Therapists in Saint Louis, MO

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Photo of Rita Skiba-Mathews, Clinical Social Work/Therapist in Saint Louis, MO
Rita Skiba-Mathews
Clinical Social Work/Therapist, LCSW
Verified Verified
Saint Louis, MO 63108
Are you seeking a therapist who is committed to providing a safe and affirming environment where your experiences, feelings, and identity are respected and valued? Perhaps you have experienced hardship or traumas and feel stuck in a loop of past memories. Or maybe you are finding it challenging to be effective in your day to day life. If something about this resonates with you, I think we might be a good fit! I hope to provide a comfortable and nonjudgemental environment where you can safely show up as your authentic self to work on treatment goals that fit your current struggles.
Are you seeking a therapist who is committed to providing a safe and affirming environment where your experiences, feelings, and identity are respected and valued? Perhaps you have experienced hardship or traumas and feel stuck in a loop of past memories. Or maybe you are finding it challenging to be effective in your day to day life. If something about this resonates with you, I think we might be a good fit! I hope to provide a comfortable and nonjudgemental environment where you can safely show up as your authentic self to work on treatment goals that fit your current struggles.
(314) 804-7725 View (314) 804-7725
Photo of Sara Trunko, LPC Intern in Saint Louis, MO
Sara Trunko
LPC Intern, Intern
Verified Verified
1 Endorsed
Saint Louis, MO 63129
Life often presents us with challenges that can easily become overwhelming or even daunting. In a world filled with relentless to-do lists and constant demands, finding time for ourselves often takes a back seat. Our society doesn’t always encourage the practice of self-care, leaving many of us feeling stretched thin. Investing time and energy in yourself is a powerful choice you can make to begin shifting this dynamic. You deserve the life you want and have the power to make meaningful changes toward that life.
Life often presents us with challenges that can easily become overwhelming or even daunting. In a world filled with relentless to-do lists and constant demands, finding time for ourselves often takes a back seat. Our society doesn’t always encourage the practice of self-care, leaving many of us feeling stretched thin. Investing time and energy in yourself is a powerful choice you can make to begin shifting this dynamic. You deserve the life you want and have the power to make meaningful changes toward that life.
(314) 866-8791 View (314) 866-8791
Photo of Kelly Stickley, Clinical Social Work/Therapist in Saint Louis, MO
Kelly Stickley
Clinical Social Work/Therapist, MAG, MSW, LCSW
Verified Verified
Saint Louis, MO 63116
Not accepting new clients
Every new day presents the opportunity to begin a new chapter. What is already written on our pages may shape us, but it does not define us. Every obstacle, experience, and transition we encounter brings opportunity for joy, growth, meaning, and connection. Therapy provides support to reflect on where you have been, where you are now, and where you want to be. New Chapter offers therapy services that fit your life and comfort level.
Every new day presents the opportunity to begin a new chapter. What is already written on our pages may shape us, but it does not define us. Every obstacle, experience, and transition we encounter brings opportunity for joy, growth, meaning, and connection. Therapy provides support to reflect on where you have been, where you are now, and where you want to be. New Chapter offers therapy services that fit your life and comfort level.
(314) 470-9485 View (314) 470-9485
Photo of Jessie Kissinger, Pre-Licensed Professional in Saint Louis, MO
Jessie Kissinger
Pre-Licensed Professional, MEd, PLPC, NCC
Verified Verified
2 Endorsed
Saint Louis, MO 63104
I believe counseling is most powerful when it sensitizes you to what’s happening in your mind, heart, and body and helps you meet whatever you find with compassion. Feeling your feels (literally) is the first step to making sense of them. Within that confusion is the possibility of deeper self-knowledge and freedom. I find it helpful to use yoga and mindfulness practices to keep you grounded as you explore big emotions, and I enjoy working with people who want to bring the wisdom of the body into their therapeutic work—whether that’s processing loss, trauma, change, overwhelm, spiritual concerns, or feeling stuck and disconnected.
I believe counseling is most powerful when it sensitizes you to what’s happening in your mind, heart, and body and helps you meet whatever you find with compassion. Feeling your feels (literally) is the first step to making sense of them. Within that confusion is the possibility of deeper self-knowledge and freedom. I find it helpful to use yoga and mindfulness practices to keep you grounded as you explore big emotions, and I enjoy working with people who want to bring the wisdom of the body into their therapeutic work—whether that’s processing loss, trauma, change, overwhelm, spiritual concerns, or feeling stuck and disconnected.
