Therapists in Portland, OR

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Photo of David C. Klingman, Clinical Social Work/Therapist in Portland, OR
David C. Klingman
Clinical Social Work/Therapist, LCSW, CHT
Verified Verified
Portland, OR 97202
Does your child have emotional outbursts seemingly out of nowhere? Does your child seem distant, sad and disconnected? Is your child having trouble expressing him/herself or connecting with peers? Being a parent can be the most meaningful and fulfilling experience we will ever have in our lives, and also sometimes the most challenging, exhausting, and emotionally overwhelming. The truth is that no matter how strongly we love our children, and how powerfully we want the best for them, life's challenges can still get in the way of our kids being able to thrive as their best, most emotionally regulated selves.
Does your child have emotional outbursts seemingly out of nowhere? Does your child seem distant, sad and disconnected? Is your child having trouble expressing him/herself or connecting with peers? Being a parent can be the most meaningful and fulfilling experience we will ever have in our lives, and also sometimes the most challenging, exhausting, and emotionally overwhelming. The truth is that no matter how strongly we love our children, and how powerfully we want the best for them, life's challenges can still get in the way of our kids being able to thrive as their best, most emotionally regulated selves.
(971) 252-5784 View (971) 252-5784
Photo of Paula Fitzgerald, Marriage & Family Therapist in Portland, OR
Paula Fitzgerald
Marriage & Family Therapist, MA, LMFT
Verified Verified
Portland, OR 97232
When I first became a Licensed Marriage and Family Therapist 19 years ago, our understanding of how past traumas and attachment wounds affected us in the present, and how to effectively treat trauma and attachment wounds was very minimal. Since that time, extensive research, studies, theories and practices have broadened our knowledge of trauma's impact on the mind and body and expanded the variety of tools and resources available to support therapists. I can honestly say I have never loved my work as a trauma/attachment-focused therapist more than I do right now.
When I first became a Licensed Marriage and Family Therapist 19 years ago, our understanding of how past traumas and attachment wounds affected us in the present, and how to effectively treat trauma and attachment wounds was very minimal. Since that time, extensive research, studies, theories and practices have broadened our knowledge of trauma's impact on the mind and body and expanded the variety of tools and resources available to support therapists. I can honestly say I have never loved my work as a trauma/attachment-focused therapist more than I do right now.
(503) 476-9900 View (503) 476-9900
Photo of Karma Brooks, LCSW, Clinical Social Work/Therapist in Portland, OR
Karma Brooks, LCSW
Clinical Social Work/Therapist, LCSW
Verified Verified
Portland, OR 97211  (Online Only)
Waitlist for new clients
I AM CURRENTLY FULL, however am taking referrals from clients and colleagues. TELETHERAPY ONLY (VIDEO SESSIONS) UNTIL FURTHER NOTICE. Karma is a Licensed Clinical Social Worker and earned her Master's of Social Work from Portland State University. She has been working in the field of mental health and addiction services for the last 20 years. She works with adults, couples and adolescents. Her specialties include anxiety, depression, postpartum depression, impulse control, communication and addiction.
I AM CURRENTLY FULL, however am taking referrals from clients and colleagues. TELETHERAPY ONLY (VIDEO SESSIONS) UNTIL FURTHER NOTICE. Karma is a Licensed Clinical Social Worker and earned her Master's of Social Work from Portland State University. She has been working in the field of mental health and addiction services for the last 20 years. She works with adults, couples and adolescents. Her specialties include anxiety, depression, postpartum depression, impulse control, communication and addiction.
(503) 351-7969 View (503) 351-7969
Photo of Headlight / Hollywood in Portland, OR
Headlight / Hollywood
Verified Verified
Portland, OR 97213
Headlight is proud to offer Portland, OR a full circle of mental health care services, including therapy, coaching, support groups, medication management, and an online library of self-care resources. We make world-class mental health care accessible for everyone!
Headlight is proud to offer Portland, OR a full circle of mental health care services, including therapy, coaching, support groups, medication management, and an online library of self-care resources. We make world-class mental health care accessible for everyone!
(971) 290-1844 View (971) 290-1844
Photo of Avvy Mar, Psychologist in Portland, OR
Avvy Mar
Psychologist, PhD
Verified Verified
Portland, OR 97239
My work involves helping you find what is most valuable to you and how you can live more in tune with your values and goals. By helping explore your feelings and relationships, we can discover together what patterns and obstacles can be shifted to bring you into the life you want. I am experienced in helping people improve their relationships, professional lives and sense of personal identity.
