Therapists in Seattle, WA

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Photo of Ethan Schwab, Marriage & Family Therapist in Seattle, WA
Ethan Schwab
Marriage & Family Therapist, PhD, LMFT, CST
Verified Verified
5 Endorsed
Seattle, WA 98109
As a relationship and sex therapist, my background and training are in relationship treatment as well as sexuality therapy. I work with heterosexual, lesbian, gay, bisexual, queer, asexual, and transgender individuals, couples, and partnerships to heal and find fulfillment. I see adults on a variety of discomforts that affect individuals, partnerships, and sexuality (e.g., orgasmic issues, erectile issues, desire issues, sexual pain). Additionally, I see couples for a myriad of relational issues. I am LGBTIQA, kink, and poly friendly and knowledgeable.
As a relationship and sex therapist, my background and training are in relationship treatment as well as sexuality therapy. I work with heterosexual, lesbian, gay, bisexual, queer, asexual, and transgender individuals, couples, and partnerships to heal and find fulfillment. I see adults on a variety of discomforts that affect individuals, partnerships, and sexuality (e.g., orgasmic issues, erectile issues, desire issues, sexual pain). Additionally, I see couples for a myriad of relational issues. I am LGBTIQA, kink, and poly friendly and knowledgeable.
(425) 998-9432 View (425) 998-9432
Photo of Erica Rubin, Psychologist in Seattle, WA
Erica Rubin
Psychologist, PsyD
Verified Verified
1 Endorsed
Seattle, WA 98112
Not accepting new clients
I view psychotherapy as a collaborative process in which we work together to make sense of the problems that have brought you in, and work towards mutually established goals. Psychotherapy involves verbalizing your thoughts and feelings, exploring relational and behavioral patterns, and learning how past experiences may impact you now. Through this process we strive to gain greater awareness of how both conscious and unconscious processes play out in your emotional, intellectual and relational life. Ultimately, therapy can help individuals come to better understand themselves and exercise greater choice in their lives.
I view psychotherapy as a collaborative process in which we work together to make sense of the problems that have brought you in, and work towards mutually established goals. Psychotherapy involves verbalizing your thoughts and feelings, exploring relational and behavioral patterns, and learning how past experiences may impact you now. Through this process we strive to gain greater awareness of how both conscious and unconscious processes play out in your emotional, intellectual and relational life. Ultimately, therapy can help individuals come to better understand themselves and exercise greater choice in their lives.
(253) 214-9405 View (253) 214-9405
Photo of Kelsey I Anderson, Marriage & Family Therapist in Seattle, WA
Kelsey I Anderson
Marriage & Family Therapist, MS, LMFT
Verified Verified
5 Endorsed
Seattle, WA 98106  (Online Only)
Not accepting new clients
My goal as a therapist is to provide a safe, nonjudgmental atmosphere in which we can work together to gain a greater understanding of your challenges and move toward healing and growth. I provide individual therapy for adults, and specialize in working with those that are impacted by anxiety, chronic illness, and eating disorders. I also commonly provide counseling services for grief and loss, life transitions, adjustment to parenthood, self-esteem, stress management, and family of origin issues.
My goal as a therapist is to provide a safe, nonjudgmental atmosphere in which we can work together to gain a greater understanding of your challenges and move toward healing and growth. I provide individual therapy for adults, and specialize in working with those that are impacted by anxiety, chronic illness, and eating disorders. I also commonly provide counseling services for grief and loss, life transitions, adjustment to parenthood, self-esteem, stress management, and family of origin issues.
(425) 441-3074 View (425) 441-3074
Photo of Anna Jannack, Counselor in Seattle, WA
Anna Jannack
Counselor, BFA, MA, LMHC, AT
Verified Verified
3 Endorsed
Seattle, WA 98116
Have you been searching for a therapist but haven't been able to find one with whom you feel a strong connection? Have you been feeling like your life lacks meaning or direction? Are you being overwhelmed by feelings of sadness, irritability, emptiness or negativity? Are you wondering who that person is staring back at you in the mirror every day? Finding a therapist can be a challenging task. You want to find someone with whom you feel safe and can trust.
Have you been searching for a therapist but haven't been able to find one with whom you feel a strong connection? Have you been feeling like your life lacks meaning or direction? Are you being overwhelmed by feelings of sadness, irritability, emptiness or negativity? Are you wondering who that person is staring back at you in the mirror every day? Finding a therapist can be a challenging task. You want to find someone with whom you feel safe and can trust.
