Therapists in Mitchell, SD

Photo of Katie Wieczorek, Licensed Professional Counselor, MA, LPC-MH, QMHP
Katie Wieczorek
Licensed Professional Counselor, MA, LPC-MH, QMHP
Mitchell, SD 57301
My goal is to provide a caring therapeutic relationship woven together with evidence-based therapeutic strategies. I've seen this approach provide lasting change for others, and I hope you reach out if it sounds like a good fit for you!
My goal is to provide a caring therapeutic relationship woven together with evidence-based therapeutic strategies. I've seen this approach provide lasting change for others, and I hope you reach out if it sounds like a good fit for you!
(605) 702-5016 View (605) 702-5016
Photo of Tracy Bailey, Licensed Professional Counselor, LPCMH
Tracy Bailey
Licensed Professional Counselor, LPCMH
Online Only
Hello! I am a licensed Mental Health Counselor in South Dakota, Minnesota, and Florida. I attended Colorado Christian University and have seven years of experience working with individuals of all backgrounds. I specialize in incorporating Christianity with evidence-based techniques to teach individuals to manage day-to-day struggles as well as significant life events. I also offer Biblical counseling to individuals in all 50 states. This may or may not be covered by insurance depending on the state that you are located in.
Hello! I am a licensed Mental Health Counselor in South Dakota, Minnesota, and Florida. I attended Colorado Christian University and have seven years of experience working with individuals of all backgrounds. I specialize in incorporating Christianity with evidence-based techniques to teach individuals to manage day-to-day struggles as well as significant life events. I also offer Biblical counseling to individuals in all 50 states. This may or may not be covered by insurance depending on the state that you are located in.
(605) 307-3748 View (605) 307-3748
Photo of Colleen Stegenga, Clinical Social Work/Therapist, MSW, LCSWPIP, QMHP
Colleen Stegenga
Clinical Social Work/Therapist, MSW, LCSWPIP, QMHP
Mitchell, SD 57301
Are you exhausted from carrying weight that feels too heavy to bear? Whether you're a farmer struggling with isolation and financial stress, a woman navigating anxiety or life transitions, or a teen feeling overwhelmed by school and social pressures, I understand what it's like when you feel you are not enough. After years of practicing therapy in traditional settings, I returned to my family's rural area and reconnected with what matters most - authentic, down-to-earth support that meets you where you are.
Are you exhausted from carrying weight that feels too heavy to bear? Whether you're a farmer struggling with isolation and financial stress, a woman navigating anxiety or life transitions, or a teen feeling overwhelmed by school and social pressures, I understand what it's like when you feel you are not enough. After years of practicing therapy in traditional settings, I returned to my family's rural area and reconnected with what matters most - authentic, down-to-earth support that meets you where you are.
(605) 309-7144 View (605) 309-7144
Photo of Ashley Morken, JD, MELP, MS-MFT
Ashley Morken
Verified Verified
1 Endorsed
Mitchell, SD 57301
As an integration-based Life Coach, I offer a trauma-informed approach grounded in both professional training and lived experience. I specialize in trauma and PTSD, chronic anxiety, identity issues, ADHD, family conflict, and relational wounds including narcissistic abuse and relationship violence. Having navigated healing from childhood abuse, trauma, and survival-based patterns myself, I understand how insight alone isn’t enough. I work with individuals, couples, children, and families to support nervous-system regulation, relational repair, and integration—helping clients move beyond coping and into embodied, active change.
As an integration-based Life Coach, I offer a trauma-informed approach grounded in both professional training and lived experience. I specialize in trauma and PTSD, chronic anxiety, identity issues, ADHD, family conflict, and relational wounds including narcissistic abuse and relationship violence. Having navigated healing from childhood abuse, trauma, and survival-based patterns myself, I understand how insight alone isn’t enough. I work with individuals, couples, children, and families to support nervous-system regulation, relational repair, and integration—helping clients move beyond coping and into embodied, active change.
(605) 250-0971 View (605) 250-0971
Photo of Lesley Atkins, Clinical Social Work/Therapist, MSW, CSW-PIP, CSITP, QMHP
Lesley Atkins
Clinical Social Work/Therapist, MSW, CSW-PIP, CSITP, QMHP
1 Endorsed
Serves Area
