Therapists in Cleveland, OH

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Photo of Dr. Psyche (Huanzhen) Xu Clinical Psychologist, Psychologist in Cleveland, OH
Dr. Psyche (Huanzhen) Xu Clinical Psychologist
Psychologist, PhD
Verified Verified
Cleveland, OH 44114
Waitlist for new clients
Thank you for reviewing my page, and a round of applause to you for showing up for your psychological wellbeing today. I am Dr. Psyche and I came from a multicultural background. My personal life experience and my precious encounters with a diverse clientele have taught me one of the most important elements of any effective interpersonal interactions - flexibility. I strive to offer a flexible space for the exploration of "self", a voice that may have been drowned out over time by the constant distractions surrounding us and changes that we endured, yet a voice so important that guide your actions and create the life you are living.
Thank you for reviewing my page, and a round of applause to you for showing up for your psychological wellbeing today. I am Dr. Psyche and I came from a multicultural background. My personal life experience and my precious encounters with a diverse clientele have taught me one of the most important elements of any effective interpersonal interactions - flexibility. I strive to offer a flexible space for the exploration of "self", a voice that may have been drowned out over time by the constant distractions surrounding us and changes that we endured, yet a voice so important that guide your actions and create the life you are living.
(216) 677-4060 View (216) 677-4060
Photo of Annemarie Colosimo, Clinical Social Work/Therapist in Cleveland, OH
Annemarie Colosimo
Clinical Social Work/Therapist, LISW, S
Verified Verified
Cleveland, OH 44131  (Online Only)
When people are struggling, they want to be heard, validated, and feel that there is hope. Their goal may be to just feel better, but they need help figuring out how to get there. They want someone they can talk to without fear of judgement and who can help them process their thoughts and emotions in a way that they may not have done in the past. They want to feel that the support they desire does exist and is accessible.
When people are struggling, they want to be heard, validated, and feel that there is hope. Their goal may be to just feel better, but they need help figuring out how to get there. They want someone they can talk to without fear of judgement and who can help them process their thoughts and emotions in a way that they may not have done in the past. They want to feel that the support they desire does exist and is accessible.
(216) 284-4715 View (216) 284-4715
Photo of Deandra Poythress, Clinical Social Work/Therapist in Cleveland, OH
Deandra Poythress
Clinical Social Work/Therapist, LISW
Verified Verified
Cleveland, OH 44111  (Online Only)
Trauma is a catalyst that can either bind us in grief or propel us toward greatness. By accepting what cannot be changed and learning how to properly cope with what is, we can all live a life we envision. In my experience as a therapist, I have noticed the impact grief, loss and trauma can have on an individual's psyche. With that being said, I have also noticed- and have profound appreciation for- the innate resilience evidenced in the healing process. For the past 10 years, I’ve worked tirelessly in community mental health, school based and psychiatric sites where I provided individual, family, and group therapy.
Trauma is a catalyst that can either bind us in grief or propel us toward greatness. By accepting what cannot be changed and learning how to properly cope with what is, we can all live a life we envision. In my experience as a therapist, I have noticed the impact grief, loss and trauma can have on an individual's psyche. With that being said, I have also noticed- and have profound appreciation for- the innate resilience evidenced in the healing process. For the past 10 years, I’ve worked tirelessly in community mental health, school based and psychiatric sites where I provided individual, family, and group therapy.
(216) 503-0567 View (216) 503-0567
Photo of Fit Mind Cleveland , Licensed Professional Clinical Counselor in Cleveland, OH
Fit Mind Cleveland
Licensed Professional Clinical Counselor, LPCC, -S
Verified Verified
Cleveland, OH 44106
The primary focus of my practice and clinical work is always meeting the client where they are. I work with teens and adults and families to assess need and work toward solutions. This work always begins with the development of a positive and trusting relationship. During the past few years in particular many clients have developed severe depression, anxiety, and substance due to isolation, fear and uncertainty. I look at family history, degree of functioning and personal goals prior to commencing. I am endlessly fascinated by people and love everyday I spend working.
