Therapists in Spokane, WA

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Photo of Alicia Lynn Paschall - Heart Warm Psychology Today, RC, MA, CBHA
Heart Warm Psychology Today
Verified Verified
Online Only
Helping parents feel seen, heal deeply, and reunite with love—faith-based, trauma-informed support for families facing CPS and court. If you’re a parent feeling overwhelmed by CPS, court requirements, or the fear of losing your child, I want you to know—you are not alone. I see how hard you’re trying, even when no one else does. You may be carrying pain, pressure, and a past that others don’t understand, but that doesn’t define you. I offer a safe space where you can breathe, be honest, and begin again—with help, compassion, and understanding. This is a judgment-free zone where you are met with an open mind, not assumptions.
Helping parents feel seen, heal deeply, and reunite with love—faith-based, trauma-informed support for families facing CPS and court. If you’re a parent feeling overwhelmed by CPS, court requirements, or the fear of losing your child, I want you to know—you are not alone. I see how hard you’re trying, even when no one else does. You may be carrying pain, pressure, and a past that others don’t understand, but that doesn’t define you. I offer a safe space where you can breathe, be honest, and begin again—with help, compassion, and understanding. This is a judgment-free zone where you are met with an open mind, not assumptions.
(509) 635-3626 View (509) 635-3626
Photo of Kurt Michael Leonard, Clinical Social Work/Therapist, MSW, LICSW, MHP
Kurt Michael Leonard
Clinical Social Work/Therapist, MSW, LICSW, MHP
Spokane, WA 99208
Welcome to my mental health counseling profile. I want you to feel very encouraged by what you are about to read. I want you to know that hope, restoration, recovery, healing, and durable personal growth are available to you in your current trauma, crisis, adjustment or loss through the counseling and therapy that I can provide for you and with you. When we experience adversity and face troubling challenges, we need compassionate support that teaches highly effective skills and techniques to best moderate or eliminate the impending symptoms of stress. We also need support that helps to access our strengths and build resilience.
Welcome to my mental health counseling profile. I want you to feel very encouraged by what you are about to read. I want you to know that hope, restoration, recovery, healing, and durable personal growth are available to you in your current trauma, crisis, adjustment or loss through the counseling and therapy that I can provide for you and with you. When we experience adversity and face troubling challenges, we need compassionate support that teaches highly effective skills and techniques to best moderate or eliminate the impending symptoms of stress. We also need support that helps to access our strengths and build resilience.
(509) 236-1813 View (509) 236-1813
Photo of Sandra Miller, Clinical Social Work/Therapist, LMSW, LSWAIC
Sandra Miller
Clinical Social Work/Therapist, LMSW, LSWAIC
Online Only
Life is hard. Sometimes it feels like we spend our days tackling one crisis after another, which can eventually take a toll on our body, mind, and spiritual lives. Friends and family often mean well, but at times, it’s also important to have a trusted therapist to walk with you through life’s mountains and valleys. It’s OK to ask for professional help. I am a Licensed Master Social Worker in Texas and a Licensed Associate Independent Clinical Social Worker in Washington State. I currently live in Texas with my husband, two smelly but good-hearted teenage boys, and our equally smelly but good-hearted Saint Bernard rescue dog, Roxy.
Life is hard. Sometimes it feels like we spend our days tackling one crisis after another, which can eventually take a toll on our body, mind, and spiritual lives. Friends and family often mean well, but at times, it’s also important to have a trusted therapist to walk with you through life’s mountains and valleys. It’s OK to ask for professional help. I am a Licensed Master Social Worker in Texas and a Licensed Associate Independent Clinical Social Worker in Washington State. I currently live in Texas with my husband, two smelly but good-hearted teenage boys, and our equally smelly but good-hearted Saint Bernard rescue dog, Roxy.
(509) 476-8592 View (509) 476-8592
Photo of Alexandria Courtney, Pre-Licensed Professional, LMHCA
Alexandria Courtney
Pre-Licensed Professional, LMHCA
1 Endorsed
Online Only
Hello there and welcome! I am here to support you, your child, or your family as you navigate this thing called life. I use a systemic and collaborative approach, focusing on improving communication patterns, resolving conflicts, while emphasizing your resilience and capacity for change. I have training in supporting individuals with trauma, anxiety and depression. I also have advanced trainings in marriage and family issues as well as play therapy.
