Therapists in Lake Oswego, OR

Photo of Susan Shimokaji, Marriage & Family Therapist in Lake Oswego, OR
Susan Shimokaji
Marriage & Family Therapist, LMFT, MBA, MAT, MA
Verified Verified
Lake Oswego, OR 97035
Not accepting new clients
Are you ready to make a change in your life? Change can be scary, difficult, and unpredictable and I am here to walk through it with you. I am passionate about working with individuals, children, teens, couples, and families to find what works for them, meeting them where they are at, and making certain that they are seen, heard, and understood. I believe that everyone is capable of change, and forming a trusting client therapist relationship is an important first step to challenge old thinking patterns and habits, and make change and growth happen in therapy.
Are you ready to make a change in your life? Change can be scary, difficult, and unpredictable and I am here to walk through it with you. I am passionate about working with individuals, children, teens, couples, and families to find what works for them, meeting them where they are at, and making certain that they are seen, heard, and understood. I believe that everyone is capable of change, and forming a trusting client therapist relationship is an important first step to challenge old thinking patterns and habits, and make change and growth happen in therapy.
(503) 461-0184 View (503) 461-0184
Photo of Janice Marie Johnson, Licensed Professional Counselor in Lake Oswego, OR
Janice Marie Johnson
Licensed Professional Counselor, LPC, MA
Verified Verified
Lake Oswego, OR 97035
Everybody at some point can benefit from therapy! Whether its just needing to talk over some relational issues or something more serious like depression, anxiety, sexual abuse or other traumas, therapy can make the difference. When people feel stuck in thought patterns or can't seem to get any peace or find joy in life, it is very discouraging. I find that my clients come in and want some tools to get out of their rut and find relief from their difficult life issues.
Everybody at some point can benefit from therapy! Whether its just needing to talk over some relational issues or something more serious like depression, anxiety, sexual abuse or other traumas, therapy can make the difference. When people feel stuck in thought patterns or can't seem to get any peace or find joy in life, it is very discouraging. I find that my clients come in and want some tools to get out of their rut and find relief from their difficult life issues.
(971) 803-3190 View (971) 803-3190
Photo of Jessica N Thomas, Marriage & Family Therapist in Lake Oswego, OR
Jessica N Thomas
Marriage & Family Therapist, PhD, LMFT
Verified Verified
Lake Oswego, OR 97034  (Online Only)
Engaging the heart and mind through a reflective therapeutic process to increase awareness, creativity, and wisdom. A PhD in Psychology and a MS in Marriage and Family Therapy, Dr. Thomas's education and training has provided her with a multidimensional perspective- she understands the web of connection and emotional dynamics that unfold in families, couples, and larger systems. Dr. Thomas's philosophical beliefs stem from the understanding that we are connected, and it is through this awareness that we can heal and create meaning from our life experiences.
Engaging the heart and mind through a reflective therapeutic process to increase awareness, creativity, and wisdom. A PhD in Psychology and a MS in Marriage and Family Therapy, Dr. Thomas's education and training has provided her with a multidimensional perspective- she understands the web of connection and emotional dynamics that unfold in families, couples, and larger systems. Dr. Thomas's philosophical beliefs stem from the understanding that we are connected, and it is through this awareness that we can heal and create meaning from our life experiences.
(503) 564-0251 View (503) 564-0251
Photo of Julie K Williams, Psychologist in Lake Oswego, OR
Julie K Williams
Psychologist, PsyD
Verified Verified
1 Endorsed
Lake Oswego, OR 97035  (Online Only)
You went to college, maybe even grad school, and made it to your real life. So why don’t you feel happy, or at least content? You have the career you dreamed of and maybe even the family you hoped for… so why do you feel like an imposter in your own life? You don’t remember anymore what it is you dreamed you would become because you’re so busy doing what society tells you you’re supposed be doing. You’re smart, you’re ambitious, you’ve followed all the rules and done all the things, and yet you can’t figure out where you went wrong. You think maybe this is just how it is.
You went to college, maybe even grad school, and made it to your real life. So why don’t you feel happy, or at least content? You have the career you dreamed of and maybe even the family you hoped for… so why do you feel like an imposter in your own life? You don’t remember anymore what it is you dreamed you would become because you’re so busy doing what society tells you you’re supposed be doing. You’re smart, you’re ambitious, you’ve followed all the rules and done all the things, and yet you can’t figure out where you went wrong. You think maybe this is just how it is.