My work involves helping you find what is most valuable to you and how you can live more in tune with your values and goals. By helping explore your feelings and relationships, we can discover together what patterns and obstacles can be shifted to bring you into the life you want. I am experienced in helping people improve their relationships, professional lives and sense of personal identity.
(503) 406-4227 View (503) 406-4227
Photo of Linda K Eisenberg, Psychological Associate in Portland, OR
Linda K Eisenberg
Psychological Associate, MA, MEd, LPC, LPA, CGP
Verified Verified
Portland, OR 97202
Not accepting new clients
As a seasoned psychoanalyst, my job is make therapy comfortable for you to discuss your concerns. I work with you to find out what you desire from life and to help you to achieve that. Issues may be specific or there may be a general sense of un-ease. Together, we explore and understand the obstacles that inhibit knowing and attaining what is desired, or obstacles that get in the way of connection with others. PRESENTLY, I am interested in talking with those who are interested in GROUP therapy; preferably those who have had some therapy experience, and/or are presently in therapy. I'm not accepting new individual referrals.
As a seasoned psychoanalyst, my job is make therapy comfortable for you to discuss your concerns. I work with you to find out what you desire from life and to help you to achieve that. Issues may be specific or there may be a general sense of un-ease. Together, we explore and understand the obstacles that inhibit knowing and attaining what is desired, or obstacles that get in the way of connection with others. PRESENTLY, I am interested in talking with those who are interested in GROUP therapy; preferably those who have had some therapy experience, and/or are presently in therapy. I'm not accepting new individual referrals.
(503) 967-0152 View (503) 967-0152
Photo of Peter Skutt, Pre-Licensed Professional in Portland, OR
Peter Skutt
Pre-Licensed Professional, MA
Verified Verified
1 Endorsed
Portland, OR 97209  (Online Only)
Sometimes the act of verbalizing our experiences can be very challenging. Art can be a great way to begin the therapeutic process and to further explore the unseen and unsaid aspects of our lives. My approach focuses primarily on the combination of art therapy and internal family systems therapy, to help my clients gain a deeper understanding of their different parts and how those parts show up in the world. I try to be very collaborative and transparent with my clients to create a more equal dynamic in our sessions.
Sometimes the act of verbalizing our experiences can be very challenging. Art can be a great way to begin the therapeutic process and to further explore the unseen and unsaid aspects of our lives. My approach focuses primarily on the combination of art therapy and internal family systems therapy, to help my clients gain a deeper understanding of their different parts and how those parts show up in the world. I try to be very collaborative and transparent with my clients to create a more equal dynamic in our sessions.
(971) 571-5217 View (971) 571-5217
Photo of Kate Van Brocklin (Accepting New Clients), Clinical Social Work Associate in Portland, OR
Kate Van Brocklin (Accepting New Clients)
Clinical Social Work Associate, CSWA
Verified Verified
Portland, OR 97215
I help people who feel that something is missing, stuck, or unfulfilled. Emotional turmoil can diminish our well-being and quality of life. I support those who want to feel loved, respected, and connected with others, free from the fear of abandonment, and feel confident and empowered in themselves and their decisions. If you'd like to work towards a sense of inner peace and fulfillment in yourself and your relationships, I'm here to guide you on that journey.
I help people who feel that something is missing, stuck, or unfulfilled. Emotional turmoil can diminish our well-being and quality of life. I support those who want to feel loved, respected, and connected with others, free from the fear of abandonment, and feel confident and empowered in themselves and their decisions. If you'd like to work towards a sense of inner peace and fulfillment in yourself and your relationships, I'm here to guide you on that journey.
(503) 501-5935 View (503) 501-5935
Photo of Annie Louise Pippert, Licensed Professional Counselor in Portland, OR
Annie Louise Pippert
Licensed Professional Counselor, MA, LPC, LMFT
Verified Verified
Portland, OR 97212  (Online Only)
I work with a variety of concerns including couples and family conflict, eating disorders, anxiety, depression, emotional distress, and the struggle to find purpose and meaning in life. I believe in highlighting the uniqueness of the individual, while understanding that we all function as part of a multitude of larger systems. The relationships we create with ourselves, with others, and with the world around us, can both transform and challenge us. Through this approach, I help individuals, couples, and families find peace and harmony. I will support you while you heal, transcend, and build the life you want.
