Therapists in Fairfax, VA

Photo of Sylvia Hanna Jacoub, Psychologist in Fairfax, VA
Sylvia Hanna Jacoub
Psychologist, PsyD
Verified Verified
1 Endorsed
Fairfax, VA 22030
When feelings of worry, irritability, sadness, anger or the curve balls life throws at you become overwhelming, they can begin to interfere with your ability to be fully present at home, work, or in your relationships. Sometimes these feelings may be related to current life stressors, or they may have deeper roots that make them feel harder to untangle. I can help you by providing a warm, safe, and non-judgmental environment to begin the process of self-exploration and healing .I am a licensed clinical psychologist with extensive experience working with adolescents and adults from diverse cultural backgrounds.
When feelings of worry, irritability, sadness, anger or the curve balls life throws at you become overwhelming, they can begin to interfere with your ability to be fully present at home, work, or in your relationships. Sometimes these feelings may be related to current life stressors, or they may have deeper roots that make them feel harder to untangle. I can help you by providing a warm, safe, and non-judgmental environment to begin the process of self-exploration and healing .I am a licensed clinical psychologist with extensive experience working with adolescents and adults from diverse cultural backgrounds.
(571) 339-5501 View (571) 339-5501
Photo of Christine E Courtney, Clinical Social Work/Therapist in Fairfax, VA
Christine E Courtney
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Fairfax, VA 22030
Currently accepting new clients. Let’s cut to the chase, I help people who are looking for self-growth, who want their relationships to improve, who are exploring ADHD issues, and people who want to figure out how to heal from hardship/trauma. We work together to discover the things that are getting in your way of reaching the goals and changes you want. Whether it’s a traumatic experience, toxic relationships, dealing with a beast of an inner critic, or uncertainty of what the problem even is, we will figure it out together. I also have particular specialties working with fellow therapists and military members/families.
Currently accepting new clients. Let’s cut to the chase, I help people who are looking for self-growth, who want their relationships to improve, who are exploring ADHD issues, and people who want to figure out how to heal from hardship/trauma. We work together to discover the things that are getting in your way of reaching the goals and changes you want. Whether it’s a traumatic experience, toxic relationships, dealing with a beast of an inner critic, or uncertainty of what the problem even is, we will figure it out together. I also have particular specialties working with fellow therapists and military members/families.
(571) 556-3432 View (571) 556-3432
Photo of Marigold Counseling Services, LLC, Marriage & Family Therapist in Fairfax, VA
Marigold Counseling Services, LLC
Marriage & Family Therapist, MS, LMFT
Verified Verified
1 Endorsed
Fairfax, VA 22030  (Online Only)
Life can be overwhelming and difficult to navigate at times. These challenges can often lead to feelings of hopelessness and anxiety. Therapy can empower you and provide you with the tools needed to manage your obstacles. I am a licensed Marriage and Family Therapist with over fifteen years of experience providing counseling to individuals, couples, and families. I value establishing a safe and open counseling environment for clients to feel heard and accepted.
Life can be overwhelming and difficult to navigate at times. These challenges can often lead to feelings of hopelessness and anxiety. Therapy can empower you and provide you with the tools needed to manage your obstacles. I am a licensed Marriage and Family Therapist with over fifteen years of experience providing counseling to individuals, couples, and families. I value establishing a safe and open counseling environment for clients to feel heard and accepted.
(571) 200-6382 View (571) 200-6382
Photo of Amy Stevenson, Licensed Professional Counselor in Fairfax, VA
Amy Stevenson
Licensed Professional Counselor, LPC, CCTP-II, C-DBT
Verified Verified
1 Endorsed
Fairfax, VA 22031
I am a Licensed Professional Counselor and Level II Certified Clinical Trauma Professional. It is my mission to enhance the lives of every individual and family I serve, though building healthy relationships and emphasizing the importance of total wellness. I practice a person-centered approach and incorporate elements of Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and Mindfulness techniques to help adolescents and adults who experience trauma, mood disorders, psychosis, anxiety, family and relationship conflict, life stage transitions, and every-day stressors.