Hello there and welcome! I am here to support you, your child, or your family as you navigate this thing called life. I use a systemic and collaborative approach, focusing on improving communication patterns, resolving conflicts, while emphasizing your resilience and capacity for change. I have training in supporting individuals with trauma, anxiety and depression. I also have advanced trainings in marriage and family issues as well as play therapy.
(509) 210-6607 View (509) 210-6607
Photo of Skye Walden, Counselor, MA, LMHCA, SUDPT
Skye Walden
Counselor, MA, LMHCA, SUDPT
2 Endorsed
Spokane, WA 99224
You’ve been to therapy before and you’re searching for a therapist again because despite knowing why you are triggered and having some skills to manage, you still find yourself repeating the same patterns. These patterns that you experience come from somewhere. My goal is to support you in not only identifying the patterns but revealing the root cause of the patterns. When we understand the root cause and the lessons your experiences have taught you about yourself and the world, we can uproot deeply held negative beliefs and replace them with the truth so that you can live your life authentically without being shackled by your past.
You’ve been to therapy before and you’re searching for a therapist again because despite knowing why you are triggered and having some skills to manage, you still find yourself repeating the same patterns. These patterns that you experience come from somewhere. My goal is to support you in not only identifying the patterns but revealing the root cause of the patterns. When we understand the root cause and the lessons your experiences have taught you about yourself and the world, we can uproot deeply held negative beliefs and replace them with the truth so that you can live your life authentically without being shackled by your past.
(509) 530-0880 View (509) 530-0880
Photo of Shannon Mitchell, Clinical Social Work/Therapist, MSW, LICSW
Shannon Mitchell
Clinical Social Work/Therapist, MSW, LICSW
1 Endorsed
Spokane, WA 99201
Waitlist for new clients
My practice focuses on the treatment of mental health issues as they relate to teens, adults, older adults, and LGBTQ+. A guiding principle that informs my therapeutic approach is a Strengths Perspective. I believe we are each looking for meaning and purpose in life. Life can bring challenges and circumstances that leave us feeling alone, scared, lost, or hopeless. It is my belief that each individual has the solutions, and my role is to create a safe and affirming environment in which solutions can be identified, growth can begin, and healing can be achieved.
My practice focuses on the treatment of mental health issues as they relate to teens, adults, older adults, and LGBTQ+. A guiding principle that informs my therapeutic approach is a Strengths Perspective. I believe we are each looking for meaning and purpose in life. Life can bring challenges and circumstances that leave us feeling alone, scared, lost, or hopeless. It is my belief that each individual has the solutions, and my role is to create a safe and affirming environment in which solutions can be identified, growth can begin, and healing can be achieved.
(509) 608-3041 View (509) 608-3041
Photo of Shelley Lunn, Clinical Social Work/Therapist, MSW, LICSW
Shelley Lunn
Clinical Social Work/Therapist, MSW, LICSW
Spokane, WA 99204
I founded Beyond Mountains Counseling with the intention of creating a space where every person feels genuinely seen and heard. My hope is that each session helps you move closer to the life you desire, with a greater sense of clarity and confidence. You are the expert in your own life—I’m here to walk alongside you, offering support, perspective, and practical ideas for next steps.
I founded Beyond Mountains Counseling with the intention of creating a space where every person feels genuinely seen and heard. My hope is that each session helps you move closer to the life you desire, with a greater sense of clarity and confidence. You are the expert in your own life—I’m here to walk alongside you, offering support, perspective, and practical ideas for next steps.
(509) 749-3993 View (509) 749-3993
Photo of Jodi Herman, Licensed Mental Health Counselor Associate, MA, LMHCA, LPCC, NCC
Jodi Herman
Licensed Mental Health Counselor Associate, MA, LMHCA, LPCC, NCC
1 Endorsed
Spokane, WA 99218
Waitlist for new clients
I am a compassionate and culturally attuned therapist with a passion for guiding individuals on their path to healing and personal growth. With a background rooted in trauma-informed care, I recognize the profound impact of life experiences on mental health.
I am a compassionate and culturally attuned therapist with a passion for guiding individuals on their path to healing and personal growth. With a background rooted in trauma-informed care, I recognize the profound impact of life experiences on mental health.
(509) 563-8708 View (509) 563-8708
Photo of Cristen Jane Luke, Clinical Social Work/Therapist, LMSW, LSWAIC
Cristen Jane Luke
Clinical Social Work/Therapist, LMSW, LSWAIC
Online Only
