Therapists in Pittsburgh, PA

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Photo of Jeff Johnston, Licensed Professional Counselor, LPC, MSEd
Jeff Johnston
Licensed Professional Counselor, LPC, MSEd
3 Endorsed
Online Only
Hi there! I'm looking for clients to encourage and support in becoming their best selves! I want to help YOU invest in YOU! No issues are too big or too small. Clients from all walks of life are welcome to reach out! I'm excited to work with you to find the answer to your questions such as: "How can I be happy?" How do I stop suffering?" "Where do I go from here?"
Hi there! I'm looking for clients to encourage and support in becoming their best selves! I want to help YOU invest in YOU! No issues are too big or too small. Clients from all walks of life are welcome to reach out! I'm excited to work with you to find the answer to your questions such as: "How can I be happy?" How do I stop suffering?" "Where do I go from here?"
(412) 604-7989 View (412) 604-7989
Photo of Stephen A Luther - Grace Christian Counseling, Licensed Professional Counselor, MSEd, MEd, LPC
Grace Christian Counseling
Licensed Professional Counselor, MSEd, MEd, LPC
Pittsburgh, PA 15235
Our ideal clients are adults and couples who long for counseling that respects both their heart and their faith. They often arrive feeling anxious, depressed, overwhelmed by grief, stuck in painful relationships, or spiritually weary. Life’s challenges have left them searching for real hope and lasting change. At Grace Christian Counseling we offer a gentle, judgment-free space where you feel truly seen and safe. We walk with you at your own pace, blending proven therapeutic tools with the comforting truth of Scripture. Together we gently process pain, strengthen relationships, rebuild resilience, and help you step into the peace.
Our ideal clients are adults and couples who long for counseling that respects both their heart and their faith. They often arrive feeling anxious, depressed, overwhelmed by grief, stuck in painful relationships, or spiritually weary. Life’s challenges have left them searching for real hope and lasting change. At Grace Christian Counseling we offer a gentle, judgment-free space where you feel truly seen and safe. We walk with you at your own pace, blending proven therapeutic tools with the comforting truth of Scripture. Together we gently process pain, strengthen relationships, rebuild resilience, and help you step into the peace.
(724) 906-4319 View (724) 906-4319
Photo of Debbie Witchel, Licensed Professional Counselor, MA, NCC, LPC
Debbie Witchel
Licensed Professional Counselor, MA, NCC, LPC
2 Endorsed
Pittsburgh, PA 15238
Not accepting new clients
Does the thought of starting a new day seem overwhelming? Do you dread interacting with others due to anxiety/depression? Are you unhappy with/or feel stuck in your relationships? Do you struggle with setting boundaries and people pleasing? Are you grieving the loss of a loved one? I listen, I care and I want to help. I can assist you to heal and lead a happier life. I believe in connecting with you as a person, the significance of identifying and releasing unexpressed feelings and changing unhealthy life themes. I am also trained in co-parenting (including court-ordered) for couples experiencing a divorce.
Does the thought of starting a new day seem overwhelming? Do you dread interacting with others due to anxiety/depression? Are you unhappy with/or feel stuck in your relationships? Do you struggle with setting boundaries and people pleasing? Are you grieving the loss of a loved one? I listen, I care and I want to help. I can assist you to heal and lead a happier life. I believe in connecting with you as a person, the significance of identifying and releasing unexpressed feelings and changing unhealthy life themes. I am also trained in co-parenting (including court-ordered) for couples experiencing a divorce.
(412) 252-2450 View (412) 252-2450
Photo of Alissa Klugh, Licensed Professional Counselor, MS, LPC, CIMHP, CCTP-II, CTMH
Alissa Klugh
Licensed Professional Counselor, MS, LPC, CIMHP, CCTP-II, CTMH
Online Only
If you find yourself constantly on edge, replaying conversations, or bracing for the next let‑down — you’re not alone. Many of my clients come to me because they’re: Stuck in people‑pleasing or over‑giving, quick to shut down or “go numb” when emotions run high, battling an inner critic that never lets up, struggling to set/keep healthy boundaries, and feeling torn between craving closeness and fearing it. I can assist in untangling these survival patterns by practicing simple tools to calm an overwhelmed nervous system, turn down the volume on self‑doubt, and build the kind of relationships where you can breathe and speak up.
