Therapists in Anacortes, WA

Photo of Erin Welsh, Counselor, MA, LMHC, EMDR
Erin Welsh
Counselor, MA, LMHC, EMDR
4 Endorsed
Anacortes, WA 98221
My approach is based on a person-centered and cognitive-behavioral therapy philosophy as I work with individuals, couples, and youth in need of support. I strive to use my experience, and honest and open style of communication to act as a positive support to help you establish and fulfill therapeutic and life goals, providing psychotherapy in accordance with an evidence-based practice recovery model. If you're a couple reaching out for support, I will work with you to encourage a deeper connection and accountability.
My approach is based on a person-centered and cognitive-behavioral therapy philosophy as I work with individuals, couples, and youth in need of support. I strive to use my experience, and honest and open style of communication to act as a positive support to help you establish and fulfill therapeutic and life goals, providing psychotherapy in accordance with an evidence-based practice recovery model. If you're a couple reaching out for support, I will work with you to encourage a deeper connection and accountability.
(360) 202-3605 View (360) 202-3605
Photo of James F Marshall, Counselor, MA, LMHC
James F Marshall
Counselor, MA, LMHC
Anacortes, WA 98221
I have been working in counseling and mental health for over 30 years. In my practice, I work with both couples and individuals. Currently, I mainly work with couples using Gottman Method Couples Therapy. I like to focus on specific changes that my clients want in their lives, build on skills and mitigate the impact of old emotional and behavioral habits that no longer serve life as it is now. It is important to look at all aspects of life: mental, emotional, behavioral and spiritual; quality of relationships, even diet and exercise, in building a positive, satisfying and fulfilling life.
I have been working in counseling and mental health for over 30 years. In my practice, I work with both couples and individuals. Currently, I mainly work with couples using Gottman Method Couples Therapy. I like to focus on specific changes that my clients want in their lives, build on skills and mitigate the impact of old emotional and behavioral habits that no longer serve life as it is now. It is important to look at all aspects of life: mental, emotional, behavioral and spiritual; quality of relationships, even diet and exercise, in building a positive, satisfying and fulfilling life.
(206) 538-2897 View (206) 538-2897
Photo of Kristine Williams, Licensed Mental Health Counselor, MA, LMHC
Kristine Williams
Licensed Mental Health Counselor, MA, LMHC
1 Endorsed
Anacortes, WA 98221
What is it that we all have in common? Perhaps it is the desire to be happy, to find meaning in life or to have connections with others. Maybe we are searching for a feeling of calmness; or to be less overwhelmed. We all have our own personal struggles. I believe that my calming presence and acceptance of others helps clients feel comfortable and at ease. Finding the right therapist is key to your personal growth and emotional wellbeing.
What is it that we all have in common? Perhaps it is the desire to be happy, to find meaning in life or to have connections with others. Maybe we are searching for a feeling of calmness; or to be less overwhelmed. We all have our own personal struggles. I believe that my calming presence and acceptance of others helps clients feel comfortable and at ease. Finding the right therapist is key to your personal growth and emotional wellbeing.
(360) 868-8156 View (360) 868-8156
Photo of Charlotte Delautre, Clinical Social Work/Therapist, MSW, LSWAIC
Charlotte Delautre
Clinical Social Work/Therapist, MSW, LSWAIC
1 Endorsed
Online Only
My therapeutic practice is eclectic, informed by behavior science, mindfulness, and other evidence-based practices. My clients may be experiencing depression and anxiety, navigating mood disorders, or otherwise wanting to change their behaviors into something more adaptive. I have over 5 years of professional experience working with neurodivergent clients and folks with disabilities. As such, my approach to treatment is individualized, creative, and relational.
My therapeutic practice is eclectic, informed by behavior science, mindfulness, and other evidence-based practices. My clients may be experiencing depression and anxiety, navigating mood disorders, or otherwise wanting to change their behaviors into something more adaptive. I have over 5 years of professional experience working with neurodivergent clients and folks with disabilities. As such, my approach to treatment is individualized, creative, and relational.
(360) 503-0424 View (360) 503-0424
Photo of John B Swain, Counselor, LMHC
John B Swain
Counselor, LMHC
Anacortes, WA 98221
Waitlist for new clients
As a practicing Licensed Mental Health counselor for the past 25 years, I fundamentally believe in an individual's innate capacity to heal, grow and thrive. My practice is strengths-based and focuses on assisting people in recognizing and maximizing their skills and abilities. I am privileged to assist clients in achieving their full potential and capacity to lead creative and fulfilling lives.