Life can feel heavy—whether you’re struggling with anxiety, depression, disconnection in your relationship, or a loss of joy in everyday life. Therapy is a place to slow down, feel understood, and begin making sense of what’s going on beneath the surface. Focus on the individual and their relationships is important because even good ones are hard. If you and your partner feel stuck in the same arguments, disconnected, or unsure how to move forward, you’re not alone. I work with adults, couples, and people of all ages, helping clients build insight, strengthen communication, and reconnect with themselves and each other.
Life can feel heavy—whether you’re struggling with anxiety, depression, disconnection in your relationship, or a loss of joy in everyday life. Therapy is a place to slow down, feel understood, and begin making sense of what’s going on beneath the surface. Focus on the individual and their relationships is important because even good ones are hard. If you and your partner feel stuck in the same arguments, disconnected, or unsure how to move forward, you’re not alone. I work with adults, couples, and people of all ages, helping clients build insight, strengthen communication, and reconnect with themselves and each other.
(605) 307-3079 View (605) 307-3079
Photo of Nikki Roth - Nikki Roth, Licensed Professional Counselor, LPC-MH, LAC, LPCC, CCTP
Nikki Roth
Licensed Professional Counselor, LPC-MH, LAC, LPCC, CCTP
3 Endorsed
Serves Area
"Nothing is impossible. The word itself says I'm possible"- Audrey Hepburn. This is one of my favorite quotes. I believe therapy works best when it feels safe, respectful and empowering. Asking for help requires strength and self-awareness. I am passionate about supporting individuals as they take that courageous first step and discovery new ways to navigate life with resilience and confidence. The journey toward healing is not always easy or linear. It can feel uneasy at times, and that discomfort is often part of the growth. I honor each step a person takes no matter how small.
"Nothing is impossible. The word itself says I'm possible"- Audrey Hepburn. This is one of my favorite quotes. I believe therapy works best when it feels safe, respectful and empowering. Asking for help requires strength and self-awareness. I am passionate about supporting individuals as they take that courageous first step and discovery new ways to navigate life with resilience and confidence. The journey toward healing is not always easy or linear. It can feel uneasy at times, and that discomfort is often part of the growth. I honor each step a person takes no matter how small.
(605) 205-7820 View (605) 205-7820
Photo of Dr. Erik Anderson, Clinical Social Work/Therapist, DPC, MSW-PIP
Dr. Erik Anderson
Clinical Social Work/Therapist, DPC, MSW-PIP
Serves Area
Are you feeling overwhelmed, emotionally exhausted, or shaped by stress or past trauma that never seems to fully ease? I work with adults and professionals who are functioning outwardly but struggling internally with burnout, anxiety, or long-standing patterns. My approach is trauma-informed, thoughtful, and collaborative, focused on understanding what’s beneath the surface and supporting meaningful, sustainable change. I offer therapy in person in Sioux Falls and through secure telehealth across South Dakota.
Are you feeling overwhelmed, emotionally exhausted, or shaped by stress or past trauma that never seems to fully ease? I work with adults and professionals who are functioning outwardly but struggling internally with burnout, anxiety, or long-standing patterns. My approach is trauma-informed, thoughtful, and collaborative, focused on understanding what’s beneath the surface and supporting meaningful, sustainable change. I offer therapy in person in Sioux Falls and through secure telehealth across South Dakota.
(605) 674-7028 View (605) 674-7028
Photo of Clint Sperle, Licensed Professional Counselor, MA, LPC-MH, QMHP
Clint Sperle
Licensed Professional Counselor, MA, LPC-MH, QMHP
Serves Area
I received my degree in Counseling and Psychology in Education and am a Licensed Professional Counselor-MH. I have worked with children and adolescents in individual, group and family settings for the past 24+ years. Special areas of interest include working with children and adolescents in areas related to: abuse issues, trauma, evaluations and therapy for children with sexualized behaviors, grief and loss, depression, anxiety, divorce issues, behavioral issues and adjustment issues. I also work with children, adolescents and adults with developmental disabilities.
I received my degree in Counseling and Psychology in Education and am a Licensed Professional Counselor-MH. I have worked with children and adolescents in individual, group and family settings for the past 24+ years. Special areas of interest include working with children and adolescents in areas related to: abuse issues, trauma, evaluations and therapy for children with sexualized behaviors, grief and loss, depression, anxiety, divorce issues, behavioral issues and adjustment issues. I also work with children, adolescents and adults with developmental disabilities.
(605) 303-6587 View (605) 303-6587
