Therapists in San Francisco, CA

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Photo of Renee Hawley, Clinical Social Work/Therapist in San Francisco, CA
Renee Hawley
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
San Francisco, CA 94114  (Online Only)
Life brings many challenges (and many blessings). At times you may feel “out of balance,” notice a heightened sense of anxiety, low mood, an increase of unhealthy habits, and stressors in your relationships. Together, we will examine how your experiences (including your thoughts, beliefs, expectations, motivations, fears and needs) are affecting your current life situation. We will identify your strengths and build a solid tool kit of skills to help you cope with life’s stressors, enabling you a sense of harmony and peace.
Life brings many challenges (and many blessings). At times you may feel “out of balance,” notice a heightened sense of anxiety, low mood, an increase of unhealthy habits, and stressors in your relationships. Together, we will examine how your experiences (including your thoughts, beliefs, expectations, motivations, fears and needs) are affecting your current life situation. We will identify your strengths and build a solid tool kit of skills to help you cope with life’s stressors, enabling you a sense of harmony and peace.
(530) 317-4876 View (530) 317-4876
Photo of Robyn Bloom, Marriage & Family Therapist in San Francisco, CA
Robyn Bloom
Marriage & Family Therapist, MS, LMFT
Verified Verified
San Francisco, CA 94105
Are you feeling anxious, depressed or stuck, believing life should be different but not sure how to move ahead? Are you fulfilled in your most important relationships or is their a sense of dissatisfaction? When life throws you challenges it may seem like you have to go it alone but there is help. Working with me, therapy is a healthy and interactive dialogue that can help you achieve the life you want for yourself, gain a greater sense of self-acceptance and acceptance of others. My style is warm, non-judgmental and curious.
Are you feeling anxious, depressed or stuck, believing life should be different but not sure how to move ahead? Are you fulfilled in your most important relationships or is their a sense of dissatisfaction? When life throws you challenges it may seem like you have to go it alone but there is help. Working with me, therapy is a healthy and interactive dialogue that can help you achieve the life you want for yourself, gain a greater sense of self-acceptance and acceptance of others. My style is warm, non-judgmental and curious.
(415) 795-2957 View (415) 795-2957
Photo of Roché Wadehra, Marriage & Family Therapist in San Francisco, CA
Roché Wadehra
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
San Francisco, CA 94102  (Online Only)
"And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom" -Anaïs Nin. There are times when we feel lost, confused, even fearful. Perhaps we find ourselves at a crossroads, undergoing life changing experiences. We want to deepen our relationship to all aspects of our lives, and may feel we know where we would like to be, but cannot find a foothold, or begin the journey alone. If any of these relate to your life situation, you are probably ready to enter into the therapeutic process.
"And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom" -Anaïs Nin. There are times when we feel lost, confused, even fearful. Perhaps we find ourselves at a crossroads, undergoing life changing experiences. We want to deepen our relationship to all aspects of our lives, and may feel we know where we would like to be, but cannot find a foothold, or begin the journey alone. If any of these relate to your life situation, you are probably ready to enter into the therapeutic process.
(415) 549-0011 View (415) 549-0011
Photo of Norma Luna, Clinical Social Work/Therapist in San Francisco, CA
Norma Luna
Clinical Social Work/Therapist, LCSW
Verified Verified
San Francisco, CA 94121
I'm Norma Luna, a Licensed Clinical Social Worker and I invite you to call and schedule an appointment. I offer a warm and safe space where you can fully express yourself. I take a person centered, compassionate and integrative approach to therapy, incorporating mind, body and spirit. Along with understanding how culture and societal issues influence an individual.
I'm Norma Luna, a Licensed Clinical Social Worker and I invite you to call and schedule an appointment. I offer a warm and safe space where you can fully express yourself. I take a person centered, compassionate and integrative approach to therapy, incorporating mind, body and spirit. Along with understanding how culture and societal issues influence an individual.
(628) 277-8598 View (628) 277-8598
Photo of Andrew Vogl in San Francisco, CA
Andrew Vogl
MA, BCBA
Verified Verified
1 Endorsed
San Francisco, CA 94114
