Therapists in New York, NY

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Photo of John Vieira Silvestre, Clinical Social Work/Therapist in New York, NY
John Vieira Silvestre
Clinical Social Work/Therapist, MS, LICPSI, LCSW
Verified Verified
New York, NY 10025
I have expertise in treating anxiety, mood and OCD disorders (trichotillomania, BDD, skin picking). I use cognitive behavioral methods that have been shown to be effective in specific problem areas and tailor them to particular patients. My treatment philosophy is one that combines humanistic values and CBT interventions.
I have expertise in treating anxiety, mood and OCD disorders (trichotillomania, BDD, skin picking). I use cognitive behavioral methods that have been shown to be effective in specific problem areas and tailor them to particular patients. My treatment philosophy is one that combines humanistic values and CBT interventions.
(646) 583-3825 View (646) 583-3825
Photo of Janice Gitterman, Clinical Social Work/Therapist in New York, NY
Janice Gitterman
Clinical Social Work/Therapist, LCSW
Verified Verified
New York, NY 10024
I have been practicing psychoanalytically-oriented psychotherapy in NYC with adults for over 20 years. My work has included mental health issues such as depression and anxiety, obsessive compulsive disorder, eating disorders, history of suicide attempts, panic disorder, agoraphobia, history of trauma and abuse. I have helped patients with a broad range of life issues, such as navigating relationships, raising children, managing financial stress, dealing with medical or sexual problems, understanding sexual orientation and gender, and adjusting to life changes such as marriage, divorce, changing jobs, release from prison, death of a parent or other loss.
I have been practicing psychoanalytically-oriented psychotherapy in NYC with adults for over 20 years. My work has included mental health issues such as depression and anxiety, obsessive compulsive disorder, eating disorders, history of suicide attempts, panic disorder, agoraphobia, history of trauma and abuse. I have helped patients with a broad range of life issues, such as navigating relationships, raising children, managing financial stress, dealing with medical or sexual problems, understanding sexual orientation and gender, and adjusting to life changes such as marriage, divorce, changing jobs, release from prison, death of a parent or other loss.
(646) 759-1549 View (646) 759-1549
Photo of Michael Portelli, Clinical Social Work/Therapist in New York, NY
Michael Portelli
Clinical Social Work/Therapist, LCSW-R
Verified Verified
New York, NY 10003  (Online Only)
Online Therapy only. Medicare accepted. Men in ACA: Welcome. Your Symptoms: Anger, Anxiety, Depression, CPTSD, Chronic Trauma from childhood. "I feel angry or frustrated all the time! I'm easily triggered and over-react. I need to stand up for myself but how and what to say in a way they can hear me? I can't seem to keep a healthy relationship going. I don't understand myself and why I keep repeating the same mistakes! Is this it? REALLY?" It's OK. Welcome to "normal" adulthood as a straight older American male (like me) who is struggling with current issues: troubled relationships, divorce, workplace conflict etc. Yikes!
Online Therapy only. Medicare accepted. Men in ACA: Welcome. Your Symptoms: Anger, Anxiety, Depression, CPTSD, Chronic Trauma from childhood. "I feel angry or frustrated all the time! I'm easily triggered and over-react. I need to stand up for myself but how and what to say in a way they can hear me? I can't seem to keep a healthy relationship going. I don't understand myself and why I keep repeating the same mistakes! Is this it? REALLY?" It's OK. Welcome to "normal" adulthood as a straight older American male (like me) who is struggling with current issues: troubled relationships, divorce, workplace conflict etc. Yikes!
(917) 791-3240 View (917) 791-3240
Photo of Karen Nercessian, Mental Health Counselor in New York, NY
Karen Nercessian
Mental Health Counselor, LMHC, MA, MPA
Verified Verified
New York, NY 10010
I firmly believe that each individual is capable of improving their life, when they are ready to do so, and with the help of a well-matched therapist. I will work with you to gain a better understanding of who you truly are and what you want, while exploring ways to help you find purpose, peace and acceptance. I use integrative therapeutic approaches, and attachment theory and shadow work frame my perspective. I believe our true self emerges when we shed the social persona and integrate our identity with the unconscious parts of ourselves, thus rediscovering who we truly are.
I firmly believe that each individual is capable of improving their life, when they are ready to do so, and with the help of a well-matched therapist. I will work with you to gain a better understanding of who you truly are and what you want, while exploring ways to help you find purpose, peace and acceptance. I use integrative therapeutic approaches, and attachment theory and shadow work frame my perspective. I believe our true self emerges when we shed the social persona and integrate our identity with the unconscious parts of ourselves, thus rediscovering who we truly are.
