Therapists in Philadelphia, PA

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Photo of Sarah Anne DeSilva, Clinical Social Work/Therapist, LCSW
Sarah Anne DeSilva
Clinical Social Work/Therapist, LCSW
2 Endorsed
Philadelphia, PA 19123
Waitlist for new clients
Hello! My name is Sarah and I am a licensed clinical Social Worker. I am dedicated to supporting individuals in healing and living a bountiful, meaningful life. I work from an integrated approach, drawing from Trauma-focused CBT, Prolonged Exposure, DBT, EFIT, and humanistic theory to tailor care to your individual situation. I am passionate about creating a safe, therapeutic space that honors all parts of the human experience so that you are able to challenge yourself in healthy ways and grow to live the life you desire.
Hello! My name is Sarah and I am a licensed clinical Social Worker. I am dedicated to supporting individuals in healing and living a bountiful, meaningful life. I work from an integrated approach, drawing from Trauma-focused CBT, Prolonged Exposure, DBT, EFIT, and humanistic theory to tailor care to your individual situation. I am passionate about creating a safe, therapeutic space that honors all parts of the human experience so that you are able to challenge yourself in healthy ways and grow to live the life you desire.
(267) 692-3870 View (267) 692-3870
Photo of Diana Jiorle, Licensed Professional Counselor, LPC
Diana Jiorle
Licensed Professional Counselor, LPC
Online Only
I am Diana Jiorle, a Licensed Professional Counselor (LPC) with over 5 years of experience. I specialize in working with adults and couples who are navigating anxiety, relationship and marriage challenges, depression, low self-esteem, and more. For those who prefer to incorporate biblical truth and prayer into their therapy, I also provide Christian counseling alongside evidence-based approaches. I earned my Master's Degree in Clinical Mental Health Counseling from Regent University in Virginia Beach.
I am Diana Jiorle, a Licensed Professional Counselor (LPC) with over 5 years of experience. I specialize in working with adults and couples who are navigating anxiety, relationship and marriage challenges, depression, low self-esteem, and more. For those who prefer to incorporate biblical truth and prayer into their therapy, I also provide Christian counseling alongside evidence-based approaches. I earned my Master's Degree in Clinical Mental Health Counseling from Regent University in Virginia Beach.
(484) 759-9441 View (484) 759-9441
Photo of Dr. Katelyn Coffey, Psychologist, PsyD
Dr. Katelyn Coffey
Psychologist, PsyD
2 Endorsed
Online Only
Hello! I am a licensed clinical psychologist and I offer therapy to adults. I help individuals navigate life challenges and transitions, gain insight and perspective, and work toward coping and healing. Areas of therapeutic focus include (but are not limited to): working with individuals coping with anxiety, ADHD, infertility/IVF, navigating the pregnancy or postpartum period, parenting, and relationship/communication issues. I work from a culturally aware, trauma-informed, and non-judgmental approach. My style is supportive, collaborative, empowering, and authentic.
Hello! I am a licensed clinical psychologist and I offer therapy to adults. I help individuals navigate life challenges and transitions, gain insight and perspective, and work toward coping and healing. Areas of therapeutic focus include (but are not limited to): working with individuals coping with anxiety, ADHD, infertility/IVF, navigating the pregnancy or postpartum period, parenting, and relationship/communication issues. I work from a culturally aware, trauma-informed, and non-judgmental approach. My style is supportive, collaborative, empowering, and authentic.
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Photo of Toyye Hargrove, Licensed Professional Counselor, MS, LPC
Toyye Hargrove
Licensed Professional Counselor, MS, LPC
Philadelphia, PA 19104
Toyye Hargrove is a Licensed Professional Counselor in Pennsylvania who has been practicing since 2019. She has a Master’s of Science in Counseling. Toyye is dedicated to listening, processing, and assisting clients with developing their own solutions without judgement and with hopes of developing an improved mindset and overall well-being. Outside of work, Toyye enjoys dancing, spending time with family, and cooking.
Toyye Hargrove is a Licensed Professional Counselor in Pennsylvania who has been practicing since 2019. She has a Master’s of Science in Counseling. Toyye is dedicated to listening, processing, and assisting clients with developing their own solutions without judgement and with hopes of developing an improved mindset and overall well-being. Outside of work, Toyye enjoys dancing, spending time with family, and cooking.
(267) 490-3624 View (267) 490-3624
Photo of Zoe Alloy, Clinical Social Work/Therapist, LCSW
