Therapists in Tacoma, WA

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Photo of Jessica Ryan Parry, Mental Health Counselor in Tacoma, WA
Jessica Ryan Parry
Mental Health Counselor, MS, LMHC, SUDP
Verified Verified
1 Endorsed
Tacoma, WA 98402
My ideal clients are neuroqueer- individuals who identify as both neurodivergent and queer. I am invested in the intersectionality of neurodiversity and gender identity, and passionate about helping neuroqueer individuals on their journey towards self-discovery and self-acceptance. Whether it's navigating gender dysphoria, exploring identity, coping with anxiety or depression, learning self-advocacy, addressing the effects of chronic masking, or other challenges faced by neurodivergent people, my aim is to empower individuals to lead fulfilling and authentic lives.
My ideal clients are neuroqueer- individuals who identify as both neurodivergent and queer. I am invested in the intersectionality of neurodiversity and gender identity, and passionate about helping neuroqueer individuals on their journey towards self-discovery and self-acceptance. Whether it's navigating gender dysphoria, exploring identity, coping with anxiety or depression, learning self-advocacy, addressing the effects of chronic masking, or other challenges faced by neurodivergent people, my aim is to empower individuals to lead fulfilling and authentic lives.
(253) 802-7557 View (253) 802-7557
Photo of Paul Hunziker, Marriage & Family Therapist in Tacoma, WA
Paul Hunziker
Marriage & Family Therapist, MA, LMFT, SUDP
Verified Verified
1 Endorsed
Tacoma, WA 98403
My ideal clients are couples in early recovery from substance use disorders or other addictions. Early recovery can be a critical time for both partners to quickly gain the skills needed to be successful and stay strong as a couple. I also have extensive experience working with youth and young adults with substance use and mental health challenges.
My ideal clients are couples in early recovery from substance use disorders or other addictions. Early recovery can be a critical time for both partners to quickly gain the skills needed to be successful and stay strong as a couple. I also have extensive experience working with youth and young adults with substance use and mental health challenges.
(253) 237-8351 View (253) 237-8351
Photo of Eileen M Hirschl, Pre-Licensed Professional in Tacoma, WA
Eileen M Hirschl
Pre-Licensed Professional, MA, LMHCA
Verified Verified
Tacoma, WA 98445  (Online Only)
I strive to create a warm, compassionate, empathetic, nurturing space that encourages emotional growth. I walk alongside individuals to inspire them to reach their healing goals or manuver through life's difficult transitions. I will also challenge you to be your best self and move towards your healing goals. The goal is to help you heal from present or past emotional wounds and offer new tools to help navigate you towards your best life. I am passionate about the power of personal growth and building healthy relationships, and following your dreams.
I strive to create a warm, compassionate, empathetic, nurturing space that encourages emotional growth. I walk alongside individuals to inspire them to reach their healing goals or manuver through life's difficult transitions. I will also challenge you to be your best self and move towards your healing goals. The goal is to help you heal from present or past emotional wounds and offer new tools to help navigate you towards your best life. I am passionate about the power of personal growth and building healthy relationships, and following your dreams.
(253) 518-3804 View (253) 518-3804
Photo of Mark Zimmerman, Counselor in Tacoma, WA
Mark Zimmerman
Counselor, MA, LMHC
Verified Verified
2 Endorsed
Tacoma, WA 98407
When our old methods of coping with life's difficulties no longer work, we can find ourselves stuck - in depression, with anxiety, feeling worthless, maybe afraid to even reach out for help. Talking with someone who can assist you in discovering what went wrong and how to heal from it could be invaluable. Each person is unique and has a story to tell. I'll want to hear your story. I strive to provide everyone with a non-judgmental, empathic atmosphere in which you can feel safe to express any experience however painful or shameful it may feel.
When our old methods of coping with life's difficulties no longer work, we can find ourselves stuck - in depression, with anxiety, feeling worthless, maybe afraid to even reach out for help. Talking with someone who can assist you in discovering what went wrong and how to heal from it could be invaluable. Each person is unique and has a story to tell. I'll want to hear your story. I strive to provide everyone with a non-judgmental, empathic atmosphere in which you can feel safe to express any experience however painful or shameful it may feel.
(206) 312-7358 View (206) 312-7358
San Francisco Peaks Counseling
Counselor, LMHC
Verified Verified
Tacoma, WA 98466  (Online Only)