Finding the right therapist can definitely feel overwhelming! I’ll keep this brief as you navigate the sea of pages on Psychology Today. I've worked with a wide range of ages from 3 years old to individuals in their 100s! I specialize in my work with teens, young adults, and couples, and families. I've worked to help clients with a wide range of experiences from trauma, ADHD, autism, depression, anxiety, bipolar, personality disorders, relationship issues, and more.
Finding the right therapist can definitely feel overwhelming! I’ll keep this brief as you navigate the sea of pages on Psychology Today. I've worked with a wide range of ages from 3 years old to individuals in their 100s! I specialize in my work with teens, young adults, and couples, and families. I've worked to help clients with a wide range of experiences from trauma, ADHD, autism, depression, anxiety, bipolar, personality disorders, relationship issues, and more.
(509) 761-6941 View (509) 761-6941
Photo of Lupe Guel, Clinical Social Work/Therapist, LICSW
Lupe Guel
Clinical Social Work/Therapist, LICSW
Online Only
Making your appointment is hard, but once you’re here with me, you will be in a safe space and a judgment-free zone. Together, we can find solutions that work best for you. I strongly believe clients know themselves the best and possess the tools to build the life they want to live. My job is to help invoke change clients want to see and guide them through this process. I’m here to serve all walks of life, and I understand life itself can be challenging. Being Mexican- American, I have experienced disparities growing up and still to this day. I truly believe talking to someone we can confide in makes navigating life easier.
Making your appointment is hard, but once you’re here with me, you will be in a safe space and a judgment-free zone. Together, we can find solutions that work best for you. I strongly believe clients know themselves the best and possess the tools to build the life they want to live. My job is to help invoke change clients want to see and guide them through this process. I’m here to serve all walks of life, and I understand life itself can be challenging. Being Mexican- American, I have experienced disparities growing up and still to this day. I truly believe talking to someone we can confide in makes navigating life easier.
(509) 404-0288 View (509) 404-0288
Photo of Julia Mackesy, Clinical Social Work/Therapist, LICSWA
Julia Mackesy
Clinical Social Work/Therapist, LICSWA
4 Endorsed
Spokane, WA 99202
Hi, I’m Julia — I’m passionate about supporting individuals on their journey toward emotional well-being and personal growth. My approach is warm, client-centered, and rooted in the belief that healing happens in safe, supportive spaces. I strive to create an environment where you feel seen, heard, and gently challenged. Together, we’ll explore patterns, uncover root causes, and work through challenges like anxiety, depression, trauma, and parenting struggles to create meaningful, lasting change.
Hi, I’m Julia — I’m passionate about supporting individuals on their journey toward emotional well-being and personal growth. My approach is warm, client-centered, and rooted in the belief that healing happens in safe, supportive spaces. I strive to create an environment where you feel seen, heard, and gently challenged. Together, we’ll explore patterns, uncover root causes, and work through challenges like anxiety, depression, trauma, and parenting struggles to create meaningful, lasting change.
(509) 479-1711 View (509) 479-1711
Photo of Patrick W Caruso, Clinical Social Work/Therapist, MDiv, MSW
Patrick W Caruso
Clinical Social Work/Therapist, MDiv, MSW
Spokane, WA 99204
With 27 years of experience, I offer clients an integrative approach to psychotherapy that allows for in-depth work while at the same time being pragmatic and focused. You will have the opportunity to work on changes within yourself in an environment that is safe and attentive. Psychotherapy is a collaborative process of personal growth that can help you work through situational problems and change long-standing patterns.
With 27 years of experience, I offer clients an integrative approach to psychotherapy that allows for in-depth work while at the same time being pragmatic and focused. You will have the opportunity to work on changes within yourself in an environment that is safe and attentive. Psychotherapy is a collaborative process of personal growth that can help you work through situational problems and change long-standing patterns.
(509) 465-2300 View (509) 465-2300
Photo of Nuria Clarke-Fargharson, Counselor, MSEd, LMHA
Nuria Clarke-Fargharson
Counselor, MSEd, LMHA
3 Endorsed
Online Only
With over 20 years of dedicated experience in counseling, I am passionate about guiding individuals on their journey towards overall wellness. My commitment to facilitating positive change is grounded in the belief that there is no one-size-fits-all approach to mental health. I recognize that everyone's path to mental health is distinct, and I am dedicated to fostering a supportive environment that acknowledges and respects client's individual differences. You've taken the first step towards a healthier, happier life, let's continue this journey together.
