Therapists in Spokane, WA

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Photo of Julie Peters Counseling, Clinical Social Work/Therapist in Spokane, WA
Julie Peters Counseling
Clinical Social Work/Therapist, LICSW
Verified Verified
Spokane, WA 99205  (Online Only)
Not accepting new clients
Congratulations in taking the brave step of considering therapy. I'm a Licensed Clinical Social Worker and I've worked with people from many diverse walks of life. I became a therapist a little later in life, my life experiences inform my practice and I understand we all do the best we can with what we have. I’m here to partner with you on this journey.
Congratulations in taking the brave step of considering therapy. I'm a Licensed Clinical Social Worker and I've worked with people from many diverse walks of life. I became a therapist a little later in life, my life experiences inform my practice and I understand we all do the best we can with what we have. I’m here to partner with you on this journey.
(509) 516-2514 View (509) 516-2514
Photo of Khadija Ewalt, Counselor in Spokane, WA
Khadija Ewalt
Counselor, LMHCA, SUDPT
Verified Verified
Spokane, WA 99201  (Online Only)
We ALL need a therapist, whether we like to admit it or not. We’re either struggling with our internal dialogue or external actions and behaviors, having the space and freedom to say what we wish to but can’t/won’t goes a long way in helping us feel more like us.
We ALL need a therapist, whether we like to admit it or not. We’re either struggling with our internal dialogue or external actions and behaviors, having the space and freedom to say what we wish to but can’t/won’t goes a long way in helping us feel more like us.
(509) 745-5651 View (509) 745-5651
Photo of Jennifer Kizima, Clinical Social Work/Therapist in Spokane, WA
Jennifer Kizima
Clinical Social Work/Therapist, MA, LICSW
Verified Verified
Spokane, WA 99201  (Online Only)
Welcome. Navigating the challenges of today's world can be hard to do alone. This journey can feel even more difficult when we are dealing with negative feelings and stressful events. I believe therapy is more than a place to talk about our feelings and experiences. Therapy should provide a warm and welcoming safe environment. It should be free of judgments and offer you the space to form a trusting and respectful therapeutic relationship on your own terms. As a therapist, I strive to provide transparency and compassion in a setting that is never rushed and always client lead, via Telehealth.
Welcome. Navigating the challenges of today's world can be hard to do alone. This journey can feel even more difficult when we are dealing with negative feelings and stressful events. I believe therapy is more than a place to talk about our feelings and experiences. Therapy should provide a warm and welcoming safe environment. It should be free of judgments and offer you the space to form a trusting and respectful therapeutic relationship on your own terms. As a therapist, I strive to provide transparency and compassion in a setting that is never rushed and always client lead, via Telehealth.
(509) 481-9438 View (509) 481-9438
Photo of Harvey Caine, Counselor in Spokane, WA
Harvey Caine
Counselor, CC, LMP
Verified Verified
Spokane, WA 99202
I specialize in helping the whole person, body, mind and spirit. I offer non traditional approaches to counseling, focused on identifying and healing the underlying causes to problems.With over 30 years experience as an intuitive counselor and massage therapist I also utilize my expertise in the mind-body connection to help you transform your life and reach your goals efficiently.
I specialize in helping the whole person, body, mind and spirit. I offer non traditional approaches to counseling, focused on identifying and healing the underlying causes to problems.With over 30 years experience as an intuitive counselor and massage therapist I also utilize my expertise in the mind-body connection to help you transform your life and reach your goals efficiently.
(509) 572-3833 View (509) 572-3833
Photo of Alyson Gamache Hervatine, Clinical Social Work/Therapist in Spokane, WA
Alyson Gamache Hervatine
Clinical Social Work/Therapist, MS, MSW, LICSW-A
Verified Verified
Spokane, WA 99204
I work with individuals and families from an attachment perspective. I have worked extensively with children ages three and up in individual and family therapy, utilizing play, art and talk therapies to help individuals handle challenging situations at home and/or school, or within their own internal world. I can help children build resilience, self-reliance, and their self-regulatory skills. I work with parents, helping them to better meet their children's needs while fostering a better relationship. I work with adults on the myriad of life transitions they are working through, helping them better cope with their everyday stresses.