As a practicing Licensed Mental Health counselor for the past 25 years, I fundamentally believe in an individual's innate capacity to heal, grow and thrive. My practice is strengths-based and focuses on assisting people in recognizing and maximizing their skills and abilities. I am privileged to assist clients in achieving their full potential and capacity to lead creative and fulfilling lives.
(360) 813-6437 View (360) 813-6437
Photo of Josie Nickum, Counselor, MEd, LMHC
Josie Nickum
Counselor, MEd, LMHC
1 Endorsed
Anacortes, WA 98221
You feel like you're constantly on the verge of a nervous system collapse. You hear your a critical voice in your head telling you to "stop being so dramatic, sensitive, etc." My speciality is work with highly sensitive people (HSPS). For deep feelers (myself included) the world isn't just a place we inhabit; it’s a place we feel, deeply and constantly. Many deep-feelers grow up in environments or cultures where their where their sensitivity isn't understood. I work with adults and teens who are: deeply empathetic and often take on other people's stress. I also work with couples and families.
You feel like you're constantly on the verge of a nervous system collapse. You hear your a critical voice in your head telling you to "stop being so dramatic, sensitive, etc." My speciality is work with highly sensitive people (HSPS). For deep feelers (myself included) the world isn't just a place we inhabit; it’s a place we feel, deeply and constantly. Many deep-feelers grow up in environments or cultures where their where their sensitivity isn't understood. I work with adults and teens who are: deeply empathetic and often take on other people's stress. I also work with couples and families.
(360) 564-6046 View (360) 564-6046
Photo of Jennifer Paddock, Drug & Alcohol Counselor, MA, MAC, SUDP, MHP
Jennifer Paddock
Drug & Alcohol Counselor, MA, MAC, SUDP, MHP
Anacortes, WA 98221
Are you feeling the weight of concern about either your own struggles with substance use or addictive behaviors or perhaps someone else's? The worry, confusion, and even shame can be overwhelming, leaving you tangled in excuses, strained relationships, and just trying to make it through each day. These feelings are all too common when dealing with challenges related to drugs, alcohol, gambling, technology, or other addictions. If you find yourself in this situation, know that you're not alone. Whether you're directly experiencing addiction or affected by a loved one's struggles, the impact can be profound.
Are you feeling the weight of concern about either your own struggles with substance use or addictive behaviors or perhaps someone else's? The worry, confusion, and even shame can be overwhelming, leaving you tangled in excuses, strained relationships, and just trying to make it through each day. These feelings are all too common when dealing with challenges related to drugs, alcohol, gambling, technology, or other addictions. If you find yourself in this situation, know that you're not alone. Whether you're directly experiencing addiction or affected by a loved one's struggles, the impact can be profound.
(360) 763-0209 View (360) 763-0209
Photo of Amy S Tibbles, Counselor, MA, LCPC, LMHC
Amy S Tibbles
Counselor, MA, LCPC, LMHC
2 Endorsed
Anacortes, WA 98221
If you’re ready to optimize your life by addressing mental, emotional, physical, and relational health, our work will be deeply transformative. Together, we’ll explore conscious and subconscious patterns to uncover the root causes of anxiety, depression, and performance blocks. Through this process, you’ll develop greater self-understanding and compassion, focus your energy more intentionally, and cultivate more fulfilling, aligned relationships. (Now accepting online clients in WA & MT, & in-person clients in Skagit County. Montana insurances only at this time.)
If you’re ready to optimize your life by addressing mental, emotional, physical, and relational health, our work will be deeply transformative. Together, we’ll explore conscious and subconscious patterns to uncover the root causes of anxiety, depression, and performance blocks. Through this process, you’ll develop greater self-understanding and compassion, focus your energy more intentionally, and cultivate more fulfilling, aligned relationships. (Now accepting online clients in WA & MT, & in-person clients in Skagit County. Montana insurances only at this time.)
(360) 795-5997 View (360) 795-5997
Photo of Judy L Heinemann, Counselor, LMHC, SUDP
Judy L Heinemann
Counselor, LMHC, SUDP
Anacortes, WA 98221
Life can be hard and many people struggle with anxiety, depression, mood swings, trauma, sleep issues, relationship issues or grief and loss. I believe we all need others to help us along our life’s journey. I can help by offering a supportive, confidential and safe place where you and I can work together to explore your unique life story and help you develop the tools and skills to cultivate meaningful and lasting change in your life.
