Therapists in Boston, MA

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Photo of Rachel Schwartz, Counselor in Boston, MA
Rachel Schwartz
Counselor, LMHC
Verified Verified
2 Endorsed
Boston, MA 02108  (Online Only)
I am a Licensed Mental Health Counselor and graduate of Boston University. I strive to create an open, safe space to help people develop an understanding of themselves to better support them. I specialize in working with people who experience anxiety, panic disorders, depression, and have a history of experiencing trauma.
I am a Licensed Mental Health Counselor and graduate of Boston University. I strive to create an open, safe space to help people develop an understanding of themselves to better support them. I specialize in working with people who experience anxiety, panic disorders, depression, and have a history of experiencing trauma.
(617) 744-4349 View (617) 744-4349
Photo of Rachel Oppenheimer, Counselor in Boston, MA
Rachel Oppenheimer
Counselor, LMHC
Verified Verified
1 Endorsed
Boston, MA 02110
Spring 2024 - Accepting New Clients! Taking the first few steps toward working on your mental health is a sign of significant strength and resilience. Finding a therapist can definitely feel overwhelming, but taking the time to find the right fit and ensuring you feel a connection is worth the effort, and is actually a therapeutic element of engaging in therapy. I look forward to supporting you through this journey and investment in your mental well-being.
Spring 2024 - Accepting New Clients! Taking the first few steps toward working on your mental health is a sign of significant strength and resilience. Finding a therapist can definitely feel overwhelming, but taking the time to find the right fit and ensuring you feel a connection is worth the effort, and is actually a therapeutic element of engaging in therapy. I look forward to supporting you through this journey and investment in your mental well-being.
(617) 539-7139 View (617) 539-7139
Photo of Dr Barbara Lavi Dream Positioning System ™, Psychologist in Boston, MA
Dr Barbara Lavi Dream Positioning System ™
Psychologist, PsyD
Not Verified Not Verified
Boston, MA 02116  (Online Only)
Waitlist for new clients
Have the changes since the pandemic left you feeling stuck? Challenged? Do you want to enhance your life? Have you lost sight of your dreams? Whether you long to feel closer to your partner, are overwhelmed at work, or feel that being a parent leaves no time for your dreams, Dr. Lavi & her Dream Positioning System (DPS) can put YOU back in control of your life so you can start moving towards your dreams. Although the psychotherapeutic relationship lasts for life, therapy with Dr. Lavi will be as brief as possible. When issues arise down the road, clients can return to "recalculate"get back on track & reach their aspirations.
Have the changes since the pandemic left you feeling stuck? Challenged? Do you want to enhance your life? Have you lost sight of your dreams? Whether you long to feel closer to your partner, are overwhelmed at work, or feel that being a parent leaves no time for your dreams, Dr. Lavi & her Dream Positioning System (DPS) can put YOU back in control of your life so you can start moving towards your dreams. Although the psychotherapeutic relationship lasts for life, therapy with Dr. Lavi will be as brief as possible. When issues arise down the road, clients can return to "recalculate"get back on track & reach their aspirations.
(203) 212-9890 View (203) 212-9890
Photo of Taylor Lombard, Counselor in Boston, MA
Taylor Lombard
Counselor, LMHC, R-DMT, CIEC
Verified Verified
1 Endorsed
Boston, MA 02110
Spring 2024 - Accepting New Clients! Throughout life, we experience many transitions and challenges that are difficult to navigate. Sometimes, we need support in identifying and removing the barriers that can hold us back. I believe therapy is a collaborative effort between therapist and client and that we work together as a team to meet your goals. I utilize a strength-based, multicultural-informed and feminist lens to empower my clients to develop insight and bring out their inner resiliencies.
Spring 2024 - Accepting New Clients! Throughout life, we experience many transitions and challenges that are difficult to navigate. Sometimes, we need support in identifying and removing the barriers that can hold us back. I believe therapy is a collaborative effort between therapist and client and that we work together as a team to meet your goals. I utilize a strength-based, multicultural-informed and feminist lens to empower my clients to develop insight and bring out their inner resiliencies.
(617) 398-4217 View (617) 398-4217
Photo of Return to Center Counseling and Holistic Health, Counselor in Boston, MA
Return to Center Counseling and Holistic Health
Counselor, MA, LMHC, LicAc
Verified Verified
Boston, MA 02130
