Therapists in Downtown, Cleveland, OH

Photo of Tomeika Simone Oliver, MSW, LISW-S, LICDC, Clinical Social Work/Therapist
Tomeika Simone Oliver
Clinical Social Work/Therapist, MSW, LISW-S, LICDC
Verified Verified
Downtown, Cleveland, OH 44114  (Online Only)
At ALC, we have a passion for helping people obtain skills aimed in improving overall quality of life. Using a trauma-informed perspective and client-centered approach through individual and group counseling, we aim to provide positive coping strategies to overcome mental and behavioral health challenges.
At ALC, we have a passion for helping people obtain skills aimed in improving overall quality of life. Using a trauma-informed perspective and client-centered approach through individual and group counseling, we aim to provide positive coping strategies to overcome mental and behavioral health challenges.
(216) 677-1485 View (216) 677-1485
Photo of Kellie Cousino, LISW-S, Clinical Social Work/Therapist
Kellie Cousino
Clinical Social Work/Therapist, LISW-S
Verified Verified
Downtown, Cleveland, OH 44114
Are you tired of being judged for not doing things the “normal” way? Has the world attempted to dim your light? Have you listened to lies of others and yourself that has led you down a path of shame and guilt? If you are looking for a space that is fun, nonjudgmental, the ability to be yourself then come see me as I take pride in being apart of others’ journey. I wont lie and say that change is easy, change is messy, but I am willing to be messy with you.
Are you tired of being judged for not doing things the “normal” way? Has the world attempted to dim your light? Have you listened to lies of others and yourself that has led you down a path of shame and guilt? If you are looking for a space that is fun, nonjudgmental, the ability to be yourself then come see me as I take pride in being apart of others’ journey. I wont lie and say that change is easy, change is messy, but I am willing to be messy with you.
(216) 412-9534 View (216) 412-9534
Photo of Heather Mitchell, LISW, Clinical Social Work/Therapist
Heather Mitchell
Clinical Social Work/Therapist, LISW
Verified Verified
Downtown, Cleveland, OH 44114  (Online Only)
It's a privilege to work with clients who have experienced trauma and are ready to take the next step toward healing. Over the course of my career, I have worked with survivors of domestic and sexual violence, human trafficking, stalking, immigrants, refugees, and aslyees, as well as folks with anxiety and depression. I have worked with many single mothers, people in recovery, people facing difficult choices, and folks who just need an empathetic ear. I would love to support you through the process of healing from trauma and creating the life you want.
It's a privilege to work with clients who have experienced trauma and are ready to take the next step toward healing. Over the course of my career, I have worked with survivors of domestic and sexual violence, human trafficking, stalking, immigrants, refugees, and aslyees, as well as folks with anxiety and depression. I have worked with many single mothers, people in recovery, people facing difficult choices, and folks who just need an empathetic ear. I would love to support you through the process of healing from trauma and creating the life you want.
(216) 284-4499 View (216) 284-4499
Photo of Chris Humpage, PsyD, Psychologist
Chris Humpage
Psychologist, PsyD
Verified Verified
Downtown, Cleveland, OH 44114  (Online Only)
Are you managing the demands of school, work, and family as you grapple with mental health concerns like depression, anxiety, and trauma? It can be overwhelming, because modern life does not slow down for us to repair our mental health and get back to optimal functioning. We often get stuck, just "getting by", suffering in silence. I keep a focus on helping clients quickly and effectively, while at the same time tailoring interventions to each client's unique lived experience.
Are you managing the demands of school, work, and family as you grapple with mental health concerns like depression, anxiety, and trauma? It can be overwhelming, because modern life does not slow down for us to repair our mental health and get back to optimal functioning. We often get stuck, just "getting by", suffering in silence. I keep a focus on helping clients quickly and effectively, while at the same time tailoring interventions to each client's unique lived experience.
(216) 867-6288 View (216) 867-6288
Photo of Jessica Michelle Martinez - Jessica Michelle Martinez Therapy, LLC, MA, LCSW, Clinical Social Work/Therapist
Jessica Michelle Martinez Therapy, LLC
Clinical Social Work/Therapist, MA, LCSW
Verified Verified
1 Endorsed
Downtown, Cleveland, OH 44113
