Therapists in Knoxville, TN

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Photo of Jennifer Williams, Clinical Social Work/Therapist in Knoxville, TN
Jennifer Williams
Clinical Social Work/Therapist
Verified
Knoxville, TN 37909
Jen Williams, LMFT Jen Williams is a Licensed Marriage and Family Therapist in Tennessee who has been practicing since 2016. She has a BA in Art History and a Master's in Psychology with an emphasis on Art Therapy. Jen believes in working with individuals to reconnect with their sense of hope, their inner child and themselves using person centered modalities and art therapy. In her free time, Jen enjoys cooking, painting, reading, lifting weights, going on walks, and spending time with her spouse and pets.
Jen Williams, LMFT Jen Williams is a Licensed Marriage and Family Therapist in Tennessee who has been practicing since 2016. She has a BA in Art History and a Master's in Psychology with an emphasis on Art Therapy. Jen believes in working with individuals to reconnect with their sense of hope, their inner child and themselves using person centered modalities and art therapy. In her free time, Jen enjoys cooking, painting, reading, lifting weights, going on walks, and spending time with her spouse and pets.
(865) 448-4314 View (865) 448-4314
Photo of Stina Nesbit, Licensed Professional Counselor in Knoxville, TN
Stina Nesbit
Licensed Professional Counselor, MS, RYT, NCC, LPCMHSP
Verified
2 Endorsed
Knoxville, TN 37920
Waitlist for new clients
I am a big nerd about humans. I get excited and curious with my clients in order to better understand them. My aim is to be very real with my clients. I try to be upfront and direct, admit when I'm wrong or don't know something, and bring in humor and self-disclosure when I believe it will be helpful.
I am a big nerd about humans. I get excited and curious with my clients in order to better understand them. My aim is to be very real with my clients. I try to be upfront and direct, admit when I'm wrong or don't know something, and bring in humor and self-disclosure when I believe it will be helpful.
(865) 448-4204 View (865) 448-4204
Photo of Sarah Hill, Psychologist in Knoxville, TN
Sarah Hill
Psychologist, PhD
Verified
1 Endorsed
Knoxville, TN 37921  (Online Only)
Not accepting new clients
Hi, I'm Sarah! I'm glad you're here. I'm a licensed clinical psychologist with 12+ years of training and experience in the field. I'm able to support folks dealing with a wide range of issues, including trauma, depression and other mood disorders, anxiety, substance use, and problems with relationships. I tailor treatment plans to your specific concerns, and I draw from humanistic, interpersonal, feminist and strengths-based approaches. I work to create an affirming and anti-racist space that feels welcoming and safe for all. My clients have described me as warm, funny, authentic and insightful. I work with adults and have a special
Hi, I'm Sarah! I'm glad you're here. I'm a licensed clinical psychologist with 12+ years of training and experience in the field. I'm able to support folks dealing with a wide range of issues, including trauma, depression and other mood disorders, anxiety, substance use, and problems with relationships. I tailor treatment plans to your specific concerns, and I draw from humanistic, interpersonal, feminist and strengths-based approaches. I work to create an affirming and anti-racist space that feels welcoming and safe for all. My clients have described me as warm, funny, authentic and insightful. I work with adults and have a special
(865) 214-7925 View (865) 214-7925
Photo of Lauren Green, Pre-Licensed Professional in Knoxville, TN
Lauren Green
Pre-Licensed Professional, MS, NCC, T-LPC
Verified
2 Endorsed
Knoxville, TN 37917
I consider it one of my greatest privileges to partner with people as they navigate their stories. I know from personal experience that therapy can be invaluable when processing change, emotional turmoil, and questions about self. While I often utilize concepts from CBT, DBT, and other theories, I most often draw from Narrative Theory and take a Person-Centered approach in my work with clients. I am trained in TF-CBT and EMDR, and my professional history includes over four years working exclusively with survivors of sexual trauma.
I consider it one of my greatest privileges to partner with people as they navigate their stories. I know from personal experience that therapy can be invaluable when processing change, emotional turmoil, and questions about self. While I often utilize concepts from CBT, DBT, and other theories, I most often draw from Narrative Theory and take a Person-Centered approach in my work with clients. I am trained in TF-CBT and EMDR, and my professional history includes over four years working exclusively with survivors of sexual trauma.
(865) 344-6830 View (865) 344-6830
Photo of Celeste Ballard, Licensed Professional Counselor in Knoxville, TN
Celeste Ballard
Licensed Professional Counselor, LCPC, LPC, MHSP
Verified
Knoxville, TN 37918
