Therapists in Charlottesville, VA

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Photo of Kelsey Fehlner, Pre-Licensed Professional, MA
Kelsey Fehlner
Pre-Licensed Professional, MA
Charlottesville, VA 22901
Not accepting new clients
Kelsey Fehlner is a resident in counseling currently seeking to be a Licensed Professional Counselor (LPC). For the past five years, Kelsey has been working to support a wide variety of individuals from toddlers to adults and currently specializes in helping individuals with ASD who may have comorbid mood disorders. Kelsey offers individual therapy and may provide parent support during or outside of sessions when working with their child.
Kelsey Fehlner is a resident in counseling currently seeking to be a Licensed Professional Counselor (LPC). For the past five years, Kelsey has been working to support a wide variety of individuals from toddlers to adults and currently specializes in helping individuals with ASD who may have comorbid mood disorders. Kelsey offers individual therapy and may provide parent support during or outside of sessions when working with their child.
Photo of Frances Ingram, Clinical Social Work/Therapist, LCSW
Frances Ingram
Clinical Social Work/Therapist, LCSW
Charlottesville, VA 22901
I work with adolescents and adults facing anxiety, depression, life transitions, trauma, sexual abuse, and relationship challenges. I’m genuinely interested in who you are and what you need. My approach is active, direct, and flexible, creating a space where you feel seen and supported. We’ll honor your past while focusing on how old wounds shape current patterns, and use practical, empowering strategies to help you build a life that nurtures your emotional, social, and spiritual well-being.
I work with adolescents and adults facing anxiety, depression, life transitions, trauma, sexual abuse, and relationship challenges. I’m genuinely interested in who you are and what you need. My approach is active, direct, and flexible, creating a space where you feel seen and supported. We’ll honor your past while focusing on how old wounds shape current patterns, and use practical, empowering strategies to help you build a life that nurtures your emotional, social, and spiritual well-being.
(434) 216-5915 View (434) 216-5915
Photo of Jane Christmas, Psychologist, PsyD
Jane Christmas
Psychologist, PsyD
1 Endorsed
Charlottesville, VA 22902
Being a psychotherapist means being available to you in a way that is different to other forms of human relatedness. It means I listen to the painful events and relationships troubling you in your life and open a conversation about them between us. This conversation is private and confidential, yet allows for the most honest and accessible way to both explore and understand your reactions and feelings. Although the foundation of my knowledge lies in the psychoanalytic tradition, I incorporate contemporary knowledge and methods that have developed since Sigmund Freud's first discoveries at the end of the 19th century.
Being a psychotherapist means being available to you in a way that is different to other forms of human relatedness. It means I listen to the painful events and relationships troubling you in your life and open a conversation about them between us. This conversation is private and confidential, yet allows for the most honest and accessible way to both explore and understand your reactions and feelings. Although the foundation of my knowledge lies in the psychoanalytic tradition, I incorporate contemporary knowledge and methods that have developed since Sigmund Freud's first discoveries at the end of the 19th century.
(434) 362-4916 View (434) 362-4916
Photo of Andrea Packwood, Clinical Social Work/Therapist, LCSW
Andrea Packwood
Clinical Social Work/Therapist, LCSW
Online Only
Only offering virtual appointments at this time. I am a Licensed Clinical Social Worker. Working from an existentialist, trauma-informed, and neurodevelopmentally sensitive lens, I believe we all have the capacity to live meaningful, complete lives. My office is a safe, supportive, non-judgmental, and radically compassionate space in which clients can heal, grow, and explore.
Only offering virtual appointments at this time. I am a Licensed Clinical Social Worker. Working from an existentialist, trauma-informed, and neurodevelopmentally sensitive lens, I believe we all have the capacity to live meaningful, complete lives. My office is a safe, supportive, non-judgmental, and radically compassionate space in which clients can heal, grow, and explore.
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Photo of Aidan Schutter, Clinical Social Work/Therapist, LCSW
Aidan Schutter
Clinical Social Work/Therapist, LCSW
Charlottesville, VA 22902
You don’t have to have it all figured out to take the first step. Therapy is for the brave, the tired, the curious—and everyone in between. Let’s start the conversation that changes things. Aidan is a Licensed Clinical Social Worker (LCSW) who works with adults facing anxiety, depression, and substance use challenges. Aidan uses practical, evidence-based approaches to support individuals in making meaningful changes at their own pace. The goal is to create a space that feels supportive, respectful, and focused on what matters most to each client.