Life can be hard and many people struggle with anxiety, depression, mood swings, trauma, sleep issues, relationship issues or grief and loss. I believe we all need others to help us along our life’s journey. I can help by offering a supportive, confidential and safe place where you and I can work together to explore your unique life story and help you develop the tools and skills to cultivate meaningful and lasting change in your life.
(360) 763-0677 View (360) 763-0677
Photo of Elisabeth Waring, Pre-Licensed Professional, MA, LMHCA
Elisabeth Waring
Pre-Licensed Professional, MA, LMHCA
2 Endorsed
Anacortes, WA 98221
You have a story—one that’s shaped by experience, relationships, culture, and the unconscious patterns that influence your life. Sometimes that story feels fragmented, painful, or unclear. Together we can approach therapy with curiosity and compassion, creating a space where all parts of you are welcomed. My work is relational and creative, helping you move toward a more authentic sense of self to connect with others around you. I believe in making space for your story to unfold, supporting you in finding peace with your past, feeling at home in your body, and building hope for the future.
You have a story—one that’s shaped by experience, relationships, culture, and the unconscious patterns that influence your life. Sometimes that story feels fragmented, painful, or unclear. Together we can approach therapy with curiosity and compassion, creating a space where all parts of you are welcomed. My work is relational and creative, helping you move toward a more authentic sense of self to connect with others around you. I believe in making space for your story to unfold, supporting you in finding peace with your past, feeling at home in your body, and building hope for the future.
(425) 276-7443 View (425) 276-7443
Photo of Lena Tello, Licensed Mental Health Counselor Associate, MA, LMHCA
Lena Tello
Licensed Mental Health Counselor Associate, MA, LMHCA
2 Endorsed
Anacortes, WA 98221
I am passionate about meeting clients where they are, no matter what challenges they come in with. The client's needs, goals, and desire for change are created by them in the therapeutic space, and my goal is to encourage, empower, and allow for growth to be possible with endless support. I value helping all individuals, including children, teens, and adults, become their authentic selves in every environment. Much of my practice includes highlighting systemic injustices and working to make minority communities feel more seen, heard, and valued.
I am passionate about meeting clients where they are, no matter what challenges they come in with. The client's needs, goals, and desire for change are created by them in the therapeutic space, and my goal is to encourage, empower, and allow for growth to be possible with endless support. I value helping all individuals, including children, teens, and adults, become their authentic selves in every environment. Much of my practice includes highlighting systemic injustices and working to make minority communities feel more seen, heard, and valued.
(360) 841-5002 x516 View (360) 841-5002 x516
Photo of Whitney Keith, Mental Health Counselor, LMHC, MA
Whitney Keith
Mental Health Counselor, LMHC, MA
1 Endorsed
Anacortes, WA 98221
Are you someone who feels everything deeply—emotionally, sensorially, intellectually? You may experience life with creative intensity or quiet resistance to systems that don’t fit. I offer therapy that’s creative, inclusive, and attuned to your unique inner world. My work is relational and anti-oppressive, supporting clients whose emotional and sensory depth may have been misunderstood. Together, we create space for healing that helps you become more fully yourself.
Are you someone who feels everything deeply—emotionally, sensorially, intellectually? You may experience life with creative intensity or quiet resistance to systems that don’t fit. I offer therapy that’s creative, inclusive, and attuned to your unique inner world. My work is relational and anti-oppressive, supporting clients whose emotional and sensory depth may have been misunderstood. Together, we create space for healing that helps you become more fully yourself.
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Photo of Deb Culver, Counselor, LMHC, CGT, ADHDCSP
Deb Culver
Counselor, LMHC, CGT, ADHDCSP
1 Endorsed
Online Only
Not accepting new clients
Are you struggling with life? Have you been trying to figure things out on your own but feel like you are not making progress? Do you wish you had more effective tools to help you navigate your problems? Sometimes we need someone to come alongside us and help. I am passionate about working with clients from a strengths-based perspective to help them gain new perspectives, insights, and skills in an honest, supportive, collaborative, and non-judgmental way. Coming to counseling will be the beginning of a new you! As a Christian therapist, I also offer counseling from a Biblical perspective to help clients on their journey.
