Therapists in San Francisco, CA

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Photo of Dr. Nadia K. Thalji, Psychologist in San Francisco, CA
Dr. Nadia K. Thalji
Psychologist, PhD
Verified Verified
7 Endorsed
San Francisco, CA 94123
Navigating relationship complexities within diverse cultural backgrounds? Struggling with communication, intimacy, or connecting amidst differing expectations? I specialize in identifying core issues hindering understanding and reducing stressors related to communication and boundaries. Whether you're an immigrant, bicultural, or part of a diverse family, my trauma-informed approach integrates various techniques to foster enduring connections and celebrate diversity within and outside your relationships. Let's embark on a journey towards sustainable, meaningful connections together.
Navigating relationship complexities within diverse cultural backgrounds? Struggling with communication, intimacy, or connecting amidst differing expectations? I specialize in identifying core issues hindering understanding and reducing stressors related to communication and boundaries. Whether you're an immigrant, bicultural, or part of a diverse family, my trauma-informed approach integrates various techniques to foster enduring connections and celebrate diversity within and outside your relationships. Let's embark on a journey towards sustainable, meaningful connections together.
(415) 980-7129 View (415) 980-7129
Photo of Dorene Paul, LMFT, Marriage & Family Therapist in San Francisco, CA
Dorene Paul, LMFT
Marriage & Family Therapist, MA, LMFT
Verified Verified
San Francisco, CA 94102
Welcome, my name Dorene Paul and I am a licensed psychotherapist and marriage counselor. I have had the honor of practicing therapy for over 20 years, working with adults, couples and youth with a wide variety of issues. In my experience, each person comes to therapy with a unique set of experiences, feelings, issues, gifts, goals, therefore I use a variety of therapeutic approaches, from cognitive to current psychodynamic approaches and EMDR for those dealing with past trauma. In therapy I am your companion and counselor on a deeply meaningful journey.
Welcome, my name Dorene Paul and I am a licensed psychotherapist and marriage counselor. I have had the honor of practicing therapy for over 20 years, working with adults, couples and youth with a wide variety of issues. In my experience, each person comes to therapy with a unique set of experiences, feelings, issues, gifts, goals, therefore I use a variety of therapeutic approaches, from cognitive to current psychodynamic approaches and EMDR for those dealing with past trauma. In therapy I am your companion and counselor on a deeply meaningful journey.
(415) 780-9081 View (415) 780-9081
Photo of Rebecca Chadwick, Marriage & Family Therapist in San Francisco, CA
Rebecca Chadwick
Marriage & Family Therapist, LMFT
Verified Verified
3 Endorsed
San Francisco, CA 94118
I help individuals who are feeling anxious, lost, disconnected, overwhelmed, unstable, or alone. These feelings may be related to a specific season of life or could be ways that you’ve felt for a long time. My areas of focus include anxiety, depression, developmental trauma, identity exploration, survivors of intimate partner abuse, life transitions, and relationship issues. My approach is compassionate, engaged, and warm.
I help individuals who are feeling anxious, lost, disconnected, overwhelmed, unstable, or alone. These feelings may be related to a specific season of life or could be ways that you’ve felt for a long time. My areas of focus include anxiety, depression, developmental trauma, identity exploration, survivors of intimate partner abuse, life transitions, and relationship issues. My approach is compassionate, engaged, and warm.
(628) 444-4877 View (628) 444-4877
Photo of Jamie Salas, Marriage & Family Therapist in San Francisco, CA
Jamie Salas
Marriage & Family Therapist, MSc, LMFT
Verified Verified
San Francisco, CA 94110  (Online Only)
Ever feel trapped in a whirlwind of "what-ifs" and "should's," spiraling in doubt, uncertainty, and overwhelm? I've been there too, and I totally get it! We're constantly juggling busy schedules, limited resources, and high expectations, life can feel like a daunting maze without a map, trying to sort out how to navigate our thoughts, feelings, and actions. I believe everyone is doing their best to cope with what they have, seeking a space to strengthen their inner resilience and develop skills that match their values and goals. Let's journey together towards empowerment and growth!
Ever feel trapped in a whirlwind of "what-ifs" and "should's," spiraling in doubt, uncertainty, and overwhelm? I've been there too, and I totally get it! We're constantly juggling busy schedules, limited resources, and high expectations, life can feel like a daunting maze without a map, trying to sort out how to navigate our thoughts, feelings, and actions. I believe everyone is doing their best to cope with what they have, seeking a space to strengthen their inner resilience and develop skills that match their values and goals. Let's journey together towards empowerment and growth!
