Therapists in Downingtown, PA

Photo of Lauren Cunkelman, Licensed Professional Counselor in Downingtown, PA
Lauren Cunkelman
Licensed Professional Counselor, MA, BC-DMT, LPC, NCC
Verified Verified
1 Endorsed
Downingtown, PA 19335
Does your child often have meltdowns or emotional explosions? Are you constantly fighting and feel like your home is a battlefield? Is it hard to connect with your child and understand why they’re behaving the way that they are? My family-oriented and collaborative approach to therapy may be a fit. I want to help you and your child decrease the amount of fighting that occurs and uncover why your child behaves the way they do. I believe that if families are more connected, our society becomes more connected, which means a more positive future. And a positive future is what you want for your child.
Does your child often have meltdowns or emotional explosions? Are you constantly fighting and feel like your home is a battlefield? Is it hard to connect with your child and understand why they’re behaving the way that they are? My family-oriented and collaborative approach to therapy may be a fit. I want to help you and your child decrease the amount of fighting that occurs and uncover why your child behaves the way they do. I believe that if families are more connected, our society becomes more connected, which means a more positive future. And a positive future is what you want for your child.
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Photo of Sandy Zeiset, Pre-Licensed Professional in Downingtown, PA
Sandy Zeiset
Pre-Licensed Professional, MA
Verified Verified
1 Endorsed
Downingtown, PA 19335
*I am now offering Telehealth appointments* Change is hard. When you’re in the middle of a life transition, it’s easy to feel lost. Heading off to college or a new career, going through a divorce or a newly “empty nest”, questioning your religious faith or your sexuality are just some of the things that can make you feel like you’re not sure who you are anymore. Maybe you want to make a change but can’t figure out what direction you want to go in. We all need guidance sometimes.
*I am now offering Telehealth appointments* Change is hard. When you’re in the middle of a life transition, it’s easy to feel lost. Heading off to college or a new career, going through a divorce or a newly “empty nest”, questioning your religious faith or your sexuality are just some of the things that can make you feel like you’re not sure who you are anymore. Maybe you want to make a change but can’t figure out what direction you want to go in. We all need guidance sometimes.
(484) 364-2509 View (484) 364-2509
Photo of Rebecca Toddes-Miller, Clinical Social Work/Therapist in Downingtown, PA
Rebecca Toddes-Miller
Clinical Social Work/Therapist, MSS, LCSW
Not Verified Not Verified
Downingtown, PA 19335
Not accepting new clients
I enjoy working with adolescents, adults, and couples who are going through transitions, experiencing symptoms of anxiety and depression, and/or who are troubled by substance abuse. I also see many people who have chronic syndromes such as autoimmune disorders. I have a collaborative approach and a conversational style, and provide a safe and confidential place where people can share their story. I see psychotherapy as an opportunity to develop greater self awareness and skills to improve relationships, and to enhance coping and decision making skills so that they are in keeping with the client's values and goals.
I enjoy working with adolescents, adults, and couples who are going through transitions, experiencing symptoms of anxiety and depression, and/or who are troubled by substance abuse. I also see many people who have chronic syndromes such as autoimmune disorders. I have a collaborative approach and a conversational style, and provide a safe and confidential place where people can share their story. I see psychotherapy as an opportunity to develop greater self awareness and skills to improve relationships, and to enhance coping and decision making skills so that they are in keeping with the client's values and goals.
(610) 594-1494 View (610) 594-1494
Photo of Jessica DiIenno, Clinical Social Work/Therapist in Downingtown, PA
Jessica DiIenno
Clinical Social Work/Therapist, MSS, LCSW, RPT
Verified Verified
2 Endorsed
Downingtown, PA 19335
Are you looking for a therapist for your child or adolescent because they seem down, anxious, or having trouble managing relationships or stress? Being a kid right now is so challenging, and having additional support from a therapist can be invaluable! Maybe you are looking for help for yourself. Maybe you are a parent struggling in that role. Or, maybe you are trying to heal your own wounds from experiences you had early on in life. Maybe you'd like to heal so you can feel better, more present, and less anxious in your here and now.