The primary focus of my practice and clinical work is always meeting the client where they are. I work with teens and adults and families to assess need and work toward solutions. This work always begins with the development of a positive and trusting relationship. During the past few years in particular many clients have developed severe depression, anxiety, and substance due to isolation, fear and uncertainty. I look at family history, degree of functioning and personal goals prior to commencing. I am endlessly fascinated by people and love everyday I spend working.
(216) 666-5890 View (216) 666-5890
Photo of Michael Pennington, Marriage & Family Therapist in Cleveland, OH
Michael Pennington
Marriage & Family Therapist, PhD, IMFT, LPC
Verified Verified
3 Endorsed
Cleveland, OH 44113
Not accepting new clients
As both a licensed professional counselor and marriage and family therapist, I work with individuals, couples, and families dealing with a variety of concerns. My goal is to meet you where you are at, and ensure that your experience in counseling is one that is both safe and comfortable. I want to be able to create a safe space filled with empathy and warmth. Together, in this space we can form a collaborative relationship that will work to access the barriers and patterns that exist as well as identify goals that will foster change and growth.
As both a licensed professional counselor and marriage and family therapist, I work with individuals, couples, and families dealing with a variety of concerns. My goal is to meet you where you are at, and ensure that your experience in counseling is one that is both safe and comfortable. I want to be able to create a safe space filled with empathy and warmth. Together, in this space we can form a collaborative relationship that will work to access the barriers and patterns that exist as well as identify goals that will foster change and growth.
(440) 791-2171 View (440) 791-2171
Photo of One Session at a Time LLC, Marriage & Family Therapist in Cleveland, OH
One Session at a Time LLC
Marriage & Family Therapist, IMFT
Verified Verified
1 Endorsed
Cleveland, OH 44111
Being trained in Marriage and Family Therapy isn't just about working with couples. It is best to state that relationships are my passion. Be it with the self: your thoughts, fears, concerns, spirituality, etc...or with others: a friend, sibling, partner, etc. Whether it's focusing on anxieties, communication, troubling thoughts, trauma, or depression, I founded One Session at a Time to provide an accepting, safe environment for those who want to challenge themselves in their journey toward self growth either on their own or with another.
Being trained in Marriage and Family Therapy isn't just about working with couples. It is best to state that relationships are my passion. Be it with the self: your thoughts, fears, concerns, spirituality, etc...or with others: a friend, sibling, partner, etc. Whether it's focusing on anxieties, communication, troubling thoughts, trauma, or depression, I founded One Session at a Time to provide an accepting, safe environment for those who want to challenge themselves in their journey toward self growth either on their own or with another.
(216) 868-8462 View (216) 868-8462
Photo of Jeffrey Ward, Drug & Alcohol Counselor in Cleveland, OH
Jeffrey Ward
Drug & Alcohol Counselor, LICDC-C
Verified Verified
Cleveland, OH 44105
My clients have come to me from many different socioeconomic backgrounds with a variety of emotional, behavioral, spiritual, and economic needs that has been impacted by substance use. Most of them are in a state helplessness and hopeless
My clients have come to me from many different socioeconomic backgrounds with a variety of emotional, behavioral, spiritual, and economic needs that has been impacted by substance use. Most of them are in a state helplessness and hopeless
(216) 279-5313 View (216) 279-5313
Photo of Able Counseling & Associates, Inc., Counselor in Cleveland, OH
Able Counseling & Associates, Inc.
Counselor, LPCC, NCC, PhD(c)
Verified Verified
Cleveland, OH 44121
While I may not change past ( personal, relationship, marriage, family or business) situations, I can help you to better understand and resolve your current situation and guide you to a happier and successful personal and professional life. By applying complementary individual, couple, family or group therapy techniques to unearth long-standing patterns or negative perceptions that may be holding you back from experiencing a meaningful and purposeful life. My team also provide EAP Consultations, Critical Incident Training & Response worldwide (24/7) Benefits:
While I may not change past ( personal, relationship, marriage, family or business) situations, I can help you to better understand and resolve your current situation and guide you to a happier and successful personal and professional life. By applying complementary individual, couple, family or group therapy techniques to unearth long-standing patterns or negative perceptions that may be holding you back from experiencing a meaningful and purposeful life. My team also provide EAP Consultations, Critical Incident Training & Response worldwide (24/7) Benefits:
(216) 446-7147 View (216) 446-7147
Photo of Ashley Stotesbery, Licensed Professional Counselor in Cleveland, OH