(646) 956-3752 View (646) 956-3752
Photo of Stephanie Sukhdeo, Pre-Licensed Professional in New York, NY
Stephanie Sukhdeo
Pre-Licensed Professional, MHC-I
Verified Verified
New York, NY 10001  (Online Only)
Stephanie Sukhdeo is a dedicated psychotherapist with a deep commitment to her client's well-being, currently pursuing her MA in Mental Health Counseling at The City College of New York. She has honed her expertise through rigorous training and practical experience, positioning herself as a rising professional in the field of mental health counseling. Guided by the distinguished team at Evolve Integrative Psychotherapy, Stephanie applies her extensive knowledge of evidence-based interventions to her practice, working diligently toward her goal of becoming a licensed mental health counselor.
Stephanie Sukhdeo is a dedicated psychotherapist with a deep commitment to her client's well-being, currently pursuing her MA in Mental Health Counseling at The City College of New York. She has honed her expertise through rigorous training and practical experience, positioning herself as a rising professional in the field of mental health counseling. Guided by the distinguished team at Evolve Integrative Psychotherapy, Stephanie applies her extensive knowledge of evidence-based interventions to her practice, working diligently toward her goal of becoming a licensed mental health counselor.
(929) 298-4117 View (929) 298-4117
Photo of Ayanna Obando, Clinical Social Work/Therapist in New York, NY
Ayanna Obando
Clinical Social Work/Therapist, LMHC
Verified Verified
New York, NY 10018  (Online Only)
Ayanna is a Licensed Mental Health Counselor who works with individuals looking to overcome the effects of adversity and trauma. She treats a range of trauma and stressor-related disorders including developmental and complex trauma, post-traumatic stress disorder, and issues related to adjustment and life transitions. Ayanna also provides support to individuals struggling with depression and anxiety. She helps her clients to navigate interpersonal/relationship challenges, family conflict, parenting, self-esteem, and personal growth.
Ayanna is a Licensed Mental Health Counselor who works with individuals looking to overcome the effects of adversity and trauma. She treats a range of trauma and stressor-related disorders including developmental and complex trauma, post-traumatic stress disorder, and issues related to adjustment and life transitions. Ayanna also provides support to individuals struggling with depression and anxiety. She helps her clients to navigate interpersonal/relationship challenges, family conflict, parenting, self-esteem, and personal growth.
(646) 681-7768 View (646) 681-7768
Photo of Suyi Duan, Counselor in New York, NY
Suyi Duan
Counselor, MA, LMHC
Verified Verified
New York, NY 10016  (Online Only)
We all deserve a safe and supportive environment to explore ourselves. Whether you are feeling trapped, anxious, or vulnerable, I am here to provide a space with nonjudgemental listening and professional support. I will help you identify and remove the barriers that are preventing you from achieving your ideal life. Using a strength-based trauma-informed therapeutic alignment, we are going to work together to find ways of empowering your inner strengths to keep moving forward. I employ client-centered, personalized treatment plans based on client-specific needs and targets.
We all deserve a safe and supportive environment to explore ourselves. Whether you are feeling trapped, anxious, or vulnerable, I am here to provide a space with nonjudgemental listening and professional support. I will help you identify and remove the barriers that are preventing you from achieving your ideal life. Using a strength-based trauma-informed therapeutic alignment, we are going to work together to find ways of empowering your inner strengths to keep moving forward. I employ client-centered, personalized treatment plans based on client-specific needs and targets.
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Photo of Eric Plotar, Clinical Social Work/Therapist in New York, NY
Eric Plotar
Clinical Social Work/Therapist, LCSW-R
Verified Verified
New York, NY 10011  (Online Only)
Contrary to popular opinion, I do not believe in safe spaces as a viable, long term solution to anyones’ challenges, unless you’re willing to sacrifice your autonomy and allow fear to dictate how you live. However, I firmly believe that therapy should be a safe place to explore the issues that are creating fear and discomfort. Life is chaotic and unpredictable, and while there is a time and place for utilizing safe spaces, they should only be used in the short term. I’m very invested in empowering my clients to foster bravery, resilience, and perseverance so they are well equipped to navigate the challenges life throws their way.
