Therapists in San Antonio, TX

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Photo of Kelley Logans-Ali, Clinical Social Work/Therapist in San Antonio, TX
Kelley Logans-Ali
Clinical Social Work/Therapist, LCSW -S, ACSW, LCDC, CCTP
Verified Verified
San Antonio, TX 78229
I am Kelley Logans-Ali, LCSW, ACSW, LCDC, CCTP are you looking for total mental wellness ? I offer innovative paths to wellness by offering an array of therapeutic services. I retired after 28 years as The Mental Health Program Specialist for the State of Texas to focus primarily on my private practice. I have experience with the child welfare system, I understand the dynamics involved with families in crisis. I have experience with individual group and family therapy. I provide psychiatric evaluations for acute hospitalizations, individual/group psychotherapy and LCSW Supervision. I am certified trauma specialist.
I am Kelley Logans-Ali, LCSW, ACSW, LCDC, CCTP are you looking for total mental wellness ? I offer innovative paths to wellness by offering an array of therapeutic services. I retired after 28 years as The Mental Health Program Specialist for the State of Texas to focus primarily on my private practice. I have experience with the child welfare system, I understand the dynamics involved with families in crisis. I have experience with individual group and family therapy. I provide psychiatric evaluations for acute hospitalizations, individual/group psychotherapy and LCSW Supervision. I am certified trauma specialist.
(210) 899-7103 View (210) 899-7103
Photo of Leticia R Villareal, Licensed Professional Counselor in San Antonio, TX
Leticia R Villareal
Licensed Professional Counselor, MS, LPC
Verified Verified
5 Endorsed
San Antonio, TX 78212
Sometimes we go through seasons in our lives in which we experience extra challenges. Reaching out for help is a courageous step to take. I am ready to walk with you in your journey by providing a calm, safe, and genuine space to help you identify and filter through feelings you are carrying inside your heart and mind that are interfering with your life balance. Together we can figure out a plan on goals to work towards to help you feel more balanced.
Sometimes we go through seasons in our lives in which we experience extra challenges. Reaching out for help is a courageous step to take. I am ready to walk with you in your journey by providing a calm, safe, and genuine space to help you identify and filter through feelings you are carrying inside your heart and mind that are interfering with your life balance. Together we can figure out a plan on goals to work towards to help you feel more balanced.
(210) 920-7834 View (210) 920-7834
Photo of Pursuit of Happiness, Licensed Professional Counselor in San Antonio, TX
Pursuit of Happiness
Licensed Professional Counselor, LPC
Verified Verified
San Antonio, TX 78216
Pursuit of Happiness provides counseling for pregnant women, children, and families with Traditional Medicaid Insurance. We offer in-home and telehealth counseling throughout Texas. All of our counselors practice trauma-informed counseling and have training in play and trauma techniques to help children and families heal and grow in a safe therapeutic space. Our counselors will come directly to you and meet with the you or your children in the home, school, or daycare depending on your schedule needs. Virtual counseling is also available.
Pursuit of Happiness provides counseling for pregnant women, children, and families with Traditional Medicaid Insurance. We offer in-home and telehealth counseling throughout Texas. All of our counselors practice trauma-informed counseling and have training in play and trauma techniques to help children and families heal and grow in a safe therapeutic space. Our counselors will come directly to you and meet with the you or your children in the home, school, or daycare depending on your schedule needs. Virtual counseling is also available.
(210) 988-6704 View (210) 988-6704
Photo of Anastacia Granado, Licensed Professional Counselor in San Antonio, TX
Anastacia Granado
Licensed Professional Counselor
Verified Verified
2 Endorsed
San Antonio, TX 78216
Are you struggling with intense anxiety or OCD-like symptoms? Do you ever feel "stuck" and overwhelmed by life's stressors? If you find yourself struggling with dysfunctional behavior, intrusive thoughts, and/or intense emotional responses, you're in the right place. Anxiety disorders can often cause immense pain in one's emotional, personal, and work/school life. If you're ready to overcome your self-doubt, feel empowered to take charge of your anxieties, and live life in the present, let's get started!
Are you struggling with intense anxiety or OCD-like symptoms? Do you ever feel "stuck" and overwhelmed by life's stressors? If you find yourself struggling with dysfunctional behavior, intrusive thoughts, and/or intense emotional responses, you're in the right place. Anxiety disorders can often cause immense pain in one's emotional, personal, and work/school life. If you're ready to overcome your self-doubt, feel empowered to take charge of your anxieties, and live life in the present, let's get started!