If you find yourself constantly on edge, replaying conversations, or bracing for the next let‑down — you’re not alone. Many of my clients come to me because they’re: Stuck in people‑pleasing or over‑giving, quick to shut down or “go numb” when emotions run high, battling an inner critic that never lets up, struggling to set/keep healthy boundaries, and feeling torn between craving closeness and fearing it. I can assist in untangling these survival patterns by practicing simple tools to calm an overwhelmed nervous system, turn down the volume on self‑doubt, and build the kind of relationships where you can breathe and speak up.
(878) 444-2916 View (878) 444-2916
Photo of Christina Maria Sauers, Licensed Professional Counselor, LPC, NCC, MS, MA
Christina Maria Sauers
Licensed Professional Counselor, LPC, NCC, MS, MA
Pittsburgh, PA 15228
Trauma can affect us in ways we are not always aware of. Healing can help us in ways we never knew were possible. I am an EMDR Approved Consultant and EMDR certified therapist. I provide EMDR intensive therapy (only). EMDR intensives offer a unique and effective approach to therapy which promotes accelerated healing, reduction in mental health symptoms, and improved mental health outcomes. EMDR intensives are structured, research based, and work really well for people who cannot make a weekly commitment to the therapy process.
Trauma can affect us in ways we are not always aware of. Healing can help us in ways we never knew were possible. I am an EMDR Approved Consultant and EMDR certified therapist. I provide EMDR intensive therapy (only). EMDR intensives offer a unique and effective approach to therapy which promotes accelerated healing, reduction in mental health symptoms, and improved mental health outcomes. EMDR intensives are structured, research based, and work really well for people who cannot make a weekly commitment to the therapy process.
(878) 205-0108 View (878) 205-0108
Photo of Avory Billman, Clinical Social Work/Therapist, LCSW, CCTP-II
Avory Billman
Clinical Social Work/Therapist, LCSW, CCTP-II
4 Endorsed
Pittsburgh, PA 15232
My focus includes trauma-informed therapy for LGBTQIA+ and neurodivergent individuals. I predominantly work with adolescents and young adults. I utilize evidence-based, affirming practices to support my clients in processing trauma, regulating mood instability, improving relationships, coping with life transitions, and building confidence in themselves. For folx that may benefit from something a bit different than traditional talk therapy, I like to incorporate a variety of activities to support the therapeutic process. This can include walk and talk or outdoor therapy, art, play, and EMDR.
My focus includes trauma-informed therapy for LGBTQIA+ and neurodivergent individuals. I predominantly work with adolescents and young adults. I utilize evidence-based, affirming practices to support my clients in processing trauma, regulating mood instability, improving relationships, coping with life transitions, and building confidence in themselves. For folx that may benefit from something a bit different than traditional talk therapy, I like to incorporate a variety of activities to support the therapeutic process. This can include walk and talk or outdoor therapy, art, play, and EMDR.
(412) 790-2758 View (412) 790-2758
Photo of Mrigaya Sinha, Psychologist, PhD
Mrigaya Sinha
Psychologist, PhD
1 Endorsed
Pittsburgh, PA 15241
We do the best we can for our lives, however, old and new trauma and life challenges may hold us back and create suffering. I have worked extensively with adults facing anxiety, depression, grief, trauma, chronic pain, interpersonal issues and learnt that when people are given a safe environment to process their emotions, and held in compassion, there can be tremendous healing and big transformations. So no matter at what pace you want to go, this journey of healing and growth should not be a lonely one and I hope to be a part of your journey in your healing.
We do the best we can for our lives, however, old and new trauma and life challenges may hold us back and create suffering. I have worked extensively with adults facing anxiety, depression, grief, trauma, chronic pain, interpersonal issues and learnt that when people are given a safe environment to process their emotions, and held in compassion, there can be tremendous healing and big transformations. So no matter at what pace you want to go, this journey of healing and growth should not be a lonely one and I hope to be a part of your journey in your healing.
(412) 460-4148 x688 View (412) 460-4148 x688
Photo of Graciela Yue Yang Gimpel, Pre-Licensed Professional, MA, LPCC, LAPC
Graciela Yue Yang Gimpel
Pre-Licensed Professional, MA, LPCC, LAPC
4 Endorsed
Pittsburgh, PA 15228
Life is full of change and uncertainty, which can feel overwhelming and isolating. Therapy is a brave step, and just by being here, you’re already showing strength. My role as a therapist is to support you like training wheels on a bike, offering safety and guidance until you’re ready to navigate life’s ups and downs on your own. My goal is to create a safe, authentic space where you can explore your emotions, express yourself freely, and begin to heal from past experiences.