Contrary to popular opinion, I do not believe in safe spaces as a viable, long term solution to anyones’ challenges, unless you’re willing to sacrifice your autonomy and allow fear to dictate how you live. However, I firmly believe that therapy should be a safe place to explore the issues that are creating fear and discomfort. Life is chaotic and unpredictable, and while there is a time and place for utilizing safe spaces, they should only be used in the short term. I’m very invested in empowering my clients to foster bravery, resilience, and perseverance so they are well equipped to navigate the challenges life throws their way.
(646) 956-3152 View (646) 956-3152
Photo of Janice Michaelson, Clinical Social Work/Therapist in New York, NY
Janice Michaelson
Clinical Social Work/Therapist, LCSW
Verified Verified
New York, NY 10019
We each want the best life we can make for ourselves. Everyone has potential that has not been developed or utilized enough. Whether one has symptoms of depression, anxiety, problematic relationships or anger difficulties, each one of us can progress to remove symptoms and develop our unique personalities more. That is what keeps me excited about my work after so many years of practice as a psychotherapist. I help people to accomplish their goals and improve their abilities to get more out of life, including their relationships. We are complex beings, filled with so much untapped potential.
We each want the best life we can make for ourselves. Everyone has potential that has not been developed or utilized enough. Whether one has symptoms of depression, anxiety, problematic relationships or anger difficulties, each one of us can progress to remove symptoms and develop our unique personalities more. That is what keeps me excited about my work after so many years of practice as a psychotherapist. I help people to accomplish their goals and improve their abilities to get more out of life, including their relationships. We are complex beings, filled with so much untapped potential.
(646) 863-9416 View (646) 863-9416
Photo of Julissa Adames-Torres, Clinical Social Work/Therapist in New York, NY
Julissa Adames-Torres
Clinical Social Work/Therapist, MSW, LCSW, ABD
Verified Verified
1 Endorsed
New York, NY 10001  (Online Only)
Not accepting new clients
I am a psychotherapist/clinical social worker with over 10 years of experience working with children, adolescents and adults. I provide individual therapy for adolescents, adults and clinical supervision to social workers.
I am a psychotherapist/clinical social worker with over 10 years of experience working with children, adolescents and adults. I provide individual therapy for adolescents, adults and clinical supervision to social workers.
(917) 920-9022 View (917) 920-9022
Photo of Gerald LaMear Bray, Clinical Social Work/Therapist in New York, NY
Gerald LaMear Bray
Clinical Social Work/Therapist, LCSW-R, BCD-P
Verified Verified
New York, NY 10024
I am an experienced adult psychotherapist with accredited postgraduate training and clinical experience. I have special interests in work-related stress, performance anxiety, eating disorders and interpersonal relationships. I have an active affiliation with many major insurance plans. You can expect to have a consultation within one to two days. My office is conveniently located on the Upper West Side. Curiosity, humor and a toleration of paradox and irony can help. Let's see how we can bring out the best in you and make the world a better place for everyone.
I am an experienced adult psychotherapist with accredited postgraduate training and clinical experience. I have special interests in work-related stress, performance anxiety, eating disorders and interpersonal relationships. I have an active affiliation with many major insurance plans. You can expect to have a consultation within one to two days. My office is conveniently located on the Upper West Side. Curiosity, humor and a toleration of paradox and irony can help. Let's see how we can bring out the best in you and make the world a better place for everyone.
(212) 427-8043 View (212) 427-8043
Photo of Sara Christian Kliger, Creative Arts Therapist in New York, NY
Sara Christian Kliger
Creative Arts Therapist, MA, LCAT, RDT
Verified Verified
New York, NY 10024  (Online Only)
Do you find yourself having difficulty communicating with others? Do you want to make a career change? Do you want to make other life transitions? Are you needing support with feelings of loss, anxiety, or depression? Are you having a difficult time expressing yourself in order to honor your TRUE identities? Do you feel that you struggle with finding your voice and your confidence? If you answered "yes" to any of these questions, working with me might be beneficial to you. I am happy to share that I have openings in my practice for older teens (17+), young adults, and adults.
Do you find yourself having difficulty communicating with others? Do you want to make a career change? Do you want to make other life transitions? Are you needing support with feelings of loss, anxiety, or depression? Are you having a difficult time expressing yourself in order to honor your TRUE identities? Do you feel that you struggle with finding your voice and your confidence? If you answered "yes" to any of these questions, working with me might be beneficial to you. I am happy to share that I have openings in my practice for older teens (17+), young adults, and adults.