(425) 441-3364 View (425) 441-3364
Photo of Kevin Klevjer, Counselor in Seattle, WA
Kevin Klevjer
Counselor, MA, LMHC
Verified Verified
2 Endorsed
Seattle, WA 98134
Depression, anxiety, and the impact of trauma in our life and story often prevents us from living the life we yearn for. Martin Buber once said, “All real living is meeting.” We humans seem built for connection, for meeting, for encounter. We thrive when we are able to deeply see and be seen by another. Yet, all humans also experience barriers to connection. How can psychotherapy help? Psychotherapy can become a place to experience belonging and attunement, to discover ways there have been maladaptive patterns of disconnection in your life, and to imagine new ways of living that will bring you relational healing.
Depression, anxiety, and the impact of trauma in our life and story often prevents us from living the life we yearn for. Martin Buber once said, “All real living is meeting.” We humans seem built for connection, for meeting, for encounter. We thrive when we are able to deeply see and be seen by another. Yet, all humans also experience barriers to connection. How can psychotherapy help? Psychotherapy can become a place to experience belonging and attunement, to discover ways there have been maladaptive patterns of disconnection in your life, and to imagine new ways of living that will bring you relational healing.
(206) 207-5518 View (206) 207-5518
Photo of Katie Graham, Counselor in Seattle, WA
Katie Graham
Counselor, MA, LMHC
Verified Verified
Seattle, WA 98101  (Online Only)
We all have times when life seems like more than we can navigate on our own. With over 30 years of experience, I help clients with a wide range of issues for both short and long-term goals. My style is warm, interactive, and direct while honoring individual uniqueness and self-expression. In a safe and confidential setting, my goal is to provide an opportunity to challenge self-limiting beliefs/behaviors and to establish lifelong tools for improving/maintaining a healthy and fulfilling life.
We all have times when life seems like more than we can navigate on our own. With over 30 years of experience, I help clients with a wide range of issues for both short and long-term goals. My style is warm, interactive, and direct while honoring individual uniqueness and self-expression. In a safe and confidential setting, my goal is to provide an opportunity to challenge self-limiting beliefs/behaviors and to establish lifelong tools for improving/maintaining a healthy and fulfilling life.
(206) 452-2729 View (206) 452-2729
Photo of Kelslan Scarbrough, Counselor in Seattle, WA
Kelslan Scarbrough
Counselor, MA, LPCC, LMHC, RDT
Verified Verified
1 Endorsed
Seattle, WA 98126  (Online Only)
As a licensed counselor in Ohio (LPCC) and the state of Washington (LMHC), I view each individual as the expert of their experience, and foster a therapeutic space where unique strengths are celebrated and employed to create meaningful change. My education and experience provide me the opportunity to work with a variety of clinical concerns, including relational distress, depression, anxiety, trauma, life transitions and personal wellness, among others. My approach to counseling is client-centered and eclectic in nature. I draw upon narrative, ACT (Acceptance and Commitment Therapy), strength-based and evidenced-based modalities
As a licensed counselor in Ohio (LPCC) and the state of Washington (LMHC), I view each individual as the expert of their experience, and foster a therapeutic space where unique strengths are celebrated and employed to create meaningful change. My education and experience provide me the opportunity to work with a variety of clinical concerns, including relational distress, depression, anxiety, trauma, life transitions and personal wellness, among others. My approach to counseling is client-centered and eclectic in nature. I draw upon narrative, ACT (Acceptance and Commitment Therapy), strength-based and evidenced-based modalities
(206) 203-5279 View (206) 203-5279
Photo of Prof. Audrey Tice, Counselor in Seattle, WA
Prof. Audrey Tice
Counselor, Life, Coach, MA
Verified Verified
Seattle, WA 98115  (Online Only)
Set and attain your goals with assistance from a Life-Coach to keep you focused on goal. Become better at what you do or want to do. Accomplish your goals focused and committed. Create your Tranquil Space.
Set and attain your goals with assistance from a Life-Coach to keep you focused on goal. Become better at what you do or want to do. Accomplish your goals focused and committed. Create your Tranquil Space.
(206) 222-5258 View (206) 222-5258
Photo of Christopher Brown, Clinical Social Work/Therapist in Seattle, WA
Christopher Brown
Clinical Social Work/Therapist, LICSW, LCSW
Verified Verified
11 Endorsed
Seattle, WA 98105  (Online Only)