(971) 252-5483 View (971) 252-5483
Photo of Libby Schwartz, Licensed Professional Counselor in Lake Oswego, OR
Libby Schwartz
Licensed Professional Counselor, MS
Verified Verified
Lake Oswego, OR 97035  (Online Only)
Sometimes life can feel overwhelming. An unexpected event can suddenly throw everything off balance, or many smaller stresses can build up until it seems impossible to cope with them. These places can feel especially demoralizing if they challenge your self-efficacy--your ability to cope with problems on your own. You are not alone. At times, everyone needs help navigating through life's passages. I believe we all have the capacity to find a deeper, more meaningful life. I can work with you to help you regain your footing to continue your journey stronger than you were before.
Sometimes life can feel overwhelming. An unexpected event can suddenly throw everything off balance, or many smaller stresses can build up until it seems impossible to cope with them. These places can feel especially demoralizing if they challenge your self-efficacy--your ability to cope with problems on your own. You are not alone. At times, everyone needs help navigating through life's passages. I believe we all have the capacity to find a deeper, more meaningful life. I can work with you to help you regain your footing to continue your journey stronger than you were before.
(503) 272-6204 View (503) 272-6204
Photo of Heartwise Counseling Services, Licensed Professional Counselor in Lake Oswego, OR
Heartwise Counseling Services
Licensed Professional Counselor, MA, LPC
Verified Verified
3 Endorsed
Lake Oswego, OR 97035
Are you longing to find an easier way of managing the demands of work, couplehood, and family? Are you looking for more peace in your core relationships? I would love to help. I help Women & Couples find a better balance, communicate in a healthier, stronger way, and find the peace you hoped for at this stage of your life. I am a compassionate partner to help you sort through the tangles of life. I get it---I'm a parent too and understand how challenging it can be. [Set up a free consultation at https://calendly.com/heartwisesusan/free-consultation]
Are you longing to find an easier way of managing the demands of work, couplehood, and family? Are you looking for more peace in your core relationships? I would love to help. I help Women & Couples find a better balance, communicate in a healthier, stronger way, and find the peace you hoped for at this stage of your life. I am a compassionate partner to help you sort through the tangles of life. I get it---I'm a parent too and understand how challenging it can be. [Set up a free consultation at https://calendly.com/heartwisesusan/free-consultation]
(503) 980-4514 View (503) 980-4514
Photo of Marina Nelson, Licensed Professional Counselor in Lake Oswego, OR
Marina Nelson
Licensed Professional Counselor, LPC, LMHC
Verified Verified
Lake Oswego, OR 97035  (Online Only)
Not accepting new clients
Accepting clients in January. Anxiety, depression, shame, stress, overwhelm, or burn out are some normal responses to life challenges. As social beings, we benefit deeply from supportive people and environments that assist us in uncovering and integrating the wisdom of our minds, bodies and emotions to return to our essential selves--the part that is unshaped by adaptation to difficult experiences. It is my honor to be present and help facilitate people finding their inner strengths, true self, abilities and qualities they didn't fully realize they own as they release the negative effects of the past.
Accepting clients in January. Anxiety, depression, shame, stress, overwhelm, or burn out are some normal responses to life challenges. As social beings, we benefit deeply from supportive people and environments that assist us in uncovering and integrating the wisdom of our minds, bodies and emotions to return to our essential selves--the part that is unshaped by adaptation to difficult experiences. It is my honor to be present and help facilitate people finding their inner strengths, true self, abilities and qualities they didn't fully realize they own as they release the negative effects of the past.
(503) 201-7502 View (503) 201-7502
Photo of Stephanie Bauer, Licensed Professional Counselor in Lake Oswego, OR
Stephanie Bauer
Licensed Professional Counselor, LPC
Verified Verified
Lake Oswego, OR 97035
Immediate openings available (please note I am only taking commercial Pacific Source (not OHP) and Out of Network/cash pay.) I have a compassion for working with people who are ready to see change in their life. I have a passion for working with therapists and therapists in training. I enjoy working with women and finding boundaries, issues with hormonal imbalances, confidence, and anxiety to help find your best self. I think it is important to find a trusting connection in therapy that combines new challenges with growth and change. Penelope, my therapy dog, is excited to join our virtual sessions and in person on occasion!
