New York, NY 10019  (Online Only)
Welcome! My name is Enya and I am a queer, trauma-informed therapist. My approach is guided by curiosity, empathy, and humor. I draw on psychodynamic, anti-oppressive, and relational frameworks, meaning our work may look like collaborating to investigate internal, communal, intergenerational, and systemic dynamics at play within your life. Throughout the process, my goal is to empower you to dismantle internalized oppressive narratives, embrace who you are, and discover what healing means and looks like for you.
Welcome! My name is Enya and I am a queer, trauma-informed therapist. My approach is guided by curiosity, empathy, and humor. I draw on psychodynamic, anti-oppressive, and relational frameworks, meaning our work may look like collaborating to investigate internal, communal, intergenerational, and systemic dynamics at play within your life. Throughout the process, my goal is to empower you to dismantle internalized oppressive narratives, embrace who you are, and discover what healing means and looks like for you.
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Photo of Brittany M Anderson, Clinical Social Work/Therapist in 10019, NY
Brittany M Anderson
Clinical Social Work/Therapist, LMSW
Verified Verified
New York, NY 10019
Sometimes life does not seem to go how you would like it to. It may feel like everything is building up and you may explode into tears. Perhaps it seems as though the more you have going on the more you feel like not doing anything at all and when you aren’t doing anything you still feel like you should be doing something. Sometimes we find ourselves being overworked and underappreciated not only by other people around us but within ourselves as well.
Sometimes life does not seem to go how you would like it to. It may feel like everything is building up and you may explode into tears. Perhaps it seems as though the more you have going on the more you feel like not doing anything at all and when you aren’t doing anything you still feel like you should be doing something. Sometimes we find ourselves being overworked and underappreciated not only by other people around us but within ourselves as well.
(646) 849-3245 View (646) 849-3245
Photo of Nathan Feiles, LCSW, Clinical Social Work/Therapist in 10019, NY
Nathan Feiles, LCSW
Clinical Social Work/Therapist, LCSW-R
Verified Verified
1 Endorsed
New York, NY 10019
Have you been generally struggling with life, experiencing anxiety, having difficulty with your relationships, or feeling sad or depressed? If so, you don’t need to face this alone. I’m here to help. I’ve worked with many people over time who have come in feeling a range of difficult emotions, and through the process of our work together have become more emotionally settled, empowered, and have felt more in control of their lives.
Have you been generally struggling with life, experiencing anxiety, having difficulty with your relationships, or feeling sad or depressed? If so, you don’t need to face this alone. I’m here to help. I’ve worked with many people over time who have come in feeling a range of difficult emotions, and through the process of our work together have become more emotionally settled, empowered, and have felt more in control of their lives.
(917) 809-5323 View (917) 809-5323
Photo of Eric W. Pierce, Creative Arts Therapist in 10019, NY
Eric W. Pierce
Creative Arts Therapist, LCAT, MT-BC
Verified Verified
New York, NY 10019
I am a dedicated psychotherapist with master's-level training and a passion for guiding individuals toward emotional wellbeing. As founder of Lagom Healing, I use a CBT approach to help balance to the lives and relationships of my clients. For every client I support identification and daily practice of skills that make a difference. By reframing your innermost thoughts, feelings and actions, I will help you to uncover a new outlook that makes sense for you.
I am a dedicated psychotherapist with master's-level training and a passion for guiding individuals toward emotional wellbeing. As founder of Lagom Healing, I use a CBT approach to help balance to the lives and relationships of my clients. For every client I support identification and daily practice of skills that make a difference. By reframing your innermost thoughts, feelings and actions, I will help you to uncover a new outlook that makes sense for you.
(646) 506-4210 View (646) 506-4210
Photo of Ily,inc Village: Family Support Network, Clinical Social Work/Therapist in 10019, NY
Ily,inc Village: Family Support Network
Clinical Social Work/Therapist, IBCLC, LPC, LICSW
Verified Verified
New York, NY 10019
Ily,inc Village specializes in family dynamics, supporting clients to create individualized solutions that uplift themselves, their loved ones& their community. We aim to cater to those in the perinatal period, whether you are just starting a family, navigating multiples, or building your support system, we're here to partner with you every step of the way.
Ily,inc Village specializes in family dynamics, supporting clients to create individualized solutions that uplift themselves, their loved ones& their community. We aim to cater to those in the perinatal period, whether you are just starting a family, navigating multiples, or building your support system, we're here to partner with you every step of the way.
(718) 768-4247 View (718) 768-4247
Photo of Carolyn Weverbergh, Clinical Social Work/Therapist in 10019, NY
Carolyn Weverbergh
Clinical Social Work/Therapist, LMSW
Verified Verified
New York, NY 10019