You don’t have to have it all figured out to take the first step. Therapy is for the brave, the tired, the curious—and everyone in between. Let’s start the conversation that changes things. Aidan is a Licensed Clinical Social Worker (LCSW) who works with adults facing anxiety, depression, and substance use challenges. Aidan uses practical, evidence-based approaches to support individuals in making meaningful changes at their own pace. The goal is to create a space that feels supportive, respectful, and focused on what matters most to each client.
(434) 423-6618 View (434) 423-6618
Photo of Diana C. Brawley, Clinical Social Work/Therapist, LCSW, ACSW, MDiv, ThM, MSW
Diana C. Brawley
Clinical Social Work/Therapist, LCSW, ACSW, MDiv, ThM, MSW
Online Only
Waitlist for new clients
True contentment arises when the emotional, spiritual, mental, and physical aspects of life meet in harmony. In my work as a Licensed Clinical Social Worker and Mindful Self-Compassion–informed psychotherapist, I trust the healing potential that lives within relationship — our capacity to be changed and softened by genuine connection. With warmth, empathy, and gentle humor, I provide a space where clients can rest, explore, and find meaning in their stories. I honor each person’s path, their resilience and ways of surviving, and I believe deeply in our innate ability to grow toward wholeness.
True contentment arises when the emotional, spiritual, mental, and physical aspects of life meet in harmony. In my work as a Licensed Clinical Social Worker and Mindful Self-Compassion–informed psychotherapist, I trust the healing potential that lives within relationship — our capacity to be changed and softened by genuine connection. With warmth, empathy, and gentle humor, I provide a space where clients can rest, explore, and find meaning in their stories. I honor each person’s path, their resilience and ways of surviving, and I believe deeply in our innate ability to grow toward wholeness.
(434) 878-0329 View (434) 878-0329
Photo of Margo Merryman Murray, Clinical Social Work/Therapist, LCSW
Margo Merryman Murray
Clinical Social Work/Therapist, LCSW
5 Endorsed
Charlottesville, VA 22902
People often seek out therapy when they are feeling overwhelmed, stuck, or alone. These feelings may cause symptoms of anxiety, depression, difficulty managing anger, or dependance on food or substances to cope. As a therapist I enjoy creating a relationship that is warm, consistent, and safe to explore difficult feelings or experiences while figuring out what symptoms like anxiety, or depression are trying to tell us. Having someone who is curious about the way you think and feel can be truly transformative. This process can lead to the rediscovery of your own innate constructive forces, bringing relief and much needed change.
People often seek out therapy when they are feeling overwhelmed, stuck, or alone. These feelings may cause symptoms of anxiety, depression, difficulty managing anger, or dependance on food or substances to cope. As a therapist I enjoy creating a relationship that is warm, consistent, and safe to explore difficult feelings or experiences while figuring out what symptoms like anxiety, or depression are trying to tell us. Having someone who is curious about the way you think and feel can be truly transformative. This process can lead to the rediscovery of your own innate constructive forces, bringing relief and much needed change.
(646) 719-0570 View (646) 719-0570
Photo of Barbara Groves, Clinical Social Work/Therapist, LCSW
Barbara Groves
Clinical Social Work/Therapist, LCSW
Charlottesville, VA 22901
As your therapist, I will guide you to recognize learned patterns of thinking, acting and feeling that may be creating suffering in your life. Together we will explore where and why you learned those patterns and what purpose they served. Once fully understood, you will find the self-compassion and courage to release those learned patterns and cultivate healthier ways of being. Through this process you will find greater self-awareness, self-compassion and new ways to create healthier relationships with yourself, others and life in general.
As your therapist, I will guide you to recognize learned patterns of thinking, acting and feeling that may be creating suffering in your life. Together we will explore where and why you learned those patterns and what purpose they served. Once fully understood, you will find the self-compassion and courage to release those learned patterns and cultivate healthier ways of being. Through this process you will find greater self-awareness, self-compassion and new ways to create healthier relationships with yourself, others and life in general.
(434) 602-2150 View (434) 602-2150
Photo of Morgan Lanier, Licensed Professional Counselor, LPC
Morgan Lanier
Licensed Professional Counselor, LPC
Charlottesville, VA 22903