Zoe Alloy
Clinical Social Work/Therapist, LCSW
1 Endorsed
Online Only
Everyone has periods in their life where they feel lost, & it is within those times that asking for help shows great strength & is a step forward. My name is Zoe & I’m a licensed social worker. I have always been sensitive & paid attention to others’ feelings & needs & as a result I have answered a call to help. I have been working as a therapist since 2015 with a number of clients. Through my journey I have felt it was important to engage others’ mind, body, & soul & I excel in integrating a holistic approach to therapy.
Everyone has periods in their life where they feel lost, & it is within those times that asking for help shows great strength & is a step forward. My name is Zoe & I’m a licensed social worker. I have always been sensitive & paid attention to others’ feelings & needs & as a result I have answered a call to help. I have been working as a therapist since 2015 with a number of clients. Through my journey I have felt it was important to engage others’ mind, body, & soul & I excel in integrating a holistic approach to therapy.
(215) 995-0155 View (215) 995-0155
Photo of Laura Geftman, Clinical Social Work/Therapist, LCSW
Laura Geftman
Clinical Social Work/Therapist, LCSW
2 Endorsed
Philadelphia, PA 19102
Okay, let me guess — life feels like a lot right now. You’re overwhelmed, drained, and stuck in patterns that just aren’t working anymore. Maybe you’re questioning your relationships, struggling at work, or wondering why you feel so disconnected. That glass of whiskey, wine, or weed isn’t helping like it used to. With nearly 20 years of experience, I use Accelerated Resolution Therapy (ART) and Internal Family Systems (IFS) to help you process difficult emotions, release what’s weighing you down, and reconnect with yourself. Together, we’ll create a path toward feeling more grounded and at peace.
Okay, let me guess — life feels like a lot right now. You’re overwhelmed, drained, and stuck in patterns that just aren’t working anymore. Maybe you’re questioning your relationships, struggling at work, or wondering why you feel so disconnected. That glass of whiskey, wine, or weed isn’t helping like it used to. With nearly 20 years of experience, I use Accelerated Resolution Therapy (ART) and Internal Family Systems (IFS) to help you process difficult emotions, release what’s weighing you down, and reconnect with yourself. Together, we’ll create a path toward feeling more grounded and at peace.
(267) 550-5130 View (267) 550-5130
Photo of Dr. Dean Leav - Psychological Testing & Evaluations - Dr. Dean, Psychologist, PsyD, QME, Author
Psychological Testing & Evaluations - Dr. Dean
Psychologist, PsyD, QME, Author
Philadelphia, PA 19104
I’m Dr. Dean Leav. I've been featured on ABC, NBC, KCAL, and other programs as an expert psychologist. I conduct ADHD / autism / learning disability evaluations, legal / forensic evaluations for court, risk assessment (violence / sexual), cognitive / neuropsychological evaluations, diagnostic psychological evaluations, immigration evaluations, adoption evaluations, parenting / bonding assessments, drug & alcohol evaluations, fitness for duty evaluations, workers' compensation (QME/AME) evaluations, and other types of psychological evaluations / assessments.
I’m Dr. Dean Leav. I've been featured on ABC, NBC, KCAL, and other programs as an expert psychologist. I conduct ADHD / autism / learning disability evaluations, legal / forensic evaluations for court, risk assessment (violence / sexual), cognitive / neuropsychological evaluations, diagnostic psychological evaluations, immigration evaluations, adoption evaluations, parenting / bonding assessments, drug & alcohol evaluations, fitness for duty evaluations, workers' compensation (QME/AME) evaluations, and other types of psychological evaluations / assessments.
(267) 310-0898 View (267) 310-0898
Photo of Katharine M Berg, Clinical Social Work/Therapist, LCSW
Katharine M Berg
Clinical Social Work/Therapist, LCSW
Philadelphia, PA 19102
As a seasoned therapist I am deeply committed to my clients and to the therapeutic process. My clients can expect that I will hold the space of our sessions for safe exploration of issues that might otherwise feel overwhelming. Together we will be co-creating what the process of your individual journey looks like. I will bring warmth, radical acceptance, creativity, curiosity, safety and even humor to the work and I will help you do the same. We will seek out your truth, how to face it, and how to make changes in your life accordingly. I believe in bringing secrets into the light and bringing self love to your healing.
