Therapists in Albemarle County, VA

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Photo of Nate Hefner, Licensed Professional Counselor in Albemarle County, VA
Nate Hefner
Licensed Professional Counselor, LPC
Verified Verified
I focus on individual Trauma, Couples, and Family. With years of family and individual work I've developed a flexible ability to meet adult and teen needs from parenting, marital, and developmental trauma and transitions of life. My work is informed by an attachment approach where I seek to create safety with you to untie negative relational patterns and move into greater awareness and courage. To assist my clients with underlying issues of trauma, my training in AEDP, EMDR and somatic approaches are well suited. I also use Ketamine Assisted Therapy in my office to break through old, unconscious patterns.
I focus on individual Trauma, Couples, and Family. With years of family and individual work I've developed a flexible ability to meet adult and teen needs from parenting, marital, and developmental trauma and transitions of life. My work is informed by an attachment approach where I seek to create safety with you to untie negative relational patterns and move into greater awareness and courage. To assist my clients with underlying issues of trauma, my training in AEDP, EMDR and somatic approaches are well suited. I also use Ketamine Assisted Therapy in my office to break through old, unconscious patterns.
(434) 249-8416 View (434) 249-8416
Photo of Jason Kent, Resident in Counseling in Albemarle County, VA
Jason Kent
Resident in Counseling, MA, LPC-R
Verified Verified
I offer individual therapy for adults and adolescents, with a primary focus and expertise on those that are currently struggling with anxiety, addiction, depression, grief, and trauma. Other areas of expertise include family conflict, difficult life transitions, career/vocational issues, and challenges unique to men during this season.
I offer individual therapy for adults and adolescents, with a primary focus and expertise on those that are currently struggling with anxiety, addiction, depression, grief, and trauma. Other areas of expertise include family conflict, difficult life transitions, career/vocational issues, and challenges unique to men during this season.
(434) 722-3494 View (434) 722-3494
Photo of Shawn Gewirtz, Psychologist in Albemarle County, VA
Shawn Gewirtz
Psychologist, PhD, LCP
Verified Verified
2 Endorsed
Not accepting new clients
In my therapy practice, I work collaboratively with children, adolescents, adults, and families to identify and counter unhelpful thinking and behavioral patterns and ultimately help them to live happier, more successful lives. Using a scientifically supported approach, the therapy work frequently includes discussions of brain functioning and why we act as we do, learning about and practicing concrete strategies to improve day-to-day functioning, and identifying and changing problematic habits (e.g., with thought patterns, exercise, sleep, screens, social interactions, etc).
In my therapy practice, I work collaboratively with children, adolescents, adults, and families to identify and counter unhelpful thinking and behavioral patterns and ultimately help them to live happier, more successful lives. Using a scientifically supported approach, the therapy work frequently includes discussions of brain functioning and why we act as we do, learning about and practicing concrete strategies to improve day-to-day functioning, and identifying and changing problematic habits (e.g., with thought patterns, exercise, sleep, screens, social interactions, etc).
(434) 363-4532 View (434) 363-4532
Photo of Virginia Center for Family Relations, pc, Marriage & Family Therapist in Albemarle County, VA
Virginia Center for Family Relations, pc
Marriage & Family Therapist, LCSW, LPC, LMFT
Verified Verified
When looking for a therapist, ask someone that knows the reputation of the therapists in this area. Ask a friend, a family doctor, a pastor or a professional. They know the best therapist in the area. Don't pick a therapist simply based on what the therapist has written about her/himself or solely on the price. This is your life; it's your marriage or your family. 90% of our clients come from "word of mouth". We maintain a respected reputation due to the staff's professional skills and therapeutic effectiveness & reliability - we've been here since 1986. ---We are proud to be a Veteran Owned counseling practice.---
When looking for a therapist, ask someone that knows the reputation of the therapists in this area. Ask a friend, a family doctor, a pastor or a professional. They know the best therapist in the area. Don't pick a therapist simply based on what the therapist has written about her/himself or solely on the price. This is your life; it's your marriage or your family. 90% of our clients come from "word of mouth". We maintain a respected reputation due to the staff's professional skills and therapeutic effectiveness & reliability - we've been here since 1986. ---We are proud to be a Veteran Owned counseling practice.---
(434) 973-5640 View (434) 973-5640
Photo of Blue Ridge Counseling Connection, Licensed Professional Counselor in Albemarle County, VA
