Therapists in Dubuque, IA

Photo of Shana Kutsch, Counselor in Dubuque, IA
Shana Kutsch
Counselor, MA, LMHC
Verified Verified
Dubuque, IA 52003
I am a Licensed Mental Health Counselor with over five years of experience providing individual therapy services to adolescents and adults. I have experience working with a wide range of emotional and behavioral issues including depression, anxiety, stress management, interpersonal concerns, low self-esteem, trauma related issues, loss and life adjustments. I work collectively with each client to create a trusting, safe and supportive therapeutic relationship. In doing so, we build the foundation for addressing issues and concerns that are impacting life.
I am a Licensed Mental Health Counselor with over five years of experience providing individual therapy services to adolescents and adults. I have experience working with a wide range of emotional and behavioral issues including depression, anxiety, stress management, interpersonal concerns, low self-esteem, trauma related issues, loss and life adjustments. I work collectively with each client to create a trusting, safe and supportive therapeutic relationship. In doing so, we build the foundation for addressing issues and concerns that are impacting life.
(563) 278-3684 View (563) 278-3684
Photo of Amy Steve, Clinical Social Work/Therapist in Dubuque, IA
Amy Steve
Clinical Social Work/Therapist, LISW
Verified Verified
2 Endorsed
Dubuque, IA 52001
Waitlist for new clients
Life’s journey can create many experiences leading us through paths of adventure and also challenge. When faced with difficulties/hardships in life, the road can often leave us feeling isolated, lonely, ashamed, weak, unloved, and even broken. My name is Amy Steve. I am a licensed Independent Social Worker, but more importantly, I am a mental health therapist and individual that cares deeply about helping children, adolescents, and adults overcome roadblocks that they may face on their journey through life. I believe that each person is unique and that is why treatment will be individually tailored to meet your specific needs.
Life’s journey can create many experiences leading us through paths of adventure and also challenge. When faced with difficulties/hardships in life, the road can often leave us feeling isolated, lonely, ashamed, weak, unloved, and even broken. My name is Amy Steve. I am a licensed Independent Social Worker, but more importantly, I am a mental health therapist and individual that cares deeply about helping children, adolescents, and adults overcome roadblocks that they may face on their journey through life. I believe that each person is unique and that is why treatment will be individually tailored to meet your specific needs.
(563) 202-5412 x1 View (563) 202-5412 x1
Photo of Ricki (Richelle) Christene Bouska, Counselor in Dubuque, IA
Ricki (Richelle) Christene Bouska
Counselor, PhD, LMHC, NCC
Verified Verified
Dubuque, IA 52003  (Online Only)
I am a woman of great faith, a deep love for my family, and an abundance of hope! I truly believe I was called into the counseling ministry. I have a heart for coming alongside others as they endeavor to move forward in life. With a belief in human potential and each person's inherent worth, I offer companionship for the journey! The name Sacred Space Counseling Center, LLC was intentionally chosen. It encapsulates the essence of what therapy is to me, and ...what I hope it becomes for you! Come, take sanctuary in my Sacred Space!
I am a woman of great faith, a deep love for my family, and an abundance of hope! I truly believe I was called into the counseling ministry. I have a heart for coming alongside others as they endeavor to move forward in life. With a belief in human potential and each person's inherent worth, I offer companionship for the journey! The name Sacred Space Counseling Center, LLC was intentionally chosen. It encapsulates the essence of what therapy is to me, and ...what I hope it becomes for you! Come, take sanctuary in my Sacred Space!
(563) 207-3793 View (563) 207-3793
Photo of Jon Hart, Counselor in Dubuque, IA
Jon Hart
Counselor, LMHC
Verified Verified
Dubuque, IA 52002  (Online Only)
I believe that one of the bravest things you can do in life is to take the time to share and understand your own story. Taking that first step toward change can cause some anxiety and stress, but the second you walk through the door, you’ve already proven that you have the courage it takes to make that change a reality. My greatest joy as a therapist is having the privilege to help others find their inner strengths and overlooked talents, and I believe that you really do deserve to wake up each day excited for new possibilities.
I believe that one of the bravest things you can do in life is to take the time to share and understand your own story. Taking that first step toward change can cause some anxiety and stress, but the second you walk through the door, you’ve already proven that you have the courage it takes to make that change a reality. My greatest joy as a therapist is having the privilege to help others find their inner strengths and overlooked talents, and I believe that you really do deserve to wake up each day excited for new possibilities.