(314) 907-2945 View (314) 907-2945
Photo of Lauren Nacke, Clinical Social Work/Therapist in Saint Louis, MO
Lauren Nacke
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Saint Louis, MO 63122  (Online Only)
Hello! Often our life transitions challenge our former identities; a new work role, changing relationship dynamics, or parenthood. Feeling overwhelmed or exhausted by the demands of the day to day is real. We often feel inadequate and powerless in new roles.
Hello! Often our life transitions challenge our former identities; a new work role, changing relationship dynamics, or parenthood. Feeling overwhelmed or exhausted by the demands of the day to day is real. We often feel inadequate and powerless in new roles.
(314) 350-7035 View (314) 350-7035
Photo of Tristan Connor, Clinical Social Work/Therapist in Saint Louis, MO
Tristan Connor
Clinical Social Work/Therapist, LCSW, CADC, CCM
Verified Verified
Saint Louis, MO 63116  (Online Only)
As a transgender therapist, one of my passions is working with clients who identify as part of the LGBTQIA+ population. I enjoy collaborating with individuals who are exploring their gender and/or sexual identities and hope to offer guidance and compassion as they let go of any residual societal expectations. I have undergone the entire process of hormones, top surgery, and bottom surgeries, and I am open with my clients about my experiences as we work to decrease their gender dysphoria and move toward the eventual goal of gender euphoria.
As a transgender therapist, one of my passions is working with clients who identify as part of the LGBTQIA+ population. I enjoy collaborating with individuals who are exploring their gender and/or sexual identities and hope to offer guidance and compassion as they let go of any residual societal expectations. I have undergone the entire process of hormones, top surgery, and bottom surgeries, and I am open with my clients about my experiences as we work to decrease their gender dysphoria and move toward the eventual goal of gender euphoria.
(314) 501-6096 View (314) 501-6096
Photo of Kela L Woods, Licensed Professional Counselor in Saint Louis, MO
Kela L Woods
Licensed Professional Counselor, LPC
Verified Verified
Saint Louis, MO 63118
Kela Woods is a Licensed Professional Counselor in Missouri with over 10 years experience in Behavioral Health & Social Services. She obtained a Master of Arts in Professional Counseling at Lindenwood University in St. Charles Missouri. Kela’s work experience includes mental health assessments, diagnosing, treatment planning, referrals, crisis intervention and de-escalation. As a therapist Kela is here to listen, to validate, and to provide support in a safe and non-judgemental setting. Kela’s counseling style is warm, empathetic, and client-centered.
Kela Woods is a Licensed Professional Counselor in Missouri with over 10 years experience in Behavioral Health & Social Services. She obtained a Master of Arts in Professional Counseling at Lindenwood University in St. Charles Missouri. Kela’s work experience includes mental health assessments, diagnosing, treatment planning, referrals, crisis intervention and de-escalation. As a therapist Kela is here to listen, to validate, and to provide support in a safe and non-judgemental setting. Kela’s counseling style is warm, empathetic, and client-centered.
(314) 742-9392 View (314) 742-9392
Photo of Lindsey Herzog, Clinical Social Work/Therapist in Saint Louis, MO
Lindsey Herzog
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Saint Louis, MO 63119
Reaching out for support can feel overwhelming. However, everyone deserves the chance to explore underlying struggles that may be impacting daily living, contentment and happiness. I am a Licensed Clinical Social Worker with over fifteen years of experience. I have experience working with adults, young adults, adolescents, couples, and families in a variety of clinical settings. My treatment approach is compassionate, non-judgmental, and collaborative. I will help you set goals, examine unhealthy coping patterns and build on internal strengths. We will work together to learn healthier ways to navigate life's challenges.
Reaching out for support can feel overwhelming. However, everyone deserves the chance to explore underlying struggles that may be impacting daily living, contentment and happiness. I am a Licensed Clinical Social Worker with over fifteen years of experience. I have experience working with adults, young adults, adolescents, couples, and families in a variety of clinical settings. My treatment approach is compassionate, non-judgmental, and collaborative. I will help you set goals, examine unhealthy coping patterns and build on internal strengths. We will work together to learn healthier ways to navigate life's challenges.
(314) 328-7580 View (314) 328-7580
Photo of Taylor Cleveland, LPC Intern in Saint Louis, MO
Taylor Cleveland
LPC Intern
Verified Verified
1 Endorsed
