Therapists in Portland, OR

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Photo of Catherine Palmer, Licensed Professional Counselor in Portland, OR
Catherine Palmer
Licensed Professional Counselor, MS, LPC, NCC
Verified Verified
2 Endorsed
Portland, OR 97209  (Online Only)
I can help you rewire your brain and improve your life. Is your life, or your relationship, not quite where you want it to be? Are you feeling stuck or misunderstood? Are you struggling with anxiety, codependency, depression, PTSD, or grief? Do you feel as if your past trauma is negatively impacting your current life? If so, I can help. As an expert in individual and couple counseling, I’m deeply passionate about helping people improve their relationships, enhance their emotional well-being, break free of anxiety and depression, discover their strengths, and re-empower their lives.
I can help you rewire your brain and improve your life. Is your life, or your relationship, not quite where you want it to be? Are you feeling stuck or misunderstood? Are you struggling with anxiety, codependency, depression, PTSD, or grief? Do you feel as if your past trauma is negatively impacting your current life? If so, I can help. As an expert in individual and couple counseling, I’m deeply passionate about helping people improve their relationships, enhance their emotional well-being, break free of anxiety and depression, discover their strengths, and re-empower their lives.
(971) 290-1657 View (971) 290-1657
Photo of Marlèn S. Conrad, Clinical Social Work/Therapist in Portland, OR
Marlèn S. Conrad
Clinical Social Work/Therapist, MSW, LCSW, WSC
Verified Verified
Portland, OR 97211
In an atmosphere of insight and compassion, pathways leading to wellness, new beginnings and joy are possible. Working together, grounded in my in-depth knowledge of and experience in Jungian and contemporary psychotherapies, we illuminate outworn attitudes and patterns. By working with the art and science of psychotherapy, I foster your natural capacities for accessing your “inner compass”, your guide to spiritual gravity and conscious aging. As you tell your story, life events and choices you have made take on new meaning. A doorway opens to pervasive change that goes far beyond symptoms and previous goals.
In an atmosphere of insight and compassion, pathways leading to wellness, new beginnings and joy are possible. Working together, grounded in my in-depth knowledge of and experience in Jungian and contemporary psychotherapies, we illuminate outworn attitudes and patterns. By working with the art and science of psychotherapy, I foster your natural capacities for accessing your “inner compass”, your guide to spiritual gravity and conscious aging. As you tell your story, life events and choices you have made take on new meaning. A doorway opens to pervasive change that goes far beyond symptoms and previous goals.
(503) 404-3410 View (503) 404-3410
Photo of Julie Collura, Clinical Social Work/Therapist in Portland, OR
Julie Collura
Clinical Social Work/Therapist, MM, MSW, LCSW, REAT
Verified Verified
Portland, OR 97203
I provide therapy to adults experiencing a wide range of strengths and challenges. I integrate expressive arts with Internal Family Systems (IFS) to help you process feelings and experiences, reduce inner conflict, and improve relationships. I use a multi-arts, or intermodal, approach, which means I use visual art, music, movement, writing, and mindfulness as therapeutic tools to initiate healing and change. Since this work is based on the creative process and not the resulting product, no background or training in the arts is required to benefit.
I provide therapy to adults experiencing a wide range of strengths and challenges. I integrate expressive arts with Internal Family Systems (IFS) to help you process feelings and experiences, reduce inner conflict, and improve relationships. I use a multi-arts, or intermodal, approach, which means I use visual art, music, movement, writing, and mindfulness as therapeutic tools to initiate healing and change. Since this work is based on the creative process and not the resulting product, no background or training in the arts is required to benefit.
(971) 293-2837 View (971) 293-2837
Photo of Carrie Love, Marriage & Family Therapist in Portland, OR
Carrie Love
Marriage & Family Therapist, MA, LMFT
Verified Verified
Portland, OR 97227
Waitlist for new clients
If you have wondered why your infant or child: does not bond or connect with you, has behavior problems, does not respect you, seems angry or withdrawn, has temper tantrums often, has excessive or no energy, is vindictive, is not connected with the family, or you ask yourself am I a good parent? Then please seek my support. As a young adult, do you feel: anxious, often worried, rejected, withdrawn, sad, depressed, or discriminated against? If so, please seek my support. Please come Talk With Love!
