Therapists in Tacoma, WA

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Photo of Stephanie Munizza, Marriage & Family Therapist in Tacoma, WA
Stephanie Munizza
Marriage & Family Therapist, MA, LMFT
Verified Verified
Tacoma, WA 98403
Perhaps you’re coming from the school of hard knocks. Because of your own trauma history, you may be re-creating painful experiences that are familiar and habitual. You want something more and/or different, but you don't know how to change. If you’re reading this, you might be interested in an offering of slowing down and practicing mindfulness as a way to befriend the various parts of your Self and understand your mind / body connection. You may wish to release burdens that no longer serve you. When a feeling of safety, connection, and choice is experienced within you, thriving is not only possible; it can become a way of life.
Perhaps you’re coming from the school of hard knocks. Because of your own trauma history, you may be re-creating painful experiences that are familiar and habitual. You want something more and/or different, but you don't know how to change. If you’re reading this, you might be interested in an offering of slowing down and practicing mindfulness as a way to befriend the various parts of your Self and understand your mind / body connection. You may wish to release burdens that no longer serve you. When a feeling of safety, connection, and choice is experienced within you, thriving is not only possible; it can become a way of life.
(253) 733-2088 View (253) 733-2088
Photo of Sunil K Kakar, Psychologist in Tacoma, WA
Sunil K Kakar
Psychologist, PsyD
Verified Verified
1 Endorsed
Tacoma, WA 98402
Congratulations for taking the first step towards helping yourself! Psychotherapy is a collaborative process and I define my job as meeting you where you are, identifying where you might be stuck, and helping you to move towards your goals. Each person is unique and treatment needs to be tailored to your goals. Effective treatment helps a person to adapt to change, manage stress and to be more effective in their lives and relationships.
Congratulations for taking the first step towards helping yourself! Psychotherapy is a collaborative process and I define my job as meeting you where you are, identifying where you might be stuck, and helping you to move towards your goals. Each person is unique and treatment needs to be tailored to your goals. Effective treatment helps a person to adapt to change, manage stress and to be more effective in their lives and relationships.
(253) 400-2856 View (253) 400-2856
Photo of Elizabeth Ecklund, Clinical Social Work/Therapist in Tacoma, WA
Elizabeth Ecklund
Clinical Social Work/Therapist, MSW, BSN, LSWAIC, RN
Verified Verified
Tacoma, WA 98402
Elizabeth specializes in working with adults who experience stress, anxiety and/or depression, are high achievers (or would like to be), legal system workers, healthcare workers, first responders, law enforcement, athletes, entrepreneurs and military members. Her clients generally report feeling “burned out”, “stuck”, “lost”, “misdirected” and/or have anxiety about the future. Young adult clients may be experiencing family pressures and conflict internally between what they would like to do with their future and what their family wants/expects. Elizabeth helps them to gain focus, find joy, purpose and sense of control.
Elizabeth specializes in working with adults who experience stress, anxiety and/or depression, are high achievers (or would like to be), legal system workers, healthcare workers, first responders, law enforcement, athletes, entrepreneurs and military members. Her clients generally report feeling “burned out”, “stuck”, “lost”, “misdirected” and/or have anxiety about the future. Young adult clients may be experiencing family pressures and conflict internally between what they would like to do with their future and what their family wants/expects. Elizabeth helps them to gain focus, find joy, purpose and sense of control.
(253) 319-1299 View (253) 319-1299
Photo of Megan Scott, Clinical Social Work/Therapist in Tacoma, WA
Megan Scott
Clinical Social Work/Therapist, LICSWA
Verified Verified
Tacoma, WA 98402
In my life, I have had many experiences that guided me to the world of social work, such as becoming a teen mom and experiencing the loss of people very close to me. These experiences led me to want to provide support to people in the midst of their own challenges. Maybe you have similar experiences or other mental health challenges, that may include anxiety and depression. You may feel that you have nowhere to turn or unvalidated in your own experiences. I am here to help, in our work together we can find the best ways to meet your individual needs.
In my life, I have had many experiences that guided me to the world of social work, such as becoming a teen mom and experiencing the loss of people very close to me. These experiences led me to want to provide support to people in the midst of their own challenges. Maybe you have similar experiences or other mental health challenges, that may include anxiety and depression. You may feel that you have nowhere to turn or unvalidated in your own experiences. I am here to help, in our work together we can find the best ways to meet your individual needs.
