Therapists in Saco, ME

Photo of Tammy Miranda, Counselor in Saco, ME
Tammy Miranda
Counselor, LCPC, CBIS
Verified Verified
1 Endorsed
Saco, ME 04072
Not accepting new clients
Sometimes life can get complicated. It can help to have someone to talk with. Together we can develop a safe, supportive relationship that helps you to discover the path that works best for you. I have worked in helping professions for over 10 years, and during that time have discovered a passion for helping others make positive changes in their lives. My approach is a blend of evidence based practices, including cognitive behavior therapy and mindfulness, with a strong focus on building a supportive therapeutic relationship. My goal is to help you develop your strengths and take concrete actions toward lasting wellness.
Sometimes life can get complicated. It can help to have someone to talk with. Together we can develop a safe, supportive relationship that helps you to discover the path that works best for you. I have worked in helping professions for over 10 years, and during that time have discovered a passion for helping others make positive changes in their lives. My approach is a blend of evidence based practices, including cognitive behavior therapy and mindfulness, with a strong focus on building a supportive therapeutic relationship. My goal is to help you develop your strengths and take concrete actions toward lasting wellness.
(207) 223-7006 View (207) 223-7006
Photo of Laurie Sivonen, LCSW, LLC, Clinical Social Work/Therapist in Saco, ME
Laurie Sivonen, LCSW, LLC
Clinical Social Work/Therapist, LCSW, BS Ed
Verified Verified
2 Endorsed
Saco, ME 04072  (Online Only)
Not accepting new clients
I am currently at capacity and not accepting new clients. Are you finding that your life isn't what you envisioned? Are you feeling depleted, anxious, stuck, parenting a challenging child, or wondering who you are? Are you looking for a safe, nurturing environment with a highly skilled practitioner? Especially an authentic person who believes that the process can and should include laughter? Clients are often pleasantly surprised with the wide array of tools and experience I draw on, including guided meditations created based on your preferred images and desired length. I then emailed to you, to access at any time.
I am currently at capacity and not accepting new clients. Are you finding that your life isn't what you envisioned? Are you feeling depleted, anxious, stuck, parenting a challenging child, or wondering who you are? Are you looking for a safe, nurturing environment with a highly skilled practitioner? Especially an authentic person who believes that the process can and should include laughter? Clients are often pleasantly surprised with the wide array of tools and experience I draw on, including guided meditations created based on your preferred images and desired length. I then emailed to you, to access at any time.
(207) 518-7142 View (207) 518-7142
Photo of Katherine LaCasse, Clinical Social Work/Therapist in Saco, ME
Katherine LaCasse
Clinical Social Work/Therapist, LCSW
Verified Verified
Saco, ME 04072
Not accepting new clients
My life experiences both professionally and personally have shown me how prevalent trauma is in our world today. While we are navigating different or in some cases very similar storms, I believe that each of us travel in our own boat. Some of us are traveling in Yachts with more amenities than we can even imagine, while others are negotiating the turbulence of the seas, in what feels like a life raft. The continuum of vessels is vast and I consider it my job to help you upgrade yours by accessing/implementing positive coping strategies, facilitating insight, collaboratively setting goals, and creating more meaningful relationships.
My life experiences both professionally and personally have shown me how prevalent trauma is in our world today. While we are navigating different or in some cases very similar storms, I believe that each of us travel in our own boat. Some of us are traveling in Yachts with more amenities than we can even imagine, while others are negotiating the turbulence of the seas, in what feels like a life raft. The continuum of vessels is vast and I consider it my job to help you upgrade yours by accessing/implementing positive coping strategies, facilitating insight, collaboratively setting goals, and creating more meaningful relationships.
(207) 605-5762 View (207) 605-5762
Photo of Julia L Orr, Clinical Social Work/Therapist in Saco, ME
Julia L Orr
Clinical Social Work/Therapist, LCSW, LADC
Verified Verified
Saco, ME 04072  (Online Only)
Not accepting new clients
In this present moment are you dealing with hard to manage life stressors? Struggling to know who you are and how to manage overwhelming emotions? Does your past invade your present and prevent you from the joy and happiness we all deserve?
In this present moment are you dealing with hard to manage life stressors? Struggling to know who you are and how to manage overwhelming emotions? Does your past invade your present and prevent you from the joy and happiness we all deserve?