(510) 871-8590 View (510) 871-8590
Photo of Brenda Santillan, Marriage & Family Therapist in San Francisco, CA
Brenda Santillan
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94110
My name is Brenda Santillan, and I am a Licensed Marriage and Family therapist based in Los Angeles, CA, and working with clients statewide via telehealth. I work with adults ages 18-60 and specialize in anxiety, stress, depression, trauma, and lgbtqia+ issues using person-centered, trauma-informed psychotherapy to assist clients in healing. As a therapist, my approach varies based on the needs of each client I work with. I most frequently use more personal-centered, psychodynamic as modalities to help me understand a client's point of view.
My name is Brenda Santillan, and I am a Licensed Marriage and Family therapist based in Los Angeles, CA, and working with clients statewide via telehealth. I work with adults ages 18-60 and specialize in anxiety, stress, depression, trauma, and lgbtqia+ issues using person-centered, trauma-informed psychotherapy to assist clients in healing. As a therapist, my approach varies based on the needs of each client I work with. I most frequently use more personal-centered, psychodynamic as modalities to help me understand a client's point of view.
(415) 993-5571 View (415) 993-5571
Photo of Stephanie Stolorow, Marriage & Family Therapist in San Francisco, CA
Stephanie Stolorow
Marriage & Family Therapist, MA, LMFT
Verified Verified
12 Endorsed
San Francisco, CA 94110  (Online Only)
Do you sometimes find yourself feeling anxious or depressed but you're not sure why? Or is there something specific in your life causing you distress? Would you like to feel more authentic or whole in connecting to your partner or others? Therapy can help you find clarity, resources, and direction in your life and relationships. Therapy with me provides you with a safe space where you are invited and encouraged to bring out any parts of yourself that need room for expression. Expressing and working through hurt, stuck, confused, and also joyful parts can in turn contribute to your sense of wholeness and health.
Do you sometimes find yourself feeling anxious or depressed but you're not sure why? Or is there something specific in your life causing you distress? Would you like to feel more authentic or whole in connecting to your partner or others? Therapy can help you find clarity, resources, and direction in your life and relationships. Therapy with me provides you with a safe space where you are invited and encouraged to bring out any parts of yourself that need room for expression. Expressing and working through hurt, stuck, confused, and also joyful parts can in turn contribute to your sense of wholeness and health.
(415) 301-3671 View (415) 301-3671
Photo of James Rosenheim, Marriage & Family Therapist in San Francisco, CA
James Rosenheim
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94105  (Online Only)
I describe myself as passionate, open, caring and engaged. I have worked for many years with teens, parents, families, and individuals experiencing anxiety and depressive disorders, including Major Depressive Disorder, OCD, and Generalized Anxiety Disorder. I am committed to helping each client meet their goals, including working with all other care providers involved. I use Acceptance and Commitment Therapy and have an extensive background in mindfulness. I meet each client where they are at, and collaborate with the client to show up for life in a way that is consistent with their values.
I describe myself as passionate, open, caring and engaged. I have worked for many years with teens, parents, families, and individuals experiencing anxiety and depressive disorders, including Major Depressive Disorder, OCD, and Generalized Anxiety Disorder. I am committed to helping each client meet their goals, including working with all other care providers involved. I use Acceptance and Commitment Therapy and have an extensive background in mindfulness. I meet each client where they are at, and collaborate with the client to show up for life in a way that is consistent with their values.
(415) 936-1364 View (415) 936-1364
Photo of Jeannine McAdams, Psychologist in San Francisco, CA
Jeannine McAdams
Psychologist, PsyD
Verified Verified
San Francisco, CA 94102
Dr. Jeannine McAdams is a Psychologist in California who has been practicing since 2024. Dr. McAdams supports client to become more selfaware, manage and move through distressing symptoms and mood states, set and reach goals, heal and manage depression, anxiety, PTSD, bipolar, and other mental health issues. Dr. McAdams offers nonjudgmental, heart centered assessment and psychotherapy. Adults, adolescents, couples, families, neurodivergent and LQBTQ+ welcome. In her free time, Dr. McAdams loves to be outdoors, snowboard and surf, garden, and hike. She loves dogs and camping under the stars.