Are you looking for a therapist for your child or adolescent because they seem down, anxious, or having trouble managing relationships or stress? Being a kid right now is so challenging, and having additional support from a therapist can be invaluable! Maybe you are looking for help for yourself. Maybe you are a parent struggling in that role. Or, maybe you are trying to heal your own wounds from experiences you had early on in life. Maybe you'd like to heal so you can feel better, more present, and less anxious in your here and now.
(610) 595-5170 View (610) 595-5170
Photo of Women's Counseling Associates of Chester County, Clinical Social Work/Therapist in Downingtown, PA
Women's Counseling Associates of Chester County
Clinical Social Work/Therapist, PsyD, LCSW
Verified Verified
Downingtown, PA 19335  (Online Only)
Please note: We only offer video sessions. Our mission at Women's Counseling Associates of Chester County is to provide a space where women can work on themselves to become happier, successful and fulfilled in their lives. We guide our clients through the process of self-exploration, self-awareness, learning and growth. We work to remove any obstacles such as self-sabotage along with negative behavioral and thought patterns that may be inhibiting you from being the best you.
Please note: We only offer video sessions. Our mission at Women's Counseling Associates of Chester County is to provide a space where women can work on themselves to become happier, successful and fulfilled in their lives. We guide our clients through the process of self-exploration, self-awareness, learning and growth. We work to remove any obstacles such as self-sabotage along with negative behavioral and thought patterns that may be inhibiting you from being the best you.
(484) 498-6713 View (484) 498-6713
Photo of Jennifer Mullowney, Clinical Social Work/Therapist in Downingtown, PA
Jennifer Mullowney
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Downingtown, PA 19335  (Online Only)
As a therapist, my favorite thing is seeing my clients feel better and improve! I am a Licensed Clinical Social Worker with over 20 years of experience and finding the right fit with your therapist is an essential part of the therapy process. I work with adults aged 18 and up. I also believe in working with my clients when developing their treatment goals and plans.
As a therapist, my favorite thing is seeing my clients feel better and improve! I am a Licensed Clinical Social Worker with over 20 years of experience and finding the right fit with your therapist is an essential part of the therapy process. I work with adults aged 18 and up. I also believe in working with my clients when developing their treatment goals and plans.
(215) 278-4544 View (215) 278-4544
Photo of Dr. Dorothy Gail Monteith, Counselor in Downingtown, PA
Dr. Dorothy Gail Monteith
Counselor, LPC, EdD, MHS
Verified Verified
Downingtown, PA 19335
I work well with clients that want to add to their own improvement and are motivated to change. I want to help with this need, or their want to improve. I want to help how you feel, and make you feel more positive. I am a positive, caring, compassionate person and i I listen carefully, and want to help.
I work well with clients that want to add to their own improvement and are motivated to change. I want to help with this need, or their want to improve. I want to help how you feel, and make you feel more positive. I am a positive, caring, compassionate person and i I listen carefully, and want to help.
(610) 347-5704 View (610) 347-5704
Photo of Chester Springs Clinical Associates, LLC, Licensed Professional Counselor in Downingtown, PA
Chester Springs Clinical Associates, LLC
Licensed Professional Counselor, PsyD, DAPA, LPC
Verified Verified
Downingtown, PA 19335
Dr. Suzann Steadman holds a doctorate degree in Clinical Psychology, and is a PA Certified School Psychologist. Licensed in Pennsylvania, Dr. Steadman has also received advanced training in behavioral analysis, conflict management, critical incident management, organizational leadership, cognitive-behavioral therapy techniques, treatment and evaluation of autism spectrum disorders, anxiety among high-achieving students, and the utilization of strength-based interventions. She provides a wide variety of psychotherapeutic and assessment services to patients in the Chester Springs office, as well as through school district or corporate contracts.
Dr. Suzann Steadman holds a doctorate degree in Clinical Psychology, and is a PA Certified School Psychologist. Licensed in Pennsylvania, Dr. Steadman has also received advanced training in behavioral analysis, conflict management, critical incident management, organizational leadership, cognitive-behavioral therapy techniques, treatment and evaluation of autism spectrum disorders, anxiety among high-achieving students, and the utilization of strength-based interventions. She provides a wide variety of psychotherapeutic and assessment services to patients in the Chester Springs office, as well as through school district or corporate contracts.
(610) 518-2422 View (610) 518-2422
Photo of Lori Nelsen Luneburg, Psychologist in Downingtown, PA
Lori Nelsen Luneburg
Psychologist, PhD