(207) 808-7302 View (207) 808-7302
Photo of Debbie Papps, LCSW, LLC, Clinical Social Work/Therapist in Saco, ME
Debbie Papps, LCSW, LLC
Clinical Social Work/Therapist, LCSW
Verified Verified
Saco, ME 04072  (Online Only)
Waitlist for new clients
Do you experience worry that you feel unable to control? Do you feel depressed more days than not? Have you had difficult life experiences that are affecting you? I offer a non-judgmental, safe and supportive environment, where we will work together to help you feel better, learning skills that will lead you to feel more confident in coping with life's problems. I have training from experts in the field of Dialectical Behavioral Therapy and have over 20 years of experience doing DBT therapy and DBT skills group.
Do you experience worry that you feel unable to control? Do you feel depressed more days than not? Have you had difficult life experiences that are affecting you? I offer a non-judgmental, safe and supportive environment, where we will work together to help you feel better, learning skills that will lead you to feel more confident in coping with life's problems. I have training from experts in the field of Dialectical Behavioral Therapy and have over 20 years of experience doing DBT therapy and DBT skills group.
(207) 803-6246 View (207) 803-6246
Lanie Howes
Counselor, LCPC-C
Verified Verified
Saco, ME 04072
Not accepting new clients
Have you ever experienced issues around your sex life, sexuality, or gender? These issues can feel awkward, lonely, and uncomfortable. Sexuality, sex, and gender are integral aspects of life that on the whole are ignored and misunderstood by society. Perhaps you want to learn about the desire difference between you and your partner, or you want to process through trauma that you have experienced in the past, or you would like to explore the world of BDSM and kink but have been too nervous to have a conversation with any of your friends. Regardless of your situation, your sexuality and gender needs are valid.
Have you ever experienced issues around your sex life, sexuality, or gender? These issues can feel awkward, lonely, and uncomfortable. Sexuality, sex, and gender are integral aspects of life that on the whole are ignored and misunderstood by society. Perhaps you want to learn about the desire difference between you and your partner, or you want to process through trauma that you have experienced in the past, or you would like to explore the world of BDSM and kink but have been too nervous to have a conversation with any of your friends. Regardless of your situation, your sexuality and gender needs are valid.
(207) 548-5451 View (207) 548-5451
Photo of Kristen J Flynn, Counselor in Saco, ME
Kristen J Flynn
Counselor, LCPC
Verified Verified
Saco, ME 04072
Hello. Welcome to my practice. As a Licensed Clinical Professional Counselor, I provide effective, holistic mental health therapy to those seeking health, balance and peace of mind in their lives. Through a collaborative and trusting relationship with my clients, I offer treatment that is ethical, professional, confidential, and one based upon respect. Within my practice I serve primarily adults of all ages in individual therapy. I do not provide couples counseling.
Hello. Welcome to my practice. As a Licensed Clinical Professional Counselor, I provide effective, holistic mental health therapy to those seeking health, balance and peace of mind in their lives. Through a collaborative and trusting relationship with my clients, I offer treatment that is ethical, professional, confidential, and one based upon respect. Within my practice I serve primarily adults of all ages in individual therapy. I do not provide couples counseling.
(207) 387-7524 View (207) 387-7524
Photo of Bethany johnson, Counselor in Saco, ME
Bethany johnson
Counselor, LCPC
Verified Verified
Saco, ME 04072  (Online Only)
I have been working in this field for over 15 years and although my specialties are substance use disorders and trauma, I support anyone who is struggling with life stressors, such as anxiety, depression, grief, and other challenges in day-to-day life. I use cognitive behavioral therapy, trauma-focused therapy, acceptance, and commitment therapy, and am certified as a dialectical behavioral therapist to support those who strive to create a healthy and balanced way of life.
I have been working in this field for over 15 years and although my specialties are substance use disorders and trauma, I support anyone who is struggling with life stressors, such as anxiety, depression, grief, and other challenges in day-to-day life. I use cognitive behavioral therapy, trauma-focused therapy, acceptance, and commitment therapy, and am certified as a dialectical behavioral therapist to support those who strive to create a healthy and balanced way of life.
(207) 569-6434 View (207) 569-6434
Photo of Madeline Lewis, Drug & Alcohol Counselor in Saco, ME
Madeline Lewis
Drug & Alcohol Counselor, BA, LADC, DEEP, CECP, PSYCH-K
Verified Verified
Saco, ME 04072
