Therapists in Pittsburgh, PA

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Photo of Jess Garrow, Licensed Professional Counselor, LPC, NCC
Jess Garrow
Licensed Professional Counselor, LPC, NCC
Online Only
Welcome! I am a therapist that helps individuals and families overcome challenges and achieve their goals, with experience in a variety of therapeutic and educational settings. I believe in creating a safe and supportive space for clients to explore their unique experience, and I work collaboratively to support clients identify goals and navigate challenges.
Welcome! I am a therapist that helps individuals and families overcome challenges and achieve their goals, with experience in a variety of therapeutic and educational settings. I believe in creating a safe and supportive space for clients to explore their unique experience, and I work collaboratively to support clients identify goals and navigate challenges.
(412) 743-9427 View (412) 743-9427
Bryan Bass-Riley
Licensed Professional Counselor, MDiv, MS, LPC
Pittsburgh, PA 15213
Not accepting new clients
Bryan Bass-Riley, MDiv, MS, LPC helps individuals navigate life's challenges by creating a supportive, collaborative environment where personal growth and healing can flourish. Practicing at LifeStance Health in Pennsylvania, Bryan works with teens, adults, and seniors, providing personalized care that addresses the unique needs of each client. His clinical expertise supports those struggling with depression, anxiety, and PTSD/trauma, using evidence-based interventions to foster resilience and lasting change.
Bryan Bass-Riley, MDiv, MS, LPC helps individuals navigate life's challenges by creating a supportive, collaborative environment where personal growth and healing can flourish. Practicing at LifeStance Health in Pennsylvania, Bryan works with teens, adults, and seniors, providing personalized care that addresses the unique needs of each client. His clinical expertise supports those struggling with depression, anxiety, and PTSD/trauma, using evidence-based interventions to foster resilience and lasting change.
(412) 775-3253 View (412) 775-3253
Photo of Patrick O'Brien, Psychologist, PhD
Patrick O'Brien
Psychologist, PhD
4 Endorsed
Pittsburgh, PA 15213
Not accepting new clients
A patient described our therapy as “a safe, guided conversation exploring what it means for me to exist.” I like that. A safe-enough space to honor the full range of your thoughts, feelings, and relationships, and to do so with curiosity and care, so you can more peacefully inhabit your body and mind. I believe that current life carries remnants of how we were shaped in childhood. What we call “symptoms” are clues of misalignment, signals that a vital aspect of us is constrained and needing fuller expression. Our task is to understand these signs, not to abolish them, but to let them breathe and grow into a fuller you.
A patient described our therapy as “a safe, guided conversation exploring what it means for me to exist.” I like that. A safe-enough space to honor the full range of your thoughts, feelings, and relationships, and to do so with curiosity and care, so you can more peacefully inhabit your body and mind. I believe that current life carries remnants of how we were shaped in childhood. What we call “symptoms” are clues of misalignment, signals that a vital aspect of us is constrained and needing fuller expression. Our task is to understand these signs, not to abolish them, but to let them breathe and grow into a fuller you.
(412) 467-0264 View (412) 467-0264
Photo of David Mente, Licensed Professional Counselor, MA, LPC
David Mente
Licensed Professional Counselor, MA, LPC
Pittsburgh, PA 15217
I have been working as a psychotherapist for over 30 years. Having a respectful, productive working relationship with my clients is my first priority. This is true whether I am working with an adult individual, a couple, children, adolescents or families. I will encourage you to evaluate whether you are improving in the ways that you desire and will strive to provide you with treatment which suits you. I have intentionally worked in a wide variety of settings and with many different kinds of clients and problems. I welcome any questions you have and offer a free initial consultation.
I have been working as a psychotherapist for over 30 years. Having a respectful, productive working relationship with my clients is my first priority. This is true whether I am working with an adult individual, a couple, children, adolescents or families. I will encourage you to evaluate whether you are improving in the ways that you desire and will strive to provide you with treatment which suits you. I have intentionally worked in a wide variety of settings and with many different kinds of clients and problems. I welcome any questions you have and offer a free initial consultation.