Saint Louis, MO 63132
I welcome everyone to share the counseling space with me, but I have experience working with those dealing with anxiety, depression, relationship issues, trauma, and OCD. I enjoy working with people who are looking to create a change in their life or those who are seeking to explore themselves. Additionally, I seek to make my space a comfortable one for those are LGBTQIA+ and love working with clients on topics related to their gender or sexuality.
I welcome everyone to share the counseling space with me, but I have experience working with those dealing with anxiety, depression, relationship issues, trauma, and OCD. I enjoy working with people who are looking to create a change in their life or those who are seeking to explore themselves. Additionally, I seek to make my space a comfortable one for those are LGBTQIA+ and love working with clients on topics related to their gender or sexuality.
(314) 886-6650 x705 View (314) 886-6650 x705
Photo of Tana Steffens, Clinical Social Work/Therapist in Saint Louis, MO
Tana Steffens
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
2 Endorsed
Saint Louis, MO 63117
Waitlist for new clients
I frequently work with people who have a lot of moving parts in their lives. Whether you’re navigating traumatic experiences, exploring components of identity, or wading through overwhelming seasons of life in other ways, my goal is to help you sift through it all and provide support to process at your own pace. I'm comfortable navigating many of the other pieces that come with trauma or overwhelm - managing episodes of depression, mitigating anxiety, and creating spaces that make life feel worth living.
I frequently work with people who have a lot of moving parts in their lives. Whether you’re navigating traumatic experiences, exploring components of identity, or wading through overwhelming seasons of life in other ways, my goal is to help you sift through it all and provide support to process at your own pace. I'm comfortable navigating many of the other pieces that come with trauma or overwhelm - managing episodes of depression, mitigating anxiety, and creating spaces that make life feel worth living.
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Photo of Holly Klostermann, Clinical Social Work/Therapist in Saint Louis, MO
Holly Klostermann
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Saint Louis, MO 63125  (Online Only)
I am Holly Klostermann, licensed clinical social worker. I enjoy working with clients of all backgrounds including but not limited to anxiety, depression, and trauma.
I am Holly Klostermann, licensed clinical social worker. I enjoy working with clients of all backgrounds including but not limited to anxiety, depression, and trauma.
(636) 339-3988 View (636) 339-3988
Photo of Relationship Gender And Sexuality Therapy Megan MacKenzie, Clinical Social Work/Therapist in Saint Louis, MO
Relationship Gender And Sexuality Therapy Megan MacKenzie
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Saint Louis, MO 63108
As a relationship, sex, and gender therapist, I help couples, relationships, and individuals explore explore identities, experience greater pleasure and intimacy, and recalibrate toward more authentic, compassionate, and courageous lives. I am passionate about supporting LGBTQ+ folks in exploring and healing from the negative impacts of internalized homophobia and transphobia as they often manifest in shame, guilt, and low self-esteem.
As a relationship, sex, and gender therapist, I help couples, relationships, and individuals explore explore identities, experience greater pleasure and intimacy, and recalibrate toward more authentic, compassionate, and courageous lives. I am passionate about supporting LGBTQ+ folks in exploring and healing from the negative impacts of internalized homophobia and transphobia as they often manifest in shame, guilt, and low self-esteem.
(314) 626-0543 View (314) 626-0543
Photo of Mallory Cohn, Clinical Social Work/Therapist in Saint Louis, MO
Mallory Cohn
Clinical Social Work/Therapist, LMSW
Verified Verified
Saint Louis, MO 63128
I'm passionate about helping adults and couples find healing, empowerment, growth, and meaning in their lives. I have experience working with anxiety, depression, trauma, identity development, relationship and attachment issues, life transitions, and grief. I'm especially dedicated to working with LGBTQIA+ and nonmonogamous clients. I practice from a humanistic standpoint, integrating psychodynamic, behavioral, and mindfulness-based strategies drawn from a variety of approaches in order to personalize therapy to the individual client’s values, goals, and strengths.
I'm passionate about helping adults and couples find healing, empowerment, growth, and meaning in their lives. I have experience working with anxiety, depression, trauma, identity development, relationship and attachment issues, life transitions, and grief. I'm especially dedicated to working with LGBTQIA+ and nonmonogamous clients. I practice from a humanistic standpoint, integrating psychodynamic, behavioral, and mindfulness-based strategies drawn from a variety of approaches in order to personalize therapy to the individual client’s values, goals, and strengths.