(210) 791-6957 View (210) 791-6957
Photo of Haziel Williams in San Antonio, TX
Haziel Williams
MS, LPC, NBCC
Verified Verified
San Antonio, TX 78232
My counseling creates a safe space to learn skills to lower anxiety and depression levels. To experience a greater sense of joy in day to day living. I help clients learn to finding hope in the midst of life challenges . I am here to provide encouragement and support to make clients’ life goals happen. Therapy gives clients the skills to approach difficult situations and relationships with confidence. My counseling provides the opportunity for new skills to be developed in a safe space. Counseling is an encouraging and positive experience that can create lasting positive change.
My counseling creates a safe space to learn skills to lower anxiety and depression levels. To experience a greater sense of joy in day to day living. I help clients learn to finding hope in the midst of life challenges . I am here to provide encouragement and support to make clients’ life goals happen. Therapy gives clients the skills to approach difficult situations and relationships with confidence. My counseling provides the opportunity for new skills to be developed in a safe space. Counseling is an encouraging and positive experience that can create lasting positive change.
(210) 791-7644 View (210) 791-7644
Photo of Karyn Smiley, Marriage & Family Therapist in San Antonio, TX
Karyn Smiley
Marriage & Family Therapist, LMFT
Verified Verified
San Antonio, TX 78212
I am Karyn Smiley a licensed marriage and family therapist. I enjoy working with couples but also work with individuals. I believe in the strength of the family to help each other. I have worked with clients that have depression, schizophrenia and bipolar for many years. I also enjoy working with couples and families. Teenagers are special to me as well because they face special challenges. I believe in the strength of the family to help loved ones and also enjoy working with family members to know what everyone can do to help make every member of the family successful.
I am Karyn Smiley a licensed marriage and family therapist. I enjoy working with couples but also work with individuals. I believe in the strength of the family to help each other. I have worked with clients that have depression, schizophrenia and bipolar for many years. I also enjoy working with couples and families. Teenagers are special to me as well because they face special challenges. I believe in the strength of the family to help loved ones and also enjoy working with family members to know what everyone can do to help make every member of the family successful.
(281) 595-1651 View (281) 595-1651
Photo of Stephanie Ann Garcia, Licensed Professional Counselor in San Antonio, TX
Stephanie Ann Garcia
Licensed Professional Counselor, MA, LPC
Verified Verified
San Antonio, TX 78254
Life is a journey that can be difficult at times. You do not have to suffer alone in your journey. I can help by providing various methods of therapy to guide you through the obstacles of life.
Life is a journey that can be difficult at times. You do not have to suffer alone in your journey. I can help by providing various methods of therapy to guide you through the obstacles of life.
(210) 495-3131 View (210) 495-3131
Photo of Callie M Davis-Carr, Licensed Professional Counselor in San Antonio, TX
Callie M Davis-Carr
Licensed Professional Counselor, MA, MS, LPC
Verified Verified
San Antonio, TX 78210
Are you feeling overwhelmed or heavy hearted due to the loss of a loved one? Are you dealing with heartache, despair, and frustration due to marital conflict and misunderstanding? Do you need help in dealing with relational matters? I'd like to help you if you are. I am more than willing to help lighten your emotional load, and offer help for today and hope for tomorrow. There is hope! I look forward to hearing from you.
Are you feeling overwhelmed or heavy hearted due to the loss of a loved one? Are you dealing with heartache, despair, and frustration due to marital conflict and misunderstanding? Do you need help in dealing with relational matters? I'd like to help you if you are. I am more than willing to help lighten your emotional load, and offer help for today and hope for tomorrow. There is hope! I look forward to hearing from you.
(281) 940-3692 View (281) 940-3692
Photo of Blossoming Butterfly Counseling Center PLLC, Licensed Professional Counselor in San Antonio, TX
Blossoming Butterfly Counseling Center PLLC
Licensed Professional Counselor, LPC-S
Verified Verified
1 Endorsed
San Antonio, TX 78228
Hi, my name is Tiffaney, and I am an experienced licensed professional counselor supervisor (LPC-S). I am enthusiastic about being authentic and real with my clients to create an encouraging environment for exploration and growth. I believe in the power of choice, and my goal as a counselor is to provide support and guidance to empower you in your decisions. My focus is on progress not perfection and becoming ok with being perfectly imperfect.