Are you struggling with life? Have you been trying to figure things out on your own but feel like you are not making progress? Do you wish you had more effective tools to help you navigate your problems? Sometimes we need someone to come alongside us and help. I am passionate about working with clients from a strengths-based perspective to help them gain new perspectives, insights, and skills in an honest, supportive, collaborative, and non-judgmental way. Coming to counseling will be the beginning of a new you! As a Christian therapist, I also offer counseling from a Biblical perspective to help clients on their journey.
(360) 299-7994 View (360) 299-7994
Photo of Lea Kennedy, Marriage & Family Therapist, LMFT
Lea Kennedy
Marriage & Family Therapist, LMFT
1 Endorsed
Anacortes, WA 98221
Hello, I am an individual, couple and family therapist who helps clients learn to be with themselves and to be with others in a healthy and authentic way. I have interests in working with clients around family life transitions, anxiety and depression, and grief and loss. I work from a strength-based, humanistic, and family systems approach in that I view concerns through an individual lens but also through a much broader relational, social, cultural, spiritual, environmental context.
Hello, I am an individual, couple and family therapist who helps clients learn to be with themselves and to be with others in a healthy and authentic way. I have interests in working with clients around family life transitions, anxiety and depression, and grief and loss. I work from a strength-based, humanistic, and family systems approach in that I view concerns through an individual lens but also through a much broader relational, social, cultural, spiritual, environmental context.
(360) 564-5507 View (360) 564-5507
Photo of Dr. Heather Hamilton, Counselor, PhD, LPC, DCC, NCC
Dr. Heather Hamilton
Counselor, PhD, LPC, DCC, NCC
Anacortes, WA 98221
Accepting new individual clients. Enrollment is also open for virtual weekly groups focused on mental health, lifestyle practices, & GLP-1 weight loss. It's my philosophy that whatever affects our emotional health (stress, depression, anxiety, trauma) will affect longevity and quality of life. Understanding challenges and working toward solutions is what I enjoy, in particular helping individuals recover from an inner critic, diminished self-worth, depression, complex trauma, ADHD, & anxiety disorders. I also excel at supporting clients through the divorce process and recovery from dysfunctional relationship and family dynamics.
Accepting new individual clients. Enrollment is also open for virtual weekly groups focused on mental health, lifestyle practices, & GLP-1 weight loss. It's my philosophy that whatever affects our emotional health (stress, depression, anxiety, trauma) will affect longevity and quality of life. Understanding challenges and working toward solutions is what I enjoy, in particular helping individuals recover from an inner critic, diminished self-worth, depression, complex trauma, ADHD, & anxiety disorders. I also excel at supporting clients through the divorce process and recovery from dysfunctional relationship and family dynamics.
(360) 746-2024 View (360) 746-2024
Photo of Josh Stabbert, Counselor, LMHC
Josh Stabbert
Counselor, LMHC
Online Only
Hi there! If you’ve found your way here, chances are that you’ve spent at least part of your life stuck in struggle. I get it. I would love to chat further with you about what you're going through. Together, we’ll create a supportive environment where you feel safe to explore the toughest things that get in the way of you being able to experience life on your terms. If you’re ready for support or simply have some questions, reach out. I look forward to connecting with you!
Hi there! If you’ve found your way here, chances are that you’ve spent at least part of your life stuck in struggle. I get it. I would love to chat further with you about what you're going through. Together, we’ll create a supportive environment where you feel safe to explore the toughest things that get in the way of you being able to experience life on your terms. If you’re ready for support or simply have some questions, reach out. I look forward to connecting with you!
(360) 505-7877 View (360) 505-7877
Photo of Josh Stabbert, Counselor, MA, LMHC
Josh Stabbert
Counselor, MA, LMHC
Online Only
Hey there! If you’ve found your way here, chances are that you’ve spent at least part of your life stuck in struggle. Feeling like you have to constantly push forward just to make it through your day and feeling powerless over it all. I get it. Your experiences can leave you feeling unlovable, unsafe, or incapable. I know it’s not easy feeling overwhelmed with anxiety of trying to figure it all out on your own. You deserve to feel empowered in your life. I would love to chat further with you about what you're going through.