Are your thoughts and emotions becoming overwhelming? Is your nervous system on overdrive? Then talk therapy might be a good place to start. My goal is to help you understand how your past experiences help shape how you process every day life scenarios. Here, you’ll also start to untangle yourself from any unhealthy thought patterns as well as experience your thoughts and emotions while staying grounded in the present moment. My practice is based in helping people come back to themselves, mind, body & spirit. I’ve also added a Reiki Practitioner to my practice, whose grounding body work is available to you based upon your need.
Are your thoughts and emotions becoming overwhelming? Is your nervous system on overdrive? Then talk therapy might be a good place to start. My goal is to help you understand how your past experiences help shape how you process every day life scenarios. Here, you’ll also start to untangle yourself from any unhealthy thought patterns as well as experience your thoughts and emotions while staying grounded in the present moment. My practice is based in helping people come back to themselves, mind, body & spirit. I’ve also added a Reiki Practitioner to my practice, whose grounding body work is available to you based upon your need.
(216) 910-5193 View (216) 910-5193
Photo of Keyoni Rates White, MS, LPCC-S
Keyoni Rates White
Licensed Professional Clinical Counselor, MS, LPCC-S
Verified Verified
Downtown, Cleveland, OH 44113  (Online Only)
A native of Cleveland, OH, Keyoni is a Licensed Professional Clinical Counselor (LPCC) with over 14 years of experience in the mental health field. Keyoni has worked with children, teenagers, and adults with a broad range of concerns including grief and loss, anxiety, depression, trauma, self-esteem issues, relationship issues, family distresses, attention and focus difficulties, and crisis intervention. Keyoni walks with her clients to help them learn and practice skills that will empower them to see the world through a healthier and more holistic lens, as well as become their best selves.
A native of Cleveland, OH, Keyoni is a Licensed Professional Clinical Counselor (LPCC) with over 14 years of experience in the mental health field. Keyoni has worked with children, teenagers, and adults with a broad range of concerns including grief and loss, anxiety, depression, trauma, self-esteem issues, relationship issues, family distresses, attention and focus difficulties, and crisis intervention. Keyoni walks with her clients to help them learn and practice skills that will empower them to see the world through a healthier and more holistic lens, as well as become their best selves.
(216) 616-4234 View (216) 616-4234
Photo of Robin Larson, LPCC, Counselor
Robin Larson
Counselor, LPCC
Verified Verified
Downtown, Cleveland, OH 44114  (Online Only)
After 15 years as a licensed counselor, I like to describe myself as a compassionate, empathic, skilled listener. I know that making the decision to talk to someone and ask for help can be scary but I can assure you, I will take the time to really listen to what you have to say and help you craft the life you want. My experience in counseling has given me a wide range of skills that I bring to every session.
After 15 years as a licensed counselor, I like to describe myself as a compassionate, empathic, skilled listener. I know that making the decision to talk to someone and ask for help can be scary but I can assure you, I will take the time to really listen to what you have to say and help you craft the life you want. My experience in counseling has given me a wide range of skills that I bring to every session.
(216) 714-8667 View (216) 714-8667
Photo of Kimberly Brzezowski, PsyD, Psychologist
Kimberly Brzezowski
Psychologist, PsyD
Verified Verified
Downtown, Cleveland, OH 44114  (Online Only)
Hi! I'm a Licensed Clinical Psychologist based in Ohio. I earned my doctorate (Psy.D.) from Wright State University's School of Professional Psychology. I have been practicing for 10+ years primarily working with adolescents and adults.
Hi! I'm a Licensed Clinical Psychologist based in Ohio. I earned my doctorate (Psy.D.) from Wright State University's School of Professional Psychology. I have been practicing for 10+ years primarily working with adolescents and adults.
(216) 714-1162 View (216) 714-1162
Photo of Dr. Jeff J. Rocker, PhD, NCC, LPCC, LMHC, LPC
Dr. Jeff J. Rocker
Licensed Professional Clinical Counselor, PhD, NCC, LPCC, LMHC, LPC
Verified Verified
Downtown, Cleveland, OH 44114
With 12 years of experience working with clients going through individual, relationship, and family issues, Celebrity Therapist Dr. Jeff Rocker has provided therapeutic services to clients nationwide. He is Licensed in 14 states and has served clients from all age groups. Over the years, Dr. Jeff has organized lectures and various events in the community, including excursions and retreats for couples to improve their communication and better understand each other. He has experience working with athletes in the NFL, NBA, and MLB. In addition, Dr. Jeff has also worked with clients in the Movie, Music, and Entertainment Industries.
