Therapists in Old Forge, PA

Photo of Nicole Dunbar Brush, Licensed Professional Counselor
Nicole Dunbar Brush
Licensed Professional Counselor
Online Only
Life can bring overwhelming pain, loss, and challenges that feel impossible to face alone. As a licensed counselor, I specialize in supporting individuals through some of life’s most difficult seasons. I have experience in many different settings including inpatient psychiatric care, outpatient counseling, nonprofit cancer centers, and schools. I have specialized training in suicide loss, suicidal thoughts, and grief. My approach combines evidence-based techniques such as Cognitive Behavioral Therapy (CBT) and person-centered counseling with compassionate, faith-informed guidance for those who desire Christian counseling.
Life can bring overwhelming pain, loss, and challenges that feel impossible to face alone. As a licensed counselor, I specialize in supporting individuals through some of life’s most difficult seasons. I have experience in many different settings including inpatient psychiatric care, outpatient counseling, nonprofit cancer centers, and schools. I have specialized training in suicide loss, suicidal thoughts, and grief. My approach combines evidence-based techniques such as Cognitive Behavioral Therapy (CBT) and person-centered counseling with compassionate, faith-informed guidance for those who desire Christian counseling.
(570) 526-2628 View (570) 526-2628
Photo of Carrie Johanson, Psychologist, PhD, MS, MA
Carrie Johanson
Psychologist, PhD, MS, MA
2 Endorsed
Old Forge, PA 18518
I work with individuals and couples that are burdened with unprecedented responsibility right now. Impossible expectations often lead to isolation and discourse, hiding our fears and doubts, and resentments. Hiding our true selves can increase negative coping skills, like over or under eating/drinking/sleeping. Therapy can become a place to process and share your inner thoughts and concerns, find balance, and find some new tools to feeling more grounded. I work with folks to feel confident to be transparent to loved ones and seek changes to improve their daily lives. My couples leave empowered to have the tough talks without fear.
I work with individuals and couples that are burdened with unprecedented responsibility right now. Impossible expectations often lead to isolation and discourse, hiding our fears and doubts, and resentments. Hiding our true selves can increase negative coping skills, like over or under eating/drinking/sleeping. Therapy can become a place to process and share your inner thoughts and concerns, find balance, and find some new tools to feeling more grounded. I work with folks to feel confident to be transparent to loved ones and seek changes to improve their daily lives. My couples leave empowered to have the tough talks without fear.
(570) 209-9898 View (570) 209-9898
Photo of Lisa Kossuth - Peace of Mind NEPA, Licensed Professional Counselor, LPC, NCC, MA
Peace of Mind NEPA
Licensed Professional Counselor, LPC, NCC, MA
Old Forge, PA 18518
When others can’t control you, they try to control what others think about you. Many people feel stuck in toxic cycles—trapped by self-doubt, anxiety, or relationships that drain them. They strive for perfection, fearing they’ll never be enough, or stay silent to avoid conflict. They’re people-pleasers, overthinkers, and caught in patterns of manipulation, constantly questioning themselves instead of trusting their instincts. They long for confidence, boundaries, and the freedom to live life on their own terms but feel paralyzed by fear and uncertainty. I help them break free, recognize their worth, and step into their power.
When others can’t control you, they try to control what others think about you. Many people feel stuck in toxic cycles—trapped by self-doubt, anxiety, or relationships that drain them. They strive for perfection, fearing they’ll never be enough, or stay silent to avoid conflict. They’re people-pleasers, overthinkers, and caught in patterns of manipulation, constantly questioning themselves instead of trusting their instincts. They long for confidence, boundaries, and the freedom to live life on their own terms but feel paralyzed by fear and uncertainty. I help them break free, recognize their worth, and step into their power.
(570) 536-8105 View (570) 536-8105
Photo of Marsinlen Blackwell, Licensed Professional Counselor, LPC
Marsinlen Blackwell
Licensed Professional Counselor, LPC
Online Only