With over 20 years of dedicated experience in counseling, I am passionate about guiding individuals on their journey towards overall wellness. My commitment to facilitating positive change is grounded in the belief that there is no one-size-fits-all approach to mental health. I recognize that everyone's path to mental health is distinct, and I am dedicated to fostering a supportive environment that acknowledges and respects client's individual differences. You've taken the first step towards a healthier, happier life, let's continue this journey together.
(509) 285-9251 View (509) 285-9251
Photo of Paul P Susac, Counselor, PhD, MA, LMHC
Paul P Susac
Counselor, PhD, MA, LMHC
1 Endorsed
Online Only
To the outside world, you have it all together. You’re the person who’s always on top of everything, eyes on the ball, getting things done. But, inside is a different story. People admire your drive, but the truth is you don’t feel like you have any choice but to keep pushing forward. You resent the feeling of being trapped on this path. But you know that if you slow down, even for a moment, you’ll have to deal with the pain you’ve been desperately trying to outrun. Of course, no matter how fast you go, the pain will always be there, ready to overwhelm you the first chance it gets. You don’t know what to do – it feels hopeless.
To the outside world, you have it all together. You’re the person who’s always on top of everything, eyes on the ball, getting things done. But, inside is a different story. People admire your drive, but the truth is you don’t feel like you have any choice but to keep pushing forward. You resent the feeling of being trapped on this path. But you know that if you slow down, even for a moment, you’ll have to deal with the pain you’ve been desperately trying to outrun. Of course, no matter how fast you go, the pain will always be there, ready to overwhelm you the first chance it gets. You don’t know what to do – it feels hopeless.
(509) 591-0581 View (509) 591-0581
Photo of Dr. Ami Owen, Marriage & Family Therapist, PhD, LMFT, CCTP, CCTS
Dr. Ami Owen
Marriage & Family Therapist, PhD, LMFT, CCTP, CCTS
Spokane, WA 99217
Dr. Ami Owen received her undergraduate degree in Social Science and a minor in Psychology. She received her Master’s in General Family Therapy with an advanced emphasis on families and trauma. Dr. Owen also received a Doctorate in Counseling and is a Clinically Certified Trauma Professional. She is Licensed in ID, WA, AZ, FL, CA, UT, NV and a nationally approved supervisor through the American Association of Marriage and Family Therapists (AAMFT). She takes delight in mentoring therapists on the complexities of family systems and consults with providers across the country to improve systems approaches.
Dr. Ami Owen received her undergraduate degree in Social Science and a minor in Psychology. She received her Master’s in General Family Therapy with an advanced emphasis on families and trauma. Dr. Owen also received a Doctorate in Counseling and is a Clinically Certified Trauma Professional. She is Licensed in ID, WA, AZ, FL, CA, UT, NV and a nationally approved supervisor through the American Association of Marriage and Family Therapists (AAMFT). She takes delight in mentoring therapists on the complexities of family systems and consults with providers across the country to improve systems approaches.
(509) 517-7166 View (509) 517-7166
Photo of Jess Cummings, Counselor, LMHCA
Jess Cummings
Counselor, LMHCA
Spokane, WA 99202
I specialize in working with individuals and families impacted by disability and neurodivergence. I bring both evidence-based techniques as well as lived experience to my work with disabled clients.
I specialize in working with individuals and families impacted by disability and neurodivergence. I bring both evidence-based techniques as well as lived experience to my work with disabled clients.
(509) 744-1117 x100 View (509) 744-1117 x100
Photo of Rebecca VanderLouw, Clinical Social Work/Therapist, MSW, LSWAIC
Rebecca VanderLouw
Clinical Social Work/Therapist, MSW, LSWAIC
1 Endorsed
Spokane, WA 99204
Waitlist for new clients
“The privilege of a lifetime is to become who you truly are.” Carl Jung – Life's early stages are often consumed by fulfilling roles essential for survival. However, true growth is found in shedding these roles to discover one's authentic self. Together, we'll honor your experiences as we work to rebuild self-trust, improve self-expression and boundaries, and cultivate personal growth. By reconnecting with your body's innate wisdom and embracing self-compassion, you can empower yourself to live a life that truly aligns with your values. Growth and thriving are possible!