With 12 years of experience working with clients going through individual, relationship, and family issues, Celebrity Therapist Dr. Jeff Rocker has provided therapeutic services to clients nationwide. He is Licensed in 14 states and has served clients from all age groups. Over the years, Dr. Jeff has organized lectures and various events in the community, including excursions and retreats for couples to improve their communication and better understand each other. He has experience working with athletes in the NFL, NBA, and MLB. In addition, Dr. Jeff has also worked with clients in the Movie, Music, and Entertainment Industries.
(216) 714-1088 View (216) 714-1088
Photo of Christina M Minoguchi, MSW, LISW-S, CCTP, LCSW-S, Clinical Social Work/Therapist
Christina M Minoguchi
Clinical Social Work/Therapist, MSW, LISW-S, CCTP, LCSW-S
Verified Verified
2 Endorsed
Downtown, Cleveland, OH 44114  (Online Only)
Hello! I understand you may be facing numerous challenges in your life that have led you here. Whether something occurred in your past or more recently, it has likely triggered flashbacks, anxiety, depression, stress, relational difficulties, work-related issues, or an overall sense of being overwhelmed. You might have sought therapy previously without finding lasting relief, finding yourself inundated once again with memories and negative thoughts. I teach each client in their 1st session how to control their symptoms through amazing neuroscience techniques. If traditional talk therapy didn't help, I can!
Hello! I understand you may be facing numerous challenges in your life that have led you here. Whether something occurred in your past or more recently, it has likely triggered flashbacks, anxiety, depression, stress, relational difficulties, work-related issues, or an overall sense of being overwhelmed. You might have sought therapy previously without finding lasting relief, finding yourself inundated once again with memories and negative thoughts. I teach each client in their 1st session how to control their symptoms through amazing neuroscience techniques. If traditional talk therapy didn't help, I can!
(614) 328-5079 View (614) 328-5079
Photo of Linda Stout, LISW, Clinical Social Work/Therapist
Linda Stout
Clinical Social Work/Therapist, LISW
Verified Verified
Downtown, Cleveland, OH 44114  (Online Only)
We all experience life differently and sometimes trying to figure out how to handle those experiences can be overwhelming. I am here for you, so you don't have to do it alone. My goal is to provide you with a warm, safe, and inviting environment where I can help you with processing any thoughts and feelings you may have about life challenges. I am a LISW-S and have over 16 years experience working with adults, children, teens, families, and groups.
We all experience life differently and sometimes trying to figure out how to handle those experiences can be overwhelming. I am here for you, so you don't have to do it alone. My goal is to provide you with a warm, safe, and inviting environment where I can help you with processing any thoughts and feelings you may have about life challenges. I am a LISW-S and have over 16 years experience working with adults, children, teens, families, and groups.
(216) 859-0224 View (216) 859-0224
Photo of Isabel Stovsky, MSSA, LISW, Clinical Social Work/Therapist
Isabel Stovsky
Clinical Social Work/Therapist, MSSA, LISW
Verified Verified
2 Endorsed
Downtown, Cleveland, OH 44114  (Online Only)
Isabel is a dedicated mental health therapist who firmly believes in the powerful connection between the mind, body, and soul. With specialized training in Eye Movement Desensitization and Reprocessing (EMDR), she has honed her skills in helping clients process traumas and overcome emotional barriers. Isabel's passion lies in working with women who are grappling with anxiety and depression, as well as those navigating significant life transitions, complex family dynamics, and the journey of self-discovery.
Isabel is a dedicated mental health therapist who firmly believes in the powerful connection between the mind, body, and soul. With specialized training in Eye Movement Desensitization and Reprocessing (EMDR), she has honed her skills in helping clients process traumas and overcome emotional barriers. Isabel's passion lies in working with women who are grappling with anxiety and depression, as well as those navigating significant life transitions, complex family dynamics, and the journey of self-discovery.
(216) 477-9142 View (216) 477-9142
Photo of Nellie Enbinge Falk Ayamga, MSSA, LISW-S, Clinical Social Work/Therapist
Nellie Enbinge Falk Ayamga
Clinical Social Work/Therapist, MSSA, LISW-S
Verified Verified
Downtown, Cleveland, OH 44114  (Online Only)
My ideal client is struggling with identity issues, self-esteem issues anxiety depression, relationship issues, grief and loss trauma and is tired of feeling this way and ready to feel better and enjoy life again. Also, clients dealing with addiction. I am a masters level and independently licensed clinician who has been helping people feel better using evidence informed practices. I have been in practice with about 14 years experience. Give me the opportunity to help you.
