Therapists in Summit, NY

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Photo of Joseph David Irish, Clinical Social Work/Therapist in Summit, NY
Joseph David Irish
Clinical Social Work/Therapist, LCSW-R
Verified Verified
Cobleskill, NY 12043
I have found that all of my clients come to me when they have exhausted their own ideas. It is my joy to help bring out new ideas about how to address these life obstacles. Often a new perspective and some new skills can help to change unhealthy patterns. I like to help people grow and become more competent in managing their own lives.
I have found that all of my clients come to me when they have exhausted their own ideas. It is my joy to help bring out new ideas about how to address these life obstacles. Often a new perspective and some new skills can help to change unhealthy patterns. I like to help people grow and become more competent in managing their own lives.
(518) 255-7322 View (518) 255-7322
Photo of Anita Horvath in Summit, NY
Anita Horvath
MS, MA, MFT
Verified Verified
1 Endorsed
Cobleskill, NY 12043  (Online Only)
My focus is on marriage & family therapy and maternal/perinatal support. As we journey through marriage and parenthood, we often encounter difficult experiences that leave us feeling stuck in stress, regret and confusion. Birth trauma, postpartum depression, overwhelming identity shifts and relationship problems are a few examples. Sometimes we need extra support to get through these. Contemporary culture doesn’t prioritize mothers or value marriage, contributes to mental health issues among children, and leaves families isolated and unsupported. It makes sense to feel like you need extra support. It takes courage to ask for it.
My focus is on marriage & family therapy and maternal/perinatal support. As we journey through marriage and parenthood, we often encounter difficult experiences that leave us feeling stuck in stress, regret and confusion. Birth trauma, postpartum depression, overwhelming identity shifts and relationship problems are a few examples. Sometimes we need extra support to get through these. Contemporary culture doesn’t prioritize mothers or value marriage, contributes to mental health issues among children, and leaves families isolated and unsupported. It makes sense to feel like you need extra support. It takes courage to ask for it.
(518) 351-7688 View (518) 351-7688
Photo of Timothy C Donovan, Clinical Social Work/Therapist in Summit, NY
Timothy C Donovan
Clinical Social Work/Therapist, LCSW-R, ACSW, DCSW
Verified Verified
Cobleskill, NY 12043  (Online Only)
*Not currently accepting new referrals.*Struggling with anxiety, depression, the lingering effects of past traumatic experiences or relationship problems? Having difficulty with your children? With over 25 years experience I can help you resolve your problems and find success. Making the decision to seek professional help can be difficult. I am here to help you through these trying times. I will work collaboratively with you or your family to identify central issues, decrease symptoms and develop effective coping strategies to help you lead a more rewarding and happy life.
*Not currently accepting new referrals.*Struggling with anxiety, depression, the lingering effects of past traumatic experiences or relationship problems? Having difficulty with your children? With over 25 years experience I can help you resolve your problems and find success. Making the decision to seek professional help can be difficult. I am here to help you through these trying times. I will work collaboratively with you or your family to identify central issues, decrease symptoms and develop effective coping strategies to help you lead a more rewarding and happy life.
(607) 873-2770 View (607) 873-2770
Photo of Ksusha Cascio, Clinical Social Work/Therapist in Summit, NY
Ksusha Cascio
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Cobleskill, NY 12043  (Online Only)
I focus on helping navigate the wild twists and turns of life, whether it's healing the caverns of complex trauma, revisiting childhood shenanigans, or riding the ADHD rollercoaster of executive dysfunction. We will use a variety of tools on our journey, including ACT, DBT, Internal Family Systems (IFS), narrative therapy, and Imagery Rehearsal Therapy. Don't worry, though – I promise to keep the jargon to a minimum and sprinkle in a healthy dose of humor along the way.
I focus on helping navigate the wild twists and turns of life, whether it's healing the caverns of complex trauma, revisiting childhood shenanigans, or riding the ADHD rollercoaster of executive dysfunction. We will use a variety of tools on our journey, including ACT, DBT, Internal Family Systems (IFS), narrative therapy, and Imagery Rehearsal Therapy. Don't worry, though – I promise to keep the jargon to a minimum and sprinkle in a healthy dose of humor along the way.
(631) 518-3877 View (631) 518-3877
Photo of Theresa Marie Guardiano, Clinical Social Work/Therapist in Summit, NY
Theresa Marie Guardiano
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
East Worcester, NY 12064
Finding the right therapist is key! The most important part of my practice is building a positive rapport in order to do the work. In doing that I offer a comfortable, judge free environment to be able to work on challenging issues. I believe that the therapeutic relationship is the most important part of the healing process. Together we can work to resolve current and past challenges and work toward future goals of a better more enjoyable life.
Finding the right therapist is key! The most important part of my practice is building a positive rapport in order to do the work. In doing that I offer a comfortable, judge free environment to be able to work on challenging issues. I believe that the therapeutic relationship is the most important part of the healing process. Together we can work to resolve current and past challenges and work toward future goals of a better more enjoyable life.
(518) 636-1667 View (518) 636-1667

