Therapists in San Francisco, CA

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Photo of Cathy Trenary, Associate Professional Clinical Counselor in San Francisco, CA
Cathy Trenary
Associate Professional Clinical Counselor, APCC
Verified Verified
San Francisco, CA 94114
Our life experiences can lead us to question our identity and purpose in the world we live in. This can lead us to anxiety, depression, and trauma. Do you want to improve how you face challenges, function in your relationships, and face overwhelming feelings? I place heavy importance on addressing trauma. Trauma disintegrates the parts that make up your whole self, which can leave aspects of who you are hidden from your awareness. Left unaddressed, anxiety and depression can worsen, which can rob you of the necessary connection that all human beings need to thrive. I aim to help you process unresolved trauma.
Our life experiences can lead us to question our identity and purpose in the world we live in. This can lead us to anxiety, depression, and trauma. Do you want to improve how you face challenges, function in your relationships, and face overwhelming feelings? I place heavy importance on addressing trauma. Trauma disintegrates the parts that make up your whole self, which can leave aspects of who you are hidden from your awareness. Left unaddressed, anxiety and depression can worsen, which can rob you of the necessary connection that all human beings need to thrive. I aim to help you process unresolved trauma.
(415) 870-3417 View (415) 870-3417
Photo of Sara K Levley, Psychologist in San Francisco, CA
Sara K Levley
Psychologist, PsyD
Verified Verified
2 Endorsed
San Francisco, CA 94118  (Online Only)
As a warm, supportive, and interactive therapist, I specialize in helping people who feel stuck and want to move forward. I work with individuals and couples struggling to figure out a specific issue, including simply wanting to feel better, as well as those who want help managing relationship concerns, loss, difficult childhood experiences, and struggles with perfectionism. Through my work at UCSF, I have had extensive training focused on improving relational dynamics within challenging situations and helping people heal from trauma and painful early childhood experiences.
As a warm, supportive, and interactive therapist, I specialize in helping people who feel stuck and want to move forward. I work with individuals and couples struggling to figure out a specific issue, including simply wanting to feel better, as well as those who want help managing relationship concerns, loss, difficult childhood experiences, and struggles with perfectionism. Through my work at UCSF, I have had extensive training focused on improving relational dynamics within challenging situations and helping people heal from trauma and painful early childhood experiences.
(206) 350-8283 View (206) 350-8283
Photo of Amy Merickel, Marriage & Family Therapist in San Francisco, CA
Amy Merickel
Marriage & Family Therapist, MA, LMFT
Verified Verified
San Francisco, CA 94102
Not accepting new clients
My work is grounded in helping people feel more like themselves, more connected in relationships, and less anxious or depressed. Together we can work to understand parts of you that may feel lost, stuck, or in pain, find new ways of relating to yourself and to others, and help you come into a more full sense of who you are. Often people who come to work with me seek support in resolving past trauma. No matter what brings you in, my goal is to offer a safe haven where you feel understood, confront your joys and sorrows, and get the support you need to develop a more full and meaningful life.
My work is grounded in helping people feel more like themselves, more connected in relationships, and less anxious or depressed. Together we can work to understand parts of you that may feel lost, stuck, or in pain, find new ways of relating to yourself and to others, and help you come into a more full sense of who you are. Often people who come to work with me seek support in resolving past trauma. No matter what brings you in, my goal is to offer a safe haven where you feel understood, confront your joys and sorrows, and get the support you need to develop a more full and meaningful life.
(415) 689-6036 View (415) 689-6036
Photo of Annmarie Hulette, Psychologist in San Francisco, CA
Annmarie Hulette
Psychologist, PhD
Verified Verified
San Francisco, CA 94107
I am a clinical psychologist specializing in CBT with children, adolescents, and young adults, offering in-person services in SF as well as telehealth. I treat a range of issues, including anxiety and stress, depression, social difficulties, adjustment problems, and disruptive behaviors. The types of services I provide include individual therapy, parent consultations, and parent-child therapy. For more information about my services, please click on the button to the left to visit my website.