(412) 532-1602 View (412) 532-1602
Photo of Roxanne E Kerstetter, Clinical Social Work/Therapist, MSW, LCSW
Roxanne E Kerstetter
Clinical Social Work/Therapist, MSW, LCSW
1 Endorsed
Pittsburgh, PA 15218
As a therapist, it is my goal to create a safe and welcoming environment for individuals to explore any concerns they may be experiencing. My approach is tailored to each individual client, and I believe that a strong therapeutic alliance can provide a safe and healing space. It is important for me to explore my client's personal history and background to help them understand how it is currently affecting their present situation and how we can collaborate to improve it.
As a therapist, it is my goal to create a safe and welcoming environment for individuals to explore any concerns they may be experiencing. My approach is tailored to each individual client, and I believe that a strong therapeutic alliance can provide a safe and healing space. It is important for me to explore my client's personal history and background to help them understand how it is currently affecting their present situation and how we can collaborate to improve it.
(412) 615-3390 View (412) 615-3390
Photo of Hannah Damgaard, Clinical Social Work/Therapist, LCSW
Hannah Damgaard
Clinical Social Work/Therapist, LCSW
3 Endorsed
Pittsburgh, PA 15221
Finding balance and living a fulfilling life is easier said than done. However, I'm in your corner to support the happier version of you. Knowing that we are all fellow humans journeying on a path towards a better life, I bring to our talk therapy a sense of genuine curiosity, gratitude and honest compassion to meet you exactly where you're at. With the help of therapy, we can be released from what holds us back, integrate hidden aspects of ourselves and fully embrace who we are, bruises and all. Therapy is my life calling and is by far the greatest gift I have been given and can give in this lifetime.
Finding balance and living a fulfilling life is easier said than done. However, I'm in your corner to support the happier version of you. Knowing that we are all fellow humans journeying on a path towards a better life, I bring to our talk therapy a sense of genuine curiosity, gratitude and honest compassion to meet you exactly where you're at. With the help of therapy, we can be released from what holds us back, integrate hidden aspects of ourselves and fully embrace who we are, bruises and all. Therapy is my life calling and is by far the greatest gift I have been given and can give in this lifetime.
(724) 436-1343 View (724) 436-1343
Photo of Beck Henriques, Licensed Professional Counselor, LPC
Beck Henriques
Licensed Professional Counselor, LPC
1 Endorsed
Pittsburgh, PA 15227
I have experience working with children, teens, young adults, and couples in a variety of mental health settings. I enjoy working with individuals to address identity exploration, anxiety, and feelings of inadequacy. With couples and families, my work emphasizes relationship-building, effective communication, and conflict-resolution skills.
I have experience working with children, teens, young adults, and couples in a variety of mental health settings. I enjoy working with individuals to address identity exploration, anxiety, and feelings of inadequacy. With couples and families, my work emphasizes relationship-building, effective communication, and conflict-resolution skills.
(412) 912-2701 View (412) 912-2701
Photo of Adam Pritchard, Associate Professional Counselor, MS, NCC, LAPC
Adam Pritchard
Associate Professional Counselor, MS, NCC, LAPC
2 Endorsed
Pittsburgh, PA 15206
Each of us faces a whole host of challenges in our lives. Whether these are challenges from our past that are still affecting us today or situations that are ongoing. Or maybe we’re having a tough time with life in general, and we’re not sure why that is, where it’s coming from, or even how to begin to process what we’re struggling with.
Each of us faces a whole host of challenges in our lives. Whether these are challenges from our past that are still affecting us today or situations that are ongoing. Or maybe we’re having a tough time with life in general, and we’re not sure why that is, where it’s coming from, or even how to begin to process what we’re struggling with.
(412) 844-5707 View (412) 844-5707
Photo of Abby Stone, Licensed Associate Professional Counselor, MA, NCC, LAPC
Abby Stone
Licensed Associate Professional Counselor, MA, NCC, LAPC
2 Endorsed
Pittsburgh, PA 15206
Invisible wounds often cause the deepest pain. If you seek healing from trauma, grief, or life's various challenges, I am here to provide a mindful and compassionate space for your healing journey. I am EMDR-trained with a person-centered approach to therapy, where I collaborate with you to harness your strengths, develop practical coping skills, build meaningful relationships, and facilitate your brain's natural healing process.