(253) 447-5385 View (253) 447-5385
Photo of Girasol Counseling, Clinical Social Work/Therapist in Tacoma, WA
Girasol Counseling
Clinical Social Work/Therapist, MSW, LSWAIC
Verified Verified
5 Endorsed
Tacoma, WA 98402
Girasol Counseling is a Latine, women, and queer owned group practice. At Girasol Counseling we are committed to the work of de-stigmatization and decolonization of mental health that advocates for collective healing practices grounded in liberation, culture, and spirituality. We believe that everyone has the inner capacity for healing ignited through self discovery and community. Our role as therapists is to facilitate healing and support your journey in homecoming to your essential self/your tribe/community of trust/sagna.
Girasol Counseling is a Latine, women, and queer owned group practice. At Girasol Counseling we are committed to the work of de-stigmatization and decolonization of mental health that advocates for collective healing practices grounded in liberation, culture, and spirituality. We believe that everyone has the inner capacity for healing ignited through self discovery and community. Our role as therapists is to facilitate healing and support your journey in homecoming to your essential self/your tribe/community of trust/sagna.
(253) 676-9291 View (253) 676-9291
Photo of Eugenia Kang, Clinical Social Work/Therapist in Tacoma, WA
Eugenia Kang
Clinical Social Work/Therapist, LICSWA
Verified Verified
Tacoma, WA 98402
Not accepting new clients
I am a clinical social worker based in Tacoma, Washington! I have experience working with children, teens, and adults in residential, school, and community settings.
I am a clinical social worker based in Tacoma, Washington! I have experience working with children, teens, and adults in residential, school, and community settings.
(253) 400-3565 View (253) 400-3565
Photo of Andrew Rogers, Counselor in Tacoma, WA
Andrew Rogers
Counselor, MA, LMHC
Verified Verified
3 Endorsed
Tacoma, WA 98403
Are you struggling with changes in your life and looking for a better way to cope? Are you trying to find direction and meaning? Perhaps you're wondering why life doesn't feel more rewarding or you can't seem to find happiness or peace. You may be feeling lonely and struggling to find relationships and friendships to help you during hard times. It can be really challenging living in the Pacific Northwest and finding friendship or relationships.
Are you struggling with changes in your life and looking for a better way to cope? Are you trying to find direction and meaning? Perhaps you're wondering why life doesn't feel more rewarding or you can't seem to find happiness or peace. You may be feeling lonely and struggling to find relationships and friendships to help you during hard times. It can be really challenging living in the Pacific Northwest and finding friendship or relationships.
(206) 350-1584 View (206) 350-1584
Photo of John J. Smith, Counselor in Tacoma, WA
John J. Smith
Counselor, LMHCA, MFT
Verified Verified
Tacoma, WA 98406  (Online Only)
I believe that everyone comes to a place in their life and experiences the feeling of being”stuck” and not knowing what to do next. Anger, anxiety and depression can leave a person feeling overwhelmed and unsure. While people often have a strong desire for change find it difficult to reach out for help. As a licensed mental health counselor have helped many singles couples and families heal and grow, and I can do the same for you.If you are ready to take that first step then please call me. I look forward to meeting you. Sincerely, John J. Smith LMHCA
I believe that everyone comes to a place in their life and experiences the feeling of being”stuck” and not knowing what to do next. Anger, anxiety and depression can leave a person feeling overwhelmed and unsure. While people often have a strong desire for change find it difficult to reach out for help. As a licensed mental health counselor have helped many singles couples and families heal and grow, and I can do the same for you.If you are ready to take that first step then please call me. I look forward to meeting you. Sincerely, John J. Smith LMHCA
(253) 252-5027 View (253) 252-5027
Photo of Sean Patrick Whalen, Counselor in Tacoma, WA
Sean Patrick Whalen
Counselor, MA, MS, LMHC, CSOTP
Verified Verified
Tacoma, WA 98402
Not accepting new clients
Not Taking New Clients- - If you are finding that worries, fears, feeling too little or feeling too much are keeping you from living the life you want help is available. Whether it's adjusting to big changes in your life, dealing with fears and worries that seem like they have always been there, or struggling to make and keep relationships help is available. Most of us get stuck at some point in our life and need someone to support and guide us to get back on track.
