Therapists in Bethesda, MD

Photo of Wendy-Nia Griffin, Counselor in Bethesda, MD
Wendy-Nia Griffin
Counselor, JD, LCPC
Verified Verified
2 Endorsed
Bethesda, MD 20814  (Online Only)
A Woman In Transition Is A Powerful FORCE. I specialize in counseling women who are moving to and from a relationship, women starting and wanting a new career, women transitioning from working outside the home to staying home with family, women starting again for so many reasons, and women that just want their lives to be better and unencumbered by past hurts. My 14 years of experience in counseling also includes working with young women who are developing their identities: helping them understand how to love themselves inside and out, and developing them into confident and productive women.
A Woman In Transition Is A Powerful FORCE. I specialize in counseling women who are moving to and from a relationship, women starting and wanting a new career, women transitioning from working outside the home to staying home with family, women starting again for so many reasons, and women that just want their lives to be better and unencumbered by past hurts. My 14 years of experience in counseling also includes working with young women who are developing their identities: helping them understand how to love themselves inside and out, and developing them into confident and productive women.
(301) 888-5305 View (301) 888-5305
Photo of Amanda Mendizabal, Clinical Social Work/Therapist in Bethesda, MD
Amanda Mendizabal
Clinical Social Work/Therapist, MSS, LCSW-C, LICSW
Verified Verified
1 Endorsed
Bethesda, MD 20814
Welcome to my practice. Regardless of what your struggle is at this time, I believe that through our relationship we can work together to help you look at your current patterns and potential changes you can make that can help you lead a fuller life. I realize that this can be difficult and I am grateful that I am able to help you in your journey.
Welcome to my practice. Regardless of what your struggle is at this time, I believe that through our relationship we can work together to help you look at your current patterns and potential changes you can make that can help you lead a fuller life. I realize that this can be difficult and I am grateful that I am able to help you in your journey.
(202) 957-4465 View (202) 957-4465
Photo of Sharilyn Wiskup Hafkin, Licensed Clinical Professional Counselor in Bethesda, MD
Sharilyn Wiskup Hafkin
Licensed Clinical Professional Counselor, MEd, EdS, LPC, CGP
Verified Verified
3 Endorsed
Bethesda, MD 20814
I believe that everyone deserves therapy and an objective ear. No problem is too big or too small. I see it as part of my job to help you understand the way you think and feel so that you can have more meaningful relationships with those closest to you. Together, we'll make sense of the things in your life that are troubling you, and explore ways to cope in order to help you feel less overwhelmed.
I believe that everyone deserves therapy and an objective ear. No problem is too big or too small. I see it as part of my job to help you understand the way you think and feel so that you can have more meaningful relationships with those closest to you. Together, we'll make sense of the things in your life that are troubling you, and explore ways to cope in order to help you feel less overwhelmed.
(202) 759-7441 View (202) 759-7441
Photo of V. Jan Freeman, Clinical Social Work/Therapist in Bethesda, MD
V. Jan Freeman
Clinical Social Work/Therapist, LCSW-C
Verified Verified
Bethesda, MD 20814
I am an experienced therapist who finds real joy in helping one person/couple/family at a time regain control of their life, improve their situation, find a better path, or understand who they really are at the deepest levels along with core relationship patterns. I have 37 years of clinical experience and specialized postgraduate training in a variety of approaches.. Trauma is a primary specialty though I am trained to address a range of problems. I want you to feel safe and comfortable when we meet so developing a trusting relationship will be important. My style is interactive; you will decide if I'm a good fit for what you need.
I am an experienced therapist who finds real joy in helping one person/couple/family at a time regain control of their life, improve their situation, find a better path, or understand who they really are at the deepest levels along with core relationship patterns. I have 37 years of clinical experience and specialized postgraduate training in a variety of approaches.. Trauma is a primary specialty though I am trained to address a range of problems. I want you to feel safe and comfortable when we meet so developing a trusting relationship will be important. My style is interactive; you will decide if I'm a good fit for what you need.
(301) 579-0108 View (301) 579-0108
Photo of Melissa Herendeen, Clinical Social Work/Therapist in Bethesda, MD
Melissa Herendeen
Clinical Social Work/Therapist, LCSW-C, LGSW
Verified Verified
1 Endorsed
Bethesda, MD 20814