I am a Licensed Professional Counselor and Level II Certified Clinical Trauma Professional. It is my mission to enhance the lives of every individual and family I serve, though building healthy relationships and emphasizing the importance of total wellness. I practice a person-centered approach and incorporate elements of Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and Mindfulness techniques to help adolescents and adults who experience trauma, mood disorders, psychosis, anxiety, family and relationship conflict, life stage transitions, and every-day stressors.
(571) 520-7843 View (571) 520-7843
Photo of Karen To, Psychologist in Fairfax, VA
Karen To
Psychologist, PsyD
Verified Verified
1 Endorsed
Fairfax, VA 22030
We all face problems in life which can at times seem overwhelming. Do you find yourself feeling sad or anxious, stressed or discouraged? Are you looking for greater happiness and fulfillment in your relationships or career? Perhaps you've tried everything you can think of but nothing seems to work. I would like to help. I believe that entering a respectful, compassionate therapeutic relationship can promote real change and lead to greater satisfaction and enjoyment in life.
We all face problems in life which can at times seem overwhelming. Do you find yourself feeling sad or anxious, stressed or discouraged? Are you looking for greater happiness and fulfillment in your relationships or career? Perhaps you've tried everything you can think of but nothing seems to work. I would like to help. I believe that entering a respectful, compassionate therapeutic relationship can promote real change and lead to greater satisfaction and enjoyment in life.
(703) 349-2999 View (703) 349-2999
Photo of Shariff Ruffin, Clinical Social Work/Therapist in Fairfax, VA
Shariff Ruffin
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Fairfax, VA 22031  (Online Only)
Lately have you felt anxious, sad or angry? And have these feelings made you feel hopeless, not good enough, or influenced you to use substances to cope? Overcoming these feelings might feel impossible to do and make you feel stuck. Many people engage in therapy to achieve peace and stop the cycle of distress. They want a therapist who can relate to them on a human level.
Lately have you felt anxious, sad or angry? And have these feelings made you feel hopeless, not good enough, or influenced you to use substances to cope? Overcoming these feelings might feel impossible to do and make you feel stuck. Many people engage in therapy to achieve peace and stop the cycle of distress. They want a therapist who can relate to them on a human level.
(571) 200-6980 View (571) 200-6980
Photo of Sarah Hagen, Clinical Social Work/Therapist in Fairfax, VA
Sarah Hagen
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
3 Endorsed
Fairfax, VA 22030
I help women through trying to conceive, infertility issues, grief and loss, adoption, pregnancy, postpartum, and beyond. Becoming a mother does not always go as expected, and parenting little humans can bring up a lot of big feelings. I am certified in perinatal mental health with specific training in perinatal mood and anxiety disorders, like postpartum (PP) depression, PP anxiety and PP OCD. I understand the unique experience of taking on this new role while still trying to maintain your own identity. I am here to support you throughout your journey of becoming a parent so that you can be the best version of yourself possible.
I help women through trying to conceive, infertility issues, grief and loss, adoption, pregnancy, postpartum, and beyond. Becoming a mother does not always go as expected, and parenting little humans can bring up a lot of big feelings. I am certified in perinatal mental health with specific training in perinatal mood and anxiety disorders, like postpartum (PP) depression, PP anxiety and PP OCD. I understand the unique experience of taking on this new role while still trying to maintain your own identity. I am here to support you throughout your journey of becoming a parent so that you can be the best version of yourself possible.
(571) 748-4202 View (571) 748-4202
Photo of Janet Boateng, Resident in Counseling in Fairfax, VA
Janet Boateng
Resident in Counseling, MA, LPC-R
Verified Verified
1 Endorsed
Fairfax, VA 22030
Are you someone who's looking to have someone to talk to. Someone who can actually listen and understand what you're saying. And give you the necessary feedback and inputs that you need to maybe see things in a different light than you haven't before. I am your girl! I have been providing counseling to individuals for seven years now in several issues such as stress and life transitions, anxiety, depression, childhood trauma, interpersonal relationship problems, personal growth, coping skills development, self-esteem, marriage and family issues and many more. Whatever it is, I am here.
Are you someone who's looking to have someone to talk to. Someone who can actually listen and understand what you're saying. And give you the necessary feedback and inputs that you need to maybe see things in a different light than you haven't before. I am your girl! I have been providing counseling to individuals for seven years now in several issues such as stress and life transitions, anxiety, depression, childhood trauma, interpersonal relationship problems, personal growth, coping skills development, self-esteem, marriage and family issues and many more. Whatever it is, I am here.