Not Taking New Clients- - If you are finding that worries, fears, feeling too little or feeling too much are keeping you from living the life you want help is available. Whether it's adjusting to big changes in your life, dealing with fears and worries that seem like they have always been there, or struggling to make and keep relationships help is available. Most of us get stuck at some point in our life and need someone to support and guide us to get back on track.
(253) 201-1256 View (253) 201-1256
Photo of Jessica Ryan Parry, Mental Health Counselor in Tacoma, WA
Jessica Ryan Parry
Mental Health Counselor, MS, LMHC, SUDP
Verified Verified
1 Endorsed
Tacoma, WA 98402
My ideal clients are neuroqueer- individuals who identify as both neurodivergent and queer. I am invested in the intersectionality of neurodiversity and gender identity, and passionate about helping neuroqueer individuals on their journey towards self-discovery and self-acceptance. Whether it's navigating gender dysphoria, exploring identity, coping with anxiety or depression, learning self-advocacy, addressing the effects of chronic masking, or other challenges faced by neurodivergent people, my aim is to empower individuals to lead fulfilling and authentic lives.
My ideal clients are neuroqueer- individuals who identify as both neurodivergent and queer. I am invested in the intersectionality of neurodiversity and gender identity, and passionate about helping neuroqueer individuals on their journey towards self-discovery and self-acceptance. Whether it's navigating gender dysphoria, exploring identity, coping with anxiety or depression, learning self-advocacy, addressing the effects of chronic masking, or other challenges faced by neurodivergent people, my aim is to empower individuals to lead fulfilling and authentic lives.
(253) 802-7557 View (253) 802-7557
Photo of Maggie Stang, Marriage & Family Therapist in Tacoma, WA
Maggie Stang
Marriage & Family Therapist, MA, LMFT
Verified Verified
3 Endorsed
Tacoma, WA 98406  (Online Only)
Hi there, I’m Maggie. If you are looking for a nurturing therapist who is genuine, wants the best for your unique life, and will challenge you towards deeper healing, we could be a good fit. I would love to support you as you begin to embrace your intersecting and unfolding identities. My specialties as a therapist include body liberation (Health At Every Size), life transitions, and exploration of self through a relational lens. My approach is centered within an anti-oppressive, anti-racist, and liberatory lens. I am a queer and neurodivergent therapist, and I enjoy supporting folks with these shared identities.
Hi there, I’m Maggie. If you are looking for a nurturing therapist who is genuine, wants the best for your unique life, and will challenge you towards deeper healing, we could be a good fit. I would love to support you as you begin to embrace your intersecting and unfolding identities. My specialties as a therapist include body liberation (Health At Every Size), life transitions, and exploration of self through a relational lens. My approach is centered within an anti-oppressive, anti-racist, and liberatory lens. I am a queer and neurodivergent therapist, and I enjoy supporting folks with these shared identities.
(253) 364-7913 View (253) 364-7913
Photo of Larissa Chen Swanland, Counselor in Tacoma, WA
Larissa Chen Swanland
Counselor, LMHCA
Verified Verified
5 Endorsed
Tacoma, WA 98422
Do you feel stuck? Through living our lives, we develop mechanisms to navigate specific contexts, but sometimes, those methods no longer work or we grow tired of them. Some signs of being stuck manifest as complicated relationships, a lack of creativity, loss of agency, inability to rest, hesitancy to play, feelings of overwhelm or a lack of interest in life. Together, we can empower your story and regain movement by having an empathetic witness journey with you, navigate your particular context, the relationships/systems around you, your unique brain and perception of self.
Do you feel stuck? Through living our lives, we develop mechanisms to navigate specific contexts, but sometimes, those methods no longer work or we grow tired of them. Some signs of being stuck manifest as complicated relationships, a lack of creativity, loss of agency, inability to rest, hesitancy to play, feelings of overwhelm or a lack of interest in life. Together, we can empower your story and regain movement by having an empathetic witness journey with you, navigate your particular context, the relationships/systems around you, your unique brain and perception of self.
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Desiree Turner
Counselor, MEd, LMHC
Verified Verified
Tacoma, WA 98406
I focus on helping my clients understand and heal attachment issues, processing of trauma, resolving parenting difficulties, and work/life conflicts. My goal is to give my clients a place to feel safe to discuss the stresses and troubles they may be experiencing. Although I counsel people of all ages, I particularly enjoy seeing children under the age of 18. I also like to provide support for parents and help the family achieve regulation by improving understanding and communication between family members.