I am a clinical psychologist specializing in CBT with children, adolescents, and young adults, offering in-person services in SF as well as telehealth. I treat a range of issues, including anxiety and stress, depression, social difficulties, adjustment problems, and disruptive behaviors. The types of services I provide include individual therapy, parent consultations, and parent-child therapy. For more information about my services, please click on the button to the left to visit my website.
(650) 257-8762 View (650) 257-8762
Photo of Christina Sanchez, Psychologist in San Francisco, CA
Christina Sanchez
Psychologist, PsyD
Verified Verified
1 Endorsed
San Francisco, CA 94115
Choosing a psychotherapist can feel daunting. People often enter therapy during times of vulnerability. At a time when you are potentially feeling overwhelmed with stress, anxiety, anger, sadness, or depression it can be challenging to trust a stranger with all these feelings and intimate details about your life. I view my role as a therapist as being able to fully understand your experience and to use that understanding to help you think through situations that have become increasingly challenging. I believe in creating a safe space for my clients, and working collaboratively in order to help you regain a sense of strength, confidence, and control.
Choosing a psychotherapist can feel daunting. People often enter therapy during times of vulnerability. At a time when you are potentially feeling overwhelmed with stress, anxiety, anger, sadness, or depression it can be challenging to trust a stranger with all these feelings and intimate details about your life. I view my role as a therapist as being able to fully understand your experience and to use that understanding to help you think through situations that have become increasingly challenging. I believe in creating a safe space for my clients, and working collaboratively in order to help you regain a sense of strength, confidence, and control.
(415) 599-7577 View (415) 599-7577
Photo of Zi Zheng, Marriage & Family Therapist Associate in San Francisco, CA
Zi Zheng
Marriage & Family Therapist Associate, MA, AMFT
Verified Verified
2 Endorsed
San Francisco, CA 94103  (Online Only)
Life can be challenging. Are you feeling stress, anxiety, or uncertainty about the future? Do life transitions seem overwhelming for you? Does dealing with conflicts with loved ones feel like walking on eggshells? Maybe you're trying to find your voice again after the breakup or change. Together, we can create a safe space where you can explore your emotions and develop a deep self-awareness, that will empower you to overcome life’s challenges. You will discover the ability and tools to voice your needs and navigate through resentments and conflicts with others.
Life can be challenging. Are you feeling stress, anxiety, or uncertainty about the future? Do life transitions seem overwhelming for you? Does dealing with conflicts with loved ones feel like walking on eggshells? Maybe you're trying to find your voice again after the breakup or change. Together, we can create a safe space where you can explore your emotions and develop a deep self-awareness, that will empower you to overcome life’s challenges. You will discover the ability and tools to voice your needs and navigate through resentments and conflicts with others.
(415) 870-2120 View (415) 870-2120
Photo of Melanie Richards Horn, Psychologist in San Francisco, CA
Melanie Richards Horn
Psychologist, PhD
Verified Verified
San Francisco, CA 94118  (Online Only)
You may be seeking help with a difficult relationship, a painful loss, anxiety, depression, or a sense of feeling "stuck" in some way. The goal of therapy is to increase your ability to face life's challenges with greater confidence, energy and creativity. Psychotherapy can help you develop a greater sense of your potential. My approach invites an engaging dialogue geared to your needs and goals.
You may be seeking help with a difficult relationship, a painful loss, anxiety, depression, or a sense of feeling "stuck" in some way. The goal of therapy is to increase your ability to face life's challenges with greater confidence, energy and creativity. Psychotherapy can help you develop a greater sense of your potential. My approach invites an engaging dialogue geared to your needs and goals.
(415) 876-4321 View (415) 876-4321
Photo of Dr. Cecilia Winfield, Pre-Licensed Professional in San Francisco, CA
Dr. Cecilia Winfield
Pre-Licensed Professional, PsyD
Verified Verified
2 Endorsed
San Francisco, CA 94102
We often come to therapy because something in our life has emerged in a way we find challenging to navigate on our own. I approach our work together with this in mind, and as an honored participant in your journey toward growth and deepened insight. My therapeutic style is rooted in relational psychodynamic, IFS, and ACT interventions and centered in values of patience, humility, empathy, and humor. I strive to see you through the lens of your unique life experiences and to work collaboratively so we can effectively address your concerns. My hope is that, together, we can help you live a life that feels authentic and empowered.