I work with a variety of concerns including couples and family conflict, eating disorders, anxiety, depression, emotional distress, and the struggle to find purpose and meaning in life. I believe in highlighting the uniqueness of the individual, while understanding that we all function as part of a multitude of larger systems. The relationships we create with ourselves, with others, and with the world around us, can both transform and challenge us. Through this approach, I help individuals, couples, and families find peace and harmony. I will support you while you heal, transcend, and build the life you want.
(971) 232-3458 View (971) 232-3458
Photo of Jennifer L. Jones, Clinical Social Work/Therapist in Portland, OR
Jennifer L. Jones
Clinical Social Work/Therapist, LCSW-C
Verified Verified
6 Endorsed
Portland, OR 97213  (Online Only)
Carrying insecurities, guilt and grief for example is not a burden you have to share alone. Opening up about your troubling thoughts and painful emotions within the context of a deep and therapeutic relationship can have a profound and lasting impact. I work well with clients who are open, curious and motivated for change. I have expertise in working with people suffering from mood disorders, anxiety, trauma, BPD and other life transitions.
Carrying insecurities, guilt and grief for example is not a burden you have to share alone. Opening up about your troubling thoughts and painful emotions within the context of a deep and therapeutic relationship can have a profound and lasting impact. I work well with clients who are open, curious and motivated for change. I have expertise in working with people suffering from mood disorders, anxiety, trauma, BPD and other life transitions.
(443) 731-2030 View (443) 731-2030
Photo of Atma Counseling, Licensed Professional Counselor in Portland, OR
Atma Counseling
Licensed Professional Counselor, LPC
Verified Verified
Portland, OR 97215
I'm William Venturelli and I run Atma Counseling. Do you feel like you can't truly be yourself? Do you feel like something is holding you back? I can help you gain a better understanding of the "why's" in your life. Have you ever asked yourself "why do I keep doing that?" "why am I like this?" or "why do I feel this way?" We can explore these themes and more in a way that honors your uniqueness and without any judgment. Your counseling experience here will not be rigid or preconceived, instead, it will be a process of discovery where you will begin to live with more choice, courage and freedom. It's time to rediscover yourself.
I'm William Venturelli and I run Atma Counseling. Do you feel like you can't truly be yourself? Do you feel like something is holding you back? I can help you gain a better understanding of the "why's" in your life. Have you ever asked yourself "why do I keep doing that?" "why am I like this?" or "why do I feel this way?" We can explore these themes and more in a way that honors your uniqueness and without any judgment. Your counseling experience here will not be rigid or preconceived, instead, it will be a process of discovery where you will begin to live with more choice, courage and freedom. It's time to rediscover yourself.
(971) 803-5828 View (971) 803-5828
Photo of Jamie Lloyd, Licensed Professional Counselor in Portland, OR
Jamie Lloyd
Licensed Professional Counselor, LPC
Verified Verified
Portland, OR 97232  (Online Only)
Jamie Lloyd is a Licensed Professional Counselor with 10 years of experience providing therapy for individuals, groups, couples, and families. For the past 5 years, Jamie has worked in a rural primary care clinic doing integrated care and found it to be both challenging and rewarding. She has worked in two additional primary care settings as well as in private practice and additional agency settings, seeing clients of all ages and from diverse socioeconomic backgrounds. Her approach to therapy is most frequently Family Systems using Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Motivational Interviewing, or EMDR.
Jamie Lloyd is a Licensed Professional Counselor with 10 years of experience providing therapy for individuals, groups, couples, and families. For the past 5 years, Jamie has worked in a rural primary care clinic doing integrated care and found it to be both challenging and rewarding. She has worked in two additional primary care settings as well as in private practice and additional agency settings, seeing clients of all ages and from diverse socioeconomic backgrounds. Her approach to therapy is most frequently Family Systems using Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Motivational Interviewing, or EMDR.
(503) 832-6433 View (503) 832-6433
Photo of Kate L Reece, Clinical Social Work/Therapist in Portland, OR
Kate L Reece
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Portland, OR 97219