Therapy is a journey, whether you are familiar to the process or just beginning, I am so glad you are here. I'm a licensed counselor with a diverse background, I enjoyed working with those who were incarcerated make better choices for their future on the outside, working with those in active addiction trying to do something to make recovery possible, and working in a busy outpatient mental health clinic. With each experience, I learned how to work with various populations and enhance my skills. The most rewarding part of my job is seeing the "light blub" moment occur with a client or helping a client heal when they are struggling.
Therapy is a journey, whether you are familiar to the process or just beginning, I am so glad you are here. I'm a licensed counselor with a diverse background, I enjoyed working with those who were incarcerated make better choices for their future on the outside, working with those in active addiction trying to do something to make recovery possible, and working in a busy outpatient mental health clinic. With each experience, I learned how to work with various populations and enhance my skills. The most rewarding part of my job is seeing the "light blub" moment occur with a client or helping a client heal when they are struggling.
(570) 774-4657 View (570) 774-4657
Photo of Jacob Herber, Licensed Professional Counselor, LPC
Jacob Herber
Licensed Professional Counselor, LPC
Old Forge, PA 18518
Reclaim Your Inner Strength! Sometimes life throws curve balls and other challenges and we found ourselves in the midst of powerful storms that impact our well being and balance. If you or someone you care about has had too many negative or unpleasant experiences, you do not have to accept a sentence of suffering and lifetime sadness or anxiety. You can learn how to heal and build a life filled with joy.
Reclaim Your Inner Strength! Sometimes life throws curve balls and other challenges and we found ourselves in the midst of powerful storms that impact our well being and balance. If you or someone you care about has had too many negative or unpleasant experiences, you do not have to accept a sentence of suffering and lifetime sadness or anxiety. You can learn how to heal and build a life filled with joy.
(201) 581-3827 View (201) 581-3827
Photo of Michelle Bilski, Licensed Professional Counselor, LPC, MA
Michelle Bilski
Licensed Professional Counselor, LPC, MA
Old Forge, PA 18518
Do you feel like your mind is always racing—worrying, overthinking, and constantly saying yes, even when you're running on empty? From the outside, it probably looks like you’ve got it all together. You’re driven, capable, and the one people turn to when something needs fixing. But inside? It’s a different story. You’re tired. The self-doubt is loud. And your brain just won’t give it a rest—spinning through every little thing, analyzing it all to death.
Do you feel like your mind is always racing—worrying, overthinking, and constantly saying yes, even when you're running on empty? From the outside, it probably looks like you’ve got it all together. You’re driven, capable, and the one people turn to when something needs fixing. But inside? It’s a different story. You’re tired. The self-doubt is loud. And your brain just won’t give it a rest—spinning through every little thing, analyzing it all to death.
(570) 244-3726 View (570) 244-3726
Photo of Sandra Giacometti, Licensed Professional Counselor, MA, LPC, LMHC, CADC, CTMH
Sandra Giacometti
Licensed Professional Counselor, MA, LPC, LMHC, CADC, CTMH
Online Only
Life is very unpredictable with many ups and downs. Today can start a new therapeutic journey for you. Step by step, the therapy process can help you through whatever hardship life has handed you, with guidance and support from an empathetic clinician. You don't have to be alone in whatever struggle you may be dealing with- big or small. Take the first step to empower yourself and do something different. This may be one of the best self-care decisions you make for yourself. I look forward to speaking with you and being part of your journey.
Life is very unpredictable with many ups and downs. Today can start a new therapeutic journey for you. Step by step, the therapy process can help you through whatever hardship life has handed you, with guidance and support from an empathetic clinician. You don't have to be alone in whatever struggle you may be dealing with- big or small. Take the first step to empower yourself and do something different. This may be one of the best self-care decisions you make for yourself. I look forward to speaking with you and being part of your journey.
(272) 444-3075 View (272) 444-3075
Photo of James Roberts, Licensed Professional Counselor, MS, LPC, NCC
James Roberts
Licensed Professional Counselor, MS, LPC, NCC
1 Endorsed
Serves Area