As a seasoned therapist I am deeply committed to my clients and to the therapeutic process. My clients can expect that I will hold the space of our sessions for safe exploration of issues that might otherwise feel overwhelming. Together we will be co-creating what the process of your individual journey looks like. I will bring warmth, radical acceptance, creativity, curiosity, safety and even humor to the work and I will help you do the same. We will seek out your truth, how to face it, and how to make changes in your life accordingly. I believe in bringing secrets into the light and bringing self love to your healing.
(267) 460-0162 View (267) 460-0162
Photo of Hanalei Berg, Clinical Social Work/Therapist, LCSW
Hanalei Berg
Clinical Social Work/Therapist, LCSW
2 Endorsed
Online Only
Not accepting new clients
Do emotions hit you like a tidal wave? Are you often stuck between feeling like you’re “too much” and “not enough”? Maybe you’re struggling to understand who you are or feel numb and disconnected from the world around you. Despite your best attempts at supporting yourself, are you still feeling stuck, anxious, and lonely? I can help you move towards a more peaceful life. I enjoy helping people who are seeking a cohesive and empowered sense of self, especially those who have complex emotions, identity challenges, and lingering effects of trauma. I have an affinity for working with neurodivergent and LGBTQ+ individuals.
Do emotions hit you like a tidal wave? Are you often stuck between feeling like you’re “too much” and “not enough”? Maybe you’re struggling to understand who you are or feel numb and disconnected from the world around you. Despite your best attempts at supporting yourself, are you still feeling stuck, anxious, and lonely? I can help you move towards a more peaceful life. I enjoy helping people who are seeking a cohesive and empowered sense of self, especially those who have complex emotions, identity challenges, and lingering effects of trauma. I have an affinity for working with neurodivergent and LGBTQ+ individuals.
(215) 774-2260 View (215) 774-2260
Photo of Elaine R Axelrod, Psychologist, PhD
Elaine R Axelrod
Psychologist, PhD
Philadelphia, PA 19103
Effective treatment allows you to live more fully, more freely, with greater joy and spiritual connection. Thirty years of a successful psychotherapy practice in addition to 20 years of spiritual studies creates a powerful set of skills. My work blends a psychodynamic orientation and spiritual awareness to help clients move from pain, confusion, anxiety, and depression into truth,clarity,healing, and heightened energy. In a respectful and open-hearted environment we will examine the triggers and habitual patterns which impede you. Then work towards unlocking them and create new ways of being.
Effective treatment allows you to live more fully, more freely, with greater joy and spiritual connection. Thirty years of a successful psychotherapy practice in addition to 20 years of spiritual studies creates a powerful set of skills. My work blends a psychodynamic orientation and spiritual awareness to help clients move from pain, confusion, anxiety, and depression into truth,clarity,healing, and heightened energy. In a respectful and open-hearted environment we will examine the triggers and habitual patterns which impede you. Then work towards unlocking them and create new ways of being.
(215) 995-0203 View (215) 995-0203
Photo of Farrell Silverberg, Psychologist, PhD, NCPsyA
Farrell Silverberg
Psychologist, PhD, NCPsyA
Online Only
I work with good-hearted people on improving their professional and personal lives, and resolving problems in living.
I work with good-hearted people on improving their professional and personal lives, and resolving problems in living.
(267) 214-6865 View (267) 214-6865
Photo of Jessica Cydnee Feldman, Clinical Social Work/Therapist, MSS, LCSW
Jessica Cydnee Feldman
Clinical Social Work/Therapist, MSS, LCSW
Philadelphia, PA 19118
Therapy and the treatment of anxiety is challenging and ultimately highly rewarding work when clients receive relief from their symptoms. I value the balance of the interpersonal and relational components of the therapeutic relationship with the development of practical and evidence- based skills to achieve long lasting symptom reduction.
Therapy and the treatment of anxiety is challenging and ultimately highly rewarding work when clients receive relief from their symptoms. I value the balance of the interpersonal and relational components of the therapeutic relationship with the development of practical and evidence- based skills to achieve long lasting symptom reduction.
(215) 709-7662 View (215) 709-7662
Photo of Linda Case, Licensed Professional Counselor, LPC
Linda Case
Licensed Professional Counselor, LPC
Online Only
Are you struggling with stress that fuels anxiety, depression, or relationship conflicts? I understand how overwhelming these challenges can be, and I’m here to help. I offer a warm, safe space where you can explore your inner world, uncover limiting beliefs, and build new habits that empower you to live your best life. I integrate counseling, neuroscience, and epigenetics with mindfulness-based Cognitive Behavioral Therapy (CBT), Energy Psychology (Psych-K), RTT Hypnosis, and Psychodynamic Therapy. In our sessions, you’ll gain practical tools, renewed hope, and clarity for lasting change.