(563) 202-2268 View (563) 202-2268
Photo of Richard Corfman, Clinical Social Work/Therapist in Dubuque, IA
Richard Corfman
Clinical Social Work/Therapist, LISW
Verified Verified
Dubuque, IA 52003
Not accepting new clients
Clients have come to me for various reasons- marital conflict, depression, anxiety, post traumatic stress, bipolar illness, grief, ADHD and other related mental health diagnoses. I have felt honored to help people to move from feeling distressed to better managing their thoughts, feelings and behaviors so they can enjoy greater success and control over their lives.
Clients have come to me for various reasons- marital conflict, depression, anxiety, post traumatic stress, bipolar illness, grief, ADHD and other related mental health diagnoses. I have felt honored to help people to move from feeling distressed to better managing their thoughts, feelings and behaviors so they can enjoy greater success and control over their lives.
(563) 649-4449 View (563) 649-4449
Photo of Lori Ollendick, Counselor in Dubuque, IA
Lori Ollendick
Counselor, LMHC, NCC
Verified Verified
Dubuque, IA 52002
Successful therapy is the result of effective collaboration between client and therapist.Choosing the right therapist for you is a very personal decision and can seem like an overwhelming task so finding the right "fit" is so important. I value creating a strong, trusting relationship with my clients and want them to feel that they can be comfortable and open sharing their burdens in our sessions. I work with the client to promote self discovery and confidence building which in turn helps them to improve their relationships and manage their life challenges.
Successful therapy is the result of effective collaboration between client and therapist.Choosing the right therapist for you is a very personal decision and can seem like an overwhelming task so finding the right "fit" is so important. I value creating a strong, trusting relationship with my clients and want them to feel that they can be comfortable and open sharing their burdens in our sessions. I work with the client to promote self discovery and confidence building which in turn helps them to improve their relationships and manage their life challenges.
(563) 538-0319 View (563) 538-0319
Photo of Wendy M Woolf, Counselor in Dubuque, IA
Wendy M Woolf
Counselor, MA, LMHC, LCPC
Verified Verified
Dubuque, IA 52002
Waitlist for new clients
Kids, adolescents and families are my passion. When I’m not at Building Blocks Counseling Center, I may be found on the University of Dubuque campus as an adjunct psychology professor, mentoring up and coming psychology professionals, or working with new moms who are experiencing postpartum depression. I am the mother of two boys, one that spent 3 months in the NICU, so we have had quite an adventure in our time as a family. My mission is to assist individuals in exploring and processing life experiences while learning tools to build healthy foundations on which to grow into stronger and healthier versions of themselves.
Kids, adolescents and families are my passion. When I’m not at Building Blocks Counseling Center, I may be found on the University of Dubuque campus as an adjunct psychology professor, mentoring up and coming psychology professionals, or working with new moms who are experiencing postpartum depression. I am the mother of two boys, one that spent 3 months in the NICU, so we have had quite an adventure in our time as a family. My mission is to assist individuals in exploring and processing life experiences while learning tools to build healthy foundations on which to grow into stronger and healthier versions of themselves.
(563) 235-1247 View (563) 235-1247
Photo of Bailey Callahan, Counselor in Dubuque, IA
Bailey Callahan
Counselor, MA, t-LMHC
Verified Verified
1 Endorsed
Dubuque, IA 52003
Taking new clients. I have worked with clients experiencing various mental health struggles, including depression, anxiety, trauma, and life changes. I use an empathetic, person-centered approach, which allows us to build a therapeutic relationship rooted in trust and acceptance.
Taking new clients. I have worked with clients experiencing various mental health struggles, including depression, anxiety, trauma, and life changes. I use an empathetic, person-centered approach, which allows us to build a therapeutic relationship rooted in trust and acceptance.
(563) 278-2825 View (563) 278-2825
Photo of Ali Schneider, Clinical Social Work/Therapist in Dubuque, IA
Ali Schneider
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Dubuque, IA 52003
Waitlist for new clients