Hi, my name is Tiffaney, and I am an experienced licensed professional counselor supervisor (LPC-S). I am enthusiastic about being authentic and real with my clients to create an encouraging environment for exploration and growth. I believe in the power of choice, and my goal as a counselor is to provide support and guidance to empower you in your decisions. My focus is on progress not perfection and becoming ok with being perfectly imperfect.
(210) 796-1986 View (210) 796-1986
Photo of Andrew D. Reichert, Psychologist in San Antonio, TX
Andrew D. Reichert
Psychologist, PhD, PLLC
Verified Verified
San Antonio, TX 78232
Not accepting new clients
A native of San Antonio, I am a semi-retired Licensed Psychologist with a specialty in completing psychological evaluations for veterans, which I do on a contract basis for a company called Veteran's Evaluation Services (VES). I am no longer taking private therapy clients. My degrees are from Texas A&M University and Duke University.
A native of San Antonio, I am a semi-retired Licensed Psychologist with a specialty in completing psychological evaluations for veterans, which I do on a contract basis for a company called Veteran's Evaluation Services (VES). I am no longer taking private therapy clients. My degrees are from Texas A&M University and Duke University.
(210) 879-3894 View (210) 879-3894
Photo of Arthur Gaylian Kirby II, Licensed Professional Counselor in San Antonio, TX
Arthur Gaylian Kirby II
Licensed Professional Counselor, MS MDIV, LPC(S)
Verified Verified
San Antonio, TX 78229
My job is to help people live happier lives. My office is a continuing education service for all who enter. The goal for me, and hopefully for the person I am working with, is to learn from each other through the change agent of conversation. After 40 years of experience, my belief is that humans never really change until what they have done is working anymore, is broken, and/or gone. Thus change begins with loss, some small and some life ending. At these moments of transition, learning how to let go is the lesson, whether we like it or not. Whatever big change you are going through, positive or negative begins with an ending.
My job is to help people live happier lives. My office is a continuing education service for all who enter. The goal for me, and hopefully for the person I am working with, is to learn from each other through the change agent of conversation. After 40 years of experience, my belief is that humans never really change until what they have done is working anymore, is broken, and/or gone. Thus change begins with loss, some small and some life ending. At these moments of transition, learning how to let go is the lesson, whether we like it or not. Whatever big change you are going through, positive or negative begins with an ending.
(210) 664-4392 View (210) 664-4392
Photo of Captured Through The Lens, PLLC, Clinical Social Work/Therapist in San Antonio, TX
Captured Through The Lens, PLLC
Clinical Social Work/Therapist, DSW, LCSW, BCD
Verified Verified
San Antonio, TX 78258  (Online Only)
Not accepting new clients
Congratulations! My name is Dr. C-Dub. You are taking the first step toward becoming the best version of yourself. Unfortunately, pain and suffering do not discriminate. However, the good news is that neither does healing. Deciding to receive therapy can be daunting; however, the results are often positive and rewarding if you are willing to put in the work. We all have or will experience some sort of life event that will leave us fractured. Many of our first fractures come from those we love most. These fractures can lead us down a path where we become stuck and unable to reach our full potential if they are not dealt with.
Congratulations! My name is Dr. C-Dub. You are taking the first step toward becoming the best version of yourself. Unfortunately, pain and suffering do not discriminate. However, the good news is that neither does healing. Deciding to receive therapy can be daunting; however, the results are often positive and rewarding if you are willing to put in the work. We all have or will experience some sort of life event that will leave us fractured. Many of our first fractures come from those we love most. These fractures can lead us down a path where we become stuck and unable to reach our full potential if they are not dealt with.
(210) 864-1193 View (210) 864-1193
Photo of Jessica F. Boulanger, Licensed Professional Counselor in San Antonio, TX
Jessica F. Boulanger
Licensed Professional Counselor, MEd, NCC, LPC
Verified Verified
San Antonio, TX 78228
I provide telemental health (virtual) & in-person therapy sessions for pre-teens, adolescents, adults & families experiencing emotional disturbance &/or difficulty w/life transitions related to family/school/peer conflict, behavioral/relational dysfunction, gender identity, occupational, relational & interpersonal stressors, trauma, grief & other situational circumstances that may be disrupting one's overall mental health well-being. Additionally, I provide access to community, local & national resources & assist w/advocacy services through coordinating & networking w/other professionals, schools, support groups, courts & agencies.