I work with children, adolescents, and adults touched by adoption. Through an attachment and trauma-informed approach clients are able to find internal safety and better understanding of themselves and their experience as an adopted person, parent, or birth parent. Many clients come with complex layers of anxiety, depression, emotional dysregulation, relationship challenges, and ambiguous grief. Through the therapeutic relationship clients gain tools for internal validation, strategies to best manage their challenges, and opportunities to explore complex emotions in a safe environment.
I work with children, adolescents, and adults touched by adoption. Through an attachment and trauma-informed approach clients are able to find internal safety and better understanding of themselves and their experience as an adopted person, parent, or birth parent. Many clients come with complex layers of anxiety, depression, emotional dysregulation, relationship challenges, and ambiguous grief. Through the therapeutic relationship clients gain tools for internal validation, strategies to best manage their challenges, and opportunities to explore complex emotions in a safe environment.
(240) 652-2309 View (240) 652-2309
Photo of Jacob S Hafkin, Clinical Social Work/Therapist in Bethesda, MD
Jacob S Hafkin
Clinical Social Work/Therapist, LCSW-C
Verified Verified
1 Endorsed
Bethesda, MD 20814
Hi, I'm Jacob. I'm a traveler, a reader, an outoorsman and a plant collector. I'm a Therapist, a Returned Peace Corps Volunteer, and a Wilderness First Responder. In 2013 I graduated with an MSW from the University of North Carolina-Chapel Hill. There, I obtained specialty certificates in Substance Abuse Counseling and School Social Work. I've aided middle schoolers, adolescents and people in their 20's/30s to transition from angry and confused to calmer and empowered. My goal is to get real work done, but also have fun along the way.
Hi, I'm Jacob. I'm a traveler, a reader, an outoorsman and a plant collector. I'm a Therapist, a Returned Peace Corps Volunteer, and a Wilderness First Responder. In 2013 I graduated with an MSW from the University of North Carolina-Chapel Hill. There, I obtained specialty certificates in Substance Abuse Counseling and School Social Work. I've aided middle schoolers, adolescents and people in their 20's/30s to transition from angry and confused to calmer and empowered. My goal is to get real work done, but also have fun along the way.
(301) 691-4381 View (301) 691-4381
Photo of Katie Cogan, Licensed Clinical Professional Counselor in Bethesda, MD
Katie Cogan
Licensed Clinical Professional Counselor, MA, LCPC, LCC
Verified Verified
Bethesda, MD 20814  (Online Only)
Katie specializes in PTSD, adoption/foster care issues, helping people who are suffering from chronic illnesses. Katie has an interest in how we can develop second careers as “retire” and reinvent ourselves to use our wealth of wisdom.
Katie specializes in PTSD, adoption/foster care issues, helping people who are suffering from chronic illnesses. Katie has an interest in how we can develop second careers as “retire” and reinvent ourselves to use our wealth of wisdom.
(240) 541-5476 View (240) 541-5476
Photo of Amanda Wiggins, Marriage & Family Therapist in Bethesda, MD
Amanda Wiggins
Marriage & Family Therapist, MS, LCMFT
Verified Verified
Bethesda, MD 20817
I work with children, teens, and adults facing stressors such as life transitions, anxiety, depression, separation and divorce, blended families, parent child relationships, as well as identity, personal, and relational growth. My training as a MFT has helped me develop a collaborative and systemically informed therapy style. I believe clients are the experts in their own lives, and I can serve as a warm, empathetic and non-judgmental presence to facilitate exploration and self growth.
I work with children, teens, and adults facing stressors such as life transitions, anxiety, depression, separation and divorce, blended families, parent child relationships, as well as identity, personal, and relational growth. My training as a MFT has helped me develop a collaborative and systemically informed therapy style. I believe clients are the experts in their own lives, and I can serve as a warm, empathetic and non-judgmental presence to facilitate exploration and self growth.
(301) 720-1706 View (301) 720-1706
Photo of Neal R Morris, Psychologist in Bethesda, MD
Neal R Morris
Psychologist, EdD, MS, CBSM, ABPP
Verified Verified
Bethesda, MD 20814
I am a practical professional who is committed to those I work with. The goal is to identify actions that improve your life and translate these actions into concrete steps to promote emotional stability and effectiveness in dealing with long-standing and daily challenges. I work with adults and children helping them deal with specific problems as well as supporting their development of long-term, positive life-goals. I am board-certified in Clinical Psychology and Sleep Psychology treating adults, children, families and couples with emotional, behavioral and physical-health concerns. I specialize in treating anxiety, panic and problems such as chronic pain and insomnia.