Immediate openings available (please note I am only taking commercial Pacific Source (not OHP) and Out of Network/cash pay.) I have a compassion for working with people who are ready to see change in their life. I have a passion for working with therapists and therapists in training. I enjoy working with women and finding boundaries, issues with hormonal imbalances, confidence, and anxiety to help find your best self. I think it is important to find a trusting connection in therapy that combines new challenges with growth and change. Penelope, my therapy dog, is excited to join our virtual sessions and in person on occasion!
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Photo of Joseph C Schutte, Marriage & Family Therapist in Lake Oswego, OR
Joseph C Schutte
Marriage & Family Therapist, LMFT, QMHP
Verified Verified
1 Endorsed
Lake Oswego, OR 97035
Our lives are filled with relationships: friendship, significant other, parent, child, intimate partner, etc. When our relationships are struggle, so do other areas of life. Frequently, feelings of depression, anger, or stress coincide with disconnection of a significant, meaningful relationship. This feeling of disconnection is threatening and scary; allowing for thoughts of abandonment, and feeling alone. Unfortunately, this results in an increased feeling of disconnection in our most important relationships.
Our lives are filled with relationships: friendship, significant other, parent, child, intimate partner, etc. When our relationships are struggle, so do other areas of life. Frequently, feelings of depression, anger, or stress coincide with disconnection of a significant, meaningful relationship. This feeling of disconnection is threatening and scary; allowing for thoughts of abandonment, and feeling alone. Unfortunately, this results in an increased feeling of disconnection in our most important relationships.
(503) 451-6702 View (503) 451-6702
Photo of Renee Mahin, Clinical Social Work/Therapist in Lake Oswego, OR
Renee Mahin
Clinical Social Work/Therapist, LCSW
Verified Verified
Lake Oswego, OR 97034
Waitlist for new clients
As a therapist, I know there are times when we feel lost or lack confidence to navigate through critical and life-changing circumstances. Although we often have many strengths and skills, we have difficulty accessing these during periods of family changes or crises, depression, anxiety, or prolonged grief/loss. In therapy, I will facilitate the process of helping you reconnect with your strengths and discover new skills, strategies, and resources toward a more healthier approach to life challenges.
As a therapist, I know there are times when we feel lost or lack confidence to navigate through critical and life-changing circumstances. Although we often have many strengths and skills, we have difficulty accessing these during periods of family changes or crises, depression, anxiety, or prolonged grief/loss. In therapy, I will facilitate the process of helping you reconnect with your strengths and discover new skills, strategies, and resources toward a more healthier approach to life challenges.
(503) 376-8529 View (503) 376-8529
Photo of Teresa Northy, Clinical Social Work/Therapist in Lake Oswego, OR
Teresa Northy
Clinical Social Work/Therapist, MSW, CSWA
Verified Verified
Lake Oswego, OR 97035
I welcome clients of all ages, experiences, and backgrounds. Diversity, equity, cultural humility, and empathy are foundational to my work. Seeking therapy can be scary and talking about the hard stuff requires vulnerability and bravery. In this nurturing space, I'm here to support you every step of the way on your journey to self-discovery, personal growth, and a brighter, more empowered future. I offer both virtual and in-person therapy sessions, providing a client-centered, strength-based and trauma informed approach.
I welcome clients of all ages, experiences, and backgrounds. Diversity, equity, cultural humility, and empathy are foundational to my work. Seeking therapy can be scary and talking about the hard stuff requires vulnerability and bravery. In this nurturing space, I'm here to support you every step of the way on your journey to self-discovery, personal growth, and a brighter, more empowered future. I offer both virtual and in-person therapy sessions, providing a client-centered, strength-based and trauma informed approach.
(503) 386-1216 View (503) 386-1216
Photo of Amanda Terry, Clinical Social Work/Therapist in Lake Oswego, OR
Amanda Terry
Clinical Social Work/Therapist, LCSW
Verified Verified
Lake Oswego, OR 97035  (Online Only)
Those who find that anxiety and/or depression have become intrusive in their life, when trying to cope with life transitions becomes difficult, when you need non-judgemental support to help you through a difficult time.
Those who find that anxiety and/or depression have become intrusive in their life, when trying to cope with life transitions becomes difficult, when you need non-judgemental support to help you through a difficult time.
(503) 902-6580 View (503) 902-6580
Photo of Holly Shumway MA, NCC, LPC, Licensed Professional Counselor in Lake Oswego, OR
Holly Shumway MA, NCC, LPC
Licensed Professional Counselor, MA, NCC, LPC
Verified Verified
3 Endorsed
Lake Oswego, OR 97035  (Online Only)
Not accepting new clients