Beginning the search for a therapist can feel daunting, intimidating or overwhelming. I work with clients who are seeking to deeply embody their questions, reflections and emotions through dance-movement therapy (primarily authentic movement) and arts-based exploration (visual arts and writing). The clients I work with define themselves as deep feelers and imaginative thinkers.
Beginning the search for a therapist can feel daunting, intimidating or overwhelming. I work with clients who are seeking to deeply embody their questions, reflections and emotions through dance-movement therapy (primarily authentic movement) and arts-based exploration (visual arts and writing). The clients I work with define themselves as deep feelers and imaginative thinkers.
(857) 290-2076 View (857) 290-2076
Photo of Hadar Lutman, Clinical Social Work/Therapist in Boston, MA
Hadar Lutman
Clinical Social Work/Therapist, LICSW
Verified Verified
Boston, MA 02130  (Online Only)
Waitlist for new clients
“The good life is a process, not a state of being. It is a direction, not a destination."- Carl Rogers. With the ever-changing circumstances of life, despite our best efforts to maintain balance, we can find ourselves stuck, and overwhelmed.
“The good life is a process, not a state of being. It is a direction, not a destination."- Carl Rogers. With the ever-changing circumstances of life, despite our best efforts to maintain balance, we can find ourselves stuck, and overwhelmed.
(978) 288-1926 View (978) 288-1926
Photo of Mandy Datro, Clinical Social Work/Therapist in Boston, MA
Mandy Datro
Clinical Social Work/Therapist, LICSW
Verified Verified
1 Endorsed
Boston, MA 02129  (Online Only)
I have close to 15 years of experience as a Licensed Clinical Social Worker, across a variety of cultures; receiving my training and practicing in both Australia and the US. I work with adults, couples and families to achieve their goals and specialize in a range of clinical presentations including trauma, relationship and family of origin issues, men’s mental health and therapy for helping professionals, among others.
I have close to 15 years of experience as a Licensed Clinical Social Worker, across a variety of cultures; receiving my training and practicing in both Australia and the US. I work with adults, couples and families to achieve their goals and specialize in a range of clinical presentations including trauma, relationship and family of origin issues, men’s mental health and therapy for helping professionals, among others.
(617) 231-9799 View (617) 231-9799
Photo of Emily Murcko in Boston, MA
Emily Murcko
MEd
Verified Verified
Boston, MA 02130  (Online Only)
Accepting NEW patients as of February/ March 2024! Emily Murcko is a Boston-based clinical psychotherapist specializing in the holistic treatment of trauma-related disorders. Emily is passionate about providing empathetic, trauma-informed care to all of her patients, utilizing a wide variety of techniques, with a primarily person-centered approach. Above all, Emily believes the quality of connection between therapist and patient is critical, and is dedicated to creating strong interpersonal bonds in the therapeutic milieu.
Accepting NEW patients as of February/ March 2024! Emily Murcko is a Boston-based clinical psychotherapist specializing in the holistic treatment of trauma-related disorders. Emily is passionate about providing empathetic, trauma-informed care to all of her patients, utilizing a wide variety of techniques, with a primarily person-centered approach. Above all, Emily believes the quality of connection between therapist and patient is critical, and is dedicated to creating strong interpersonal bonds in the therapeutic milieu.
(857) 376-5477 View (857) 376-5477
Katalyst Psychological Family Center
Psychologist, PhD
Verified Verified
Boston, MA 02116
We are a group of mental health providers with over 15 years of experience working with children, adolescents, and families. We work with individuals and families who have parenting concerns, depression, anxiety, PTSD, ADHD, ODD, and autism. Our providers conduct neuropsychological evaluations for children and adults to help with diagnostic clarity and treatment planning.
We are a group of mental health providers with over 15 years of experience working with children, adolescents, and families. We work with individuals and families who have parenting concerns, depression, anxiety, PTSD, ADHD, ODD, and autism. Our providers conduct neuropsychological evaluations for children and adults to help with diagnostic clarity and treatment planning.
(857) 376-5367 View (857) 376-5367
Photo of Kristen LaRue, Clinical Social Work/Therapist in Boston, MA
Kristen LaRue
Clinical Social Work/Therapist, LICSW
Verified Verified
Boston, MA 02199  (Online Only)
Hello, I am a Licensed Independent Clinical Social Worker. I am licensed in both New Hampshire and Massachusetts. I graduated with my MSW from University of New Hampshire in 2018. I have extensive social work experience in hospitals, government and non profit settings, and transitioned into private practice work three years ago.
