Therapists in Seattle, WA

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Photo of Daniel Jacob Self, Counselor, MA, LMHCA
Daniel Jacob Self
Counselor, MA, LMHCA
Verified Verified
1 Endorsed
Seattle, WA 98112
Deep inside of you is the awareness of what you need to heal. I help facilitate and unearth that inner wisdom with individuals, couples, and groups. Together, we'll practice tuning into your own unique embodied awareness. From there, we can translate that increased clarity into tangible action that aligns with your greatest, most authentic wellbeing. Our bodies exist within larger systems — many of which can disconnect us from ourselves and each other. We'll look together at the messages we've internalized from these systems in order to unearth the ones that are no longer helpful.
Deep inside of you is the awareness of what you need to heal. I help facilitate and unearth that inner wisdom with individuals, couples, and groups. Together, we'll practice tuning into your own unique embodied awareness. From there, we can translate that increased clarity into tangible action that aligns with your greatest, most authentic wellbeing. Our bodies exist within larger systems — many of which can disconnect us from ourselves and each other. We'll look together at the messages we've internalized from these systems in order to unearth the ones that are no longer helpful.
(425) 510-5749 View (425) 510-5749
Photo of Gabby Santerre, Counselor, MA, LMHCA
Gabby Santerre
Counselor, MA, LMHCA
Verified Verified
3 Endorsed
Seattle, WA 98117
Existence is stressful. Despite all the good, being a human can often be a lonely and confusing experience. And yet, part of you senses there is joy and connection to be had — so how do you access it? Before becoming a therapist, I spent over a decade as an organic farmer; without knowing why, I sensed that I needed to do work that was close to the ground, to be near things that felt fundamental and foundational to life. I view therapy in much the same way: as a space to work with what is deep and foundational in you.
Existence is stressful. Despite all the good, being a human can often be a lonely and confusing experience. And yet, part of you senses there is joy and connection to be had — so how do you access it? Before becoming a therapist, I spent over a decade as an organic farmer; without knowing why, I sensed that I needed to do work that was close to the ground, to be near things that felt fundamental and foundational to life. I view therapy in much the same way: as a space to work with what is deep and foundational in you.
(425) 270-1958 View (425) 270-1958
Photo of Melissa Kullman, Counselor, MA, LMHCA
Melissa Kullman
Counselor, MA, LMHCA
Verified Verified
1 Endorsed
Online Only
There comes a time when we are forced to meet ourselves, hard as we might try to avoid it. It can happen for different reasons and during different life stages. Maybe you’re experiencing a big change that’s bringing everything up all at once, or perhaps you’re realizing the mask you’ve been wearing doesn’t quite fit right anymore. What you’ve always done is no longer working for you, and the new things you’ve tried so far aren't cutting it. And while you feel ready for change, the path forward feels messy, confusing, and overwhelming.
There comes a time when we are forced to meet ourselves, hard as we might try to avoid it. It can happen for different reasons and during different life stages. Maybe you’re experiencing a big change that’s bringing everything up all at once, or perhaps you’re realizing the mask you’ve been wearing doesn’t quite fit right anymore. What you’ve always done is no longer working for you, and the new things you’ve tried so far aren't cutting it. And while you feel ready for change, the path forward feels messy, confusing, and overwhelming.
(425) 310-4903 View (425) 310-4903
Photo of Elizabeth Randall, Licensed Mental Health Counselor, MSW, LMHC
Elizabeth Randall
Licensed Mental Health Counselor, MSW, LMHC
Verified Verified
Seattle, WA 98126
Waitlist for new clients
I am continually inspired by the depth and breadth of the human experience. With a passion for learning about individuals, groups, and systems across varied backgrounds, I seek to support clients in being heard, understood, and empowered. My bachelor's degree in language studies and master's degree in social work allow me to carefully consider the socio-emotional experience of an individual, while accounting for the unique ways in which we express, perceive, and develop meaning. I offer tools and resources for practicing coping strategies outside of sessions, based on client interest. I am open to new and eclectic approaches.