Helping others discover peace, connection, and confidence in the face of turmoil has long been a passion of mine. I believe everyone is capable of growth and healing if they are provided sufficient encouragement, support, and effective strategies. My therapeutic style is conversational and relaxed. I encourage clients to identify and communicate their unique needs and concerns in order to improve interpersonal relationships, manage bothersome emotions or behaviors, and develop healthier family connections. No matter their goal, I strongly believe in the client’s right to decide the focus of therapy.
Helping others discover peace, connection, and confidence in the face of turmoil has long been a passion of mine. I believe everyone is capable of growth and healing if they are provided sufficient encouragement, support, and effective strategies. My therapeutic style is conversational and relaxed. I encourage clients to identify and communicate their unique needs and concerns in order to improve interpersonal relationships, manage bothersome emotions or behaviors, and develop healthier family connections. No matter their goal, I strongly believe in the client’s right to decide the focus of therapy.
(503) 487-5114 View (503) 487-5114
Photo of Allison Berl, Licensed Professional Counselor in Portland, OR
Allison Berl
Licensed Professional Counselor, LPC, MA
Verified Verified
Portland, OR 97205
I provide mental health counseling and wellness coaching services that offer a safe space and professional support to those that want to work towards mental wellness by creating balance, internally and externally. It uses a three part system to help people from all walks of life build skills, develop sustainable routines, and engage in deep healing work so they can enjoy their life, calmly and confidently. I’m body positive, sex and kink positive, and I affirm disabled, BIPOC, trans, and LGBTQIA+ individuals.
I provide mental health counseling and wellness coaching services that offer a safe space and professional support to those that want to work towards mental wellness by creating balance, internally and externally. It uses a three part system to help people from all walks of life build skills, develop sustainable routines, and engage in deep healing work so they can enjoy their life, calmly and confidently. I’m body positive, sex and kink positive, and I affirm disabled, BIPOC, trans, and LGBTQIA+ individuals.
(971) 231-2908 View (971) 231-2908
Photo of Ellie Antico, Licensed Professional Counselor in Portland, OR
Ellie Antico
Licensed Professional Counselor
Verified Verified
1 Endorsed
Portland, OR 97202
Waitlist for new clients
I'm interested in you as whole person: mind, body and spirit. I know it takes courage to reveal ourselves so I hold space for all aspects of you with deep compassion. As a therapist I respect both your strength and vulnerability, offering a safe, nonjudgmental environment to express your truth, explore, and heal.
I'm interested in you as whole person: mind, body and spirit. I know it takes courage to reveal ourselves so I hold space for all aspects of you with deep compassion. As a therapist I respect both your strength and vulnerability, offering a safe, nonjudgmental environment to express your truth, explore, and heal.
(833) 885-2803 View (833) 885-2803
Photo of Elizabeth Wallace, Licensed Professional Counselor in Portland, OR
Elizabeth Wallace
Licensed Professional Counselor, MA, LPC
Verified Verified
Portland, OR 97219  (Online Only)
Not accepting new clients
Hello! I specialize in couples/sex, addictions, and trauma/anxiety. I take Cigna, Aetna and Optum insurance. I have been helping adults and couples reach their goals for 19 years. I'm here for those that want to free themselves from old patterns, be they traumatic events, anxiety attacks, destructive patterns, infidelity, issues with sex, or unhelpful styles of communication. I'm known for being an active participant, open-minded and direct. I also love using my great sense of humor, when appropriate. I'm casual. Cussing in sessions welcome!
Hello! I specialize in couples/sex, addictions, and trauma/anxiety. I take Cigna, Aetna and Optum insurance. I have been helping adults and couples reach their goals for 19 years. I'm here for those that want to free themselves from old patterns, be they traumatic events, anxiety attacks, destructive patterns, infidelity, issues with sex, or unhelpful styles of communication. I'm known for being an active participant, open-minded and direct. I also love using my great sense of humor, when appropriate. I'm casual. Cussing in sessions welcome!
(503) 470-7009 View (503) 470-7009
Photo of Robert Poe, Psychologist in Portland, OR
Robert Poe
Psychologist, PsyD, Coach
Verified Verified
Portland, OR 97209  (Online Only)
Taking new clients. My niche is working with individuals in the STEM field, (science, technology, engineering, and math). I enjoy working with individuals in this field because I feel there is a real need helping people navigate the complexities they face in both work and personal relationships. In other words, help them solve their, "work problems," that come with navigating particular personality dynamics in the workplace. We also focus on areas which define your personal relationships. Therapy can provide learning that can help you feel more integrated, aware, and effective in life.
