Therapists in Ramsey County, MN

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Photo of Mary E Sanders, Marriage & Family Therapist in Ramsey County, MN
Mary E Sanders
Marriage & Family Therapist, MA, LMFT
Verified Verified
Shoreview, MN 55126
I specialize in helping clients navigate life transitions and the anxiety and depression that can go with them. I am trained in DBT and use a variety of therapies to assist clients.
I specialize in helping clients navigate life transitions and the anxiety and depression that can go with them. I am trained in DBT and use a variety of therapies to assist clients.
(651) 383-1603 View (651) 383-1603
Photo of Elizabeth Paulsen, Marriage & Family Therapist in Ramsey County, MN
Elizabeth Paulsen
Marriage & Family Therapist, MA, LMFT
Verified Verified
2 Endorsed
Roseville, MN 55113  (Online Only)
Waitlist for new clients
Therapy can provide a powerful opportunity for self-understanding and balance restoration which ultimately leads to growth and emotional healing. My goal as a therapist is to create a safe and trusted space with clients to help them begin to identify problematic patterns and explore healthy, effective coping skills. My hope is this repairative process will facilitate change not just within the context of therapy but in all relationships and areas of a client's life. There are many issues we may explore in therapy: anxiety, depression, eating disorders, body image, grief/loss and life transitions among others.
Therapy can provide a powerful opportunity for self-understanding and balance restoration which ultimately leads to growth and emotional healing. My goal as a therapist is to create a safe and trusted space with clients to help them begin to identify problematic patterns and explore healthy, effective coping skills. My hope is this repairative process will facilitate change not just within the context of therapy but in all relationships and areas of a client's life. There are many issues we may explore in therapy: anxiety, depression, eating disorders, body image, grief/loss and life transitions among others.
(763) 600-7223 View (763) 600-7223
Photo of Allison Kirk, Clinical Social Work/Therapist in Ramsey County, MN
Allison Kirk
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Saint Paul, MN 55102
I believe each person deserves to live the best life possible. Often, that can be a challenge due to difficult things that have happened in the past or current challenges we face. Trauma and hurt effect how we view the world and ourselves. I work with individuals in including teens and adults, as well as couples, to help them get to a better place in their life. We will work together to figure out how move through current and past challenges more effectively so that hope and ease become a part of everyday life.
I believe each person deserves to live the best life possible. Often, that can be a challenge due to difficult things that have happened in the past or current challenges we face. Trauma and hurt effect how we view the world and ourselves. I work with individuals in including teens and adults, as well as couples, to help them get to a better place in their life. We will work together to figure out how move through current and past challenges more effectively so that hope and ease become a part of everyday life.
(651) 413-9481 View (651) 413-9481
Photo of Mary Hendrickson, Counselor in Ramsey County, MN
Mary Hendrickson
Counselor, MA, LPCC
Verified Verified
1 Endorsed
Saint Paul, MN 55119
I have openings for Thursdays, Fridays, and Saturday am. I have 13 years of experience working with children and families, especially young children. I've worked with diagnoses such as anxiety, depression, behavior issues, ADHD (mostly in children), attachment issues, adoption, parenting issues, and trauma. I also enjoy working with adults of all ages.
I have openings for Thursdays, Fridays, and Saturday am. I have 13 years of experience working with children and families, especially young children. I've worked with diagnoses such as anxiety, depression, behavior issues, ADHD (mostly in children), attachment issues, adoption, parenting issues, and trauma. I also enjoy working with adults of all ages.
(651) 376-2641 View (651) 376-2641
Photo of Minnesota Ctr for Psychology-Childrens Svcs, Psychologist in Ramsey County, MN
Minnesota Ctr for Psychology-Childrens Svcs
Psychologist, PsyD
Verified Verified
Saint Paul, MN 55114
At Minnesota Center for Psychology, we offer comprehensive mental health services for children and adolescents age 3-17, as well as their families. We are committed to providing the best quality care in an environment that fosters integrity, respect, hope, health, and learning. If your child is experiencing anxiety, depression, low self-esteem, family conflict, school or relationship issues, grief, sadness, body image issues, sleep problems, suicidal thoughts, trauma, low motivation, restlessness, communication issues, LGBT or gender identity issues, life transitions mood swings, shame, anger, or behavioral issues, our highly trained and experienced clinicians can help!