(571) 459-7701 View (571) 459-7701
Photo of Christine Gauthier, Licensed Professional Counselor in Fairfax, VA
Christine Gauthier
Licensed Professional Counselor, MA, LCMHC, LPC, SP
Verified Verified
Fairfax, VA 22030  (Online Only)
A good clinical match would be those seeking clarity related to life decisions, transitions, or relationships, those trying to overcome anxiety or depression, improve their self-esteem, or come to a place of contentment with their lives. I really enjoy working with college students or other adults on the cusp, or in the midst, of life changes.
A good clinical match would be those seeking clarity related to life decisions, transitions, or relationships, those trying to overcome anxiety or depression, improve their self-esteem, or come to a place of contentment with their lives. I really enjoy working with college students or other adults on the cusp, or in the midst, of life changes.
(571) 946-7981 View (571) 946-7981
Photo of The Royal Care Counseling Services in Fairfax, VA
The Royal Care Counseling Services
MA, NCC, LPCs, CSACs
Verified Verified
1 Endorsed
Fairfax, VA 22030
Human beings are born with a desire to be seen, witnessed, and engaged in determining their life path. Yet, loneliness, identity struggles, and shame alienate us from our authentic self. My passion is supporting clients as they uncover their real self, their original self before shame and trauma, and find ways that feel authentic for healing and moving forward in life. I am interested in supporting the whole person – emotional, developmental, and life-transitions.
Human beings are born with a desire to be seen, witnessed, and engaged in determining their life path. Yet, loneliness, identity struggles, and shame alienate us from our authentic self. My passion is supporting clients as they uncover their real self, their original self before shame and trauma, and find ways that feel authentic for healing and moving forward in life. I am interested in supporting the whole person – emotional, developmental, and life-transitions.
(571) 444-8382 View (571) 444-8382
Photo of Laura Wakefield, Licensed Professional Counselor in Fairfax, VA
Laura Wakefield
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Fairfax, VA 22030
I support individuals and couples by using the science of attachment to make sense of important relationships. My role is to help you to organize your life experiences and emotions so you can better understand your patterns/needs for connection and then find more satisfying ways to share and relate to loved ones. I work to help you make sense of your emotions, especially the vulnerabilities, misunderstandings, protections, and hurts that underpin your experience and often drive your behavior or responses. From there, I can support you to create more satisfying relationships, abundant self-work, clear boundaries, and emotional calm.
I support individuals and couples by using the science of attachment to make sense of important relationships. My role is to help you to organize your life experiences and emotions so you can better understand your patterns/needs for connection and then find more satisfying ways to share and relate to loved ones. I work to help you make sense of your emotions, especially the vulnerabilities, misunderstandings, protections, and hurts that underpin your experience and often drive your behavior or responses. From there, I can support you to create more satisfying relationships, abundant self-work, clear boundaries, and emotional calm.
(571) 200-5220 View (571) 200-5220
Photo of Kaitlyn Steel, Marriage & Family Therapist in Fairfax, VA
Kaitlyn Steel
Marriage & Family Therapist, MS, LMFT
Verified Verified
1 Endorsed
Fairfax, VA 22030
I am a Licensed Marriage and Family Therapist in Virginia and New York. I earned my Master’s Degree in Marriage and Family Therapy/Counseling from Capella University and my Bachelor’s in Psychology from Christopher Newport University. I am also a member of the American Association for Marriage and Family Therapy. I work with couples and individuals on a multitude of issues including transition, communication, addiction, life-events, and more. I practice from an attachment-based, trauma informed, Emotionally Focused Therapy model.
I am a Licensed Marriage and Family Therapist in Virginia and New York. I earned my Master’s Degree in Marriage and Family Therapy/Counseling from Capella University and my Bachelor’s in Psychology from Christopher Newport University. I am also a member of the American Association for Marriage and Family Therapy. I work with couples and individuals on a multitude of issues including transition, communication, addiction, life-events, and more. I practice from an attachment-based, trauma informed, Emotionally Focused Therapy model.
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Photo of DaShondra (Day) Charles, Licensed Professional Counselor in Fairfax, VA
