Therapists in Pittsburgh, PA

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Photo of Avory Billman, Clinical Social Work/Therapist, LCSW
Avory Billman
Clinical Social Work/Therapist, LCSW
2 Endorsed
Pittsburgh, PA 15232
My focus includes trauma-informed therapy for LGBTQIA+ and neurodivergent individuals. I primarily 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, or play.
My focus includes trauma-informed therapy for LGBTQIA+ and neurodivergent individuals. I primarily 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, or play.
(412) 790-2758 View (412) 790-2758
Photo of Erin Fox, Licensed Professional Counselor, MA, LPC
Erin Fox
Licensed Professional Counselor, MA, LPC
Pittsburgh, PA 15203
Are you facing challenges like anxiety, depression, life transitions, or identity issues? Are you seeking a safe, nonjudgmental space, craving validation, understanding, and guidance? You may be open to self-exploration, aiming for personal growth, seeking insights, coping strategies, and resilience. My ideal client values seeking support and actively participates in therapy. Motivated to improve their lives and relationships, they seek empowerment and self-discovery in therapy.
Are you facing challenges like anxiety, depression, life transitions, or identity issues? Are you seeking a safe, nonjudgmental space, craving validation, understanding, and guidance? You may be open to self-exploration, aiming for personal growth, seeking insights, coping strategies, and resilience. My ideal client values seeking support and actively participates in therapy. Motivated to improve their lives and relationships, they seek empowerment and self-discovery in therapy.
(412) 547-5319 View (412) 547-5319
Photo of Jasmine DeBeary, Clinical Social Work/Therapist, LCSW
Jasmine DeBeary
Clinical Social Work/Therapist, LCSW
Online Only
I look forward to three things: meeting you, supporting you on your mental health journey, and eventually helping you feel ready to move on from therapy. Know that I am fully committed to my role as your therapist and accountability partner. I specialize in addressing depression (including high-functioning), anxiety, grief, trauma, and intimate partner violence. If any of these challenges feel familiar to you or reflects your current experiences, I'm glad you're here and you certainly are not alone.
I look forward to three things: meeting you, supporting you on your mental health journey, and eventually helping you feel ready to move on from therapy. Know that I am fully committed to my role as your therapist and accountability partner. I specialize in addressing depression (including high-functioning), anxiety, grief, trauma, and intimate partner violence. If any of these challenges feel familiar to you or reflects your current experiences, I'm glad you're here and you certainly are not alone.
(484) 779-6811 View (484) 779-6811
Photo of Ashley Gallo - Fourth River Therapy, Clinical Social Work/Therapist, LCSW, CCDPD
Fourth River Therapy
Clinical Social Work/Therapist, LCSW, CCDPD
2 Endorsed
Pittsburgh, PA 15203
Fourth River Therapy is a group private practice founded and operated by experienced Licensed Clinical Social Workers and psychotherapists. Our mission is to provide quality, accessible, and personalized mental healthcare. Check out our website for more information!
Fourth River Therapy is a group private practice founded and operated by experienced Licensed Clinical Social Workers and psychotherapists. Our mission is to provide quality, accessible, and personalized mental healthcare. Check out our website for more information!
(412) 998-7281 View (412) 998-7281
Photo of Megan Palko, Licensed Professional Counselor, MA, ATR-BC, CCLS, LPC
Megan Palko
Licensed Professional Counselor, MA, ATR-BC, CCLS, LPC
Pittsburgh, PA 15209
Life changes and transitions can be difficult to experience, especially alone. As a Registered and Board Certified Art Therapist (ATR-BC), as well as a Licensed Professional Counselor (LPC), I will meet you where you are and sit with you in what you are experiencing. Together we can define your goals, discover your strengths, explore meaning and any possible resolutions.
Life changes and transitions can be difficult to experience, especially alone. As a Registered and Board Certified Art Therapist (ATR-BC), as well as a Licensed Professional Counselor (LPC), I will meet you where you are and sit with you in what you are experiencing. Together we can define your goals, discover your strengths, explore meaning and any possible resolutions.
(412) 538-6495 View (412) 538-6495
Photo of Kayla Gilman, Clinical Social Work/Therapist, LCSW
Kayla Gilman
Clinical Social Work/Therapist, LCSW
Online Only