Online Therapists

Photo of Jo Anne Mitchum, Marriage & Family Therapist in Summit, NY
Jo Anne Mitchum
Marriage & Family Therapist, LMFT
Verified Verified
Latham, NY 12110
I bring a very balanced, real-life approach to assisting Couples with their therapeutic goals and support them on their journey toward achieving a deeper sense of understanding, awareness, empathy, and connectedness within their relationships. A diverse background includes published Author, featured Artist, licensed Marriage and Family Therapist, and Corporate Executive with more than thirty years’ experience in the financial sector. Past experience also includes working in the mental health field as a crisis counselor with a primary focus on alcohol and drug prevention.
I bring a very balanced, real-life approach to assisting Couples with their therapeutic goals and support them on their journey toward achieving a deeper sense of understanding, awareness, empathy, and connectedness within their relationships. A diverse background includes published Author, featured Artist, licensed Marriage and Family Therapist, and Corporate Executive with more than thirty years’ experience in the financial sector. Past experience also includes working in the mental health field as a crisis counselor with a primary focus on alcohol and drug prevention.
(518) 636-1333 View (518) 636-1333
Photo of Cindy Tesch, Counselor in Summit, NY
Cindy Tesch
Counselor, MS , LMHC, NCC
Verified Verified
3 Endorsed
Johnson City, NY 13790
My primary focus is on young adults (ages 18-24) and adults who seek counseling to break free from feeling stuck and want to gain deeper self-understanding. I aim to equip my clients with strategies to effectively handle their current struggles and to prepare them for future challenges. These may include transitional phases, managing anxiety and depression, processing trauma or adverse experiences, or any other issues that hinder them from leading a fulfilling life. My commitment to this profession stems from a desire to support individuals through these trying times.
My primary focus is on young adults (ages 18-24) and adults who seek counseling to break free from feeling stuck and want to gain deeper self-understanding. I aim to equip my clients with strategies to effectively handle their current struggles and to prepare them for future challenges. These may include transitional phases, managing anxiety and depression, processing trauma or adverse experiences, or any other issues that hinder them from leading a fulfilling life. My commitment to this profession stems from a desire to support individuals through these trying times.
(607) 246-2282 View (607) 246-2282
Photo of WellDone Therapeutic Services LLC, Counselor in Summit, NY
WellDone Therapeutic Services LLC
Counselor, LMHC
Verified Verified
Wappingers Falls, NY 12590  (Online Only)
My goal as your therapist is to ensure an authentic connection is made, where we can fully explore & address the barriers to your personal success- whatever that looks like to you! I partner with my clients & seek to customize my approach based upon the issues/concerns being presented. As a Person Centered Therapist specializing in Cognitive Behaviroal Therapy & Dialectical Behavioral Therapy (DBT)- Behavior Modification techniques, I have proven success working with clients of all ages dealing with a range of issues from Anxiety, Depression, Loss & Grief, Trauma, Interpersonal, Gender Identity, Life/Role Transitions & more.
My goal as your therapist is to ensure an authentic connection is made, where we can fully explore & address the barriers to your personal success- whatever that looks like to you! I partner with my clients & seek to customize my approach based upon the issues/concerns being presented. As a Person Centered Therapist specializing in Cognitive Behaviroal Therapy & Dialectical Behavioral Therapy (DBT)- Behavior Modification techniques, I have proven success working with clients of all ages dealing with a range of issues from Anxiety, Depression, Loss & Grief, Trauma, Interpersonal, Gender Identity, Life/Role Transitions & more.
(845) 209-2641 View (845) 209-2641
Photo of Patricia Cluett, Clinical Social Work/Therapist in Summit, NY
Patricia Cluett
Clinical Social Work/Therapist, LCSW-R
Verified Verified
Ithaca, NY 14850  (Online Only)
Welcome to my page! I am a licensed certified social worker with 30 plus years experience and I love my job. I enjoy helping clients find their strengths and guide them to their goals. Together we can find the tools to allow you to gain your full potential. I have a calm presence which allows me to connect with my clients.
Welcome to my page! I am a licensed certified social worker with 30 plus years experience and I love my job. I enjoy helping clients find their strengths and guide them to their goals. Together we can find the tools to allow you to gain your full potential. I have a calm presence which allows me to connect with my clients.