(516) 701-2940 View (516) 701-2940
Photo of Ching Sum Leung, Clinical Social Work/Therapist in New York, NY
Ching Sum Leung
Clinical Social Work/Therapist, LCSW-R
Verified Verified
New York, NY 10038
Are you ready to embark on a transformative journey towards a happier, healthier, and more fulfilling life? I believe that everyone has the potential to lead a life filled with purpose, resilience, and joy. My mission is to provide compassionate and empowering counseling services to individuals seeking positive change and personal growth.
Are you ready to embark on a transformative journey towards a happier, healthier, and more fulfilling life? I believe that everyone has the potential to lead a life filled with purpose, resilience, and joy. My mission is to provide compassionate and empowering counseling services to individuals seeking positive change and personal growth.
(929) 475-0549 View (929) 475-0549
Photo of Tyvon A Foster, Clinical Social Work/Therapist in New York, NY
Tyvon A Foster
Clinical Social Work/Therapist, LCSW, CAMS, REBT
Verified Verified
2 Endorsed
New York, NY 10001  (Online Only)
For many of us, we experience trauma or otherwise harmful events that impact our mental health significantly. Oftentimes it makes us doubt our worth, question if we matter, or makes us uncontrollably angry, for example. For me, I find it important to provide therapy to those who struggle with such issues, who believe there isn't another side. I'm here to tell you, there is.
For many of us, we experience trauma or otherwise harmful events that impact our mental health significantly. Oftentimes it makes us doubt our worth, question if we matter, or makes us uncontrollably angry, for example. For me, I find it important to provide therapy to those who struggle with such issues, who believe there isn't another side. I'm here to tell you, there is.
(914) 340-5359 View (914) 340-5359
Photo of Peter Vietze, Psychologist in New York, NY
Peter Vietze
Psychologist, PhD
Verified Verified
New York, NY 10002
I began practicing in Maryland in 1978. I resumed practicing in New York in 2004 and added an office in New Jersey in 2013. My practice covers a broad age range from 2-90. I am most comfortable treating adults with a variety of mental health issues. I also see couples and do family therapy. In addition, I have done play therapy with children. I am also comfortable conducting psychological evaluations of children ranging in age from a year to 21 years. I am an expert in developmental disabilities including autism spectrum disorders.
I began practicing in Maryland in 1978. I resumed practicing in New York in 2004 and added an office in New Jersey in 2013. My practice covers a broad age range from 2-90. I am most comfortable treating adults with a variety of mental health issues. I also see couples and do family therapy. In addition, I have done play therapy with children. I am also comfortable conducting psychological evaluations of children ranging in age from a year to 21 years. I am an expert in developmental disabilities including autism spectrum disorders.
(347) 673-0206 View (347) 673-0206
Photo of Alex S Buckner, Psychologist in New York, NY
Alex S Buckner
Psychologist, PsyD
Verified Verified
2 Endorsed
New York, NY 10017
I believe that each person wants to find fulfillment in life, and that through the therapeutic relationship, we can work together to achieve this goal. In today's world, there are so many pressures and obstacles that people face on a daily basis. I work to help people identify the factors that affect their lives, assist them in gaining insight into the causes of their problems, and develop real-life solutions to address problematic issues. I use techniques from various types of therapy to achieve this. I work to help people identify their strengths in order to increase resiliency and autonomy and develop growing self-respect.
I believe that each person wants to find fulfillment in life, and that through the therapeutic relationship, we can work together to achieve this goal. In today's world, there are so many pressures and obstacles that people face on a daily basis. I work to help people identify the factors that affect their lives, assist them in gaining insight into the causes of their problems, and develop real-life solutions to address problematic issues. I use techniques from various types of therapy to achieve this. I work to help people identify their strengths in order to increase resiliency and autonomy and develop growing self-respect.
(914) 618-5723 View (914) 618-5723
Photo of Gabrielle Friedman, Clinical Social Work/Therapist in New York, NY
Gabrielle Friedman
Clinical Social Work/Therapist, LMSW
Verified Verified
New York, NY 10023
