Therapists in Montana

View cities and counties in Montana
Photo of Suzy Rizza, MA, PCLC, Pre-Licensed Professional
Suzy Rizza
Pre-Licensed Professional, MA, PCLC
Verified Verified
Missoula, MT 59804
Waitlist for new clients
Many of us will go through times in our lives that feel like too much to navigate on our own - life transitions, grief, relationship difficulties. In those times, it can be useful to have someone to help explore how we learned to cope and encourage positive change, resilience, and healthy relationships. My primary goal is to provide space for you to be heard, seen, understood and know that you are not alone in your struggles (because we seldom are)! I have experience working with intimate relationships, intimate partner violence, life transitions, and parenting issues.
Many of us will go through times in our lives that feel like too much to navigate on our own - life transitions, grief, relationship difficulties. In those times, it can be useful to have someone to help explore how we learned to cope and encourage positive change, resilience, and healthy relationships. My primary goal is to provide space for you to be heard, seen, understood and know that you are not alone in your struggles (because we seldom are)! I have experience working with intimate relationships, intimate partner violence, life transitions, and parenting issues.
(406) 505-4902 View (406) 505-4902
Photo of Carleen Grussling - Stacking Stones Counseling, LLC, MSW, LCSW, Clinical Social Work/Therapist
Stacking Stones Counseling, LLC
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Hamilton, MT 59840
We believe in a Strength's Based approach when working with people in therapy. We have extensive experience working in the mental health field in a variety of different settings. We have worked with a vast majority of mental health issues, including PTSD, Anxiety, Depression, Grief and Loss, ADHD, Schizophrenia, Bipolar Disorder, Reactive Attachment Disorder, Eating Disorders, and various Addictions.
We believe in a Strength's Based approach when working with people in therapy. We have extensive experience working in the mental health field in a variety of different settings. We have worked with a vast majority of mental health issues, including PTSD, Anxiety, Depression, Grief and Loss, ADHD, Schizophrenia, Bipolar Disorder, Reactive Attachment Disorder, Eating Disorders, and various Addictions.
(406) 623-5972 View (406) 623-5972
Photo of Grace Kok, LCSW, Clinical Social Work/Therapist
Grace Kok
Clinical Social Work/Therapist, LCSW
Verified Verified
Missoula, MT 59801
Hello and Welcome! Thank you for visiting my profile, I am so glad you are here! I work from a strength-based, person-centered approach as I believe every individual has the strength and resiliency within for growth, healing, and change. I offer a compassionate, warm, and supportive space where you will feel heard and validated. I strive to create an empowering environment where we will collaboratively establish ongoing, flexible goals to make sessions most effective. I am passionate about working with adolescents and adults in addressing anxiety, depression, trauma, stress, self-esteem/self-acceptance challenges and more!
Hello and Welcome! Thank you for visiting my profile, I am so glad you are here! I work from a strength-based, person-centered approach as I believe every individual has the strength and resiliency within for growth, healing, and change. I offer a compassionate, warm, and supportive space where you will feel heard and validated. I strive to create an empowering environment where we will collaboratively establish ongoing, flexible goals to make sessions most effective. I am passionate about working with adolescents and adults in addressing anxiety, depression, trauma, stress, self-esteem/self-acceptance challenges and more!
(406) 732-6799 View (406) 732-6799
Photo of Stanford Spurlock, MS, PCLC, LMFT, Licensed Professional Counselor
Stanford Spurlock
Licensed Professional Counselor, MS, PCLC, LMFT
Verified Verified
6 Endorsed
Bozeman, MT 59715
Not accepting new clients
Hi. My name is Stanford.
Hi. My name is Stanford.
(406) 936-3356 View (406) 936-3356
Photo of Ann Szalda-Petree, LCSW, LICSW, PhD, Clinical Social Work/Therapist
Ann Szalda-Petree
Clinical Social Work/Therapist, LCSW, LICSW, PhD
Verified Verified
Missoula, MT 59803
Not accepting new clients
Supportive, non-judgmental and curious relationship is the key to good therapy. What do you deeply want and need? What's next for you in improving your overall satisfaction with life? I hope we can discover strengths you never knew you had, uncover your profoundest desires for your future and make a plan to get there. Whether that includes resolution of trauma, greater self-understanding, achieving healthy relationships, help with day to day stressors and/or relief from depression or anxiety, I'd like to collaborate to create the change you want.