(607) 208-7732 View (607) 208-7732
Photo of Abby Edgington, Clinical Social Work/Therapist in Summit, NY
Abby Edgington
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Binghamton, NY 13901  (Online Only)
My therapeutic journey has led me to embrace the diversity of human experiences. From supporting displaced individuals in Grad school to working with a broad spectrum of clients at a high-risk mental health clinic, I've found fulfillment in every encounter. There's no 'ideal' client for me—each person's story is worth hearing, whether they're facing trauma, anxiety, or other challenges. My goal is simple: to offer empathy and support as they navigate their unique paths to healing and self-discovery.
My therapeutic journey has led me to embrace the diversity of human experiences. From supporting displaced individuals in Grad school to working with a broad spectrum of clients at a high-risk mental health clinic, I've found fulfillment in every encounter. There's no 'ideal' client for me—each person's story is worth hearing, whether they're facing trauma, anxiety, or other challenges. My goal is simple: to offer empathy and support as they navigate their unique paths to healing and self-discovery.
(607) 300-5322 View (607) 300-5322
Photo of Jennifer Mattler, Counselor in Summit, NY
Jennifer Mattler
Counselor, LMHC
Verified Verified
Hudson, NY 12534  (Online Only)
I have been providing individual therapy to children, adolescents and adults for many years. I focus on helping clients with anxiety, depression and those living through traumatic experiences. I believe we all deserve to not only survive, but thrive. Living the life we deserve may look different for everyone. For some this may mean alleviating symptoms of anxiety, depression or other mental health concerns. For others it may mean better understanding how negative thoughts patterns can hinder daily living.
I have been providing individual therapy to children, adolescents and adults for many years. I focus on helping clients with anxiety, depression and those living through traumatic experiences. I believe we all deserve to not only survive, but thrive. Living the life we deserve may look different for everyone. For some this may mean alleviating symptoms of anxiety, depression or other mental health concerns. For others it may mean better understanding how negative thoughts patterns can hinder daily living.
(518) 760-0693 View (518) 760-0693
Photo of Emilee Valler, Psychologist in Summit, NY
Emilee Valler
Psychologist, PhD
Verified Verified
Latham, NY 12110
Dr. Valler is a psychologist specializing in comprehensive evaluations tailored to each individual, which identifies their own strengths and support needs. At MindWell Psychological Assessment, Dr. Valler evaluates children, adolescents, and young adults for questions of ADHD, Autism, learning disabilities, and co-occurring mental health conditions. She utilizes a multi-factorial approach, which combines evidence-based testing methods with a client's lived experience, to determine appropriate diagnoses and treatment recommendations to support a client's educational and therapeutic journey.
Dr. Valler is a psychologist specializing in comprehensive evaluations tailored to each individual, which identifies their own strengths and support needs. At MindWell Psychological Assessment, Dr. Valler evaluates children, adolescents, and young adults for questions of ADHD, Autism, learning disabilities, and co-occurring mental health conditions. She utilizes a multi-factorial approach, which combines evidence-based testing methods with a client's lived experience, to determine appropriate diagnoses and treatment recommendations to support a client's educational and therapeutic journey.
(518) 510-3100 View (518) 510-3100
Photo of Martin Lyden, Ph.D., Psychologist in Summit, NY
Martin Lyden, Ph.D.
Psychologist, Martin, Lyden, PhD
Verified Verified
Rensselaer, NY 12144  (Online Only)
I have helped thousands of persons who suffered from a variety of difficulties such as depression, anxiety, stress, trauma, grief, attention deficit disorder, and health problems. I have assisted many couples in learning how to reduce destructive conflict and improve healthy communication and cooperation.
I have helped thousands of persons who suffered from a variety of difficulties such as depression, anxiety, stress, trauma, grief, attention deficit disorder, and health problems. I have assisted many couples in learning how to reduce destructive conflict and improve healthy communication and cooperation.
(518) 318-9857 View (518) 318-9857
Photo of Leading Edge Therapy & Coaching, Clinical Social Work/Therapist in Summit, NY