Hello, I am a Licensed Independent Clinical Social Worker. I am licensed in both New Hampshire and Massachusetts. I graduated with my MSW from University of New Hampshire in 2018. I have extensive social work experience in hospitals, government and non profit settings, and transitioned into private practice work three years ago.
(508) 290-4727 View (508) 290-4727
Photo of Cristina Vesprini, Counselor in Boston, MA
Cristina Vesprini
Counselor, LMHC
Verified Verified
1 Endorsed
Boston, MA 02110  (Online Only)
I believe "Feeling Good" matters and that it takes both strength and courage to seek out therapy. I am a licensed mental health counselor, who received my master's degree in mental health counseling from The College of Saint Rose in Albany, NY. I have 10+ years of experience working with children, teens, and adults providing both child, individual, and family therapy. Some of my specialty areas include life transitions, relationship/family issues and dynamics, narcissistic abuse, women's issues, self-worth, LGBTQ+, sexuality, and gender identity, along with grief and loss.
I believe "Feeling Good" matters and that it takes both strength and courage to seek out therapy. I am a licensed mental health counselor, who received my master's degree in mental health counseling from The College of Saint Rose in Albany, NY. I have 10+ years of experience working with children, teens, and adults providing both child, individual, and family therapy. Some of my specialty areas include life transitions, relationship/family issues and dynamics, narcissistic abuse, women's issues, self-worth, LGBTQ+, sexuality, and gender identity, along with grief and loss.
(617) 934-3862 View (617) 934-3862
Photo of Ashley M Weaver-Unadkat - Movement For The Mind, Counselor in Boston, MA
Ashley M Weaver-Unadkat - Movement For The Mind
Counselor, LMHC, LCAT, BC-DMT, CMA
Verified Verified
Boston, MA 02115  (Online Only)
The therapy session is a time and space one sets aside to focus on self. To be with self. And to build one’s self. It can be challenging to reflect on patterns, thoughts and emotions, relationships, past events and/or change, but it can also be transformative and rewarding. My role as your therapist is to witness your process and to reflect back with you along the way. The therapeutic relationship is an essential piece of my practice and is built on honesty, trust, empathy, and compassion.
The therapy session is a time and space one sets aside to focus on self. To be with self. And to build one’s self. It can be challenging to reflect on patterns, thoughts and emotions, relationships, past events and/or change, but it can also be transformative and rewarding. My role as your therapist is to witness your process and to reflect back with you along the way. The therapeutic relationship is an essential piece of my practice and is built on honesty, trust, empathy, and compassion.
(617) 535-8684 View (617) 535-8684
Photo of Elizabeth K Stout, Psychologist in Boston, MA
Elizabeth K Stout
Psychologist, PhD
Verified Verified
3 Endorsed
Boston, MA 02114  (Online Only)
Not accepting new clients
When you entrust your healing to my care, it is my sincere hope to help you feel seen, accepted, & valued. My practice is rooted in values of compassion, justice, & empowerment. I believe in the power of connection and relationship to help individuals move through their journey to their ideal self. I integrate body liberation and identity affirmation principles into a relational approach. I work well with folx who identify as larger-bodied , queer , and/or trans-, non-binary, and gender non-conforming. I also work well with individuals who are struggling to navigate a range of relationships, depression/anxiety, and trauma.
When you entrust your healing to my care, it is my sincere hope to help you feel seen, accepted, & valued. My practice is rooted in values of compassion, justice, & empowerment. I believe in the power of connection and relationship to help individuals move through their journey to their ideal self. I integrate body liberation and identity affirmation principles into a relational approach. I work well with folx who identify as larger-bodied , queer , and/or trans-, non-binary, and gender non-conforming. I also work well with individuals who are struggling to navigate a range of relationships, depression/anxiety, and trauma.
(978) 991-8795 View (978) 991-8795
Photo of Abigail Eaves (Calon Wellness: Psychotherapy And Coaching), Counselor in Boston, MA
Abigail Eaves (Calon Wellness: Psychotherapy And Coaching)
Counselor, PsyD, LMHC, LCPC
Verified Verified
Boston, MA 02109
