Therapists in Rockland County, NY

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Photo of Matthew Kraus, Counselor in Rockland County, NY
Matthew Kraus
Counselor, MPH, LMHC, LCAT
Verified Verified
Nyack, NY 10960
The foundation of what makes working with me helpful, based on feedback from clients, is the personable nature of our conversations and our connection. I do not place myself on a higher footing than clients. Clients feel more at ease when they realize what they are working on is often the same as many others or things I have faced as a human. Clients know that I am accessible and committed to helping them strive towards the therapy or life goals they express are close to their values.
The foundation of what makes working with me helpful, based on feedback from clients, is the personable nature of our conversations and our connection. I do not place myself on a higher footing than clients. Clients feel more at ease when they realize what they are working on is often the same as many others or things I have faced as a human. Clients know that I am accessible and committed to helping them strive towards the therapy or life goals they express are close to their values.
(845) 643-2090 View (845) 643-2090
Photo of Michelle Caruso, Clinical Social Work/Therapist in Rockland County, NY
Michelle Caruso
Clinical Social Work/Therapist, LCSW, LSW
Verified Verified
Pearl River, NY 10965
Not accepting new clients
Change can be difficult at any stage of life. Starting a new school/career, dealing with a medical diagnosis, divorce or grieving the loss of a loved one are just some of the many examples of the curveballs life throws at us. Although personal experiences vary, we as humans are connected through shared emotions. Choosing a therapist that empowers you to cope with these changes is vital to your healing.
Change can be difficult at any stage of life. Starting a new school/career, dealing with a medical diagnosis, divorce or grieving the loss of a loved one are just some of the many examples of the curveballs life throws at us. Although personal experiences vary, we as humans are connected through shared emotions. Choosing a therapist that empowers you to cope with these changes is vital to your healing.
(845) 209-1240 View (845) 209-1240
Photo of Lisa E. Heuer, MD in Rockland County, NY
Lisa E. Heuer
MD
Verified Verified
Nyack, NY 10960
Dr. Heuer's clinical expertise in the neurobiology of weight management, nutrition, exercise physiology, and psychopharmacology has made her an expert in the fight against obesity. Dr. Heuer utilizes an integrative approach to reversing diabetes and other metabolic disorders. She graduated from the Mount Sinai School of Medicine, holds a Bachelor of Science with Honors from Cornell University, and did graduate work in Clinical Nutrition at New York University. Dr. Heuer's psychiatry training also includes the treatment of depression, anxiety, OCD, and ADHD, as well as integrating lifestyle change with careful medication management.
Dr. Heuer's clinical expertise in the neurobiology of weight management, nutrition, exercise physiology, and psychopharmacology has made her an expert in the fight against obesity. Dr. Heuer utilizes an integrative approach to reversing diabetes and other metabolic disorders. She graduated from the Mount Sinai School of Medicine, holds a Bachelor of Science with Honors from Cornell University, and did graduate work in Clinical Nutrition at New York University. Dr. Heuer's psychiatry training also includes the treatment of depression, anxiety, OCD, and ADHD, as well as integrating lifestyle change with careful medication management.
(914) 361-4063 View (914) 361-4063
Photo of Gin MacCallum in Rockland County, NY
Gin MacCallum
MA DMT, RSMT, SEP
Verified Verified
Sparkill, NY 10976
We may wisely withdraw, or hold, around moments of threat and overwhelm. But if holding becomes our automatic way of being, even as circumstances change, we may feel increasingly disconnected and less alive. By slowing down, giving ourselves time to notice changes in our experience, we can explore different responses. As we make space in our immediate (experience, relationship and environment) for what is happening now, we can experiment with holding less. And, as we engage our bodies without as much holding, our possibilities for moving, breathing, feeling alive and in relationship to what is beyond us - widen.
We may wisely withdraw, or hold, around moments of threat and overwhelm. But if holding becomes our automatic way of being, even as circumstances change, we may feel increasingly disconnected and less alive. By slowing down, giving ourselves time to notice changes in our experience, we can explore different responses. As we make space in our immediate (experience, relationship and environment) for what is happening now, we can experiment with holding less. And, as we engage our bodies without as much holding, our possibilities for moving, breathing, feeling alive and in relationship to what is beyond us - widen.
(845) 237-0751 View (845) 237-0751