Supportive, non-judgmental and curious relationship is the key to good therapy. What do you deeply want and need? What's next for you in improving your overall satisfaction with life? I hope we can discover strengths you never knew you had, uncover your profoundest desires for your future and make a plan to get there. Whether that includes resolution of trauma, greater self-understanding, achieving healthy relationships, help with day to day stressors and/or relief from depression or anxiety, I'd like to collaborate to create the change you want.
(406) 344-7826 View (406) 344-7826
Photo of Megan Spalding, MS, LCPC, NCC, Counselor
Megan Spalding
Counselor, MS, LCPC, NCC
Verified Verified
2 Endorsed
Bozeman, MT 59718
My focus is working with individual adults. I support individuals in finding happiness, fulfilment, and balance in their lives by helping them navigate life transitions, dissatisfying relationships, and life stressors. I also specialize in helping people in overcoming issues like anxiety, depression, and attachment trauma.
My focus is working with individual adults. I support individuals in finding happiness, fulfilment, and balance in their lives by helping them navigate life transitions, dissatisfying relationships, and life stressors. I also specialize in helping people in overcoming issues like anxiety, depression, and attachment trauma.
(406) 365-1411 View (406) 365-1411
Photo of Mary F Geiger, LCPC, LMFT, SAP, LAC, Counselor
Mary F Geiger
Counselor, LCPC, LMFT, SAP, LAC
Verified Verified
8 Endorsed
Glendive, MT 59330
My counseling practice focuses on serving children, adults, and couples or families. In working with children, I am certified in Cognitive Behavioral Therapy-Trauma Focused for children. I also work with adults in issues of anxiety, depression, and other mental health issues. In my practice I provide counseling, therapy, psychodynamic psychotherapy, and psychoanalysis. My treatment approach allows for the effective engagement of a wide range of conditions, including but not limited to personality issues, depression, bi-polar, psychotic states, autistic spectrum, and trauma (PTSD).
My counseling practice focuses on serving children, adults, and couples or families. In working with children, I am certified in Cognitive Behavioral Therapy-Trauma Focused for children. I also work with adults in issues of anxiety, depression, and other mental health issues. In my practice I provide counseling, therapy, psychodynamic psychotherapy, and psychoanalysis. My treatment approach allows for the effective engagement of a wide range of conditions, including but not limited to personality issues, depression, bi-polar, psychotic states, autistic spectrum, and trauma (PTSD).
(406) 848-5111 View (406) 848-5111
Photo of Marianne Jackson Amsden, MS, SEP, LCPC, Counselor
Marianne Jackson Amsden
Counselor, MS, SEP, LCPC
Verified Verified
1 Endorsed
Bozeman, MT 59718
I am passionate about facilitating wellbeing. My hope is to help you live free, free to discover and reach your potential. I work from Gestalt theory, which is a holistic, integrative perspective that considers mind, body, spirit, and your environment. Additionally, I am a Somatic Experiencing Practitioner. SE is a comprehensive, body-centered & naturalistic method of healing trauma. Through traditional talk therapy and creative, experiential, body-centered methods, I will help you build awareness of your unique adaptations to your environment to allow a natural shift to healthier and more fulfilling responses to life.
I am passionate about facilitating wellbeing. My hope is to help you live free, free to discover and reach your potential. I work from Gestalt theory, which is a holistic, integrative perspective that considers mind, body, spirit, and your environment. Additionally, I am a Somatic Experiencing Practitioner. SE is a comprehensive, body-centered & naturalistic method of healing trauma. Through traditional talk therapy and creative, experiential, body-centered methods, I will help you build awareness of your unique adaptations to your environment to allow a natural shift to healthier and more fulfilling responses to life.
(406) 414-7669 View (406) 414-7669
Photo of Sara Matthews, LCPC, Counselor
Sara Matthews
Counselor, LCPC
Verified Verified
5 Endorsed
Online Only
Not accepting new clients
I have been in private practice for over 17 years, working mostly with college students, therapists, and individual adults. I help people understand relationship patterns to gain deeper understanding of their needs and insecurities. I offer trauma, anxiety, and depression treatment. I help people navigate life adjustments, sexuality concerns, and life stressors. I appreciate that everyone is different, and that there are many paths to success. I approach therapy flexibly, utilizing multiple modalities, to meet your unique needs.
