Therapists in Albuquerque, NM

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Photo of Krystalyn Madden, Counselor in Albuquerque, NM
Krystalyn Madden
Counselor, MA, LPCC, LPC
Verified Verified
Albuquerque, NM 87109  (Online Only)
Not accepting new clients
The three main ingredients for a helpful therapeutic relationship are unconditional positive regard, non-judgment, and empathy. I am a believer that you are the world’s leading expert in what it is like to be you. My role as your therapist is to help you navigate your journey, pointing out mile markers and other signs, while your role is to be in the driver’s seat as the expert of your own world. My goal as a therapist is to integrate a variety of therapeutic approaches that best suit clients on an individual, case-to-case basis.
The three main ingredients for a helpful therapeutic relationship are unconditional positive regard, non-judgment, and empathy. I am a believer that you are the world’s leading expert in what it is like to be you. My role as your therapist is to help you navigate your journey, pointing out mile markers and other signs, while your role is to be in the driver’s seat as the expert of your own world. My goal as a therapist is to integrate a variety of therapeutic approaches that best suit clients on an individual, case-to-case basis.
(505) 302-2740 View (505) 302-2740
Photo of Matthias Dietrich, Counselor in Albuquerque, NM
Matthias Dietrich
Counselor, MA, LPCC, NCC
Verified Verified
1 Endorsed
Albuquerque, NM 87109
Therapy and inner healing are difficult. It demands not only commitment, but the desire and willingness to persevere through inevitable discomfort in order to move towards growth. I commit myself to creating a secure, trustworthy, and judgment-free environment as the relationship we build together is essential to the healing process as well as positive client outcome. My training has led me to adopt and follow a primarily cognitive behavioral/biopsychosocial/holistic approach to treating mental disorders. However, I also apply methods from other important subfields of psychology.
Therapy and inner healing are difficult. It demands not only commitment, but the desire and willingness to persevere through inevitable discomfort in order to move towards growth. I commit myself to creating a secure, trustworthy, and judgment-free environment as the relationship we build together is essential to the healing process as well as positive client outcome. My training has led me to adopt and follow a primarily cognitive behavioral/biopsychosocial/holistic approach to treating mental disorders. However, I also apply methods from other important subfields of psychology.
(505) 305-1173 View (505) 305-1173
Photo of Tamara Auger, Counselor in Albuquerque, NM
Tamara Auger
Counselor, MA, LPCC, CMT, NCC
Verified Verified
Albuquerque, NM 87110
Therapy is a very personal and intimate process. I believe a therapist should be a bit less clinical than other health professionals, while at the same time providing a safe and comfortable, yet professional atmosphere. My practice is designed to allow clients to truly be at ease with me, which is one of the most important steps in the completion of successful therapy.
Therapy is a very personal and intimate process. I believe a therapist should be a bit less clinical than other health professionals, while at the same time providing a safe and comfortable, yet professional atmosphere. My practice is designed to allow clients to truly be at ease with me, which is one of the most important steps in the completion of successful therapy.
(505) 926-2295 View (505) 926-2295
Photo of Heidi Monge, Clinical Social Work/Therapist in Albuquerque, NM
Heidi Monge
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Albuquerque, NM 87109  (Online Only)
I utilize CBT, DBT, and Solution Focused Therapy while providing empathy and a non judgmental space for my clients to grow and heal. I'm a Licensed Clinical Social Worker, LCSW and graduated with my Master’s in Social Work from the University of Pittsburgh. I have experience in treating complex trauma, anxiety and depression in people throughout the lifespan, including families and couples. I am passionate about enhancing quality of life while taking pride in the values of communication, safety, and trust in working with individuals. I am deeply motivated to give back to my community.
I utilize CBT, DBT, and Solution Focused Therapy while providing empathy and a non judgmental space for my clients to grow and heal. I'm a Licensed Clinical Social Worker, LCSW and graduated with my Master’s in Social Work from the University of Pittsburgh. I have experience in treating complex trauma, anxiety and depression in people throughout the lifespan, including families and couples. I am passionate about enhancing quality of life while taking pride in the values of communication, safety, and trust in working with individuals. I am deeply motivated to give back to my community.
(505) 405-3643 View (505) 405-3643