Are you feeling stuck or overwhelmed? Too reactive toward others? Is your mind racing when you need it to slow down? Struggling to perform at your best? Sleep issues? These are common signs of someone with unresolved stress or trauma. The good news is I have tools to help you change toward healing, growth, and optimal performance. I can help you overcome the impacts of stress and trauma, achieving the life you know you’re capable of.
Are you feeling stuck or overwhelmed? Too reactive toward others? Is your mind racing when you need it to slow down? Struggling to perform at your best? Sleep issues? These are common signs of someone with unresolved stress or trauma. The good news is I have tools to help you change toward healing, growth, and optimal performance. I can help you overcome the impacts of stress and trauma, achieving the life you know you’re capable of.
(206) 672-9578 View (206) 672-9578
Photo of Mira Farrow, Clinical Social Work/Therapist in Seattle, WA
Mira Farrow
Clinical Social Work/Therapist, MA, MSW, LSWAIC
Verified Verified
Seattle, WA 98122  (Online Only)
Life can be complicated and stressful at times and change can include triggers making the journey complicated. During these times it is human to reach out for empathy, support, and safety. My therapy approach is guided by the needs of each individual I work with. We will collaboratively create affirming, safe space to share and address your needs and concerns, explore potential solutions, and honor growth, no matter what stage your are at along your journey to a more fulfilled life. I employ a psychodynamic approach to therapy for healing of trauma and identity exploration. I treat all individuals with dignity and respect.
Life can be complicated and stressful at times and change can include triggers making the journey complicated. During these times it is human to reach out for empathy, support, and safety. My therapy approach is guided by the needs of each individual I work with. We will collaboratively create affirming, safe space to share and address your needs and concerns, explore potential solutions, and honor growth, no matter what stage your are at along your journey to a more fulfilled life. I employ a psychodynamic approach to therapy for healing of trauma and identity exploration. I treat all individuals with dignity and respect.
(206) 203-7335 View (206) 203-7335
Photo of Elizabeth Hernandez, Marriage & Family Therapist in Seattle, WA
Elizabeth Hernandez
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Seattle, WA 98101  (Online Only)
Elizabeth Hernandez or Liz is a Licensed Marriage and Family Therapist who received her Master's degree from Lewis and Clark University in Portland Oregon. She has experience working with adults and teens that are looking to reduce anxiety, burnout, and depression and have previously been diagnosed with ADHD/ADD. Liz pulls from Emotionally Focused, Client-Centered, Solution Focused, Narrative, and Attachment-Based Theories. She utilizes collaborative treatment planning to ensure that individuals are part of their therapeutic journey throughout their time working with Liz.
Elizabeth Hernandez or Liz is a Licensed Marriage and Family Therapist who received her Master's degree from Lewis and Clark University in Portland Oregon. She has experience working with adults and teens that are looking to reduce anxiety, burnout, and depression and have previously been diagnosed with ADHD/ADD. Liz pulls from Emotionally Focused, Client-Centered, Solution Focused, Narrative, and Attachment-Based Theories. She utilizes collaborative treatment planning to ensure that individuals are part of their therapeutic journey throughout their time working with Liz.
(425) 375-7963 View (425) 375-7963
Photo of Healing Powers of Therapy, Clinical Social Work/Therapist in Seattle, WA
Healing Powers of Therapy
Clinical Social Work/Therapist, PhD, MSW, LSWAIC
Verified Verified
Seattle, WA 98125  (Online Only)
Waitlist for new clients
I have experience working with military service members (active duty, reserves, and guard) and veterans (and their families). I also have experience working with students in a variety of different settings (to include student veterans). Additionally, I specialize in working with women for women-focused issues, women leaders in particular. My ideal client wants to process their issue with me as their guide to obtain an ultimate goal of feeling better. Ultimately, my clients will be the deciders of their own goals in therapy with me.
I have experience working with military service members (active duty, reserves, and guard) and veterans (and their families). I also have experience working with students in a variety of different settings (to include student veterans). Additionally, I specialize in working with women for women-focused issues, women leaders in particular. My ideal client wants to process their issue with me as their guide to obtain an ultimate goal of feeling better. Ultimately, my clients will be the deciders of their own goals in therapy with me.
(206) 875-2465 View (206) 875-2465
Photo of Kelly Thoma, Clinical Social Work/Therapist in Seattle, WA
Kelly Thoma
Clinical Social Work/Therapist, LSWAIC