How can I help? I personally believe that therapy is about finding your authentic self, turning suffering into joy and eventually happiness. It is my passion to develop a genuine relationship with my clients, build rapport and safely have difficult conversations, resolve conflicts, with experiencing your authentic self, including your pain. I will work with you to tune into your true self, recognize your unfavorable coping mechanisms and, discover self-compassion. The spiritual journey involves finding and exploring our particular spiritual path and seeking experiences that open us to the vastness of an individual’s potential.
How can I help? I personally believe that therapy is about finding your authentic self, turning suffering into joy and eventually happiness. It is my passion to develop a genuine relationship with my clients, build rapport and safely have difficult conversations, resolve conflicts, with experiencing your authentic self, including your pain. I will work with you to tune into your true self, recognize your unfavorable coping mechanisms and, discover self-compassion. The spiritual journey involves finding and exploring our particular spiritual path and seeking experiences that open us to the vastness of an individual’s potential.
(253) 600-4095 View (253) 600-4095
Photo of Ignite A Path to Wellness in Tacoma, WA
Ignite A Path to Wellness
Verified Verified
Tacoma, WA 98402
Counseling is most effective when taking a collaborative and holistic approach. The Ignite team strives to create a strong, therapeutic relationship built on trust, respect, responsibility, empathy, and open-mindedness. We offer a safe and supportive space to explore aspects of the 'self' and life experiences that make up the 'self'. Our staff is trauma-trained and trauma informed. We value our ability to hear the unheard and to help clients find their voice of empowerment.
Counseling is most effective when taking a collaborative and holistic approach. The Ignite team strives to create a strong, therapeutic relationship built on trust, respect, responsibility, empathy, and open-mindedness. We offer a safe and supportive space to explore aspects of the 'self' and life experiences that make up the 'self'. Our staff is trauma-trained and trauma informed. We value our ability to hear the unheard and to help clients find their voice of empowerment.
(253) 242-8587 View (253) 242-8587
Photo of Transcending Connections Counseling & Wellness, Counselor in Tacoma, WA
Transcending Connections Counseling & Wellness
Counselor, MA, LMHC
Verified Verified
Tacoma, WA 98403
We are currently ONLY taking Microcurrent Neurofeedback clients. Please note that MOST insurances do not cover this treatment. Please visit my website at www.transcendingconnectionstranscending.com to learn more. Transcending Connections is a wellness and counseling private practice. It promotes health, hope, and deeper connections with self and others. The goal of Transcending Connections is to help people discover their true potential, understand and resolve challenges in their live, and receive compassion and unconditional support.
We are currently ONLY taking Microcurrent Neurofeedback clients. Please note that MOST insurances do not cover this treatment. Please visit my website at www.transcendingconnectionstranscending.com to learn more. Transcending Connections is a wellness and counseling private practice. It promotes health, hope, and deeper connections with self and others. The goal of Transcending Connections is to help people discover their true potential, understand and resolve challenges in their live, and receive compassion and unconditional support.
(253) 499-6786 View (253) 499-6786
Photo of Sarah Sanderson, Counselor in Tacoma, WA
Sarah Sanderson
Counselor, MA, LMHC, CMHS
Verified Verified
1 Endorsed
Tacoma, WA 98402  (Online Only)
I provide individual therapy and coaching services to adults. Therapy is an active process of change. My role as your therapist is to guide and support you in strengthening your sense of self and personal power to make changes in your life. I strive to create a highly collaborative working relationship founded in respect and honesty.
I provide individual therapy and coaching services to adults. Therapy is an active process of change. My role as your therapist is to guide and support you in strengthening your sense of self and personal power to make changes in your life. I strive to create a highly collaborative working relationship founded in respect and honesty.
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Photo of Maggie Stang, Marriage & Family Therapist in Tacoma, WA
Maggie Stang
Marriage & Family Therapist, MA, LMFT
Verified Verified
3 Endorsed
Tacoma, WA 98406  (Online Only)
Hi there, I’m Maggie. If you are looking for a nurturing therapist who is genuine, wants the best for your unique life, and will challenge you towards deeper healing, we could be a good fit. I would love to support you as you begin to embrace your intersecting and unfolding identities. My specialties as a therapist include body liberation (Health At Every Size), life transitions, and exploration of self through a relational lens. My approach is centered within an anti-oppressive, anti-racist, and liberatory lens. I am a queer and neurodivergent therapist, and I enjoy supporting folks with these shared identities.