Verified Verified
2 Endorsed
Downingtown, PA 19335
Do you feel like you are not enough? Have you lost your identity? Do you feel crazy in your current relationship or with your family? Emotional/Psychological/Narcissistic and other types of abuse can take a huge toll on an individual's self esteem and ability to cope. I am a caring Licensed Clinical Psychologist with extensive experience with Narcissistic/Abusive/Toxic Relationships and Trauma. I also specialize in Women Issues, Mood Disorders/Anxiety as well as Eating Disorders. My goal in therapy is to help you understand what "healthy" looks like and empower you to set boundaries and create the life that you desire.
Do you feel like you are not enough? Have you lost your identity? Do you feel crazy in your current relationship or with your family? Emotional/Psychological/Narcissistic and other types of abuse can take a huge toll on an individual's self esteem and ability to cope. I am a caring Licensed Clinical Psychologist with extensive experience with Narcissistic/Abusive/Toxic Relationships and Trauma. I also specialize in Women Issues, Mood Disorders/Anxiety as well as Eating Disorders. My goal in therapy is to help you understand what "healthy" looks like and empower you to set boundaries and create the life that you desire.
(610) 490-8635 View (610) 490-8635
Photo of Theresa Anne Counihan, Psychologist in Downingtown, PA
Theresa Anne Counihan
Psychologist, PsyD
Verified Verified
Downingtown, PA 19335  (Online Only)
I have worked with persons throughout the lifespan. Most recently, I consulted at skilled nursing homes and assisted care facilities with a focus on illness and end of life challenges. I enjoy working with young adults who are just finding their way in this world and navigating new relationships and responsibilities. I accept clients with a wide range of concerns including depression, anxiety, phobias, stress, identity development, assertiveness, anger management, and relationship challenges for those who are heterosexual, LGBTQ, caregivers, and parents.
I have worked with persons throughout the lifespan. Most recently, I consulted at skilled nursing homes and assisted care facilities with a focus on illness and end of life challenges. I enjoy working with young adults who are just finding their way in this world and navigating new relationships and responsibilities. I accept clients with a wide range of concerns including depression, anxiety, phobias, stress, identity development, assertiveness, anger management, and relationship challenges for those who are heterosexual, LGBTQ, caregivers, and parents.
(484) 209-6486 View (484) 209-6486
Photo of Allison Brunner in Downingtown, PA
Allison Brunner
MSW, LCSW
Verified Verified
1 Endorsed
Downingtown, PA 19335  (Online Only)
You who are highly sensitive and feel a lot, welcome! You'll explore more deeply with me than in traditional talk therapy. You’ve likely tried psychotherapy before but have noticed that the work has either gone nowhere or taken you only so far, or you felt misunderstood. With an uncanny and intuitive ability to really “get” people from many walks of life, I will invite you to go beneath your thoughts, connect with your body and emotions, and gently access the root of your emotional discomfort and hurts to facilitate noticeable shifts with each session.
You who are highly sensitive and feel a lot, welcome! You'll explore more deeply with me than in traditional talk therapy. You’ve likely tried psychotherapy before but have noticed that the work has either gone nowhere or taken you only so far, or you felt misunderstood. With an uncanny and intuitive ability to really “get” people from many walks of life, I will invite you to go beneath your thoughts, connect with your body and emotions, and gently access the root of your emotional discomfort and hurts to facilitate noticeable shifts with each session.
(484) 214-2477 View (484) 214-2477
Photo of Angela Sylvina, Clinical Social Work/Therapist in Downingtown, PA
Angela Sylvina
Clinical Social Work/Therapist, LCSW, CADC
Verified Verified
1 Endorsed
Downingtown, PA 19335
Are you going through a difficult life transition or feeling confused about your relationship(s)? Perhaps you are struggling with depression, anxiety, low self-esteem, or maybe suffering from trauma. If this resonates, therapy could be beneficial in aiding you with self-reflection and by empowering you to seek the life you desire. I believe that the therapeutic relationship itself can be a powerful agent for change, and that emotional safety within our relationship is paramount. I provide a safe and trusting environment so that you can learn to trust yourself and others in your life.
Are you going through a difficult life transition or feeling confused about your relationship(s)? Perhaps you are struggling with depression, anxiety, low self-esteem, or maybe suffering from trauma. If this resonates, therapy could be beneficial in aiding you with self-reflection and by empowering you to seek the life you desire. I believe that the therapeutic relationship itself can be a powerful agent for change, and that emotional safety within our relationship is paramount. I provide a safe and trusting environment so that you can learn to trust yourself and others in your life.
