Therapists in Vancouver, WA

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Photo of Molly Callahan, Counselor in Vancouver, WA
Molly Callahan
Counselor, MS, LMHC, DDMHS
Verified Verified
Vancouver, WA 98661
Therapy is a collaborative process of self-discovery and personal growth. I focus on helping my clients through the development of greater self-understanding, self-awareness and self-acceptance. I treat a wide range of clinical issues and invite clients of diverse identities and backgrounds into my therapy practice. I specialize in working with complex and single incident trauma, sexual/relational trauma, anxiety and mood disorders, life transitions, identity exploration, and stress reduction. I have experience working with people across the lifespan, including children ages 3-12, adolescents, and adults in various stages of life.
Therapy is a collaborative process of self-discovery and personal growth. I focus on helping my clients through the development of greater self-understanding, self-awareness and self-acceptance. I treat a wide range of clinical issues and invite clients of diverse identities and backgrounds into my therapy practice. I specialize in working with complex and single incident trauma, sexual/relational trauma, anxiety and mood disorders, life transitions, identity exploration, and stress reduction. I have experience working with people across the lifespan, including children ages 3-12, adolescents, and adults in various stages of life.
(360) 226-7556 View (360) 226-7556
Photo of Caitlin Truitt, Clinical Social Work/Therapist in Vancouver, WA
Caitlin Truitt
Clinical Social Work/Therapist, MSW, LSWAIC
Verified Verified
Vancouver, WA 98661
Waitlist for new clients
Experiencing trauma, loss, or upheaval is destabilizing and isolating. It can erode the relationships we value the most while making us call into question our sense of identity. Even if we avoid consciously thinking about it, the imprint of our past can wreak havoc on our physical health, our nervous system, and our present experience. The healing process asks us tune into our intuition and our bodies so that we can notice which parts of ourselves most need our attention and care. I can offer tools and support for those seeking to regain a sense of safety and connection with themselves, others, and the world around them.
Experiencing trauma, loss, or upheaval is destabilizing and isolating. It can erode the relationships we value the most while making us call into question our sense of identity. Even if we avoid consciously thinking about it, the imprint of our past can wreak havoc on our physical health, our nervous system, and our present experience. The healing process asks us tune into our intuition and our bodies so that we can notice which parts of ourselves most need our attention and care. I can offer tools and support for those seeking to regain a sense of safety and connection with themselves, others, and the world around them.
(360) 218-0915 View (360) 218-0915
Photo of Krystal Reece in Vancouver, WA
Krystal Reece
LMHC
Verified Verified
Vancouver, WA 98662  (Online Only)
As a practitioner with over 9 years experience, I do my best to present as honest, straight forward, trustworthy and safe right away. I enjoy working with adults who are bravely working through past trauma in order to better understand ourselves, our responses, and the world around us. As a witness and guide, I will help you learn to process grief and loss, access self-worth, boundaries, and inner wisdom so you can go forward feeling safe and with trust. I have worked with many different struggles, the most important thing for our relationship is that you show up willing to be open.
As a practitioner with over 9 years experience, I do my best to present as honest, straight forward, trustworthy and safe right away. I enjoy working with adults who are bravely working through past trauma in order to better understand ourselves, our responses, and the world around us. As a witness and guide, I will help you learn to process grief and loss, access self-worth, boundaries, and inner wisdom so you can go forward feeling safe and with trust. I have worked with many different struggles, the most important thing for our relationship is that you show up willing to be open.
(360) 535-7385 View (360) 535-7385
Photo of Dr. Krista Bacon, Psychologist in Vancouver, WA
Dr. Krista Bacon
Psychologist, PsyD
Verified Verified
Vancouver, WA 98663
Sometimes different parts of life can be a struggle and we may not know why. If you or your adolescent child are struggling in one or more areas of your life and you're interested in a psychological evaluation to get answers, please reach out! I also perform a variety of forensic evaluations for civil, criminal, and administrative proceedings.
Sometimes different parts of life can be a struggle and we may not know why. If you or your adolescent child are struggling in one or more areas of your life and you're interested in a psychological evaluation to get answers, please reach out! I also perform a variety of forensic evaluations for civil, criminal, and administrative proceedings.