Ashley Stotesbery
Licensed Professional Counselor, LPC
Verified Verified
5 Endorsed
Cleveland, OH 44113
Many of my clients struggle with dread, shame, anxiety, trauma, existential thoughts, as well as negative expectations for themselves and the world around them. Through a combination of evidence-based techniques, such as cognitive-behavioral therapy (CBT), mindfulness-based approaches, eye movement desensitization and reprocessing (EMDR), and a person-centered approach, I walk with my clients on the journey of overcoming these obstacles, toward achieving both their emotional and behavioral goals.
Many of my clients struggle with dread, shame, anxiety, trauma, existential thoughts, as well as negative expectations for themselves and the world around them. Through a combination of evidence-based techniques, such as cognitive-behavioral therapy (CBT), mindfulness-based approaches, eye movement desensitization and reprocessing (EMDR), and a person-centered approach, I walk with my clients on the journey of overcoming these obstacles, toward achieving both their emotional and behavioral goals.
(440) 644-3657 View (440) 644-3657
Photo of Victoria Byler, Licensed Professional Clinical Counselor in Cleveland, OH
Victoria Byler
Licensed Professional Clinical Counselor, MS Ed, LPCC, CGP
Verified Verified
4 Endorsed
Cleveland, OH 44144  (Online Only)
Do you struggle with anger, difficulty communicating, anxiety, depression, grief, or a loss of a sense of self that affects your ability to function, your career, and relationships? Do you feel overwhelmed and frustrated by just getting through the day? Do you wonder if life could be better? Now more than ever, men face the challenge of safeguarding their families, ensuring financial stability, and managing the pressures of society, often while masking their true emotions with a 'happy face.'"
Do you struggle with anger, difficulty communicating, anxiety, depression, grief, or a loss of a sense of self that affects your ability to function, your career, and relationships? Do you feel overwhelmed and frustrated by just getting through the day? Do you wonder if life could be better? Now more than ever, men face the challenge of safeguarding their families, ensuring financial stability, and managing the pressures of society, often while masking their true emotions with a 'happy face.'"
(330) 325-4526 View (330) 325-4526
Photo of Alexandria Olosunde, Marriage & Family Therapist in Cleveland, OH
Alexandria Olosunde
Marriage & Family Therapist, LMFT, ILMFT
Verified Verified
Cleveland, OH 44119  (Online Only)
Waitlist for new clients
If you are looking for ways to help you learn better ways to communicate your feelings and opinions without unnecessarily arousing the defenses of others, heal from past emotional injuries, develop better individual relationship habits, and learn more about yourself in the process, I’m the therapist for you. If you want to break the cycle of bad relationships in your life, let’s work together to give you the skills you need to be a better partner, peer, parent, or child. I will show you how to communicate in a way that enables you to require that you be treated with respect while making it very easy for others to do so.
If you are looking for ways to help you learn better ways to communicate your feelings and opinions without unnecessarily arousing the defenses of others, heal from past emotional injuries, develop better individual relationship habits, and learn more about yourself in the process, I’m the therapist for you. If you want to break the cycle of bad relationships in your life, let’s work together to give you the skills you need to be a better partner, peer, parent, or child. I will show you how to communicate in a way that enables you to require that you be treated with respect while making it very easy for others to do so.
(216) 600-1757 View (216) 600-1757
Photo of Lauren M Morgan, Marriage & Family Therapist in Cleveland, OH
Lauren M Morgan
Marriage & Family Therapist, LPC, MFT
Verified Verified
Cleveland, OH 44102
I am an Licensed Professional Counselor and Marriage and Family Therapist with special training in the attachment theory-based modality of Emotionally Focused Couples Therapy. I believe in building a relationship with clients where they feel safe and accepted, yet challenged to grow. Through this therapeutic relationship, individuals, couples, and families can heal and develop new perspectives and practices they can use throughout their entire lives. I utilize an array of techniques, including psycho-education, genograms, role plays, art therapy, and communication exercises, but I feel the most important aspect to therapy is developing a unique relationship with each client.
I am an Licensed Professional Counselor and Marriage and Family Therapist with special training in the attachment theory-based modality of Emotionally Focused Couples Therapy. I believe in building a relationship with clients where they feel safe and accepted, yet challenged to grow. Through this therapeutic relationship, individuals, couples, and families can heal and develop new perspectives and practices they can use throughout their entire lives. I utilize an array of techniques, including psycho-education, genograms, role plays, art therapy, and communication exercises, but I feel the most important aspect to therapy is developing a unique relationship with each client.