I work with individuals and families from an attachment perspective. I have worked extensively with children ages three and up in individual and family therapy, utilizing play, art and talk therapies to help individuals handle challenging situations at home and/or school, or within their own internal world. I can help children build resilience, self-reliance, and their self-regulatory skills. I work with parents, helping them to better meet their children's needs while fostering a better relationship. I work with adults on the myriad of life transitions they are working through, helping them better cope with their everyday stresses.
(509) 779-6216 View (509) 779-6216
Photo of Jennine E Powell, Marriage & Family Therapist in Spokane, WA
Jennine E Powell
Marriage & Family Therapist, LMFT
Verified Verified
Spokane, WA 99205
Hi! I'm Jennine! I am here to help you improve your relationships, feel better emotionally, and fill up your emotional toolbox. Yes - I am taking on new clients. Yes - I have in-person counseling sessions. I am certified in Emotionally Focused Therapy and I work at getting to the root of the issues quickly. With years of experience in the field, I have earned a reputation for my expertise in fostering healthy relationships and facilitating personal growth. Let's Talk! Give me a call.
Hi! I'm Jennine! I am here to help you improve your relationships, feel better emotionally, and fill up your emotional toolbox. Yes - I am taking on new clients. Yes - I have in-person counseling sessions. I am certified in Emotionally Focused Therapy and I work at getting to the root of the issues quickly. With years of experience in the field, I have earned a reputation for my expertise in fostering healthy relationships and facilitating personal growth. Let's Talk! Give me a call.
(509) 563-7205 View (509) 563-7205
Photo of Sarah X Winn, Marriage & Family Therapist in Spokane, WA
Sarah X Winn
Marriage & Family Therapist, MA, LMHC, LMFTA
Not Verified Not Verified
Spokane, WA 99204
I provide counseling services for children, youth, young adults, adults and families. I utilize a variety of orientations, methods and techniques, based on what is most appropriate for my clients at any given time. Together with clients I explore their unique selves, including their thoughts, feelings and experiences. My goal is to accompany them on their healing journey towards empowerment, greater self-awareness, knowledge and hope. I also aim to assist clients in identifying how their life experiences have helped make them the person they are and to recognize areas where they may have gotten stuck.
I provide counseling services for children, youth, young adults, adults and families. I utilize a variety of orientations, methods and techniques, based on what is most appropriate for my clients at any given time. Together with clients I explore their unique selves, including their thoughts, feelings and experiences. My goal is to accompany them on their healing journey towards empowerment, greater self-awareness, knowledge and hope. I also aim to assist clients in identifying how their life experiences have helped make them the person they are and to recognize areas where they may have gotten stuck.
(509) 412-3727 View (509) 412-3727
Photo of Allie Zachariades, Counselor in Spokane, WA
Allie Zachariades
Counselor, MA, LMHC, RYT
Verified Verified
4 Endorsed
Spokane, WA 99204
I enjoy working with clients who are experiencing difficult life transitions, adoption, sexual trauma, mood and anxiety disorders, and those who aren't quite sure what category they would fall into. Once you walk into the room it is up to the therapist & the client to figure out how the therapist can facilitate personal life growth.In session we will learn to Express ourselves through art, nature, our bodies and minds. We may take a walk, create something abstract or sit and talk; the therapy adventure is yours and I am simply a therapist to guide you towards stability, growth and your highest potential.
I enjoy working with clients who are experiencing difficult life transitions, adoption, sexual trauma, mood and anxiety disorders, and those who aren't quite sure what category they would fall into. Once you walk into the room it is up to the therapist & the client to figure out how the therapist can facilitate personal life growth.In session we will learn to Express ourselves through art, nature, our bodies and minds. We may take a walk, create something abstract or sit and talk; the therapy adventure is yours and I am simply a therapist to guide you towards stability, growth and your highest potential.