Hey there! If you’ve found your way here, chances are that you’ve spent at least part of your life stuck in struggle. Feeling like you have to constantly push forward just to make it through your day and feeling powerless over it all. I get it. Your experiences can leave you feeling unlovable, unsafe, or incapable. I know it’s not easy feeling overwhelmed with anxiety of trying to figure it all out on your own. You deserve to feel empowered in your life. I would love to chat further with you about what you're going through.
(360) 215-2761 View (360) 215-2761
Photo of Tony Vecchione, Counselor, MEd, LMHC
Tony Vecchione
Counselor, MEd, LMHC
Anacortes, WA 98221
Sometimes life is hard. You get stuck. You realize that this isn't the life you thought you'd be living. Unexpected life changing events happen. Old patterns or unresolved trauma may hold you back.. My strength is to help support you in an honest and direct way. I want to help you gain insight into the challenges you are facing and the life experiences that have brought you here. With that insight, we can work together to develop a plan for positive change, and give you the tools you need to live the life you want to be living.
Sometimes life is hard. You get stuck. You realize that this isn't the life you thought you'd be living. Unexpected life changing events happen. Old patterns or unresolved trauma may hold you back.. My strength is to help support you in an honest and direct way. I want to help you gain insight into the challenges you are facing and the life experiences that have brought you here. With that insight, we can work together to develop a plan for positive change, and give you the tools you need to live the life you want to be living.
(360) 234-3811 View (360) 234-3811
Photo of Rachel D Wagner - Blue Water Behavior Consulting, MS, LBA, BCBA
Blue Water Behavior Consulting
Verified Verified
Anacortes, WA 98221
I am a Board Certified Behavior Analyst (BCBA) that specializes in the treatment of autism spectrum disorders and other developmental disabilities using Applied Behavior Analysis (ABA). Services can take place at our office, in your home, or at your child's school or daycare. I develop an individualized treatment plan for each person I serve in order to help them reach their full potential. Some of the skills ABA is highly effective in teaching include functional communication, strategies to reduce challenging behavior, social skills, activities of daily living, gross and fine motor skills, and cognitive skills/academics.
I am a Board Certified Behavior Analyst (BCBA) that specializes in the treatment of autism spectrum disorders and other developmental disabilities using Applied Behavior Analysis (ABA). Services can take place at our office, in your home, or at your child's school or daycare. I develop an individualized treatment plan for each person I serve in order to help them reach their full potential. Some of the skills ABA is highly effective in teaching include functional communication, strategies to reduce challenging behavior, social skills, activities of daily living, gross and fine motor skills, and cognitive skills/academics.
(360) 972-3612 View (360) 972-3612
Photo of Barbara N Gaffney, Clinical Social Work/Therapist, LICSW
Barbara N Gaffney
Clinical Social Work/Therapist, LICSW
Online Only
Waitlist for new clients
Life can be challenging. Whether it's loss, change, death of a loved one or uncertainty of life's direction, we all hit roadblocks and obstacles. During those times it's important to be heard. I am here to listen and to inspire hope. I believe in my clients' abilities to change. I nurture their inner strength until they can believe in themselves. Change is powerful. It can be transformational, scary and exciting. When I worked in Palliative Care with patients who were at the end stage of their lives, I was witness to the power of being present. In the quiet presence of acceptance, a deep healing can occur. PLEASE EMAIL FOR CONSULT
Life can be challenging. Whether it's loss, change, death of a loved one or uncertainty of life's direction, we all hit roadblocks and obstacles. During those times it's important to be heard. I am here to listen and to inspire hope. I believe in my clients' abilities to change. I nurture their inner strength until they can believe in themselves. Change is powerful. It can be transformational, scary and exciting. When I worked in Palliative Care with patients who were at the end stage of their lives, I was witness to the power of being present. In the quiet presence of acceptance, a deep healing can occur. PLEASE EMAIL FOR CONSULT
(360) 226-5889 View (360) 226-5889

See more therapy options for Anacortes

How does your Therapist compare?

Number of Therapists in Anacortes, WA

90+

Average cost per session

$150

Therapists in Anacortes, WA who prioritize treating:

89% Anxiety
89% Social Anxiety
89% Health Anxiety
89% Driving Anxiety
83% Depression
76% Self Esteem
74% Stress

Average years in practice

12 Years

Top 3 insurances accepted

81% Premera Blue Cross
78% Regence
66% Aetna

How Therapists in Anacortes, WA see their clients

68% In Person and Online
32% Online Only

Gender breakdown

79% Female
20% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Anacortes?

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.