At Minnesota Center for Psychology, we offer comprehensive mental health services for children and adolescents age 3-17, as well as their families. We are committed to providing the best quality care in an environment that fosters integrity, respect, hope, health, and learning. If your child is experiencing anxiety, depression, low self-esteem, family conflict, school or relationship issues, grief, sadness, body image issues, sleep problems, suicidal thoughts, trauma, low motivation, restlessness, communication issues, LGBT or gender identity issues, life transitions mood swings, shame, anger, or behavioral issues, our highly trained and experienced clinicians can help!
(651) 419-3768 View (651) 419-3768
Photo of Brant Thomsen: EMDR Therapist, Clinical Social Work/Therapist in Ramsey County, MN
Brant Thomsen: EMDR Therapist
Clinical Social Work/Therapist, LICSW, EMDR
Verified Verified
1 Endorsed
Saint Paul, MN 55102
EMDR offers an accelerated experience unlike any other therapy. If you want lasting healing from trauma and an upgrade in your confidence and well-being, let's talk. I'm here to collaborate and provide guidance through a process of change unlike any other.
EMDR offers an accelerated experience unlike any other therapy. If you want lasting healing from trauma and an upgrade in your confidence and well-being, let's talk. I'm here to collaborate and provide guidance through a process of change unlike any other.
(651) 409-6413 View (651) 409-6413
Photo of Sam Lorang, Pre-Licensed Professional in Ramsey County, MN
Sam Lorang
Pre-Licensed Professional, MA
Verified Verified
Whether you're navigating the challenges of life, improving relationships, or seeking support for neurodivergent concerns, together, we create a way for you, or your child, to discover your strengths and acquire new skills. I value open dialogue, emotional awareness, and a willingness to explore new ways. In my practice, I take an inclusive, non-judgmental approach to help my clients to assess their relationship to themselves and others, and teach them to provide themselves with options for change. We do this by sharing and learning from each other.
Whether you're navigating the challenges of life, improving relationships, or seeking support for neurodivergent concerns, together, we create a way for you, or your child, to discover your strengths and acquire new skills. I value open dialogue, emotional awareness, and a willingness to explore new ways. In my practice, I take an inclusive, non-judgmental approach to help my clients to assess their relationship to themselves and others, and teach them to provide themselves with options for change. We do this by sharing and learning from each other.
(651) 615-3235 View (651) 615-3235
Photo of Hope & Healing For Life, Clinical Social Work/Therapist in Ramsey County, MN
Hope & Healing For Life
Clinical Social Work/Therapist, MSW, LICSW, LCSW
Verified Verified
1 Endorsed
Saint Paul, MN 55104
I believe in encouraging clients to find their inner strength, resilience, and confidence. My approach to therapy includes offering hope and the skills to overcome struggles, no matter how difficult they might seem. Engaging in therapy will work to develop your own strengths and allow you to feel more comfortable in your own skin, leading to a greater sense of vitality and peace of mind. When you are ready to open yourself to these changes, don't wait. Call me today. I currently have openings in my schedule for day appointments and can get an appointment setup quickly.
I believe in encouraging clients to find their inner strength, resilience, and confidence. My approach to therapy includes offering hope and the skills to overcome struggles, no matter how difficult they might seem. Engaging in therapy will work to develop your own strengths and allow you to feel more comfortable in your own skin, leading to a greater sense of vitality and peace of mind. When you are ready to open yourself to these changes, don't wait. Call me today. I currently have openings in my schedule for day appointments and can get an appointment setup quickly.
(612) 217-4994 View (612) 217-4994
Photo of Kelly Heagle, Marriage & Family Therapist in Ramsey County, MN
Kelly Heagle
Marriage & Family Therapist, MA, LMFT, RPT
Verified Verified
Saint Paul, MN 55105
I am honored to offer space to process and reflect and help clients connect to themselves and others in a deeper way. I believe we each have our own inner widsom and therapy is a place to discover that wisdom. Clients describe me as down to earth, creative, compassionate, funny, direct, warm and intuitive. I specialize in grief and loss, education, healthcare and mental health professionals, secondary and primary trauma and clients who have connection with adoption or foster care. I work from strength based and trauma informed models and draw from IFS, Attachment, Narrative and Somatic/Experiential/Sandtray modalities.