(314) 886-8640 View (314) 886-8640
Photo of Claudine Miller, Licensed Professional Counselor in Saint Louis, MO
Claudine Miller
Licensed Professional Counselor, LPC(MO), LCPC(IL
Verified Verified
Saint Louis, MO 63108  (Online Only)
Change can create stress, depression and anxiety or it can be a transformative experience. I help individuals and couples cope with changes in career, relationships, and life goals. Whether you are unhappy in your relationships, your work, or some other aspect of your life, counseling can help. If you are recognizing the need to create change in your life, I would love to help you create the life you desire. My primary focus is on helping others transform and create joy in their lives.
Change can create stress, depression and anxiety or it can be a transformative experience. I help individuals and couples cope with changes in career, relationships, and life goals. Whether you are unhappy in your relationships, your work, or some other aspect of your life, counseling can help. If you are recognizing the need to create change in your life, I would love to help you create the life you desire. My primary focus is on helping others transform and create joy in their lives.
(314) 310-4088 View (314) 310-4088
Photo of Susie Berg, Licensed Professional Counselor in Saint Louis, MO
Susie Berg
Licensed Professional Counselor, MEd, LPC, NCC, CPAT
Verified Verified
Saint Louis, MO 63141
I believe a core element of growth lies in the understanding that the only thing you have control over is your thinking and response to any given situation. I seek to provide an atmosphere of non-judgmental support so that you can educate and empower yourself to no longer believe your happiness and contentment lies in anything outside yourself. I invite you, from the heart, to start your journey and discover how to take charge of your wellbeing.
I believe a core element of growth lies in the understanding that the only thing you have control over is your thinking and response to any given situation. I seek to provide an atmosphere of non-judgmental support so that you can educate and empower yourself to no longer believe your happiness and contentment lies in anything outside yourself. I invite you, from the heart, to start your journey and discover how to take charge of your wellbeing.
(314) 470-9217 View (314) 470-9217
Photo of Joshua Goff, Clinical Social Work/Therapist in Saint Louis, MO
Joshua Goff
Clinical Social Work/Therapist, LMSW
Verified Verified
Saint Louis, MO 63139
Life is hard enough without having to go through it alone. No matter who you are or where you are from, my greatest wish for you at the outset is for you to recognize that we all have complications — we all need growth and healing. As we embrace these realities, we also learn to embrace all of the parts of ourselves, including those that most need our attention and affection Make no mistake, the path to growth can be difficult. It involves equal parts frustration and exploration, and even a good dose of humor! But when we face ourselves, we may also find that the outcome is beautiful, rewarding, and even enchanting.
Life is hard enough without having to go through it alone. No matter who you are or where you are from, my greatest wish for you at the outset is for you to recognize that we all have complications — we all need growth and healing. As we embrace these realities, we also learn to embrace all of the parts of ourselves, including those that most need our attention and affection Make no mistake, the path to growth can be difficult. It involves equal parts frustration and exploration, and even a good dose of humor! But when we face ourselves, we may also find that the outcome is beautiful, rewarding, and even enchanting.
(314) 947-2585 View (314) 947-2585
Photo of Stacey D Miller, Clinical Social Work/Therapist in Saint Louis, MO
Stacey D Miller
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Saint Louis, MO 63117  (Online Only)
Not accepting new clients
Does it feel like your past has hijacked your present life? Are you struggling to find hope for peace and happiness? Are you sick and tired of being sick and tired? If you have answered yes to any of these questions...... I am so happy that you are here. Life can be so unpredictable and feel as if your feet have been knocked right from under you without warning. Sometimes to the point where you might think you will never stand steady again. There are many things that are out of our control, however, we can all learn tools that can help us manage and bring balance and healing to our lives restoring that sense of hope.