Dr. Jeannine McAdams is a Psychologist in California who has been practicing since 2024. Dr. McAdams supports client to become more selfaware, manage and move through distressing symptoms and mood states, set and reach goals, heal and manage depression, anxiety, PTSD, bipolar, and other mental health issues. Dr. McAdams offers nonjudgmental, heart centered assessment and psychotherapy. Adults, adolescents, couples, families, neurodivergent and LQBTQ+ welcome. In her free time, Dr. McAdams loves to be outdoors, snowboard and surf, garden, and hike. She loves dogs and camping under the stars.
(628) 244-8227 View (628) 244-8227
Photo of Celeste Poe, Psychologist in San Francisco, CA
Celeste Poe
Psychologist, PhD, LMFT, PMH-C
Verified Verified
San Francisco, CA 94103  (Online Only)
As a multigenerational psychologist with specialized training in working with infants, young children, mothers, fathers, and couples, my work is rooted in supporting families of young children, particularly during circumstances of trauma, grief, and bereavement. Growing a family is a time of great vulnerability but also an opportunity to promote nurturing, growth, and often, intergenerational healing. The adjustment and changes associated with this period of time can impact a child, parent, or an entire family’s emotional wellbeing. I work to support families during this transformative period.
As a multigenerational psychologist with specialized training in working with infants, young children, mothers, fathers, and couples, my work is rooted in supporting families of young children, particularly during circumstances of trauma, grief, and bereavement. Growing a family is a time of great vulnerability but also an opportunity to promote nurturing, growth, and often, intergenerational healing. The adjustment and changes associated with this period of time can impact a child, parent, or an entire family’s emotional wellbeing. I work to support families during this transformative period.
(415) 496-0887 View (415) 496-0887
Photo of Cary Dakin, Marriage & Family Therapist in San Francisco, CA
Cary Dakin
Marriage & Family Therapist, PhD, MFT
Verified Verified
1 Endorsed
San Francisco, CA 94104
If you're feeling anxious about the state of things these days and would like to talk, I am meeting with people remotely via phone and video. Therapy is a conversation in which you can discuss the most complex and sensitive subjects. Together we reach an understanding of what you're experiencing by sorting through your thoughts and feelings.
If you're feeling anxious about the state of things these days and would like to talk, I am meeting with people remotely via phone and video. Therapy is a conversation in which you can discuss the most complex and sensitive subjects. Together we reach an understanding of what you're experiencing by sorting through your thoughts and feelings.
(415) 801-0591 View (415) 801-0591
Photo of Rene Dumetz Ph. D., Marriage & Family Therapist in San Francisco, CA
Rene Dumetz Ph. D.
Marriage & Family Therapist, PhD, MA, LMFT
Verified Verified
1 Endorsed
San Francisco, CA 94109  (Online Only)
"Look within. All you need, you have. Use it. Behave as best you know; do what you think you should. Don't be afraid of mistakes; you can always correct them; only intentions matter. The shape things take is not within your power; the motives of your actions are." (Nisargadata 1973, p.365)
"Look within. All you need, you have. Use it. Behave as best you know; do what you think you should. Don't be afraid of mistakes; you can always correct them; only intentions matter. The shape things take is not within your power; the motives of your actions are." (Nisargadata 1973, p.365)
(323) 431-9369 View (323) 431-9369
Photo of Fiona Walsh Dinan, Marriage & Family Therapist in San Francisco, CA
Fiona Walsh Dinan
Marriage & Family Therapist, LMFT, MA, MBA
Verified Verified
5 Endorsed
San Francisco, CA 94115
Are you feeling stuck with past trauma or dealing with daily anxiety? Are you struggling with the challenges of being a new mom and postpartum depression or anxiety? Are you not where you wish to be in your life and with your well-being? Do you want to connect more deeply with your inner knowing and guidance? It can be hard to know where to start, and life's day-to-day can feel all-encompassing. The time is now to seek support and say yes to your needs.
Are you feeling stuck with past trauma or dealing with daily anxiety? Are you struggling with the challenges of being a new mom and postpartum depression or anxiety? Are you not where you wish to be in your life and with your well-being? Do you want to connect more deeply with your inner knowing and guidance? It can be hard to know where to start, and life's day-to-day can feel all-encompassing. The time is now to seek support and say yes to your needs.
View