I provide coaching and therapy for autism and Asperger's and have been doing so for 30 years. Most of my clients consider themselves autistic or on the autism spectrum. My clients learn to understand autism on a deeper level. I work with my clients on black-and-white thinking, expressing emotions, the need for masking, and understanding the needs of others. My clients learn to prioritize flexibility from a heartfelt standpoint to achieve a better career, relationship, or social life. I also train parents to teach this process to their children. Parents learn to address difficult behaviors and limitations in communication.
I provide coaching and therapy for autism and Asperger's and have been doing so for 30 years. Most of my clients consider themselves autistic or on the autism spectrum. My clients learn to understand autism on a deeper level. I work with my clients on black-and-white thinking, expressing emotions, the need for masking, and understanding the needs of others. My clients learn to prioritize flexibility from a heartfelt standpoint to achieve a better career, relationship, or social life. I also train parents to teach this process to their children. Parents learn to address difficult behaviors and limitations in communication.
(415) 527-5431 View (415) 527-5431
Photo of Vanessa Vertin, Marriage & Family Therapist in San Francisco, CA
Vanessa Vertin
Marriage & Family Therapist, PhD, LMFT
Verified Verified
1 Endorsed
San Francisco, CA 94115  (Online Only)
Dr. Vertin specializes in modern-day relationships with self and others. Her work helps people thrive by revolutionizing how people think about health and relationship and thus, how they function. Vanessa's specializations are integral health, coupling relationships, and life transitions/stress. Other areas in which she has extensive training and therapeutic experience include: freedom and intimacy dynamics, marriage and other relationship forms, survivors of abuse, anxiety and depression, issues of elders and their families, aging & death, developmental issues, PTSD, and women’s issues.
Dr. Vertin specializes in modern-day relationships with self and others. Her work helps people thrive by revolutionizing how people think about health and relationship and thus, how they function. Vanessa's specializations are integral health, coupling relationships, and life transitions/stress. Other areas in which she has extensive training and therapeutic experience include: freedom and intimacy dynamics, marriage and other relationship forms, survivors of abuse, anxiety and depression, issues of elders and their families, aging & death, developmental issues, PTSD, and women’s issues.
(650) 262-3687 View (650) 262-3687
Photo of Laura M Jasen, Licensed Professional Counselor in San Francisco, CA
Laura M Jasen
Licensed Professional Counselor, LPCC, LMHC
Verified Verified
4 Endorsed
San Francisco, CA 94123  (Online Only)
Life's hurdles can challenge even the strongest of us. With therapeutic support and compassionate guidance, we can overcome your struggles to help you improve your mental health, regain control and start your healing so you can live the life you've always envisioned. With the proper help, you can improve your anxiety, strengthen your relationships, push yourself to take on new challenges, and find the right tools to help you manage the difficulties you face and find your well-being. Areas of specialty include: Life Transitions, Anxiety, Feelings of Unease, Healing Trauma, Relationship Issues, Grief and Loss.
Life's hurdles can challenge even the strongest of us. With therapeutic support and compassionate guidance, we can overcome your struggles to help you improve your mental health, regain control and start your healing so you can live the life you've always envisioned. With the proper help, you can improve your anxiety, strengthen your relationships, push yourself to take on new challenges, and find the right tools to help you manage the difficulties you face and find your well-being. Areas of specialty include: Life Transitions, Anxiety, Feelings of Unease, Healing Trauma, Relationship Issues, Grief and Loss.
(415) 226-4854 View (415) 226-4854
Photo of Estelle Rubenstein, Marriage & Family Therapist in San Francisco, CA
Estelle Rubenstein
Marriage & Family Therapist
Verified Verified
San Francisco, CA 94102  (Online Only)
Welcome. I know that choosing a therapist can be hard. How can a therapist help you? How can you find the right therapist? I hope the information here helps. I work with all age groups - and especially well with clients whose challenges include gender identity and sexuality, life transitions, alcohol and drug addiction, foster care and adoption issues, parenting, ageing, depression, anxiety, veterans and active duty military, relationships, grief, loss, and trauma. I can work within short-term and long-term frameworks, depending on your goals and expectations. I am kink-, gender-, and ENM/poly-affirming.
Welcome. I know that choosing a therapist can be hard. How can a therapist help you? How can you find the right therapist? I hope the information here helps. I work with all age groups - and especially well with clients whose challenges include gender identity and sexuality, life transitions, alcohol and drug addiction, foster care and adoption issues, parenting, ageing, depression, anxiety, veterans and active duty military, relationships, grief, loss, and trauma. I can work within short-term and long-term frameworks, depending on your goals and expectations. I am kink-, gender-, and ENM/poly-affirming.
