Therapists in Columbus, OH

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Photo of Dr. Shonali Raney, Psychologist in Columbus, OH
Dr. Shonali Raney
Psychologist, PhD
Verified Verified
4 Endorsed
Columbus, OH 43214
Not accepting new clients
I work solely with clients who are 25 years old and above. Being engaged in individual counseling is an opportunity to receive support and experience growth during challenging times of life. Counseling allows individuals to explore their feelings, beliefs, and behaviors, to address concerns that lead to mental health problems. You will work with me in a safe, caring and confidential environment. The focus of our work could be on specific goals or long-standing concerns such as, family of origin issues or past-unsolved trauma. The ultimate goal is to help you heal, grow, and re-engage in a productive, personally fulfilling life.
I work solely with clients who are 25 years old and above. Being engaged in individual counseling is an opportunity to receive support and experience growth during challenging times of life. Counseling allows individuals to explore their feelings, beliefs, and behaviors, to address concerns that lead to mental health problems. You will work with me in a safe, caring and confidential environment. The focus of our work could be on specific goals or long-standing concerns such as, family of origin issues or past-unsolved trauma. The ultimate goal is to help you heal, grow, and re-engage in a productive, personally fulfilling life.
(380) 207-1504 View (380) 207-1504
Photo of Jennifer Francis, Counselor in Columbus, OH
Jennifer Francis
Counselor, LPCC-S
Verified Verified
Columbus, OH 43212  (Online Only)
Jen (Jennifer) Francis is a Licensed Professional Clinical Counselor (LPCC) who has over 9 years of experience working with adults. Jen specializes in anxiety and stress disorders, mood disorders, and trauma. Additionally, Jen specializes in working with individuals who are experiencing life stressors.
Jen (Jennifer) Francis is a Licensed Professional Clinical Counselor (LPCC) who has over 9 years of experience working with adults. Jen specializes in anxiety and stress disorders, mood disorders, and trauma. Additionally, Jen specializes in working with individuals who are experiencing life stressors.
(614) 662-1713 View (614) 662-1713
Photo of Betsy Harlan, Counselor in Columbus, OH
Betsy Harlan
Counselor, MSEd, LPCC
Verified Verified
2 Endorsed
Columbus, OH 43209  (Online Only)
Not accepting new clients
I am a Certified EMDR Therapist who uses EMDR and other proven techniques, to help clients with anxiety, depression, trauma, PTSD, chronic illness, chronic pain, medical trauma, difficult childhood experiences, attachment issues, and dissociation. EMDR based therapy for chronic pain is effective in many cases of low back pain, migraine, fibromyalgia, neuropathy, whiplash, irritable bowel syndrome, and sexual pain disorder. Other types of pain may respond favorably, as well. As a result of our work together you should have a clearer view of yourself, feel calmer, more positive, be able to make better life decisions, and experience improved quality of life.
I am a Certified EMDR Therapist who uses EMDR and other proven techniques, to help clients with anxiety, depression, trauma, PTSD, chronic illness, chronic pain, medical trauma, difficult childhood experiences, attachment issues, and dissociation. EMDR based therapy for chronic pain is effective in many cases of low back pain, migraine, fibromyalgia, neuropathy, whiplash, irritable bowel syndrome, and sexual pain disorder. Other types of pain may respond favorably, as well. As a result of our work together you should have a clearer view of yourself, feel calmer, more positive, be able to make better life decisions, and experience improved quality of life.
(614) 721-8239 View (614) 721-8239
Photo of Tiffany M Shader, Psychologist in Columbus, OH
Tiffany M Shader
Psychologist, PhD
Verified Verified
Columbus, OH 43214
I am a psychologist located in Columbus, OH and I see virtual clients that are located in California. I provide assessment and therapy services. My assessments are designed to help families understand their child or adolescent's strengths and challenges. I use empirically supported methods and provide solution-focused, meaningful, and understandable feedback. My therapy services use evidence-based, effective, and goal-oriented cognitive-behavioral therapies (CBT).
I am a psychologist located in Columbus, OH and I see virtual clients that are located in California. I provide assessment and therapy services. My assessments are designed to help families understand their child or adolescent's strengths and challenges. I use empirically supported methods and provide solution-focused, meaningful, and understandable feedback. My therapy services use evidence-based, effective, and goal-oriented cognitive-behavioral therapies (CBT).
(714) 464-6627 View (714) 464-6627