We often come to therapy because something in our life has emerged in a way we find challenging to navigate on our own. I approach our work together with this in mind, and as an honored participant in your journey toward growth and deepened insight. My therapeutic style is rooted in relational psychodynamic, IFS, and ACT interventions and centered in values of patience, humility, empathy, and humor. I strive to see you through the lens of your unique life experiences and to work collaboratively so we can effectively address your concerns. My hope is that, together, we can help you live a life that feels authentic and empowered.
(415) 980-6482 View (415) 980-6482
Photo of Lea Didion, Psychologist in San Francisco, CA
Lea Didion
Psychologist, PsyD
Verified Verified
9 Endorsed
San Francisco, CA 94123  (Online Only)
​Trauma does not discriminate. It can happen to anyone no matter their circumstances. Fortunately, there are also treatments that can help. In my 20 years of experience, I have born witness to the incredible resilience of individuals who have experienced trauma and firmly believe that recovery is possible. I have expertise in working with survivors of all forms of trauma including (but not limited to) service members, veterans, journalists (JTSN certificate), childhood abuse, chronic invalidation, developmental trauma, intergenerational trauma, immigration-related trauma, race-based trauma, and interpersonal violence.
​Trauma does not discriminate. It can happen to anyone no matter their circumstances. Fortunately, there are also treatments that can help. In my 20 years of experience, I have born witness to the incredible resilience of individuals who have experienced trauma and firmly believe that recovery is possible. I have expertise in working with survivors of all forms of trauma including (but not limited to) service members, veterans, journalists (JTSN certificate), childhood abuse, chronic invalidation, developmental trauma, intergenerational trauma, immigration-related trauma, race-based trauma, and interpersonal violence.
(202) 318-6076 View (202) 318-6076
Photo of Gia Stark, Marriage & Family Therapist in San Francisco, CA
Gia Stark
Marriage & Family Therapist, MA, LMFT, LPCC
Verified Verified
6 Endorsed
San Francisco, CA 94110
Not accepting new clients
Thank you for reading this. Having a background in grassroots and non-profit work as well as teaching, so I am fiercely passionate about equity, social justice and liberation for all people. The therapeutic relationship is unique and radical --- your words have exquisite power and we get to think together about what they mean.
Thank you for reading this. Having a background in grassroots and non-profit work as well as teaching, so I am fiercely passionate about equity, social justice and liberation for all people. The therapeutic relationship is unique and radical --- your words have exquisite power and we get to think together about what they mean.
(415) 650-2651 View (415) 650-2651
Photo of Kathleen Hoffman, Clinical Social Work/Therapist in San Francisco, CA
Kathleen Hoffman
Clinical Social Work/Therapist, LMFT
Verified Verified
San Francisco, CA 94102
Kathleen Hoffman is a Licensed Marriage and Family Therapist in California who has been practicing since 2014. She graduated from California State University, Sacramento with a Master of Science degree in Marriage and Family Counseling in 2007. Kathleen is multifaceted in her experience working with individuals (adolescents and adults from young to the senior years), couples, children, and families. She began her therapist journey in equine assisted therapy and then transitioned to a clinic setting.
Kathleen Hoffman is a Licensed Marriage and Family Therapist in California who has been practicing since 2014. She graduated from California State University, Sacramento with a Master of Science degree in Marriage and Family Counseling in 2007. Kathleen is multifaceted in her experience working with individuals (adolescents and adults from young to the senior years), couples, children, and families. She began her therapist journey in equine assisted therapy and then transitioned to a clinic setting.
(628) 277-5080 View (628) 277-5080
Photo of The Fluent Mind, Clinical Social Work/Therapist in San Francisco, CA
The Fluent Mind
Clinical Social Work/Therapist, LCSW
Verified Verified
San Francisco, CA 94115
As parents and clinicians, we know it is hard to have a unique brain in a typical world. We know you need different navigational tools in these turbulent waters. So, we designed a program based on well-researched therapies for all ages that will strengthen core brain functions - attention, memory, processing speed and problem-solving - and increase social skills. For parents, we work together to find the right community supports and develop the skills you need as a parent to support a calm and thriving family life.
As parents and clinicians, we know it is hard to have a unique brain in a typical world. We know you need different navigational tools in these turbulent waters. So, we designed a program based on well-researched therapies for all ages that will strengthen core brain functions - attention, memory, processing speed and problem-solving - and increase social skills. For parents, we work together to find the right community supports and develop the skills you need as a parent to support a calm and thriving family life.