I specialize in working with children, teens, and families struggling with risky/aggressive behaviors, depression, anxiety, ADHD, as well as adults and families managing lifelong psychiatric disorders, including Bipolar Disorder, Schizophrenia, and/or Schizoaffective Disorders. I also help families with young children learn to improve their ability to manage their feelings in a healthy way, solve problems, and improve communication.
I specialize in working with children, teens, and families struggling with risky/aggressive behaviors, depression, anxiety, ADHD, as well as adults and families managing lifelong psychiatric disorders, including Bipolar Disorder, Schizophrenia, and/or Schizoaffective Disorders. I also help families with young children learn to improve their ability to manage their feelings in a healthy way, solve problems, and improve communication.
(434) 608-8581 View (434) 608-8581
Beth L Daane
Pre-Licensed Professional, QMHP
1 Endorsed
Online Only
Many of the people I work with seem composed and capable, balancing careers, families, and expectations with quiet determination. Beneath that strength, they’re often exhausted, anxious, or uncertain about what’s next. Most reach out when they’re ready for something deeper than quick fixes and want lasting change that feels authentic. Here, you’ll find calm, clarity, and space to be understood — without pressure or pretense. Together, we slow down, uncover what’s beneath the stress, and build a grounded, sustainable foundation so you can feel steady, whole, and restored again.
Many of the people I work with seem composed and capable, balancing careers, families, and expectations with quiet determination. Beneath that strength, they’re often exhausted, anxious, or uncertain about what’s next. Most reach out when they’re ready for something deeper than quick fixes and want lasting change that feels authentic. Here, you’ll find calm, clarity, and space to be understood — without pressure or pretense. Together, we slow down, uncover what’s beneath the stress, and build a grounded, sustainable foundation so you can feel steady, whole, and restored again.
(434) 204-9491 View (434) 204-9491
Photo of Kellie Cannon, Licensed Professional Counselor, LPC
Kellie Cannon
Licensed Professional Counselor, LPC
Charlottesville, VA 22902
Waitlist for new clients
My name is Kellie, and I would be honored to meet with you and collaborate on what you are looking for in therapy. I graduated with a Master's in Clinical Mental Health, and I am a Licensed Professional Counselor. Specific treatments areas I specialize in: Identity, Depression, Anxiety, Eating Disorders, Suicide ideation, Religious-trauma recovery, complex-ptsd, ptsd, emotionally immature parents, emotional regulation, as well as personality and mood disorders.
My name is Kellie, and I would be honored to meet with you and collaborate on what you are looking for in therapy. I graduated with a Master's in Clinical Mental Health, and I am a Licensed Professional Counselor. Specific treatments areas I specialize in: Identity, Depression, Anxiety, Eating Disorders, Suicide ideation, Religious-trauma recovery, complex-ptsd, ptsd, emotionally immature parents, emotional regulation, as well as personality and mood disorders.
(434) 442-5662 View (434) 442-5662
Photo of Elizabeth Oberheu, Licensed Professional Counselor, LPC
Elizabeth Oberheu
Licensed Professional Counselor, LPC
Charlottesville, VA 22901
I am passionate about helping my clients identify the roots of their concerns and work toward making changes that allow them to live happier, healthier lives. I have experience working with anxiety, depression, and adjustment/stressor-related concerns. I obtained my M.S. in Clinical Mental Health Counseling at the University of Texas San Antonio.
I am passionate about helping my clients identify the roots of their concerns and work toward making changes that allow them to live happier, healthier lives. I have experience working with anxiety, depression, and adjustment/stressor-related concerns. I obtained my M.S. in Clinical Mental Health Counseling at the University of Texas San Antonio.
(434) 436-1823 View (434) 436-1823
Photo of Brittany Ayers, Licensed Professional Counselor, MEd, LPC
Brittany Ayers
Licensed Professional Counselor, MEd, LPC
1 Endorsed
Online Only
Waitlist for new clients
It’s easy to feel lost when the past still has a grip on your present. I specialize in supporting adults navigating depression, anxiety, and the lingering effects of trauma. My goal is to help you feel empowered to explore your story, reconnect with your sense of self, and reclaim control over your life. I provide an affirming, nonjudgmental space for clients from all walks of life, including members of the LGBTQIA+ community, sex workers, and individuals in ethically non-monogamous or polyamorous relationships. Whoever you are, you deserve a therapist who meets you with compassion, curiosity, and respect.