For the person who finds their self re-creating harmful patterns, in negative relationships, acting out of anxiety, depression or emotional pain and using alcohol or drugs more then they want. Even if you use alcohol or drugs a couple times a week to cope. You may not identify with having a substance problem but are interested in harm reduction, patterns of substance misuse, and want change, reach out and we can explore it together, even if you have been abstinent from substances but are concerned about thinking and behaviors. I use a holistic, person-centered approach, along with CBT to provide individualized treatment.
For the person who finds their self re-creating harmful patterns, in negative relationships, acting out of anxiety, depression or emotional pain and using alcohol or drugs more then they want. Even if you use alcohol or drugs a couple times a week to cope. You may not identify with having a substance problem but are interested in harm reduction, patterns of substance misuse, and want change, reach out and we can explore it together, even if you have been abstinent from substances but are concerned about thinking and behaviors. I use a holistic, person-centered approach, along with CBT to provide individualized treatment.
(207) 656-1957 View (207) 656-1957
Photo of Jeffrey S Levy, Clinical Social Work/Therapist in Saco, ME
Jeffrey S Levy
Clinical Social Work/Therapist, LCSW, GAL
Verified Verified
Saco, ME 04072
Waitlist for new clients
I have been in practice since 2001, specializing in Cognitive Behavioral Therapy for the treatment of anxiety and depression. I will work with children over 10, adolescents and adults. I'll work with individuals, couples and families. I believe that therapists are like shoes...some fit and some don't, and sometimes it could be the right shoe for the wrong occasion. I appreciate your interest, and would like to see if our therapeutic relationship is a comfortable fit.
I have been in practice since 2001, specializing in Cognitive Behavioral Therapy for the treatment of anxiety and depression. I will work with children over 10, adolescents and adults. I'll work with individuals, couples and families. I believe that therapists are like shoes...some fit and some don't, and sometimes it could be the right shoe for the wrong occasion. I appreciate your interest, and would like to see if our therapeutic relationship is a comfortable fit.
(207) 613-2064 View (207) 613-2064
Photo of Mary Maguire, Clinical Social Work/Therapist in Saco, ME
Mary Maguire
Clinical Social Work/Therapist, LCSW
Verified Verified
Saco, ME 04072
Waitlist for new clients
I am a licensed clinical social worker providing individual, family and couples counseling. I have been working in the field and as a therapist for more than 10 years. I have extensive training and expertise in working with children, adolescents, adults and geriatric populations. I have been nationally trained to provide specific and positive outcome based treatments in areas of trauma, depression, and anxiety. Other areas of interest include anger management, behavioral issues, parenting, relationship issues, chronic pain, grief and women's issues. My approach is collaborative and includes elements of cognitive behavioral therapy, interpersonal, mindfulness and strength based.
I am a licensed clinical social worker providing individual, family and couples counseling. I have been working in the field and as a therapist for more than 10 years. I have extensive training and expertise in working with children, adolescents, adults and geriatric populations. I have been nationally trained to provide specific and positive outcome based treatments in areas of trauma, depression, and anxiety. Other areas of interest include anger management, behavioral issues, parenting, relationship issues, chronic pain, grief and women's issues. My approach is collaborative and includes elements of cognitive behavioral therapy, interpersonal, mindfulness and strength based.
(207) 370-1972 View (207) 370-1972
Photo of Jessica Wallner, Clinical Professional Counselor in Saco, ME
Jessica Wallner
Clinical Professional Counselor, MS, LCPC
Verified Verified
2 Endorsed
Saco, ME 04072
Waitlist for new clients
Have you ever experienced a life change, trauma, or loss that you simply can’t make sense of? That makes it hard to be present in your body? To stay connected to what and whom you care about? I hold sacred space for your journey home to a sense of wholeness. I offer psychotherapy for those who want to go deeper into the body to process patterns of grief and trauma showing up in the present. I offer somatic coaching for those who have specific goals and want to better manage stress and pain, feel more present in their bodies, and gain a toolbox of skills to increase their ability to regulate.
Have you ever experienced a life change, trauma, or loss that you simply can’t make sense of? That makes it hard to be present in your body? To stay connected to what and whom you care about? I hold sacred space for your journey home to a sense of wholeness. I offer psychotherapy for those who want to go deeper into the body to process patterns of grief and trauma showing up in the present. I offer somatic coaching for those who have specific goals and want to better manage stress and pain, feel more present in their bodies, and gain a toolbox of skills to increase their ability to regulate.