I am a practical professional who is committed to those I work with. The goal is to identify actions that improve your life and translate these actions into concrete steps to promote emotional stability and effectiveness in dealing with long-standing and daily challenges. I work with adults and children helping them deal with specific problems as well as supporting their development of long-term, positive life-goals. I am board-certified in Clinical Psychology and Sleep Psychology treating adults, children, families and couples with emotional, behavioral and physical-health concerns. I specialize in treating anxiety, panic and problems such as chronic pain and insomnia.
(301) 852-7604 View (301) 852-7604
Photo of Heidi Emmer Safe Place Healing LLC, Clinical Social Work/Therapist in Bethesda, MD
Heidi Emmer Safe Place Healing LLC
Clinical Social Work/Therapist, LCSW-C
Verified Verified
2 Endorsed
Bethesda, MD 20817  (Online Only)
Do you feel helpless and alone? Do you have a feeling of dread or threat of danger, even though you know it isn't there? Do you have negative beliefs about yourself that get in the way of your potential? I work with adults with depression, anxiety, PTSD. I specialize in EMDR. I believe that certain shaming experiences in early childhood, lead to negative core beliefs that cause depression and anxiety. We can, however change these negative beliefs to positive ones and find your strength and wisdom prevailing from these traumas. Let's work together to help you take charge of your life and begin your healing journey.
Do you feel helpless and alone? Do you have a feeling of dread or threat of danger, even though you know it isn't there? Do you have negative beliefs about yourself that get in the way of your potential? I work with adults with depression, anxiety, PTSD. I specialize in EMDR. I believe that certain shaming experiences in early childhood, lead to negative core beliefs that cause depression and anxiety. We can, however change these negative beliefs to positive ones and find your strength and wisdom prevailing from these traumas. Let's work together to help you take charge of your life and begin your healing journey.
(301) 265-3155 View (301) 265-3155
Photo of Rosario de Gregorio, Marriage & Family Therapist in Bethesda, MD
Rosario de Gregorio
Marriage & Family Therapist, LCMFT
Verified Verified
Bethesda, MD 20814
I am a bilingual Marriage and Family Therapist I believe therapy can help individuals find new ways of functioning and increase self-knowledge that can help them move forward in life. Every crisis, obstacle and challenge in life can offer an opportunity for personal growth and self-discovery that can help us learn new things about ourselves. As an immigrant myself I know the individual and family challenges of living in a different culture. I enjoy working with immigrant families helping them navigate the benefits and challenges of living in a new culture.
I am a bilingual Marriage and Family Therapist I believe therapy can help individuals find new ways of functioning and increase self-knowledge that can help them move forward in life. Every crisis, obstacle and challenge in life can offer an opportunity for personal growth and self-discovery that can help us learn new things about ourselves. As an immigrant myself I know the individual and family challenges of living in a different culture. I enjoy working with immigrant families helping them navigate the benefits and challenges of living in a new culture.
(240) 233-4407 View (240) 233-4407
Photo of Patricia J. Ullman, Counselor in Bethesda, MD
Patricia J. Ullman
Counselor, MA, LGPC
Verified Verified
Bethesda, MD 20814
I offer individual and group therapy, virtually and in-person, for grief and loss, anxiety and depression, life transitions, and spiritual issues ranging from the existential life journey to cult awareness and recovery. We all need support through the inevitable challenges of human life, and being able to talk with a counselor in a safe, empathetic, and nonjudgmental setting is essential to healing and strengthening our mental and physical well-being.
I offer individual and group therapy, virtually and in-person, for grief and loss, anxiety and depression, life transitions, and spiritual issues ranging from the existential life journey to cult awareness and recovery. We all need support through the inevitable challenges of human life, and being able to talk with a counselor in a safe, empathetic, and nonjudgmental setting is essential to healing and strengthening our mental and physical well-being.
(301) 298-3421 View (301) 298-3421
Photo of Katelyn Alcamo, Marriage & Family Therapist in Bethesda, MD
Katelyn Alcamo
Marriage & Family Therapist, MS, LCMFT
Verified Verified
5 Endorsed
Bethesda, MD 20817