It’s easy to feel lost when the past still has a grip on your present. I specialize in supporting adults navigating depression, anxiety, and the lingering effects of trauma. My goal is to help you feel empowered to explore your story, reconnect with your sense of self, and reclaim control over your life. I provide an affirming, nonjudgmental space for clients from all walks of life, including members of the LGBTQIA+ community, sex workers, and individuals in ethically non-monogamous or polyamorous relationships. Whoever you are, you deserve a therapist who meets you with compassion, curiosity, and respect.
(434) 480-3963 View (434) 480-3963
Photo of Laura Alm, Counselor, MA
Laura Alm
Counselor, MA
Online Only
Laura Alm believes that each human person has inherent dignity and value because they are created by God out of love and made in His Image; the more they become their authentic, best selves, the more they are empowered, free, and glorify God. She believes that, through the power of Jesus Christ, who renews hearts and minds, change can happen, and all things are possible. Laura uses an integrative approach to counseling, and draws from person-centered, cognitive-behavioral, and narrative therapies, as well as dialectical behavior and mindfulness techniques. She strives to foster a warm, caring, and empathic therapeutic environment.
Laura Alm believes that each human person has inherent dignity and value because they are created by God out of love and made in His Image; the more they become their authentic, best selves, the more they are empowered, free, and glorify God. She believes that, through the power of Jesus Christ, who renews hearts and minds, change can happen, and all things are possible. Laura uses an integrative approach to counseling, and draws from person-centered, cognitive-behavioral, and narrative therapies, as well as dialectical behavior and mindfulness techniques. She strives to foster a warm, caring, and empathic therapeutic environment.
(434) 448-2704 View (434) 448-2704
Photo of Rosemary Cosselmon, Licensed Professional Counselor, LPC
Rosemary Cosselmon
Licensed Professional Counselor, LPC
Charlottesville, VA 22901
Therapy is a safe place to rebuild, reflect, and heal. I’ll meet you where you are. Rosemary holds a BA in Psychology from Syracuse University and an MS in Clinical Mental Health Counseling from Longwood University. With over 15 years of experience across diverse mental health settings, she works with clients from teenagers to seniors. Her approach focuses on building strong, respectful therapeutic relationships and empowering clients to recognize and use their strengths to enhance well-being, overcome challenges, and achieve their personal goals.
Therapy is a safe place to rebuild, reflect, and heal. I’ll meet you where you are. Rosemary holds a BA in Psychology from Syracuse University and an MS in Clinical Mental Health Counseling from Longwood University. With over 15 years of experience across diverse mental health settings, she works with clients from teenagers to seniors. Her approach focuses on building strong, respectful therapeutic relationships and empowering clients to recognize and use their strengths to enhance well-being, overcome challenges, and achieve their personal goals.
(571) 548-3866 View (571) 548-3866
Photo of Jessica L Jennings, Licensed Professional Counselor, MA, LPC, CADC
Jessica L Jennings
Licensed Professional Counselor, MA, LPC, CADC
Charlottesville, VA 22902
I am a Licensed Professional Counselor and have 24 years of counseling experience working with mental health disorders, eating disorders, and marital therapy. I take an emotion-focused and Jungian approach that allows for depth therapy. I also use Dialectical Behavior Therapy skills training to promote self-acceptance, non-judgment, and behavior change through teaching skills in the area of interpersonal effectiveness, mindfulness, distress tolerance, and emotion regulation. My therapeutic approach promotes an environment of acceptance and compassion that becomes an increasing internal experience.
I am a Licensed Professional Counselor and have 24 years of counseling experience working with mental health disorders, eating disorders, and marital therapy. I take an emotion-focused and Jungian approach that allows for depth therapy. I also use Dialectical Behavior Therapy skills training to promote self-acceptance, non-judgment, and behavior change through teaching skills in the area of interpersonal effectiveness, mindfulness, distress tolerance, and emotion regulation. My therapeutic approach promotes an environment of acceptance and compassion that becomes an increasing internal experience.
(434) 363-4647 View (434) 363-4647
Photo of Cynthia Miller, Licensed Professional Counselor, PhD, LPC
Cynthia Miller
Licensed Professional Counselor, PhD, LPC
3 Endorsed
Charlottesville, VA 22901
Everyone struggles from time to time - what's important is how we respond to the struggle. I believe struggle turns to suffering when we refuse to accept what we cannot change or when we passively accept what can be changed. In my practice I help people learn to avoid suffering by changing the things they can and accepting the things they can't change. Using a variety of skills and techniques, I help people learn how to thrive - even in the face of struggle - while being true to themselves and effective in their interactions with others.