Celeste specializes in working with clients who are seeking to unseat, and unlock long held patterns in their lives. Individuals who wish to get to the root of their problems, and face issues that may be preventing meaningful change and peace in their lives. Oftentimes these clients are those who have had traditional therapy methods or have been doing their own self-help work and are at a “stuck” point and are looking for answers that can be accessed through somatic or meditation based work. She also works with therapists looking to deepen their own personal process to increase their efficacy and joy in their work as a therapist.
Celeste specializes in working with clients who are seeking to unseat, and unlock long held patterns in their lives. Individuals who wish to get to the root of their problems, and face issues that may be preventing meaningful change and peace in their lives. Oftentimes these clients are those who have had traditional therapy methods or have been doing their own self-help work and are at a “stuck” point and are looking for answers that can be accessed through somatic or meditation based work. She also works with therapists looking to deepen their own personal process to increase their efficacy and joy in their work as a therapist.
(865) 401-6870 View (865) 401-6870
Photo of Steve Brown, Clinical Social Work/Therapist in Knoxville, TN
Steve Brown
Clinical Social Work/Therapist, MSSW, LCSW
Verified
Knoxville, TN 37919
I enjoy working with children, adolescents, and adults in individual, couples, family and group therapy. I work with most private and group insurance plans as well employee assistance programs and private paying individuals. I recieved a Masters of Social Work degree from the University of Tennessee in 1996 and the Licensed Clinical Social Work certification in 1999. I have been an adjunct instructor for the masters program at the UT College of Social Work, having taught courses in family therapy, group therapy, clinical social work with children and adolescents, and foundation courses.
I enjoy working with children, adolescents, and adults in individual, couples, family and group therapy. I work with most private and group insurance plans as well employee assistance programs and private paying individuals. I recieved a Masters of Social Work degree from the University of Tennessee in 1996 and the Licensed Clinical Social Work certification in 1999. I have been an adjunct instructor for the masters program at the UT College of Social Work, having taught courses in family therapy, group therapy, clinical social work with children and adolescents, and foundation courses.
(865) 630-4218 x103 View (865) 630-4218 x103
Photo of Shannon D Warden, Marriage & Family Therapist in Knoxville, TN
Shannon D Warden
Marriage & Family Therapist, MA, LMFT
Verified
1 Endorsed
Knoxville, TN 37934
It is my honor and privilege to get to work in a profession that I love, where I am able to partner with hard-working people to find solutions to their struggles. I have seen the positive results of people being able to open up in a non-threatening environment. Together, we look at your whole self, taking into account relationships and their influence on who you are. I'm passionate about my work and I'm blessed to have the opportunity to witness someone making a significant change and being there when they experience the moment or series of moments where it all clicks.
It is my honor and privilege to get to work in a profession that I love, where I am able to partner with hard-working people to find solutions to their struggles. I have seen the positive results of people being able to open up in a non-threatening environment. Together, we look at your whole self, taking into account relationships and their influence on who you are. I'm passionate about my work and I'm blessed to have the opportunity to witness someone making a significant change and being there when they experience the moment or series of moments where it all clicks.
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Photo of Angela Hill, Pre-Licensed Professional in Knoxville, TN
Angela Hill
Pre-Licensed Professional, MSSW, LMT
Verified
Knoxville, TN 37919
Healing begins when we learn to understand ourselves. I help adults, children, adolescents and families shine a compassionate light on their thoughts, feelings, and patterns of relating to find new possibilities beyond the habitual survival strategies that have helped you to defend against stress and trauma. Therapy can give you the tools and awareness to make the changes that you want to make while you learn to experience a greater sense of safety and resilience, recover from difficult experiences, find more acceptance, get your needs met with more clarity, balance connection with boundaries, and live life with greater meaning.