(415) 639-3834 View (415) 639-3834
Photo of Jiyoung Kim, Associate Clinical Social Worker in San Francisco, CA
Jiyoung Kim
Associate Clinical Social Worker, ASW, EMDR
Verified Verified
San Francisco, CA 94114
Do you find difficulties with feelings of depression, anxiety, relationship/family problems, and trauma? These emotional disruptions can have a significant impact on our lives. Coping with these events requires various approaches, and I can assist you in recognizing your emotions and identifying possible patterns in your relationships. I can also help you develop resilience and acceptance towards challenging emotions, and support you in setting meaningful goals. I utilize EMDR, CBT, trauma-informed care, mindfulness, & person-centered therapy to reduce anxiety and trauma symptoms, foster resilience, and enhance the quality of life.
Do you find difficulties with feelings of depression, anxiety, relationship/family problems, and trauma? These emotional disruptions can have a significant impact on our lives. Coping with these events requires various approaches, and I can assist you in recognizing your emotions and identifying possible patterns in your relationships. I can also help you develop resilience and acceptance towards challenging emotions, and support you in setting meaningful goals. I utilize EMDR, CBT, trauma-informed care, mindfulness, & person-centered therapy to reduce anxiety and trauma symptoms, foster resilience, and enhance the quality of life.
(415) 870-8256 View (415) 870-8256
Photo of Judith L Wyatt, Marriage & Family Therapist in San Francisco, CA
Judith L Wyatt
Marriage & Family Therapist, MS, MFT
Verified Verified
San Francisco, CA 94102
I am inspired witnessing the courage with which people face their fears. I work to earn a person's trust, so that they are safe to risk vulnerability. I love to help people discover or unblock the sensing of their life direction, and the motivation to pursue it. In my many years of practice, some clients get there quickly, and others need to delve more deeply. Depression, anxiety, PTSD, addictions, bad relationship patterns, inhibitions in work or love, all change best when we bring compassion to their roots in the past.
I am inspired witnessing the courage with which people face their fears. I work to earn a person's trust, so that they are safe to risk vulnerability. I love to help people discover or unblock the sensing of their life direction, and the motivation to pursue it. In my many years of practice, some clients get there quickly, and others need to delve more deeply. Depression, anxiety, PTSD, addictions, bad relationship patterns, inhibitions in work or love, all change best when we bring compassion to their roots in the past.
(415) 800-2558 View (415) 800-2558
Photo of Davi Weisberger, Psychologist in San Francisco, CA
Davi Weisberger
Psychologist, PhD
Verified Verified
San Francisco, CA 94118
Over the past 30+ years I have helped people with a wide range of problems and challenges. These may include anxiety and worry, depression and sadness, relationship difficulties, work related stress, loss of a loved one, loss of a relationship, and difficulty with life transitions such as divorce, losing or changing jobs, becoming a parent, moving to a new city, facing an empty nest, and aging. I also see people who are struggling with old feelings from an earlier difficulty or trauma that are being triggered by some current life situation or event.
Over the past 30+ years I have helped people with a wide range of problems and challenges. These may include anxiety and worry, depression and sadness, relationship difficulties, work related stress, loss of a loved one, loss of a relationship, and difficulty with life transitions such as divorce, losing or changing jobs, becoming a parent, moving to a new city, facing an empty nest, and aging. I also see people who are struggling with old feelings from an earlier difficulty or trauma that are being triggered by some current life situation or event.
(628) 214-4749 View (628) 214-4749
Photo of Amelia Jayanty, Psychologist in San Francisco, CA
Amelia Jayanty
Psychologist, PsyD
Verified Verified
2 Endorsed
San Francisco, CA 94115  (Online Only)
Our mental health doesn’t exist in a vacuum. That means we need to look at the context of our past, our relationships, and the world around us to be able to understand ourselves and the challenges we face. As a therapist, I’m here to help you put those pieces together so you can step into a more empowered, authentic, and connected version of yourself. I work with clients who are looking for a combination of improved insight and practical tools to improve their relationships with themselves and others.
Our mental health doesn’t exist in a vacuum. That means we need to look at the context of our past, our relationships, and the world around us to be able to understand ourselves and the challenges we face. As a therapist, I’m here to help you put those pieces together so you can step into a more empowered, authentic, and connected version of yourself. I work with clients who are looking for a combination of improved insight and practical tools to improve their relationships with themselves and others.