(207) 464-2971 View (207) 464-2971
Photo of Karlene Hafemann, Clinical Social Work/Therapist in Saco, ME
Karlene Hafemann
Clinical Social Work/Therapist, LCSW
Verified Verified
Saco, ME 04072
Waitlist for new clients
I am a trauma informed, neurodiversity celebrating, gender affirming, complex attachment navigating, soft spot landing, therapist. I welcome adults, teens, children, and families that have experienced complex and generational trauma, attachment trauma, and those that have found themselves on foster care and adoption journeys. I also specialize in co-collaborative work with OTs, PTs, and SLPs, in working with families that experience the complex behaviors and challenges that come with sensory integration needs, Autism Spectrum Disorder, FASD, ADHD, and other neurological diversity.
I am a trauma informed, neurodiversity celebrating, gender affirming, complex attachment navigating, soft spot landing, therapist. I welcome adults, teens, children, and families that have experienced complex and generational trauma, attachment trauma, and those that have found themselves on foster care and adoption journeys. I also specialize in co-collaborative work with OTs, PTs, and SLPs, in working with families that experience the complex behaviors and challenges that come with sensory integration needs, Autism Spectrum Disorder, FASD, ADHD, and other neurological diversity.
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Photo of Gary D Bingham, Counselor in Saco, ME
Gary D Bingham
Counselor, MEd, LCPC, CADC
Verified Verified
Saco, ME 04072
If you have been having relationship troubles, career concerns, financial issues, struggling to make decisions, feeling down, confused about life in general, having a hard time trusting people, feeling anxious, have struggled with past trauma, or maybe experiencing difficulties avoiding drugs, or alcohol. Maybe you aren't sure about how your life is going but just know you need change, I would like to be your partner in working toward helping you solve whatever challenges you are facing. Let's find a solution together.
If you have been having relationship troubles, career concerns, financial issues, struggling to make decisions, feeling down, confused about life in general, having a hard time trusting people, feeling anxious, have struggled with past trauma, or maybe experiencing difficulties avoiding drugs, or alcohol. Maybe you aren't sure about how your life is going but just know you need change, I would like to be your partner in working toward helping you solve whatever challenges you are facing. Let's find a solution together.
(207) 218-0165 View (207) 218-0165
Photo of Deb Carroll, Clinical Social Work/Therapist in Saco, ME
Deb Carroll
Clinical Social Work/Therapist, LCSW
Verified Verified
Saco, ME 04072
Currently, I am unable to accept new clients. My goal as a therapist is to help clients embrace their fullest potential by exploring thoughts, feelings and behaviors that impact their relationship with themselves and others. I am committed to helping clients view their challenges as pathways to create positive change.
Currently, I am unable to accept new clients. My goal as a therapist is to help clients embrace their fullest potential by exploring thoughts, feelings and behaviors that impact their relationship with themselves and others. I am committed to helping clients view their challenges as pathways to create positive change.
(207) 708-8712 View (207) 708-8712
Photo of Scott Kenneth Morse, Clinical Social Work/Therapist in Saco, ME
Scott Kenneth Morse
Clinical Social Work/Therapist, LCSW
Verified Verified
Saco, ME 04072
Not accepting new clients
Life can be overwhelming-leaving little time or energy for peaceful introspection. I use a warm acceptance and humor to help clients face challenging dilemmas. Without understanding the motivation behind our impulses, we can lose our way, sometimes getting stuck for years, and developing maladaptive emotional coping difficulties. I help people recognize and overcome their self-limiting belief systems, generating greater self knowledge, confidence and having the ability to tolerate the emotional strains of contemporary living. I have over 20 years of work experience in the trauma field- working with both survivors and perpetrators of abuse.
Life can be overwhelming-leaving little time or energy for peaceful introspection. I use a warm acceptance and humor to help clients face challenging dilemmas. Without understanding the motivation behind our impulses, we can lose our way, sometimes getting stuck for years, and developing maladaptive emotional coping difficulties. I help people recognize and overcome their self-limiting belief systems, generating greater self knowledge, confidence and having the ability to tolerate the emotional strains of contemporary living. I have over 20 years of work experience in the trauma field- working with both survivors and perpetrators of abuse.
(207) 329-4941 View (207) 329-4941
Photo of Karen Lemoine, Clinical Social Work/Therapist in Saco, ME