I have been in private practice for over 17 years, working mostly with college students, therapists, and individual adults. I help people understand relationship patterns to gain deeper understanding of their needs and insecurities. I offer trauma, anxiety, and depression treatment. I help people navigate life adjustments, sexuality concerns, and life stressors. I appreciate that everyone is different, and that there are many paths to success. I approach therapy flexibly, utilizing multiple modalities, to meet your unique needs.
(406) 998-1874 View (406) 998-1874
Photo of Theresa Clearman - Clearman Counseling & Mental Health Services LLC, LCPC, Counselor
Clearman Counseling & Mental Health Services LLC
Counselor, LCPC
Verified Verified
1 Endorsed
Helena, MT 59601
My therapeutic approach emphasizes a focus on subconscious motives & creativity forms of expression. I am Depth Psychologist with a PhD in Community, Liberation, and Eco psychology and a Masters in Counseling Psychology. I do not believe in fixing people, but instead in helping them explore the reasons symptoms and behaviors are coming forward, then working toward building stronger coping skills and resiliency. Evidence for the efficacy of depth psychological approaches to psychotherapy is growing as studies show that depth psychology has a longer-lasting and more profound impact than cognitive or behavioral psychologies alone.
My therapeutic approach emphasizes a focus on subconscious motives & creativity forms of expression. I am Depth Psychologist with a PhD in Community, Liberation, and Eco psychology and a Masters in Counseling Psychology. I do not believe in fixing people, but instead in helping them explore the reasons symptoms and behaviors are coming forward, then working toward building stronger coping skills and resiliency. Evidence for the efficacy of depth psychological approaches to psychotherapy is growing as studies show that depth psychology has a longer-lasting and more profound impact than cognitive or behavioral psychologies alone.
(406) 412-6451 View (406) 412-6451
Photo of Lisa McKee, LCSW, Clinical Social Work/Therapist
Lisa McKee
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Bigfork, MT 59911
Although adept in various therapeutic modalities, I have a particular interest in grief work and Acceptance and Commitment Therapy (ACT) to assist clients congruently with their spirituality and values.
Although adept in various therapeutic modalities, I have a particular interest in grief work and Acceptance and Commitment Therapy (ACT) to assist clients congruently with their spirituality and values.
(406) 284-0481 View (406) 284-0481
Photo of Dawn Marie Birk, PhD, Psychologist
Dawn Marie Birk
Psychologist, PhD
Verified Verified
Billings, MT 59101
Dr. Dawn M. Birk, Ph.D. d.b.a. A Peaceful Point, L.L.C. No matter where you are in your life, let me help you find your peaceful point. Life is hard sometimes and we all go through periods when we could use guidance, assistance in coping, a warm empathic listener and someone who can aid us in identifying and achieving our goals. I look for the strengths in every individual whether we meet solely for an evaluation or for short or long-term therapy. Together we look for ways to find peace in life.
Dr. Dawn M. Birk, Ph.D. d.b.a. A Peaceful Point, L.L.C. No matter where you are in your life, let me help you find your peaceful point. Life is hard sometimes and we all go through periods when we could use guidance, assistance in coping, a warm empathic listener and someone who can aid us in identifying and achieving our goals. I look for the strengths in every individual whether we meet solely for an evaluation or for short or long-term therapy. Together we look for ways to find peace in life.
(406) 318-6443 View (406) 318-6443
Photo of Julie H Eaton, MA, LCPC, Counselor
Julie H Eaton
Counselor, MA, LCPC
Verified Verified
1 Endorsed
Livingston, MT 59047
I help people grow and live more satisfying lives. My clients can expect to learn new tools for emotional regulation and feeling better. Therapy is dynamic and I utilize a variety of approaches to help my clients find the right road map to recovery and better living. Surprisingly as it sounds, therapy can be fun, enlightening and a place not only out of pain but onto a more rewarded life. By developing our natural curiosity we can start letting go of our inner critic and open ourselves up to more balance and connection.
I help people grow and live more satisfying lives. My clients can expect to learn new tools for emotional regulation and feeling better. Therapy is dynamic and I utilize a variety of approaches to help my clients find the right road map to recovery and better living. Surprisingly as it sounds, therapy can be fun, enlightening and a place not only out of pain but onto a more rewarded life. By developing our natural curiosity we can start letting go of our inner critic and open ourselves up to more balance and connection.