Blue Ridge Counseling Connection
Licensed Professional Counselor, LPC, ASDCS, CCTP
Verified Verified
1 Endorsed
Crozet, VA 22932
Afton has experience working with individuals in the areas of anxiety, depression, interpersonal conflict, trauma, grief/loss and life transitions. Afton believes that every person is fully capable of change, growth and healing. Her work focuses on empowering clients to recognize their inner strengths and cultivate healthy mindsets. Afton integrates elements of cognitive behavior therapy and solution focused therapy to aid clients in challenging negative thought processes, setting goals and envisioning their future selves. She also uses mindfulness as a way to help clients explore their present situation and find joy and peace.
Afton has experience working with individuals in the areas of anxiety, depression, interpersonal conflict, trauma, grief/loss and life transitions. Afton believes that every person is fully capable of change, growth and healing. Her work focuses on empowering clients to recognize their inner strengths and cultivate healthy mindsets. Afton integrates elements of cognitive behavior therapy and solution focused therapy to aid clients in challenging negative thought processes, setting goals and envisioning their future selves. She also uses mindfulness as a way to help clients explore their present situation and find joy and peace.
(540) 709-8984 View (540) 709-8984
Photo of Rachel Hoover, Marriage & Family Therapist in Albemarle County, VA
Rachel Hoover
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Crozet, VA 22932
I provide therapy to teenagers, adults, and couples who have diverse reasons for seeking therapy, including mental health support, personal growth, and conflict and communication issues. I especially enjoy working with individuals who want support for managing anxiety, for navigating the significant life changes that come with adolescence, the transition to college, and young adulthood, and for developing self-esteem and more positive relationships with food, eating, and their body. My hope is that the work we do together will help you in better understanding yourself and feeling empowered to make meaningful changes in your life.
I provide therapy to teenagers, adults, and couples who have diverse reasons for seeking therapy, including mental health support, personal growth, and conflict and communication issues. I especially enjoy working with individuals who want support for managing anxiety, for navigating the significant life changes that come with adolescence, the transition to college, and young adulthood, and for developing self-esteem and more positive relationships with food, eating, and their body. My hope is that the work we do together will help you in better understanding yourself and feeling empowered to make meaningful changes in your life.
(757) 693-4708 View (757) 693-4708
Photo of Matthew Tolman, Psychologist in Albemarle County, VA
Matthew Tolman
Psychologist, PsyD
Verified Verified
I am a licensed Clinical Psychologist who specializes in treating children, young adults, and adults using an approach that integrates classic and modern psychodynamic theory with contemporary approaches including family systems, cognitive-behavioral, and mindfulness-based treatment. Therapy can be an invaluable part of helping individuals to overcome life's challenges. Whether our struggle is related to life transitions, loss, trauma or interpersonal difficulties, painful feelings commonly arise such as depression and anxiety. My goal is to provide a therapeutic environment and a collaborative partnership to individuals that seek relief from these painful symptoms and hope to achieve growth and positive change in their lives.
I am a licensed Clinical Psychologist who specializes in treating children, young adults, and adults using an approach that integrates classic and modern psychodynamic theory with contemporary approaches including family systems, cognitive-behavioral, and mindfulness-based treatment. Therapy can be an invaluable part of helping individuals to overcome life's challenges. Whether our struggle is related to life transitions, loss, trauma or interpersonal difficulties, painful feelings commonly arise such as depression and anxiety. My goal is to provide a therapeutic environment and a collaborative partnership to individuals that seek relief from these painful symptoms and hope to achieve growth and positive change in their lives.
(434) 442-4561 View (434) 442-4561
Photo of Deb Early, Licensed Professional Counselor in Albemarle County, VA
Deb Early
Licensed Professional Counselor, MA, LPC
Verified Verified
1 Endorsed
When our life and relationships are good, everything is good. But when our relationships are facing challenges or when there are stressors in our lives, our whole world feels inside out. My therapeutic focus is to have my clients navigate through difficult times and emotions in order to better express themselves, communicate more effectively with loved ones, and improve self-understanding using a Cognitive Behavioral approach. Everyone has a valued voice and I believe fostering a sense of belonging and self-understanding is key to strong, healthy relationships.