I am continually inspired by the depth and breadth of the human experience. With a passion for learning about individuals, groups, and systems across varied backgrounds, I seek to support clients in being heard, understood, and empowered. My bachelor's degree in language studies and master's degree in social work allow me to carefully consider the socio-emotional experience of an individual, while accounting for the unique ways in which we express, perceive, and develop meaning. I offer tools and resources for practicing coping strategies outside of sessions, based on client interest. I am open to new and eclectic approaches.
(206) 590-6271 View (206) 590-6271
Photo of James Rose - Award-Winning UK Hypnotherapist & Executive Coach, MS, MBPsS, MNCH, FHEQ
Award-Winning UK Hypnotherapist & Executive Coach
MS, MBPsS, MNCH, FHEQ
Verified Verified
2 Endorsed
Seattle, WA 98101
Are you feeling overwhelmed by stress, anxiety, burnout, or struggles like insomnia, addiction, or performance anxiety? Whether you're a busy professional, a parent juggling responsibilities, or a high achiever facing leadership pressures, you may feel stuck. I’ve worked with CEOs, A-list celebrities, Olympic athletes, and others facing similar challenges. Licensed in both the UK and USA, I bring over 14 years of experience to help you regain control, overcome emotional blocks, and achieve deep, quick, and sustainable results—personally and professionally—without the barriers holding you back.
Are you feeling overwhelmed by stress, anxiety, burnout, or struggles like insomnia, addiction, or performance anxiety? Whether you're a busy professional, a parent juggling responsibilities, or a high achiever facing leadership pressures, you may feel stuck. I’ve worked with CEOs, A-list celebrities, Olympic athletes, and others facing similar challenges. Licensed in both the UK and USA, I bring over 14 years of experience to help you regain control, overcome emotional blocks, and achieve deep, quick, and sustainable results—personally and professionally—without the barriers holding you back.
(253) 331-2365 View (253) 331-2365
Photo of Tiffany Somera, Marriage & Family Therapist, MA , LMFT, MHP
Tiffany Somera
Marriage & Family Therapist, MA , LMFT, MHP
Verified Verified
5 Endorsed
Seattle, WA 98108
Waitlist for new clients
Life can be challenging and change is inevitable, and with transitions there are many aspects to growth and loss. I work with individuals, couples, and family systems; often dealing with unprocessed grief, trauma, parenting, identity issues, and midlife decisions. It takes courage to communicate the strong emotions felt within these difficult topics, especially to those you love the most. I prioritize holding a non-judgmental space for these strong emotions to be seen, heard, and liberated.
Life can be challenging and change is inevitable, and with transitions there are many aspects to growth and loss. I work with individuals, couples, and family systems; often dealing with unprocessed grief, trauma, parenting, identity issues, and midlife decisions. It takes courage to communicate the strong emotions felt within these difficult topics, especially to those you love the most. I prioritize holding a non-judgmental space for these strong emotions to be seen, heard, and liberated.
(253) 525-5712 View (253) 525-5712
Photo of Sheryl E Kool, Counselor, MA, LMHC
Sheryl E Kool
Counselor, MA, LMHC
Verified Verified
Seattle, WA 98125
Not accepting new clients
Welcome! I am a warm, compassionate and experienced counselor who works in a collaborative style that allows you to draw upon your own strengths and experience in order to grow. Trust and a sense of safety are the necessary foundations for effective treatment. You need to feel connected and understood to share your internal world. I respect the tremendous courage it takes to face up to deeply buried or avoided thoughts and feelings. My ability to listen, follow and connect deeply will enable you to feel safe enough to explore the problems which have hindered your life and relationships.
Welcome! I am a warm, compassionate and experienced counselor who works in a collaborative style that allows you to draw upon your own strengths and experience in order to grow. Trust and a sense of safety are the necessary foundations for effective treatment. You need to feel connected and understood to share your internal world. I respect the tremendous courage it takes to face up to deeply buried or avoided thoughts and feelings. My ability to listen, follow and connect deeply will enable you to feel safe enough to explore the problems which have hindered your life and relationships.
(206) 981-3189 View (206) 981-3189
Photo of Laura Thomas, Counselor, MA, LMHC, NCC
Laura Thomas
Counselor, MA, LMHC, NCC
Verified Verified
1 Endorsed
Seattle, WA 98101
I work to alleviate emotional pain or confusion, establish more effective coping skills, while fostering a more accurate understanding of your past and what you want for your future.
I work to alleviate emotional pain or confusion, establish more effective coping skills, while fostering a more accurate understanding of your past and what you want for your future.
(206) 207-2212 View (206) 207-2212
Photo of Katie Hellerud, Counselor, LMHC