I help individuals, couples, and families achieve a sense of integrative wholeness by creating healthy connections for mind, body, and the emotional self to work effectively together rather than in opposition to one another. Often, the overlooked, the unspoken, and the unaccepted pieces of our inner selves prohibit our ability to experience a sense of wholeness. Personal challenges often become more manageable and approachable when the unknown is met with compassionate understanding.
I help individuals, couples, and families achieve a sense of integrative wholeness by creating healthy connections for mind, body, and the emotional self to work effectively together rather than in opposition to one another. Often, the overlooked, the unspoken, and the unaccepted pieces of our inner selves prohibit our ability to experience a sense of wholeness. Personal challenges often become more manageable and approachable when the unknown is met with compassionate understanding.
(503) 766-5491 View (503) 766-5491
Photo of Cynthia Hiles, Clinical Social Work/Therapist in Lake Oswego, OR
Cynthia Hiles
Clinical Social Work/Therapist, LCSW
Verified Verified
Lake Oswego, OR 97035
Cynthia Hiles, LCSW received her master's degree in Social Work from University of Southern California three decades ago. She has been a practicing Clinical Social Worker in private practice and in a neonatal intensive care unit in a medical setting. Working with individuals or families coping with a medical crisis or facing a life challenge is her primary focus. Utilizing various treatment modalities, she is able to tailor a tool kit to maximize the therapeutic process in a respectful and compassionate setting.
Cynthia Hiles, LCSW received her master's degree in Social Work from University of Southern California three decades ago. She has been a practicing Clinical Social Worker in private practice and in a neonatal intensive care unit in a medical setting. Working with individuals or families coping with a medical crisis or facing a life challenge is her primary focus. Utilizing various treatment modalities, she is able to tailor a tool kit to maximize the therapeutic process in a respectful and compassionate setting.
(503) 966-9117 View (503) 966-9117
Photo of Vickey Giap Thistlethwaite, Marriage & Family Therapist Associate in Lake Oswego, OR
Vickey Giap Thistlethwaite
Marriage & Family Therapist Associate, MA
Verified Verified
Lake Oswego, OR 97034
Being part of the interconnected natural world, we thrive in connection, and without connection, we wither. In our work together we will collaborate in understanding what makes you come alive and wither, to look for ways to get unstuck and make meaning of your emotions, reactivity, and suffering. I believe that individuals and families can tap into their inner strength to repair and grow new resilience with guidance and support. My role is to restore balance, build communication, and provide support to help you create space to learn and integrate new skills and encourage new perspectives as you grow and thrive in connections.
Being part of the interconnected natural world, we thrive in connection, and without connection, we wither. In our work together we will collaborate in understanding what makes you come alive and wither, to look for ways to get unstuck and make meaning of your emotions, reactivity, and suffering. I believe that individuals and families can tap into their inner strength to repair and grow new resilience with guidance and support. My role is to restore balance, build communication, and provide support to help you create space to learn and integrate new skills and encourage new perspectives as you grow and thrive in connections.
(503) 218-3885 View (503) 218-3885
Photo of Chynna Springer, Licensed Professional Counselor in Lake Oswego, OR
Chynna Springer
Licensed Professional Counselor, MA, LMHC, LPC, CADCI
Verified Verified
Lake Oswego, OR 97035  (Online Only)
Waitlist for new clients
Do you want to improve your quality of life? Are symptoms of stress, anxiety, or depression preventing you from living your life to its fullest potential? Do you feel trapped in an unhealthy relationship? Are you overwhelmed, burnt out, or juggling multiple roles? Counseling can support you through these challenges! I will create a safe therapeutic environment where you can be heard, feel understood, and work towards positive growth. You will learn practical tools to reach your goals based on your individual needs. I approach counseling from a client-driven and strengths-based perspective.
Do you want to improve your quality of life? Are symptoms of stress, anxiety, or depression preventing you from living your life to its fullest potential? Do you feel trapped in an unhealthy relationship? Are you overwhelmed, burnt out, or juggling multiple roles? Counseling can support you through these challenges! I will create a safe therapeutic environment where you can be heard, feel understood, and work towards positive growth. You will learn practical tools to reach your goals based on your individual needs. I approach counseling from a client-driven and strengths-based perspective.
(503) 455-7348 View (503) 455-7348
Photo of Lynae Nelson, Licensed Professional Counselor in Lake Oswego, OR
Lynae Nelson
Licensed Professional Counselor, MEd, LPC
Verified Verified