Verified Verified
Seattle, WA 98105
I work with people in an authentic and collaborative way, where we first build a safe environment so that you can feel open to exploring what you want to talk about at your own pace. I believe in relationally focused therapy, using the relationship between us to look into patterns, difficulties, wants, and goals in life. I believe therapy can help us find meaning, connection, and alignment with our own values. Whether it be your upbringing, life transitions, relationships, or understanding your feelings better, therapy can help you navigate these topics and live in a way that feels more integrated.
I work with people in an authentic and collaborative way, where we first build a safe environment so that you can feel open to exploring what you want to talk about at your own pace. I believe in relationally focused therapy, using the relationship between us to look into patterns, difficulties, wants, and goals in life. I believe therapy can help us find meaning, connection, and alignment with our own values. Whether it be your upbringing, life transitions, relationships, or understanding your feelings better, therapy can help you navigate these topics and live in a way that feels more integrated.
(206) 210-3602 View (206) 210-3602
Photo of Sunni Dupree, Clinical Social Work/Therapist in Seattle, WA
Sunni Dupree
Clinical Social Work/Therapist
Verified Verified
Seattle, WA 98188
As a mental health practitioner, fitness, and nutritional educator based in Washington, I specialize in addressing a wide range of mental health issues, including anxiety, depression, grief & loss, crisis journeys, Dementia-related diseases, body image, eating disorders, and women’s issues. I approach each client's journey with compassion and personalized care, utilizing evidence-based practices, fitness and nutrition.
As a mental health practitioner, fitness, and nutritional educator based in Washington, I specialize in addressing a wide range of mental health issues, including anxiety, depression, grief & loss, crisis journeys, Dementia-related diseases, body image, eating disorders, and women’s issues. I approach each client's journey with compassion and personalized care, utilizing evidence-based practices, fitness and nutrition.
(206) 208-7477 x1 View (206) 208-7477 x1
Photo of Hannah C Paine, Counselor in Seattle, WA
Hannah C Paine
Counselor, LMHC, MA, NCC
Verified Verified
7 Endorsed
Seattle, WA 98109  (Online Only)
Accepting new clients for early May 2024! I believe that everyone can develop the skills necessary to live the life they’ve always wanted, and it begins with their mental health. My goal as a therapist is to help clients explore their past, their patterns of thinking, and their behaviors in order to adapt and overcome their trauma. Using an individualized and integrative approach, clients will develop the skills needed to reach their goals and become drivers of change.
Accepting new clients for early May 2024! I believe that everyone can develop the skills necessary to live the life they’ve always wanted, and it begins with their mental health. My goal as a therapist is to help clients explore their past, their patterns of thinking, and their behaviors in order to adapt and overcome their trauma. Using an individualized and integrative approach, clients will develop the skills needed to reach their goals and become drivers of change.
(206) 567-7177 View (206) 567-7177
Photo of Amy Nickum, Clinical Social Work/Therapist in Seattle, WA
Amy Nickum
Clinical Social Work/Therapist, MSSW, LSWAIC
Verified Verified
Seattle, WA 98107  (Online Only)
Accepting New Clients! Please contact me for a free consultation. Life's challenges can sometimes feel overwhelming. During those times, it's crucial to have the support you need to navigate difficult decisions or life changes. My client-centered approach aims to meet you exactly where you are in your journey and join with you on the path toward healing and fulfillment. By creating a safe and non-judgmental space, this allows you to freely explore your thoughts, emotions, and concerns.
Accepting New Clients! Please contact me for a free consultation. Life's challenges can sometimes feel overwhelming. During those times, it's crucial to have the support you need to navigate difficult decisions or life changes. My client-centered approach aims to meet you exactly where you are in your journey and join with you on the path toward healing and fulfillment. By creating a safe and non-judgmental space, this allows you to freely explore your thoughts, emotions, and concerns.
(206) 944-3590 View (206) 944-3590
Photo of Rosalynn Recine, Clinical Social Work/Therapist in Seattle, WA
Rosalynn Recine
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Seattle, WA 98136
I use a holistic approach to healing that includes mind, body and spirit. I have a particular focus on women's health issues, sexual abuse, and PTSD. Every pain, trauma, and obstacle we experience in life has information to share with us. The most difficult times we face can be truly transformative if we know how to listen to them. Sometimes we can get lost down these turbulent roads and my job is to help you navigate the path that you are already on.