Whether you want to shift thinking patterns, heal from trauma, adapt behavior, or are seeking deeper insights into your relationships, therapy can be powerful and life-altering. As a Psychotherapist and Leadership Psychologist, I partner with my clients to help them work through challenges so that new possibilities can emerge. When individuals or couples recognize how they make sense of their lives, their past, and their thinking habits, they move closer to living the life they want. My practice is psychodynamic, drawing on tools from a variety of modalities, such as coaching, yoga, meditation, CBT, and narrative therapy.
Whether you want to shift thinking patterns, heal from trauma, adapt behavior, or are seeking deeper insights into your relationships, therapy can be powerful and life-altering. As a Psychotherapist and Leadership Psychologist, I partner with my clients to help them work through challenges so that new possibilities can emerge. When individuals or couples recognize how they make sense of their lives, their past, and their thinking habits, they move closer to living the life they want. My practice is psychodynamic, drawing on tools from a variety of modalities, such as coaching, yoga, meditation, CBT, and narrative therapy.
(617) 752-8513 View (617) 752-8513
Photo of Amy Santana, Counselor in Boston, MA
Amy Santana
Counselor, LMHC, CCTP
Verified Verified
Boston, MA 02110  (Online Only)
Waitlist for new clients
Do you have a loud inner critic or a lot happening internally? Do you often feel overwhelmed or disconnected from yourself and others? Are you experiencing flashbacks or do you feel stuck in the past? I work with people experiencing symptoms of trauma and anxiety related to identity-based trauma, difficult experiences in childhood, or relationship trauma. I have significant experience working with LGBTQ survivors of abuse and trauma and have a particular interest in supporting QTPoC, BIPOC, neurodivergent clients, and those who struggle to feel a sense of belonging. I provide a space that is anti-racist and LGBTQ-affirming.
Do you have a loud inner critic or a lot happening internally? Do you often feel overwhelmed or disconnected from yourself and others? Are you experiencing flashbacks or do you feel stuck in the past? I work with people experiencing symptoms of trauma and anxiety related to identity-based trauma, difficult experiences in childhood, or relationship trauma. I have significant experience working with LGBTQ survivors of abuse and trauma and have a particular interest in supporting QTPoC, BIPOC, neurodivergent clients, and those who struggle to feel a sense of belonging. I provide a space that is anti-racist and LGBTQ-affirming.
(617) 855-0039 View (617) 855-0039
Photo of Katie McGeough, Clinical Social Work/Therapist in Boston, MA
Katie McGeough
Clinical Social Work/Therapist, LCSW
Verified Verified
Boston, MA 02131
Not accepting new clients
My style is based on the biopsychosocial model of therapy, which is grounded in the idea that mental health does not exist in a vacuum but is impacted by the systems we are a part of. Additionally, my therapeutic style draws from feminist theory, trauma informed therapy, acceptance and commitment therapy, and motivational interviewing. I have experience working with LGBTQIA+ individuals, victims of sexual violence, as well as individuals struggling with addiction. I am particularly interested in working with individuals that have experienced trauma around sexual violence as well as sexual and gender identity.
My style is based on the biopsychosocial model of therapy, which is grounded in the idea that mental health does not exist in a vacuum but is impacted by the systems we are a part of. Additionally, my therapeutic style draws from feminist theory, trauma informed therapy, acceptance and commitment therapy, and motivational interviewing. I have experience working with LGBTQIA+ individuals, victims of sexual violence, as well as individuals struggling with addiction. I am particularly interested in working with individuals that have experienced trauma around sexual violence as well as sexual and gender identity.
(857) 420-7212 View (857) 420-7212
Photo of Andrew James Maihos, Clinical Social Work/Therapist in Boston, MA
Andrew James Maihos
Clinical Social Work/Therapist, LICSW
Verified Verified
Boston, MA 02199  (Online Only)
Website: Mentalhealthwithandrewmaihos.com (Fully Remote and accepting Massachusetts, NH, VT, and Florida clients) My name is Andrew (AJ) Maihos I am a Licensed Independent Clinical Social Worker licensed in Massachusetts, Vermont, Florida, and New Hampshire. I have been working in human services since 2011 and have been practicing as a counselor since 2016. I have worked in a wide variety of settings including schools, prisons, substance abuse treatment facilities, and mental health centers. I have experience working with all age groups and a wide variety of mental health/substance use disorders.