Anxious? Depressed? Lacking motivation or direction? You're not alone. I believe that each of us possesses the ability to change, grow and live happier, healthier, more fulfilling lives. Sometimes we just need a little help along the way. I work with persons of all ages and incorporate a variety of evidence-based treatment modalities into my practice, including Cognitive Behavioral Therapy (CBT), Motivational Interviewing, and Solution-Focused Brief Therapy (SFBT). I do not believe in a one-size-fits-all model for counseling and take special care to honor the unique lived experiences of those I work with.
Anxious? Depressed? Lacking motivation or direction? You're not alone. I believe that each of us possesses the ability to change, grow and live happier, healthier, more fulfilling lives. Sometimes we just need a little help along the way. I work with persons of all ages and incorporate a variety of evidence-based treatment modalities into my practice, including Cognitive Behavioral Therapy (CBT), Motivational Interviewing, and Solution-Focused Brief Therapy (SFBT). I do not believe in a one-size-fits-all model for counseling and take special care to honor the unique lived experiences of those I work with.
(570) 405-9909 View (570) 405-9909
Photo of Constance Manley, Licensed Professional Counselor, LPC
Constance Manley
Licensed Professional Counselor, LPC
Online Only
Constance Manley is a Licensed Professional Counselor in Pennsylvania and Virginia. She utilizes an eclectic approach to therapy, emphasizing Cognitive Behavioral Therapy, Evidence-Based techniques, and Person-Centered practices. Constance specializes in treating a variety of mental health concerns, including Depression, Anxiety, Stress, Grief, ADHD, Autism, Abuse, Substance Abuse, and Self-Esteem challenges, with a compassionate and client-focused approach.
Constance Manley is a Licensed Professional Counselor in Pennsylvania and Virginia. She utilizes an eclectic approach to therapy, emphasizing Cognitive Behavioral Therapy, Evidence-Based techniques, and Person-Centered practices. Constance specializes in treating a variety of mental health concerns, including Depression, Anxiety, Stress, Grief, ADHD, Autism, Abuse, Substance Abuse, and Self-Esteem challenges, with a compassionate and client-focused approach.
(267) 729-8558 View (267) 729-8558
Photo of Mary Helen Yatko - Counseling & Wellness Center Scranton, Licensed Professional Counselor, MS, LPC, NCC
Counseling & Wellness Center Scranton
Licensed Professional Counselor, MS, LPC, NCC
2 Endorsed
Serves Area
Hello ! You may reach us at 570-961-WELL (961- 9355), or see our therapists' information at ScrantonTherapy.com. Our therapists have decades of experience in multiple personal, relationship and mental health issues. We know that despite best intentions and effort, people often feel stuck in the same patterns, feelings or behaviors. Counseling is an opportunity for personal growth and /or help you identify and cope with difficult life circumstances or emotions. We hope to hear from you to get started, and learn your strengths and abilities toward change.
Hello ! You may reach us at 570-961-WELL (961- 9355), or see our therapists' information at ScrantonTherapy.com. Our therapists have decades of experience in multiple personal, relationship and mental health issues. We know that despite best intentions and effort, people often feel stuck in the same patterns, feelings or behaviors. Counseling is an opportunity for personal growth and /or help you identify and cope with difficult life circumstances or emotions. We hope to hear from you to get started, and learn your strengths and abilities toward change.
(570) 244-3534 View (570) 244-3534
Photo of Dzana Saynes, Licensed Professional Counselor, LPC
Dzana Saynes
Licensed Professional Counselor, LPC
Online Only
My name is Dzana Saynes, DM, MS, LPC, and I am a therapist with a Lithuanian upbringing and accent. I believe that a unique approach to life changes, and difficulties can be accomplished through cooperative engagements toward improving or making powerful changes in your unique life situations. I specialize in helping clients improve interpersonal skills, reduce symptoms of mental illness, develop better cognitive and emotional skills, and improve self-esteem.
My name is Dzana Saynes, DM, MS, LPC, and I am a therapist with a Lithuanian upbringing and accent. I believe that a unique approach to life changes, and difficulties can be accomplished through cooperative engagements toward improving or making powerful changes in your unique life situations. I specialize in helping clients improve interpersonal skills, reduce symptoms of mental illness, develop better cognitive and emotional skills, and improve self-esteem.
(717) 876-8734 View (717) 876-8734