Moving toward personal healing and growth can be hard! I acknowledge client's vulnerability and meet them with compassion and kindness. I am here to help clients navigate the uncomfortable, difficult, unwanted times in their life. I am a Licensed Master Social Worker with a passion for working with children, adolescents, and adults struggling with anxiety, self doubt, peer or relationship conflict, and depression. We all need help sometimes, and I'll be dedicated to being the help clients seek!
Moving toward personal healing and growth can be hard! I acknowledge client's vulnerability and meet them with compassion and kindness. I am here to help clients navigate the uncomfortable, difficult, unwanted times in their life. I am a Licensed Master Social Worker with a passion for working with children, adolescents, and adults struggling with anxiety, self doubt, peer or relationship conflict, and depression. We all need help sometimes, and I'll be dedicated to being the help clients seek!
(563) 202-8694 View (563) 202-8694
Photo of Chris Chandler, Counselor in Dubuque, IA
Chris Chandler
Counselor, MA, LPCC, LMHC, CSAT-S, AF-EMDR
Verified Verified
1 Endorsed
Dubuque, IA 52001  (Online Only)
My passion is helping people build healthy and meaningful lives. I am a Certified Sexual Addiction Therapist trained by Dr. Patrick Carnes, the pioneer in the field of sex addiction. I have extensive experience working with individuals struggling with all forms of addictions and compulsive behaviors including: sex, pornography, drugs, alcohol, food, work, spending, codependent relationships, etc. I use Attachment-Focused EMDR, Internal Family Systems, and Lifespan Integration to help people become free from underlying relational/attachment wounds.
My passion is helping people build healthy and meaningful lives. I am a Certified Sexual Addiction Therapist trained by Dr. Patrick Carnes, the pioneer in the field of sex addiction. I have extensive experience working with individuals struggling with all forms of addictions and compulsive behaviors including: sex, pornography, drugs, alcohol, food, work, spending, codependent relationships, etc. I use Attachment-Focused EMDR, Internal Family Systems, and Lifespan Integration to help people become free from underlying relational/attachment wounds.
(563) 412-2893 View (563) 412-2893
Photo of Chloe A Heberlein, Counselor in Dubuque, IA
Chloe A Heberlein
Counselor, MA, tLMHC
Verified Verified
1 Endorsed
Dubuque, IA 52001
Hello and welcome! I'm Chloe Heberlein, a mental health therapist passionate about guiding individuals towards healing and empowerment. I specialize in helping clients navigate through challenges related to boundaries, trauma, anxiety, women's issues, and personal development. I believe in a holistic approach to therapy, integrating evidence-based techniques with nature-inspired methods for optimal healing.
Hello and welcome! I'm Chloe Heberlein, a mental health therapist passionate about guiding individuals towards healing and empowerment. I specialize in helping clients navigate through challenges related to boundaries, trauma, anxiety, women's issues, and personal development. I believe in a holistic approach to therapy, integrating evidence-based techniques with nature-inspired methods for optimal healing.
(563) 925-4182 View (563) 925-4182
Photo of Lynne Lutze, Counselor in Dubuque, IA
Lynne Lutze
Counselor, PhD, LMHC, LPC, NBCC
Verified Verified
Dubuque, IA 52003
Do you ever feel so overwhelmed with life that you're not sure where to go or who to turn too? Stressed, anxious, alone, added with frustration, heartbreak, and grief? It's okay to feel and sometimes you need to tell someone exactly how you're doing without being judged or told "Get over it". Sometimes you need a quick reminder that you are human and life can be difficult. If you want to learn how to cope, and live feeling more positive, I am the therapist for you. I work with all age levels and backgrounds and have been in the counseling field since 2006.
Do you ever feel so overwhelmed with life that you're not sure where to go or who to turn too? Stressed, anxious, alone, added with frustration, heartbreak, and grief? It's okay to feel and sometimes you need to tell someone exactly how you're doing without being judged or told "Get over it". Sometimes you need a quick reminder that you are human and life can be difficult. If you want to learn how to cope, and live feeling more positive, I am the therapist for you. I work with all age levels and backgrounds and have been in the counseling field since 2006.
(563) 228-8828 View (563) 228-8828
Photo of Antonia Frost, Clinical Social Work/Therapist in Dubuque, IA
Antonia Frost
Clinical Social Work/Therapist, LMSW
Verified Verified
Dubuque, IA 52003
Accepting New Clients! Beginning your therapy journey can possibly feel nerve-racking. Did you know that 75% of individuals who attend therapy demonstrate improvement in their life? However, only 20.3% of U.S. adults attend therapy. Everyone needs someone who can help them navigate through the tough obstacles life has to offer them. I approach each client with a person-centered focus and attempt to utilize their strengths. As a therapist, I believe each person is capable of achieving change.