I am honored to offer space to process and reflect and help clients connect to themselves and others in a deeper way. I believe we each have our own inner widsom and therapy is a place to discover that wisdom. Clients describe me as down to earth, creative, compassionate, funny, direct, warm and intuitive. I specialize in grief and loss, education, healthcare and mental health professionals, secondary and primary trauma and clients who have connection with adoption or foster care. I work from strength based and trauma informed models and draw from IFS, Attachment, Narrative and Somatic/Experiential/Sandtray modalities.
(612) 324-5088 View (612) 324-5088
Photo of Allen Burns, Counselor in Ramsey County, MN
Allen Burns
Counselor, MA, LPCC
Verified Verified
Saint Paul, MN 55102
Are you feeling irritable, having difficulty sleeping or focusing, experiencing mood swings or angry outbursts? Are you avoiding people or places or activities out of fear? These kinds of problems affect relationships at home and at work, our friendships, and our love relationships. They keep us from living the kind of rewarding life we really want; they keep us from thriving. If you want to find your own path to your thriving life, I'm ready to help. I will bring my compassion, curiosity, courage, and patience. And I will encourage you to bring yours.
Are you feeling irritable, having difficulty sleeping or focusing, experiencing mood swings or angry outbursts? Are you avoiding people or places or activities out of fear? These kinds of problems affect relationships at home and at work, our friendships, and our love relationships. They keep us from living the kind of rewarding life we really want; they keep us from thriving. If you want to find your own path to your thriving life, I'm ready to help. I will bring my compassion, curiosity, courage, and patience. And I will encourage you to bring yours.
(651) 243-9807 View (651) 243-9807
Photo of Hector Rene Matascastillo, Clinical Social Work/Therapist in Ramsey County, MN
Hector Rene Matascastillo
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Roseville, MN 55113
Waitlist for new clients
I am trained in DBT, EMDR (Certified Therapist, Approved Consultant and Trainer), and developed batterer intervention programs. Most of my work deals with the effects of trauma in people's lives and it's behavioral manifestations. The clients I treat vary in issues, from individual to family issues, and from seemingly simple to highly complex cases. My strengths are mostly in the area of stabilizing clients to be able to do their trauma work and then improve their relationships. We want to stop suffering and live the abundant life. A life of joy. A life worth living.
I am trained in DBT, EMDR (Certified Therapist, Approved Consultant and Trainer), and developed batterer intervention programs. Most of my work deals with the effects of trauma in people's lives and it's behavioral manifestations. The clients I treat vary in issues, from individual to family issues, and from seemingly simple to highly complex cases. My strengths are mostly in the area of stabilizing clients to be able to do their trauma work and then improve their relationships. We want to stop suffering and live the abundant life. A life of joy. A life worth living.
(952) 314-4316 View (952) 314-4316
Photo of Ben Mushel, Pre-Licensed Professional in Ramsey County, MN
Ben Mushel
Pre-Licensed Professional, MS, LGSW
Verified Verified
Saint Paul, MN 55114  (Online Only)
Currently accepting telehealth clients! Healing from the past can be daunting. The vulnerability that comes with uncertainty can expose our fears and insecurities. Licensed Graduate Social Worker, Ben supports clients who have trauma reaction, anxiety and depression as well as those who feel overwhelmed, stuck, or unfulfilled. He specifically enjoys working with motivated adults of all ages and has a special interest in treating trauma with EMDR. Ben has additional expertise for members of the LGBTQIA+ community, immigrants, and elders navigating later life stages and changes.
Currently accepting telehealth clients! Healing from the past can be daunting. The vulnerability that comes with uncertainty can expose our fears and insecurities. Licensed Graduate Social Worker, Ben supports clients who have trauma reaction, anxiety and depression as well as those who feel overwhelmed, stuck, or unfulfilled. He specifically enjoys working with motivated adults of all ages and has a special interest in treating trauma with EMDR. Ben has additional expertise for members of the LGBTQIA+ community, immigrants, and elders navigating later life stages and changes.
(651) 538-2830 View (651) 538-2830
Photo of Lacrestia Anderson, Pre-Licensed Professional in Ramsey County, MN
Lacrestia Anderson
Pre-Licensed Professional, MA, LADC
Verified Verified
2 Endorsed
Saint Paul, MN 55104  (Online Only)
Your experience with me will be different than what you think of in a typical therapy session! I'm an old soul with a down to earth personality that is rooted in Southern Georgia. I bring a southern hospitality twist to my 9 years of evidenced based clinical work! You see, it takes a village to get through life and all it's challenges, you can't do it alone! You deserve to be the best you, and if you need some extra support to get there, there is nothing wrong with that! I offer an empathic, authentic, and supportive space that is free from judgement.