Life is full of change and uncertainty, which can feel overwhelming and isolating. Therapy is a brave step, and just by being here, you’re already showing strength. My role as a therapist is to support you like training wheels on a bike, offering safety and guidance until you’re ready to navigate life’s ups and downs on your own. My goal is to create a safe, authentic space where you can explore your emotions, express yourself freely, and begin to heal from past experiences.
(412) 990-2091 View (412) 990-2091
Photo of Kourtney Wofford, Clinical Social Work/Therapist, LCSW
Kourtney Wofford
Clinical Social Work/Therapist, LCSW
Pittsburgh, PA 15213
Kourtney Wofford, LCSW, is a compassionate and experienced therapist at LifeStance Health who offers individual therapy, couples therapy, and group therapy to a diverse range of clients in Pennsylvania. She specializes in treating anxiety, depression, ADHD, substance use, and PTSD/trauma. Kourtney is dedicated to helping clients navigate life’s challenges, offering a supportive and empathetic environment where individuals can work toward emotional healing and personal growth. Kourtney is passionate about treating individuals experiencing ADHD, anxiety, and substance use issues.
Kourtney Wofford, LCSW, is a compassionate and experienced therapist at LifeStance Health who offers individual therapy, couples therapy, and group therapy to a diverse range of clients in Pennsylvania. She specializes in treating anxiety, depression, ADHD, substance use, and PTSD/trauma. Kourtney is dedicated to helping clients navigate life’s challenges, offering a supportive and empathetic environment where individuals can work toward emotional healing and personal growth. Kourtney is passionate about treating individuals experiencing ADHD, anxiety, and substance use issues.
(412) 754-4573 View (412) 754-4573
Photo of Andrew Nocita, Licensed Professional Counselor, LP
Andrew Nocita
Licensed Professional Counselor, LP
Online Only
I take a holistic perspective with my clients to address the health of body, mind, and spirit. I believe that a solid therapeutic relationship between client and therapist is a crucial part of the healing process, and that techniques and therapy approaches must “fit” the client in order to be effective—there is no “one size fits all” therapy. My goal, as a counselor and therapist, is to deeply understand my client, and when this happens we are able to identify areas of life that need to be changed, and ways of going about doing that. Therapy is a collaborative process between a trained therapist and a client who wants to change.
I take a holistic perspective with my clients to address the health of body, mind, and spirit. I believe that a solid therapeutic relationship between client and therapist is a crucial part of the healing process, and that techniques and therapy approaches must “fit” the client in order to be effective—there is no “one size fits all” therapy. My goal, as a counselor and therapist, is to deeply understand my client, and when this happens we are able to identify areas of life that need to be changed, and ways of going about doing that. Therapy is a collaborative process between a trained therapist and a client who wants to change.
(412) 837-8928 View (412) 837-8928
Photo of Lu Farley, Pre-Licensed Professional, MSW
Lu Farley
Pre-Licensed Professional, MSW
Pittsburgh, PA 15219
Therapy should be a space where you can find empathy and gently challenge areas of your life that distress you. My goal as a therapist is to support you in exploring your desires, needs, and identities in order for you to live with authenticity. I work with individuals seeking to explore what is preventing you from finding comfort and safety in your everyday life. I aim to find strengths in your struggles and guide you towards a deeper understanding of who you are. Some areas I am passionate about include: trauma, suicidality/self-harm, navigating identities, dismantling shame, and navigating the world with neurodivergence.
Therapy should be a space where you can find empathy and gently challenge areas of your life that distress you. My goal as a therapist is to support you in exploring your desires, needs, and identities in order for you to live with authenticity. I work with individuals seeking to explore what is preventing you from finding comfort and safety in your everyday life. I aim to find strengths in your struggles and guide you towards a deeper understanding of who you are. Some areas I am passionate about include: trauma, suicidality/self-harm, navigating identities, dismantling shame, and navigating the world with neurodivergence.
(412) 754-3893 View (412) 754-3893
Photo of Claire Thomas, Clinical Social Work/Therapist, MSW, LCSW
Claire Thomas
Clinical Social Work/Therapist, MSW, LCSW
7 Endorsed
Pittsburgh, PA 15202