(360) 302-4522 View (360) 302-4522
Photo of Blake Frey @ Everstronger Counseling, Counselor in Vancouver, WA
Blake Frey @ Everstronger Counseling
Counselor, MA, LMHC
Verified Verified
Vancouver, WA 98662  (Online Only)
Welcome. We all need spaces to come as we are and just talk. In our sessions we will move towards the topics that matter most to you. Clients report that they experience a safe and attuned space to show up authentically, without the worry of judgment, so they can explore important circumstances that are bringing challenges. Everstronger is a term that invites leaning a bit more towards the parts of us that have been pained, stuck, muted, or are stirring to find expression and relief in new ways.
Welcome. We all need spaces to come as we are and just talk. In our sessions we will move towards the topics that matter most to you. Clients report that they experience a safe and attuned space to show up authentically, without the worry of judgment, so they can explore important circumstances that are bringing challenges. Everstronger is a term that invites leaning a bit more towards the parts of us that have been pained, stuck, muted, or are stirring to find expression and relief in new ways.
(360) 813-6917 View (360) 813-6917
Photo of Luke M Wright, Counselor in Vancouver, WA
Luke M Wright
Counselor, LMHC
Verified Verified
Vancouver, WA 98683
Luke M. Wright is a Licensed Mental Health Counselor in Washington who has been practicing since 2022. He has an MACP from The Seattle School of Theology and Psychology and a Certification of completion from the Narrative Focused Trauma Care Level II at The Allender Center. In Luke's approach to therapy, you will find it conversationally and relationally driven. He believes that relationships are the framework in which change, and healing occur regardless of the therapeutic context a therapist draws from. In addition to this, Luke believes that our symptoms and pain are rooted in the deep stories of our life.
Luke M. Wright is a Licensed Mental Health Counselor in Washington who has been practicing since 2022. He has an MACP from The Seattle School of Theology and Psychology and a Certification of completion from the Narrative Focused Trauma Care Level II at The Allender Center. In Luke's approach to therapy, you will find it conversationally and relationally driven. He believes that relationships are the framework in which change, and healing occur regardless of the therapeutic context a therapist draws from. In addition to this, Luke believes that our symptoms and pain are rooted in the deep stories of our life.
(360) 218-0317 View (360) 218-0317
Photo of Justin S. Schultz, Counselor in Vancouver, WA
Justin S. Schultz
Counselor, MA, LMHC
Verified Verified
Vancouver, WA 98661
Are you struggling with feeling overwhelmed, depressed, or anxious with your current situation or recent life transition? Maybe you feel like life is an uphill battle. Well, I am here to help. I am a licensed mental health counselor in Vancouver, Washington. My approach to counseling is to provide you with a safe, nonjudgmental, and comfortable space to explore what you would like your life to look like and how we can get you moving in that direction.
Are you struggling with feeling overwhelmed, depressed, or anxious with your current situation or recent life transition? Maybe you feel like life is an uphill battle. Well, I am here to help. I am a licensed mental health counselor in Vancouver, Washington. My approach to counseling is to provide you with a safe, nonjudgmental, and comfortable space to explore what you would like your life to look like and how we can get you moving in that direction.
(360) 205-9536 View (360) 205-9536
Ally Christian Counseling
Licensed Professional Counselor
Verified Verified
1 Endorsed
Vancouver, WA 98684
If you are looking for help in overcoming a mental, emotional, spiritual, or relational distress, you have come to the right place. Our team of highly trained and spiritually-minded specialists offer a variety of options for allying with you on your journey. Regardless of your background; who you are, what you've done, or what's been done to you, we desire to provide a safe space for you to process where you've been, where you are, and where you desire to go. We have witnessed many clients have tremendous success in achieving their goals and experiencing growth and healing through counseling.
If you are looking for help in overcoming a mental, emotional, spiritual, or relational distress, you have come to the right place. Our team of highly trained and spiritually-minded specialists offer a variety of options for allying with you on your journey. Regardless of your background; who you are, what you've done, or what's been done to you, we desire to provide a safe space for you to process where you've been, where you are, and where you desire to go. We have witnessed many clients have tremendous success in achieving their goals and experiencing growth and healing through counseling.
(360) 295-2988 View (360) 295-2988
Photo of Ollie Gibson-Lavell, Clinical Social Work/Therapist in Vancouver, WA
Ollie Gibson-Lavell