Photo of Francesca Festa, Counselor in Columbus, OH
Francesca Festa
Counselor, MA, LPCC-S, CCATP
Verified Verified
2 Endorsed
Columbus, OH 43215
Infertility, miscarriages, sexual difficulties, postpartum anxiety and depression can be very hard for you and your partner to deal with and cause a strain in your relationships. These experiences may bring feelings of shame, disappointment, anger, and grief that could be overwhelming and difficult to understand for the people around us.
Infertility, miscarriages, sexual difficulties, postpartum anxiety and depression can be very hard for you and your partner to deal with and cause a strain in your relationships. These experiences may bring feelings of shame, disappointment, anger, and grief that could be overwhelming and difficult to understand for the people around us.
(614) 702-7742 View (614) 702-7742
Gillian Sapp
LPC Intern, LSW
Verified Verified
Columbus, OH 43215
I believe that knowing the truth about ourselves, others, and the world can free us to live fully and be our healthiest selves. Through an open and trusting relationship with a therapist, people can feel safe to be real, be known, and be understood. From that place of understanding we can work together to help you align the truth with your life to reach your goals. I approach clients with intentionality and empathy and view us as a team, and I believe that together we can make progress towards any goal.
I believe that knowing the truth about ourselves, others, and the world can free us to live fully and be our healthiest selves. Through an open and trusting relationship with a therapist, people can feel safe to be real, be known, and be understood. From that place of understanding we can work together to help you align the truth with your life to reach your goals. I approach clients with intentionality and empathy and view us as a team, and I believe that together we can make progress towards any goal.
(614) 541-8220 View (614) 541-8220
Photo of Annie Kondrot, Clinical Social Work/Therapist in Columbus, OH
Annie Kondrot
Clinical Social Work/Therapist, MSW, LISW
Verified Verified
Columbus, OH 43215
I believe that positive relationships are the most powerful agent of healing. If you are struggling with depression, anxiety, body image, life transitions, or a history of trauma such as physical or sexual abuse or neglect, we will work together to strengthen your relationship with your therapist, the people around you, and ultimately yourself. I use a warm, person-centered approach to help you feel that I am your partner in reaching your goals.
I believe that positive relationships are the most powerful agent of healing. If you are struggling with depression, anxiety, body image, life transitions, or a history of trauma such as physical or sexual abuse or neglect, we will work together to strengthen your relationship with your therapist, the people around you, and ultimately yourself. I use a warm, person-centered approach to help you feel that I am your partner in reaching your goals.
(380) 600-9416 View (380) 600-9416
Photo of John K Lodge, Psychologist in Columbus, OH
John K Lodge
Psychologist, PsyD
Verified Verified
Columbus, OH 43221
I have worked in outpatient clinics, community mental health centers, and college counseling. I have experience working with adults, children, and adolescents in individual, family, and group-based therapy. I also have experience conducting comprehensive psychological assessments for a wide range of behavioral and psychological issues. My clinical interests include mood and anxiety disorders, trauma, adjustment and relationship difficulties, stress and anger management, behavioral pain management, employee-assistance programs (EAPs), psychological assessment, and working with individuals of diverse multicultural backgrounds.
I have worked in outpatient clinics, community mental health centers, and college counseling. I have experience working with adults, children, and adolescents in individual, family, and group-based therapy. I also have experience conducting comprehensive psychological assessments for a wide range of behavioral and psychological issues. My clinical interests include mood and anxiety disorders, trauma, adjustment and relationship difficulties, stress and anger management, behavioral pain management, employee-assistance programs (EAPs), psychological assessment, and working with individuals of diverse multicultural backgrounds.
(937) 528-1061 View (937) 528-1061
Photo of NOCD - Therapists for OCD, Counselor in Columbus, OH
NOCD - Therapists for OCD
Counselor, LPCC
Verified Verified
Columbus, OH 43220
Imagine what life would be like if you weren't bothered by OCD. NOCD is here to help you regain peace of mind. NOCD is a digital health company that’s focused on effectively treating people with Obsessive Compulsive Disorder. Inside the NOCD mobile app, you can work with one of our licensed mental health therapists with specialty training in OCD. When your therapist isn’t available, access support communities and therapeutic tools - so that you are never alone. NOCD’s protocol has been proven to reduce OCD severity by 40% in less than 10 weeks.