Hi! I'm a Licensed Clinical Social Worker based in Michigan and Pennsylvania. I received my Masters from Wayne State University and have been practicing for 7 years. My approach to therapy relies on creating a safe environment to assist my clients in processing and healing from various aspects of their lives. I am passionate about assisting my clients in healing from trauma, building self-worth, improving communication in their relationships, and reaching their goals. As a clinician, I utilize a multidimensional approach to therapy, exploring everyone’s biological, psychological, social and spiritual needs. I am an interactive, fami
Hi! I'm a Licensed Clinical Social Worker based in Michigan and Pennsylvania. I received my Masters from Wayne State University and have been practicing for 7 years. My approach to therapy relies on creating a safe environment to assist my clients in processing and healing from various aspects of their lives. I am passionate about assisting my clients in healing from trauma, building self-worth, improving communication in their relationships, and reaching their goals. As a clinician, I utilize a multidimensional approach to therapy, exploring everyone’s biological, psychological, social and spiritual needs. I am an interactive, fami
(412) 797-6065 View (412) 797-6065
Photo of Angelica Victoria Daniele, Licensed Professional Counselor, MA, MS, NCC, E-RYT, LPC
Angelica Victoria Daniele
Licensed Professional Counselor, MA, MS, NCC, E-RYT, LPC
2 Endorsed
Pittsburgh, PA 15201
Nothing is inherently wrong with you. Your diagnosis (if any) is a temporary experience; it does not define you. You don’t NEED me, I’m just a guide. But, if something feels off; if your head is clouded; if your career, relationships, or health are stressful; if you’re sick and tired of being sick and tired; if you can’t comb through your options; if you feel stuck, unsure, or overwhelmed; if you can’t find relief… I’m here to help empower you. The power is in YOU. I’ll help you become so self-aware that you wholeheartedly trust your intuition enough to offer yourself the answers: no doubt, fear, or guilt.
Nothing is inherently wrong with you. Your diagnosis (if any) is a temporary experience; it does not define you. You don’t NEED me, I’m just a guide. But, if something feels off; if your head is clouded; if your career, relationships, or health are stressful; if you’re sick and tired of being sick and tired; if you can’t comb through your options; if you feel stuck, unsure, or overwhelmed; if you can’t find relief… I’m here to help empower you. The power is in YOU. I’ll help you become so self-aware that you wholeheartedly trust your intuition enough to offer yourself the answers: no doubt, fear, or guilt.
(412) 328-2680 View (412) 328-2680
Photo of Zoe Beard, Associate Professional Counselor, MA, LAPC
Zoe Beard
Associate Professional Counselor, MA, LAPC
Pittsburgh, PA 15232
I am passionate about helping children, teens, and adults gain practical skills to manage emotions effectively. I believe that building a strong therapeutic relationship is the first step in helping you achieve your goals. My hope is that you will find my warm and personable nature to be a comfort, and my knowledge of the most effective psychological techniques to be useful. When working with children, and often adolescents, I strive to have that working relationship with parents as well so that everyone feels informed, empowered, and at ease in my office. I am able to help with a variety of concerns related to mood or attention.
I am passionate about helping children, teens, and adults gain practical skills to manage emotions effectively. I believe that building a strong therapeutic relationship is the first step in helping you achieve your goals. My hope is that you will find my warm and personable nature to be a comfort, and my knowledge of the most effective psychological techniques to be useful. When working with children, and often adolescents, I strive to have that working relationship with parents as well so that everyone feels informed, empowered, and at ease in my office. I am able to help with a variety of concerns related to mood or attention.
(412) 275-4662 View (412) 275-4662
Photo of Danielle Cohen, Licensed Professional Counselor, LPC, NCC
Danielle Cohen
Licensed Professional Counselor, LPC, NCC
1 Endorsed
Online Only
Life can be stressful and I am here to offer you a space where you feel comfortable processing your emotions and learning to cope with the difficulties of everyday life. I have extensive training and experience working with teens and young adults suffering from depression and anxiety. I hope to help support and guide you through managing life's transitions, relationships and identity development. I believe a strong therapeutic relationship filled with trust and respect is the foundation of the work we will do together, and I am committed to always being open, honest and compassionate.