Does it feel like your past has hijacked your present life? Are you struggling to find hope for peace and happiness? Are you sick and tired of being sick and tired? If you have answered yes to any of these questions...... I am so happy that you are here. Life can be so unpredictable and feel as if your feet have been knocked right from under you without warning. Sometimes to the point where you might think you will never stand steady again. There are many things that are out of our control, however, we can all learn tools that can help us manage and bring balance and healing to our lives restoring that sense of hope.
(314) 697-2408 View (314) 697-2408
Angela Johnson
Counselor, MA, LPC
Verified Verified
Saint Louis, MO 63122
Angela Johnson is an LPC, who has been practicing since 2014. She graduated with a Master's degree from Lindenwood. Angela takes an integrated approach to therapy because everyone is unique and has different needs. She also believes in the attachment theory and likes to look at a holistic viewpoint. She can do CBT and some DBT therapy. She especially enjoys couples therapy, OCD, Christian counseling, and grief, but also has past experience in substance abuse issues. And of course, anxiety and depression, which are the two most common reasons for therapy.
Angela Johnson is an LPC, who has been practicing since 2014. She graduated with a Master's degree from Lindenwood. Angela takes an integrated approach to therapy because everyone is unique and has different needs. She also believes in the attachment theory and likes to look at a holistic viewpoint. She can do CBT and some DBT therapy. She especially enjoys couples therapy, OCD, Christian counseling, and grief, but also has past experience in substance abuse issues. And of course, anxiety and depression, which are the two most common reasons for therapy.
(314) 916-9475 View (314) 916-9475
Photo of Holly Pfisterer Strelow, Licensed Professional Counselor in Saint Louis, MO
Holly Pfisterer Strelow
Licensed Professional Counselor, LPC, NCC, MEd
Verified Verified
2 Endorsed
Saint Louis, MO 63105
About a decade ago I attended a conference at the Omega Institute and was reawakened to the immense suffering in the world and I realized there was no more time to waste. I needed to change careers in order to be of service. All of my life I wanted to be a healer and pursued a Masters degree in Clinical Mental Health. My approach is mindful, practical, respectful and always hopeful. I believe each of us holds the key to our own healing within our highest sense of Self. My role is to help support that discovery process through thoughtful exploration, creativity and a little humor.
About a decade ago I attended a conference at the Omega Institute and was reawakened to the immense suffering in the world and I realized there was no more time to waste. I needed to change careers in order to be of service. All of my life I wanted to be a healer and pursued a Masters degree in Clinical Mental Health. My approach is mindful, practical, respectful and always hopeful. I believe each of us holds the key to our own healing within our highest sense of Self. My role is to help support that discovery process through thoughtful exploration, creativity and a little humor.
(314) 309-3605 View (314) 309-3605
Photo of Kristie M Tyson, Licensed Professional Counselor in Saint Louis, MO
Kristie M Tyson
Licensed Professional Counselor, MA, LPC
Verified Verified
Saint Louis, MO 63146
During the human experience, we will have struggles along the way. There are times we don't understand our own actions. We decide to take one approach to solve our problems and find ourselves doing something opposite of what we intended on doing. It is in those moments that we ask ourselves "How did I get here?" As a counselor for over 16 years, I partner with people to find their answers and to unlock their solutions. I have a solution-focused approach that assists clients in reestablishing balance, developing coping skills, and educating them on techniques and strategies to improve their capabilities.
During the human experience, we will have struggles along the way. There are times we don't understand our own actions. We decide to take one approach to solve our problems and find ourselves doing something opposite of what we intended on doing. It is in those moments that we ask ourselves "How did I get here?" As a counselor for over 16 years, I partner with people to find their answers and to unlock their solutions. I have a solution-focused approach that assists clients in reestablishing balance, developing coping skills, and educating them on techniques and strategies to improve their capabilities.
(314) 207-4614 View (314) 207-4614

How does your Therapist compare?

Number of Therapists in Saint Louis, MO

1,000+

Average cost per session

$128

Therapists in Saint Louis, MO who prioritize treating:

92% Anxiety
87% Depression
77% Relationship Issues
75% Self Esteem
70% Trauma and PTSD
67% Coping Skills
67% Stress

Average years in practice

11 Years

Top 3 insurances accepted

74% UnitedHealthcare UHC | UBH
72% Aetna
72% Cigna and Evernorth

How Therapists in Saint Louis, MO see their clients

75% In Person and Online
25% Online Only

Gender breakdown

78% Female
20% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Saint Louis?

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.