Imagine what life would be like if you weren't bothered by OCD. NOCD is here to help you regain peace of mind. NOCD is a digital health company that’s focused on effectively treating people with Obsessive Compulsive Disorder. Inside the NOCD mobile app, you can work with one of our licensed mental health therapists with specialty training in OCD. When your therapist isn’t available, access support communities and therapeutic tools - so that you are never alone. NOCD’s protocol has been proven to reduce OCD severity by 40% in less than 10 weeks.
(312) 766-6780 View (312) 766-6780
Photo of Megan Webster, Clinical Social Work/Therapist in Columbus, OH
Megan Webster
Clinical Social Work/Therapist, MSW, LISW-S
Verified Verified
Columbus, OH 43220  (Online Only)
I view counseling as a partnership between an individual or family and their therapist. When the theraputic relationship is strong I believe much can be accomplished. I work with individuals, adolescents and families as a partner in the process of wholeness. I believe that counseling can assist in the development of an understanding of yourself, your family and enhancing important relationships in your life.
I view counseling as a partnership between an individual or family and their therapist. When the theraputic relationship is strong I believe much can be accomplished. I work with individuals, adolescents and families as a partner in the process of wholeness. I believe that counseling can assist in the development of an understanding of yourself, your family and enhancing important relationships in your life.
(614) 996-6985 View (614) 996-6985
Photo of The Online Insomnia Center with Dr. Rosenblum, Psychologist in Columbus, OH
The Online Insomnia Center with Dr. Rosenblum
Psychologist, PsyD, DBSM
Verified Verified
Columbus, OH 43214  (Online Only)
Are you often battling fatigue, tossing and turning at night, or finding yourself waking up before your alarm? Perhaps you're a self-described night owl. Or maybe you're troubled by how your sleep—or lack thereof—is affecting your health, your mood, and your ability to navigate daily life. If any of this resonates with you, then it's time to explore a solution tailored specifically to your needs. Welcome, I'm Dr. Mark Rosenblum, a Sleep Psychologist with over 15 years of experience providing Cognitive Behavioral Therapy for Insomnia (CBT-I), the gold standard treatment for persistent insomnia, and the cornerstone of my practice.
Are you often battling fatigue, tossing and turning at night, or finding yourself waking up before your alarm? Perhaps you're a self-described night owl. Or maybe you're troubled by how your sleep—or lack thereof—is affecting your health, your mood, and your ability to navigate daily life. If any of this resonates with you, then it's time to explore a solution tailored specifically to your needs. Welcome, I'm Dr. Mark Rosenblum, a Sleep Psychologist with over 15 years of experience providing Cognitive Behavioral Therapy for Insomnia (CBT-I), the gold standard treatment for persistent insomnia, and the cornerstone of my practice.
(614) 963-2640 View (614) 963-2640
Photo of Kacie M Pedon, Counselor in Columbus, OH
Kacie M Pedon
Counselor, LPCCS
Verified Verified
Columbus, OH 43220  (Online Only)
My therapeutic approach is person centered, supportive, positive and challenging to the point of helping you develop self-compassion, self-love and overall confidence. We all struggle from time to time and deserve a non-judgmental support person. If you are wanting to improve any aspect of your life, or to cope with trauma, grief, depression, anxiety, I am here to assist you as you work toward your goals. If you do not want to utilize insurance to cover sessions cost, my self-pay rate is $120 per session for individuals. I am in compliance with the No Surprise Act and will provide you with a Good Faith Estimate.
My therapeutic approach is person centered, supportive, positive and challenging to the point of helping you develop self-compassion, self-love and overall confidence. We all struggle from time to time and deserve a non-judgmental support person. If you are wanting to improve any aspect of your life, or to cope with trauma, grief, depression, anxiety, I am here to assist you as you work toward your goals. If you do not want to utilize insurance to cover sessions cost, my self-pay rate is $120 per session for individuals. I am in compliance with the No Surprise Act and will provide you with a Good Faith Estimate.
(380) 207-1078 View (380) 207-1078
Photo of Mosaic Therapy and Wellness LLC, Licensed Professional Clinical Counselor in Columbus, OH
Mosaic Therapy and Wellness LLC
Licensed Professional Clinical Counselor, Ms Ed, LPCC-S, LICDCCS
Verified Verified
3 Endorsed
Columbus, OH 43206  (Online Only)