Photo of LaShonne C Greene, LLC, Clinical Social Work/Therapist in Rockland County, NY
LaShonne C Greene, LLC
Clinical Social Work/Therapist, LMSW , MSEd
Verified Verified
Pomona, NY 10970  (Online Only)
Do you just need someone to talk to? Feeling like things are out of control? Coping with day to day stress? Experiencing loss? Experiencing “big” life changes? Setting personal and or professional goals? If you find yourself wanting more out of life, it’s time to take it to the next level. The first step towards getting somewhere.....is to decide that you are not staying where you are.
Do you just need someone to talk to? Feeling like things are out of control? Coping with day to day stress? Experiencing loss? Experiencing “big” life changes? Setting personal and or professional goals? If you find yourself wanting more out of life, it’s time to take it to the next level. The first step towards getting somewhere.....is to decide that you are not staying where you are.
(845) 237-0760 View (845) 237-0760
Photo of Christine Knorr, Clinical Social Work/Therapist in Rockland County, NY
Christine Knorr
Clinical Social Work/Therapist, LCSW, CEDS
Not Verified Not Verified
5 Endorsed
New City, NY 10956
Having an eating disorder can make you feel trapped in a world where thoughts about food and your body become your whole life. You don’t have to stay trapped. You don’t have to keep canceling plans, making excuses, or hiding your behaviors. You can start to feel comfortable in your own skin, eat the way others do, and be more present in your life. I have over 10 years of experience providing specialized therapy to people with eating disorders and understand the complex nuances of what you are facing. I know how to move you towards recovery so that you don’t have to continue to suffer.
Having an eating disorder can make you feel trapped in a world where thoughts about food and your body become your whole life. You don’t have to stay trapped. You don’t have to keep canceling plans, making excuses, or hiding your behaviors. You can start to feel comfortable in your own skin, eat the way others do, and be more present in your life. I have over 10 years of experience providing specialized therapy to people with eating disorders and understand the complex nuances of what you are facing. I know how to move you towards recovery so that you don’t have to continue to suffer.
(845) 505-1119 View (845) 505-1119
Photo of Ahxia Stanton, Mental Health Counselor in Rockland County, NY
Ahxia Stanton
Mental Health Counselor, LMHC
Verified Verified
West Nyack, NY 10994
Ahxia Stanton is a Licensed Mental Health Counselor in New York who has been practicing since 2021. She received her Masters in Clinical Mental Health Counseling at SUNY New Paltz. Ahxia provides holistic psychotherapy with a focus on BIPOC/ WOC, Couples, and young adults. Her experience entails providing direct counseling to those struggling with anxiety, depression, and self-image. Ahxia also works with couples dealing with infidelity, newlyweds, premarital and other attachment issues that may strain a relationship.
Ahxia Stanton is a Licensed Mental Health Counselor in New York who has been practicing since 2021. She received her Masters in Clinical Mental Health Counseling at SUNY New Paltz. Ahxia provides holistic psychotherapy with a focus on BIPOC/ WOC, Couples, and young adults. Her experience entails providing direct counseling to those struggling with anxiety, depression, and self-image. Ahxia also works with couples dealing with infidelity, newlyweds, premarital and other attachment issues that may strain a relationship.
(914) 600-8008 View (914) 600-8008
Photo of Vicky Forster, Clinical Social Work/Therapist in Rockland County, NY
Vicky Forster
Clinical Social Work/Therapist, LCSW
Verified Verified
Nyack, NY 10960
You are the expert of your story. As a therapist, I will meet you where you are. Together we will look at what holds you back from feeling healthier, happier and whole. Seeking therapy now is your commitment to yourself to live a more meaningful and full life; a life that is less burdened by worries, fears, or self-doubt. Your willingness to be curious about your thoughts and feelings is a huge step – a step toward increased independence, confidence and peace of mind.
You are the expert of your story. As a therapist, I will meet you where you are. Together we will look at what holds you back from feeling healthier, happier and whole. Seeking therapy now is your commitment to yourself to live a more meaningful and full life; a life that is less burdened by worries, fears, or self-doubt. Your willingness to be curious about your thoughts and feelings is a huge step – a step toward increased independence, confidence and peace of mind.
(845) 714-0602 View (845) 714-0602
Photo of Bill DeSiena, Clinical Social Work/Therapist in Rockland County, NY
Bill DeSiena
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
7 Endorsed
West Nyack, NY 10994