If you have wondered why your infant or child: does not bond or connect with you, has behavior problems, does not respect you, seems angry or withdrawn, has temper tantrums often, has excessive or no energy, is vindictive, is not connected with the family, or you ask yourself am I a good parent? Then please seek my support. As a young adult, do you feel: anxious, often worried, rejected, withdrawn, sad, depressed, or discriminated against? If so, please seek my support. Please come Talk With Love!
(971) 265-6157 View (971) 265-6157
Photo of Todd Borgie, Marriage & Family Therapist in Portland, OR
Todd Borgie
Marriage & Family Therapist, LMFT, LPCC
Verified Verified
Portland, OR 97212
Finding a therapist can be a difficult task; actually calling one is even harder. When I am struggling with something I find myself irritable, directionless, and without energy (or too much nervous energy) a difficult time to build new relationships. It is my hope that stepping into my office might feel like finding an oasis; a welcoming place where you can put down your burdens, relax, and see what you can unpack or unload. I engage with people with acceptance and curiosity. I find things I like and inspiration in conversations. I am constantly amazed by people’s creativity, perspective, and desire to connect in a personal ways.
Finding a therapist can be a difficult task; actually calling one is even harder. When I am struggling with something I find myself irritable, directionless, and without energy (or too much nervous energy) a difficult time to build new relationships. It is my hope that stepping into my office might feel like finding an oasis; a welcoming place where you can put down your burdens, relax, and see what you can unpack or unload. I engage with people with acceptance and curiosity. I find things I like and inspiration in conversations. I am constantly amazed by people’s creativity, perspective, and desire to connect in a personal ways.
(510) 876-4972 View (510) 876-4972
Photo of Susan Diane Gendein-Marshall, Psychologist in Portland, OR
Susan Diane Gendein-Marshall
Psychologist, PhD
Verified Verified
Portland, OR 97210
Whether the focus is self esteem, depression, anxiety, relationships, trauma, addiction, or other sorts of pain, you will feel understood within a safe, caring and growth enhancing private therapy. A deeper understanding and comfort with yourself will empower you to live a richer, more productive and satisfying life. Discover important mind-body connections, better identify your desires and goals, be more organized, hopeful and able to enjoy relationships. Design and direct your life in creative, powerful and satisfying ways. Embrace this opportunity for insight, greater happiness and positive change. I can help you to become your most hoped for self.
Whether the focus is self esteem, depression, anxiety, relationships, trauma, addiction, or other sorts of pain, you will feel understood within a safe, caring and growth enhancing private therapy. A deeper understanding and comfort with yourself will empower you to live a richer, more productive and satisfying life. Discover important mind-body connections, better identify your desires and goals, be more organized, hopeful and able to enjoy relationships. Design and direct your life in creative, powerful and satisfying ways. Embrace this opportunity for insight, greater happiness and positive change. I can help you to become your most hoped for self.
(248) 461-3493 View (248) 461-3493
Photo of Sofia Khan, Clinical Social Work/Therapist in Portland, OR
Sofia Khan
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Portland, OR 97213
I am passionate about empowering folks to gain awareness into their own lives so that they can learn to support themselves while navigating life’s challenges. I strive to help people live in a way that invites deeper fulfillment and balance by harnessing their natural ability to cope with stress, emotional pain, and trauma. My therapeutic style incorporates warmth, humor, honest feedback, and values respect and creativity. I prioritize creating a space to safely experiment with sincere ways of being. My goal is to help people create meaningful and positive changes to their lives.
I am passionate about empowering folks to gain awareness into their own lives so that they can learn to support themselves while navigating life’s challenges. I strive to help people live in a way that invites deeper fulfillment and balance by harnessing their natural ability to cope with stress, emotional pain, and trauma. My therapeutic style incorporates warmth, humor, honest feedback, and values respect and creativity. I prioritize creating a space to safely experiment with sincere ways of being. My goal is to help people create meaningful and positive changes to their lives.
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Photo of Yael Schweitzer, Clinical Social Work/Therapist in Portland, OR
Yael Schweitzer
Clinical Social Work/Therapist, LCSW, MSW, BC-DMT
Verified Verified
Portland, OR 97219
Not accepting new clients