Photo of Susan Buechele, Clinical Social Work/Therapist in Albuquerque, NM
Susan Buechele
Clinical Social Work/Therapist, LCSW
Verified Verified
Albuquerque, NM 87123
Not accepting new clients
NEW: Susan is no longer able to schedule new clients. Established and former clients are encouraged to contact me as needed (PRN).
NEW: Susan is no longer able to schedule new clients. Established and former clients are encouraged to contact me as needed (PRN).
(505) 557-1337 View (505) 557-1337
Photo of Ryan Porter, Clinical Social Work/Therapist in Albuquerque, NM
Ryan Porter
Clinical Social Work/Therapist, LCSW
Verified Verified
Albuquerque, NM 87102
Now Accepting New Clients. Providing therapeutic services since late 2012 to a wide array of clients with different needs has taught me so much as a therapist and as a human being. I have learned that all people desire positive and safe connections with others. Working from the perspective of the interpersonal process approach, I seek to develop an affirming therapeutic alliance as the foundation for the work ahead. Once that foundation has been built, healing can begin to take place.
Now Accepting New Clients. Providing therapeutic services since late 2012 to a wide array of clients with different needs has taught me so much as a therapist and as a human being. I have learned that all people desire positive and safe connections with others. Working from the perspective of the interpersonal process approach, I seek to develop an affirming therapeutic alliance as the foundation for the work ahead. Once that foundation has been built, healing can begin to take place.
(505) 405-6182 View (505) 405-6182
Photo of R Michael Westbay, Clinical Social Work/Therapist in Albuquerque, NM
R Michael Westbay
Clinical Social Work/Therapist, LISW, ACSW
Verified Verified
Albuquerque, NM 87109  (Online Only)
Do you want to feel better, be more successful and grow more in your life? Do you want to take back your power? Do you want to create a relationship that is better then it ever was? The mission of my work is to help people to use their own strengths & inner resources, to create more possibilities and develop a plan to achieve these goals and dreams. Life can be filled with great sadness and great joy.
Do you want to feel better, be more successful and grow more in your life? Do you want to take back your power? Do you want to create a relationship that is better then it ever was? The mission of my work is to help people to use their own strengths & inner resources, to create more possibilities and develop a plan to achieve these goals and dreams. Life can be filled with great sadness and great joy.
(505) 234-1530 View (505) 234-1530
Photo of Jennifer Bear, Counselor in Albuquerque, NM
Jennifer Bear
Counselor, LPCC
Verified Verified
Albuquerque, NM 87109
Therapy is a unique opportunity to explore your most authentic self. It is a space with no right or wrong. My goal as a therapist is to hold a safe space for you to go on a journey to explore the experiences that have caused pain and discomfort in your life and help guide you to understanding your authentic self as you foster self-love and acceptance for all the parts of yourself.
Therapy is a unique opportunity to explore your most authentic self. It is a space with no right or wrong. My goal as a therapist is to hold a safe space for you to go on a journey to explore the experiences that have caused pain and discomfort in your life and help guide you to understanding your authentic self as you foster self-love and acceptance for all the parts of yourself.
(505) 591-3710 View (505) 591-3710
Photo of Alison Murphy, Counselor in Albuquerque, NM
Alison Murphy
Counselor, LPCC
Verified Verified
Albuquerque, NM 87112  (Online Only)
Are you a woman who feels hopeless or lacking purpose? Are you struggling with feelings of emptiness, guilt, anxiety, or depression. If so, please know that your life CAN be different, and we can help you make the changes to give you "you" back. If you've ever been told you're too "emotional, sensitive, dramatic, etc," you've come to the right place. My expertise is YOU. Together, we will develop a plan to strategically address your areas of concern to get you back on the right track as quickly as possible.
Are you a woman who feels hopeless or lacking purpose? Are you struggling with feelings of emptiness, guilt, anxiety, or depression. If so, please know that your life CAN be different, and we can help you make the changes to give you "you" back. If you've ever been told you're too "emotional, sensitive, dramatic, etc," you've come to the right place. My expertise is YOU. Together, we will develop a plan to strategically address your areas of concern to get you back on the right track as quickly as possible.
(505) 503-0272 View (505) 503-0272
Photo of Natalie Ann Hess, Clinical Social Work/Therapist in Albuquerque, NM
Natalie Ann Hess
Clinical Social Work/Therapist, LCSW
Verified Verified
Albuquerque, NM 87110