Clinical Social Work/Therapist, LCSW
Verified Verified
Vancouver, WA 98683
Ollie Gibson-Lavell, LCSW Ollie Gibson-Lavell is a Licensed Clinical Social Worker in Washington who has been practicing since 2022. Ollie believes in focusing on the positive aspects of your reality as you creatively engage with the challenges of daily life. She utilizes a humanist, integrative, solution focus, trauma-informed approach to enhance the daily living experience of those impacted with Co-Occurring Disorders (Mental Health and SUD and other Disorders) and their families. Outside of work, Ollie enjoys engaging with others and watching plants and butterflies transform on their journey.
Ollie Gibson-Lavell, LCSW Ollie Gibson-Lavell is a Licensed Clinical Social Worker in Washington who has been practicing since 2022. Ollie believes in focusing on the positive aspects of your reality as you creatively engage with the challenges of daily life. She utilizes a humanist, integrative, solution focus, trauma-informed approach to enhance the daily living experience of those impacted with Co-Occurring Disorders (Mental Health and SUD and other Disorders) and their families. Outside of work, Ollie enjoys engaging with others and watching plants and butterflies transform on their journey.
(360) 226-4742 View (360) 226-4742
Photo of Rachel J Guadamuz, Counselor in Vancouver, WA
Rachel J Guadamuz
Counselor, MA, LMHCA, LPCA
Verified Verified
4 Endorsed
Vancouver, WA 98661  (Online Only)
It is my heart to work with fellow believers as they walk through various hardships in their lives. Whether that be loss, infidelity, or anxiety; it is a privilege to sit with people in those hard seasons.
It is my heart to work with fellow believers as they walk through various hardships in their lives. Whether that be loss, infidelity, or anxiety; it is a privilege to sit with people in those hard seasons.
(360) 339-8647 View (360) 339-8647
Photo of Nicole Churchill, Counselor in Vancouver, WA
Nicole Churchill
Counselor, LMHC
Verified Verified
Vancouver, WA 98683
Nicole Churchill is a Licensed Mental Health Counselor in Washington who has been practicing since 2020. She has a Masters in Clinical Mental Health Counseling from Antioch University. Nicole is able to walk clients through trauma processing in a safe and informed way that leads to healing. She has experience with a wide range of diagnostics and is able to offer guidance for those that are seeking answers. Nicole utilizes a person-centered approach that centers treatment around the client's goals so that they can truly be autonomous in their path to healing.
Nicole Churchill is a Licensed Mental Health Counselor in Washington who has been practicing since 2020. She has a Masters in Clinical Mental Health Counseling from Antioch University. Nicole is able to walk clients through trauma processing in a safe and informed way that leads to healing. She has experience with a wide range of diagnostics and is able to offer guidance for those that are seeking answers. Nicole utilizes a person-centered approach that centers treatment around the client's goals so that they can truly be autonomous in their path to healing.
(360) 564-6167 View (360) 564-6167
Photo of Marina Vile, Licensed Professional Counselor in Vancouver, WA
Marina Vile
Licensed Professional Counselor, MA, LMHC
Verified Verified
Vancouver, WA 98661
Finding a therapist can feel a lot like swiping through dating apps trying to find the right fit. You want to work with someone who gets you and is thoughtful and easy to talk to. That's how I work. I work with individuals and couples in a warm, attachment based approach. I'm here to help you heal old patterns, vent, or whatever you need. We can figure out the traps you fall into, cry, and laugh for 50 minutes. I'm not here to judge you or tell you how to live your life, just to support you in living authentically.
Finding a therapist can feel a lot like swiping through dating apps trying to find the right fit. You want to work with someone who gets you and is thoughtful and easy to talk to. That's how I work. I work with individuals and couples in a warm, attachment based approach. I'm here to help you heal old patterns, vent, or whatever you need. We can figure out the traps you fall into, cry, and laugh for 50 minutes. I'm not here to judge you or tell you how to live your life, just to support you in living authentically.
(360) 519-5305 View (360) 519-5305
Photo of Nicole Kennedy, Counselor in Vancouver, WA
Nicole Kennedy
Counselor, LMHC
Verified Verified
Vancouver, WA 98660
Welcome. I'm so glad you're here. If you're seeking therapy, you're likely looking for some sort of change, which requires hope. I believe hope is gritty and requires courage. I believe the magic is found right in that liminal space where we start to open the door to new possibilities. I currently serve adult women-identifying clients in my private practice who desire to work through grief, trauma, anxiety, depression, and relational conflict. Informed by relational psychodynamic theory and existential psychotherapy, my therapeutic orientation is relationship centered.