Your experience with me will be different than what you think of in a typical therapy session! I'm an old soul with a down to earth personality that is rooted in Southern Georgia. I bring a southern hospitality twist to my 9 years of evidenced based clinical work! You see, it takes a village to get through life and all it's challenges, you can't do it alone! You deserve to be the best you, and if you need some extra support to get there, there is nothing wrong with that! I offer an empathic, authentic, and supportive space that is free from judgement.
(651) 565-9683 View (651) 565-9683
Photo of Liz Lanari, Pre-Licensed Professional in Ramsey County, MN
Liz Lanari
Pre-Licensed Professional
Verified Verified
Roseville, MN 55113  (Online Only)
Not accepting new clients
Liz has her master's degree in Marriage and Family Therapy from Saint Mary's University of Minnesota. She has attended advanced trainings on Emotionally Focused Therapy (EFT) and is on the certification track for EFT, an empirically researched, and proven effective model for therapy. Liz utilizes this and other attachment-based approaches with couples and individuals. Liz believes secure relationships are the foundation to a happy, healthy life. She aims to assist clients in forming deeper and more meaningful connections in their significant relationships through facilitating new interactions. She offers clients a non-judgemental,
Liz has her master's degree in Marriage and Family Therapy from Saint Mary's University of Minnesota. She has attended advanced trainings on Emotionally Focused Therapy (EFT) and is on the certification track for EFT, an empirically researched, and proven effective model for therapy. Liz utilizes this and other attachment-based approaches with couples and individuals. Liz believes secure relationships are the foundation to a happy, healthy life. She aims to assist clients in forming deeper and more meaningful connections in their significant relationships through facilitating new interactions. She offers clients a non-judgemental,
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Photo of Megan Quadri, Licensed Professional Counselor in Ramsey County, MN
Megan Quadri
Licensed Professional Counselor, LPCC
Verified Verified
“People will forget what you said or what you did, but not how you made them feel.” This is a quote I try to live by both as a therapist and in my personal life. Life isn’t always about being the smartest, or the funniest, or the most successful. Being kind towards others often resonates louder and lasts longer. As a therapist, I strive to make sure my clients feel heard and understood. Life often takes unexpected twists and turns, and we can all use an extra ear to listen and help us get back on track. I take a genuine and down to earth approach and I’m ready to join you wherever you are in life.
“People will forget what you said or what you did, but not how you made them feel.” This is a quote I try to live by both as a therapist and in my personal life. Life isn’t always about being the smartest, or the funniest, or the most successful. Being kind towards others often resonates louder and lasts longer. As a therapist, I strive to make sure my clients feel heard and understood. Life often takes unexpected twists and turns, and we can all use an extra ear to listen and help us get back on track. I take a genuine and down to earth approach and I’m ready to join you wherever you are in life.
(651) 615-5186 View (651) 615-5186
Photo of Joelle L Kallio, Psychologist in Ramsey County, MN
Joelle L Kallio
Psychologist, PsyD, LP
Verified Verified
Saint Paul, MN 55116
If you are looking to make a change but are not sure how, therapy can help. Therapy can feel intimidating but it shouldn't be. The process of learning about yourself and evaluating how you think can prove to be a healing one. It also helps you to find ways to cope with the past and to heal from pain related to one's experiences. It's human to get stuck sometimes and it helps to talk things through, to help make sense of it all, and to move toward living a more satisfying life.
If you are looking to make a change but are not sure how, therapy can help. Therapy can feel intimidating but it shouldn't be. The process of learning about yourself and evaluating how you think can prove to be a healing one. It also helps you to find ways to cope with the past and to heal from pain related to one's experiences. It's human to get stuck sometimes and it helps to talk things through, to help make sense of it all, and to move toward living a more satisfying life.
(651) 564-8506 View (651) 564-8506
Photo of Sunstone Counseling LLC, Counselor in Ramsey County, MN
Sunstone Counseling LLC
Counselor, MA, LPCC
Verified Verified