Are you worried that your child is anxious, depressed or having difficulty navigating peer relationships? Are you struggling with parenting a teenager? Do you feel disconnected from your partner and find yourself wondering where the passion went? Relationships can be both the most rewarding and most challenging aspects of our lives. As a Marriage and Family Therapist, I am specially trained to work with children, couples, and families. I provide a safe and supportive place where you are empowered to reach your personal and relationship goals. Together we can help you find balance, enrichment, and happiness in your life.
Are you worried that your child is anxious, depressed or having difficulty navigating peer relationships? Are you struggling with parenting a teenager? Do you feel disconnected from your partner and find yourself wondering where the passion went? Relationships can be both the most rewarding and most challenging aspects of our lives. As a Marriage and Family Therapist, I am specially trained to work with children, couples, and families. I provide a safe and supportive place where you are empowered to reach your personal and relationship goals. Together we can help you find balance, enrichment, and happiness in your life.
(240) 949-7990 View (240) 949-7990
Photo of Beletiah Mani, Clinical Social Work/Therapist in Bethesda, MD
Beletiah Mani
Clinical Social Work/Therapist, LCSW
Verified Verified
Bethesda, MD 20814  (Online Only)
Hello, I am a Licensed Clinical Social Worker located in Maryland. I have worked with youth and young adults for the past 5 years as a social worker in several different capacities.
Hello, I am a Licensed Clinical Social Worker located in Maryland. I have worked with youth and young adults for the past 5 years as a social worker in several different capacities.
(240) 820-2754 View (240) 820-2754
Photo of Dr. Stephanie Marcy Dinius, Psychological Associate in Bethesda, MD
Dr. Stephanie Marcy Dinius
Psychological Associate, PhD, EdM
Verified Verified
Bethesda, MD 20814
Dr. Stephanie Dinius is a mental performance coach and registered psychology associate in Maryland. Stephanie received her B.A. from Stanford University, where she was also an All-American student athlete. Stephanie earned her master’s degree (Ed.M.) in Counseling with a specialization in sport and performance psychology, followed by a Ph.D. in Counseling Psychology, both from Boston University. She completed her doctoral psychology internship at the University of Oregon Counseling Services.
Dr. Stephanie Dinius is a mental performance coach and registered psychology associate in Maryland. Stephanie received her B.A. from Stanford University, where she was also an All-American student athlete. Stephanie earned her master’s degree (Ed.M.) in Counseling with a specialization in sport and performance psychology, followed by a Ph.D. in Counseling Psychology, both from Boston University. She completed her doctoral psychology internship at the University of Oregon Counseling Services.
(240) 301-3852 View (240) 301-3852
Photo of The Counseling Center of Maryland, Counselor in Bethesda, MD
The Counseling Center of Maryland
Counselor, LCPC, NCC, MA
Verified Verified
1 Endorsed
Bethesda, MD 20814
The professionals at The Counseling Center of Maryland use a variety of techniques to help improve the quality of life for individuals, couples, groups, and families. Through our strength-based and collaborative approach, we offer new insights that enable our clients to see things from different perspectives. We provide treatment and counseling for anxiety, depression, grief, emotional regulation issues, self-esteem, relationship concerns, and parenting. Through active and evidence based strategies we help empower our clients to make choices that evoke positive changes in their lives. Together, we will look at feelings, thoughts and behaviors as vehicles to affirmative changes.
The professionals at The Counseling Center of Maryland use a variety of techniques to help improve the quality of life for individuals, couples, groups, and families. Through our strength-based and collaborative approach, we offer new insights that enable our clients to see things from different perspectives. We provide treatment and counseling for anxiety, depression, grief, emotional regulation issues, self-esteem, relationship concerns, and parenting. Through active and evidence based strategies we help empower our clients to make choices that evoke positive changes in their lives. Together, we will look at feelings, thoughts and behaviors as vehicles to affirmative changes.
(301) 918-5182 View (301) 918-5182
Photo of Stuart Warren, Clinical Social Work/Therapist in Bethesda, MD
Stuart Warren
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Bethesda, MD 20815
The therapeutic relationship is the foundation of the growth and healing process. My primary goal is to cultivate trust, comfort and connection with my clients. This relationship is essential to whatever challenge has caused you to seek help. I have a true passion for helping others and have spent my career learning from world class clinicians and mental health professionals of various disciplines. I offer a range of different therapies that effectively treat anxiety, depression, mood disorders, trauma, substance use issues and other compulsive behaviors.