I work with individuals in PA and MI seeking a compassionate space for introspection and healing. You may feel overwhelmed by life’s challenges or past experiences, but you also bring unique perspectives and strengths. My approach honors your individuality, helping you uncover insights and foster meaningful growth along your journey.
I work with individuals in PA and MI seeking a compassionate space for introspection and healing. You may feel overwhelmed by life’s challenges or past experiences, but you also bring unique perspectives and strengths. My approach honors your individuality, helping you uncover insights and foster meaningful growth along your journey.
(412) 301-7224 View (412) 301-7224
Photo of Adam Friedlander - Head & Heart Counseling, Licensed Professional Counselor, LPC, NCC
Head & Heart Counseling
Licensed Professional Counselor, LPC, NCC
1 Endorsed
Pittsburgh, PA 15228
Don't struggle alone. Together we'll move toward your goal, whether it's dealing with an overwhelming situation, repairing or improving a relationship, managing stress and anxiety, overcoming trauma or depression, living a fulfilling life, or even just being heard and understood.
Don't struggle alone. Together we'll move toward your goal, whether it's dealing with an overwhelming situation, repairing or improving a relationship, managing stress and anxiety, overcoming trauma or depression, living a fulfilling life, or even just being heard and understood.
(878) 206-0181 View (878) 206-0181
Photo of Madeline Morse, Licensed Social Worker, LSW
Madeline Morse
Licensed Social Worker, LSW
Pittsburgh, PA 15236
I work with children, teens, and adults navigating anxiety, trauma, PTSD, women’s issues, and life transitions, often with a focus on interpersonal relationships. Many clients come in feeling stuck, overwhelmed, or disconnected. As a veteran, I also offer a uniquely validating experience for those connected to military life. Together, we build insight, strengthen relationships, and create meaningful, sustainable change.
I work with children, teens, and adults navigating anxiety, trauma, PTSD, women’s issues, and life transitions, often with a focus on interpersonal relationships. Many clients come in feeling stuck, overwhelmed, or disconnected. As a veteran, I also offer a uniquely validating experience for those connected to military life. Together, we build insight, strengthen relationships, and create meaningful, sustainable change.
(412) 347-7461 View (412) 347-7461
Photo of Elizabeth Hufford - Elizabeth Hufford | Makin Wellness Online Therapy, Licensed Professional Counselor, LPC
Elizabeth Hufford | Makin Wellness Online Therapy
Licensed Professional Counselor, LPC
2 Endorsed
Online Only
If you’ve been feeling overwhelmed, stuck in old patterns, or unsure how to manage big emotions, you’re not alone. You don’t have to figure it all out on your own. I work with children, adolescents, and adults navigating anxiety, depression, trauma, defiance, stress, and more. Whether you’re seeking support for yourself or your child, I provide practical, compassionate care that’s focused on helping you build insight, learn new skills, and create lasting change.
If you’ve been feeling overwhelmed, stuck in old patterns, or unsure how to manage big emotions, you’re not alone. You don’t have to figure it all out on your own. I work with children, adolescents, and adults navigating anxiety, depression, trauma, defiance, stress, and more. Whether you’re seeking support for yourself or your child, I provide practical, compassionate care that’s focused on helping you build insight, learn new skills, and create lasting change.
(412) 981-2066 View (412) 981-2066
Photo of Autumn Walsh - Elements Counseling and Wellness Spa , Licensed Social Worker, MSW, LSW, CCTS
Elements Counseling and Wellness Spa
Licensed Social Worker, MSW, LSW, CCTS
2 Endorsed
Pittsburgh, PA 15221
Pittsburgh's ONLY Holistic Mental Health Center and Day Spa! Elements offers the most demanded, most reputable wellness fusion in Pittsburgh: Expert psychotherapy paired with an affordable day spa. Stress and trauma live in your BODY. At Elements, you can heal your mind, body, and spirit in one location. Experience total well-being in Pittsburgh's premier sanctuary. Providing inclusive care and creating safe spaces, your journey to complete healing starts here
Pittsburgh's ONLY Holistic Mental Health Center and Day Spa! Elements offers the most demanded, most reputable wellness fusion in Pittsburgh: Expert psychotherapy paired with an affordable day spa. Stress and trauma live in your BODY. At Elements, you can heal your mind, body, and spirit in one location. Experience total well-being in Pittsburgh's premier sanctuary. Providing inclusive care and creating safe spaces, your journey to complete healing starts here
(412) 797-5535 View (412) 797-5535
Photo of Jodi Lynn Buzzell, Licensed Professional Counselor, LPC
Jodi Lynn Buzzell
Licensed Professional Counselor, LPC