Let's Do This Together! Rachel (she/her) connects with clients from a place of acceptance using humor and warmth to make the therapeutic process collaborative and comfortable. Rachel takes a systemic perspective striving to understand how an individual’s difficulties and symptoms arise from their life experiences and relationships. She views the therapeutic process as a way to come alongside clients in an effort to improve their satisfaction with life and relationships. Rachel specializes in trauma, perinatal mental health, adolescents, child anxiety.
Let's Do This Together! Rachel (she/her) connects with clients from a place of acceptance using humor and warmth to make the therapeutic process collaborative and comfortable. Rachel takes a systemic perspective striving to understand how an individual’s difficulties and symptoms arise from their life experiences and relationships. She views the therapeutic process as a way to come alongside clients in an effort to improve their satisfaction with life and relationships. Rachel specializes in trauma, perinatal mental health, adolescents, child anxiety.
(651) 383-9324 View (651) 383-9324
Photo of Curt Folkestad, Marriage & Family Therapist in Ramsey County, MN
Curt Folkestad
Marriage & Family Therapist, LMFT
Verified Verified
Maplewood, MN 55109  (Online Only)
Curt completed his Master's Degree in Marriage and Family Therapy at Saint Mary's University, and is a Licensed Marriage and Family Therapist through the state of Minnesota. He enjoys working with children, adolescents, and adults individually or in a family setting. Curt has experience working with individuals and families in many settings including community, school, home, and outpatient services. He has also received additional training and is certified in providing Trauma-Focused Cognitive Behavioral Therapy (TF-CBT).
Curt completed his Master's Degree in Marriage and Family Therapy at Saint Mary's University, and is a Licensed Marriage and Family Therapist through the state of Minnesota. He enjoys working with children, adolescents, and adults individually or in a family setting. Curt has experience working with individuals and families in many settings including community, school, home, and outpatient services. He has also received additional training and is certified in providing Trauma-Focused Cognitive Behavioral Therapy (TF-CBT).
(651) 538-2436 View (651) 538-2436
Photo of Kelly Norris, Pre-Licensed Professional in Ramsey County, MN
Kelly Norris
Pre-Licensed Professional, MA
Verified Verified
Mahtomedi, MN 55115  (Online Only)
An individual’s mental health is fluid and can be affected by many factors including mood, relationships, and life events. In therapy, I meet you wherever you are at in the moment. Sometimes this means figuring out surviving before we can focus on thriving. Wherever you may be on your mental health journey, you deserve to receive the support you need for your concerns.
An individual’s mental health is fluid and can be affected by many factors including mood, relationships, and life events. In therapy, I meet you wherever you are at in the moment. Sometimes this means figuring out surviving before we can focus on thriving. Wherever you may be on your mental health journey, you deserve to receive the support you need for your concerns.
(651) 565-6684 View (651) 565-6684
Photo of Allie Bonyata, Clinical Social Work/Therapist in Ramsey County, MN
Allie Bonyata
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Not accepting new clients
Being a human can be incredibly difficult and overwhelming at times. Having someone you feel safe to process life’s stressors with, and an open space to learn new ways to cope with stress, can help make life more manageable and enjoyable. I have a client-centered, strength-based approach to therapy, and I believe that every person deserves to be seen and understood. I look forward to supporting you in your journey of healing and growth - however that looks for you!
Being a human can be incredibly difficult and overwhelming at times. Having someone you feel safe to process life’s stressors with, and an open space to learn new ways to cope with stress, can help make life more manageable and enjoyable. I have a client-centered, strength-based approach to therapy, and I believe that every person deserves to be seen and understood. I look forward to supporting you in your journey of healing and growth - however that looks for you!
(651) 867-4324 View (651) 867-4324

See more therapy options for Ramsey County

How does your Therapist compare?

Number of Therapists in Ramsey County, MN

1,000+

Average cost per session

$169

Therapists in Ramsey County, MN who prioritize treating:

93% Anxiety
89% Depression
81% Relationship Issues
76% Self Esteem
75% Trauma and PTSD
68% Stress
67% Coping Skills

Average years in practice

11 Years

Top 3 insurances accepted

86% BlueCross and BlueShield
74% UCare
70% HealthPartners of MN and WI

How Therapists in Ramsey County, MN see their clients

74% In Person and Online
26% Online Only

Gender breakdown

77% Female
21% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Ramsey County?

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.