Photo of Jennifer Walker, Clinical Social Work/Therapist, MSW, LCSWPIP, NADD-CC, QMHP
Jennifer Walker
Clinical Social Work/Therapist, MSW, LCSWPIP, NADD-CC, QMHP
3 Endorsed
Serves Area
It can be hard and intimidating to reach out for help. Finding a therapist, you feel comfortable with is the key to beginning a journey of healing. Nobody deserves to feel overlooked, forgotten or left out at any stage of life. At times we all need support to help us find our purpose in life and a sense of community and belonging. I am here to walk that journey to wellness with you by using a non-judgmental, gentle demeanor, and compassionate approach through individualized treatment planning to meet your unique needs.
It can be hard and intimidating to reach out for help. Finding a therapist, you feel comfortable with is the key to beginning a journey of healing. Nobody deserves to feel overlooked, forgotten or left out at any stage of life. At times we all need support to help us find our purpose in life and a sense of community and belonging. I am here to walk that journey to wellness with you by using a non-judgmental, gentle demeanor, and compassionate approach through individualized treatment planning to meet your unique needs.
(605) 205-8956 View (605) 205-8956
Photo of Sarajo Kegler, Clinical Social Work/Therapist, LCSW, PIP, LAC, QMHP
Sarajo Kegler
Clinical Social Work/Therapist, LCSW, PIP, LAC, QMHP
1 Endorsed
Serves Area
My ideal client is someone aged 13 and up who would like a safe, non judgmental place to start regaining control over their lives. I have worked with individuals who are going through rough break ups, substance abuse, anxiety and depression to individuals with significant trauma, such as sexual abuse, domestic violence, neglect or abandonment. Their goals often include coping with anxiety, healing from past trauma, building resilience, and creating a healthier future. They seek understanding, practical tools, and emotional support to regain control over their lives and foster a sense of empowerment.
My ideal client is someone aged 13 and up who would like a safe, non judgmental place to start regaining control over their lives. I have worked with individuals who are going through rough break ups, substance abuse, anxiety and depression to individuals with significant trauma, such as sexual abuse, domestic violence, neglect or abandonment. Their goals often include coping with anxiety, healing from past trauma, building resilience, and creating a healthier future. They seek understanding, practical tools, and emotional support to regain control over their lives and foster a sense of empowerment.
(605) 861-4114 View (605) 861-4114
Photo of Molly Therese McIntosh, Licensed Professional Counselor, MS, LPC-MH, LAC, QMHP, RYS-200
Molly Therese McIntosh
Licensed Professional Counselor, MS, LPC-MH, LAC, QMHP, RYS-200
2 Endorsed
Serves Area
Waitlist for new clients
When daily life is increasingly difficult to navigate, we can reach a point where we just stop seeing the joy in things. It can feel like it takes so much effort to complete simple tasks. During these times we may begin to wonder if we will ever feel any better. I'm here to assure you that you are not alone and you are not going to feel this way forever. I have worked in the counseling field for over 20 years, during which time I have helped people of all ages in a variety of settings. I am equipped with clinical experience, education and training to help you experience relief, increased insights, and peace of mind.
When daily life is increasingly difficult to navigate, we can reach a point where we just stop seeing the joy in things. It can feel like it takes so much effort to complete simple tasks. During these times we may begin to wonder if we will ever feel any better. I'm here to assure you that you are not alone and you are not going to feel this way forever. I have worked in the counseling field for over 20 years, during which time I have helped people of all ages in a variety of settings. I am equipped with clinical experience, education and training to help you experience relief, increased insights, and peace of mind.
(605) 210-5633 View (605) 210-5633
Photo of Virginia Strubbe, Clinical Social Work/Therapist, MSW, CSW-PIP
Virginia Strubbe
Clinical Social Work/Therapist, MSW, CSW-PIP
Serves Area
I am a clinical social worker with an interest in integrative mental health care. I support clients dealing with the impacts of life adjustments, challenging relationships, college transitions, parenting, work stress, chronic illness and autoimmune conditions, grief/loss, or hormonal changes.
I am a clinical social worker with an interest in integrative mental health care. I support clients dealing with the impacts of life adjustments, challenging relationships, college transitions, parenting, work stress, chronic illness and autoimmune conditions, grief/loss, or hormonal changes.
(605) 702-0708 View (605) 702-0708