The therapeutic relationship is the foundation of the growth and healing process. My primary goal is to cultivate trust, comfort and connection with my clients. This relationship is essential to whatever challenge has caused you to seek help. I have a true passion for helping others and have spent my career learning from world class clinicians and mental health professionals of various disciplines. I offer a range of different therapies that effectively treat anxiety, depression, mood disorders, trauma, substance use issues and other compulsive behaviors.
(561) 782-4405 View (561) 782-4405
Photo of Stephanie Helwig, Psychologist in Bethesda, MD
Stephanie Helwig
Psychologist, PsyD
Verified Verified
Bethesda, MD 20814
Feeling chronic negative emotions such as sadness, anger, anxiety, or loneliness is often a sign that something in our relationships has gone awry. By the time we attend psychotherapy, the task of altering our relationships may feel difficult or impossible to navigate alone. As a psychodynamic therapist, I am interested in how your early relationships impact your personality, worldview, attachment, perceptions, and coping mechanisms. Through compassion, challenge and sometimes humor, I aim to help my patients gain insight, learn new ways of relating to others, and implement change in order to heal, grow, and flourish.
Feeling chronic negative emotions such as sadness, anger, anxiety, or loneliness is often a sign that something in our relationships has gone awry. By the time we attend psychotherapy, the task of altering our relationships may feel difficult or impossible to navigate alone. As a psychodynamic therapist, I am interested in how your early relationships impact your personality, worldview, attachment, perceptions, and coping mechanisms. Through compassion, challenge and sometimes humor, I aim to help my patients gain insight, learn new ways of relating to others, and implement change in order to heal, grow, and flourish.
(202) 677-3546 View (202) 677-3546
Photo of Elaine Klionsky, Psychologist in Bethesda, MD
Elaine Klionsky
Psychologist, JD, PhD
Verified Verified
Bethesda, MD 20815
Waitlist for new clients
I am committed to helping individuals and couples gain insight and make behavioral changes to enhance their lives. My focus is on relationships with friends, family, romantic partners and/or the workplace as I believe engagement in these areas is an important aspect of living a satisfying and purposeful life. I also work with those struggling with addictions, compulsions, self-destructive behavior (especially eating disorders), and balancing the competing demands of life. My professional strengths are reflected in a nonjudgmental stance and an ability to help people examine themselves and make the changes necessary to live in a more fulfilling life.
I am committed to helping individuals and couples gain insight and make behavioral changes to enhance their lives. My focus is on relationships with friends, family, romantic partners and/or the workplace as I believe engagement in these areas is an important aspect of living a satisfying and purposeful life. I also work with those struggling with addictions, compulsions, self-destructive behavior (especially eating disorders), and balancing the competing demands of life. My professional strengths are reflected in a nonjudgmental stance and an ability to help people examine themselves and make the changes necessary to live in a more fulfilling life.
(301) 244-8991 View (301) 244-8991
Photo of Shawnta McMillian, Licensed Clinical Professional Counselor in Bethesda, MD
Shawnta McMillian
Licensed Clinical Professional Counselor, LCPC
Verified Verified
Bethesda, MD 20814  (Online Only)
Hello, I'm Shawnta (pronounced with a long a sound at the end)! Do you want to rediscover yourself in a way that moves you forward in life toward purpose and joy? Are you experiencing challenges in moving forward after a significant loss? Do you find yourself consumed with the past and not able to move forward?
Hello, I'm Shawnta (pronounced with a long a sound at the end)! Do you want to rediscover yourself in a way that moves you forward in life toward purpose and joy? Are you experiencing challenges in moving forward after a significant loss? Do you find yourself consumed with the past and not able to move forward?
(240) 266-0648 View (240) 266-0648

How does your Therapist compare?

Number of Therapists in Bethesda, MD

1,000+

Average cost per session

$180

Therapists in Bethesda, MD who prioritize treating:

94% Anxiety
90% Depression
78% Relationship Issues
74% Self Esteem
66% Coping Skills
64% Trauma and PTSD
61% Grief

Average years in practice

13 Years

Top 3 insurances accepted

64% BlueCross and BlueShield
63% CareFirst
57% Cigna and Evernorth

How Therapists in Bethesda, MD see their clients

60% In Person and Online
40% Online Only

Gender breakdown

82% Female
17% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Bethesda?

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.