Karen Lemoine
Clinical Social Work/Therapist, LCSW
Verified Verified
Saco, ME 04072
Waitlist for new clients
Counseling is a collaborative effort, and I see my job as being a supportive guide in this undertaking, providing a safe, comfortable and trusting environment for honest discussion. I offer counseling for adolescents and adults of all ages, bringing 28 years of experience to my clinical practice. Believing we all want the best for our children and ourselves, wherever we are in the life span. Helping facilitate happy and productive lives is at the core of my practice. There are proven tools and techniques that can improve personal outlooks with positive results.
Counseling is a collaborative effort, and I see my job as being a supportive guide in this undertaking, providing a safe, comfortable and trusting environment for honest discussion. I offer counseling for adolescents and adults of all ages, bringing 28 years of experience to my clinical practice. Believing we all want the best for our children and ourselves, wherever we are in the life span. Helping facilitate happy and productive lives is at the core of my practice. There are proven tools and techniques that can improve personal outlooks with positive results.
(207) 391-3212 View (207) 391-3212
Photo of Paul D Pinette, Clinical Social Work/Therapist in Saco, ME
Paul D Pinette
Clinical Social Work/Therapist, LCSW
Verified Verified
Saco, ME 04072
Not accepting new clients
I believe you are the expert in the room!! That being said....I do not have a magic book of answers.... but instead I provide, caring, thoughtful cooperative approach to helping people make changes in their lives. Making changes, requires a team approach. I have extensive experience in addressing fears, anxiety, depression, low self esteem and psychological trauma.
I believe you are the expert in the room!! That being said....I do not have a magic book of answers.... but instead I provide, caring, thoughtful cooperative approach to helping people make changes in their lives. Making changes, requires a team approach. I have extensive experience in addressing fears, anxiety, depression, low self esteem and psychological trauma.
(207) 707-1302 View (207) 707-1302
Photo of Liz Hennedy-Friel, Clinical Social Work/Therapist in Saco, ME
Liz Hennedy-Friel
Clinical Social Work/Therapist, LCSW
Verified Verified
Saco, ME 04072
Waitlist for new clients
Life can be difficult at times. We all have periods of ups and downs.It's when those downs begin to feel overwhelming, make you anxious, and negatively impact important areas of your life, such as your relationships, work, health, spirituality, and the way you feel about yourself that seeking professional help might be beneficial.
Life can be difficult at times. We all have periods of ups and downs.It's when those downs begin to feel overwhelming, make you anxious, and negatively impact important areas of your life, such as your relationships, work, health, spirituality, and the way you feel about yourself that seeking professional help might be beneficial.
(207) 358-3409 View (207) 358-3409
Photo of Erika Smith, Counselor in Saco, ME
Erika Smith
Counselor, LCPC
Verified Verified
1 Endorsed
Saco, ME 04072  (Online Only)
Not accepting new clients
Are you looking to make a change, but don't know where to start? Maybe you have tried everything you can think of, but haven't experienced relief. I can help you adjust to a life change, address mental health or substance abuse issues, or resolve past experiences getting in the way of the present. I provide clinical counseling through cultivation of insight in session with skills development to help you make practical, realistic changes now. I couple evidence based techniques with an active, accepting, style to create a safe space to meet your individual needs and adopt lasting change.
Are you looking to make a change, but don't know where to start? Maybe you have tried everything you can think of, but haven't experienced relief. I can help you adjust to a life change, address mental health or substance abuse issues, or resolve past experiences getting in the way of the present. I provide clinical counseling through cultivation of insight in session with skills development to help you make practical, realistic changes now. I couple evidence based techniques with an active, accepting, style to create a safe space to meet your individual needs and adopt lasting change.
(207) 245-1369 View (207) 245-1369

How does your Therapist compare?

Number of Therapists in Saco, ME

80+

Average cost per session

$125

Therapists in Saco, ME who prioritize treating:

90% Anxiety
86% Depression
80% Trauma and PTSD
79% Self Esteem
76% Coping Skills
74% Relationship Issues
74% Stress

Average years in practice

13 Years

Top 3 insurances accepted

60% Harvard Pilgrim
58% UnitedHealthcare UHC | UBH
57% Anthem | Elevance

How Therapists in Saco, ME see their clients

70% In Person and Online
30% Online Only

Gender breakdown

81% Female
19% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Saco?

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.