Website: Mentalhealthwithandrewmaihos.com (Fully Remote and accepting Massachusetts, NH, VT, and Florida clients) My name is Andrew (AJ) Maihos I am a Licensed Independent Clinical Social Worker licensed in Massachusetts, Vermont, Florida, and New Hampshire. I have been working in human services since 2011 and have been practicing as a counselor since 2016. I have worked in a wide variety of settings including schools, prisons, substance abuse treatment facilities, and mental health centers. I have experience working with all age groups and a wide variety of mental health/substance use disorders.
(603) 509-3148 View (603) 509-3148
Photo of Jessica Hornig, MSW, LICSW, Clinical Social Work/Therapist in Boston, MA
Jessica Hornig, MSW, LICSW
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Boston, MA 02114  (Online Only)
Welcome and thank you for your interest in my practice. I am a Licensed Independent Clinical Social Worker in Rhode Island, Connecticut, and Massachusetts with 20 years of experience helping clients work through personal challenges. I focus on developing and fostering a safe, non-judgmental space in which clients can more comfortably explore their struggles and barriers to self-fulfillment. My approach to therapy is integrative and draws on multiple modalities, thus allowing me to tailor how I work with each client as an individual.
Welcome and thank you for your interest in my practice. I am a Licensed Independent Clinical Social Worker in Rhode Island, Connecticut, and Massachusetts with 20 years of experience helping clients work through personal challenges. I focus on developing and fostering a safe, non-judgmental space in which clients can more comfortably explore their struggles and barriers to self-fulfillment. My approach to therapy is integrative and draws on multiple modalities, thus allowing me to tailor how I work with each client as an individual.
(401) 249-4351 View (401) 249-4351
Photo of Zanita Bohea Zody, Marriage & Family Therapist in Boston, MA
Zanita Bohea Zody
Marriage & Family Therapist, PhD, LMFT
Verified Verified
Boston, MA 02115  (Online Only)
My work focuses on creating body trust and respect, healing from disordered eating behaviors and thoughts, and recovering from diagnosable eating disorders. I have worked across the continuum of all levels of care, age groups, genders, sexual orientations, races, and religions. My work combines honoring your individual story and path toward recovery with evidenced-based interventions to provide you with the tools and information you need for that journey. For my younger clients, this often also includes working with parents so they can effectively support their loved one's recovery.
My work focuses on creating body trust and respect, healing from disordered eating behaviors and thoughts, and recovering from diagnosable eating disorders. I have worked across the continuum of all levels of care, age groups, genders, sexual orientations, races, and religions. My work combines honoring your individual story and path toward recovery with evidenced-based interventions to provide you with the tools and information you need for that journey. For my younger clients, this often also includes working with parents so they can effectively support their loved one's recovery.
(857) 466-2017 View (857) 466-2017
Photo of Jeffrey Ly I Porn Addiction Relationships in Boston, MA
Jeffrey Ly I Porn Addiction Relationships
LPHA, MA, AMFT
Verified Verified
Boston, MA 02109  (Online Only)
Pornography addiction can significantly impact your life and relationships but there is hope for recovery. I’m not just a mental health professional, I’ve been “you” for many years. I understand firsthand the personal struggles in your life and committed relationships that come with uncontrollable pornography use. The endless stream of attractive women a few clicks away on Pornhub, Onlyfan or Social Media is hard to quit even with all your willpower and promise to quit for the sake of your relationship.
Pornography addiction can significantly impact your life and relationships but there is hope for recovery. I’m not just a mental health professional, I’ve been “you” for many years. I understand firsthand the personal struggles in your life and committed relationships that come with uncontrollable pornography use. The endless stream of attractive women a few clicks away on Pornhub, Onlyfan or Social Media is hard to quit even with all your willpower and promise to quit for the sake of your relationship.
(857) 887-2451 View (857) 887-2451

How does your Therapist compare?

Number of Therapists in Boston, MA

3,000+

Average cost per session

$160

Therapists in Boston, MA who prioritize treating:

93% Anxiety
86% Depression
76% Relationship Issues
74% Self Esteem
69% Stress
68% Trauma and PTSD
68% Coping Skills

Average years in practice

11 Years

Top 3 insurances accepted

78% BlueCross and BlueShield
61% UnitedHealthcare UHC | UBH
59% Aetna

How Therapists in Boston, MA see their clients

60% Online Only
40% In Person and Online

Gender breakdown

79% Female
19% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Boston?

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.