I focus on helping my clients understand and heal attachment issues, processing of trauma, resolving parenting difficulties, and work/life conflicts. My goal is to give my clients a place to feel safe to discuss the stresses and troubles they may be experiencing. Although I counsel people of all ages, I particularly enjoy seeing children under the age of 18. I also like to provide support for parents and help the family achieve regulation by improving understanding and communication between family members.
(253) 237-4973 View (253) 237-4973
Photo of Kelsey Schank, Marriage & Family Therapist in Tacoma, WA
Kelsey Schank
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Tacoma, WA 98403
Therapy is a place to feel heard, validated and offer growth and change to your life.  I am here to support your needs whether you are looking as an individual, couple or family. Every person holds a unique story and experiences; it is my goal to work collaboratively with you to achieve personal goals and growth throughout the therapy experience. I work with teens, adults, couples and families and bring a systemic focus on each individual’s needs in session. Traditional and non-traditional families are welcome.
Therapy is a place to feel heard, validated and offer growth and change to your life.  I am here to support your needs whether you are looking as an individual, couple or family. Every person holds a unique story and experiences; it is my goal to work collaboratively with you to achieve personal goals and growth throughout the therapy experience. I work with teens, adults, couples and families and bring a systemic focus on each individual’s needs in session. Traditional and non-traditional families are welcome.
(253) 676-9397 View (253) 676-9397
Photo of Olivia McKenna, Marriage & Family Therapist in Tacoma, WA
Olivia McKenna
Marriage & Family Therapist, MA, LMFT
Verified Verified
2 Endorsed
Tacoma, WA 98422
Not accepting new clients
There are times in our lives when we feel stuck. We struggle with transition, grief, and loss. We may find it difficult to relate to others or even ourselves. My approach to therapy with adolescents, men, women, and families is client-centered and collaborative. My role is to help you solve your problems in positive and fulfilling ways. I provide a safe and compassionate place where you can find balance, connection and growth. Because my experience involves working with children, teens, adults and families, I hold a broad scope and view you as a whole person.
There are times in our lives when we feel stuck. We struggle with transition, grief, and loss. We may find it difficult to relate to others or even ourselves. My approach to therapy with adolescents, men, women, and families is client-centered and collaborative. My role is to help you solve your problems in positive and fulfilling ways. I provide a safe and compassionate place where you can find balance, connection and growth. Because my experience involves working with children, teens, adults and families, I hold a broad scope and view you as a whole person.
(253) 214-3725 View (253) 214-3725
Photo of Mary Allison Jensen, Clinical Social Work/Therapist in Tacoma, WA
Mary Allison Jensen
Clinical Social Work/Therapist, MSW, LICSW, CMHS, IMH-E
Verified Verified
Tacoma, WA 98407
My ideal clients are motivated to explore the origin of unhelpful patterns of thought, emotion, and behavior. I am a certified clinical trauma specialist and primarily work with adults and adolescents who have experienced adversity and/or trauma. My clients often present with a feeling of being stuck and through a collaborative process of reflection and skill-building we identify the most effective personalized strategies. I am also a certified compassion fatigue specialist and work extensively with professionals around compassion fatigue and burnout.
My ideal clients are motivated to explore the origin of unhelpful patterns of thought, emotion, and behavior. I am a certified clinical trauma specialist and primarily work with adults and adolescents who have experienced adversity and/or trauma. My clients often present with a feeling of being stuck and through a collaborative process of reflection and skill-building we identify the most effective personalized strategies. I am also a certified compassion fatigue specialist and work extensively with professionals around compassion fatigue and burnout.
(253) 499-7896 View (253) 499-7896
Photo of Meaghan Trezza, Counselor in Tacoma, WA
Meaghan Trezza
Counselor, LMHC, MS, NCC
Verified Verified
Tacoma, WA 98405
I am a Licensed Mental Health Therapist with a passion for helping individuals connect with themselves, their strengths, and joy to live a more balanced and fulfilling life. In my practice, I utilize a combination of person-centered, Somatic Experiencing, existential, self-compassion work, and mindfulness-based interventions. My approach is multicultural and intersectional, utilizing my degree in political science to take into account the impact that oppressive systems have on mental health. My approach is relational, trauma-informed, and showing up genuine, authentic, and curious in our space together.