(415) 741-5533 View (415) 741-5533
Photo of James McCollum, Psychologist in San Francisco, CA
James McCollum
Psychologist, PhD
Verified Verified
1 Endorsed
San Francisco, CA 94117
A good therapy session should feel emotional and immediate, yet grounded in the past so one can understand and feel old experiences in new ways. Sometimes there is laughter and sometimes there are tears. A good therapy session feels alive and satisfying.
A good therapy session should feel emotional and immediate, yet grounded in the past so one can understand and feel old experiences in new ways. Sometimes there is laughter and sometimes there are tears. A good therapy session feels alive and satisfying.
(415) 423-2695 View (415) 423-2695
Photo of Pam Miller, Marriage & Family Therapist in San Francisco, CA
Pam Miller
Marriage & Family Therapist, MFT
Verified Verified
1 Endorsed
San Francisco, CA 94117
I work well with individuals going through life transitions, in love, work, identity, grief, parenting, infertility. Psychotherapy is not one size fits all, but a relationship finely tailored to each individual(s). Your needs determine the approach I take. I have over 30 years of experience and a wide variety of approaches to choose from. My main tools are good listening, and a strong belief people can learn from their past and current experiences, if they have the support to face themselves honestly. No one is too old to learn new strategies to make life more fulfilling.
I work well with individuals going through life transitions, in love, work, identity, grief, parenting, infertility. Psychotherapy is not one size fits all, but a relationship finely tailored to each individual(s). Your needs determine the approach I take. I have over 30 years of experience and a wide variety of approaches to choose from. My main tools are good listening, and a strong belief people can learn from their past and current experiences, if they have the support to face themselves honestly. No one is too old to learn new strategies to make life more fulfilling.
(415) 766-9030 View (415) 766-9030
Photo of Margaret Flynn, Psychologist in San Francisco, CA
Margaret Flynn
Psychologist, PsyD
Verified Verified
San Francisco, CA 94109  (Online Only)
Are you are stuck in unhelpful patterns in your life or relationships? Do you want to feel differently about yourself or your partner? Is conflict or distance in your romantic relationship causing stress? Is there a sexual health concern you are not sure where to start to address? Let’s talk! In my practice with couples, I work from an Emotionally Focused Therapy framework, an evidence-based treatment facilitating change from distress to a secure bond. With increased security in your relationship, you can more productively navigate conflict and feel more confident in the world knowing your partner has your back.
Are you are stuck in unhelpful patterns in your life or relationships? Do you want to feel differently about yourself or your partner? Is conflict or distance in your romantic relationship causing stress? Is there a sexual health concern you are not sure where to start to address? Let’s talk! In my practice with couples, I work from an Emotionally Focused Therapy framework, an evidence-based treatment facilitating change from distress to a secure bond. With increased security in your relationship, you can more productively navigate conflict and feel more confident in the world knowing your partner has your back.
(628) 200-4308 View (628) 200-4308
Photo of Helen Elizabeth Shamis, Marriage & Family Therapist in San Francisco, CA
Helen Elizabeth Shamis
Marriage & Family Therapist, LMFT, LPCC
Verified Verified
San Francisco, CA 94123
My treatment approach is best described as strength-based. I believe that we come to even our most challenging moments, with the best of intentions. When a client chooses me as their therapist, they provide themselves with a dedicated, judgment-free professional who believes in their ability to guide their own journey. If you are at your most vulnerable or in the darkest of places, there is always hope. Both short-term and long-term therapy is available.
My treatment approach is best described as strength-based. I believe that we come to even our most challenging moments, with the best of intentions. When a client chooses me as their therapist, they provide themselves with a dedicated, judgment-free professional who believes in their ability to guide their own journey. If you are at your most vulnerable or in the darkest of places, there is always hope. Both short-term and long-term therapy is available.
(415) 877-6328 View (415) 877-6328
Photo of Garett Weinstein - Expansive Therapy, Licensed Professional Clinical Counselor in San Francisco, CA
Garett Weinstein - Expansive Therapy
Licensed Professional Clinical Counselor, AMFT
Verified Verified
San Francisco, CA 94110