My ideal client is struggling with identity issues, self-esteem issues anxiety depression, relationship issues, grief and loss trauma and is tired of feeling this way and ready to feel better and enjoy life again. Also, clients dealing with addiction. I am a masters level and independently licensed clinician who has been helping people feel better using evidence informed practices. I have been in practice with about 14 years experience. Give me the opportunity to help you.
(216) 369-1517 View (216) 369-1517
Photo of Vanessa Wortmann, LISW, Clinical Social Work/Therapist
Vanessa Wortmann
Clinical Social Work/Therapist, LISW
Verified Verified
Downtown, Cleveland, OH 44115  (Online Only)
I am a firm believer in the power of storytelling as a therapeutic tool, therefore I utilize narrative therapy techniques into my work. By listening attentively and fostering a non-judgmental environment, I encourage clients to share their unique stories and explore new perspectives in order to re-author their life and externalize their identified problems rather than internalize. I am passionate about working with individuals from diverse backgrounds and I enjoy working with those who deal with concerns of anxiety, depression, childhood trauma, and anger management.
I am a firm believer in the power of storytelling as a therapeutic tool, therefore I utilize narrative therapy techniques into my work. By listening attentively and fostering a non-judgmental environment, I encourage clients to share their unique stories and explore new perspectives in order to re-author their life and externalize their identified problems rather than internalize. I am passionate about working with individuals from diverse backgrounds and I enjoy working with those who deal with concerns of anxiety, depression, childhood trauma, and anger management.
(216) 304-3956 View (216) 304-3956
Photo of Thomas Masters, LPCC
Thomas Masters
Licensed Professional Clinical Counselor, LPCC
Verified Verified
Downtown, Cleveland, OH 44114  (Online Only)
If you are struggling with the everyday stressors, anxiety, and/or moods then I am able to help you explore these difficulties and better help you to manage life. I am equipped to assist you to access better tools to thrive from day to day. I have over twenty-two years of licensed counseling experience.
If you are struggling with the everyday stressors, anxiety, and/or moods then I am able to help you explore these difficulties and better help you to manage life. I am equipped to assist you to access better tools to thrive from day to day. I have over twenty-two years of licensed counseling experience.
(216) 777-1738 View (216) 777-1738
Photo of Dr. Psyche (Huanzhen) Xu Clinical Psychologist, PhD, Psychologist
Dr. Psyche (Huanzhen) Xu Clinical Psychologist
Psychologist, PhD
Verified Verified
Downtown, Cleveland, OH 44114
Waitlist for new clients
Thank you for reviewing my page, and a round of applause to you for showing up for your psychological wellbeing today. I am Dr. Psyche and I came from a multicultural background. My personal life experience and my precious encounters with a diverse clientele have taught me one of the most important elements of any effective interpersonal interactions - flexibility. I strive to offer a flexible space for the exploration of "self", a voice that may have been drowned out over time by the constant distractions surrounding us and changes that we endured, yet a voice so important that guide your actions and create the life you are living.
Thank you for reviewing my page, and a round of applause to you for showing up for your psychological wellbeing today. I am Dr. Psyche and I came from a multicultural background. My personal life experience and my precious encounters with a diverse clientele have taught me one of the most important elements of any effective interpersonal interactions - flexibility. I strive to offer a flexible space for the exploration of "self", a voice that may have been drowned out over time by the constant distractions surrounding us and changes that we endured, yet a voice so important that guide your actions and create the life you are living.
(216) 677-4060 View (216) 677-4060
Photo of Bruce Arnold - Dr Bruce Arnold, LLC, LISW, Clinical Social Work/Therapist
Dr Bruce Arnold, LLC
Clinical Social Work/Therapist, LISW
Verified Verified
1 Endorsed
Downtown, Cleveland, OH 44114  (Online Only)
I'm a social worker with over 45 years of experience with children, adolescents, families, couples and adults. I find that people get the best results when we look at their lives as a whole -physical, emotional, intellectual, spiritual (your most deeply held beliefs and values), and socially, as a member off your community. I have training and experience in a variety of treatments which are evidence-based.
I'm a social worker with over 45 years of experience with children, adolescents, families, couples and adults. I find that people get the best results when we look at their lives as a whole -physical, emotional, intellectual, spiritual (your most deeply held beliefs and values), and socially, as a member off your community. I have training and experience in a variety of treatments which are evidence-based.