It is easy to get swept up into what the world defines a woman should be. This world can pollute the mind into believing that extreme measures need to be taken in order to fulfill the status quo. It is exhausting molding oneself into a mold that was never meant to be. Each woman has been created for a unique purpose, and if the purpose gets diluted with the expectations of this world, the true beauty and intellect of the woman is hidden and that is a travesty. When a women sees her value in God's eyes, she truly becomes alive, as she understands she was created for a purpose, and is not a mere afterthought.
It is easy to get swept up into what the world defines a woman should be. This world can pollute the mind into believing that extreme measures need to be taken in order to fulfill the status quo. It is exhausting molding oneself into a mold that was never meant to be. Each woman has been created for a unique purpose, and if the purpose gets diluted with the expectations of this world, the true beauty and intellect of the woman is hidden and that is a travesty. When a women sees her value in God's eyes, she truly becomes alive, as she understands she was created for a purpose, and is not a mere afterthought.
(505) 257-4606 View (505) 257-4606
Photo of David E. Salas, Counselor in Albuquerque, NM
David E. Salas
Counselor, MA, MBA, LMHC
Verified Verified
9 Endorsed
Albuquerque, NM 87112  (Online Only)
Not accepting new clients
Within every one of us lies the potential and wisdom to live as joyfully and fulfilled as possible. While we cannot change the past and in some situations current stressors, we can develop strengths, strategies, and insight to better manage our responses in the present and future. As a strength-based, solution-focused provider, it is my purpose to help you gain awareness and control of thoughts, feelings, and possibly actions that prevent you from living the life you seek. Through culturally sensitive, compassionate, client-centered care, I will help you identify and reach your goals regardless of what they may be.
Within every one of us lies the potential and wisdom to live as joyfully and fulfilled as possible. While we cannot change the past and in some situations current stressors, we can develop strengths, strategies, and insight to better manage our responses in the present and future. As a strength-based, solution-focused provider, it is my purpose to help you gain awareness and control of thoughts, feelings, and possibly actions that prevent you from living the life you seek. Through culturally sensitive, compassionate, client-centered care, I will help you identify and reach your goals regardless of what they may be.
(505) 657-9312 View (505) 657-9312
Photo of Resolutions Counseling Group LLC, Counselor in Albuquerque, NM
Resolutions Counseling Group LLC
Counselor, PsyD, LPCC
Verified Verified
Albuquerque, NM 87112
Life can get chaotic, out of control and overwhelming, making it difficult to manage life's demands. Such stress can lead to mental health problems for many. RCG can help. RCG provides a safe and supportive environment where you will be heard and understood. RCG will help you resolve mental and behavioral health problems so you can live a healthier life. Are you a parent or child care organizations uncertain of what to do with child(ren's) behavior. RCG can help you develop effective behavior management strategies for children. Are you a recent Master's Psych or Counseling grad? RCG provides supervision hours toward licensure.
Life can get chaotic, out of control and overwhelming, making it difficult to manage life's demands. Such stress can lead to mental health problems for many. RCG can help. RCG provides a safe and supportive environment where you will be heard and understood. RCG will help you resolve mental and behavioral health problems so you can live a healthier life. Are you a parent or child care organizations uncertain of what to do with child(ren's) behavior. RCG can help you develop effective behavior management strategies for children. Are you a recent Master's Psych or Counseling grad? RCG provides supervision hours toward licensure.
(505) 933-7211 View (505) 933-7211
Photo of Cheryl Birmingham, Clinical Social Work/Therapist in Albuquerque, NM
Cheryl Birmingham
Clinical Social Work/Therapist, LCSW
Verified Verified
Albuquerque, NM 87123  (Online Only)
My approach involves the use of our presence in nature to find resilience, intuition, ingenuity, along with mindfulness. There may be some life coaching plus cognitive behavioral therapy and art expression.
My approach involves the use of our presence in nature to find resilience, intuition, ingenuity, along with mindfulness. There may be some life coaching plus cognitive behavioral therapy and art expression.
(505) 806-2384 View (505) 806-2384
Photo of Perfectly Imperfect, Clinical Social Work/Therapist in Albuquerque, NM
Perfectly Imperfect
Clinical Social Work/Therapist, MA, LCSW, LADAC
Verified Verified
Albuquerque, NM 87108