Are you struggling with stress that fuels anxiety, depression, or relationship conflicts? I understand how overwhelming these challenges can be, and I’m here to help. I offer a warm, safe space where you can explore your inner world, uncover limiting beliefs, and build new habits that empower you to live your best life. I integrate counseling, neuroscience, and epigenetics with mindfulness-based Cognitive Behavioral Therapy (CBT), Energy Psychology (Psych-K), RTT Hypnosis, and Psychodynamic Therapy. In our sessions, you’ll gain practical tools, renewed hope, and clarity for lasting change.
(267) 592-6957 View (267) 592-6957
Photo of Mike Molloy, Clinical Social Work/Therapist, LCSW
Mike Molloy
Clinical Social Work/Therapist, LCSW
Philadelphia, PA 19103
I am currently accepting new clients for therapy, parent coaching, and ADHD coaching. If you think we might be a good fit, please reach out for a free consultation. I see folks for therapy in-person and virtually in Pennsylvania, New Jersey, and Colorado as well as for ADHD coaching/therapy virtually and in-person in those same states through the Center for ADHD. I am also a Good Inside trained parent coach and work with parents throughout the country.
I am currently accepting new clients for therapy, parent coaching, and ADHD coaching. If you think we might be a good fit, please reach out for a free consultation. I see folks for therapy in-person and virtually in Pennsylvania, New Jersey, and Colorado as well as for ADHD coaching/therapy virtually and in-person in those same states through the Center for ADHD. I am also a Good Inside trained parent coach and work with parents throughout the country.
(215) 593-2617 View (215) 593-2617
Photo of Haley Faragher, Licensed Professional Counselor, LPC, MS
Haley Faragher
Licensed Professional Counselor, LPC, MS
Online Only
Hi there! Are you looking to start your therapeutic journey? It can feel scary and out of our comfort zones to ask for help, but I commend you for doing so. I strive to make therapy a safe space where you feel supported to learn about yourself and grow/heal in any way you find necessary. I approach the counseling relationship from a warm, empathetic, non-judgmental, and compassionate viewpoint. I understand that trauma impacts us all differently, therefore I am mindful to operate through a trauma-informed lens as we all come from different walks of life with different worldviews & experiences.
Hi there! Are you looking to start your therapeutic journey? It can feel scary and out of our comfort zones to ask for help, but I commend you for doing so. I strive to make therapy a safe space where you feel supported to learn about yourself and grow/heal in any way you find necessary. I approach the counseling relationship from a warm, empathetic, non-judgmental, and compassionate viewpoint. I understand that trauma impacts us all differently, therefore I am mindful to operate through a trauma-informed lens as we all come from different walks of life with different worldviews & experiences.
(267) 493-1425 View (267) 493-1425
Photo of Jerome Griffin, Clinical Social Work/Therapist, LCSW
Jerome Griffin
Clinical Social Work/Therapist, LCSW
Online Only
I’m a licensed clinical social worker dedicated to helping individuals navigate anxiety, trauma, and life transitions through a supportive, collaborative, and evidence-based approach. I provide therapy that blends compassion with practical tools—drawing from modalities like CBT, narrative therapy, and psychodynamic insight—to help clients understand themselves, heal from the past, and build more fulfilling lives. My goal is to create a safe space where you can be heard, challenged, and empowered.
I’m a licensed clinical social worker dedicated to helping individuals navigate anxiety, trauma, and life transitions through a supportive, collaborative, and evidence-based approach. I provide therapy that blends compassion with practical tools—drawing from modalities like CBT, narrative therapy, and psychodynamic insight—to help clients understand themselves, heal from the past, and build more fulfilling lives. My goal is to create a safe space where you can be heard, challenged, and empowered.
(484) 623-6746 View (484) 623-6746
Photo of Jill Reed, Clinical Social Work/Therapist, LCSW
Jill Reed
Clinical Social Work/Therapist, LCSW
Online Only
Are you struggling with anxiety, overthinking, or a general sense of being overwhelmed? Perhaps you’re looking for a space to gain clarity, or you simply feel stuck without knowing why. I help clients identify thought and behavior patterns, develop practical coping strategies, and find lasting relief.