DaShondra (Day) Charles
Licensed Professional Counselor, LPC
Verified Verified
Fairfax, VA 22030  (Online Only)
Hello, my name is Day Charles, and I'm a board-certified Licensed Professional Counselor (LPC), Certified Advanced Grief Counseling Specialist, and a Certified Telemental Health Provider. I have over 15 years of mental health counseling experience and I am entering my 6th year of practicing independently. The name of my private practice - Day One Counseling & Consulting - describes exactly how I encourage my clients to view their wellness journey - every day IS “Day One.” If you are suffering from stress, anxiety, or depression, need to overcome low self-esteem and discover your authentic self, or are seeking support as you navigate
Hello, my name is Day Charles, and I'm a board-certified Licensed Professional Counselor (LPC), Certified Advanced Grief Counseling Specialist, and a Certified Telemental Health Provider. I have over 15 years of mental health counseling experience and I am entering my 6th year of practicing independently. The name of my private practice - Day One Counseling & Consulting - describes exactly how I encourage my clients to view their wellness journey - every day IS “Day One.” If you are suffering from stress, anxiety, or depression, need to overcome low self-esteem and discover your authentic self, or are seeking support as you navigate
(571) 946-5822 View (571) 946-5822
Photo of Allyson Markussen, Licensed Professional Counselor in Fairfax, VA
Allyson Markussen
Licensed Professional Counselor, LPC, EdS
Verified Verified
1 Endorsed
Fairfax, VA 22030
Waitlist for new clients
Hello! Thanks so much for including me as a consideration in your healing journey! I am a Resident in Counseling in Virginia. I have experience supporting children, adolescents, and young adults who are moving through life's challenges including behavioral challenges, friendship challenges, anxiety, anger management, OCD, emotional regulation, adjustment, and self-esteem.
Hello! Thanks so much for including me as a consideration in your healing journey! I am a Resident in Counseling in Virginia. I have experience supporting children, adolescents, and young adults who are moving through life's challenges including behavioral challenges, friendship challenges, anxiety, anger management, OCD, emotional regulation, adjustment, and self-esteem.
(571) 570-3439 View (571) 570-3439
Photo of Heather Ann Harper, Clinical Social Work/Therapist in Fairfax, VA
Heather Ann Harper
Clinical Social Work/Therapist, LCSW, MSW, BSW
Verified Verified
3 Endorsed
Fairfax, VA 22030
I have worked in many settings including inpatient, outpatient, schools, home based therapy, sexual assault services, respite care, family services, emergency/crisis intervention and community mental health. I am trained and certified in many clinical interventions that allows for an integrative approach. I incorporate skill building, trauma interventions, behavioral modification, resourcing, and collaborative work with others to provide the most effective results possible.
I have worked in many settings including inpatient, outpatient, schools, home based therapy, sexual assault services, respite care, family services, emergency/crisis intervention and community mental health. I am trained and certified in many clinical interventions that allows for an integrative approach. I incorporate skill building, trauma interventions, behavioral modification, resourcing, and collaborative work with others to provide the most effective results possible.
(571) 248-7027 View (571) 248-7027
Photo of Melody Ege, Licensed Professional Counselor in Fairfax, VA
Melody Ege
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Fairfax, VA 22030
Life is a journey, and I want to help you enjoy that journey. Sometimes we face obstacles along the way— racing thoughts, challenging memories, irritability, relationship conflict, daily stress. Whatever it may be, you don’t have to struggle alone. I strive to create an environment where you are free to express your inner world and experiences in a warm, empathetic, non-judgmental space.
Life is a journey, and I want to help you enjoy that journey. Sometimes we face obstacles along the way— racing thoughts, challenging memories, irritability, relationship conflict, daily stress. Whatever it may be, you don’t have to struggle alone. I strive to create an environment where you are free to express your inner world and experiences in a warm, empathetic, non-judgmental space.
(571) 701-2085 View (571) 701-2085
Photo of Vicki Kirsch, Clinical Social Work/Therapist in Fairfax, VA
Vicki Kirsch
Clinical Social Work/Therapist, LCSW, PhD
Verified Verified
Fairfax, VA 22031
I am passionate about working with individuals to help them uncover their unique, vital selves in relation to others and the world. I come to my practice with a toolbox approach of methods and strengths including EMDR, DBT and relational psychodynamic psychotherapy. With empathy and insight, I meet the client where they are and support them in their process of therapy and life. I am also Director of the MSW Program, Associate Professor, Dept. of Social Work at George Mason University.