I provide telemental health (virtual) & in-person therapy sessions for pre-teens, adolescents, adults & families experiencing emotional disturbance &/or difficulty w/life transitions related to family/school/peer conflict, behavioral/relational dysfunction, gender identity, occupational, relational & interpersonal stressors, trauma, grief & other situational circumstances that may be disrupting one's overall mental health well-being. Additionally, I provide access to community, local & national resources & assist w/advocacy services through coordinating & networking w/other professionals, schools, support groups, courts & agencies.
(210) 739-4200 View (210) 739-4200
Photo of Lori Gulley, Psychologist in San Antonio, TX
Lori Gulley
Psychologist, PsyD
Verified Verified
San Antonio, TX 78217
Hello, I am a Licensed Clinical Psychologist and Army Veteran with over 12 years of experience working with the military population, dependents, and Veterans. I work collaboratively with clients to provide individualized treatment that is evidence based and empirically founded. By learning positive coping skills, improving insight and modifying thoughts and behaviors, clients make meaningful changes while being active participants in their therapy. I value the therapeutic relationship and seek to empower individuals with empathy and knowledge.
Hello, I am a Licensed Clinical Psychologist and Army Veteran with over 12 years of experience working with the military population, dependents, and Veterans. I work collaboratively with clients to provide individualized treatment that is evidence based and empirically founded. By learning positive coping skills, improving insight and modifying thoughts and behaviors, clients make meaningful changes while being active participants in their therapy. I value the therapeutic relationship and seek to empower individuals with empathy and knowledge.
(210) 864-5347 View (210) 864-5347
Photo of Christopher Gulde, Licensed Professional Counselor in San Antonio, TX
Christopher Gulde
Licensed Professional Counselor, MD, MA, LPC , CSAT
Verified Verified
San Antonio, TX 78209
Sex addiction is cunning and baffling. It asserts itself into every other life issue. It cuts relationships deeply and oftentimes completely. But there is help for those who seek solutions. I will walk with you as you work toward gaining sobriety in this addiction. I can offer my time, objective information, and energizing hope to you individually and to your relationship partner.
Sex addiction is cunning and baffling. It asserts itself into every other life issue. It cuts relationships deeply and oftentimes completely. But there is help for those who seek solutions. I will walk with you as you work toward gaining sobriety in this addiction. I can offer my time, objective information, and energizing hope to you individually and to your relationship partner.
(210) 361-7887 View (210) 361-7887
Photo of Larami Serrano, LPC Associate in San Antonio, TX
Larami Serrano
LPC Associate, LPC-A
Verified Verified
San Antonio, TX 78257
If you’re reading this, then you’ve taken the most important step in your mental and emotional wellness journey, and for that I am so proud! Deciding to address your mental health concerns can be terrifying. Many of us fear that our issues are either too complicated to resolve or not complicated enough to warrant counseling. The truth is that therapy is for EVERYbody. It’s a safe space to process trauma, share feelings, celebrate even the smallest wins, and work through the losses. I'm excited to embark on this journey with you.
If you’re reading this, then you’ve taken the most important step in your mental and emotional wellness journey, and for that I am so proud! Deciding to address your mental health concerns can be terrifying. Many of us fear that our issues are either too complicated to resolve or not complicated enough to warrant counseling. The truth is that therapy is for EVERYbody. It’s a safe space to process trauma, share feelings, celebrate even the smallest wins, and work through the losses. I'm excited to embark on this journey with you.
(830) 396-5777 View (830) 396-5777
Photo of Phi-Long Le, Licensed Professional Counselor Associate in San Antonio, TX
Phi-Long Le
Licensed Professional Counselor Associate, MA, NCC, LPC-A
Verified Verified
10 Endorsed
San Antonio, TX 78229
Are you ready to dig deeper with us? We strive to build strong relationships and help dig deeper 'into the roots' of any challenges that you or your family may be experiencing. Our goal is to ensure that all parties feel connected throughout the treatment process as this contributes positively to the progress in and outside of therapy. We pride ourselves on how quick and efficient our setup process is. Whether or not we are the right service for you, we promise to give you a response and strive to make you feel less-alone in your searching process. Our therapists are ready to be a part of your journey.