Perfectly Imperfect's mission is to provide a secure, clean, comfortable and accepting environment for clients to explore their; substance use/co-occurring disorders, mood instability and issues related to domestic abuse and sexual identity. Our services are individual family focused based on principles of individual capacity for recovery and resiliency. Perfectly Imperfect embraces and celebrates different cultures and cultural healing traditions and practices and promotes a recovery process whereby people with serious mental illnesses and//or substance use and domestic abuse issues can live fulfilling, autonomous lives.
Perfectly Imperfect's mission is to provide a secure, clean, comfortable and accepting environment for clients to explore their; substance use/co-occurring disorders, mood instability and issues related to domestic abuse and sexual identity. Our services are individual family focused based on principles of individual capacity for recovery and resiliency. Perfectly Imperfect embraces and celebrates different cultures and cultural healing traditions and practices and promotes a recovery process whereby people with serious mental illnesses and//or substance use and domestic abuse issues can live fulfilling, autonomous lives.
(505) 588-5685 View (505) 588-5685
Photo of Michelle Nickerson, Clinical Social Work/Therapist in Albuquerque, NM
Michelle Nickerson
Clinical Social Work/Therapist, MA, LCSW
Verified Verified
Albuquerque, NM 87102
Immediate Openings Available! I work with clients to create a safe place to process what is happening in your life, build a therapeutic relationship, and look at the whole self: spiritual, physical and emotional. Feeling safe enough to look at what's not working in your life right now, and having a therapist with the wide range of skills to help you shift in the areas you want to, can make all the difference. We can all often not feel assertive and or able to be connected in relationships, and I can help you connect to yourself and your intuition to shift patterns that aren't serving you.
Immediate Openings Available! I work with clients to create a safe place to process what is happening in your life, build a therapeutic relationship, and look at the whole self: spiritual, physical and emotional. Feeling safe enough to look at what's not working in your life right now, and having a therapist with the wide range of skills to help you shift in the areas you want to, can make all the difference. We can all often not feel assertive and or able to be connected in relationships, and I can help you connect to yourself and your intuition to shift patterns that aren't serving you.
(505) 666-4527 View (505) 666-4527
Photo of Katherine Jeane Potts, Clinical Social Work/Therapist in Albuquerque, NM
Katherine Jeane Potts
Clinical Social Work/Therapist, LCSW
Verified Verified
Albuquerque, NM 87112  (Online Only)
Hello Its completely normal to struggle with life's challenges and stress at times. It is also normal to feel anxious and depressed. Sometimes it has gone on too long or the challenges have become too much. Whether you are experiencing a new challenge or an old issue is re-surfacing, or you are just realizing that life is becoming too stressful, counseling can help you to finally get to talk about what is happening inside of you, untagle your thoughts and emotions, and see what you have not been seeing to understand yourself. It can help you to develop new skills to face challenges and stress in new ways that can change your life.
Hello Its completely normal to struggle with life's challenges and stress at times. It is also normal to feel anxious and depressed. Sometimes it has gone on too long or the challenges have become too much. Whether you are experiencing a new challenge or an old issue is re-surfacing, or you are just realizing that life is becoming too stressful, counseling can help you to finally get to talk about what is happening inside of you, untagle your thoughts and emotions, and see what you have not been seeing to understand yourself. It can help you to develop new skills to face challenges and stress in new ways that can change your life.
(505) 421-6826 View (505) 421-6826
Photo of Ava Dasya Rasa Dragonfly Trauma Counseling Center, Clinical Social Work/Therapist in Albuquerque, NM
Ava Dasya Rasa Dragonfly Trauma Counseling Center
Clinical Social Work/Therapist, MSW, MA, LCSW-C
Verified Verified
Albuquerque, NM 87193  (Online Only)
TRAUMA, Grief & Spirituality: I am a Certified Brainspotting Therapist & CIT, working with C-PTSD, Complicated Grief, Dissociation & Relational Trauma, Religious Trauma, Post-Traumatic Spiritual Growth & Contemplative Spirituality. Brainspotting is a neuro-experiential model of therapy that accesses stored trauma in our brain & body through relevant eye positions. We use Focused Mindfulness to identify, process & resolve stored trauma. I provide other neuro-somatic (brain-body) Trauma Therapies including: EMDR, Somatic-Attachment, Mindfulness & Integrative Parts work, informed by Internal Family Systems and a Transpersonal lens.