(216) 859-0604 View (216) 859-0604
Photo of Tiara Kendrick, LPCC, Counselor
Tiara Kendrick
Counselor, LPCC
Verified Verified
Downtown, Cleveland, OH 44114  (Online Only)
Whether you or your teen needs help with managing depression, reducing anxiety, improving decision making, developing effective communication skills, stress management, strengthening your social life, or successfully creating lifestyle changes (from divorce/relationship strains, school changes, to parenting struggles or health issues), my personal mission is to provide hope, help, and healing to those in need. A lot of what I do is help people learn to see situations in a new way and be prepared to handle these challenges. I enjoy working with older children, middle school students, teenagers, young adults, and college-aged.
Whether you or your teen needs help with managing depression, reducing anxiety, improving decision making, developing effective communication skills, stress management, strengthening your social life, or successfully creating lifestyle changes (from divorce/relationship strains, school changes, to parenting struggles or health issues), my personal mission is to provide hope, help, and healing to those in need. A lot of what I do is help people learn to see situations in a new way and be prepared to handle these challenges. I enjoy working with older children, middle school students, teenagers, young adults, and college-aged.
(216) 677-4837 View (216) 677-4837
Photo of Jazmine Danner - Head & Heart Therapeutic Solutions, LISW-S, Clinical Social Work/Therapist
Head & Heart Therapeutic Solutions
Clinical Social Work/Therapist, LISW-S
Verified Verified
Downtown, Cleveland, OH 44113  (Online Only)
Not accepting new clients
You are resilient, but you deserve rest too. At Head & Heart we support you in achieving that rest whether it be mentally, emotionally, spiritually, or in your relationships. We believe ANYBODY can benefit from therapy no matter your identity. Our clinicians have experience working in a multitude of settings including schools, community agencies, and private practice. Head & Heart clinicians work with a variety of populations including children, teenagers, adults, families, couples, and groups.
You are resilient, but you deserve rest too. At Head & Heart we support you in achieving that rest whether it be mentally, emotionally, spiritually, or in your relationships. We believe ANYBODY can benefit from therapy no matter your identity. Our clinicians have experience working in a multitude of settings including schools, community agencies, and private practice. Head & Heart clinicians work with a variety of populations including children, teenagers, adults, families, couples, and groups.
(216) 238-3356 View (216) 238-3356
Photo of Laura Palisin, MEd, LPCC, Counselor
Laura Palisin
Counselor, MEd, LPCC
Verified Verified
Downtown, Cleveland, OH 44114  (Online Only)
Do you suffer from depression, anxiety, or low self-esteem? Have you experienced trauma in your life and struggle to move on, or to let go of the past? Do your emotions often override your thoughts making it difficult to think logically? Life can be overwhelming and painful at times, but it is possible to live a happy life even if you have endured pain in the past. I can help you to think more logically and to feel more in control of your emotions. I welcome you to make the first step in finding change and to building a happier and more fulfilling life. I look forward to meeting you!
Do you suffer from depression, anxiety, or low self-esteem? Have you experienced trauma in your life and struggle to move on, or to let go of the past? Do your emotions often override your thoughts making it difficult to think logically? Life can be overwhelming and painful at times, but it is possible to live a happy life even if you have endured pain in the past. I can help you to think more logically and to feel more in control of your emotions. I welcome you to make the first step in finding change and to building a happier and more fulfilling life. I look forward to meeting you!
(440) 791-2483 View (440) 791-2483
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How does your Therapist compare?

Number of Therapists in Downtown, Cleveland, OH

100+

Average cost per session

$120

Therapists in Downtown, Cleveland, OH who prioritize treating:

89% Anxiety
88% Depression
74% Self Esteem
73% Trauma and PTSD
71% Coping Skills
64% Relationship Issues
64% Stress

Average years in practice

10 Years

Top 3 insurances accepted

88% Aetna
82% Cigna and Evernorth
79% UnitedHealthcare UHC | UBH

How Therapists in Downtown, Cleveland, OH see their clients

63% Online Only
37% In Person and Online

Gender breakdown

81% Female
15% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Downtown, Cleveland?

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.