Despite the adversity and struggles we face, there’s often a place of hope and light in ourselves that we overlook. Taking the time to prioritize oneself takes strength and presents the opportunity to recognize one’s ability to grow. Together, we can understand and learn how to better manage the barriers that present themselves and that can get in the way of you attaining the quality of life you deserve.
Despite the adversity and struggles we face, there’s often a place of hope and light in ourselves that we overlook. Taking the time to prioritize oneself takes strength and presents the opportunity to recognize one’s ability to grow. Together, we can understand and learn how to better manage the barriers that present themselves and that can get in the way of you attaining the quality of life you deserve.
(347) 647-2602 View (347) 647-2602
Photo of Alexandria Tremante, Clinical Social Work/Therapist in 10019, NY
Alexandria Tremante
Clinical Social Work/Therapist, LCSW
Verified Verified
New York, NY 10019  (Online Only)
Are you ready to get started on a journey of taking your control back? When we work towards more balanced living, we are more likely to conquer life's obstacles. Through my experience as a therapist, I am always amazed at the resiliency among humans during their most trying seasons. But what if we worked towards setting you up for success, improving your quality of life and setting boundaries so that the trying seasons don't need to feel AS trying? I genuinely enjoy creating a therapeutic partnership with my clients to identify and implement clear action steps towards reaching your highest potential.
Are you ready to get started on a journey of taking your control back? When we work towards more balanced living, we are more likely to conquer life's obstacles. Through my experience as a therapist, I am always amazed at the resiliency among humans during their most trying seasons. But what if we worked towards setting you up for success, improving your quality of life and setting boundaries so that the trying seasons don't need to feel AS trying? I genuinely enjoy creating a therapeutic partnership with my clients to identify and implement clear action steps towards reaching your highest potential.
(646) 692-0034 View (646) 692-0034
Photo of Alyssa Tortorella, Counselor in 10019, NY
Alyssa Tortorella
Counselor, LMHC
Verified Verified
1 Endorsed
New York, NY 10019
Alyssa Tortorella understands that initiating therapy can be intimidating and therefore takes care to ensure a therapeutic setting that emanates non-judgment and compassion. Sessions with Alyssa are interactive, with client and therapist working as a team to clarify treatment goals, establish a course of action, and move toward self-actualization. Alyssa welcomes open, direct, and ongoing feedback, and is always willing to alter sessions to meet the client’s changing circumstances and priorities. Most commonly, Alyssa’s clients are motivated individuals who struggle with self-esteem, anxiety, depression, and body-image issues.
Alyssa Tortorella understands that initiating therapy can be intimidating and therefore takes care to ensure a therapeutic setting that emanates non-judgment and compassion. Sessions with Alyssa are interactive, with client and therapist working as a team to clarify treatment goals, establish a course of action, and move toward self-actualization. Alyssa welcomes open, direct, and ongoing feedback, and is always willing to alter sessions to meet the client’s changing circumstances and priorities. Most commonly, Alyssa’s clients are motivated individuals who struggle with self-esteem, anxiety, depression, and body-image issues.
(347) 801-0647 View (347) 801-0647
Photo of Ash Choi, Clinical Social Work/Therapist in 10019, NY
Ash Choi
Clinical Social Work/Therapist, LMSW
Verified Verified
New York, NY 10019
I am a queer and trans nonbinary therapist mainly providing support for trans and nonbinary clients coping with transphobia as well as navigating gender identity and a/sexuality exploration and development. Race, class, and gender are at the forefront in my work with survivors of complex trauma. I help queer and trans immigrant communities with mental health challenges related to their lived experiences of abuse and neglect, long-term grief, and intergenerational trauma. My clinical modalities are psychodynamic and experiential.
I am a queer and trans nonbinary therapist mainly providing support for trans and nonbinary clients coping with transphobia as well as navigating gender identity and a/sexuality exploration and development. Race, class, and gender are at the forefront in my work with survivors of complex trauma. I help queer and trans immigrant communities with mental health challenges related to their lived experiences of abuse and neglect, long-term grief, and intergenerational trauma. My clinical modalities are psychodynamic and experiential.
(914) 350-4270 View (914) 350-4270

How does your Therapist compare?

Number of Therapists in 10019

800+

Average cost per session

$200

Therapists in 10019 who prioritize treating:

93% Anxiety
88% Depression
84% Relationship Issues
74% Self Esteem
66% Trauma and PTSD
59% Grief
59% Coping Skills

Average years in practice

16 Years

Top 3 insurances accepted

74% Aetna
58% UnitedHealthcare UHC | UBH
53% Cigna and Evernorth

How Therapists in 10019 see their clients

68% In Person and Online
32% Online Only

Gender breakdown

69% Female
29% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 10019?

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.