I am a Licensed Mental Health Therapist with a passion for helping individuals connect with themselves, their strengths, and joy to live a more balanced and fulfilling life. In my practice, I utilize a combination of person-centered, Somatic Experiencing, existential, self-compassion work, and mindfulness-based interventions. My approach is multicultural and intersectional, utilizing my degree in political science to take into account the impact that oppressive systems have on mental health. My approach is relational, trauma-informed, and showing up genuine, authentic, and curious in our space together.
(253) 352-3476 View (253) 352-3476
Photo of Andrew Martin Knight, Counselor in Tacoma, WA
Andrew Martin Knight
Counselor, MAC, LMHCA
Verified Verified
Tacoma, WA 98402  (Online Only)
I can help clients when they are at a difficult moment dealing with complex life transitions and experiencing grief, anxiety, stress, and anger. I prefer to help clients with existential methods that invoke depth orientated psychological approaches from Jung, Gestalt, and stoicism. Clients that are able to receive homework assignments for mindfulness and reflect on the challenges they are having will be the best equipped to look at introspection and navigate their mood disturbances with assistance in the therapeutic relationship.
I can help clients when they are at a difficult moment dealing with complex life transitions and experiencing grief, anxiety, stress, and anger. I prefer to help clients with existential methods that invoke depth orientated psychological approaches from Jung, Gestalt, and stoicism. Clients that are able to receive homework assignments for mindfulness and reflect on the challenges they are having will be the best equipped to look at introspection and navigate their mood disturbances with assistance in the therapeutic relationship.
(253) 528-7350 View (253) 528-7350
Photo of Morgan Shields, Marriage & Family Therapist Associate in Tacoma, WA
Morgan Shields
Marriage & Family Therapist Associate, MA, LMFTA
Verified Verified
Tacoma, WA 98408  (Online Only)
I work with adults ages 18+ to provide support for anxiety, trauma, relationships, and LGBTQ+ identities. I work from an anti-oppression and social justice oriented framework, and my work with clients often focuses on themes of personal agency and empowerment, shame resolution, and self-acceptance. I enjoy supporting clients with issues related to burnout, chronic stress, anxiety, and trauma to live more authentically alignment with their values and to build stronger and more connective relationships with themselves and others.
I work with adults ages 18+ to provide support for anxiety, trauma, relationships, and LGBTQ+ identities. I work from an anti-oppression and social justice oriented framework, and my work with clients often focuses on themes of personal agency and empowerment, shame resolution, and self-acceptance. I enjoy supporting clients with issues related to burnout, chronic stress, anxiety, and trauma to live more authentically alignment with their values and to build stronger and more connective relationships with themselves and others.
(253) 243-8652 View (253) 243-8652
Photo of Winona Wallace, Counselor in Tacoma, WA
Winona Wallace
Counselor, LMHC
Verified Verified
Tacoma, WA 98405
Winona enjoys working with adolescents and adults of all ages. She works with clients dealing with mood disorders, personality disorders, anxiety, self-esteem issues, PTSD, grief and loss, and those facing other life challenges. In addition, she has worked with clients experiencing domestic violence. Her objective is to help individuals heal, and then find and build on their strengths in order to achieve their goals and become their very best selves. Winona enjoys working with clients and assisting them in developing coping skills that they can use for the rest of their lives.
Winona enjoys working with adolescents and adults of all ages. She works with clients dealing with mood disorders, personality disorders, anxiety, self-esteem issues, PTSD, grief and loss, and those facing other life challenges. In addition, she has worked with clients experiencing domestic violence. Her objective is to help individuals heal, and then find and build on their strengths in order to achieve their goals and become their very best selves. Winona enjoys working with clients and assisting them in developing coping skills that they can use for the rest of their lives.
(253) 523-2311 View (253) 523-2311

How does your Therapist compare?

Number of Therapists in Tacoma, WA

1,000+

Average cost per session

$150

Therapists in Tacoma, WA who prioritize treating:

93% Anxiety
88% Depression
76% Trauma and PTSD
75% Relationship Issues
75% Self Esteem
70% Stress
67% Coping Skills

Average years in practice

9 Years

Top 3 insurances accepted

78% Premera
66% Regence
61% Aetna

How Therapists in Tacoma, WA see their clients

50% In Person and Online
50% Online Only

Gender breakdown

75% Female
21% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Tacoma?

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.