(509) 550-0608 View (509) 550-0608
Photo of Sarah Walsh, Clinical Social Work/Therapist in Spokane, WA
Sarah Walsh
Clinical Social Work/Therapist, MSW, LSWAIC
Verified Verified
2 Endorsed
Spokane, WA 99201
Waitlist for new clients
My business is named Muddy Lotus Wellness & Therapy because lotuses need mud in order to grow. I believe that's an apt metaphor for therapy and how we can find value in the mud we grow in the midst of. It's my hope that I can provide an environment where you feel safe and heard so you can grow, dream and heal. I identify with what Carl R. Rogers said. “The gentle and sensitive companionship of an empathic stance… provides illumination and healing. In such situations deep understanding is, I believe, the most precious gift one can give to another.”
My business is named Muddy Lotus Wellness & Therapy because lotuses need mud in order to grow. I believe that's an apt metaphor for therapy and how we can find value in the mud we grow in the midst of. It's my hope that I can provide an environment where you feel safe and heard so you can grow, dream and heal. I identify with what Carl R. Rogers said. “The gentle and sensitive companionship of an empathic stance… provides illumination and healing. In such situations deep understanding is, I believe, the most precious gift one can give to another.”
(760) 453-0796 View (760) 453-0796
Photo of Sammy Blatner in Spokane, WA
Sammy Blatner
MA, LMHCA
Verified Verified
1 Endorsed
Spokane, WA 99202
I believe it is possible to experience peace in any of life’s circumstances. One thing that comes between us and this peace, however, is our thoughts - without intentional direction for our thoughts, we tend to fixate on our fears, anxieties, and doubts. When this happens, we turn inward and lose connection with what we believe in and the people around us. As your counselor, I aim to guide you to a deeper understanding and validation of your current experience while empowering you to refocus your attention on what is true and life-giving, reestablishing a calming connection with your values, beliefs, and loved ones.
I believe it is possible to experience peace in any of life’s circumstances. One thing that comes between us and this peace, however, is our thoughts - without intentional direction for our thoughts, we tend to fixate on our fears, anxieties, and doubts. When this happens, we turn inward and lose connection with what we believe in and the people around us. As your counselor, I aim to guide you to a deeper understanding and validation of your current experience while empowering you to refocus your attention on what is true and life-giving, reestablishing a calming connection with your values, beliefs, and loved ones.
(509) 253-5044 View (509) 253-5044
Photo of Holly Sossi, Clinical Social Work/Therapist in Spokane, WA
Holly Sossi
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
1 Endorsed
Spokane, WA 99201  (Online Only)
My passion for helping my clients involves providing the space to feel heard, validated, and empowered to commit to positive behavioral health changes for themselves, interpersonally and with the world around them. My theoretical lens is grounded through my studies and practice in humanistic theory, attachment-based theory, child development, and family systems theory. I strive to help individuals and when working with families, to develop healthier communication, interpersonal, behavioral, relational and coping skills to strengthen both their interpersonal relationships and positive behaviors, for overall mental well-being.
My passion for helping my clients involves providing the space to feel heard, validated, and empowered to commit to positive behavioral health changes for themselves, interpersonally and with the world around them. My theoretical lens is grounded through my studies and practice in humanistic theory, attachment-based theory, child development, and family systems theory. I strive to help individuals and when working with families, to develop healthier communication, interpersonal, behavioral, relational and coping skills to strengthen both their interpersonal relationships and positive behaviors, for overall mental well-being.
(425) 584-5712 View (425) 584-5712
Photo of Eric Lillibridge, Counselor in Spokane, WA
Eric Lillibridge
Counselor, MS, LMHC, SRT
Verified Verified
Spokane, WA 99204  (Online Only)