Life can be stressful and I am here to offer you a space where you feel comfortable processing your emotions and learning to cope with the difficulties of everyday life. I have extensive training and experience working with teens and young adults suffering from depression and anxiety. I hope to help support and guide you through managing life's transitions, relationships and identity development. I believe a strong therapeutic relationship filled with trust and respect is the foundation of the work we will do together, and I am committed to always being open, honest and compassionate.
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Photo of Michelle Sabino, Licensed Professional Counselor, MA, LPC
Michelle Sabino
Licensed Professional Counselor, MA, LPC
1 Endorsed
Pittsburgh, PA 15217
I have over 20 years of experience working with women who have problems with their moods and difficulty managing emotions. Formally trained in Dialectal Behavior Therapy, Cognitive Behavioral Therapy and Gestalt Therapy, I blend these approaches with warmth, compassion and a genuine desire to understand the experience of my clients, to help empower them to overcome personal obstacles and move forward to a happier, healthier life. I encourage being present in the moment without judgment of ourselves, others, or our circumstances. I tend to approach my work with enthusiasm and often a bit of humor.
I have over 20 years of experience working with women who have problems with their moods and difficulty managing emotions. Formally trained in Dialectal Behavior Therapy, Cognitive Behavioral Therapy and Gestalt Therapy, I blend these approaches with warmth, compassion and a genuine desire to understand the experience of my clients, to help empower them to overcome personal obstacles and move forward to a happier, healthier life. I encourage being present in the moment without judgment of ourselves, others, or our circumstances. I tend to approach my work with enthusiasm and often a bit of humor.
(412) 906-9296 View (412) 906-9296
Photo of Charles Cribben, Licensed Professional Counselor, LPC
Charles Cribben
Licensed Professional Counselor, LPC
1 Endorsed
Pittsburgh, PA 15241
I received my master’s degree from California University of Pennsylvania. I am a Licensed Professional Counselor that has spent my counseling career working with adolescents, children, adults, and families. I have worked in inpatient, outpatient, and family-based treatment settings. I have been able to incorporate life experience and my professional expertise to work with individuals and families. I have experience treating problematic interactions and relationships in the home, school, and community. I have experience treating grief and loss, family structures, traumatic events, depression, and anxiety to name a few.
I received my master’s degree from California University of Pennsylvania. I am a Licensed Professional Counselor that has spent my counseling career working with adolescents, children, adults, and families. I have worked in inpatient, outpatient, and family-based treatment settings. I have been able to incorporate life experience and my professional expertise to work with individuals and families. I have experience treating problematic interactions and relationships in the home, school, and community. I have experience treating grief and loss, family structures, traumatic events, depression, and anxiety to name a few.
(412) 312-5124 View (412) 312-5124
Photo of Neal Holmes, Licensed Professional Counselor, LPC, NCC, MS, MA, C-DBT
Neal Holmes
Licensed Professional Counselor, LPC, NCC, MS, MA, C-DBT
1 Endorsed
Online Only
Hi, I’m Neal Holmes. I am a believer in holistic and collaborative therapy. Bearing witness to your lived experience is an honor, because we are all striving to live and build relationships the best way we know how as people. I like to help my clients find their passion in life, remove blocks that are keeping them from being their authentic self, and live the life they wish to live with their dreams and hopes fulfilled.
Hi, I’m Neal Holmes. I am a believer in holistic and collaborative therapy. Bearing witness to your lived experience is an honor, because we are all striving to live and build relationships the best way we know how as people. I like to help my clients find their passion in life, remove blocks that are keeping them from being their authentic self, and live the life they wish to live with their dreams and hopes fulfilled.
(412) 530-4360 View (412) 530-4360
Photo of Rachel Williams, Licensed Professional Counselor, MS, LPC, NCC
Rachel Williams
Licensed Professional Counselor, MS, LPC, NCC
Online Only
Not accepting new clients
Hi I’m Rachel, a Licensed Professional Counselor and proud owner of Lavande Counseling Services. My overall approach to therapy is collaborative and science based. What does that mean? I aim to help clients learn tools to assist growth and move toward change while also creating a supportive and empathetic environment. I have the ability to be flexible with treatment approaches because of 15 years of experience in the mental health field. Whether you’re dealing with general life stress/transitions or you have specific goals, I aim to work with you on your needs.