TRAUMA, Grief & Spirituality: I am a Certified Brainspotting Therapist & CIT, working with C-PTSD, Complicated Grief, Dissociation & Relational Trauma, Religious Trauma, Post-Traumatic Spiritual Growth & Contemplative Spirituality. Brainspotting is a neuro-experiential model of therapy that accesses stored trauma in our brain & body through relevant eye positions. We use Focused Mindfulness to identify, process & resolve stored trauma. I provide other neuro-somatic (brain-body) Trauma Therapies including: EMDR, Somatic-Attachment, Mindfulness & Integrative Parts work, informed by Internal Family Systems and a Transpersonal lens.
(505) 387-3027 View (505) 387-3027
Photo of Nicole Hartson, Counselor in Albuquerque, NM
Nicole Hartson
Counselor, LPCC
Verified Verified
2 Endorsed
Albuquerque, NM 87110
Are you struggling with feelings of sadness, hopelessness or missing direction in your life? Do you battle with feelings of anxiety, guilt, shame or avoidance? Maybe you’ve experienced trauma or loss in your life and you are looking for a way to make changes and find some relief but just do not know how to? If so, then let’s chat. I specialize in a variety of evidence-based modalities such as CBT and EMDR and focus on working with highly motivated individuals with depression, anxiety, trauma and stress. You CAN make the changes that help you move through this difficult time to feel more centered and grounded.
Are you struggling with feelings of sadness, hopelessness or missing direction in your life? Do you battle with feelings of anxiety, guilt, shame or avoidance? Maybe you’ve experienced trauma or loss in your life and you are looking for a way to make changes and find some relief but just do not know how to? If so, then let’s chat. I specialize in a variety of evidence-based modalities such as CBT and EMDR and focus on working with highly motivated individuals with depression, anxiety, trauma and stress. You CAN make the changes that help you move through this difficult time to feel more centered and grounded.
(505) 308-0781 View (505) 308-0781
Photo of Mindful Counseling LLC, Clinical Social Work/Therapist in Albuquerque, NM
Mindful Counseling LLC
Clinical Social Work/Therapist, MA, LCSW
Verified Verified
Albuquerque, NM 87107
Experience a non-judgmental environment with a therapist who is fully present to what you are going through. We will create a 'therapeutic custom fit' as we work with you. Whether you are experiencing symptoms of depression or anxiety, facing past trauma, or wanting to enhance relationships, we can help you navigate through. Not sure whether working with us is the right decision? We invite you to visit our website to learn more about our therapists and how we can help you. Our website also confirms the appointments we currently have available as well as instructions on how to start therapy.
Experience a non-judgmental environment with a therapist who is fully present to what you are going through. We will create a 'therapeutic custom fit' as we work with you. Whether you are experiencing symptoms of depression or anxiety, facing past trauma, or wanting to enhance relationships, we can help you navigate through. Not sure whether working with us is the right decision? We invite you to visit our website to learn more about our therapists and how we can help you. Our website also confirms the appointments we currently have available as well as instructions on how to start therapy.
(505) 899-9329 View (505) 899-9329
Photo of Rhonda Neswald, Counselor in Albuquerque, NM
Rhonda Neswald
Counselor, PhD, , LPCC, ACS
Verified Verified
Albuquerque, NM 87102
I offer a therapeutic setting congruent with individuals seeking depth work, self-exploration, with a focus on identity and personal growth. I also have extensive background working with post trauma, depression, anxiety, women's and men's issues and sexual congruence. Feel free to contact me if you have questions about my work and therapeutic style.
I offer a therapeutic setting congruent with individuals seeking depth work, self-exploration, with a focus on identity and personal growth. I also have extensive background working with post trauma, depression, anxiety, women's and men's issues and sexual congruence. Feel free to contact me if you have questions about my work and therapeutic style.
(505) 591-3277 View (505) 591-3277

How does your Therapist compare?

Number of Therapists in Albuquerque, NM

900+

Average cost per session

$129

Therapists in Albuquerque, NM who prioritize treating:

89% Anxiety
85% Depression
78% Trauma and PTSD
74% Self Esteem
73% Relationship Issues
68% Coping Skills
66% Stress

Average years in practice

13 Years

Top 3 insurances accepted

81% Presbyterian
79% BlueCross and BlueShield
74% Medicaid

How Therapists in Albuquerque, NM see their clients

65% In Person and Online
35% Online Only

Gender breakdown

78% Female
21% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Albuquerque?

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.