As a Mindfulness-Based Therapist, people come to me because they want to be heard, and I provide a safe and welcoming space where their voice is heard with respect and a non judgmental approach. I am skilled in listening not just to the spoken word, but also to the body and non verbal expressions. An essential component of my approach is to demonstrate and work with my clients on developing acceptance and compassion to themselves and others. Everyone who seeks therapy for medical, personal and interpersonal reasons is welcome to my clinic. I work with individuals, couples, families and groups.
As a Mindfulness-Based Therapist, people come to me because they want to be heard, and I provide a safe and welcoming space where their voice is heard with respect and a non judgmental approach. I am skilled in listening not just to the spoken word, but also to the body and non verbal expressions. An essential component of my approach is to demonstrate and work with my clients on developing acceptance and compassion to themselves and others. Everyone who seeks therapy for medical, personal and interpersonal reasons is welcome to my clinic. I work with individuals, couples, families and groups.
(971) 236-4069 View (971) 236-4069
Photo of Laura C Chase, Clinical Social Work/Therapist in Portland, OR
Laura C Chase
Clinical Social Work/Therapist, LCSW
Verified Verified
Portland, OR 97206  (Online Only)
Laura Chase has over 20 years of experience working with clients with attachment styles that make adulthood difficult. I enjoy working with victims of sexual abuse and substance abuse using tapping and EMDR. Life can be more fulfilling with self-reflection and action, with understanding and compassion. You can heal. The best time to start is now.
Laura Chase has over 20 years of experience working with clients with attachment styles that make adulthood difficult. I enjoy working with victims of sexual abuse and substance abuse using tapping and EMDR. Life can be more fulfilling with self-reflection and action, with understanding and compassion. You can heal. The best time to start is now.
(503) 410-7717 View (503) 410-7717
Photo of Sakura Counseling, Licensed Professional Counselor in Portland, OR
Sakura Counseling
Licensed Professional Counselor, LPC, LPC-A, LCSW, QMHP-R, Intern
Verified Verified
Portland, OR 97209  (Online Only)
At Sakura Counseling, we aspire to create an environment that is all inclusive and provides a safe space for diversity in all forms to untangle the challenges that have been holding you back from being authentically you. We are collaborative in our approach, holding high regard for your experience in your environment, paying close attention to the many systems of our society that play a part in perpetuating oppression.
At Sakura Counseling, we aspire to create an environment that is all inclusive and provides a safe space for diversity in all forms to untangle the challenges that have been holding you back from being authentically you. We are collaborative in our approach, holding high regard for your experience in your environment, paying close attention to the many systems of our society that play a part in perpetuating oppression.
(971) 206-6273 View (971) 206-6273
Photo of Todd Mercural, Licensed Professional Counselor in Portland, OR
Todd Mercural
Licensed Professional Counselor, MPA, NCC, LPC
Verified Verified
Portland, OR 97217  (Online Only)
I use an existential approach to work with anxiety, depression, life transitions, trauma, chronic stress and burnout, spirituality, grief and loss, and relationship challenges. My clients are typically struggling with change, relationships, making difficult choices, and finding meaning or purpose. Themes often involve freedom/constraint, responsibility, boundary, authenticity, meaning/meaninglessness, safety/risk, belonging/isolation, identity, power/powerlessness, and mortality.
I use an existential approach to work with anxiety, depression, life transitions, trauma, chronic stress and burnout, spirituality, grief and loss, and relationship challenges. My clients are typically struggling with change, relationships, making difficult choices, and finding meaning or purpose. Themes often involve freedom/constraint, responsibility, boundary, authenticity, meaning/meaninglessness, safety/risk, belonging/isolation, identity, power/powerlessness, and mortality.
(971) 414-3035 View (971) 414-3035
Photo of Satya Gaia Grace, Marriage & Family Therapist in Portland, OR
Satya Gaia Grace
Marriage & Family Therapist, MS, LMFT, CHT, RM, TRY
Verified Verified
5 Endorsed
Portland, OR 97209
Our work together involves tending to the root of imbalance, alchemizing pain into medicine, and re-orienting artistic creation and mothers as the center of life. As a relational, intuitive, and earth-centered practitioner, I believe reality can be imagined, gestated, and birthed anew. We can meet in my office in Portland, our local forests, or virtually. May we remember healing is belonging within the village of our hearts, our communities, and our planet.
Our work together involves tending to the root of imbalance, alchemizing pain into medicine, and re-orienting artistic creation and mothers as the center of life. As a relational, intuitive, and earth-centered practitioner, I believe reality can be imagined, gestated, and birthed anew. We can meet in my office in Portland, our local forests, or virtually. May we remember healing is belonging within the village of our hearts, our communities, and our planet.