Healing begins when we learn to understand ourselves. I help adults, children, adolescents and families shine a compassionate light on their thoughts, feelings, and patterns of relating to find new possibilities beyond the habitual survival strategies that have helped you to defend against stress and trauma. Therapy can give you the tools and awareness to make the changes that you want to make while you learn to experience a greater sense of safety and resilience, recover from difficult experiences, find more acceptance, get your needs met with more clarity, balance connection with boundaries, and live life with greater meaning.
(865) 672-8363 View (865) 672-8363
Photo of Alexa Borrows, Licensed Professional Counselor in Knoxville, TN
Alexa Borrows
Licensed Professional Counselor, MS, LPC, MHSP
Verified
1 Endorsed
Knoxville, TN 37934  (Online Only)
My goal is to empower you to identify and overcome personal obstacles that are preventing you from getting the most out of life. I strive to create a warm, empathetic, understanding and, most importantly, collaborative environment. Working together, we will tackle life’s challenges—whether they may be problems of anxiety, self-esteem, or unhealthy patterns of behavior. I specialize in treating adults with anxiety, OCD, phobias, eating disorders, and life transitions. I also work with transgender individuals. My background is in Acceptance and Commitment Therapy (ACT), and my hope is to help you live a more meaningful life.
My goal is to empower you to identify and overcome personal obstacles that are preventing you from getting the most out of life. I strive to create a warm, empathetic, understanding and, most importantly, collaborative environment. Working together, we will tackle life’s challenges—whether they may be problems of anxiety, self-esteem, or unhealthy patterns of behavior. I specialize in treating adults with anxiety, OCD, phobias, eating disorders, and life transitions. I also work with transgender individuals. My background is in Acceptance and Commitment Therapy (ACT), and my hope is to help you live a more meaningful life.
(865) 205-0788 View (865) 205-0788
Photo of Daniel Shirley, Licensed Professional Counselor in Knoxville, TN
Daniel Shirley
Licensed Professional Counselor, LPC, MHSP, MS
Verified
2 Endorsed
Knoxville, TN 37922
Life is often confusing and sometimes very difficult. I believe my clients can improve their lives, even in difficult situations. I take a holistic approach that considers the wellness and level of functioning of each client across their many roles and responsibilities. It is my hope that each of my clients gains greater feelings of hope and autonomy as a result of our work together.
Life is often confusing and sometimes very difficult. I believe my clients can improve their lives, even in difficult situations. I take a holistic approach that considers the wellness and level of functioning of each client across their many roles and responsibilities. It is my hope that each of my clients gains greater feelings of hope and autonomy as a result of our work together.
(865) 419-7462 View (865) 419-7462
Photo of Nicola Bone, Clinical Social Work/Therapist in Knoxville, TN
Nicola Bone
Clinical Social Work/Therapist, MSW, LCSW
Verified
Knoxville, TN 37922
Nicola is a licensed clinical social worker who has encouraged individuals in the pursuit of personal growth and healing for more than 20 years. Nicola has worked in a variety of settings including the District Attorney's Office in Atlanta, GA, Loudon County School systems, hospice and private practice. In these arenas, Nicola has learned about the resilience of the human spirit.
Nicola is a licensed clinical social worker who has encouraged individuals in the pursuit of personal growth and healing for more than 20 years. Nicola has worked in a variety of settings including the District Attorney's Office in Atlanta, GA, Loudon County School systems, hospice and private practice. In these arenas, Nicola has learned about the resilience of the human spirit.
(865) 326-3997 View (865) 326-3997
Photo of Katherine Campbell in Knoxville, TN
Katherine Campbell
NCC, LPC(T)
2 Endorsed
Knoxville, TN 37922
Hi, I’m Katherine I’m here to •share space with you, so you feel heard, safe, & able to grow beyond shame, distress, or any other barrier standing in your way. •help you develop the right environment & relationships so you can learn to thrive in your life rather than struggle to survive. •be your ally & advocate along your mental health journey. •enjoy collaborating with you when you find yourself in a season of confusion & desire to renew yourself & discover a new path to health & wellness.
Hi, I’m Katherine I’m here to •share space with you, so you feel heard, safe, & able to grow beyond shame, distress, or any other barrier standing in your way. •help you develop the right environment & relationships so you can learn to thrive in your life rather than struggle to survive. •be your ally & advocate along your mental health journey. •enjoy collaborating with you when you find yourself in a season of confusion & desire to renew yourself & discover a new path to health & wellness.
(865) 419-9293 View (865) 419-9293
Photo of Michele Aguilar, Pre-Licensed Professional in Knoxville, TN
Michele Aguilar
Pre-Licensed Professional, MSW
Verified