(415) 944-5813 View (415) 944-5813
Photo of Ryan Noble, Marriage & Family Therapist in San Francisco, CA
Ryan Noble
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94114
Everyone has the potential for growth, healing, and self-discovery. In my career I have been fortunate to work with individuals, couples, and families from a diverse range of backgrounds and experiences. I have witnessed the resilience that each person has and how providing support can help people channel their unique strengths, resources, and insights. I aim to create a safe and supportive environment that empowers those I work with to explore their emotions and experiences, and to work towards developing greater self-awareness, self-acceptance, and self-confidence.
Everyone has the potential for growth, healing, and self-discovery. In my career I have been fortunate to work with individuals, couples, and families from a diverse range of backgrounds and experiences. I have witnessed the resilience that each person has and how providing support can help people channel their unique strengths, resources, and insights. I aim to create a safe and supportive environment that empowers those I work with to explore their emotions and experiences, and to work towards developing greater self-awareness, self-acceptance, and self-confidence.
(415) 941-3496 View (415) 941-3496
Photo of Ford Peck, Marriage & Family Therapist in San Francisco, CA
Ford Peck
Marriage & Family Therapist, MA, LMFT
Verified Verified
San Francisco, CA 94123  (Online Only)
Healing is a natural process. It is not something that needs to be forced, only supported and allowed. Often the beliefs and strategies we formed when young were helpful and necessary at the time, yet they can linger on into adulthood and limit us rather than assist us. Therapy is a process of unwinding what is no longer true or helpful, exploring what is most essential and true for us, and resting into a deeper sense of wholeness, authenticity, and well-being. My job is to help you find your own answers, your own clarity, your own empowerment. I can help you discover what is needed to support this healing and this growth.
Healing is a natural process. It is not something that needs to be forced, only supported and allowed. Often the beliefs and strategies we formed when young were helpful and necessary at the time, yet they can linger on into adulthood and limit us rather than assist us. Therapy is a process of unwinding what is no longer true or helpful, exploring what is most essential and true for us, and resting into a deeper sense of wholeness, authenticity, and well-being. My job is to help you find your own answers, your own clarity, your own empowerment. I can help you discover what is needed to support this healing and this growth.
(628) 262-2257 View (628) 262-2257
Photo of Barri Pitkoff Aji, Marriage & Family Therapist in San Francisco, CA
Barri Pitkoff Aji
Marriage & Family Therapist, LMFT
Verified Verified
San Francisco, CA 94115  (Online Only)
Is anxiety or depression preventing you from living the life you want? Are you longing for fulfilling relationships with others, but unable to attain them? I have helped adults and adolescents figure out what's blocking them and create happier and more fulfilling lives for over twenty years.
Is anxiety or depression preventing you from living the life you want? Are you longing for fulfilling relationships with others, but unable to attain them? I have helped adults and adolescents figure out what's blocking them and create happier and more fulfilling lives for over twenty years.
(415) 599-7364 View (415) 599-7364
Photo of Jennifer A. Caplan, Marriage & Family Therapist in San Francisco, CA
Jennifer A. Caplan
Marriage & Family Therapist, MA, MFT
Verified Verified
San Francisco, CA 94123
I am here to help you work through the challenges you've been trying to resolve alone. I specialize in working with individuals who are "high-achievers/perfectionists" yet struggle with satisfying, stable intimacy in their relationships. I also work with those who feel "different" from their peers in a variety of ways. I help my clients transform their struggles into a pathway to a powerful and deep alliance with themselves and with the important people in their lives. Inner intimacy can become the basis and blueprint for all other forms of connection in your life.
I am here to help you work through the challenges you've been trying to resolve alone. I specialize in working with individuals who are "high-achievers/perfectionists" yet struggle with satisfying, stable intimacy in their relationships. I also work with those who feel "different" from their peers in a variety of ways. I help my clients transform their struggles into a pathway to a powerful and deep alliance with themselves and with the important people in their lives. Inner intimacy can become the basis and blueprint for all other forms of connection in your life.
(415) 658-9358 View (415) 658-9358