Now Accepting New Clients. I provide individual psychotherapy to teens and adults struggling with Sexual Addiction, Anxiety, Depression, Behavioral Issues, Stress, Infidelity, and Relationships. I believe curiosity and acceptance, instead of hiding in fear and shame, provides self-acceptance and consequently relief. The ultimate goal is for you to feel empowered and free to create the life you want.
Now Accepting New Clients. I provide individual psychotherapy to teens and adults struggling with Sexual Addiction, Anxiety, Depression, Behavioral Issues, Stress, Infidelity, and Relationships. I believe curiosity and acceptance, instead of hiding in fear and shame, provides self-acceptance and consequently relief. The ultimate goal is for you to feel empowered and free to create the life you want.
(360) 300-5974 View (360) 300-5974
Photo of Karin Potter, Counselor in Spokane, WA
Karin Potter
Counselor, LMHC, CMHS
Verified Verified
Spokane, WA 99201  (Online Only)
Being a person is hard work; our lives are complex and navigating the world is challenging even in the best of circumstances. What we all long for, a sense of wellness, is not just the absence of affliction, it is the presence of vitality. Each of us has the capacity for this vitality, where we live fully and whole-heartedly. Clients who find my services most helpful tend to be those who are looking for a new way of living, who seek a deeper understanding of their feelings, their relationships, and their life.
Being a person is hard work; our lives are complex and navigating the world is challenging even in the best of circumstances. What we all long for, a sense of wellness, is not just the absence of affliction, it is the presence of vitality. Each of us has the capacity for this vitality, where we live fully and whole-heartedly. Clients who find my services most helpful tend to be those who are looking for a new way of living, who seek a deeper understanding of their feelings, their relationships, and their life.
(425) 414-7844 View (425) 414-7844
Photo of Family Essentials Counseling - North, Mental Health Counselor in Spokane, WA
Family Essentials Counseling - North
Mental Health Counselor, PhD, LMHC, LMFT
Verified Verified
Spokane, WA 99208
Family Essentials is here to help! www.familyessentialscounseling.com reach out today to start your journey to the future you are hoping for.
Family Essentials is here to help! www.familyessentialscounseling.com reach out today to start your journey to the future you are hoping for.
(509) 794-3612 View (509) 794-3612
Photo of Rebecca VanderLouw, Clinical Social Work/Therapist in Spokane, WA
Rebecca VanderLouw
Clinical Social Work/Therapist, MSW, LSWAIC
Verified Verified
Spokane, WA 99202
As a parent, you're deeply invested in your child's well-being, constantly ensuring their needs are met. Yet, it's disheartening when you see them struggling emotionally or behaviorally, leaving you feeling anxious and questioning your own abilities. Parenting is undeniably challenging, full of unexpected hurdles that can leave you feeling out of your depth. Seeking help is a sign of strength, and you're here because you're ready to make a positive change for your child. You're committed to helping your child gain confidence, emotional intelligence, and grit. Let's embark on this journey together.
As a parent, you're deeply invested in your child's well-being, constantly ensuring their needs are met. Yet, it's disheartening when you see them struggling emotionally or behaviorally, leaving you feeling anxious and questioning your own abilities. Parenting is undeniably challenging, full of unexpected hurdles that can leave you feeling out of your depth. Seeking help is a sign of strength, and you're here because you're ready to make a positive change for your child. You're committed to helping your child gain confidence, emotional intelligence, and grit. Let's embark on this journey together.
(509) 331-7515 View (509) 331-7515
Photo of Sylvia D Berger, Licensed Professional Counselor in Spokane, WA
Sylvia D Berger
Licensed Professional Counselor, MA, LPC, LAC
Verified Verified
Spokane, WA 99201  (Online Only)
Building rapport and having the appropriate fit with your therapist is such a key ingredient. I bring my empathetic, creative, and intuitive approach into the therapeutic relationship. Creating a safe space for my clients to be authentic is my number one goal. My focus is on empowering you to create authentic, meaningful change. I am passionate about supporting you on your journey of self-discovery, helping you in uncovering underlying causes, and guiding you towards the life you're hoping for. Through a process of developing self-awareness, emotional regulation skills, and enhancing strengths within, you'll experience deep healing.