Are you an over thinker? Have you had panic attacks? Do you question your value or do you find yourself prioritizing others' needs because you struggle with setting boundaries? Are you conflict avoidant? If any of these scenarios resonate...I can help you learn better ways to respond and cope with stess and anxiety. You CAN overcome your challenges. Facing them is the first step to changing your patterns. You are your best resource and I am committed to helping you realize that.
Are you an over thinker? Have you had panic attacks? Do you question your value or do you find yourself prioritizing others' needs because you struggle with setting boundaries? Are you conflict avoidant? If any of these scenarios resonate...I can help you learn better ways to respond and cope with stess and anxiety. You CAN overcome your challenges. Facing them is the first step to changing your patterns. You are your best resource and I am committed to helping you realize that.
(614) 682-6133 View (614) 682-6133
Photo of Madison Piehl, Psychologist in Columbus, OH
Madison Piehl
Psychologist, PhD
Verified Verified
2 Endorsed
Columbus, OH 43220
I work with adults using Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) to treat a wide range of eating-related concerns, as well as anxiety, depression, and associated conditions. I also provide Cognitive Processing Therapy (CPT) for adults seeking trauma therapy, and I provide couples therapy using Integrative Behavioral Couple Therapy (IBCT).
I work with adults using Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) to treat a wide range of eating-related concerns, as well as anxiety, depression, and associated conditions. I also provide Cognitive Processing Therapy (CPT) for adults seeking trauma therapy, and I provide couples therapy using Integrative Behavioral Couple Therapy (IBCT).
(614) 532-2576 View (614) 532-2576
Photo of Jenean Stokes, Clinical Social Work/Therapist in Columbus, OH
Jenean Stokes
Clinical Social Work/Therapist, MSW, LSW
Verified Verified
1 Endorsed
Columbus, OH 43227  (Online Only)
Not accepting new clients
We all must start somewhere. Simply reviewing this site is a step within itself. Healing starts with just that, a simple yet intentional step towards a better version of you. My job isn't to "fix" you but rather to provide a space where you can process and examine thoughts, feelings, behaviors, and patterns that aren't in alignment with your ultimate goals. In practice, I use a person-centered, strength-based approach rooted in narrative therapy. You're the author of your story, no one else. I'll gently maneuver at your speed as we explore both pleasant and unpleasant parts of your journey.
We all must start somewhere. Simply reviewing this site is a step within itself. Healing starts with just that, a simple yet intentional step towards a better version of you. My job isn't to "fix" you but rather to provide a space where you can process and examine thoughts, feelings, behaviors, and patterns that aren't in alignment with your ultimate goals. In practice, I use a person-centered, strength-based approach rooted in narrative therapy. You're the author of your story, no one else. I'll gently maneuver at your speed as we explore both pleasant and unpleasant parts of your journey.
(614) 450-1216 View (614) 450-1216
Photo of Counseling 2 Hope LLC, Counselor in Columbus, OH
Counseling 2 Hope LLC
Counselor, LPCC, LMHC, LPC
Verified Verified
Columbus, OH 43215
Counseling 2 Hope LLC can help you step into healing from the past, set your life in a positive direction, and move toward a future of optimal well-being. Are you experiencing brokenness and hopelessness? Do you struggle with anxiety, depression, grief/loss, trauma, anger, relationships, mental health, emotional disturbance, spirituality, abandonment, substance use, or addiction? We can come along side you amid this pain and suffering.
Counseling 2 Hope LLC can help you step into healing from the past, set your life in a positive direction, and move toward a future of optimal well-being. Are you experiencing brokenness and hopelessness? Do you struggle with anxiety, depression, grief/loss, trauma, anger, relationships, mental health, emotional disturbance, spirituality, abandonment, substance use, or addiction? We can come along side you amid this pain and suffering.
(614) 954-7085 View (614) 954-7085
Photo of Alexandra Gilbert, Clinical Social Work/Therapist in Columbus, OH
Alexandra Gilbert
Clinical Social Work/Therapist, LISW-S, MSW
Verified Verified
1 Endorsed
Columbus, OH 43235
Therapy can be a comfortable place to unpack life’s “uncomfortable” moments. I believe therapy is collaborative and that a relaxed, honest and, at times humorous, communication style is important to creating an authentic environment. Personal growth best happens in a compassionate and supportive atmosphere. I am a licensed independent social worker who specializes in treating children, adults and families who seek a greater understanding of how their behaviors and emotions are connected to their life experiences. I can help you discover how your own natural strengths can be used to foster resilience and independence.