Stress, anxiety and depression can surface as reactive anger, sadness, as isolating from others, and just feel exhausting. I work with adults (many men) to remove obstacles, find emotional clarity and meaning, and open the door to lasting change. I believe therapy to be a partnership where we build trust, become curious and collaborate on how best to remove blocks and old patterns, and acquire tools along the way toward a more fulfilled life. I seek to empower adults who struggle with trauma/PTSD, grief, at-risk behaviors, self-esteem, relationship and attachment difficulties, the codependency-narcissism bond, and life transitions.
Stress, anxiety and depression can surface as reactive anger, sadness, as isolating from others, and just feel exhausting. I work with adults (many men) to remove obstacles, find emotional clarity and meaning, and open the door to lasting change. I believe therapy to be a partnership where we build trust, become curious and collaborate on how best to remove blocks and old patterns, and acquire tools along the way toward a more fulfilled life. I seek to empower adults who struggle with trauma/PTSD, grief, at-risk behaviors, self-esteem, relationship and attachment difficulties, the codependency-narcissism bond, and life transitions.
(845) 671-5029 View (845) 671-5029
Photo of Abundant Life Counseling, Counselor in Rockland County, NY
Abundant Life Counseling
Counselor, MA, LMHC
Verified Verified
New City, NY 10956
Jesus said, “The thief comes only to steal, kill and destroy. I came that they may have life, and have it abundantly.” (John 10:10). What would abundant life look like for you? And are there any roadblocks you've encountered? For some its loss, fear, sadness, regret, shame, disappointment or a toxic relationship. I don't presume to have all of the answers, but I am here to partner with you on your journey. Whether it's discovering what your goals are, or just the cherry on the top. Counseling can be an investment in yourself and your future.
Jesus said, “The thief comes only to steal, kill and destroy. I came that they may have life, and have it abundantly.” (John 10:10). What would abundant life look like for you? And are there any roadblocks you've encountered? For some its loss, fear, sadness, regret, shame, disappointment or a toxic relationship. I don't presume to have all of the answers, but I am here to partner with you on your journey. Whether it's discovering what your goals are, or just the cherry on the top. Counseling can be an investment in yourself and your future.
(845) 442-4547 View (845) 442-4547
Photo of Carl Tulevech, Clinical Social Work/Therapist in Rockland County, NY
Carl Tulevech
Clinical Social Work/Therapist, LMSW
Verified Verified
West Nyack, NY 10994
100% sliding scale - having trouble finding affordable counseling? Negotiate a fee you can afford. I specialize in navigating emotional and relationship challenges on the path to recovery from alcohol and substance abuse. I also assist men with anger management issues and guide individuals living with depression, anxiety, and panic disorders to pursue their professional, personal, and relational aspirations. I provide couples counseling to help partners navigate differences and disagreements. As a seasoned professional I offer a welcoming, secure, and confidential space to unravel past and present struggles hindering healthy growth.
100% sliding scale - having trouble finding affordable counseling? Negotiate a fee you can afford. I specialize in navigating emotional and relationship challenges on the path to recovery from alcohol and substance abuse. I also assist men with anger management issues and guide individuals living with depression, anxiety, and panic disorders to pursue their professional, personal, and relational aspirations. I provide couples counseling to help partners navigate differences and disagreements. As a seasoned professional I offer a welcoming, secure, and confidential space to unravel past and present struggles hindering healthy growth.
(845) 299-8276 View (845) 299-8276
Photo of Jennifer Neuhof, Psychologist in Rockland County, NY
Jennifer Neuhof
Psychologist, PsyD, MS
Verified Verified
Nyack, NY 10960
I provide a warm and safe yet dynamic environment in which my clients express their innermost thoughts, gain insight, heal wounds and learn to live with more confidence, humor and joy. With 25 years of supervising and clinical experience with children, adults and couples, I am able to quickly attune and help clients feel at ease. I listen closely to my client’s thoughts, fears and dreams while helping them to make meaningful connections that strengthen their sense of self. While deep inner work generally takes time, some positive change can be anticipated rapidly.
I provide a warm and safe yet dynamic environment in which my clients express their innermost thoughts, gain insight, heal wounds and learn to live with more confidence, humor and joy. With 25 years of supervising and clinical experience with children, adults and couples, I am able to quickly attune and help clients feel at ease. I listen closely to my client’s thoughts, fears and dreams while helping them to make meaningful connections that strengthen their sense of self. While deep inner work generally takes time, some positive change can be anticipated rapidly.