More Therapists Nearby

Photo of Virginia Jones, Clinical Social Work/Therapist, LCSW
Virginia Jones
Clinical Social Work/Therapist, LCSW
Online Only
Welcome, I am Virginia and it is so nice to meet you! Thank you for taking this first step in feeling better, I believe this is the hardest one because people generally don't wake up one morning and desire to include a stranger in on their personal thoughts, beliefs, feelings, and troublesome behaviors. I hope to be a helpful fellow traveler to you and I am happy to let you be in the drivers seat regarding your treatment, I have lot's of suggestions - but they each only work if you put them to use :-)
Welcome, I am Virginia and it is so nice to meet you! Thank you for taking this first step in feeling better, I believe this is the hardest one because people generally don't wake up one morning and desire to include a stranger in on their personal thoughts, beliefs, feelings, and troublesome behaviors. I hope to be a helpful fellow traveler to you and I am happy to let you be in the drivers seat regarding your treatment, I have lot's of suggestions - but they each only work if you put them to use :-)
(605) 667-4602 View (605) 667-4602
Photo of Madi Griebel, Licensed Professional Counselor, MS, LPC, QMHP
Madi Griebel
Licensed Professional Counselor, MS, LPC, QMHP
Parkston, SD 57366
Hello! I am so glad you’re here. I’m Madi, a trauma-trained therapist in Parkston, SD helping individuals and couples find healing and harmony. If you're feeling stuck, exhausted, overwhelmed, or simply unsure where to turn, you're in the right place. Being stuck doesn't mean that you're broken, and therapy isn't about "fixing" you - it's about helping you get unstuck and feel more like you again. This is where I come in!
Hello! I am so glad you’re here. I’m Madi, a trauma-trained therapist in Parkston, SD helping individuals and couples find healing and harmony. If you're feeling stuck, exhausted, overwhelmed, or simply unsure where to turn, you're in the right place. Being stuck doesn't mean that you're broken, and therapy isn't about "fixing" you - it's about helping you get unstuck and feel more like you again. This is where I come in!
(605) 600-3976 View (605) 600-3976
Photo of Rikki Ohlrogge, Clinical Social Work/Therapist, CSW-PIP
Rikki Ohlrogge
Clinical Social Work/Therapist, CSW-PIP
Online Only
Hi, I’m Rikki. I know reaching out for therapy can feel like a big step, and I want you to know you don’t have to go through it alone. My style is warm, down-to-earth, and focused on creating a safe space where you can feel truly heard. I work with people navigating stress, anxiety, depression, relationship challenges, or just feeling stuck. Together, we’ll explore what’s going on in your life and find practical, meaningful ways forward. I pull from approaches like CBT, DBT, and IFS, but always tailor therapy to fit you.
Hi, I’m Rikki. I know reaching out for therapy can feel like a big step, and I want you to know you don’t have to go through it alone. My style is warm, down-to-earth, and focused on creating a safe space where you can feel truly heard. I work with people navigating stress, anxiety, depression, relationship challenges, or just feeling stuck. Together, we’ll explore what’s going on in your life and find practical, meaningful ways forward. I pull from approaches like CBT, DBT, and IFS, but always tailor therapy to fit you.
(605) 605-0831 View (605) 605-0831