Katie Hellerud
Counselor, LMHC
Verified Verified
Online Only
Waitlist for new clients
Have you ever been told or wondered if you're "too sensitive" or "too emotional?" As if this is a shameful thing? I'll take a wild guess and say that hearing this probably doesn't help in feeling "less" emotional. This can be such a bind – maybe intense emotions/behaviors make things harder. However, a sense of acceptance, whether it comes from within or from loved ones, can profoundly support in feeling understood, safe, and resilient. And these more subtle feelings can absolutely assist in the pursuit of making necessary changes in emotional expression & related behaviors, impact on relationships, and presence day-to-day.
Have you ever been told or wondered if you're "too sensitive" or "too emotional?" As if this is a shameful thing? I'll take a wild guess and say that hearing this probably doesn't help in feeling "less" emotional. This can be such a bind – maybe intense emotions/behaviors make things harder. However, a sense of acceptance, whether it comes from within or from loved ones, can profoundly support in feeling understood, safe, and resilient. And these more subtle feelings can absolutely assist in the pursuit of making necessary changes in emotional expression & related behaviors, impact on relationships, and presence day-to-day.
(206) 203-3745 View (206) 203-3745
Photo of Elizabeth E Hubert, Psychologist, PhD
Elizabeth E Hubert
Psychologist, PhD
Verified Verified
2 Endorsed
Seattle, WA 98103
I approach my work with adults and teens with warmth, humor, and compassion. My goal is to support you in moving toward what is most important to you in your life. I use a variety of evidence-based treatments in my work including Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Exposure/Response Prevention (E/RP), Cognitive Processing Therapy, Harm Reduction/Relapse Prevention, and Behavioral Activation.
I approach my work with adults and teens with warmth, humor, and compassion. My goal is to support you in moving toward what is most important to you in your life. I use a variety of evidence-based treatments in my work including Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Exposure/Response Prevention (E/RP), Cognitive Processing Therapy, Harm Reduction/Relapse Prevention, and Behavioral Activation.
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Photo of Lori A Hiltz, Clinical Social Work/Therapist, LICSW
Lori A Hiltz
Clinical Social Work/Therapist, LICSW
Verified Verified
Seattle, WA 98112
I believe in the potential of all people to live satisfying and healthy lives and enjoy helping people reach their individual goals. In my work I join with clients in a safe and collaborative way working to explore, understand and resolve the challenges related to their identified goals. I work with people dealing with a variety of emotional and personal difficulties including depression, anxiety, relationship or work conflicts, personality disorders, trauma or abuse histories, parenting, adolescent issues, grief, reproductive issues, self esteem issues and other general disruptions to social, work or relationship functioning.
I believe in the potential of all people to live satisfying and healthy lives and enjoy helping people reach their individual goals. In my work I join with clients in a safe and collaborative way working to explore, understand and resolve the challenges related to their identified goals. I work with people dealing with a variety of emotional and personal difficulties including depression, anxiety, relationship or work conflicts, personality disorders, trauma or abuse histories, parenting, adolescent issues, grief, reproductive issues, self esteem issues and other general disruptions to social, work or relationship functioning.
(253) 200-9855 View (253) 200-9855
Photo of Sarah J Kyle, Marriage & Family Therapist, MA, LMFT
Sarah J Kyle
Marriage & Family Therapist, MA, LMFT
Verified Verified
8 Endorsed
Seattle, WA 98109
Waitlist for new clients
I specialize in couples therapy, where I help partners work toward relational repair after infidelity, betrayal, or ongoing conflict. I also work with individuals who want to work through attachment and relationship issues, identity development, spirituality, trauma, anxiety, and depression. Therapy is work that asks a great deal from us, but it also holds potential for meaningful change: to awaken to your own life, to make strides toward repairing broken bonds, and to imagine new possibilities and new ways of being, for yourself and for your relationships.
I specialize in couples therapy, where I help partners work toward relational repair after infidelity, betrayal, or ongoing conflict. I also work with individuals who want to work through attachment and relationship issues, identity development, spirituality, trauma, anxiety, and depression. Therapy is work that asks a great deal from us, but it also holds potential for meaningful change: to awaken to your own life, to make strides toward repairing broken bonds, and to imagine new possibilities and new ways of being, for yourself and for your relationships.