Invisible wounds often cause the deepest pain. If you seek healing from trauma, grief, or life's various challenges, I am here to provide a mindful and compassionate space for your healing journey. I am EMDR-trained with a person-centered approach to therapy, where I collaborate with you to harness your strengths, develop practical coping skills, build meaningful relationships, and facilitate your brain's natural healing process.
(412) 743-9559 View (412) 743-9559
Photo of Paula J Moreci - Paula J. Moreci, MSW, LCSW, Psychoanalyst, Clinical Social Work/Therapist, MSW, LCSW
Paula J. Moreci, MSW, LCSW, Psychoanalyst
Clinical Social Work/Therapist, MSW, LCSW
1 Endorsed
Online Only
I enjoy working with people struggling with stress and anxiety from the pressures of life whether that be related to relationships, academics, career, or leadership dynamics. The people I work with are looking for deep understanding of what is bothering them and the tools for lasting change. I often work with people who have been successful in life despite early trauma or disadvantaged backgrounds. I hold various leadership positions and understand the pressures and lonliness that comes with leadership. I also offer leadership advising and coaching to CEO’s and leaders in medicine, law, family businesses, and nonprofits.
I enjoy working with people struggling with stress and anxiety from the pressures of life whether that be related to relationships, academics, career, or leadership dynamics. The people I work with are looking for deep understanding of what is bothering them and the tools for lasting change. I often work with people who have been successful in life despite early trauma or disadvantaged backgrounds. I hold various leadership positions and understand the pressures and lonliness that comes with leadership. I also offer leadership advising and coaching to CEO’s and leaders in medicine, law, family businesses, and nonprofits.
(412) 314-8603 View (412) 314-8603
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 Megan Schwemmer, Licensed Professional Counselor, LPC, NCC
Megan Schwemmer
Licensed Professional Counselor, LPC, NCC
2 Endorsed
Pittsburgh, PA 15228
Hello! Thank you for taking the time to search for a therapist. It can be overwhelming selecting a therapist and I appreciate you taking the first steps to do so. I am a passionate mental health clinician seeking motivated clients who are looking for change. I have four years of experience working with children, adolescents, and families in the community mental health setting including Wrap-around services and Family-Focused mental health. It is inspiring and motivating to see clients change and become the best versions of themselves.
Hello! Thank you for taking the time to search for a therapist. It can be overwhelming selecting a therapist and I appreciate you taking the first steps to do so. I am a passionate mental health clinician seeking motivated clients who are looking for change. I have four years of experience working with children, adolescents, and families in the community mental health setting including Wrap-around services and Family-Focused mental health. It is inspiring and motivating to see clients change and become the best versions of themselves.
(412) 960-1443 View (412) 960-1443
Photo of Kaitlyn Barbarow, Licensed Professional Counselor, MS, NCC, LPC
Kaitlyn Barbarow
Licensed Professional Counselor, MS, NCC, LPC
Pittsburgh, PA 15226
Life can be exhausting, and sometimes it might feel like you just can’t manage everything. From school and work to relationships with friends and family, there is always a lot to juggle, and stress can build up quickly! When you’re overwhelmed because of a transition period or a traumatic event, your behavior, mood, and relationships are all impacted, and it can feel like you're spiraling or that things will never get better.
Life can be exhausting, and sometimes it might feel like you just can’t manage everything. From school and work to relationships with friends and family, there is always a lot to juggle, and stress can build up quickly! When you’re overwhelmed because of a transition period or a traumatic event, your behavior, mood, and relationships are all impacted, and it can feel like you're spiraling or that things will never get better.