Everyone struggles from time to time - what's important is how we respond to the struggle. I believe struggle turns to suffering when we refuse to accept what we cannot change or when we passively accept what can be changed. In my practice I help people learn to avoid suffering by changing the things they can and accepting the things they can't change. Using a variety of skills and techniques, I help people learn how to thrive - even in the face of struggle - while being true to themselves and effective in their interactions with others.
(434) 262-4030 View (434) 262-4030
Photo of Amelia Jacokes, Clinical Social Work/Therapist, LCSW
Amelia Jacokes
Clinical Social Work/Therapist, LCSW
Online Only
Do you want to learn more about yourself and how you walk through life? Do you experience difficulties in areas that others seem to have a relatively easy time managing? I’m a licensed clinical social worker in Virginia and California (license numbers: VA: 0904013582, CA: 99619). I spent my internship years working with dementia patients as well as gaining experience with the chronic pain population. By working in the intensive outpatient program environment,
Do you want to learn more about yourself and how you walk through life? Do you experience difficulties in areas that others seem to have a relatively easy time managing? I’m a licensed clinical social worker in Virginia and California (license numbers: VA: 0904013582, CA: 99619). I spent my internship years working with dementia patients as well as gaining experience with the chronic pain population. By working in the intensive outpatient program environment,
(757) 517-8409 View (757) 517-8409
Photo of Lara Harrison, Marriage & Family Therapist, LMFT
Lara Harrison
Marriage & Family Therapist, LMFT
Charlottesville, VA 22902
I'm passionate about helping individuals, couples and families heal and experience deeper, more meaningful connections. My work as a counselor has spanned over a decade and through a variety of settings including community-based counseling, outpatient level services, residential care, and crisis support. I have particular interest in working with issues related to foster care and culturally-based trauma. I also have many years experience treating mood-disorders in adolescents.
I'm passionate about helping individuals, couples and families heal and experience deeper, more meaningful connections. My work as a counselor has spanned over a decade and through a variety of settings including community-based counseling, outpatient level services, residential care, and crisis support. I have particular interest in working with issues related to foster care and culturally-based trauma. I also have many years experience treating mood-disorders in adolescents.
(757) 378-0724 View (757) 378-0724
Photo of Nikki Bowles, Clinical Social Work/Therapist, LCSW
Nikki Bowles
Clinical Social Work/Therapist, LCSW
1 Endorsed
Charlottesville, VA 22911
I specialize in working with children 10-12 yo, teenagers, adults, families, and couples. I have particular interest in helping with life transitions, understanding and coping with anxiety, stress, relationship difficulty, parenting, grief, and feelings of depression. I am driven to support self compassion, deepening connections to the important people in our lives, and kind acceptance of our whole selves and our common humanity. I use Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), attachment theory, and mindfulness and knowledge of neuroscience. I am also informed about Internal Family Systems (IFS).
I specialize in working with children 10-12 yo, teenagers, adults, families, and couples. I have particular interest in helping with life transitions, understanding and coping with anxiety, stress, relationship difficulty, parenting, grief, and feelings of depression. I am driven to support self compassion, deepening connections to the important people in our lives, and kind acceptance of our whole selves and our common humanity. I use Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), attachment theory, and mindfulness and knowledge of neuroscience. I am also informed about Internal Family Systems (IFS).
(434) 608-9444 View (434) 608-9444

See more therapy options for Charlottesville

How does your Therapist compare?

Number of Therapists in Charlottesville, VA

800+

Average cost per session

$150

Therapists in Charlottesville, VA who prioritize treating:

93% Anxiety
86% Depression
74% Relationship Issues
73% Self Esteem
72% Trauma and PTSD
71% Stress
70% Life Transitions

Average years in practice

13 Years

Top 3 insurances accepted

85% Aetna
78% BlueCross and BlueShield
78% Anthem

How Therapists in Charlottesville, VA see their clients

66% In Person and Online
34% Online Only

Gender breakdown

81% Female
17% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Charlottesville?

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.