(610) 379-1941 View (610) 379-1941
Photo of Laura McCorry, Clinical Social Work/Therapist in Downingtown, PA
Laura McCorry
Clinical Social Work/Therapist, LCSW
Verified Verified
3 Endorsed
Downingtown, PA 19335
Are you experiencing a recent loss or death? One minute, we’re going about our lives as usual and then sometimes in an instant, everything changes. With these changes grief brings, are you finding yourself disconnected from the world around you, your family/friends, and the person you used to be? Many people who are grieving find themselves struggling to make it through the day, relating to other people, and imagining a life after loss. Grief can be an incredibly isolating experience but you don't have to navigate it without support. Let's work together to help get to know your grief and integrate your loss.
Are you experiencing a recent loss or death? One minute, we’re going about our lives as usual and then sometimes in an instant, everything changes. With these changes grief brings, are you finding yourself disconnected from the world around you, your family/friends, and the person you used to be? Many people who are grieving find themselves struggling to make it through the day, relating to other people, and imagining a life after loss. Grief can be an incredibly isolating experience but you don't have to navigate it without support. Let's work together to help get to know your grief and integrate your loss.
(484) 218-2649 View (484) 218-2649
Photo of Dr. Kathleen West, Psychologist in Downingtown, PA
Dr. Kathleen West
Psychologist, PhD, SEP
Verified Verified
1 Endorsed
Downingtown, PA 19335
A graduate of Temple University, I have been a licensed psychologist since 1996. I work with a wide variety of clients and presenting problems including anxiety, depression, stress, grief and loss. I have specific expertise in the areas of early trauma, childhood and adolescent issues, parenting and chronic stress. Throughout my experience I have witnessed remarkable healing and a return to a sense of wholeness and aliveness that comes with support through honest and gentle exploration, reflection and self-awareness. The results often manifest in improved relationships, judgment and clarity.
A graduate of Temple University, I have been a licensed psychologist since 1996. I work with a wide variety of clients and presenting problems including anxiety, depression, stress, grief and loss. I have specific expertise in the areas of early trauma, childhood and adolescent issues, parenting and chronic stress. Throughout my experience I have witnessed remarkable healing and a return to a sense of wholeness and aliveness that comes with support through honest and gentle exploration, reflection and self-awareness. The results often manifest in improved relationships, judgment and clarity.
(610) 624-8743 View (610) 624-8743
Erin Elizabeth Reigle
Licensed Professional Counselor, LPC, NCC
Verified Verified
Downingtown, PA 19335
Thank you for visiting my psychology today page! My philosophy is that clients are the experts on their own lives, and sometimes we all need guidance and support to achieve what we want to achieve. I base my approach on each individual client but primarily use a person centered approach along with teaching many coping skills from the DBT modality. I enjoy working with clients of all ages, including young children. I have also worked with a variety of different diagnoses and can help clients with a variety of issues. Included in this would be anxiety, depression, grief/loss, self esteem, and relationship issues.
Thank you for visiting my psychology today page! My philosophy is that clients are the experts on their own lives, and sometimes we all need guidance and support to achieve what we want to achieve. I base my approach on each individual client but primarily use a person centered approach along with teaching many coping skills from the DBT modality. I enjoy working with clients of all ages, including young children. I have also worked with a variety of different diagnoses and can help clients with a variety of issues. Included in this would be anxiety, depression, grief/loss, self esteem, and relationship issues.
(484) 209-0392 View (484) 209-0392
Photo of Brandon LeBoeuf, Clinical Social Work/Therapist in Downingtown, PA
Brandon LeBoeuf
Clinical Social Work/Therapist, LCSW, CSW-G
Verified Verified
1 Endorsed
Downingtown, PA 19335
As a Licensed Clinical Social Worker I aim to help adults, older adults, families, and couples stop struggling with difficult emotions and start living a life that aligns with their values. I have experience helping those struggling with eating disorders, body image issues, substance abuse, LGBTQI+ issues, illness, chronic pain, communication problems, burnout, and more.