(646) 859-2119 View (646) 859-2119
Photo of Gloria D Mulitauopele, Marriage & Family Therapist in Rockland County, NY
Gloria D Mulitauopele
Marriage & Family Therapist, MA, LMFT, CLC
Verified Verified
1 Endorsed
Suffern, NY 10901  (Online Only)
I specialize in healing relationships with self and others. Whether these relationships are unfulfilling, challenging, unhealthy or just plain confusing, I am here to help! If you've lost yourself, given up on your dreams, have anxious thoughts, are feeling overwhelmed, or if you can't decide whether to stay in a relationship or leave, I'll help you learn to manage those difficult emotions and confusing situations so that you can move through those life stressors with a greater sense of confidence, ease, and empowerment.
I specialize in healing relationships with self and others. Whether these relationships are unfulfilling, challenging, unhealthy or just plain confusing, I am here to help! If you've lost yourself, given up on your dreams, have anxious thoughts, are feeling overwhelmed, or if you can't decide whether to stay in a relationship or leave, I'll help you learn to manage those difficult emotions and confusing situations so that you can move through those life stressors with a greater sense of confidence, ease, and empowerment.
(845) 684-9218 View (845) 684-9218
Photo of Kathryn Mason, Counselor in Rockland County, NY
Kathryn Mason
Counselor, MA, LPCC, LMHC
Verified Verified
Congers, NY 10920
NOTE: Currently accepting In-Home and Remote Child Therapy referrals. Welcome! I offer a welcoming place for your child to explore a wide range of issues, learn to process and explore emotions and build upon skills. I engage in children's natural play language to unpack and examine a child’s strong feelings with the goal of helping all children build on their strengths and develop resiliency . I also use other modalities such as art, story telling, and mindfulness to teach coping tools, and help children understand their internal world. Together we will co-create a creative and productive therapeutic experience.
NOTE: Currently accepting In-Home and Remote Child Therapy referrals. Welcome! I offer a welcoming place for your child to explore a wide range of issues, learn to process and explore emotions and build upon skills. I engage in children's natural play language to unpack and examine a child’s strong feelings with the goal of helping all children build on their strengths and develop resiliency . I also use other modalities such as art, story telling, and mindfulness to teach coping tools, and help children understand their internal world. Together we will co-create a creative and productive therapeutic experience.
(845) 506-8065 View (845) 506-8065
Photo of Angela D. Cabble, Mental Health Counselor in Rockland County, NY
Angela D. Cabble
Mental Health Counselor, LMHC
Verified Verified
Spring Valley, NY 10977  (Online Only)
Not accepting new clients
With life’s daily stressors that manifest in so many ways; the loss of loved ones, family/relationship issues, work stress, gun violence, discrimination, civil unrest, health issues, financial stress to name a few, many are angry, confused, distrustful, fearful, depressed, and anxious, and are desperately seeking help to deal with these stressors and issues they are confronted with.
With life’s daily stressors that manifest in so many ways; the loss of loved ones, family/relationship issues, work stress, gun violence, discrimination, civil unrest, health issues, financial stress to name a few, many are angry, confused, distrustful, fearful, depressed, and anxious, and are desperately seeking help to deal with these stressors and issues they are confronted with.
(845) 262-2474 View (845) 262-2474
Photo of Donald William Albright Jr, Licensed Mental Health Counselor in Rockland County, NY
Donald William Albright Jr
Licensed Mental Health Counselor, LMHC
Verified Verified
1 Endorsed
West Nyack, NY 10994  (Online Only)
I primarily work with adults either individally or as couples who have anxiety, self esteem, anger managment and communication issues. They often want to feel better about themselves, feel less stress and want to communicate their needs to their partners effectively. My clients are searching for happiness and fulfillment in their daily lives and want to develop the tools needed to be able to accomplish this.
I primarily work with adults either individally or as couples who have anxiety, self esteem, anger managment and communication issues. They often want to feel better about themselves, feel less stress and want to communicate their needs to their partners effectively. My clients are searching for happiness and fulfillment in their daily lives and want to develop the tools needed to be able to accomplish this.
(845) 379-3293 View (845) 379-3293
Photo of Stephen Kiesling, Clinical Social Work/Therapist in Rockland County, NY
Stephen Kiesling