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Photo of Project LIFT Services, Clinical Social Work/Therapist in Cleveland, OH
Project LIFT Services
Clinical Social Work/Therapist, MSSA, LISW-S, ABD
Verified Verified
Cleveland, OH 44103
Ms. Logan is a clinical social worker (LISW-S) who specializes in trauma, cultural inclusivity, and innovative recovery practices for sustained independence. Ms. Logan is dedicated to eliminating the antecedents of incarceration, homelessness, and mental instability related to community and institutional dysfunction. Project LIFT has several clinicians to support your wellness journey.
Ms. Logan is a clinical social worker (LISW-S) who specializes in trauma, cultural inclusivity, and innovative recovery practices for sustained independence. Ms. Logan is dedicated to eliminating the antecedents of incarceration, homelessness, and mental instability related to community and institutional dysfunction. Project LIFT has several clinicians to support your wellness journey.
(216) 270-6178 View (216) 270-6178
Photo of Monica Yost Kiss, Clinical Social Work/Therapist in Cleveland, OH
Monica Yost Kiss
Clinical Social Work/Therapist, MPH, MSW, LISW-S
Verified Verified
8 Endorsed
Cleveland, OH 44139
Not accepting new clients
Monica is often described as very “real” and genuine as she uses candor & humor to help clients feel comfortable and engage in the therapeutic process. Using a direct yet compassionate approach, she empowers others to identify their strengths, needs, and goals to improve their quality of life. Monica has over 15 years of experience providing mental health services for individuals, groups, and families in a variety of settings. She works with clients coping with life transitions, relationship concerns, traumatic events, as well as mood and anxiety disorders including Depression, Bipolar, PTSD and Personality Disorders.
Monica is often described as very “real” and genuine as she uses candor & humor to help clients feel comfortable and engage in the therapeutic process. Using a direct yet compassionate approach, she empowers others to identify their strengths, needs, and goals to improve their quality of life. Monica has over 15 years of experience providing mental health services for individuals, groups, and families in a variety of settings. She works with clients coping with life transitions, relationship concerns, traumatic events, as well as mood and anxiety disorders including Depression, Bipolar, PTSD and Personality Disorders.
(216) 242-1495 View (216) 242-1495
Photo of Mary Rose Tichar, Licensed Professional Counselor in Cleveland, OH
Mary Rose Tichar
Licensed Professional Counselor, MEd, LPC, CCC
Verified Verified
Cleveland, OH 44119
Hello! I am a career counselor, life coach, and a licensed professional counselor with 20 years of experience. Your natural talent and strengths, along with meaning and purpose for your work, is the cornerstone of a satisfying career. At InsideOut, we talk a lot about your natural talent and we build narratives and communication strategies for interviews and networking. We work a process that builds confidence and clarity for who you are, and the value you bring to your work. If you are an early, mid, or seasoned person seeking a pathway forward, please connect with me. I look forward to meeting you!
Hello! I am a career counselor, life coach, and a licensed professional counselor with 20 years of experience. Your natural talent and strengths, along with meaning and purpose for your work, is the cornerstone of a satisfying career. At InsideOut, we talk a lot about your natural talent and we build narratives and communication strategies for interviews and networking. We work a process that builds confidence and clarity for who you are, and the value you bring to your work. If you are an early, mid, or seasoned person seeking a pathway forward, please connect with me. I look forward to meeting you!
(216) 502-2787 View (216) 502-2787
Photo of Jacquese Southern, Licensed Professional Counselor in Cleveland, OH
Jacquese Southern
Licensed Professional Counselor, MEd, LPC
Verified Verified
1 Endorsed
Cleveland, OH 44120  (Online Only)
Waitlist for new clients
Life can be overwhelming and tough. Sometimes, we need more than our normal support systems. Sometimes, we need help moving forward and healing. Color, sexuality, gender, societal stereotypes, labels and trauma can add to ones struggle to navigate through life. Whatever brings you to counseling, it is my honor and goal to be with you through your journey in healing
Life can be overwhelming and tough. Sometimes, we need more than our normal support systems. Sometimes, we need help moving forward and healing. Color, sexuality, gender, societal stereotypes, labels and trauma can add to ones struggle to navigate through life. Whatever brings you to counseling, it is my honor and goal to be with you through your journey in healing