(206) 339-4277 View (206) 339-4277
Photo of Eric Borgh, Counselor, MA, LMHC
Eric Borgh
Counselor, MA, LMHC
Verified Verified
14 Endorsed
Seattle, WA 98112
I specialize developing a relational space in which self discovery and inner growth can emerge. Less about the functional and directive, this is an emotive, aspirationally impactful approach, based in the long history of the depth/soul work psychotherapy and psychoanalysis have fostered. Therapy is a process, non-linear and creative at times. In that formational space, I am committed to mutual impact, a reflective disposition and the on-going therapeutic process which I earnestly believe can be transformative.
I specialize developing a relational space in which self discovery and inner growth can emerge. Less about the functional and directive, this is an emotive, aspirationally impactful approach, based in the long history of the depth/soul work psychotherapy and psychoanalysis have fostered. Therapy is a process, non-linear and creative at times. In that formational space, I am committed to mutual impact, a reflective disposition and the on-going therapeutic process which I earnestly believe can be transformative.
(206) 594-4394 View (206) 594-4394
Photo of Enrique Gracian, Psychologist, PhD
Enrique Gracian
Psychologist, PhD
Verified Verified
Online Only
Accepting new clients! Dr. Enrique Gracian joined Therapy Lab in early 2020 while completing his Post-Doctoral Fellowship at the UCLA Semel Institute. Therapy Lab clients and the team appreciate the compassion, intellect, and sense of humor that Dr. Gracian brings to his sessions. With his additional expertise in neuroscience, Dr. Gracian brings that special insight into his work with clients. He specializes in all Therapy Lab plans and treatments, including the Unified Protocol, CBT for Insomnia, CBT for IBS, DBT-based interpersonal and emotion regulation, positive psychology, VR-enhanced exposure therapy, and crisis response.
Accepting new clients! Dr. Enrique Gracian joined Therapy Lab in early 2020 while completing his Post-Doctoral Fellowship at the UCLA Semel Institute. Therapy Lab clients and the team appreciate the compassion, intellect, and sense of humor that Dr. Gracian brings to his sessions. With his additional expertise in neuroscience, Dr. Gracian brings that special insight into his work with clients. He specializes in all Therapy Lab plans and treatments, including the Unified Protocol, CBT for Insomnia, CBT for IBS, DBT-based interpersonal and emotion regulation, positive psychology, VR-enhanced exposure therapy, and crisis response.
(206) 203-7995 View (206) 203-7995
Photo of Christina Tobie, Marriage & Family Therapist, MA, LMFT
Christina Tobie
Marriage & Family Therapist, MA, LMFT
Verified Verified
Seattle, WA 98136
It takes tremendous courage to work on yourself. Change is hard. While I can’t do this work for you, I will walk beside you. You will have my guidance and support as you learn how to examine your own actions, choices, and relationships. I love helping my clients figure out what they want and how to make it happen. Let’s work together to find, care for, and celebrate you; as you are, have been, and would like to be.
It takes tremendous courage to work on yourself. Change is hard. While I can’t do this work for you, I will walk beside you. You will have my guidance and support as you learn how to examine your own actions, choices, and relationships. I love helping my clients figure out what they want and how to make it happen. Let’s work together to find, care for, and celebrate you; as you are, have been, and would like to be.
(206) 202-1804 View (206) 202-1804
Photo of Christen A. Carson, Psychologist, PhD, ABPP
Christen A. Carson
Psychologist, PhD, ABPP
Verified Verified
Seattle, WA 98136
Not accepting new clients
Dr. Carson is a clinical and forensic psychologist specializing in evaluations and expert testimony for civil and criminal cases. She holds dual Board Certifications in Forensic Psychology and Couple and Family Psychology through the American Board of Professional Psychology (ABPP). Dr. Carson serves as the President of the American Board of Couple and Family Psychology and is a past President of the Board of Trustees for the Washington State Psychological Association (WSPA). She is also a faculty member of the American Academy of Forensic Psychology.
Dr. Carson is a clinical and forensic psychologist specializing in evaluations and expert testimony for civil and criminal cases. She holds dual Board Certifications in Forensic Psychology and Couple and Family Psychology through the American Board of Professional Psychology (ABPP). Dr. Carson serves as the President of the American Board of Couple and Family Psychology and is a past President of the Board of Trustees for the Washington State Psychological Association (WSPA). She is also a faculty member of the American Academy of Forensic Psychology.