Leading Edge Therapy & Coaching
Clinical Social Work/Therapist, LCSW, JD
Verified Verified
1 Endorsed
Warwick, NY 10990
I integrate the most effective approaches to mental health, marital/family, and addiction challenges. I blend traditional with cutting edge and provide concrete tools, practical advice, and spiritual guidance while effecting lasting change and healing. For 27 years, I have helped countless people struggling with depression, anxiety, ADD, trauma, low self-esteem, anger and management, and with marital, sexuality, family, and parenting challenges. In testimonials I have been described as "having vast knowledge"; "a very down to earth guy who puts you at ease almost instantly; as having "laser-sharp" perceptions; & "an old soul ."
I integrate the most effective approaches to mental health, marital/family, and addiction challenges. I blend traditional with cutting edge and provide concrete tools, practical advice, and spiritual guidance while effecting lasting change and healing. For 27 years, I have helped countless people struggling with depression, anxiety, ADD, trauma, low self-esteem, anger and management, and with marital, sexuality, family, and parenting challenges. In testimonials I have been described as "having vast knowledge"; "a very down to earth guy who puts you at ease almost instantly; as having "laser-sharp" perceptions; & "an old soul ."
(845) 262-2179 View (845) 262-2179
Photo of Mariah Hoffman, Counselor in Summit, NY
Mariah Hoffman
Counselor, LMHC
Verified Verified
Goshen, NY 10924
We are born innately curious, equipped with tools and perseverance to succeed in life. We are so strong and capable, full of great intuition and instincts. As babies and young children, we know our own truth and speak it confidently. As we grow, in order to fit in with life and society around us, we compromise our needs and ideals. We want to please others and feel acceptance. As a result, we may sacrifice our own beliefs. Trauma and oppression become obstacles in our path to healthy relationships, with our self and others. We feel individual, collective, and societal pain.
We are born innately curious, equipped with tools and perseverance to succeed in life. We are so strong and capable, full of great intuition and instincts. As babies and young children, we know our own truth and speak it confidently. As we grow, in order to fit in with life and society around us, we compromise our needs and ideals. We want to please others and feel acceptance. As a result, we may sacrifice our own beliefs. Trauma and oppression become obstacles in our path to healthy relationships, with our self and others. We feel individual, collective, and societal pain.
(845) 286-4830 View (845) 286-4830
Photo of Dr. Gila Z Reckess, Psychologist in Summit, NY
Dr. Gila Z Reckess
Psychologist, PhD
Verified Verified
1 Endorsed
Poughkeepsie, NY 12603  (Online Only)
Parents of kids under 10: Are you struggling to show up for your kids the way you want because you’re feeling overwhelmed or weighed down with worry, sadness, or maybe even feeling nothing at all? And no matter how badly you want to “do better,” you find yourself snapping, yelling, making threats, and cringing as your own parents’ words come out of your mouth, leaving you wondering if you’re broken and unfixable and failing at the job that matters most to you. Or has your child's medical or psychological diagnosis left you feeling scared and confused and alone?
Parents of kids under 10: Are you struggling to show up for your kids the way you want because you’re feeling overwhelmed or weighed down with worry, sadness, or maybe even feeling nothing at all? And no matter how badly you want to “do better,” you find yourself snapping, yelling, making threats, and cringing as your own parents’ words come out of your mouth, leaving you wondering if you’re broken and unfixable and failing at the job that matters most to you. Or has your child's medical or psychological diagnosis left you feeling scared and confused and alone?
(845) 720-4273 View (845) 720-4273
Photo of Meredith Madden in Summit, NY
Meredith Madden
LMHC
Verified Verified
Poughkeepsie, NY 12603
Waitlist for new clients
Existing as a human being these days can be rough. "Existing" translates into "not living fully." This is no fun for anybody. Many individuals suffer from uncomfortable symptoms leading to feelings of sadness, irritability, or fatigue. Others experience trouble concentrating, racing or negative thoughts, and even difficulty breathing. You are not alone in this complicated world; it's easy to get off course and/or it can be difficult to find your way due to various roadblocks. It may help to work with a person outside your friend & family groups in an effort to gain a fresh perspective, to be seen with unbiased, non-judgmental eyes.