Photo of Debra Miller, Marriage & Family Therapist in San Francisco, CA
Debra Miller
Marriage & Family Therapist, RN, MFT, LPCC
Verified Verified
2 Endorsed
San Francisco, CA 94115  (Online Only)
"The more aspects of myself I am given the freedom to know and live without reacting to as right or wrong, good or bad, the more I can witness all the elements of who I am and the healthier I am" ---Diane Shainberg. As a psychotherapist, I practice with the belief that therapy can be a rich and vital exploration into understanding the deepest parts of ourselves.The parts we cherish as well as the parts we want to change.
"The more aspects of myself I am given the freedom to know and live without reacting to as right or wrong, good or bad, the more I can witness all the elements of who I am and the healthier I am" ---Diane Shainberg. As a psychotherapist, I practice with the belief that therapy can be a rich and vital exploration into understanding the deepest parts of ourselves.The parts we cherish as well as the parts we want to change.
(415) 347-5972 View (415) 347-5972
Photo of Eliot M. Lev, Associate Clinical Social Worker in San Francisco, CA
Eliot M. Lev
Associate Clinical Social Worker, ACSW, MS
Verified Verified
1 Endorsed
San Francisco, CA 94103  (Online Only)
Waitlist for new clients
In the journey towards healing and self-discovery, finding a therapist who truly understands the intersectionality of your experiences is key. As a therapist and part of the trans, queer, ethnic minority, multicultural, immigrant, trauma survivor, and (dis)ability communities, I'm dedicated to honoring all that makes you - you. The uniqueness of your journey, recognition of your experiences, and collaboration will be at the core of our work.
In the journey towards healing and self-discovery, finding a therapist who truly understands the intersectionality of your experiences is key. As a therapist and part of the trans, queer, ethnic minority, multicultural, immigrant, trauma survivor, and (dis)ability communities, I'm dedicated to honoring all that makes you - you. The uniqueness of your journey, recognition of your experiences, and collaboration will be at the core of our work.
(415) 498-1860 View (415) 498-1860
Photo of Leora Fulvio, Marriage & Family Therapist in San Francisco, CA
Leora Fulvio
Marriage & Family Therapist, MA, MFT, CCHT
Verified Verified
5 Endorsed
San Francisco, CA 94123
If you are suffering with food & body image issues, issues of self-esteem & self-worth, relationship issues or dealing with trauma, I can help you. There are so many women who feel as though they are not enough. They believe that they somehow have to be better, look different, lose weight, be a whole different person to have a good relationship and a happy life. They beat themselves up constantly and are always trying to change. Do you understand this feeling? If so, I can help you have a loving relationship with yourself and settle into who you really are.
If you are suffering with food & body image issues, issues of self-esteem & self-worth, relationship issues or dealing with trauma, I can help you. There are so many women who feel as though they are not enough. They believe that they somehow have to be better, look different, lose weight, be a whole different person to have a good relationship and a happy life. They beat themselves up constantly and are always trying to change. Do you understand this feeling? If so, I can help you have a loving relationship with yourself and settle into who you really are.
(415) 649-8964 View (415) 649-8964
Photo of Shira Appell, Marriage & Family Therapist in San Francisco, CA
Shira Appell
Marriage & Family Therapist, MA, LMFT
Verified Verified
4 Endorsed
San Francisco, CA 94123
Do you feel like you aren't good enough? Do you struggle with issues of self esteem or self worth? Do you want to explore mind-body connection & the way stress or emotional pain lives in our bodies? If these are themes for you or in your relationships, then perhaps we might work well together. I center my work around self compassion. Only from a place of self kindness can we feel grounded within ourselves to develop a compassionate relationship with others around us. I use mindfulness and somatic body oriented work in order to help us connect deeper with our self, our inner knowing and to be able to cultivate trust with ourselves.
Do you feel like you aren't good enough? Do you struggle with issues of self esteem or self worth? Do you want to explore mind-body connection & the way stress or emotional pain lives in our bodies? If these are themes for you or in your relationships, then perhaps we might work well together. I center my work around self compassion. Only from a place of self kindness can we feel grounded within ourselves to develop a compassionate relationship with others around us. I use mindfulness and somatic body oriented work in order to help us connect deeper with our self, our inner knowing and to be able to cultivate trust with ourselves.