(503) 738-1633 View (503) 738-1633
Photo of Ruth Q. Leibowitz, Psychologist in Portland, OR
Ruth Q. Leibowitz
Psychologist, PhD, SEP
Verified Verified
Portland, OR 97239
Not accepting new clients
My apologies, however, my waitlist is currently closed. I will edit this profile when that changes. I especially enjoy working with individuals who have experienced "outsider status" and are on a journey to create a sense of belonging in their own way and style. Many of my patients are creatives who experience hindrances in connecting with their creative energies and seek ways to more fully nourish and honor these aspects of Self.
My apologies, however, my waitlist is currently closed. I will edit this profile when that changes. I especially enjoy working with individuals who have experienced "outsider status" and are on a journey to create a sense of belonging in their own way and style. Many of my patients are creatives who experience hindrances in connecting with their creative energies and seek ways to more fully nourish and honor these aspects of Self.
(503) 567-4327 View (503) 567-4327
Photo of Elizabeth Raffer Anderson, Licensed Professional Counselor in Portland, OR
Elizabeth Raffer Anderson
Licensed Professional Counselor, MA, LPC
Verified Verified
Portland, OR 97214
Hi! I am so glad you are here. My approach is direct, nurturing and connective. I believe in the capacity to grow and to become our best selves. I incorporate psychodynamic talk therapy to understand the stuck points, while incorporating mindfulness and somatic work to connect the mind and body. Additionally, I acknowledge that oppression exists within marginalized communities, thus treating the individual in a social context.
Hi! I am so glad you are here. My approach is direct, nurturing and connective. I believe in the capacity to grow and to become our best selves. I incorporate psychodynamic talk therapy to understand the stuck points, while incorporating mindfulness and somatic work to connect the mind and body. Additionally, I acknowledge that oppression exists within marginalized communities, thus treating the individual in a social context.
(503) 694-4740 View (503) 694-4740
Photo of Madison Paskett: Congruent Therapy, Professional Counselor Associate in Portland, OR
Madison Paskett: Congruent Therapy
Professional Counselor Associate, MA
Verified Verified
1 Endorsed
Portland, OR 97214  (Online Only)
Madison has numerous years of experience working with individuals, families, couples, and systems, all who bring their own unique lived experiences including Queer, first responders, trauma survivors and those who experience emotional intensity. She aims to help individuals/families/systems build skills and find their path to the life they are wanting to live. This means together, you will work to identify and utilize strategies to best handle whatever life throws your way.
Madison has numerous years of experience working with individuals, families, couples, and systems, all who bring their own unique lived experiences including Queer, first responders, trauma survivors and those who experience emotional intensity. She aims to help individuals/families/systems build skills and find their path to the life they are wanting to live. This means together, you will work to identify and utilize strategies to best handle whatever life throws your way.
(503) 647-4284 View (503) 647-4284
Photo of Tever Nickerson, Licensed Professional Counselor in Portland, OR
Tever Nickerson
Licensed Professional Counselor, LPC
Verified Verified
2 Endorsed
Portland, OR 97214
Not accepting new clients
I offer caring and compassionate counseling for individuals, couples, and families. I work with a wide range of emotional and behavioral issues that may be impacting you, your relationships and your family. Whether it is depression and anxiety, parenting support, or resolution to interpersonal conflict, I strive to provide a comfortable and supportive environment for you to explore your concerns.
I offer caring and compassionate counseling for individuals, couples, and families. I work with a wide range of emotional and behavioral issues that may be impacting you, your relationships and your family. Whether it is depression and anxiety, parenting support, or resolution to interpersonal conflict, I strive to provide a comfortable and supportive environment for you to explore your concerns.
(503) 342-2156 View (503) 342-2156
Photo of Tirzah Jacob, Licensed Professional Counselor in Portland, OR
Tirzah Jacob
Licensed Professional Counselor, LPC
Verified Verified
Portland, OR 97218  (Online Only)
Waitlist for new clients
We all have occasions throughout life that are particularly difficult or painful. During these times, additional emotional & social support are needed. Therapy is a helpful resource for navigating these inevitable challenges... it is a unique process, as it requires a willingness to look honestly within ourselves, assessing our strengths as well as our limitations. I enjoy working collaboratively with clients. Together we will explore the parts of life that you feel uneasy about, and then proactively develop strategies that can enable more peace of mind & a greater sense of well-being. Shifting from simply surviving... to thriving.