More Therapists Nearby

Photo of Noel Hopson, Licensed Professional Counselor, LPC
Noel Hopson
Licensed Professional Counselor, LPC
Online Only
Life can feel overwhelming at times, but you don’t have to face it alone. I specialize in helping adults develop a stronger, healthier relationship with themselves and, in turn, with others. My approach is client-centered, blending psychodynamic insights and mindfulness practices to support meaningful growth. If you're ready to take the next step toward healing and connection, I’d be honored to support you. Reaching out for support takes courage, and it’s a meaningful first step toward change.
Life can feel overwhelming at times, but you don’t have to face it alone. I specialize in helping adults develop a stronger, healthier relationship with themselves and, in turn, with others. My approach is client-centered, blending psychodynamic insights and mindfulness practices to support meaningful growth. If you're ready to take the next step toward healing and connection, I’d be honored to support you. Reaching out for support takes courage, and it’s a meaningful first step toward change.
(717) 716-7944 View (717) 716-7944
Photo of Jennifer Julstedt, Licensed Professional Counselor, MS, NCC, LPC
Jennifer Julstedt
Licensed Professional Counselor, MS, NCC, LPC
1 Endorsed
Peckville, PA 18452
Do you feel stuck, trapped, that you are not living the life you want for yourself? Are you triggered by certain events, people or not sure what is creating negative feelings? I am caring, compassionate and want to see people become their best self, no matter what traumas that have occurred. Working with child self and physical symptoms to help heal past traumas is a basis in my therapeutic approach.
Do you feel stuck, trapped, that you are not living the life you want for yourself? Are you triggered by certain events, people or not sure what is creating negative feelings? I am caring, compassionate and want to see people become their best self, no matter what traumas that have occurred. Working with child self and physical symptoms to help heal past traumas is a basis in my therapeutic approach.
(272) 359-8600 View (272) 359-8600
Photo of Fabienne Clark, Licensed Professional Counselor, LPC
Fabienne Clark
Licensed Professional Counselor, LPC
Online Only
I am a highly motivated and caring Licensed Professional Counselor (LPC) based in Philadelphia, Pennsylvania. I received my Master of Arts at La Salle University in Philadelphia and have been practicing in the mental health field for almost 6 years. I have at present worked extensively in community mental health, where I have learned the necessary fundamentals of counseling.
I am a highly motivated and caring Licensed Professional Counselor (LPC) based in Philadelphia, Pennsylvania. I received my Master of Arts at La Salle University in Philadelphia and have been practicing in the mental health field for almost 6 years. I have at present worked extensively in community mental health, where I have learned the necessary fundamentals of counseling.
(717) 470-2546 View (717) 470-2546
Photo of Tiffany Griffiths - Tiffany Griffiths, Psy.D. & Associates, Inc., Psychologist
Tiffany Griffiths, Psy.D. & Associates, Inc.
Psychologist
1 Endorsed
Dunmore, PA 18512
I have worked to create an integrated, evidence-based, and holistic group practice where my vision of the ideal environment for growth can unfold. The associates in the practice have diverse backgrounds, interests, and training. No matter what problem or difficulty with which you present, someone in our group can assist you. We have cultivated an environment of peace, warmth, and acceptance to assure you will be respected, unconditionally.
I have worked to create an integrated, evidence-based, and holistic group practice where my vision of the ideal environment for growth can unfold. The associates in the practice have diverse backgrounds, interests, and training. No matter what problem or difficulty with which you present, someone in our group can assist you. We have cultivated an environment of peace, warmth, and acceptance to assure you will be respected, unconditionally.
(570) 560-6579 View (570) 560-6579
Photo of Michelle Gonzalez, Licensed Professional Counselor, MS, NCC, LPC
Michelle Gonzalez
Licensed Professional Counselor, MS, NCC, LPC
Online Only
Don't you love when your doctor tells you to "reduce the stress in your life". Life in general is stressful, right? Relationships can become stressful. Work can be stressful. Kids can be stressful. Anxiety, depression, anger, frustration, and lack of effective ways to cope will influence your need for counseling. Everyone needs someone to vent to and therapy provides you not only with a way to express your frustrations, but it also helps you learn how to cope better with the things that stress you out! Eliminating stress is impossible however learning better ways to cope is not impossible, I can help you work on it.
Don't you love when your doctor tells you to "reduce the stress in your life". Life in general is stressful, right? Relationships can become stressful. Work can be stressful. Kids can be stressful. Anxiety, depression, anger, frustration, and lack of effective ways to cope will influence your need for counseling. Everyone needs someone to vent to and therapy provides you not only with a way to express your frustrations, but it also helps you learn how to cope better with the things that stress you out! Eliminating stress is impossible however learning better ways to cope is not impossible, I can help you work on it.
(272) 999-1910 View (272) 999-1910
Photo of Jessica Ferretti, MSW, LSW