Online Therapists

Photo of Margaret McCloud, Clinical Social Work/Therapist, CSW-PIP, QMHP
Margaret McCloud
Clinical Social Work/Therapist, CSW-PIP, QMHP
Sioux Falls, SD 57104
I'm Margaret! I'm here to support you in your journey of change and growth. It's my belief that everyone deserves clarity and support with life's challenges, especially those that feel overwhelming. I understand you're here for a reason. I'm honored to walk alongside you through your own unique transformation. My goal is to provide a safe, judgment-free space where you can be met with acceptance and validation. Whatever burdens you carry—whether it's work stress, grief, life transitions, parenting struggles, anxiety, depression or relationship issues—know that you're not alone. You deserve to feel valued, heard, and truly seen.
I'm Margaret! I'm here to support you in your journey of change and growth. It's my belief that everyone deserves clarity and support with life's challenges, especially those that feel overwhelming. I understand you're here for a reason. I'm honored to walk alongside you through your own unique transformation. My goal is to provide a safe, judgment-free space where you can be met with acceptance and validation. Whatever burdens you carry—whether it's work stress, grief, life transitions, parenting struggles, anxiety, depression or relationship issues—know that you're not alone. You deserve to feel valued, heard, and truly seen.
(605) 205-8720 View (605) 205-8720
Photo of Michelle Anne Pliska, Licensed Professional Counselor, MA, LPC-MH, QMHP, RPT, NCSC
Michelle Anne Pliska
Licensed Professional Counselor, MA, LPC-MH, QMHP, RPT, NCSC
2 Endorsed
Sioux Falls, SD 57103
It takes courage and strength to ask for help. I am honored to be trusted with your story. I believe healing and inspiration can come from a variety of sources: including creative outlets like music and art, the outdoors, spirituality and our relationships. I will honor our relationship with unconditional positive regard, safety, and confidentiality. I am excited to learn more about you and what you believe it is important for a person to be. I believe we will do good and meaningful work together.
It takes courage and strength to ask for help. I am honored to be trusted with your story. I believe healing and inspiration can come from a variety of sources: including creative outlets like music and art, the outdoors, spirituality and our relationships. I will honor our relationship with unconditional positive regard, safety, and confidentiality. I am excited to learn more about you and what you believe it is important for a person to be. I believe we will do good and meaningful work together.
(605) 540-1530 View (605) 540-1530
Photo of Geoff Faustman, Marriage & Family Therapist, MA, LMFT
Geoff Faustman
Marriage & Family Therapist, MA, LMFT
Online Only
I offer a direct, active, goal-oriented approach in helping you find relief from the anxiety, anger, depression, shame, or whatever it is that leaves you feeling stuck. By taking a look at 1) What are you trying to achieve? 2) What are you trying to preserve? 3) What are you trying to avoid? and 4) What are you trying to eliminate? we can highlight the sometimes-complex interaction among your thoughts, decisions, actions and outcomes. Knowing yourself, making use of your personal strengths & your tools at hand while allowing your values guide you, you can propel yourself toward becoming the best, most fulfilled version of yourself.
I offer a direct, active, goal-oriented approach in helping you find relief from the anxiety, anger, depression, shame, or whatever it is that leaves you feeling stuck. By taking a look at 1) What are you trying to achieve? 2) What are you trying to preserve? 3) What are you trying to avoid? and 4) What are you trying to eliminate? we can highlight the sometimes-complex interaction among your thoughts, decisions, actions and outcomes. Knowing yourself, making use of your personal strengths & your tools at hand while allowing your values guide you, you can propel yourself toward becoming the best, most fulfilled version of yourself.
(605) 349-1370 View (605) 349-1370
Photo of Anne Marie Goraj-McDade, Licensed Professional Counselor, MA, LPC-MH, LPCC
Anne Marie Goraj-McDade
Licensed Professional Counselor, MA, LPC-MH, LPCC
Sioux Falls, SD 57105
I am a licensed mental health therapist. I work primarily with adolescents and adults, using Dialectical Behavior Therapy (DBT) to address emotions and ineffective thoughts. I support my clients to gain a deeper awareness and acceptance of themselves. As a Certified Yoga Therapist, I journey with my clients as they gain self awareness of their body, mind and spirit.
I am a licensed mental health therapist. I work primarily with adolescents and adults, using Dialectical Behavior Therapy (DBT) to address emotions and ineffective thoughts. I support my clients to gain a deeper awareness and acceptance of themselves. As a Certified Yoga Therapist, I journey with my clients as they gain self awareness of their body, mind and spirit.
(605) 349-1208 View (605) 349-1208
Photo of Marie-Anne Abenroth, Licensed Professional Counselor, MA, LPC, LAC
Marie-Anne Abenroth
Licensed Professional Counselor, MA, LPC, LAC
Online Only
Feeling overwhelmed, anxious, or just plain worn out? Life’s tough moments can leave scars that make it hard to feel like your true self again. But guess what? You don’t have to go through it alone. Trauma-informed counseling is here to help you rediscover peace, balance, and you.
Feeling overwhelmed, anxious, or just plain worn out? Life’s tough moments can leave scars that make it hard to feel like your true self again. But guess what? You don’t have to go through it alone. Trauma-informed counseling is here to help you rediscover peace, balance, and you.
(719) 988-3748 View (719) 988-3748

See more therapy options for Mitchell

How does your Therapist compare?

Number of Therapists in Mitchell, SD

10+

Average cost per session

$225

Therapists in Mitchell, SD who prioritize treating:

100% Anxiety
100% Self Esteem
92% Depression
92% Trauma and PTSD
83% Grief
67% Relationship Issues
58% Spirituality

Average years in practice

14 Years

Top 3 insurances accepted

90% BlueCross and BlueShield
90% Avera Health Plans
90% Sanford Health Plan

How Therapists in Mitchell, SD see their clients

92% In Person and Online
8% Online Only

Gender breakdown

83% Female
17% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Mitchell?

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.