Existing as a human being these days can be rough. "Existing" translates into "not living fully." This is no fun for anybody. Many individuals suffer from uncomfortable symptoms leading to feelings of sadness, irritability, or fatigue. Others experience trouble concentrating, racing or negative thoughts, and even difficulty breathing. You are not alone in this complicated world; it's easy to get off course and/or it can be difficult to find your way due to various roadblocks. It may help to work with a person outside your friend & family groups in an effort to gain a fresh perspective, to be seen with unbiased, non-judgmental eyes.
(845) 681-6590 View (845) 681-6590
Photo of Katie Hunter, Clinical Social Work/Therapist in Summit, NY
Katie Hunter
Clinical Social Work/Therapist, LCSW
Verified Verified
Cornwall on Hudson, NY 12520  (Online Only)
Hello and Welcome. I'm so glad you are here. We live in a world with a multitude of pressures and stressors. Many of us often feel stuck and overwhelmed by those pressures. You are not alone, and there is help. We all have parts of ourselves that we want to work on, whether that is an anxious part, a self-critical part, a part that can say mean things, or is highly reactive. All of your parts are welcome here in therapy. I understand and appreciate the interconnection of mind, body, and spirit and the importance of helping you nurture all aspects of you.
Hello and Welcome. I'm so glad you are here. We live in a world with a multitude of pressures and stressors. Many of us often feel stuck and overwhelmed by those pressures. You are not alone, and there is help. We all have parts of ourselves that we want to work on, whether that is an anxious part, a self-critical part, a part that can say mean things, or is highly reactive. All of your parts are welcome here in therapy. I understand and appreciate the interconnection of mind, body, and spirit and the importance of helping you nurture all aspects of you.
(845) 671-3506 View (845) 671-3506
Photo of Anna Poiarkoff, Clinical Social Work/Therapist in Summit, NY
Anna Poiarkoff
Clinical Social Work/Therapist, LCSW
Verified Verified
Hudson, NY 12534
Waitlist for new clients
Hi there! If you are reading this, you are already taking important steps towards something different, perhaps better. It takes guts to seek therapy - so congratulations on getting this far! I am a licensed clinical social worker with 10+ years of experience having spent most of my early career working with families impacted by the child welfare system in New York City. I am fluent in American Sign Language and have worked closely in/with the Deaf community.
Hi there! If you are reading this, you are already taking important steps towards something different, perhaps better. It takes guts to seek therapy - so congratulations on getting this far! I am a licensed clinical social worker with 10+ years of experience having spent most of my early career working with families impacted by the child welfare system in New York City. I am fluent in American Sign Language and have worked closely in/with the Deaf community.
(518) 336-0232 View (518) 336-0232
Photo of Christine Li, Psychologist in Summit, NY
Christine Li
Psychologist, PhD
Verified Verified
1 Endorsed
Yorktown Heights, NY 10598  (Online Only)
I enjoy working with people who feel stuck in their lives. Over time, I have developed a broad range of techniques to help clients identify their problems and to support the changes they wish to make. My clients are diverse in their backgrounds, but the primary areas of focus for many of them are Procrastination, Anxiety, and ADD/ADHD. I also am interested in working with Adult Children of Alcoholics and individuals who are having difficulties in their relationships. I feel privileged to be able to assist people in making their lives more fulfilling and gratifying.
I enjoy working with people who feel stuck in their lives. Over time, I have developed a broad range of techniques to help clients identify their problems and to support the changes they wish to make. My clients are diverse in their backgrounds, but the primary areas of focus for many of them are Procrastination, Anxiety, and ADD/ADHD. I also am interested in working with Adult Children of Alcoholics and individuals who are having difficulties in their relationships. I feel privileged to be able to assist people in making their lives more fulfilling and gratifying.
(914) 259-8831 View (914) 259-8831

How does your Therapist compare?

Number of Therapists in Summit, NY

< 10

Therapists in Summit, NY who prioritize treating:

How Therapists in Summit, NY see their clients

2% Online Only
1% In Person and Online
FAQs - About Therapy and Counseling

How can I find a therapist in Summit?

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.