Welcome. I'm so glad you're here. If you're seeking therapy, you're likely looking for some sort of change, which requires hope. I believe hope is gritty and requires courage. I believe the magic is found right in that liminal space where we start to open the door to new possibilities. I currently serve adult women-identifying clients in my private practice who desire to work through grief, trauma, anxiety, depression, and relational conflict. Informed by relational psychodynamic theory and existential psychotherapy, my therapeutic orientation is relationship centered.
(360) 559-6373 View (360) 559-6373
Photo of Lawrance McClung, Clinical Social Work/Therapist in Vancouver, WA
Lawrance McClung
Clinical Social Work/Therapist, LICSW, LCSW
Verified Verified
Vancouver, WA 98660
I believe all people deserve to recognize and embrace their inherent worth and dignity. EMDR trained, I assist people reprocess their trauma in an accepting and validating space to reduce symptoms of PTSD and regain confidence in their sense of safety. I provide an inclusive space for gender identity exploration and affirmation. As a transgender man myself, I encourage and support people as they grow into living fully as their authentic self. I offer support and skills for individuals with mental health conditions including Bipolar I and psychosis for symptom reduction, stabilization and maintenance.
I believe all people deserve to recognize and embrace their inherent worth and dignity. EMDR trained, I assist people reprocess their trauma in an accepting and validating space to reduce symptoms of PTSD and regain confidence in their sense of safety. I provide an inclusive space for gender identity exploration and affirmation. As a transgender man myself, I encourage and support people as they grow into living fully as their authentic self. I offer support and skills for individuals with mental health conditions including Bipolar I and psychosis for symptom reduction, stabilization and maintenance.
(360) 745-1123 View (360) 745-1123
Photo of Chanel Brown, Counselor in Vancouver, WA
Chanel Brown
Counselor, MA, LMHC
Verified Verified
Vancouver, WA 98660  (Online Only)
Obsessive Compulsive Disorder (OCD) has been called "The Doubting Disease," and is characterized by unwanted and intrusive doubts, fears, “irrational” worries, and at its worst, terror and psychological torment. People with OCD experience doubts and fears which usually focus on whatever they most care about or highly value, such as their most important relationships, their moral character, their health or the health and well-being of those they care about. Sufferers use mental or behavioral rituals that provide temporary relief from the obsession, which become compulsions that can be painful in and of themselves.
Obsessive Compulsive Disorder (OCD) has been called "The Doubting Disease," and is characterized by unwanted and intrusive doubts, fears, “irrational” worries, and at its worst, terror and psychological torment. People with OCD experience doubts and fears which usually focus on whatever they most care about or highly value, such as their most important relationships, their moral character, their health or the health and well-being of those they care about. Sufferers use mental or behavioral rituals that provide temporary relief from the obsession, which become compulsions that can be painful in and of themselves.
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Photo of Christine Griffiths, Counselor in Vancouver, WA
Christine Griffiths
Counselor, LMHC, CADC I
Verified Verified
1 Endorsed
Vancouver, WA 98660  (Online Only)
Waitlist for new clients
My approach is holistic in nature, applying mind, body and spirit. For over seven years, I have worked with adults in a variety of settings. I have had the privilege of coming alongside individuals who are going through intense and often life-changing situations. All of these relationships are personal to me and through these experiences I have come to learn the devastating effects painful life events has on lives. I know therapy can feel scary and vulnerable. Just the thought of it can feel overwhelming and exhausting. And yes, it can even feel risky. It takes courage to confront fears and ask for help.
My approach is holistic in nature, applying mind, body and spirit. For over seven years, I have worked with adults in a variety of settings. I have had the privilege of coming alongside individuals who are going through intense and often life-changing situations. All of these relationships are personal to me and through these experiences I have come to learn the devastating effects painful life events has on lives. I know therapy can feel scary and vulnerable. Just the thought of it can feel overwhelming and exhausting. And yes, it can even feel risky. It takes courage to confront fears and ask for help.
(360) 919-0113 View (360) 919-0113
Photo of Preston Brennan, Counselor in Vancouver, WA
Preston Brennan
Counselor, MA, LMHCA
Verified Verified
1 Endorsed
Vancouver, WA 98684