(628) 229-2098 View (628) 229-2098
Photo of Nicole Minor - Expansive Therapy, Licensed Professional Clinical Counselor in San Francisco, CA
Nicole Minor - Expansive Therapy
Licensed Professional Clinical Counselor, AMFT
Verified Verified
San Francisco, CA 94107
I value helping to foster a secure space and use an integrative approach to help clients feel empowered to reach their personal goals. Intersectionality has been paramount on my own personal healing journey and I have had the opportunity to work with clients who benefit from the same lens.
I value helping to foster a secure space and use an integrative approach to help clients feel empowered to reach their personal goals. Intersectionality has been paramount on my own personal healing journey and I have had the opportunity to work with clients who benefit from the same lens.
(628) 277-5830 View (628) 277-5830
Photo of Will Koehler, Marriage & Family Therapist in San Francisco, CA
Will Koehler
Marriage & Family Therapist, MA, MFT
Verified Verified
6 Endorsed
San Francisco, CA 94114  (Online Only)
If any of the following ring true for you, I can help. You get stuck in the downward spiral of self doubt and criticism. You have trouble organizing your life, and are struggling to deepen relationships, feeling like an outsider much of the time. You have difficulty managing intense emotions and find yourself in conflict with loved ones. You have or suspect you have ADHD. You want to better understand yourself.
If any of the following ring true for you, I can help. You get stuck in the downward spiral of self doubt and criticism. You have trouble organizing your life, and are struggling to deepen relationships, feeling like an outsider much of the time. You have difficulty managing intense emotions and find yourself in conflict with loved ones. You have or suspect you have ADHD. You want to better understand yourself.
(415) 275-6990 View (415) 275-6990
Photo of Bay Area Center for ADD/ADHD, Psychologist in San Francisco, CA
Bay Area Center for ADD/ADHD
Psychologist
Verified Verified
2 Endorsed
San Francisco, CA 94123
At the Bay Area Center for ADD/ADHD we work collaboratively as a group to provide the most effective treatment possible. We have psychiatrists, psychologists, marriage and family therapists, and an educational therapist to help develop the best treatment for you. Who provide up-to-date evidence-based, effective treatment.
At the Bay Area Center for ADD/ADHD we work collaboratively as a group to provide the most effective treatment possible. We have psychiatrists, psychologists, marriage and family therapists, and an educational therapist to help develop the best treatment for you. Who provide up-to-date evidence-based, effective treatment.
(415) 236-3165 View (415) 236-3165
Photo of Sarah K Spencer Psychotherapy Inc., Marriage & Family Therapist in San Francisco, CA
Sarah K Spencer Psychotherapy Inc.
Marriage & Family Therapist, LMFT
Not Verified Not Verified
San Francisco, CA 94118
My practice focuses on working with individuals, couples, adolescents and their families from a family system perspective. I believe that all of us benefit from recognizing who we are within the construct of our larger social dynamics. I am a psychodynamic and interactive therapist, focusing on your strengths as a means to work through your challenges. I will work with you to identify your therapeutic goals, and we will explore how best to reach your desired outcomes. I am creative, empathetic and very pragmatic. Therapy is a journey, we will work hard together to make the most of your energy, finances and time.
My practice focuses on working with individuals, couples, adolescents and their families from a family system perspective. I believe that all of us benefit from recognizing who we are within the construct of our larger social dynamics. I am a psychodynamic and interactive therapist, focusing on your strengths as a means to work through your challenges. I will work with you to identify your therapeutic goals, and we will explore how best to reach your desired outcomes. I am creative, empathetic and very pragmatic. Therapy is a journey, we will work hard together to make the most of your energy, finances and time.
(415) 991-7568 View (415) 991-7568

See more therapy options for San Francisco

How does your Therapist compare?

Number of Therapists in San Francisco, CA

3,000+

Average cost per session

$189

Therapists in San Francisco, CA who prioritize treating:

93% Anxiety
87% Depression
81% Relationship Issues
75% Self Esteem
70% Trauma and PTSD
68% Stress
66% Life Transitions

Average years in practice

12 Years

Top 3 insurances accepted

69% Aetna
55% UnitedHealthcare UHC | UBH
54% Cigna and Evernorth

How Therapists in San Francisco, CA see their clients

55% In Person and Online
45% Online Only

Gender breakdown

75% Female
23% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in San Francisco?

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.