Accepting New Clients! Beginning your therapy journey can possibly feel nerve-racking. Did you know that 75% of individuals who attend therapy demonstrate improvement in their life? However, only 20.3% of U.S. adults attend therapy. Everyone needs someone who can help them navigate through the tough obstacles life has to offer them. I approach each client with a person-centered focus and attempt to utilize their strengths. As a therapist, I believe each person is capable of achieving change.
(563) 522-5689 View (563) 522-5689
Photo of Cody Tentis, Clinical Social Work/Therapist in Dubuque, IA
Cody Tentis
Clinical Social Work/Therapist, LMSW
Verified Verified
Dubuque, IA 52001
A genuine and trusting relationship is the most important part of the therapy process. I’m here to provide you with a confidential and compassionate space to explore your emotions, thoughts and experiences. I aim to meet you wherever you're at and together we can work towards achieving the goals you set, at the pace that works best for you.
A genuine and trusting relationship is the most important part of the therapy process. I’m here to provide you with a confidential and compassionate space to explore your emotions, thoughts and experiences. I aim to meet you wherever you're at and together we can work towards achieving the goals you set, at the pace that works best for you.
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Photo of Ashlee Weber, Counselor in Dubuque, IA
Ashlee Weber
Counselor, LMHC
Verified Verified
Dubuque, IA 52001
I believe life is a series of winding paths and enjoy meeting with individuals, families, and couples to navigate these paths so they can work towards a more fulfilling life. My overall style of therapy is eclectic, meaning I enjoy mixing a variety of techniques. Using this therapy strategy, I find I am best able to meet the needs of each individual client. Even so, cognitive-behavioral therapy and client-centered therapy are among my favorite styles. I believe the therapeutic alliance between therapist and client is of extreme importance, so I focus strongly on building this therapeutic connection.
I believe life is a series of winding paths and enjoy meeting with individuals, families, and couples to navigate these paths so they can work towards a more fulfilling life. My overall style of therapy is eclectic, meaning I enjoy mixing a variety of techniques. Using this therapy strategy, I find I am best able to meet the needs of each individual client. Even so, cognitive-behavioral therapy and client-centered therapy are among my favorite styles. I believe the therapeutic alliance between therapist and client is of extreme importance, so I focus strongly on building this therapeutic connection.
(563) 362-3012 x3 View (563) 362-3012 x3
Photo of Mindy J Finn, Counselor in Dubuque, IA
Mindy J Finn
Counselor, MS, LMHC
Verified Verified
Dubuque, IA 52003
Mindy Finn is a Licensed Mental Health Counselor in the state of Iowa. She has a Master’s Degree in Counseling Psychology from University of Wisconsin-Platteville. Mindy operates from a strengths-based, client-centered approach to empower her clients, promote positive self-image, and improve interpersonal relationships. She is experienced in treating adults, adolescents, children, families, and couples. Mindy specializes in treating trauma, PTSD, depression, anxiety, mood disorders, life adjustment issues, family and relationship issues.
Mindy Finn is a Licensed Mental Health Counselor in the state of Iowa. She has a Master’s Degree in Counseling Psychology from University of Wisconsin-Platteville. Mindy operates from a strengths-based, client-centered approach to empower her clients, promote positive self-image, and improve interpersonal relationships. She is experienced in treating adults, adolescents, children, families, and couples. Mindy specializes in treating trauma, PTSD, depression, anxiety, mood disorders, life adjustment issues, family and relationship issues.
(563) 921-6348 View (563) 921-6348
Photo of Teresa White, Clinical Social Work/Therapist in Dubuque, IA
Teresa White
Clinical Social Work/Therapist, LMSW
Verified Verified
Dubuque, IA 52001
Thursday availability only- I work with a variety of clients helping with growth, healing, and empowerment. The most important aspect of therapy is the connection between the therapist and the client. We all have struggles throughout our lives. I enjoying helping clients achieve their therapy goals through understanding, empathy, and genuine compassion for what is happening in their lives. I started my career in the helping field in 1999, working with teens as a youth counselor. I spent ten years working with young adults who have experienced foster care and adoption. I really enjoy seeing the growth in those I help.