(412) 538-6873 View (412) 538-6873
Photo of Sage Logan, Associate Professional Counselor , MS, LAPC
Sage Logan
Associate Professional Counselor , MS, LAPC
Pittsburgh, PA 15221
You deserve a space where you are free from empty promises of "healing" or this week’s new buzzwords. Naturally, I like to keep things simple up front. My work with folks typically focuses on some combination of High Intelligence/Giftedness, Autism/ADHD, and OCD. Often, these are paired with Depression, Anxiety, and/or trauma. I also tend to work with those who identify as LGBTQIA+. I find that a crucial part of working with the folks I do is being able to “just get” a lot of the shame, struggle, and frustration they carry, which I feel I can do quite well both intuitively/personally and professionally.
You deserve a space where you are free from empty promises of "healing" or this week’s new buzzwords. Naturally, I like to keep things simple up front. My work with folks typically focuses on some combination of High Intelligence/Giftedness, Autism/ADHD, and OCD. Often, these are paired with Depression, Anxiety, and/or trauma. I also tend to work with those who identify as LGBTQIA+. I find that a crucial part of working with the folks I do is being able to “just get” a lot of the shame, struggle, and frustration they carry, which I feel I can do quite well both intuitively/personally and professionally.
(412) 301-9584 View (412) 301-9584
Photo of Mandy Kushner, Licensed Professional Counselor, LPC-S, NCC, CCTP, CBT-C
Mandy Kushner
Licensed Professional Counselor, LPC-S, NCC, CCTP, CBT-C
1 Endorsed
Pittsburgh, PA 15237
My goal is to make sure my clients feel heard, understood, supported, and achieve meaningful insights. I have 25 years of experience working with children, teens, and adults. While I specialize in trauma/PTSD counseling, I also work with clients who struggle with anxiety, depression, mood disorders, intrusive thoughts, and other mental health challenges. I am committed to creating a relaxed, supportive, and positive space for my clients, because I know that disclosing personal information can be very difficult. I strive to be honest, compassionate, and non-judgmental in my interactions with each client.
My goal is to make sure my clients feel heard, understood, supported, and achieve meaningful insights. I have 25 years of experience working with children, teens, and adults. While I specialize in trauma/PTSD counseling, I also work with clients who struggle with anxiety, depression, mood disorders, intrusive thoughts, and other mental health challenges. I am committed to creating a relaxed, supportive, and positive space for my clients, because I know that disclosing personal information can be very difficult. I strive to be honest, compassionate, and non-judgmental in my interactions with each client.
(412) 999-2244 View (412) 999-2244
Photo of Katherine Kearns, Clinical Social Work/Therapist, LCSW
Katherine Kearns
Clinical Social Work/Therapist, LCSW
1 Endorsed
Pittsburgh, PA 15217
Waitlist for new clients
Is your relationship with food and body image getting in the way of the life you wish to live? Are you overwhelmed by unpleasant thoughts and emotions linked to your appearance, self-esteem, and concerns about food? I have a passion for helping individuals develop a normalized relationship with food, weight, and shape! Together, we can discover and change the barriers to achieving a sense of peace and joy around food and body image. Reaching out for help takes courage. Whether you’re ready to begin your recovery journey or simply curious about how therapy might support you, I’d be honored to walk alongside you.
Is your relationship with food and body image getting in the way of the life you wish to live? Are you overwhelmed by unpleasant thoughts and emotions linked to your appearance, self-esteem, and concerns about food? I have a passion for helping individuals develop a normalized relationship with food, weight, and shape! Together, we can discover and change the barriers to achieving a sense of peace and joy around food and body image. Reaching out for help takes courage. Whether you’re ready to begin your recovery journey or simply curious about how therapy might support you, I’d be honored to walk alongside you.
(412) 743-8972 View (412) 743-8972
Photo of Jess Levick, Clinical Social Work/Therapist, LCSW
Jess Levick
Clinical Social Work/Therapist, LCSW
2 Endorsed
Pittsburgh, PA 15208
We are wired for growth, for healing, and for connection. All of us have an in-built, innate capacity to weather changes, recover from/with pain and loss, and find balance and meaning in our worlds amidst difficulty and change. And still, we can encounter real barriers to living in connection with our strengths. Sometimes habitual thoughts, painful emotions, ineffective patterns of behavior, or stressors, losses and traumas that we meet without the support or stability needed to move through - such challenges can leave us depleted and distrustful of our own capacity for well-being and connection.