1 Endorsed
Pittsburgh, PA 15239
Life challenges can be overwhelming and stressful. Individuals, families and couples can be effected by these issues . If you are feeling anxious, depressed or suffering from emotional or substance uses issues, experiencing family or relationship conflicts, let my years of experience working with children, adults, families and couples, assist. My approach for families and couples, is exploring patterns in relationship dynamics, providing insight and improving communication . I have worked with adults and children to develop coping skills to manage emotional issues. Therapy is client centered, strength based and the goal is to empower and reach full potential.
Life challenges can be overwhelming and stressful. Individuals, families and couples can be effected by these issues . If you are feeling anxious, depressed or suffering from emotional or substance uses issues, experiencing family or relationship conflicts, let my years of experience working with children, adults, families and couples, assist. My approach for families and couples, is exploring patterns in relationship dynamics, providing insight and improving communication . I have worked with adults and children to develop coping skills to manage emotional issues. Therapy is client centered, strength based and the goal is to empower and reach full potential.
(724) 216-6773 View (724) 216-6773
Photo of Ellen Freise-March, Licensed Professional Counselor, MSCP, LPC, NCC, CCTP
Ellen Freise-March
Licensed Professional Counselor, MSCP, LPC, NCC, CCTP
3 Endorsed
Pittsburgh, PA 15238
Not accepting new clients
The focus of my counseling is to provide support and help for individuals of all ages to discover their strengths as they work through life's challenges. My clinical experience and training enable me to provide palliative and hospice support counseling to individuals who are currently aggressively treating their life-threatening illness or those individuals who have transitioned to hospice care.
The focus of my counseling is to provide support and help for individuals of all ages to discover their strengths as they work through life's challenges. My clinical experience and training enable me to provide palliative and hospice support counseling to individuals who are currently aggressively treating their life-threatening illness or those individuals who have transitioned to hospice care.
(412) 847-5007 View (412) 847-5007
Photo of Ryan Sabolcik, Associate Professional Counselor, MS Ed
Ryan Sabolcik
Associate Professional Counselor, MS Ed
Online Only
If you have experienced sexual violence in the state of PA, ask me about ways to help cover costs for counseling. I use a relational framework influenced by existential approaches that helps clients make meaning of their experiences as they navigate through life. My clinical experience includes sexual trauma, religious trauma, crisis management, community mental health, men's issues including the navigation of traditional masculinity and conflict resolution, substance abuse, and OCD.
If you have experienced sexual violence in the state of PA, ask me about ways to help cover costs for counseling. I use a relational framework influenced by existential approaches that helps clients make meaning of their experiences as they navigate through life. My clinical experience includes sexual trauma, religious trauma, crisis management, community mental health, men's issues including the navigation of traditional masculinity and conflict resolution, substance abuse, and OCD.
(412) 213-6778 View (412) 213-6778
Photo of Ashley Linton, Licensed Professional Counselor, MS, LPC, NCC
Ashley Linton
Licensed Professional Counselor, MS, LPC, NCC
Online Only
My passion is to support those who are struggling with stress, anxiety and mood concerns. I recognize that many times negative emotions can get in the way of personal happiness, cause problems among families and peers, and hinder school or work performance.
My passion is to support those who are struggling with stress, anxiety and mood concerns. I recognize that many times negative emotions can get in the way of personal happiness, cause problems among families and peers, and hinder school or work performance.
(412) 413-9832 View (412) 413-9832

See more therapy options for Pittsburgh

How does your Therapist compare?

Number of Therapists in Pittsburgh, PA

2,000+

Average cost per session

$130

Therapists in Pittsburgh, PA who prioritize treating:

92% Anxiety
85% Depression
72% Self Esteem
67% Relationship Issues
67% Trauma and PTSD
62% Stress
59% Grief

Average years in practice

11 Years

Top 3 insurances accepted

81% Aetna
81% Highmark
66% Cigna and Evernorth

How Therapists in Pittsburgh, PA see their clients

57% In Person and Online
43% Online Only

Gender breakdown

76% Female
20% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Pittsburgh?

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.