Lake Oswego, OR 97035
I believe that we all experience struggles in life, both within ourselves and through challenging circumstances. These struggles can result in trauma, anxiety, depression, brain and body changes, influence our sense of self-worth, identity, belief in our abilities, the world around us, and otherwise limit us . So often, these struggles can impact our relationships, career, and long-term well-being. Clients who want to address these, and other, concerns head on in a supportive manner with a trauma lens and utilize treatment guided by science and a neuro-biological approach would enjoy my approach to therapy.
I believe that we all experience struggles in life, both within ourselves and through challenging circumstances. These struggles can result in trauma, anxiety, depression, brain and body changes, influence our sense of self-worth, identity, belief in our abilities, the world around us, and otherwise limit us . So often, these struggles can impact our relationships, career, and long-term well-being. Clients who want to address these, and other, concerns head on in a supportive manner with a trauma lens and utilize treatment guided by science and a neuro-biological approach would enjoy my approach to therapy.
(458) 218-8364 View (458) 218-8364
Photo of Kushanthi Samaratunge, Psychologist in Lake Oswego, OR
Kushanthi Samaratunge
Psychologist, PsyD
Verified Verified
2 Endorsed
Lake Oswego, OR 97035
Do you feel that you and your family have been struggling lately? are you, or your family members struggling with anything that you are not certain how to deal with? No matter how much you have tried things seem to be the same or seem to be getting worse for you and your family? Do you feel accepted and understood?
Do you feel that you and your family have been struggling lately? are you, or your family members struggling with anything that you are not certain how to deal with? No matter how much you have tried things seem to be the same or seem to be getting worse for you and your family? Do you feel accepted and understood?
(503) 755-5511 View (503) 755-5511
Photo of Yulia Tsarenko Carey, Professional Counselor Associate in Lake Oswego, OR
Yulia Tsarenko Carey
Professional Counselor Associate, PCA
Verified Verified
2 Endorsed
Lake Oswego, OR 97035  (Online Only)
As a mental health professional, I aim to help clients achieve well-being in a safe and supportive environment. I understand that each person's experiences and needs are unique, and I am dedicated to assisting clients in exploring their thoughts, feelings, and behaviors without fear of judgment. I empower my clients to participate actively in their mental health journey. As an immigrant, I provide mental health treatment in English and Russian.
As a mental health professional, I aim to help clients achieve well-being in a safe and supportive environment. I understand that each person's experiences and needs are unique, and I am dedicated to assisting clients in exploring their thoughts, feelings, and behaviors without fear of judgment. I empower my clients to participate actively in their mental health journey. As an immigrant, I provide mental health treatment in English and Russian.
(503) 744-5297 View (503) 744-5297
Photo of Eric Bruemmer, Licensed Professional Counselor in Lake Oswego, OR
Eric Bruemmer
Licensed Professional Counselor, MS, LPC, EMDR
Verified Verified
2 Endorsed
Lake Oswego, OR 97035
Having worked with Virtual Therapy (phone and video) since 2004 and Virtual EMDR since 2017, I can serve you now. Fitting my training and style, EMDR (eye movement desensitization and reprocessing) is a comprehensive and gently compassionate approach to adversity and trauma including anxiety, depression, couple and family issues. I work with diverse adults across the life spectrum. Licensed in both Oregon and Illinois, I am committed to life change and am on a personal adventure as well. Any questions, please ask? There are answers and I have help.
Having worked with Virtual Therapy (phone and video) since 2004 and Virtual EMDR since 2017, I can serve you now. Fitting my training and style, EMDR (eye movement desensitization and reprocessing) is a comprehensive and gently compassionate approach to adversity and trauma including anxiety, depression, couple and family issues. I work with diverse adults across the life spectrum. Licensed in both Oregon and Illinois, I am committed to life change and am on a personal adventure as well. Any questions, please ask? There are answers and I have help.
(971) 351-2720 View (971) 351-2720

How does your Therapist compare?

Number of Therapists in Lake Oswego, OR

400+

Average cost per session

$165

Therapists in Lake Oswego, OR who prioritize treating:

94% Anxiety
87% Depression
83% Relationship Issues
78% Self Esteem
70% Trauma and PTSD
70% Coping Skills
70% Stress

Average years in practice

14 Years

Top 3 insurances accepted

57% PacificSource
48% Aetna
44% BlueCross and BlueShield

How Therapists in Lake Oswego, OR see their clients

64% In Person and Online
36% Online Only

Gender breakdown

78% Female
21% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Lake Oswego?

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.