Are you struggling with anxiety, overthinking, or a general sense of being overwhelmed? Perhaps you’re looking for a space to gain clarity, or you simply feel stuck without knowing why. I help clients identify thought and behavior patterns, develop practical coping strategies, and find lasting relief.
(267) 680-7217 View (267) 680-7217
Photo of Corinna Rosen, Clinical Social Work/Therapist, MSW, LCSW
Corinna Rosen
Clinical Social Work/Therapist, MSW, LCSW
3 Endorsed
Online Only
Not accepting new clients
I seek to create a space where people can express themselves as freely as possible. I offer deep listening and thoughtful collaboration to help bring curiosity and compassion into areas where you find yourself seeking, struggling, or stuck. Through exploring your inner and outer worlds within a trusted relationship, you can more deeply understand what your feelings are communicating to you, begin untangling outdated patterns, and work toward unearthing a greater sense of possibility and aliveness.
I seek to create a space where people can express themselves as freely as possible. I offer deep listening and thoughtful collaboration to help bring curiosity and compassion into areas where you find yourself seeking, struggling, or stuck. Through exploring your inner and outer worlds within a trusted relationship, you can more deeply understand what your feelings are communicating to you, begin untangling outdated patterns, and work toward unearthing a greater sense of possibility and aliveness.
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Photo of Rachel Lee-Nigsch - Elm Counseling Treatment Center, Clinical Social Work/Therapist, LCSW
Elm Counseling Treatment Center
Clinical Social Work/Therapist, LCSW
1 Endorsed
Online Only
I’m here to support you in achieving your personal goals, whether they involve enhancing your emotional well-being, improving relationships, or addressing sexual and reproductive health concerns. My focus is on helping you manage and alleviate symptoms of depression, anxiety, and stress by developing effective coping strategies tailored to your needs. If you’re looking to strengthen relationships, explore sexual fulfillment, or navigate the emotional challenges of infertility, I’m committed to guiding you through these journeys. Together, we’ll work to make informed decisions and find the best path forward based on your unique goal
I’m here to support you in achieving your personal goals, whether they involve enhancing your emotional well-being, improving relationships, or addressing sexual and reproductive health concerns. My focus is on helping you manage and alleviate symptoms of depression, anxiety, and stress by developing effective coping strategies tailored to your needs. If you’re looking to strengthen relationships, explore sexual fulfillment, or navigate the emotional challenges of infertility, I’m committed to guiding you through these journeys. Together, we’ll work to make informed decisions and find the best path forward based on your unique goal
(610) 904-3740 View (610) 904-3740
Photo of Algernon Baker, Marriage & Family Therapist, PhD, LMFT
Algernon Baker
Marriage & Family Therapist, PhD, LMFT
2 Endorsed
Philadelphia, PA 19146
Has there been an affair? Do you replay the details over and over, trying to make sense of how it happened? You want to move on, but something inside you keeps circling back—to the shock, the anger, the loss of trust. One moment, you want to rebuild; the next, you want to run. You may even find yourself questioning everything you thought you knew about your partner—and about yourself. Despite what’s happened, you don’t want to throw away everything you’ve built together.
Has there been an affair? Do you replay the details over and over, trying to make sense of how it happened? You want to move on, but something inside you keeps circling back—to the shock, the anger, the loss of trust. One moment, you want to rebuild; the next, you want to run. You may even find yourself questioning everything you thought you knew about your partner—and about yourself. Despite what’s happened, you don’t want to throw away everything you’ve built together.
(215) 791-8636 View (215) 791-8636

See more therapy options for Philadelphia

How does your Therapist compare?

Number of Therapists in Philadelphia, PA

3,000+

Average cost per session

$149

Therapists in Philadelphia, PA who prioritize treating:

92% Anxiety
85% Depression
70% Self Esteem
69% Trauma and PTSD
67% Relationship Issues
63% Coping Skills
63% Life Transitions

Average years in practice

11 Years

Top 3 insurances accepted

84% Aetna
68% Cigna and Evernorth
58% Highmark

How Therapists in Philadelphia, PA see their clients

54% Online Only
46% In Person and Online

Gender breakdown

77% Female
19% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Philadelphia?

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.