1 Endorsed
Knoxville, TN 37920  (Online Only)
Are you feeling burnt out or having issues struggling with all of life’s obstacles? I get that. Let’s work through it together. I hope to help assist and support you in gaining the skills needed to successfully overcome the obstacles that you are facing as we are on this healing journey together. I currently only offer virtual sessions. I understand that virtual sessions are not everyone's cup of tea, therefore starting Spring 2024 I will be offering walk and talk therapy at three different parks in Knoxville.
Are you feeling burnt out or having issues struggling with all of life’s obstacles? I get that. Let’s work through it together. I hope to help assist and support you in gaining the skills needed to successfully overcome the obstacles that you are facing as we are on this healing journey together. I currently only offer virtual sessions. I understand that virtual sessions are not everyone's cup of tea, therefore starting Spring 2024 I will be offering walk and talk therapy at three different parks in Knoxville.
(865) 346-3857 View (865) 346-3857
Photo of Jazmyn Heathcock, Pre-Licensed Professional in Knoxville, TN
Jazmyn Heathcock
Pre-Licensed Professional, MA
Verified
Knoxville, TN 37922
In our sessions, you are the expert whether you’re 5 years old or 87. I will walk alongside you as we discover who you are as a person and develop the skills to allow you to thrive and be the healthiest version of yourself. I utilize evidence-based practices such as DBT, CBT, and play therapy. All treatment will be developmentally and cognitively appropriate for the stage of life that the individual or kiddo is in as well as including family members and social supports.
In our sessions, you are the expert whether you’re 5 years old or 87. I will walk alongside you as we discover who you are as a person and develop the skills to allow you to thrive and be the healthiest version of yourself. I utilize evidence-based practices such as DBT, CBT, and play therapy. All treatment will be developmentally and cognitively appropriate for the stage of life that the individual or kiddo is in as well as including family members and social supports.
(865) 424-6741 View (865) 424-6741
Photo of Weatherstone Collaborative, Clinical Social Work/Therapist in Knoxville, TN
Weatherstone Collaborative
Clinical Social Work/Therapist, LCSW, CEDS-S
Verified
Knoxville, TN 37923
Are you or a loved one struggling with an eating disorder? Are you ready to make peace with food, your mind, and your body? Let the eating disorder treatment professionals at Weatherstone Collaborative assist you in your recovery today. Weatherstone Collaborative, LLC is an outpatient group of therapists who specialize in the treatment of eating disorders and share an insight-driven perspective regarding mental health and wellness. We share a vision of helping people reconnect with the best parts of themselves by aligning their resiliencies with their current needs.
Are you or a loved one struggling with an eating disorder? Are you ready to make peace with food, your mind, and your body? Let the eating disorder treatment professionals at Weatherstone Collaborative assist you in your recovery today. Weatherstone Collaborative, LLC is an outpatient group of therapists who specialize in the treatment of eating disorders and share an insight-driven perspective regarding mental health and wellness. We share a vision of helping people reconnect with the best parts of themselves by aligning their resiliencies with their current needs.
(865) 270-5430 View (865) 270-5430
Photo of Nick Morgan, Clinical Social Work/Therapist in Knoxville, TN
Nick Morgan
Clinical Social Work/Therapist, LCSW
Verified
2 Endorsed
Knoxville, TN 37931
I enjoy working with individuals ages 14+ who have expressed a desire to better themselves and work hard on their mental health. Together, we will identify areas of difficulty, and discuss treatment solutions that both client and therapist are comfortable with.
I enjoy working with individuals ages 14+ who have expressed a desire to better themselves and work hard on their mental health. Together, we will identify areas of difficulty, and discuss treatment solutions that both client and therapist are comfortable with.
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Photo of Julius Melvin Jefferies, Licensed Professional Counselor in Knoxville, TN
Julius Melvin Jefferies
Licensed Professional Counselor, ASDCS, ELD, C-GC, LPC
Verified
3 Endorsed
Knoxville, TN 37923
Julius M. Jefferies is a Clinical Mental Health Therapist serving the Knox County area of Tennessee with specialties in a wide range of individual, couple, and group therapy interventions. His clinical experience in the last 25 years has focused on holistic, solution-focused therapy for both adolescents and adults who are living with autism, crisis, psychological disorder, trauma, and grief.  Julius earned a Masters of Mental Health Counseling from Freed-Hardeman University followed by specialty certifications in Grief Counseling, Autism Disorder Specialist intervention, and as an End of Life Doula.