You’ve seen enough videos, listened to enough podcasts, and read enough articles to know what you should do to fix your problems. Yet, you always seem to find yourself back in the same patterns you wanted out of. Whether it’s porn, substance use, procrastination, stress, or anger, you can’t shake the feeling that you're stuck with them. You may have even started to wonder if change is possible. Often, we feel this way because we are so focused on the symptoms, that we cannot address the deeper pain that is causing them.
You’ve seen enough videos, listened to enough podcasts, and read enough articles to know what you should do to fix your problems. Yet, you always seem to find yourself back in the same patterns you wanted out of. Whether it’s porn, substance use, procrastination, stress, or anger, you can’t shake the feeling that you're stuck with them. You may have even started to wonder if change is possible. Often, we feel this way because we are so focused on the symptoms, that we cannot address the deeper pain that is causing them.
(360) 215-5905 View (360) 215-5905
Photo of Jasmine Cejna (She_Her), Counselor in Vancouver, WA
Jasmine Cejna (She_Her)
Counselor, LMHC, LPC
Verified Verified
3 Endorsed
Vancouver, WA 98662
Life can be as painful as it is beautiful. It's not always easy to be our true selves. I am here to support you in living life authentically and without shame - to be confident in the person you truly are. Together we can celebrate the positives and work through the challenges that life presents. I believe your personal goals can be achieved and your struggles can be overcome with support that meets your needs.
Life can be as painful as it is beautiful. It's not always easy to be our true selves. I am here to support you in living life authentically and without shame - to be confident in the person you truly are. Together we can celebrate the positives and work through the challenges that life presents. I believe your personal goals can be achieved and your struggles can be overcome with support that meets your needs.
(971) 205-7843 View (971) 205-7843
Photo of Maritza Gomez, Clinical Social Work/Therapist in Vancouver, WA
Maritza Gomez
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Vancouver, WA 98663  (Online Only)
Accepting Washington and California Telehealth Clients. Seeking help is not easy! But you've already taken the first step right here. My passion is to help individuals process the things that are causing them pain, distress, sadness, and/or anxiety. To help battle those feelings of being stuck, lost or empty. To address the negative thoughts/feelings that are not allowing you to live the life you want. To help you reconnect with the things in life that bring you true happiness. You don't have to do it alone! Some of us just need a little extra help; someone to talk to, someone to vent to, someone that listens without judgement.
Accepting Washington and California Telehealth Clients. Seeking help is not easy! But you've already taken the first step right here. My passion is to help individuals process the things that are causing them pain, distress, sadness, and/or anxiety. To help battle those feelings of being stuck, lost or empty. To address the negative thoughts/feelings that are not allowing you to live the life you want. To help you reconnect with the things in life that bring you true happiness. You don't have to do it alone! Some of us just need a little extra help; someone to talk to, someone to vent to, someone that listens without judgement.
(360) 207-2678 View (360) 207-2678
Photo of Joy Wilson, Counselor in Vancouver, WA
Joy Wilson
Counselor, LMHCA
Verified Verified
2 Endorsed
Vancouver, WA 98684
Our life stories do not always have the fairy tale endings that we hoped for, but we are not mere puppets. We are active agents in pursuit of meaningful moments and positive outcomes. I will help you identify your strengths and collaborate with you to find solutions to challenges in your story. I strive to provide a counseling relationship in which you can feel safe, heard, and supported as you explore or process whatever you choose.
Our life stories do not always have the fairy tale endings that we hoped for, but we are not mere puppets. We are active agents in pursuit of meaningful moments and positive outcomes. I will help you identify your strengths and collaborate with you to find solutions to challenges in your story. I strive to provide a counseling relationship in which you can feel safe, heard, and supported as you explore or process whatever you choose.
(503) 850-8088 View (503) 850-8088

How does your Therapist compare?

Number of Therapists in Vancouver, WA

800+

Average cost per session

$150

Therapists in Vancouver, WA who prioritize treating:

93% Anxiety
87% Depression
76% Trauma and PTSD
71% Relationship Issues
69% Self Esteem
67% Grief
67% Stress

Average years in practice

10 Years

Top 3 insurances accepted

72% Aetna
54% Cigna and Evernorth
51% UnitedHealthcare UHC | UBH

How Therapists in Vancouver, WA see their clients

65% In Person and Online
35% Online Only

Gender breakdown

78% Female
20% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Vancouver?

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.