Hi there, I’m Maggie. If you are looking for a nurturing therapist who is genuine, wants the best for your unique life, and will challenge you towards deeper healing, we could be a good fit. I would love to support you as you begin to embrace your intersecting and unfolding identities. My specialties as a therapist include body liberation (Health At Every Size), life transitions, and exploration of self through a relational lens. My approach is centered within an anti-oppressive, anti-racist, and liberatory lens. I am a queer and neurodivergent therapist, and I enjoy supporting folks with these shared identities.
(253) 364-7913 View (253) 364-7913
Photo of Lucas David Abernathy, Counselor in Tacoma, WA
Lucas David Abernathy
Counselor, MA, LMHC
Verified Verified
4 Endorsed
Tacoma, WA 98402
Waitlist for new clients
Do you feel stuck? Stressed out? Are you confused about a relationship? Are you repeating the same destructive behavior you promised yourself that you would stop? You are not alone. To have problems means that you are human; but there is hope. Counseling can help you uncover the reasons for your troubles and help you learn to live in ways that are healthier, more productive and more fun. If you would like to become more of the person you want to be, call or email me to set up a consultation.
Do you feel stuck? Stressed out? Are you confused about a relationship? Are you repeating the same destructive behavior you promised yourself that you would stop? You are not alone. To have problems means that you are human; but there is hope. Counseling can help you uncover the reasons for your troubles and help you learn to live in ways that are healthier, more productive and more fun. If you would like to become more of the person you want to be, call or email me to set up a consultation.
(206) 745-5080 View (206) 745-5080
Photo of Psychological Health Consultants & Services, LLC, Counselor in Tacoma, WA
Psychological Health Consultants & Services, LLC
Counselor, EdD, LMHC, CCTP
Verified Verified
Tacoma, WA 98409  (Online Only)
I am a retired Senior Leader of the US Army. I consider myself an eclectic therapist with a sense of humor and do not believe one size fits all. I draw from various theories and use different therapeutic approaches such as Cognitive Behavior Therapy, Exposure Therapy, Family Systems Theories, Solution Focused, Brief Solution Focused as well as Behavior Activation techniques. I use the client center approach and use resources and support systems available for the client. I also assist with providing resources and connecting clients to their community. My specialization is in narcissist abuse education and recovery.
I am a retired Senior Leader of the US Army. I consider myself an eclectic therapist with a sense of humor and do not believe one size fits all. I draw from various theories and use different therapeutic approaches such as Cognitive Behavior Therapy, Exposure Therapy, Family Systems Theories, Solution Focused, Brief Solution Focused as well as Behavior Activation techniques. I use the client center approach and use resources and support systems available for the client. I also assist with providing resources and connecting clients to their community. My specialization is in narcissist abuse education and recovery.
(253) 259-3315 View (253) 259-3315
Photo of Angie Osborne, Marriage & Family Therapist in Tacoma, WA
Angie Osborne
Marriage & Family Therapist, MA, LMFT
Verified Verified
3 Endorsed
Tacoma, WA 98406
Not accepting new clients
My passion comes from life experiences & my desire to create positive changes in life. We all get stuck & that's part of being imperfectly human. There are times in life when we need someone to walk beside us in that stuckness entering the darkness - creating safety - allowing light to shine in new ways. Mindfully contemplating new ways of viewing & dealing with emotions & patterns surrounding emotions can be liberating, healing and life altering. I act as a choreographer of conversations, aimed to explore emotional connections & attachment injuries and impasses. As humans, we have a biological need to feel safe, secure & connected in our relationships.
My passion comes from life experiences & my desire to create positive changes in life. We all get stuck & that's part of being imperfectly human. There are times in life when we need someone to walk beside us in that stuckness entering the darkness - creating safety - allowing light to shine in new ways. Mindfully contemplating new ways of viewing & dealing with emotions & patterns surrounding emotions can be liberating, healing and life altering. I act as a choreographer of conversations, aimed to explore emotional connections & attachment injuries and impasses. As humans, we have a biological need to feel safe, secure & connected in our relationships.
(253) 259-2941 View (253) 259-2941
Photo of Steven M Brown, Counselor in Tacoma, WA