(406) 204-4894 View (406) 204-4894
Photo of Hanna Knudsen, PCLC, Counselor
Hanna Knudsen
Counselor, PCLC
Verified Verified
1 Endorsed
Online Only
I can see clients throughout Montana via telehealth. I work with adolescent, adult, geriatric, multicultural, and LGBTQIA+ clients. My specialties include working with ADHD, ASD and sensory sensitivities, Depressive Disorders (MDD, Dysthymia, PMDD), Dissociative Disorders (DPD, DPR, DID), complex-interpersonal relationships (family members or partners with: NPD, substance-use, BPD, imprisonment, etc.), Social Anxiety, PTSD (physical, mental, emotional, spiritual, sexual), Suicidality, Somatic Disorders, Insomnia, Sexual Dysfunctions, Sex Positivity, Gender Dysphoria, and Burnout.
I can see clients throughout Montana via telehealth. I work with adolescent, adult, geriatric, multicultural, and LGBTQIA+ clients. My specialties include working with ADHD, ASD and sensory sensitivities, Depressive Disorders (MDD, Dysthymia, PMDD), Dissociative Disorders (DPD, DPR, DID), complex-interpersonal relationships (family members or partners with: NPD, substance-use, BPD, imprisonment, etc.), Social Anxiety, PTSD (physical, mental, emotional, spiritual, sexual), Suicidality, Somatic Disorders, Insomnia, Sexual Dysfunctions, Sex Positivity, Gender Dysphoria, and Burnout.
(406) 747-2234 View (406) 747-2234
Photo of Jennifer Finn (Sentinel Mental Health), MSW, LCSW, Clinical Social Work/Therapist
Jennifer Finn (Sentinel Mental Health)
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
12 Endorsed
Billings, MT 59102
I believe that strength is not defined by burying our feelings, keeping your chin up, or other cliche sayings that encourage silence. True strength is being vulnerable, talking about how you feel, and yes, asking for help. If you are ready to dive into whatever is hurting you, interfering in your relationships, and whatever is keeping you from the life that you want to live, THAT is strength, and where your true power lies.
I believe that strength is not defined by burying our feelings, keeping your chin up, or other cliche sayings that encourage silence. True strength is being vulnerable, talking about how you feel, and yes, asking for help. If you are ready to dive into whatever is hurting you, interfering in your relationships, and whatever is keeping you from the life that you want to live, THAT is strength, and where your true power lies.
(406) 393-8443 View (406) 393-8443
Photo of Caitlin Adamo (Fireweed Integrative Therapy), LCPC, Counselor
Caitlin Adamo (Fireweed Integrative Therapy)
Counselor, LCPC
Verified Verified
Livingston, MT 59047
Waitlist for new clients
As Fireweed grows and spreads vibrantly in the years following a forest fire, we too can renourish our soil, strengthen our substrate, and bloom amongst community. I support individuals and couples who are curious to understand, repair, connect, and live in greater alignment with their values and vision. Together, we can remember and help you access your enduring strengths and create new opportunities for a nourishing life.
As Fireweed grows and spreads vibrantly in the years following a forest fire, we too can renourish our soil, strengthen our substrate, and bloom amongst community. I support individuals and couples who are curious to understand, repair, connect, and live in greater alignment with their values and vision. Together, we can remember and help you access your enduring strengths and create new opportunities for a nourishing life.
(406) 296-5561 View (406) 296-5561
Photo of Liz Bassler, LCSW, Clinical Social Work/Therapist
Liz Bassler
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Missoula, MT 59808
Not accepting new clients
I'm a part the Montana DBT Associates group practice and specialize in working with adults. Dialectical Behavior Therapy is an evidence-based therapy and is widely considered to be the gold standard treatment for individuals who experience intense and unstable emotions, and who are struggling with suicide and self-harm. DBT helps individuals find the middle ground between extremes and opposites and increases their skills in mindfulness, emotion regulation, relationships, communication, and tolerating intense emotions.
I'm a part the Montana DBT Associates group practice and specialize in working with adults. Dialectical Behavior Therapy is an evidence-based therapy and is widely considered to be the gold standard treatment for individuals who experience intense and unstable emotions, and who are struggling with suicide and self-harm. DBT helps individuals find the middle ground between extremes and opposites and increases their skills in mindfulness, emotion regulation, relationships, communication, and tolerating intense emotions.