As a Licensed Clinical Social Worker I aim to help adults, older adults, families, and couples stop struggling with difficult emotions and start living a life that aligns with their values. I have experience helping those struggling with eating disorders, body image issues, substance abuse, LGBTQI+ issues, illness, chronic pain, communication problems, burnout, and more.
(610) 467-3449 View (610) 467-3449
Photo of New Beginnings Therapeutic Services, Clinical Social Work/Therapist in Downingtown, PA
New Beginnings Therapeutic Services
Clinical Social Work/Therapist, LPC, LCSW
Verified Verified
5 Endorsed
Downingtown, PA 19335
New Beginnings Therapeutic Services is committed to being a client-centered practice. It is our goal to create a space for clients to share their most intimate thoughts and feelings, and for those thoughts to be received without judgment.
New Beginnings Therapeutic Services is committed to being a client-centered practice. It is our goal to create a space for clients to share their most intimate thoughts and feelings, and for those thoughts to be received without judgment.
(484) 237-1853 x100 View (484) 237-1853 x100
Photo of Bill Curtin, Clinical Social Work/Therapist in Downingtown, PA
Bill Curtin
Clinical Social Work/Therapist, MSW, LSW
Verified Verified
1 Endorsed
Downingtown, PA 19335  (Online Only)
I work with those who have worries, sadness, stressors, trauma, or life changes. I will work with you towards a healthy life and relationships around you. I create a safe and supportive environment where you can feel comfortable sharing your experiences and working towards growth.
I work with those who have worries, sadness, stressors, trauma, or life changes. I will work with you towards a healthy life and relationships around you. I create a safe and supportive environment where you can feel comfortable sharing your experiences and working towards growth.
(717) 853-1524 View (717) 853-1524
Photo of Nikki Talarico Yatron, Licensed Professional Counselor in Downingtown, PA
Nikki Talarico Yatron
Licensed Professional Counselor, MA, LPC, NCC
Verified Verified
Downingtown, PA 19335  (Online Only)
Hello! I am so happy you found my page! I am very passionate about what I do and the families I serve. I have been a Mental Health Therapist serving children and adolescence for over 7 years.  I'm a Licensed Professional Counselor and Nationally Certified Counselor. I am licensed in both DC and Pennsylvania. I hold a certification in TFCBT (Trauma Focused Cognitive Behavioral Therapy) and am in the process of obtaining my Registered Play Therapy Licensure.
Hello! I am so happy you found my page! I am very passionate about what I do and the families I serve. I have been a Mental Health Therapist serving children and adolescence for over 7 years.  I'm a Licensed Professional Counselor and Nationally Certified Counselor. I am licensed in both DC and Pennsylvania. I hold a certification in TFCBT (Trauma Focused Cognitive Behavioral Therapy) and am in the process of obtaining my Registered Play Therapy Licensure.
(484) 209-1478 View (484) 209-1478
Photo of Dr. Luke Bieber, Psychologist in Downingtown, PA
Dr. Luke Bieber
Psychologist
Verified Verified
Downingtown, PA 19335  (Online Only)
If you are struggling with depression, anxiety, ADHD, or a major life transition, we might be a good fit! As a psychotherapist, I have over 8 years of experience providing evidence-based therapies for a variety of presenting concerns. I specialize in individual and couples therapy, and I approach therapy from a strengths-based, client-centered focus. Most importantly, I am committed to providing a warm, collaborative, and empathetic environment where you can achieve your goals and create a life worth living. I am accepting new tele-therapy clients with reduced cost intake sessions.
If you are struggling with depression, anxiety, ADHD, or a major life transition, we might be a good fit! As a psychotherapist, I have over 8 years of experience providing evidence-based therapies for a variety of presenting concerns. I specialize in individual and couples therapy, and I approach therapy from a strengths-based, client-centered focus. Most importantly, I am committed to providing a warm, collaborative, and empathetic environment where you can achieve your goals and create a life worth living. I am accepting new tele-therapy clients with reduced cost intake sessions.
(484) 593-1959 View (484) 593-1959

How does your Therapist compare?

Number of Therapists in Downingtown, PA

200+

Average cost per session

$140

Therapists in Downingtown, PA who prioritize treating:

93% Anxiety
88% Depression
77% Self Esteem
75% Relationship Issues
66% Coping Skills
63% Stress
59% Grief

Average years in practice

13 Years

Top 3 insurances accepted

84% Aetna
76% Highmark
64% Cigna and Evernorth

How Therapists in Downingtown, PA see their clients

72% In Person and Online
28% Online Only

Gender breakdown

79% Female
21% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Downingtown?

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.