Thursday availability only- I work with a variety of clients helping with growth, healing, and empowerment. The most important aspect of therapy is the connection between the therapist and the client. We all have struggles throughout our lives. I enjoying helping clients achieve their therapy goals through understanding, empathy, and genuine compassion for what is happening in their lives. I started my career in the helping field in 1999, working with teens as a youth counselor. I spent ten years working with young adults who have experienced foster care and adoption. I really enjoy seeing the growth in those I help.
(563) 239-3005 View (563) 239-3005
Photo of Gary Probst, Counselor in Dubuque, IA
Gary Probst
Counselor
Verified Verified
Dubuque, IA 52001  (Online Only)
Anxiety? Depression? Mood Disorder? On the spectrum? There are many areas where I can help. I am an Iowa-born mental health counselor with a doctorate degree in Clinical Psychology. I also help clients in Wisconsin and Arizona. My extensive experience can help with many mental health challenges and I will work with teens. I often use a solutions-focused approach. I get to the heart of the issue and can help people feel better faster. Anxiety is often the primary issue. However, I have helped people out of serious depressive issues and guided them through treatment of mood disorders. I am also Neurodivergent and get it. Let me help.
Anxiety? Depression? Mood Disorder? On the spectrum? There are many areas where I can help. I am an Iowa-born mental health counselor with a doctorate degree in Clinical Psychology. I also help clients in Wisconsin and Arizona. My extensive experience can help with many mental health challenges and I will work with teens. I often use a solutions-focused approach. I get to the heart of the issue and can help people feel better faster. Anxiety is often the primary issue. However, I have helped people out of serious depressive issues and guided them through treatment of mood disorders. I am also Neurodivergent and get it. Let me help.
(563) 855-8094 View (563) 855-8094
Photo of Beth Garza, Clinical Social Work/Therapist in Dubuque, IA
Beth Garza
Clinical Social Work/Therapist, LISW
Verified Verified
Dubuque, IA 52001
Are you feeling overwhelmed, anxious, confused, or stuck in life? Together, we will work on strategies that allow you to address the root cause of your difficulties while improving your resiliency. Hi, I’m Beth Garza. I am a Licensed Independent Social Worker. I returned to Eastern Iowa after living in many locations for more than 25 years as a military spouse. This has given me a diverse perspective on culture, the human condition, and what makes us unique as individuals. Interests are treatment of anxiety, depression, PTSD, trauma, moral injury, mood disorders, life transitions, grief/loss, self-esteem, and relationship issues.
Are you feeling overwhelmed, anxious, confused, or stuck in life? Together, we will work on strategies that allow you to address the root cause of your difficulties while improving your resiliency. Hi, I’m Beth Garza. I am a Licensed Independent Social Worker. I returned to Eastern Iowa after living in many locations for more than 25 years as a military spouse. This has given me a diverse perspective on culture, the human condition, and what makes us unique as individuals. Interests are treatment of anxiety, depression, PTSD, trauma, moral injury, mood disorders, life transitions, grief/loss, self-esteem, and relationship issues.
(563) 239-5342 x4 View (563) 239-5342 x4
Photo of Gwen Merfeld, Counselor in Dubuque, IA
Gwen Merfeld
Counselor, MS, tLMHC
Verified Verified
Dubuque, IA 52002
Not accepting new clients
My approach is rooted in providing trauma-informed, culturally competent care. I have experience working with clients from various backgrounds, aged six and older, and provide individualized services according to each client’s needs. I particularly love working with women, LGBTQIA+ individuals, anxiety, depression, and religious issues.
My approach is rooted in providing trauma-informed, culturally competent care. I have experience working with clients from various backgrounds, aged six and older, and provide individualized services according to each client’s needs. I particularly love working with women, LGBTQIA+ individuals, anxiety, depression, and religious issues.
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How does your Therapist compare?

Number of Therapists in Dubuque, IA

90+

Average cost per session

$150

Therapists in Dubuque, IA who prioritize treating:

97% Anxiety
90% Depression
80% Coping Skills
77% Self Esteem
76% Stress
74% Trauma and PTSD
73% Relationship Issues

Average years in practice

10 Years

Top 3 insurances accepted

82% BlueCross and BlueShield
69% UnitedHealthcare UHC | UBH
55% Wellmark BCBS

How Therapists in Dubuque, IA see their clients

83% In Person and Online
17% Online Only

Gender breakdown

82% Female
16% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Dubuque?

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.