Taking new clients. My niche is working with individuals in the STEM field, (science, technology, engineering, and math). I enjoy working with individuals in this field because I feel there is a real need helping people navigate the complexities they face in both work and personal relationships. In other words, help them solve their, "work problems," that come with navigating particular personality dynamics in the workplace. We also focus on areas which define your personal relationships. Therapy can provide learning that can help you feel more integrated, aware, and effective in life.
(503) 213-9208 View (503) 213-9208
Photo of Angel Ray, Licensed Professional Counselor in Portland, OR
Angel Ray
Licensed Professional Counselor, LPC
Verified Verified
Portland, OR 97205  (Online Only)
We all have moments of change in our lives that take us through ups and downs. Sometimes we can get stuck in understanding what is happening and knowing how to move forward. Living with challenging transitions is one of those moments when having someone to talk to, who truly understands from personal experience, makes the difference. I am a licensed counselor who through a social justice lens, will listen to all your frustrations with loved ones, friends, co-workers, and our misinformed society.
We all have moments of change in our lives that take us through ups and downs. Sometimes we can get stuck in understanding what is happening and knowing how to move forward. Living with challenging transitions is one of those moments when having someone to talk to, who truly understands from personal experience, makes the difference. I am a licensed counselor who through a social justice lens, will listen to all your frustrations with loved ones, friends, co-workers, and our misinformed society.
(971) 259-7850 View (971) 259-7850
Photo of Emily L Trum, Art Therapist in Portland, OR
Emily L Trum
Art Therapist, LPC, ATR-BC
Verified Verified
1 Endorsed
Portland, OR 97239
Waitlist for new clients
I love working with kids and teens. Whether its a play therapy session with a seven year old who is learning to build skills around emotional regulation or a teenager exploring their identity as an individual, it is wonderful. I also enjoy supporting kids and teens process life challenges that are impacting their quality of existence so that they can move through them and begin to heal. There is nothing like supporting an individual to see themselves through the light of their strengths and how they can take those strengths out into the world.
I love working with kids and teens. Whether its a play therapy session with a seven year old who is learning to build skills around emotional regulation or a teenager exploring their identity as an individual, it is wonderful. I also enjoy supporting kids and teens process life challenges that are impacting their quality of existence so that they can move through them and begin to heal. There is nothing like supporting an individual to see themselves through the light of their strengths and how they can take those strengths out into the world.
(971) 363-5383 View (971) 363-5383
Photo of Nonie Jarvie, Marriage & Family Therapist Associate in Portland, OR
Nonie Jarvie
Marriage & Family Therapist Associate, BS, MS
Verified Verified
1 Endorsed
Portland, OR 97223
I am a registered associate. If you need to dismantle trauma and rebuild your life, find answers to questions that burden you, save or repair your relationships, or you need fresh skills to manage your emotional state, I can serve you. It is not too late to find what you are looking for by learning new patterns. In fact, it's the perfect time. You can find clarity and create a life that feels peaceful and whole. I'm here to help your life be what you want. I am under supervision and have interests in relational problems, couples, parenting, children, disability, anxiety, sex therapy, and trauma.
I am a registered associate. If you need to dismantle trauma and rebuild your life, find answers to questions that burden you, save or repair your relationships, or you need fresh skills to manage your emotional state, I can serve you. It is not too late to find what you are looking for by learning new patterns. In fact, it's the perfect time. You can find clarity and create a life that feels peaceful and whole. I'm here to help your life be what you want. I am under supervision and have interests in relational problems, couples, parenting, children, disability, anxiety, sex therapy, and trauma.
(503) 749-9946 View (503) 749-9946

How does your Therapist compare?

Number of Therapists in Portland, OR

3,000+

Average cost per session

$160

Therapists in Portland, OR who prioritize treating:

91% Anxiety
85% Depression
78% Relationship Issues
76% Self Esteem
74% Trauma and PTSD
71% Stress
67% Life Transitions

Average years in practice

10 Years

Top 3 insurances accepted

55% PacificSource
47% Aetna
38% BlueCross and BlueShield

How Therapists in Portland, OR see their clients

56% In Person and Online
44% Online Only

Gender breakdown

75% Female
21% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Portland?

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.