I use a holistic approach to healing that includes mind, body and spirit. I have a particular focus on women's health issues, sexual abuse, and PTSD. Every pain, trauma, and obstacle we experience in life has information to share with us. The most difficult times we face can be truly transformative if we know how to listen to them. Sometimes we can get lost down these turbulent roads and my job is to help you navigate the path that you are already on.
(844) 237-9391 View (844) 237-9391
Photo of Jeanan Hyat, Mental Health Counselor in Seattle, WA
Jeanan Hyat
Mental Health Counselor, LMHC, MA
Verified Verified
1 Endorsed
Seattle, WA 98119
Life comes at us fast and we’re not always ready for it but that’s okay! I believe that we all crave connection with our peers, friends, family, and partners. And when we aren’t working on those connections, we’re working to build our connection with ourself. To fully work through that and make progress, I use a direct approach in helping clients address concerns that may arise from their connections with others or with themself. I believe that the most progress can be made when it’s accompanied with empathy and unconditional positive regard - two pillars of therapeutic work to foster growth and a sense of safety.
Life comes at us fast and we’re not always ready for it but that’s okay! I believe that we all crave connection with our peers, friends, family, and partners. And when we aren’t working on those connections, we’re working to build our connection with ourself. To fully work through that and make progress, I use a direct approach in helping clients address concerns that may arise from their connections with others or with themself. I believe that the most progress can be made when it’s accompanied with empathy and unconditional positive regard - two pillars of therapeutic work to foster growth and a sense of safety.
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Photo of Erin Swan Fearless Healing Therapy, Clinical Social Work/Therapist in Seattle, WA
Erin Swan Fearless Healing Therapy
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
1 Endorsed
Seattle, WA 98115
You are finally ready to start working on healing inner wounds. We can begin by getting curious about what your nervous system needs to feel safe and ready, using curiosity and compassion. This can create an instant softening of symptoms related to anxiety, PTSD or C-PTSD, and grief/loss. For couples in distress, you CAN engage with more thoughtful reflection and heal relational wounds in order to transform your relationship; And if there is ambivalence about your future together as a couple, I can help you choose a path forward using short-term Discernment Counseling.
You are finally ready to start working on healing inner wounds. We can begin by getting curious about what your nervous system needs to feel safe and ready, using curiosity and compassion. This can create an instant softening of symptoms related to anxiety, PTSD or C-PTSD, and grief/loss. For couples in distress, you CAN engage with more thoughtful reflection and heal relational wounds in order to transform your relationship; And if there is ambivalence about your future together as a couple, I can help you choose a path forward using short-term Discernment Counseling.
(206) 966-4920 View (206) 966-4920
Photo of Gail Rosenberg, Psychologist in Seattle, WA
Gail Rosenberg
Psychologist, PhD
Verified Verified
Seattle, WA 98144  (Online Only)
I am most interested in working with people who are wanting to more fully be themselves, who are wanting to face their feelings without depression or excessive anxiety and being themselves creatively and within relationships. I enjoy helping people to develop the resources to regulate their emotions and to tolerate the inevitable discomfort that comes with growth.
I am most interested in working with people who are wanting to more fully be themselves, who are wanting to face their feelings without depression or excessive anxiety and being themselves creatively and within relationships. I enjoy helping people to develop the resources to regulate their emotions and to tolerate the inevitable discomfort that comes with growth.
(425) 610-9836 View (425) 610-9836

How does your Therapist compare?

Number of Therapists in Seattle, WA

3,000+

Average cost per session

$150

Therapists in Seattle, WA who prioritize treating:

93% Anxiety
86% Depression
79% Relationship Issues
76% Self Esteem
72% Trauma and PTSD
71% Stress
69% Life Transitions

Average years in practice

9 Years

Top 3 insurances accepted

70% Premera
53% Aetna
47% Regence

How Therapists in Seattle, WA see their clients

51% Online Only
49% In Person and Online

Gender breakdown

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

How can I find a therapist in Seattle?

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.