I am passionate about working with individuals to help them uncover their unique, vital selves in relation to others and the world. I come to my practice with a toolbox approach of methods and strengths including EMDR, DBT and relational psychodynamic psychotherapy. With empathy and insight, I meet the client where they are and support them in their process of therapy and life. I am also Director of the MSW Program, Associate Professor, Dept. of Social Work at George Mason University.
(617) 306-7417 View (617) 306-7417
Photo of Jackie Custer, Pre-Licensed Professional in Fairfax, VA
Jackie Custer
Pre-Licensed Professional
Verified Verified
Fairfax, VA 22030
My experience with trauma work allows me to address the needs of children, adolescents, adults, and their families effectively. I specialize in ensuring effective case management, goal setting, and, most importantly, creating a solid therapeutic relationship with my clients. My approach is client-centered and evidence-based, using different therapeutic modalities to meet individual client needs. This kind of support includes providing psychoeducation and skills training to help clients gain insights into their lives, manage their emotions, and change particular behaviors.
My experience with trauma work allows me to address the needs of children, adolescents, adults, and their families effectively. I specialize in ensuring effective case management, goal setting, and, most importantly, creating a solid therapeutic relationship with my clients. My approach is client-centered and evidence-based, using different therapeutic modalities to meet individual client needs. This kind of support includes providing psychoeducation and skills training to help clients gain insights into their lives, manage their emotions, and change particular behaviors.
(571) 568-8307 View (571) 568-8307
Photo of Diane Marie Hoekstra, Psychologist in Fairfax, VA
Diane Marie Hoekstra
Psychologist, PhD
Verified Verified
Fairfax, VA 22030
As a therapist, I have a supportive but directive approach to therapy. My approach to therapy is collaborative with my clients. I emphasize how one's internal working model of relationships impacts present relationships, mood, and overall quality of life. I am very focused in my work and believe in educating the client about the process of therapy. You can view my website at www.drdianehoekstra.com.
As a therapist, I have a supportive but directive approach to therapy. My approach to therapy is collaborative with my clients. I emphasize how one's internal working model of relationships impacts present relationships, mood, and overall quality of life. I am very focused in my work and believe in educating the client about the process of therapy. You can view my website at www.drdianehoekstra.com.
(540) 212-2374 x101 View (540) 212-2374 x101
Photo of Kate Walker, Licensed Professional Counselor in Fairfax, VA
Kate Walker
Licensed Professional Counselor, ATR-BC, LPC
Verified Verified
1 Endorsed
Fairfax, VA 22033
Are uncomfortable emotions or limiting beliefs clouding your ability to connect to your internal compass and live a life aligned with what you value? Have you been left reeling from the impacts of the pandemic, world events, or other life stressors? If so, I'm here to help you make sense of it all. I believe change is possible when we couple compassionate curiosity with consistent and appropriate support. We are social creatures by nature and thrive when we feel connected and understood by others. But it can be hard to seek out those connections when we're struggling to understand and be at peace with ourselves.
Are uncomfortable emotions or limiting beliefs clouding your ability to connect to your internal compass and live a life aligned with what you value? Have you been left reeling from the impacts of the pandemic, world events, or other life stressors? If so, I'm here to help you make sense of it all. I believe change is possible when we couple compassionate curiosity with consistent and appropriate support. We are social creatures by nature and thrive when we feel connected and understood by others. But it can be hard to seek out those connections when we're struggling to understand and be at peace with ourselves.
(703) 783-2358 View (703) 783-2358

How does your Therapist compare?

Number of Therapists in Fairfax, VA

1,000+

Average cost per session

$150

Therapists in Fairfax, VA who prioritize treating:

93% Anxiety
88% Depression
78% Self Esteem
73% Coping Skills
71% Relationship Issues
67% Trauma and PTSD
62% Stress

Average years in practice

12 Years

Top 3 insurances accepted

74% BlueCross and BlueShield
64% Cigna and Evernorth
58% UnitedHealthcare UHC | UBH

How Therapists in Fairfax, VA see their clients

58% In Person and Online
42% Online Only

Gender breakdown

84% Female
15% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Fairfax?

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.