We are wired for growth, for healing, and for connection. All of us have an in-built, innate capacity to weather changes, recover from/with pain and loss, and find balance and meaning in our worlds amidst difficulty and change. And still, we can encounter real barriers to living in connection with our strengths. Sometimes habitual thoughts, painful emotions, ineffective patterns of behavior, or stressors, losses and traumas that we meet without the support or stability needed to move through - such challenges can leave us depleted and distrustful of our own capacity for well-being and connection.
(878) 213-4684 View (878) 213-4684
Photo of Megan Lynn Crane, Associate Professional Counselor, MS
Megan Lynn Crane
Associate Professional Counselor, MS
1 Endorsed
Online Only
Are you feeling sick in your career, uncertain about your next steps, or simply longing to find more meaning in your life? Perhaps you're a parent navigating the challenges of raising a child with unique needs, you’re part of a couple struggling to communicate in a way that brings you closer rather than further apart. If this resonates with you, you don’t have to go through it alone.
Are you feeling sick in your career, uncertain about your next steps, or simply longing to find more meaning in your life? Perhaps you're a parent navigating the challenges of raising a child with unique needs, you’re part of a couple struggling to communicate in a way that brings you closer rather than further apart. If this resonates with you, you don’t have to go through it alone.
Photo of Catherine Vogel Mistick, Counselor, LPC
Catherine Vogel Mistick
Counselor, LPC
1 Endorsed
Pittsburgh, PA 15217
Hello, I’m glad you’re here. I work well with adults who are self-aware and ready to look honestly at the patterns keeping them stuck. You may feel anxious, low, reactive, disconnected, or caught in relationship dynamics you want to understand more clearly. Often, you have insight yet still find yourself repeating familiar responses under stress. Therapy is a place to look at these patterns safely and directly. I believe patterns make sense when we slow down to understand them, not to judge, but to see clearly and begin shifting them. This work can lead to a stronger, more grounded sense of self and greater choice in how you respond
Hello, I’m glad you’re here. I work well with adults who are self-aware and ready to look honestly at the patterns keeping them stuck. You may feel anxious, low, reactive, disconnected, or caught in relationship dynamics you want to understand more clearly. Often, you have insight yet still find yourself repeating familiar responses under stress. Therapy is a place to look at these patterns safely and directly. I believe patterns make sense when we slow down to understand them, not to judge, but to see clearly and begin shifting them. This work can lead to a stronger, more grounded sense of self and greater choice in how you respond
(412) 844-5364 View (412) 844-5364
Photo of Alanna Hanzlik, Licensed Professional Counselor, LPC
Alanna Hanzlik
Licensed Professional Counselor, LPC
45 Endorsed
Pittsburgh, PA 15237
Welcome! As a therapist, I deeply believe in the profound impact of self-awareness, empathy, and genuine connection. I am a strong advocate for holistic healing, acknowledging the intricate link between the mind, body, and soul. In my practice, I integrate various evidence-based therapeutic techniques, such as Person-Centered, Empowerment, Cognitive Behavioral, Motivational Interviewing, Solution Focused, Acceptance and Commitment, and Psychodynamic approaches. My ultimate goal is to support clients in cultivating their fullest potential.
Welcome! As a therapist, I deeply believe in the profound impact of self-awareness, empathy, and genuine connection. I am a strong advocate for holistic healing, acknowledging the intricate link between the mind, body, and soul. In my practice, I integrate various evidence-based therapeutic techniques, such as Person-Centered, Empowerment, Cognitive Behavioral, Motivational Interviewing, Solution Focused, Acceptance and Commitment, and Psychodynamic approaches. My ultimate goal is to support clients in cultivating their fullest potential.
(412) 455-3840 View (412) 455-3840

See more therapy options for Pittsburgh

How does your Therapist compare?

Number of Therapists in Pittsburgh, PA

2,000+

Average cost per session

$131

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.