When our life and relationships are good, everything is good. But when our relationships are facing challenges or when there are stressors in our lives, our whole world feels inside out. My therapeutic focus is to have my clients navigate through difficult times and emotions in order to better express themselves, communicate more effectively with loved ones, and improve self-understanding using a Cognitive Behavioral approach. Everyone has a valued voice and I believe fostering a sense of belonging and self-understanding is key to strong, healthy relationships.
(434) 474-2786 View (434) 474-2786
Photo of Mackenzie Nelson, Licensed Professional Counselor in Albemarle County, VA
Mackenzie Nelson
Licensed Professional Counselor, LPC
Verified Verified
Crozet, VA 22932
I work with adolescents and adults who are seeking counseling services for a variety of reasons. Many of my clients have depressive, anxious, or disordered eating symptoms. Others are in life transitions or are seeking support with something such as athletic performance. I believe counseling can benefit everyone and collaborate with clients on individual goals. Together we reflect, build upon strengths, and apply new strategies to increase fulfillment. I am happy to meet at my office, via video, or outside for a walk.
I work with adolescents and adults who are seeking counseling services for a variety of reasons. Many of my clients have depressive, anxious, or disordered eating symptoms. Others are in life transitions or are seeking support with something such as athletic performance. I believe counseling can benefit everyone and collaborate with clients on individual goals. Together we reflect, build upon strengths, and apply new strategies to increase fulfillment. I am happy to meet at my office, via video, or outside for a walk.
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Photo of Sandra Monohan, Resident in Counseling in Albemarle County, VA
Sandra Monohan
Resident in Counseling, MA
Verified Verified
Healing can be experienced in an empathetic relationship where you feel accepted, valued, and heard. Past hurts, damaging relationships, traumatic experiences, and life stressors can leave you feeling burdened with unmanageable emotions. My wish is to come alongside you as we work to lighten your load and empower you with increased self-awareness and self-compassion. An environment of non-judgment and the provision of caring support can enhance your inherent ability to grow, to change, and to find lasting freedom in your life.
Healing can be experienced in an empathetic relationship where you feel accepted, valued, and heard. Past hurts, damaging relationships, traumatic experiences, and life stressors can leave you feeling burdened with unmanageable emotions. My wish is to come alongside you as we work to lighten your load and empower you with increased self-awareness and self-compassion. An environment of non-judgment and the provision of caring support can enhance your inherent ability to grow, to change, and to find lasting freedom in your life.
(769) 287-8145 View (769) 287-8145
Photo of Clare Venus, Psychologist in Albemarle County, VA
Clare Venus
Psychologist, PhD, CDE, LCP
Verified Verified
1 Endorsed
Charlottesville, VA 22901  (Online Only)
Are you experiencing a crisis in your life, feeling overwhelmed and struggling to cope? Dealing with a major life transition, physical illness or caregiver stress? I have worked with people who suffer with depressed mood, persistent anxiety, chronic illness, pain and disability. These emotional and physical stressors can result in considerable disruption in relationships and work life balance. As a Licensed Psychologist I utilize a variety of therapeutic approaches that promote healing and change. I welcome clients from all backgrounds, cultures, ethnicities and sexual orientations.
Are you experiencing a crisis in your life, feeling overwhelmed and struggling to cope? Dealing with a major life transition, physical illness or caregiver stress? I have worked with people who suffer with depressed mood, persistent anxiety, chronic illness, pain and disability. These emotional and physical stressors can result in considerable disruption in relationships and work life balance. As a Licensed Psychologist I utilize a variety of therapeutic approaches that promote healing and change. I welcome clients from all backgrounds, cultures, ethnicities and sexual orientations.
(434) 481-1644 View (434) 481-1644
Photo of Wrenn Carlson, Psychologist in Albemarle County, VA
Wrenn Carlson
Psychologist, PhD
Verified Verified
3 Endorsed
I am a clinical psychologist with experience providing individual, couples, and family therapy in outpatient and inpatient settings. My areas of interest include working with couples, parents of adolescents, high-stress families, and women with trauma histories. I enjoy working with couples and families to help them find new ways of communicating with each other and their children. I provide comprehensive psychological assessments for children and adults using cognitive, achievement, and personality measures. I aim to make assessments a useful addendum to therapy, psychiatric care, and improved classroom and home functioning.