Clinical Social Work/Therapist, LCSW-R
Verified Verified
Nyack, NY 10960
I am a licensed clinical social worker with 20 years of experience working with children, adolescents and their families. I have a warm, non-judgmental manner and a good sense of humor, which has enabled me to form strong working relationships with my clients. I consider parents an invaluable source of knowledge about their children and I involve them collaboratively in understanding the presenting issues and in effecting change
I am a licensed clinical social worker with 20 years of experience working with children, adolescents and their families. I have a warm, non-judgmental manner and a good sense of humor, which has enabled me to form strong working relationships with my clients. I consider parents an invaluable source of knowledge about their children and I involve them collaboratively in understanding the presenting issues and in effecting change
(845) 875-4840 View (845) 875-4840
Photo of Lauren Mongiori, Clinical Social Work/Therapist in Rockland County, NY
Lauren Mongiori
Clinical Social Work/Therapist, LCSW
Verified Verified
Pearl River, NY 10965  (Online Only)
Welcome! My goal is providing individuals a sense of safety in healing through offering a space to grow and to understand the impact of life experiences. I am passionate in promoting self-care through self-understanding and supporting individuals in developing healthier coping strategies to manage past and current life stressors. I believe highlighting one's strengths through adversities is valuable in healing. I utilize evidence-based practices and interventions of Cognitive Behavioral Therapy, Motivational Interviewing, and a Strength-Based, Trauma-Informed, Person-Centered approach to assist individuals in attaining their goals.
Welcome! My goal is providing individuals a sense of safety in healing through offering a space to grow and to understand the impact of life experiences. I am passionate in promoting self-care through self-understanding and supporting individuals in developing healthier coping strategies to manage past and current life stressors. I believe highlighting one's strengths through adversities is valuable in healing. I utilize evidence-based practices and interventions of Cognitive Behavioral Therapy, Motivational Interviewing, and a Strength-Based, Trauma-Informed, Person-Centered approach to assist individuals in attaining their goals.
(845) 393-2644 View (845) 393-2644
Photo of Millie Pacheco, Clinical Social Work/Therapist in Rockland County, NY
Millie Pacheco
Clinical Social Work/Therapist, LCSW-R, CASAC
Verified Verified
Nyack, NY 10960
I am a Licensed Clinical Therapist with extensive background and experience in working with families, individuals, adolescents, young adults and groups.
I am a Licensed Clinical Therapist with extensive background and experience in working with families, individuals, adolescents, young adults and groups.
(646) 606-3857 View (646) 606-3857
Photo of Alma Withim, Clinical Social Work/Therapist in Rockland County, NY
Alma Withim
Clinical Social Work/Therapist, LCSW
Verified Verified
West Nyack, NY 10994
Alma Withim is a Licensed Clinical Social Worker in New York who has been practicing since 1998. Alma has many years of experience in multiple areas working with minors, adults of all ages, couples, families, and individuals. Her main area of expertise is with trauma survivors: domestic violence, sexual assault, and 9/11 first responders and survivors. Alma is trained in EMDR and has testified in court on behalf of survivors and prepared survivors for the emotional difficulties of testifying in court. Of course, she has worked extensively with people suffering from other problems.
Alma Withim is a Licensed Clinical Social Worker in New York who has been practicing since 1998. Alma has many years of experience in multiple areas working with minors, adults of all ages, couples, families, and individuals. Her main area of expertise is with trauma survivors: domestic violence, sexual assault, and 9/11 first responders and survivors. Alma is trained in EMDR and has testified in court on behalf of survivors and prepared survivors for the emotional difficulties of testifying in court. Of course, she has worked extensively with people suffering from other problems.
(914) 685-6840 View (914) 685-6840

See more therapy options for Rockland County

How does your Therapist compare?

Number of Therapists in Rockland County, NY

500+

Average cost per session

$175

Therapists in Rockland County, NY who prioritize treating:

93% Anxiety
86% Depression
79% Relationship Issues
73% Self Esteem
67% Coping Skills
66% Trauma and PTSD
64% Stress

Average years in practice

14 Years

Top 3 insurances accepted

74% Aetna
62% Cigna and Evernorth
60% UnitedHealthcare UHC | UBH

How Therapists in Rockland County, NY see their clients

67% In Person and Online
33% Online Only

Gender breakdown

76% Female
23% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Rockland County?

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.