It is easy to forget that each person is an individual in the complex world we live in. It is common for humans to struggle with their individuality, identity, and finding themselves or their life’s purpose. This struggle can leave you feeling confused, isolated, anxious, overwhelmed, disconnected, or lost. I view therapy as a way to connect by providing patients with a supportive, safe, non-judgemental space to explore and confront these feelings.
It is easy to forget that each person is an individual in the complex world we live in. It is common for humans to struggle with their individuality, identity, and finding themselves or their life’s purpose. This struggle can leave you feeling confused, isolated, anxious, overwhelmed, disconnected, or lost. I view therapy as a way to connect by providing patients with a supportive, safe, non-judgemental space to explore and confront these feelings.
(718) 550-3655 View (718) 550-3655
Photo of Samuel Parton, Clinical Social Work/Therapist in New York, NY
Samuel Parton
Clinical Social Work/Therapist, LMSW
Verified Verified
New York, NY 10028
Working in schools and foster care settings for years, Sam is an expert in child and adolescent therapy. He utilizes two of the leading therapies, Cognitive Behavior Therapy (CBT) and Dialectical Behavioral Therapy (DBT). With CBT, Sam helps clients change unhelpful thought processes and behavioral patterns and aids clients in bravely facing their fears. While with DBT, he helps clients learn better emotion regulation, distress tolerance, and interpersonal skills. He is passionate about building connections and assists clients in finding strengths and skills within themselves to work through any struggles they might be experiencing.
Working in schools and foster care settings for years, Sam is an expert in child and adolescent therapy. He utilizes two of the leading therapies, Cognitive Behavior Therapy (CBT) and Dialectical Behavioral Therapy (DBT). With CBT, Sam helps clients change unhelpful thought processes and behavioral patterns and aids clients in bravely facing their fears. While with DBT, he helps clients learn better emotion regulation, distress tolerance, and interpersonal skills. He is passionate about building connections and assists clients in finding strengths and skills within themselves to work through any struggles they might be experiencing.
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Photo of Xiaoxi Elsie Lin, Clinical Social Work/Therapist in New York, NY
Xiaoxi Elsie Lin
Clinical Social Work/Therapist, LCSW
Verified Verified
New York, NY 10016  (Online Only)
Elsie received her Master's in Social Work from New York University's Silver School of Social Work. She has years of experience working with individuals struggling with OCD, anxiety, depression, trauma, eating disorders, as well as different phobias. Elsie holds certifications in Exposure and Response Prevention (EX/RP), Eye Movement Desensitization and Reprocessing (EMDR), Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), and Trauma-Focused CBT.
Elsie received her Master's in Social Work from New York University's Silver School of Social Work. She has years of experience working with individuals struggling with OCD, anxiety, depression, trauma, eating disorders, as well as different phobias. Elsie holds certifications in Exposure and Response Prevention (EX/RP), Eye Movement Desensitization and Reprocessing (EMDR), Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), and Trauma-Focused CBT.
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Photo of Lauren Reynolds in New York, NY
Lauren Reynolds
LMHC
Verified Verified
1 Endorsed
New York, NY 10012
My client can struggle with stressors such as substance use to high-"functioning" depression; individuals that are 'going through the motions' to maintain their day-to-day life, inside they’re screaming. In recognizing the the void in care and understanding of marginalized persons' my approach in counseling is to provide emotional insight and reframing maladaptive thinking patterns through strength building.
My client can struggle with stressors such as substance use to high-"functioning" depression; individuals that are 'going through the motions' to maintain their day-to-day life, inside they’re screaming. In recognizing the the void in care and understanding of marginalized persons' my approach in counseling is to provide emotional insight and reframing maladaptive thinking patterns through strength building.
(516) 701-2776 View (516) 701-2776

How does your Therapist compare?

Number of Therapists in New York, NY

3,000+

Average cost per session

$200

Therapists in New York, NY who prioritize treating:

94% Anxiety
89% Depression
85% Relationship Issues
78% Self Esteem
67% Trauma and PTSD
66% Stress
63% Coping Skills

Average years in practice

12 Years

Top 3 insurances accepted

78% Aetna
62% UnitedHealthcare UHC | UBH
60% Cigna and Evernorth

How Therapists in New York, NY see their clients

59% In Person and Online
41% Online Only

Gender breakdown

78% Female
21% Male
1% Non-Binary

FAQs - About Therapy and Counseling

How can I find a therapist in New York?

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.