I am a clinical psychologist with experience providing individual, couples, and family therapy in outpatient and inpatient settings. My areas of interest include working with couples, parents of adolescents, high-stress families, and women with trauma histories. I enjoy working with couples and families to help them find new ways of communicating with each other and their children. I provide comprehensive psychological assessments for children and adults using cognitive, achievement, and personality measures. I aim to make assessments a useful addendum to therapy, psychiatric care, and improved classroom and home functioning.
(434) 446-1862 x104 View (434) 446-1862 x104
Photo of Lisa M Locke-Downer, Psychologist in Albemarle County, VA
Lisa M Locke-Downer
Psychologist, PhD
Verified Verified
7 Endorsed
Crozet, VA 22932
Waitlist for new clients
I enjoy working with children, adolescents, and adults who are experiencing difficulties such as anxiety, depression, obsessive-compulsive disorder, behavioral problems, and social concerns. I use a cognitive-behavioral treatment approach, with family and school consultation as important components of the treatment. Consultation with physicians, psychiatrists, and other treatment providers is also welcomed. I believe in using a collaborative problem-solving approach in which we work as a team to develop an intervention plan.
I enjoy working with children, adolescents, and adults who are experiencing difficulties such as anxiety, depression, obsessive-compulsive disorder, behavioral problems, and social concerns. I use a cognitive-behavioral treatment approach, with family and school consultation as important components of the treatment. Consultation with physicians, psychiatrists, and other treatment providers is also welcomed. I believe in using a collaborative problem-solving approach in which we work as a team to develop an intervention plan.
(434) 483-5210 View (434) 483-5210
Photo of Lifebulb Counseling and Therapy, Licensed Professional Counselor in Albemarle County, VA
Lifebulb Counseling and Therapy
Licensed Professional Counselor, LPC
Verified Verified
We're confident we can help you achieve your therapy goals. We believe you're best served by a therapist passionate about not only their work, but who they work with as well. That's why we started Lifebulb - We're committed to helping therapists to get back to enjoying their work, so you, our client, can receive the highest quality therapy services, whether in person at one of our locations or online through telehealth. We hire only highly trained and educated, licensed clinicians dedicated to the therapy process. Working with us, you'll get results.
We're confident we can help you achieve your therapy goals. We believe you're best served by a therapist passionate about not only their work, but who they work with as well. That's why we started Lifebulb - We're committed to helping therapists to get back to enjoying their work, so you, our client, can receive the highest quality therapy services, whether in person at one of our locations or online through telehealth. We hire only highly trained and educated, licensed clinicians dedicated to the therapy process. Working with us, you'll get results.
(434) 231-5012 View (434) 231-5012
Photo of Kate Pozo, Clinical Social Work/Therapist in Albemarle County, VA
Kate Pozo
Clinical Social Work/Therapist, LCSW
Verified Verified
Waitlist for new clients
Hello, My name is Kate Pozo, and I am a licensed clinical social worker specializing in trauma. I focus mainly on working with teenagers and adults with trauma backgrounds.
Hello, My name is Kate Pozo, and I am a licensed clinical social worker specializing in trauma. I focus mainly on working with teenagers and adults with trauma backgrounds.
(434) 218-2175 View (434) 218-2175
Photo of Sean Flannery, Psychologist in Albemarle County, VA
Sean Flannery
Psychologist, PhD
Verified Verified
1 Endorsed
I enjoy working with clients ages 16+ who are struggling with relationship distress, trauma, depression, anxiety, grief, and a variety of other issues. My areas of special interest are couple therapy, acceptance-based therapy (ACT), and assessment. I provide psychological testing/assessment for clients ages 6 and up. This includes psychoeducational assessment for accommodations at school.
I enjoy working with clients ages 16+ who are struggling with relationship distress, trauma, depression, anxiety, grief, and a variety of other issues. My areas of special interest are couple therapy, acceptance-based therapy (ACT), and assessment. I provide psychological testing/assessment for clients ages 6 and up. This includes psychoeducational assessment for accommodations at school.
(434) 216-0165 View (434) 216-0165
Photo of Angela D'Amelio, Marriage & Family Therapist in Albemarle County, VA
Angela D'Amelio
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Finding the right therapist - one you feel comfortable with, trust, and can be open and honest with - is essential to your healing. I am committed to facilitating an environment of acceptance, hope, and encouragement. I help individuals who are dealing with depression, anxiety, relationships, and women's issues. My goal is to help you feel empowered, and to create a balanced life and a renewed relationship with yourself and others. Together, we will develop skills, build emotional strength, and find the path toward living out your goals.