Steven M Brown
Counselor, MA, LMHC, LPC, NCC
Verified Verified
1 Endorsed
Tacoma, WA 98402  (Online Only)
A responsible social practitioner, I provide psychological care, and services using American Sign Language (ASL). I work with individuals from diverse cultural backgrounds, including various populations that encompass sign language users. My interests center on developing tailored, specific psychotherapy applications that benefit the patients with hearing losses. Much of my work places an emphasis on the importance of "courageous will" to empower individuals to make choices that are useful and practical.
A responsible social practitioner, I provide psychological care, and services using American Sign Language (ASL). I work with individuals from diverse cultural backgrounds, including various populations that encompass sign language users. My interests center on developing tailored, specific psychotherapy applications that benefit the patients with hearing losses. Much of my work places an emphasis on the importance of "courageous will" to empower individuals to make choices that are useful and practical.
(253) 466-7490 View (253) 466-7490
Photo of Ashley A. Orr, Marriage & Family Therapist in Tacoma, WA
Ashley A. Orr
Marriage & Family Therapist, LMFT, MA, MHP, CMHS
Verified Verified
Tacoma, WA 98409  (Online Only)
Everyone deserves to feel supported in their mental health journey and not everyone experiences mental health issues the same way. I would love to support you in the awareness and understanding of your own mental health needs, unique triggers, natural supports, and coping mechanisms. Counseling should be a collaborative effort between the therapist and the client, working towards developing client autonomy and confidence to manage symptoms independently. Through avenues of psychoeducation, talk-therapy, skills development, and behavioral modifications, you can do this!
Everyone deserves to feel supported in their mental health journey and not everyone experiences mental health issues the same way. I would love to support you in the awareness and understanding of your own mental health needs, unique triggers, natural supports, and coping mechanisms. Counseling should be a collaborative effort between the therapist and the client, working towards developing client autonomy and confidence to manage symptoms independently. Through avenues of psychoeducation, talk-therapy, skills development, and behavioral modifications, you can do this!
(253) 400-3936 View (253) 400-3936
Photo of Sara Elkington, Counselor in Tacoma, WA
Sara Elkington
Counselor, MA, LMHC
Verified Verified
Tacoma, WA 98403
Sara Elkington MA, LMHC is a licensed mental health therapist currently building a practice in Tacoma, Washington. She has specialized in working with individuals struggling with anxiety, depression, dissociative symptoms, post-trauma reactions, intimate partner abuse recovery, ADHD-related concerns, and those living with a life-changing medical condition or chronic illness. She firmly believes in the power of therapy to promote self-growth and resilience. Sara is committed to providing a safe, supportive, and judgment-free space for her clients to explore their experiences and foster healing.
Sara Elkington MA, LMHC is a licensed mental health therapist currently building a practice in Tacoma, Washington. She has specialized in working with individuals struggling with anxiety, depression, dissociative symptoms, post-trauma reactions, intimate partner abuse recovery, ADHD-related concerns, and those living with a life-changing medical condition or chronic illness. She firmly believes in the power of therapy to promote self-growth and resilience. Sara is committed to providing a safe, supportive, and judgment-free space for her clients to explore their experiences and foster healing.
(206) 973-7804 View (206) 973-7804
Photo of James A Voss, Mental Health Counselor in Tacoma, WA
James A Voss
Mental Health Counselor, MA, LMHC
Verified Verified
1 Endorsed
Tacoma, WA 98402  (Online Only)
Welcome, and thank you for stopping by. My name is James Voss and I am a licensed mental health therapist. I received my MA in Mental Health Counseling at City University of Seattle in 2018. Since then, I have worked with a diverse range of individuals on issues relating to anxiety, OCD, depression, and addiction.
Welcome, and thank you for stopping by. My name is James Voss and I am a licensed mental health therapist. I received my MA in Mental Health Counseling at City University of Seattle in 2018. Since then, I have worked with a diverse range of individuals on issues relating to anxiety, OCD, depression, and addiction.
(425) 375-7828 View (425) 375-7828
Photo of Ignite a Path to Wellness, Counselor in Tacoma, WA
Ignite a Path to Wellness
Counselor, LMHC, MHP
Verified Verified
1 Endorsed
Tacoma, WA 98402  (Online Only)
My name is Amber and I am here to help. I have worked for over a decade with adults struggling with depression, anxiety, PTSD, personality disorders and so much more. I know choosing a therapist is difficult and requires a lot of trust and patience, you made it this far, let me support you on your path to wellness.