Building rapport and having the appropriate fit with your therapist is such a key ingredient. I bring my empathetic, creative, and intuitive approach into the therapeutic relationship. Creating a safe space for my clients to be authentic is my number one goal. My focus is on empowering you to create authentic, meaningful change. I am passionate about supporting you on your journey of self-discovery, helping you in uncovering underlying causes, and guiding you towards the life you're hoping for. Through a process of developing self-awareness, emotional regulation skills, and enhancing strengths within, you'll experience deep healing.
(720) 445-8810 View (720) 445-8810
Photo of Lupe Guel, Clinical Social Work/Therapist in Spokane, WA
Lupe Guel
Clinical Social Work/Therapist, LICSW
Verified Verified
Spokane, WA 99205  (Online Only)
Making your therapy 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 therapy 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 Dianna Gulick, Counselor in Spokane, WA
Dianna Gulick
Counselor, MA, LMHC, CMHS
Verified Verified
4 Endorsed
Spokane, WA 99201
Not accepting new clients
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 Dawn Saari, Counselor in Spokane, WA
Dawn Saari
Counselor, MS, LCMHC, LMHC, LCPC
Verified Verified
Spokane, WA 99201  (Online Only)
Not accepting new clients
**My practice offers telehealth delivery of service for clients (both phone/video sessions). Many insurances cover these.** I have over 20 years of experience helping people with their broken pieces, obstacles or stuck places in life. When your life changes and you don't know how to face that change, I can help. When you want to create a change but feel lost in how to create it, I can help with that too. Relationship obstacles, scary new beginnings, healing old wounds, dealing with stress, anxiety, and sadness- all of these are things I can help you navigate and heal.
**My practice offers telehealth delivery of service for clients (both phone/video sessions). Many insurances cover these.** I have over 20 years of experience helping people with their broken pieces, obstacles or stuck places in life. When your life changes and you don't know how to face that change, I can help. When you want to create a change but feel lost in how to create it, I can help with that too. Relationship obstacles, scary new beginnings, healing old wounds, dealing with stress, anxiety, and sadness- all of these are things I can help you navigate and heal.
(509) 565-2023 View (509) 565-2023
Photo of Lady Sarah Joseph, Clinical Social Work/Therapist in Spokane, WA
Lady Sarah Joseph
Clinical Social Work/Therapist, LSWAIC, LMSW
Verified Verified
1 Endorsed
Spokane, WA 99201  (Online Only)
Christian principles, drawing strength and guidance from my unwavering faith, you will find a Compassionate Voice and Listening Ear: Your Story Matters, and You Will Be Truly Heard. As a Licensed Independent Clinical Associate Social Worker, I am dedicated to empowering individuals on their journey to improve mental health and overall well-being. With 24 years of experience in behavioral health and social work, I am committed to facilitating the healing journey from traumas, such as divorce, religious/spiritual abuse, childhood sexual exposure/abuse, narcissistic experiences, workplace bullying, dementia, grief, and loss.
Christian principles, drawing strength and guidance from my unwavering faith, you will find a Compassionate Voice and Listening Ear: Your Story Matters, and You Will Be Truly Heard. As a Licensed Independent Clinical Associate Social Worker, I am dedicated to empowering individuals on their journey to improve mental health and overall well-being. With 24 years of experience in behavioral health and social work, I am committed to facilitating the healing journey from traumas, such as divorce, religious/spiritual abuse, childhood sexual exposure/abuse, narcissistic experiences, workplace bullying, dementia, grief, and loss.
(509) 236-1466 View (509) 236-1466

How does your Therapist compare?

Number of Therapists in Spokane, WA

1,000+

Average cost per session

$135

Therapists in Spokane, WA who prioritize treating:

92% Anxiety
87% Depression
77% Self Esteem
75% Trauma and PTSD
73% Relationship Issues
73% Stress
71% Coping Skills

Average years in practice

8 Years

Top 3 insurances accepted

74% Premera
71% Aetna
58% Regence

How Therapists in Spokane, WA see their clients

52% In Person and Online
48% Online Only

Gender breakdown

79% Female
19% Male
2% 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.