(253) 343-0868 View (253) 343-0868
Photo of Brien Wood, Marriage & Family Therapist, MA, LMHC, LMFT
Brien Wood
Marriage & Family Therapist, MA, LMHC, LMFT
Verified Verified
Seattle, WA 98144
I am an Emotionally Focused Couples Therapist with 18 years of experience specializing in relationship counseling and trauma, i.e. helping individuals heal from the wounds of a difficult childhood.
I am an Emotionally Focused Couples Therapist with 18 years of experience specializing in relationship counseling and trauma, i.e. helping individuals heal from the wounds of a difficult childhood.
(206) 237-6475 View (206) 237-6475
Photo of Pam Dell Fitzgerald, Psychologist, PhD
Pam Dell Fitzgerald
Psychologist, PhD
Verified Verified
Seattle, WA 98119
I work with people of all ages—child, adolescent, and adult. I have strengths in working with children, with people experiencing depression, anxiety, and trauma reactions, and with people who have been abused in the past. My goals are to help you make the changes you are ready to make, and to help relieve the struggles you are having.
I work with people of all ages—child, adolescent, and adult. I have strengths in working with children, with people experiencing depression, anxiety, and trauma reactions, and with people who have been abused in the past. My goals are to help you make the changes you are ready to make, and to help relieve the struggles you are having.
(425) 428-6894 x1167 View (425) 428-6894 x1167
Photo of Christelle Silue, Pre-Licensed Professional, MSW, LSWAIC
Christelle Silue
Pre-Licensed Professional, MSW, LSWAIC
Verified Verified
2 Endorsed
Online Only
EMDR Trained and Accepting new clients. Do you find yourself doubting your worth, feeling drained from code-switching, or navigating the exhaustion of being misunderstood or policed by others? Taking the first step toward healing takes immense courage, and I’m here to support you. I understand how life's challenges—compounded by trauma, systemic oppression, and racialized experiences—can leave lasting emotional imprints. My goal is to provide a safe, direct, and empathetic space where you can explore your emotions, confront your past, and embrace a brighter future.
EMDR Trained and Accepting new clients. Do you find yourself doubting your worth, feeling drained from code-switching, or navigating the exhaustion of being misunderstood or policed by others? Taking the first step toward healing takes immense courage, and I’m here to support you. I understand how life's challenges—compounded by trauma, systemic oppression, and racialized experiences—can leave lasting emotional imprints. My goal is to provide a safe, direct, and empathetic space where you can explore your emotions, confront your past, and embrace a brighter future.
(206) 488-1667 View (206) 488-1667
Photo of Bee Cook, Counselor, LMHCA
Bee Cook
Counselor, LMHCA
Verified Verified
1 Endorsed
Seattle, WA 98103
My ideal clients are children, adolescents, and adults who seek to understand and express their emotions in relation to their life experiences and identity. Clients who work with me want to grow in processing their feelings and deepen self-understanding. Through a psychodynamic basis, I utilize a trauma-informed, narrative, and relational approach to therapy, incorporating parts work, attachment theory, and somatic techniques to emphasize the mind-body connection. I specialize in working with neurodivergent clients, those with chronic illnesses, queer clients, and those processing spiritual deconstruction and grief.
My ideal clients are children, adolescents, and adults who seek to understand and express their emotions in relation to their life experiences and identity. Clients who work with me want to grow in processing their feelings and deepen self-understanding. Through a psychodynamic basis, I utilize a trauma-informed, narrative, and relational approach to therapy, incorporating parts work, attachment theory, and somatic techniques to emphasize the mind-body connection. I specialize in working with neurodivergent clients, those with chronic illnesses, queer clients, and those processing spiritual deconstruction and grief.
(425) 382-6394 View (425) 382-6394
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How does your Therapist compare?

Number of Therapists in Seattle, WA

3,000+

Average cost per session

$158

Therapists in Seattle, WA who prioritize treating:

93% Anxiety
86% Depression
76% Relationship Issues
75% Self Esteem
71% Trauma and PTSD
71% Stress
69% Life Transitions

Average years in practice

9 Years

Top 3 insurances accepted

70% Premera Blue Cross
66% Aetna
59% Regence

How Therapists in Seattle, WA see their clients

55% Online Only
45% In Person and Online

Gender breakdown

76% Female
20% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Seattle?

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.