Hi I’m Rachel, a Licensed Professional Counselor and proud owner of Lavande Counseling Services. My overall approach to therapy is collaborative and science based. What does that mean? I aim to help clients learn tools to assist growth and move toward change while also creating a supportive and empathetic environment. I have the ability to be flexible with treatment approaches because of 15 years of experience in the mental health field. Whether you’re dealing with general life stress/transitions or you have specific goals, I aim to work with you on your needs.
(412) 844-2879 View (412) 844-2879
Photo of Holly Jasin, Licensed Professional Counselor, MA, LPC, NCC
Holly Jasin
Licensed Professional Counselor, MA, LPC, NCC
Pittsburgh, PA 15228
"Love is the great miracle cure, loving ourselves works great miracles in our lives." I am a Licensed Professional Counselor and I aspire to team with my clients to achieve their fullest potential using a holistic, wellness-based approach to therapy. By focusing on the mind, body, & spirit, we are capable of healing and moving toward our highest potential. In therapy I like to take both a solution-focused and personal growth approach. Looking at one's life and stressors using a wellness model, allows growth and healing in all areas of life.
"Love is the great miracle cure, loving ourselves works great miracles in our lives." I am a Licensed Professional Counselor and I aspire to team with my clients to achieve their fullest potential using a holistic, wellness-based approach to therapy. By focusing on the mind, body, & spirit, we are capable of healing and moving toward our highest potential. In therapy I like to take both a solution-focused and personal growth approach. Looking at one's life and stressors using a wellness model, allows growth and healing in all areas of life.
(724) 675-4538 View (724) 675-4538
Photo of Mariel Piechowicz, MD
Mariel Piechowicz
Verified Verified
Pittsburgh, PA 15224
I am a psychiatrist and psychotherapist who believes therapy is an opportunity to address aspects of the human condition that are very much felt, though not as often examined in contemporary life. The development of a secure, safe, and supportive therapeutic relationship is central to the effectiveness of psychotherapy and lays the groundwork for self-reflection, healing, and growth. My approach is dedicated to facilitating this process and creating a collaborative space for empathy, curiosity, and understanding. As a psychiatrist, I am also able to provide thoughtful, adjunctive medication management.
I am a psychiatrist and psychotherapist who believes therapy is an opportunity to address aspects of the human condition that are very much felt, though not as often examined in contemporary life. The development of a secure, safe, and supportive therapeutic relationship is central to the effectiveness of psychotherapy and lays the groundwork for self-reflection, healing, and growth. My approach is dedicated to facilitating this process and creating a collaborative space for empathy, curiosity, and understanding. As a psychiatrist, I am also able to provide thoughtful, adjunctive medication management.
(412) 267-0171 View (412) 267-0171
Photo of Abagail Bowman, Clinical Social Work/Therapist, LCSW
Abagail Bowman
Clinical Social Work/Therapist, LCSW
Online Only
I have experience providing therapy to individuals utilizing cognitive behavioral therapy, dialectical behavioral therapy, motivational interviewing, solution-focused therapy, person-centered therapy, and harm reduction model therapy. I utilize these methods to meet the client where they are and provide support. I believe in allowing the client to dictate the path therapy goes down while I provide tools to take that path.
I have experience providing therapy to individuals utilizing cognitive behavioral therapy, dialectical behavioral therapy, motivational interviewing, solution-focused therapy, person-centered therapy, and harm reduction model therapy. I utilize these methods to meet the client where they are and provide support. I believe in allowing the client to dictate the path therapy goes down while I provide tools to take that path.
(412) 547-8678 View (412) 547-8678
Photo of Kathryn Lecci - Kathryn M Lecci LPC, Licensed Professional Counselor, MSEd, NCC, LPC
Kathryn M Lecci LPC
Licensed Professional Counselor, MSEd, NCC, LPC
1 Endorsed
Pittsburgh, PA 15226
Come as you are—messiness and all. Life transitions, relationships, and past experiences can feel overwhelming to untangle alone. I’m here to help you make sense of it all, at your pace. Whether you want guided support or space to explore, we’ll tailor therapy to fit you. This summer is a great time to try short-term trauma therapies—perfect for a mental health tune-up with lasting impact.