Photo of Silvia MacAllister Voermanek, Marriage & Family Therapist in San Francisco, CA
Silvia MacAllister Voermanek
Marriage & Family Therapist, LMFT, PCC, MA
Verified Verified
4 Endorsed
San Francisco, CA 94114
I'm here to support your personal growth journey. With nearly 20 years of experience as a psychotherapist and life & executive coach, my approach empowers you to conquer mental health challenges and find your purpose. Whether you're facing anxiety, depression, addiction, anger, self-doubt, or life's challenges, I'm here to help you embrace change. Get ready to embark on this transformative journey, and together, we'll unlock your full potential!
I'm here to support your personal growth journey. With nearly 20 years of experience as a psychotherapist and life & executive coach, my approach empowers you to conquer mental health challenges and find your purpose. Whether you're facing anxiety, depression, addiction, anger, self-doubt, or life's challenges, I'm here to help you embrace change. Get ready to embark on this transformative journey, and together, we'll unlock your full potential!
(415) 965-2414 View (415) 965-2414
Photo of Roger Lake, Marriage & Family Therapist in San Francisco, CA
Roger Lake
Marriage & Family Therapist, MS
Verified Verified
2 Endorsed
San Francisco, CA 94114
I am a family therapist and my approach to psychotherapy has been shaped by over thirty years of work with addictions. Helping clients into Recovery has led to a special understanding of the complexities of relationships and the processes of change for individuals, couples, and families. I have spent most of those years seeing couples and families in San Francisco's wonderfully diverse cultural landscape. I am no stranger to the complexities of gender, class and ethnicity as they influence the work of family or individual therapy.
I am a family therapist and my approach to psychotherapy has been shaped by over thirty years of work with addictions. Helping clients into Recovery has led to a special understanding of the complexities of relationships and the processes of change for individuals, couples, and families. I have spent most of those years seeing couples and families in San Francisco's wonderfully diverse cultural landscape. I am no stranger to the complexities of gender, class and ethnicity as they influence the work of family or individual therapy.
(650) 741-3364 View (650) 741-3364
Photo of Rebecca Siegel, Marriage & Family Therapist in San Francisco, CA
Rebecca Siegel
Marriage & Family Therapist, LMFT, RDT
Verified Verified
5 Endorsed
San Francisco, CA 94117  (Online Only)
I believe that the capacity to thrive already lives in your hands, heart, and imagination. As your therapist, I will work with you to uncover your own inherent wisdom. With your wise self in the room, we can explore how parts of you may feel lost, unsure or left out. As your wise self learns to take up more space in your life, you may come to realize that the painful parts of you are just that: a part of you, and that your life is not defined by these parts. I will help you to realize that you are indeed amazing, capable, and loved.
I believe that the capacity to thrive already lives in your hands, heart, and imagination. As your therapist, I will work with you to uncover your own inherent wisdom. With your wise self in the room, we can explore how parts of you may feel lost, unsure or left out. As your wise self learns to take up more space in your life, you may come to realize that the painful parts of you are just that: a part of you, and that your life is not defined by these parts. I will help you to realize that you are indeed amazing, capable, and loved.
(415) 877-3616 View (415) 877-3616
Photo of Kimia Mansoor, Psychologist in San Francisco, CA
Kimia Mansoor
Psychologist, PsyD
Verified Verified
2 Endorsed
San Francisco, CA 94115
Are you feeling disappointed and dissatisfied with your current circumstances, relationships, work, or the world at large? I specialize in working with adults, adolescents, and couples experiencing high levels of stress, interpersonal conflict, difficult family/relationship dynamics, grief, and chronic pain or illness. I often work with people who feel "different" and who may have experienced deep feelings of otherness throughout their lives. This includes children of immigrants, neurodiverse individuals, survivors of complex trauma/abuse, and those who identify with minority status in one or more ways.
Are you feeling disappointed and dissatisfied with your current circumstances, relationships, work, or the world at large? I specialize in working with adults, adolescents, and couples experiencing high levels of stress, interpersonal conflict, difficult family/relationship dynamics, grief, and chronic pain or illness. I often work with people who feel "different" and who may have experienced deep feelings of otherness throughout their lives. This includes children of immigrants, neurodiverse individuals, survivors of complex trauma/abuse, and those who identify with minority status in one or more ways.
(415) 423-0335 View (415) 423-0335