Finding the right therapist - one you feel comfortable with, trust, and can be open and honest with - is essential to your healing. I am committed to facilitating an environment of acceptance, hope, and encouragement. I help individuals who are dealing with depression, anxiety, relationships, and women's issues. My goal is to help you feel empowered, and to create a balanced life and a renewed relationship with yourself and others. Together, we will develop skills, build emotional strength, and find the path toward living out your goals.
(434) 277-2125 View (434) 277-2125
Photo of Angela Green, Licensed Professional Counselor in Albemarle County, VA
Angela Green
Licensed Professional Counselor, LPC, CCTP
Verified Verified
8 Endorsed
As a trauma-informed therapist, I am passionate about helping my clients shed their burdens and feel more empowered in their lives. I believe each of us has innate healing powers that can become overcome by trauma, leaving us feeling stuck, frozen, or in states of panic. EMDR is a research-based approach that can be combined with other methods to allow old "unprocessed" memories to become processed, thereby relieving you of unwanted negative thoughts and feelings. I have been honored to witness my clients experience profound transformations using this approach and was inspired to pursue advanced training and Certification in EMDR.
As a trauma-informed therapist, I am passionate about helping my clients shed their burdens and feel more empowered in their lives. I believe each of us has innate healing powers that can become overcome by trauma, leaving us feeling stuck, frozen, or in states of panic. EMDR is a research-based approach that can be combined with other methods to allow old "unprocessed" memories to become processed, thereby relieving you of unwanted negative thoughts and feelings. I have been honored to witness my clients experience profound transformations using this approach and was inspired to pursue advanced training and Certification in EMDR.
(434) 208-1925 View (434) 208-1925
Photo of Laurel Feigley, Clinical Social Work/Therapist in Albemarle County, VA
Laurel Feigley
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Most of us struggle with overwhelming emotions and situations at some point in our lives. How we cope often has its origin in our family and serves us well in some ways and not in others. I will collaborate with you to identify these patterns and make the changes that bring you greater health. I work with people in their late teens and beyond to address issues related to mood, relationships, life transitions and problematic behaviors.
Most of us struggle with overwhelming emotions and situations at some point in our lives. How we cope often has its origin in our family and serves us well in some ways and not in others. I will collaborate with you to identify these patterns and make the changes that bring you greater health. I work with people in their late teens and beyond to address issues related to mood, relationships, life transitions and problematic behaviors.
(434) 510-8383 View (434) 510-8383
Photo of Brandon Phillips, Psychologist in Albemarle County, VA
Brandon Phillips
Psychologist, PsyD
Verified Verified
1 Endorsed
Hope, confidence, and increased understanding are some of the general benefits most people can expect from therapy. Therapy can be even more helpful when you find the right person to work with. I am a psychologist in Charlottesville, Virginia, and I work with adults experiencing a wide range of issues, including depression, anxiety, and difficulties in relationships. My approach is collaborative and multifaceted. We work together to become more aware and effective. In this way people feel more able to overcome challenging situations, manage difficult emotions, and reduce future problems.
Hope, confidence, and increased understanding are some of the general benefits most people can expect from therapy. Therapy can be even more helpful when you find the right person to work with. I am a psychologist in Charlottesville, Virginia, and I work with adults experiencing a wide range of issues, including depression, anxiety, and difficulties in relationships. My approach is collaborative and multifaceted. We work together to become more aware and effective. In this way people feel more able to overcome challenging situations, manage difficult emotions, and reduce future problems.
(434) 325-5211 View (434) 325-5211

See more therapy options for Albemarle County

How does your Therapist compare?

Number of Therapists in Albemarle County, VA

300+

Average cost per session

$150

Therapists in Albemarle County, VA who prioritize treating:

93% Anxiety
88% Depression
78% Relationship Issues
78% Self Esteem
70% Trauma and PTSD
69% Coping Skills
68% Stress

Average years in practice

13 Years

Top 3 insurances accepted

81% Aetna
80% Anthem | Elevance
74% BlueCross and BlueShield

How Therapists in Albemarle County, VA see their clients

79% In Person and Online
21% Online Only

Gender breakdown

80% Female
19% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Albemarle County?

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.