Julius M. Jefferies is a Clinical Mental Health Therapist serving the Knox County area of Tennessee with specialties in a wide range of individual, couple, and group therapy interventions. His clinical experience in the last 25 years has focused on holistic, solution-focused therapy for both adolescents and adults who are living with autism, crisis, psychological disorder, trauma, and grief.  Julius earned a Masters of Mental Health Counseling from Freed-Hardeman University followed by specialty certifications in Grief Counseling, Autism Disorder Specialist intervention, and as an End of Life Doula.
(731) 327-4781 View (731) 327-4781
Photo of Joe Mixon, Marriage & Family Therapist in Knoxville, TN
Joe Mixon
Marriage & Family Therapist, LMFT
Verified
3 Endorsed
Knoxville, TN 37919
Starting therapy can be scary, especially when you're not sure where to begin. As a therapist, I'm here to guide you through the process and provide a safe and supportive space where you can explore your thoughts, feelings, and experiences. I specialize in using Internal Family Systems (IFS) and Eye Movement Desensitization and Reprocessing (EMDR) to help you with the impact of trauma and achieve lasting positive change helping you gain insight into the effects of trauma, develop coping skills, and create a more positive self-narrative.
Starting therapy can be scary, especially when you're not sure where to begin. As a therapist, I'm here to guide you through the process and provide a safe and supportive space where you can explore your thoughts, feelings, and experiences. I specialize in using Internal Family Systems (IFS) and Eye Movement Desensitization and Reprocessing (EMDR) to help you with the impact of trauma and achieve lasting positive change helping you gain insight into the effects of trauma, develop coping skills, and create a more positive self-narrative.
(865) 217-2562 View (865) 217-2562
Photo of Kelsey Rochelle, Pre-Licensed Professional in Knoxville, TN
Kelsey Rochelle
Pre-Licensed Professional, MS, NCC
Verified
1 Endorsed
Knoxville, TN 37923
The most genuine way I can think to start this personal statement is by disclosing how difficult I have found it to write what you are now reading (or skimming). I'd like to show you that I know your pain, but I don't know all the ins and outs of your many experiences leading up to this point in your life. What I do know is that there is often loneliness in feeling unseen, unknown, or misunderstood. I find meaning in working with individuals who feel detached or disconnected from others, their surroundings, or even themselves.
The most genuine way I can think to start this personal statement is by disclosing how difficult I have found it to write what you are now reading (or skimming). I'd like to show you that I know your pain, but I don't know all the ins and outs of your many experiences leading up to this point in your life. What I do know is that there is often loneliness in feeling unseen, unknown, or misunderstood. I find meaning in working with individuals who feel detached or disconnected from others, their surroundings, or even themselves.
(865) 830-3044 View (865) 830-3044
Photo of Elizabeth A Woodward, Pre-Licensed Professional in Knoxville, TN
Elizabeth A Woodward
Pre-Licensed Professional, MS, T-LPC, T-MHSP
Verified
1 Endorsed
Knoxville, TN 37923
Not accepting new clients
I work with adults, teens, preteens, and children starting at 6 years old. Many of my clients are looking for coping skills to aid with mood disorders, conduct issues, or impulse-control disorders, such as anxiety, depression, behavior problems, and ADHD. Some want to work through trauma or grief. Others have less common problems. However, all are looking to make a change, but they do not know how to or do not want to do it on their own.
I work with adults, teens, preteens, and children starting at 6 years old. Many of my clients are looking for coping skills to aid with mood disorders, conduct issues, or impulse-control disorders, such as anxiety, depression, behavior problems, and ADHD. Some want to work through trauma or grief. Others have less common problems. However, all are looking to make a change, but they do not know how to or do not want to do it on their own.
(865) 213-7707 View (865) 213-7707

See more therapy options for Knoxville

How does your Therapist compare?

Number of Therapists in Knoxville, TN

600+

Average cost per session

$125

Therapists in Knoxville, TN who prioritize treating:

92% Anxiety
87% Depression
73% Relationship Issues
72% Trauma and PTSD
72% Self Esteem
67% Coping Skills
66% Grief

Average years in practice

10 Years

Top 3 insurances accepted

73% UnitedHealthcare UHC | UBH
70% Optum
68% Cigna and Evernorth

How Therapists in Knoxville, TN see their clients

78% In Person and Online
22% Online Only

Gender breakdown

77% Female
22% Male
1% Non-Binary

FAQs - About Therapy and Counseling

How can I find a therapist in Knoxville?

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.