My name is Amber and I am here to help. I have worked for over a decade with adults struggling with depression, anxiety, PTSD, personality disorders and so much more. I know choosing a therapist is difficult and requires a lot of trust and patience, you made it this far, let me support you on your path to wellness.
(253) 400-3170 View (253) 400-3170
Photo of Erin C Tansill, Psychologist in Tacoma, WA
Erin C Tansill
Psychologist, PhD
Verified Verified
Tacoma, WA 98402
Waitlist for new clients
I provide compassionate, person-centered therapy in-person or via telehealth for adult clients. My training focused specifically on trauma survivors and helping professionals - which includes a focus on PTSD, vicarious trauma, substance use concerns, struggles with emotion regulation, anxiety, depression, sexual identity, and interpersonal conflicts. I also work with couples facing relationship concerns including, but not limited to: increased conflict, repairing after betrayal, and considering separation/divorce. In couples therapy, I work from Gottman Method, Discernment Counseling and EFT approaches.
I provide compassionate, person-centered therapy in-person or via telehealth for adult clients. My training focused specifically on trauma survivors and helping professionals - which includes a focus on PTSD, vicarious trauma, substance use concerns, struggles with emotion regulation, anxiety, depression, sexual identity, and interpersonal conflicts. I also work with couples facing relationship concerns including, but not limited to: increased conflict, repairing after betrayal, and considering separation/divorce. In couples therapy, I work from Gottman Method, Discernment Counseling and EFT approaches.
(253) 487-0955 View (253) 487-0955
Photo of Courtney Putnam, Counselor in Tacoma, WA
Courtney Putnam
Counselor, MA, MFA, LMHCA, LMT, RM
Verified Verified
3 Endorsed
Tacoma, WA 98406
I support clients in managing the stressors in their lives, getting unstuck, expressing themselves, and deepening their relationships with themselves and others. I work with adults (18+) from all walks of life who may be struggling with self-esteem, identity, anxiety, depression, grief/loss, life transitions, chronic pain/illness, college stress, burnout, past trauma, and more. I am also an LGBTQ+ affirming therapist and offer gender-affirming care. I hold an inclusive and anti-oppressive lens and invite clients’ intersecting cultural identities to be acknowledged, respected, and celebrated.
I support clients in managing the stressors in their lives, getting unstuck, expressing themselves, and deepening their relationships with themselves and others. I work with adults (18+) from all walks of life who may be struggling with self-esteem, identity, anxiety, depression, grief/loss, life transitions, chronic pain/illness, college stress, burnout, past trauma, and more. I am also an LGBTQ+ affirming therapist and offer gender-affirming care. I hold an inclusive and anti-oppressive lens and invite clients’ intersecting cultural identities to be acknowledged, respected, and celebrated.
(253) 243-8345 View (253) 243-8345
Photo of Kim K Armit, Marriage & Family Therapist in Tacoma, WA
Kim K Armit
Marriage & Family Therapist, MS, LMFTA, LMHCA
Verified Verified
Tacoma, WA 98402
Marriage and family life can present a series of challenges that at times can seem overwhelming. For each stage of the marriage relationship there are a set of challenges that help transition the relationship to a closer more intimate bonding. Instead of ending the marriage identify what stage you are in and the challenges you need to meet as a couple.The same can be true for child and parent relationships, different stages represent different challenges and skills to acquire. Knowing when to let go and when to stand firm as a parent.
Marriage and family life can present a series of challenges that at times can seem overwhelming. For each stage of the marriage relationship there are a set of challenges that help transition the relationship to a closer more intimate bonding. Instead of ending the marriage identify what stage you are in and the challenges you need to meet as a couple.The same can be true for child and parent relationships, different stages represent different challenges and skills to acquire. Knowing when to let go and when to stand firm as a parent.
(253) 248-4467 View (253) 248-4467

How does your Therapist compare?

Number of Therapists in Tacoma, WA

1,000+

Average cost per session

$150

Therapists in Tacoma, WA who prioritize treating:

93% Anxiety
88% Depression
76% Trauma and PTSD
75% Relationship Issues
75% Self Esteem
70% Stress
67% Coping Skills

Average years in practice

9 Years

Top 3 insurances accepted

78% Premera
66% Regence
61% Aetna

How Therapists in Tacoma, WA see their clients

50% In Person and Online
50% Online Only

Gender breakdown

75% Female
21% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Tacoma?

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.