Are you ready to dig deeper with us? We strive to build strong relationships and help dig deeper 'into the roots' of any challenges that you or your family may be experiencing. Our goal is to ensure that all parties feel connected throughout the treatment process as this contributes positively to the progress in and outside of therapy. We pride ourselves on how quick and efficient our setup process is. Whether or not we are the right service for you, we promise to give you a response and strive to make you feel less-alone in your searching process. Our therapists are ready to be a part of your journey.
(210) 405-9976 View (210) 405-9976
Photo of Teresa Bethany, Marriage & Family Therapist in San Antonio, TX
Teresa Bethany
Marriage & Family Therapist, MEd, LMFT
Verified Verified
San Antonio, TX 78209  (Online Only)
Your present circumstances do not determine where you go...they merely determine where you start. — Nido Qubein. Hello! I'm glad you are here. I believe in meeting my clients where they are, providing a safe space to process and learn, and helping them overcome obstacles preventing personal growth. Working through a cognitive-behavioral lens, we will work towards identifying patterns of thoughts and behaviors that do not align with goals for yourself and your relationships.
Your present circumstances do not determine where you go...they merely determine where you start. — Nido Qubein. Hello! I'm glad you are here. I believe in meeting my clients where they are, providing a safe space to process and learn, and helping them overcome obstacles preventing personal growth. Working through a cognitive-behavioral lens, we will work towards identifying patterns of thoughts and behaviors that do not align with goals for yourself and your relationships.
(210) 972-5852 View (210) 972-5852
Photo of Valerie A F Stewart, Licensed Professional Counselor in San Antonio, TX
Valerie A F Stewart
Licensed Professional Counselor, MS, LPC
Verified Verified
2 Endorsed
San Antonio, TX 78212
When life presents challenges that are too difficult to overcome on your own, I offer a safe, non-judgmental space to explore and express your emotions. Working together, you and I will reveal your existing strengths and develop them into viable coping skills to overcome these challenges. I have personal experience, as a parent and a daughter, in dealing with the challenges of physical and mental disabilities. I have lived and worked in various regions of the United States and abroad thus I understand the feelings of isolation and uncertainty that can surface when in a new environment, situation, or even in every day circumstances.
When life presents challenges that are too difficult to overcome on your own, I offer a safe, non-judgmental space to explore and express your emotions. Working together, you and I will reveal your existing strengths and develop them into viable coping skills to overcome these challenges. I have personal experience, as a parent and a daughter, in dealing with the challenges of physical and mental disabilities. I have lived and worked in various regions of the United States and abroad thus I understand the feelings of isolation and uncertainty that can surface when in a new environment, situation, or even in every day circumstances.
(210) 625-5965 View (210) 625-5965
Photo of Tim Peterson, Psychologist in San Antonio, TX
Tim Peterson
Psychologist, PsyD, MEd
Verified Verified
1 Endorsed
San Antonio, TX 78209
As a psychologist, I specialize in working with bright and motivated men and women in their 30s and 40s who have come to a point of needing help but are wisely insisting on help from the right match. Whatever your presenting problem might be, my experience suggests the right help is someone who can: show they understand your problem; skillfully guide your self-exploration; consult on learning in your edges of growth; and project a course for how your work might proceed. Finding the right help may be the most important task of therapy. If what I've suggested here resonates with you, we might could be a good match together.
As a psychologist, I specialize in working with bright and motivated men and women in their 30s and 40s who have come to a point of needing help but are wisely insisting on help from the right match. Whatever your presenting problem might be, my experience suggests the right help is someone who can: show they understand your problem; skillfully guide your self-exploration; consult on learning in your edges of growth; and project a course for how your work might proceed. Finding the right help may be the most important task of therapy. If what I've suggested here resonates with you, we might could be a good match together.
(210) 880-2046 View (210) 880-2046

How does your Therapist compare?

Number of Therapists in San Antonio, TX

2,000+

Average cost per session

$125

Therapists in San Antonio, TX who prioritize treating:

92% Anxiety
88% Depression
73% Self Esteem
72% Coping Skills
70% Relationship Issues
69% Trauma and PTSD
69% Stress

Average years in practice

10 Years

Top 3 insurances accepted

84% Aetna
78% BlueCross and BlueShield
77% UnitedHealthcare UHC | UBH

How Therapists in San Antonio, TX see their clients

54% In Person and Online
46% Online Only

Gender breakdown

81% Female
18% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in San Antonio?

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.