We all have occasions throughout life that are particularly difficult or painful. During these times, additional emotional & social support are needed. Therapy is a helpful resource for navigating these inevitable challenges... it is a unique process, as it requires a willingness to look honestly within ourselves, assessing our strengths as well as our limitations. I enjoy working collaboratively with clients. Together we will explore the parts of life that you feel uneasy about, and then proactively develop strategies that can enable more peace of mind & a greater sense of well-being. Shifting from simply surviving... to thriving.
(503) 342-7752 View (503) 342-7752
Photo of L. Rebecca Propst, Psychologist in Portland, OR
L. Rebecca Propst
Psychologist, PhD
Verified Verified
Portland, OR 97219  (Online Only)
Life can hurt. Set-backs, emotional pain, social awkwardness, fear of anger, shame or rejection can block that which we desire most-loving nurturing relationships, affirmation from others, and self-valuing. I have been helping individuals and couples better achieve those desires for 40+ years. I bring a long history of a variety of skills to a mutually created process.
Life can hurt. Set-backs, emotional pain, social awkwardness, fear of anger, shame or rejection can block that which we desire most-loving nurturing relationships, affirmation from others, and self-valuing. I have been helping individuals and couples better achieve those desires for 40+ years. I bring a long history of a variety of skills to a mutually created process.
(503) 542-9730 View (503) 542-9730
Photo of Brittany Drosdak, Licensed Professional Counselor in Portland, OR
Brittany Drosdak
Licensed Professional Counselor, LPC
Verified Verified
Portland, OR 97209
Not accepting new clients
I believe that meaningful change begins with a strong therapeutic relationship. I hope to earn your trust by creating a space in which you feel accepted, heard, and supported. My therapeutic style is warm, person-centered, humanistic, and trauma-informed. Over the years as a therapist, I have worked with teens and adults around depression, anxiety disorders, PTSD, generational trauma, grief and loss, life transitions and stress, ADHD and neurodivergence, the LGBTQIA+ community and exploring identity.
I believe that meaningful change begins with a strong therapeutic relationship. I hope to earn your trust by creating a space in which you feel accepted, heard, and supported. My therapeutic style is warm, person-centered, humanistic, and trauma-informed. Over the years as a therapist, I have worked with teens and adults around depression, anxiety disorders, PTSD, generational trauma, grief and loss, life transitions and stress, ADHD and neurodivergence, the LGBTQIA+ community and exploring identity.
(971) 203-0671 View (971) 203-0671
Photo of Brooke Welch in Portland, OR
Brooke Welch
MA
Verified Verified
Portland, OR 97219
Your Spirit is calling you to remember your true nature; to dive below the judgments of your mind, the conditioning of your past, and fears of not being enough or worthy of a rich and satisfying life. Many people struggle in life trying to find a place in the world to fit, feeling inadequate and judging their pain. All along, the perfection of who you are is waiting to be discovered. For this you must journey within. With careful attention, each moment is an opening to what is most essential, true and relevant NOW. Tap into your creativity and learn to play for real. I do not assess, diagnose, or offer remediation for dysfunction.
Your Spirit is calling you to remember your true nature; to dive below the judgments of your mind, the conditioning of your past, and fears of not being enough or worthy of a rich and satisfying life. Many people struggle in life trying to find a place in the world to fit, feeling inadequate and judging their pain. All along, the perfection of who you are is waiting to be discovered. For this you must journey within. With careful attention, each moment is an opening to what is most essential, true and relevant NOW. Tap into your creativity and learn to play for real. I do not assess, diagnose, or offer remediation for dysfunction.
(503) 461-1299 View (503) 461-1299

How does your Therapist compare?

Number of Therapists in Portland, OR

3,000+

Average cost per session

$160

Therapists in Portland, OR who prioritize treating:

91% Anxiety
85% Depression
78% Relationship Issues
76% Self Esteem
73% Trauma and PTSD
70% Stress
67% Life Transitions

Average years in practice

10 Years

Top 3 insurances accepted

54% PacificSource
47% Aetna
38% BlueCross and BlueShield

How Therapists in Portland, OR see their clients

56% In Person and Online
44% Online Only

Gender breakdown

75% Female
21% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Portland?

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.