I believe in the transformative power of genuine connection, acknowledging the unique intersections of each person's journey and creating an affirming environment where diverse identities are celebrated. Together we will navigate the intricacies of relationships, identity, and personal growth in a holistic and affirming manner.
I believe in the transformative power of genuine connection, acknowledging the unique intersections of each person's journey and creating an affirming environment where diverse identities are celebrated. Together we will navigate the intricacies of relationships, identity, and personal growth in a holistic and affirming manner.
(628) 265-3610 View (628) 265-3610
Photo of Bryan Russo, Marriage & Family Therapist in San Francisco, CA
Bryan Russo
Marriage & Family Therapist, MS, PhD, LMFT
Verified Verified
San Francisco, CA 94115  (Online Only)
Too often psychotherapy focuses on causality, pathology and cures. However, rather than being "sick" or 'broken", often we are just lost inside ourselves or relationships. Everyone is a unique person with their own story, experience and perspective. The goal of therapy is to achieve a deeper awareness of where we are, to discover internal meaning for our many experiences, and to experience a life worth living. While working towards that awareness, I also feel it important to teach individuals, couples and families the skills needed to cope with the pain and day to day stressors that bring them into therapy.
Too often psychotherapy focuses on causality, pathology and cures. However, rather than being "sick" or 'broken", often we are just lost inside ourselves or relationships. Everyone is a unique person with their own story, experience and perspective. The goal of therapy is to achieve a deeper awareness of where we are, to discover internal meaning for our many experiences, and to experience a life worth living. While working towards that awareness, I also feel it important to teach individuals, couples and families the skills needed to cope with the pain and day to day stressors that bring them into therapy.
(415) 449-7330 View (415) 449-7330
Photo of Jan S. Cehn, LCSW,BCD, Clinical Social Work/Therapist in San Francisco, CA
Jan S. Cehn, LCSW,BCD
Clinical Social Work/Therapist, LCSW, BCD
Verified Verified
San Francisco, CA 94114
I am an experienced therapist who has been working with teens, individuals, couples and families for over 30 years. I see therapy as a partnership: you enter this process with your particular issues and uniqueness and together, through building trust, being curious and using specialized techniques, you progress. My approach is based on my client's personal history and their needs and, in general, I am quite interactive. I provide short-term as well as long-term treatment.
I am an experienced therapist who has been working with teens, individuals, couples and families for over 30 years. I see therapy as a partnership: you enter this process with your particular issues and uniqueness and together, through building trust, being curious and using specialized techniques, you progress. My approach is based on my client's personal history and their needs and, in general, I am quite interactive. I provide short-term as well as long-term treatment.
(415) 889-8965 View (415) 889-8965
Photo of Jennifer Margolis, Psychologist in San Francisco, CA
Jennifer Margolis
Psychologist, PsyD
Verified Verified
San Francisco, CA 94114
In every psychotherapy session there is a place where the client and therapist meet and come alive in the present moment. This is the place that I work from. I achieve this through active dialogue, attentive listening and creative exchange. I think it is essential to offer a space where you can feel safe to be honest about what is happening in your life. Whether you're dealing with relationship issues, anxiety, depression or struggling with a life transition, it is the relationship between you and me that leads to insight and healing.
In every psychotherapy session there is a place where the client and therapist meet and come alive in the present moment. This is the place that I work from. I achieve this through active dialogue, attentive listening and creative exchange. I think it is essential to offer a space where you can feel safe to be honest about what is happening in your life. Whether you're dealing with relationship issues, anxiety, depression or struggling with a life transition, it is the relationship between you and me that leads to insight and healing.
(415) 800-2017 View (415) 800-2017

See more therapy options for San Francisco

How does your Therapist compare?

Number of Therapists in San Francisco, CA

3,000+

Average cost per session

$189

Therapists in San Francisco, CA who prioritize treating:

93% Anxiety
87% Depression
81% Relationship Issues
75% Self Esteem
70% Trauma and PTSD
68% Stress
66% Life Transitions

Average years in practice

12 Years

Top 3 insurances accepted

69% Aetna
55% UnitedHealthcare UHC | UBH
54% Cigna and Evernorth

How Therapists in San Francisco, CA see their clients

55% In Person and Online
45% Online Only

Gender breakdown

75% Female
23% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in San Francisco?

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.