(216) 262-8883 View (216) 262-8883
Photo of Yesenia N. Carpio, Clinical Social Work/Therapist in Cleveland, OH
Yesenia N. Carpio
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
2 Endorsed
Cleveland, OH 44113
I am accepting new clients! I am passionate about helping adults overcome anxiety, depression, trauma reactions and interpersonal difficulties. My goal is to help you feel more confident and support you as you practice new tools to improve your coping and communication skills.
I am accepting new clients! I am passionate about helping adults overcome anxiety, depression, trauma reactions and interpersonal difficulties. My goal is to help you feel more confident and support you as you practice new tools to improve your coping and communication skills.
(424) 305-3936 View (424) 305-3936
Photo of Stephen Brown, Licensed Professional Counselor in Cleveland, OH
Stephen Brown
Licensed Professional Counselor, LCPC
Verified Verified
Cleveland, OH 44102
My name is Stephen Brown, and I am a Licensed Professional Clinical Counselor based in Northeast Ohio and seeing clients throughout the state via telehealth. I work with adolescents and adults specializing in stress, depression, anxiety, and trauma. I primarily use Cognitive Behavioral Therapy to help my clients find positive solutions to start feeling better. I have found that my approach is effective for teens and adults struggling with the challenges and stressors of life, which take the forms of depression, anxiety, stress, and trauma.
My name is Stephen Brown, and I am a Licensed Professional Clinical Counselor based in Northeast Ohio and seeing clients throughout the state via telehealth. I work with adolescents and adults specializing in stress, depression, anxiety, and trauma. I primarily use Cognitive Behavioral Therapy to help my clients find positive solutions to start feeling better. I have found that my approach is effective for teens and adults struggling with the challenges and stressors of life, which take the forms of depression, anxiety, stress, and trauma.
(216) 350-7358 View (216) 350-7358
Photo of Tonya Black, Licensed Professional Clinical Counselor in Cleveland, OH
Tonya Black
Licensed Professional Clinical Counselor, LPCC-S
Verified Verified
Cleveland, OH 44120  (Online Only)
"Getting Well to be Whole"..I believe in working together to find an individual solution to the problem(s) you are experiencing. Whether it is a mood disorder, low self-value, boundary setting, family issues, etc., we get to the source of the issue and set obtainable goals to achieve the relief you need and want. I believe there is a deeper, spiritual component to each one of us, to be whole from our inner being outward. There is a freedom to be had from our worries and symptomology, and we will work to find that freedom.
"Getting Well to be Whole"..I believe in working together to find an individual solution to the problem(s) you are experiencing. Whether it is a mood disorder, low self-value, boundary setting, family issues, etc., we get to the source of the issue and set obtainable goals to achieve the relief you need and want. I believe there is a deeper, spiritual component to each one of us, to be whole from our inner being outward. There is a freedom to be had from our worries and symptomology, and we will work to find that freedom.
(216) 415-6193 View (216) 415-6193
Photo of Maureen McGervey, Counselor in Cleveland, OH
Maureen McGervey
Counselor, LPCC
Verified Verified
Cleveland, OH 44115  (Online Only)
Maureen McGervey is a Licensed Professional Clinical Counselor with 2 years of experience in the mental health field. She has enjoyed working with teens and adults to address and heal trauma, depression, anxiety, life adjustments and transitions, and communication skills. Maureen completed her Bachelor of Arts in Psychology and her Master of Education in Clinical Mental Health Counseling at Cleveland State University.
Maureen McGervey is a Licensed Professional Clinical Counselor with 2 years of experience in the mental health field. She has enjoyed working with teens and adults to address and heal trauma, depression, anxiety, life adjustments and transitions, and communication skills. Maureen completed her Bachelor of Arts in Psychology and her Master of Education in Clinical Mental Health Counseling at Cleveland State University.
(216) 369-4964 View (216) 369-4964

How does your Therapist compare?

Number of Therapists in Cleveland, OH

800+

Average cost per session

$130

Therapists in Cleveland, OH who prioritize treating:

92% Anxiety
89% Depression
74% Trauma and PTSD
70% Relationship Issues
68% Self Esteem
65% Coping Skills
60% Grief

Average years in practice

10 Years

Top 3 insurances accepted

82% Aetna
82% UnitedHealthcare UHC | UBH
71% Cigna and Evernorth

How Therapists in Cleveland, OH see their clients

59% In Person and Online
41% Online Only

Gender breakdown

79% Female
20% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Cleveland?

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.