(406) 642-0850 View (406) 642-0850
Photo of Erica Parrish, MS, LSC, LCPC, NCC, Counselor
Erica Parrish
Counselor, MS, LSC, LCPC, NCC
Verified Verified
Bozeman, MT 59718
I specialize in working with a variety of different age groups and backgrounds. In the therapist role, I believe in meeting the client where they are at, and transparency. When working with younger clients I believe that it is important to also work with the family. I have experience working with families in order to work towards understanding and strengthen the overall family unit. The key to making progress is building and maintaining a trusting and empathetic relationship with the client. For the past 11 years I have primarily worked in the school system as a licensed school counselor.
I specialize in working with a variety of different age groups and backgrounds. In the therapist role, I believe in meeting the client where they are at, and transparency. When working with younger clients I believe that it is important to also work with the family. I have experience working with families in order to work towards understanding and strengthen the overall family unit. The key to making progress is building and maintaining a trusting and empathetic relationship with the client. For the past 11 years I have primarily worked in the school system as a licensed school counselor.
(406) 540-9318 View (406) 540-9318
Photo of Kathryn (Kittie) Bowen, MS, LCPC, Counselor
Kathryn (Kittie) Bowen
Counselor, MS, LCPC
Verified Verified
9 Endorsed
Bozeman, MT 59718
My group practice Bozeman Counseling Center has openings! Are you feeling stuck, confused, or just want things to be different in your life? Are you overwhelmed with life's challenges or unhappy in your relationships? Most people express similar sentiments at one point or another in their lives. We help people get unstuck, find solutions to problems, and facilitate the transformation of their relationships. Our role as your therapist is collaborative - to support you in your unique process of healing and growth. Sessions are interactive and we use effective, solutions focused tools that can lead to positive changes.
My group practice Bozeman Counseling Center has openings! Are you feeling stuck, confused, or just want things to be different in your life? Are you overwhelmed with life's challenges or unhappy in your relationships? Most people express similar sentiments at one point or another in their lives. We help people get unstuck, find solutions to problems, and facilitate the transformation of their relationships. Our role as your therapist is collaborative - to support you in your unique process of healing and growth. Sessions are interactive and we use effective, solutions focused tools that can lead to positive changes.
(406) 624-6007 View (406) 624-6007
Photo of Andrew (Andy) Kemp, SWLC, MSW, Clinical Social Work/Therapist
Andrew (Andy) Kemp
Clinical Social Work/Therapist, SWLC, MSW
Verified Verified
Bozeman, MT 59718
I am a therapist specializing in trauma-focused therapy. I am passionate about helping individuals heal from past traumas and regain a sense of empowerment and balance in their lives. With extensive training in Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive Behavioral Therapy (CBT), I work with my clients to process painful memories, reduce distressing symptoms, and develop healthier coping mechanisms. These evidence-based approaches are highly effective in addressing trauma, anxiety, PTSD, and other emotional challenges, and I tailor each session to meet the unique needs of each client.
I am a therapist specializing in trauma-focused therapy. I am passionate about helping individuals heal from past traumas and regain a sense of empowerment and balance in their lives. With extensive training in Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive Behavioral Therapy (CBT), I work with my clients to process painful memories, reduce distressing symptoms, and develop healthier coping mechanisms. These evidence-based approaches are highly effective in addressing trauma, anxiety, PTSD, and other emotional challenges, and I tailor each session to meet the unique needs of each client.
(406) 215-2392 View (406) 215-2392
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How does your Therapist compare?

Average cost per session

$160

Therapists in Montana who prioritize treating:

91% Anxiety
86% Depression
77% Trauma and PTSD
76% Relationship Issues
74% Self Esteem
70% Coping Skills
69% Stress

Average years in practice

9 Years

Top 3 insurances accepted

93% BlueCross and BlueShield
78% Allegiance
76% PacificSource

How Therapists in Montana see their clients

82% In Person and Online
18% Online Only

Gender breakdown

81% Female
18% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Montana?

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.