“The privilege of a lifetime is to become who you truly are.” Carl Jung – Life's early stages are often consumed by fulfilling roles essential for survival. However, true growth is found in shedding these roles to discover one's authentic self. Together, we'll honor your experiences as we work to rebuild self-trust, improve self-expression and boundaries, and cultivate personal growth. By reconnecting with your body's innate wisdom and embracing self-compassion, you can empower yourself to live a life that truly aligns with your values. Growth and thriving are possible!
(509) 257-4514 View (509) 257-4514
Photo of Charlotte Harrington, Counselor, MA, LMHC, NCC
Charlotte Harrington
Counselor, MA, LMHC, NCC
4 Endorsed
Spokane, WA 99202
The seasons of life can feel impossible to navigate alone. Sometimes it’s a lost feeling of disconnection from ourselves. Other times maybe it’s the grief of losing someone we love. Or perhaps it’s a relationship that fuels anxiety or distress. Whatever the reason, counseling is a space for us to explore and discover the tools you need to connect, heal, and grow in new ways. My framework in our work together is grounded in attachment science and the belief that connection to self and other is a basic tenant of human wellness. While leaning in can be terrifying, I'll be there every step of the way.
The seasons of life can feel impossible to navigate alone. Sometimes it’s a lost feeling of disconnection from ourselves. Other times maybe it’s the grief of losing someone we love. Or perhaps it’s a relationship that fuels anxiety or distress. Whatever the reason, counseling is a space for us to explore and discover the tools you need to connect, heal, and grow in new ways. My framework in our work together is grounded in attachment science and the belief that connection to self and other is a basic tenant of human wellness. While leaning in can be terrifying, I'll be there every step of the way.
(509) 253-5804 View (509) 253-5804
Photo of Dianna Gulick, Counselor, MA, LMHC, CMHS
Dianna Gulick
Counselor, MA, LMHC, CMHS
4 Endorsed
Spokane, WA 99201
Are you having a difficult time managing emotions or thoughts that you once thought were manageable? Many people experience trauma or other adverse life events at some point in their lives. I believe each person has the potential to be free from the burden of symptoms that trauma, anxiety, and depression can create. People often come to counseling unsure of what they want to be different but knowing that they would like something to change. I enjoy working with people trying to identify goals and those who already have goals in mind.
Are you having a difficult time managing emotions or thoughts that you once thought were manageable? Many people experience trauma or other adverse life events at some point in their lives. I believe each person has the potential to be free from the burden of symptoms that trauma, anxiety, and depression can create. People often come to counseling unsure of what they want to be different but knowing that they would like something to change. I enjoy working with people trying to identify goals and those who already have goals in mind.
(509) 769-3510 View (509) 769-3510
Photo of Crystalena Lightel, Licensed Mental Health Counselor Associate , LMHCA
Crystalena Lightel
Licensed Mental Health Counselor Associate , LMHCA
3 Endorsed
Spokane, WA 99208
Healing begins with a safe, supportive, and nonjudgmental relationship. I see therapy as a collaborative effort—one where your experiences, emotions, and values are honored, and where we work together to create meaningful change. My path into therapy was shaped by both professional interest and personal experiences. I’ve seen how powerful it can be to have someone truly listen and witness your story. Whether you're navigating anxiety, depression, trauma, relationship challenges, or simply feeling stuck, I aim to provide a space where you can explore your inner world with compassion and clarity.
Healing begins with a safe, supportive, and nonjudgmental relationship. I see therapy as a collaborative effort—one where your experiences, emotions, and values are honored, and where we work together to create meaningful change. My path into therapy was shaped by both professional interest and personal experiences. I’ve seen how powerful it can be to have someone truly listen and witness your story. Whether you're navigating anxiety, depression, trauma, relationship challenges, or simply feeling stuck, I aim to provide a space where you can explore your inner world with compassion and clarity.
(509) 850-0847 View (509) 850-0847

See more therapy options for Spokane

How does your Therapist compare?

Number of Therapists in Spokane, WA

1,000+

Average cost per session

$150

Therapists in Spokane, WA who prioritize treating:

92% Anxiety
86% Depression
74% Trauma and PTSD
73% Relationship Issues
73% Self Esteem
71% Stress
67% Coping Skills

Average years in practice

7 Years

Top 3 insurances accepted

79% Aetna
72% Premera Blue Cross
72% Regence

How Therapists in Spokane, WA see their clients

53% Online Only
47% In Person and Online

Gender breakdown

77% Female
20% Male
3% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Spokane?

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.