See more therapy options for San Francisco

How does your Therapist compare?

Number of Therapists in San Francisco, CA

3,000+

Average cost per session

$189

Therapists in San Francisco, CA who prioritize treating:

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

Average years in practice

12 Years

Top 3 insurances accepted

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

How Therapists in San Francisco, CA see their clients

55% In Person and Online
45% Online Only

Gender breakdown

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

How can I find a therapist in San Francisco?

Search for nearby therapists or counselors by inputting your city, town, or suburb; or zip code; or a provider’s name into the search bar. From there, you can filter providers by the issues they treat, cost, insurance, gender, and other factors to find providers who are well-suited to your needs. To navigate between locations within the same country, enter a new city or zip code into the search bar.

Learn more about how to find a therapist

Is everyone in the Psychology Today Therapy Directory a licensed therapist?

The Psychology Today directory lists providers who offer legitimate mental health services to the public, including psychologists, psychiatrists, social workers, and counselors.

Many have been licensed by the country or state where they practice; providers whose license or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Some clinicians or organizations provide services for which their state or country does not offer licenses, such as pastoral counseling. They may be selectively included without the “Verified” seal.

What’s the difference between a psychologist, a therapist, and a counselor?

Therapists, psychologists, and counselors are all licensed mental health professionals. In the US, psychologists have earned a doctoral degree. The terms “therapist” and “counselor” are used somewhat interchangeably, but generally therapists offer longer-term, mental health care, while counselors offer shorter-term care that may focus on one domain, such as marriage, career, or academic challenges.

Clients should consider factors such as insurance coverage and their primary reason(s) for seeking therapy to determine the type of professional best suited to their needs. Someone struggling with mental health challenges such as depression or anxiety, for example, may wish to seek out a clinical psychologist or therapist, while someone navigating career obstacles or marital upheaval may benefit from seeing a counselor who can offer short-term, targeted support.

What type of therapy is right for me?

The type of therapy best suited to a particular individual depends on several factors, including their primary reason for seeking therapy, their preferred timeline (some therapy types last for a set number of sessions, while others are open-ended), and their personality and preferences—some may prefer a more structured approach. For many individuals, multiple types of therapy could provide a good fit.

How much does therapy cost?

The cost of therapy depends on a number of variables, including location and the therapist’s experience and training. On average, a therapy session in the United States could cost between $100 and $200 or more. If you have insurance, the expense of mental health care is typically lower, but it varies based on your insurance plan details and whether you choose an in-network or out-of-network mental healthcare provider.

What are more affordable or low cost therapy solutions?

Many therapists offer sliding scale payments, usually on a limited number of slots, which consists in an agreement between the therapist and a client to pay a reduced rate. Therapists who provide such arrangements often consider the client's income or ability to pay, but the extent of the discount is ultimately at the therapist's discretion. Furthermore, while group therapy may have different goals and benefits compared to individual therapy, it can be a more affordable solution to address certain types of issues.

Is online therapy cheaper than in-person therapy?

Many therapists charge the same amount for online therapy as they do for in-person therapy—though clients may still find this cost-effective if it cuts down on their transportation costs. Health insurance plans often offer equivalent coverage for online and in-person therapy; indeed, in many places, they are legally required to do so. Text-based or on-demand therapy apps may be cheaper than traditional one-on-one psychotherapy; however, the practice may be less effective and is not likely to be covered by insurance.

Is online therapy a good option?

Therapy conducted online can be just as effective as in-person therapy, as long as there is a strong alliance between the client and the therapist. To find a therapist who provides telehealth services to clients in your area, click “Online Therapy” on the directory homepage and search by your city or town or your zip code.

Are therapy sessions confidential?

Confidentiality is a crucial part of the therapeutic relationship. Therapists in the United States are bound by the regulations set out by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which aims to protect sensitive health information. With very few exceptions, a therapist will only discuss their client with others when the client has given their written permission. The instances in which a therapist would be required to disclose personal information are: if a client poses a danger to themselves or others, if the therapist suspects the abuse of a child or an elderly or otherwise dependent adult, or if they are legally forced to by court order. These exceptions to the confidentiality agreement are usually discussed with a client before their first session.