Jessica Ferretti
Verified Verified
Scranton, PA 18505
Welcome, I’m glad you’re here! I look forward to meeting you and supporting you on this important stage of your personal journey. Together, we’ll focus on your goals and well-being as you take the next steps in caring for yourself. As a licensed social worker in Pennsylvania with nearly 20 years of experience, I understand the importance of having a safe, supportive space where you can be heard. I earned both my bachelor’s and master’s degrees in social work from Marywood University and have dedicated my career to helping individuals and families navigate life’s challenges.
Welcome, I’m glad you’re here! I look forward to meeting you and supporting you on this important stage of your personal journey. Together, we’ll focus on your goals and well-being as you take the next steps in caring for yourself. As a licensed social worker in Pennsylvania with nearly 20 years of experience, I understand the importance of having a safe, supportive space where you can be heard. I earned both my bachelor’s and master’s degrees in social work from Marywood University and have dedicated my career to helping individuals and families navigate life’s challenges.
(272) 381-6228 View (272) 381-6228
Photo of Jillian Gratz, Associate Professional Counselor, MA, NCC, LAPC
Jillian Gratz
Associate Professional Counselor, MA, NCC, LAPC
Mayfield, PA 18433
Using an integrative approach, I meet you in your current experience and assess how you would like to make changes to your emotional and mental health. I am passionate about providing psychoeducation to clients to normalize and teach self-compassion for all of the universally human struggles we have. I use multiple therapies to integrate the aspects of mind, spirit, and meaning that are unique to each individual to create overall wellness.
Using an integrative approach, I meet you in your current experience and assess how you would like to make changes to your emotional and mental health. I am passionate about providing psychoeducation to clients to normalize and teach self-compassion for all of the universally human struggles we have. I use multiple therapies to integrate the aspects of mind, spirit, and meaning that are unique to each individual to create overall wellness.
(570) 843-1843 View (570) 843-1843
Photo of John Oraczewski, Licensed Professional Counselor, LPC
John Oraczewski
Licensed Professional Counselor, LPC
Kingston, PA 18704
Hi! I'm John. Are you having a hard time managing your work stress? Anxiety? Are you feeling like your relationship/marriage is 'On the rocks?' Or, just feeling down? If so, I can help! I have helped both individuals and couples work through challenges of all varieties stemming from many different and unique issues. I help clients work through their challenges by helping them identify practical solutions, barriers, and strengths that lead them to be able to solve their particular issue(s).
Hi! I'm John. Are you having a hard time managing your work stress? Anxiety? Are you feeling like your relationship/marriage is 'On the rocks?' Or, just feeling down? If so, I can help! I have helped both individuals and couples work through challenges of all varieties stemming from many different and unique issues. I help clients work through their challenges by helping them identify practical solutions, barriers, and strengths that lead them to be able to solve their particular issue(s).
(570) 281-0844 View (570) 281-0844
Photo of Adriana Arana, Licensed Professional Counselor, MS, LPC , NCC
Adriana Arana
Licensed Professional Counselor, MS, LPC , NCC
3 Endorsed
Kingston, PA 18704
Hey there & welcome! If you are here, I can imagine that there is something you are struggling with and need a little help. I want to be able to help you through your journey to be the best version of yourself that you can be. but Before we can do that, I do believe a therapeutic relationship is just as important. so just as much as I want to get to know you, I think it’s equally important you get to know me! With over 10 years experience in the mental health field, I am a Licensed Professional Counselor & I have worked in both inpatient and outpatient settings. I am born & raised in Brooklyn, New York and moved to PA in 2016.
Hey there & welcome! If you are here, I can imagine that there is something you are struggling with and need a little help. I want to be able to help you through your journey to be the best version of yourself that you can be. but Before we can do that, I do believe a therapeutic relationship is just as important. so just as much as I want to get to know you, I think it’s equally important you get to know me! With over 10 years experience in the mental health field, I am a Licensed Professional Counselor & I have worked in both inpatient and outpatient settings. I am born & raised in Brooklyn, New York and moved to PA in 2016.
(272) 204-3023 View (272) 204-3023

See more therapy options for Old Forge

How does your Therapist compare?

Number of Therapists in Old Forge, PA

10+

Average cost per session

$132

Therapists in Old Forge, PA who prioritize treating:

91% Stress
82% Depression
82% Anxiety
82% Trauma and PTSD
82% Family Conflict
82% Coping Skills
82% Self Esteem

Average years in practice

9 Years

Top 3 insurances accepted

82% Highmark
82% Optum
73% BlueCross and BlueShield

How Therapists in Old Forge, PA see their clients

55% In Person and Online
45% Online Only

Gender breakdown

100% Female
FAQs - About Therapy and Counseling

How can I find a therapist in Old Forge?

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.