Come as you are—messiness and all. Life transitions, relationships, and past experiences can feel overwhelming to untangle alone. I’m here to help you make sense of it all, at your pace. Whether you want guided support or space to explore, we’ll tailor therapy to fit you. This summer is a great time to try short-term trauma therapies—perfect for a mental health tune-up with lasting impact.
(412) 274-7741 View (412) 274-7741
Photo of Tiffany Leonard, Psychologist, PsyD
Tiffany Leonard
Psychologist, PsyD
1 Endorsed
Online Only
Not accepting new clients
Life is constantly changing. Transitions are often rewarding, yet change can create distress, upsetting your closest relationships, turn daily functioning into a struggle, or have you feeling physically ill. I specialize in working with adults & young adults managing life transitions & interpersonal conflicts (partner, coworker, peer). I would like to join with you on your journey to regaining a sense of control over your life. Other special interests include issues related to: young adulthood, college, career change or conflict, family of origin conflict/(how growing up impacted your choices today), & codependency.
Life is constantly changing. Transitions are often rewarding, yet change can create distress, upsetting your closest relationships, turn daily functioning into a struggle, or have you feeling physically ill. I specialize in working with adults & young adults managing life transitions & interpersonal conflicts (partner, coworker, peer). I would like to join with you on your journey to regaining a sense of control over your life. Other special interests include issues related to: young adulthood, college, career change or conflict, family of origin conflict/(how growing up impacted your choices today), & codependency.
(412) 407-4182 View (412) 407-4182
Photo of Kimberly D Fairley, Pre-Licensed Professional, MA
Kimberly D Fairley
Pre-Licensed Professional, MA
3 Endorsed
Pittsburgh, PA 15235
Have you ever thought, "I don't want them to judge me." Maybe this is your roadblock from exploring the pain caused by the experiences you've had in life. It's something that I have heard many times in my role as a therapist. The reality is that I am not only not in a position to judge, but it is nothing short of an honor to be the one that gets to sit across from anyone who takes the courageous step to explore their trauma. I have experienced the weight of a person verbalizing a trauma for the first time and I would be honored to have that moment with you.
Have you ever thought, "I don't want them to judge me." Maybe this is your roadblock from exploring the pain caused by the experiences you've had in life. It's something that I have heard many times in my role as a therapist. The reality is that I am not only not in a position to judge, but it is nothing short of an honor to be the one that gets to sit across from anyone who takes the courageous step to explore their trauma. I have experienced the weight of a person verbalizing a trauma for the first time and I would be honored to have that moment with you.
(412) 990-2903 View (412) 990-2903
Photo of Curtis Terry, Licensed Professional Counselor, MA, LPC, NCC
Curtis Terry
Licensed Professional Counselor, MA, LPC, NCC
Online Only
If it is time to reorient your life course, allow me to assist you. My goal is to assist you in establishing inner peace. I view counseling from a tripartite approach where I assist my clients with self-awareness, gaining knowledge, and developing skills that may assist them with strategies to manage effectively and successfully the various transitions experienced in life. I believe people long to live lives that reflect harmony between their thoughts and their actions. Many times, stress and distress complicate this effort.
If it is time to reorient your life course, allow me to assist you. My goal is to assist you in establishing inner peace. I view counseling from a tripartite approach where I assist my clients with self-awareness, gaining knowledge, and developing skills that may assist them with strategies to manage effectively and successfully the various transitions experienced in life. I believe people long to live lives that reflect harmony between their thoughts and their actions. Many times, stress and distress complicate this effort.
(878) 205-0175 View (878) 205-0175

See more therapy options for Pittsburgh

How does your Therapist compare?

Number of Therapists in Pittsburgh, PA

2,000+

Average cost per session

$125

Therapists in Pittsburgh, PA who prioritize treating:

93% Anxiety
87% Depression
75% Self Esteem
69% Relationship Issues
68% Coping Skills
67% Trauma and PTSD
65% Stress

Average years in practice

10 Years

Top 3 insurances accepted

81% Aetna
81% Highmark
68% Cigna and Evernorth

How Therapists in Pittsburgh, PA see their clients

55% In Person and Online
45% Online Only

Gender breakdown

79% Female
18% Male
3% 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.