Therapy can be a comfortable place to unpack life’s “uncomfortable” moments. I believe therapy is collaborative and that a relaxed, honest and, at times humorous, communication style is important to creating an authentic environment. Personal growth best happens in a compassionate and supportive atmosphere. I am a licensed independent social worker who specializes in treating children, adults and families who seek a greater understanding of how their behaviors and emotions are connected to their life experiences. I can help you discover how your own natural strengths can be used to foster resilience and independence.
(740) 273-8307 View (740) 273-8307
Photo of Abigail Branco, Clinical Social Work/Therapist in Columbus, OH
Abigail Branco
Clinical Social Work/Therapist, MSW, LSW
Verified Verified
1 Endorsed
Columbus, OH 43235  (Online Only)
Welcome! If you are looking for an empathetic, warm environment that invites you to be your authentic self without shame and emphasizes your strengths, this is the place for you. If you are dealing with anxiety, depression, or life circumstances that are overwhelming you, you've come to the right therapist. I am currently working with adults only. I am here to meet you where you are, and I believe that therapy is a collaborative experience. I work closely with clients to establish treatment plans that meet their unique needs and I LOVE when we can incorporate your interests in sessions (drawing, music, yoga, etc.).
Welcome! If you are looking for an empathetic, warm environment that invites you to be your authentic self without shame and emphasizes your strengths, this is the place for you. If you are dealing with anxiety, depression, or life circumstances that are overwhelming you, you've come to the right therapist. I am currently working with adults only. I am here to meet you where you are, and I believe that therapy is a collaborative experience. I work closely with clients to establish treatment plans that meet their unique needs and I LOVE when we can incorporate your interests in sessions (drawing, music, yoga, etc.).
(740) 661-6146 View (740) 661-6146
Photo of Kegan D Beraduce, Clinical Social Work/Therapist in Columbus, OH
Kegan D Beraduce
Clinical Social Work/Therapist, MSW, LISW
Verified Verified
Columbus, OH 43214
Hello, I am a licensed social worker who has been practicing for 7 years. I have worked with many different client backgrounds from addiction to children and family issues. I take an eclectic approach in therapy with my clients. I'm specifically trained in cognitive behavioral therapy, solution focused, motivational interviewing and interpersonal therapy.
Hello, I am a licensed social worker who has been practicing for 7 years. I have worked with many different client backgrounds from addiction to children and family issues. I take an eclectic approach in therapy with my clients. I'm specifically trained in cognitive behavioral therapy, solution focused, motivational interviewing and interpersonal therapy.
(614) 432-8404 View (614) 432-8404
Photo of Destiny Segovia, Licensed Professional Counselor in Columbus, OH
Destiny Segovia
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Columbus, OH 43214
When was the last time you showed up for yourself with the same love and compassion you have for those around you? All too often shame and self-judgement feed anxiety and insecurities, getting in the way of feeling good about yourself. I can help you quiet the self-judgement, calm your anxieties, and learn to really value yourself. You can have your own back, set boundaries without guilt, and feel comfortable in your own skin.
When was the last time you showed up for yourself with the same love and compassion you have for those around you? All too often shame and self-judgement feed anxiety and insecurities, getting in the way of feeling good about yourself. I can help you quiet the self-judgement, calm your anxieties, and learn to really value yourself. You can have your own back, set boundaries without guilt, and feel comfortable in your own skin.
(380) 204-9655 View (380) 204-9655

How does your Therapist compare?

Number of Therapists in Columbus, OH

1,000+

Average cost per session

$125

Therapists in Columbus, OH who prioritize treating:

92% Anxiety
87% Depression
73% Trauma and PTSD
71% Self Esteem
68% Relationship Issues
65% Coping Skills
62% Stress

Average years in practice

10 Years

Top 3 insurances accepted

83% Aetna
76% UnitedHealthcare UHC | UBH
68% Cigna and Evernorth

How Therapists in Columbus, OH see their clients

61% In Person and Online
39% Online Only

Gender breakdown

80% Female
19% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Columbus?

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.