Therapists in Madison, WI

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Photo of Bjorn Hanson, Psychologist in Madison, WI
Bjorn Hanson
Psychologist, PhD
Verified Verified
1 Endorsed
Madison, WI 53705
Are you lost, stuck, or hurting? Does anxiety, depression, or perfectionism hold you back in life? Are you struggling with a crucial relationship? Do you have the sense that something is not quite right, but you aren't sure what it is? If you are looking for a supportive space to explore the important questions in your life while being given practical tools to manage your thoughts and emotions, Lakeland Counseling and Assessment is for you. If you are looking for a thorough, objective assessment to get you on the right track, Lakeland Counseling and Assessment is for you.
Are you lost, stuck, or hurting? Does anxiety, depression, or perfectionism hold you back in life? Are you struggling with a crucial relationship? Do you have the sense that something is not quite right, but you aren't sure what it is? If you are looking for a supportive space to explore the important questions in your life while being given practical tools to manage your thoughts and emotions, Lakeland Counseling and Assessment is for you. If you are looking for a thorough, objective assessment to get you on the right track, Lakeland Counseling and Assessment is for you.
(608) 925-2849 View (608) 925-2849
Photo of Karla Locher, Clinical Social Work/Therapist in Madison, WI
Karla Locher
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Madison, WI 53704
While therapy can begin because of a symptom or problem – depression, insomnia, alcohol and substance use, or sexual dysfunction – symptoms are not the guiding stars of therapy. I practice therapy that is about making space for your whole self and making use of insight to understand your relationship to change. Whether our work is brief or long-lasting, we will work to discover and relate to the totality of who you are.
While therapy can begin because of a symptom or problem – depression, insomnia, alcohol and substance use, or sexual dysfunction – symptoms are not the guiding stars of therapy. I practice therapy that is about making space for your whole self and making use of insight to understand your relationship to change. Whether our work is brief or long-lasting, we will work to discover and relate to the totality of who you are.
(608) 200-2851 View (608) 200-2851
Photo of Alexandra Jean Schrank, Marriage & Family Therapist in Madison, WI
Alexandra Jean Schrank
Marriage & Family Therapist, MS, LMFT
Verified Verified
1 Endorsed
Madison, WI 53715  (Online Only)
Waitlist for new clients
Often times throughout life we find ourselves feeling disconnected. This can leave us feeling anxious, depressed, untethered and lost without any sense of direction. My goal as a therapist is to support my clients as they navigate and discover the path to their most authentic self. I strive to provide a safe space where clients feel comfortable in exploring their past, rewriting personal narratives, and forging an understanding of self that enables living presently. Together we'll discover your strengths, while exploring areas that crave nurturing and healing.
Often times throughout life we find ourselves feeling disconnected. This can leave us feeling anxious, depressed, untethered and lost without any sense of direction. My goal as a therapist is to support my clients as they navigate and discover the path to their most authentic self. I strive to provide a safe space where clients feel comfortable in exploring their past, rewriting personal narratives, and forging an understanding of self that enables living presently. Together we'll discover your strengths, while exploring areas that crave nurturing and healing.
(608) 493-1119 x120 View (608) 493-1119 x120
Photo of Anesis Center for Marriage and Family Therapy, Marriage & Family Therapist in Madison, WI
Anesis Center for Marriage and Family Therapy
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Madison, WI 53711
We love to collaborate with clients to help them draw from their own expertise, build on their own positive values, discover their own skills, and use these new tools to work through conflicts and hardships. We are systems therapist. What that means is: we like to approach problems that people have within the context of social, political and cultural storylines that influence the way we view ourselves and our own personal stories. We use this same approach in family therapy to seek ways to change the way the family system works rather than trying to "fix" a specific family member.
We love to collaborate with clients to help them draw from their own expertise, build on their own positive values, discover their own skills, and use these new tools to work through conflicts and hardships. We are systems therapist. What that means is: we like to approach problems that people have within the context of social, political and cultural storylines that influence the way we view ourselves and our own personal stories. We use this same approach in family therapy to seek ways to change the way the family system works rather than trying to "fix" a specific family member.
(608) 802-7669 View (608) 802-7669
Photo of Laura J LeBlanc, Clinical Social Work/Therapist in Madison, WI
Laura J LeBlanc
Clinical Social Work/Therapist, MDiv, MA, LCSW
Verified Verified
Madison, WI 53703
Not accepting new clients
***I am not accepting new patients at this time. Returning patients can leave a message and I will get back to you.***** I work with straight and queer identified individuals and couples addressing depression, anxiety, self-esteem, trauma, life transitions, infertility, grief and loss. I have been in practice 23 years and the people I work with have described me as warm, sincere, non-judgmental, and funny.
***I am not accepting new patients at this time. Returning patients can leave a message and I will get back to you.***** I work with straight and queer identified individuals and couples addressing depression, anxiety, self-esteem, trauma, life transitions, infertility, grief and loss. I have been in practice 23 years and the people I work with have described me as warm, sincere, non-judgmental, and funny.
(608) 473-3952 View (608) 473-3952
Martin Tamkin
Marriage & Family Therapist, LMFT
Verified Verified
Madison, WI 53711
Marty Tamkin, Ph.D., LMFT is a Licensed Marriage and Family Therapist, who has been practicing psychotherapy since 2004 and has been fully licensed since 2008. Dr. Tamkin has a Ph.D. from Capella University, a master's degree in marriage and family therapy from Phillips Graduate Institute, and a bachelor's degree in social work from California State University, Los Angeles. He is actively licensed in Wisconsin, as well as in California, and only sees clients through a telehealth platform. Marty is trained in several different psychotherapy approaches.
Marty Tamkin, Ph.D., LMFT is a Licensed Marriage and Family Therapist, who has been practicing psychotherapy since 2004 and has been fully licensed since 2008. Dr. Tamkin has a Ph.D. from Capella University, a master's degree in marriage and family therapy from Phillips Graduate Institute, and a bachelor's degree in social work from California State University, Los Angeles. He is actively licensed in Wisconsin, as well as in California, and only sees clients through a telehealth platform. Marty is trained in several different psychotherapy approaches.
(608) 413-3772 View (608) 413-3772
Photo of Ian Nelson-Johnson, Psychologist in Madison, WI
Ian Nelson-Johnson
Psychologist, PsyD, LP
Verified Verified
1 Endorsed
Madison, WI 53705
Currently accepting new clients! It takes tremendous courage to turn the spotlight inwards and work on ourselves. I consider it a genuine privilege to walk alongside people as we navigate their struggles and successes. It is why I have such deep respect for the people who walk through my door. If you are that person, know this: ALL of you is welcome here. Meaningful relationships are central to our well-being, just as much as water or air; however, they often are the source of intense pain. Our therapeutic work will be built on a foundation of trust, and focus on developing the relationships with yourself and others you deserve.
Currently accepting new clients! It takes tremendous courage to turn the spotlight inwards and work on ourselves. I consider it a genuine privilege to walk alongside people as we navigate their struggles and successes. It is why I have such deep respect for the people who walk through my door. If you are that person, know this: ALL of you is welcome here. Meaningful relationships are central to our well-being, just as much as water or air; however, they often are the source of intense pain. Our therapeutic work will be built on a foundation of trust, and focus on developing the relationships with yourself and others you deserve.
(608) 602-7225 View (608) 602-7225
Photo of Jamie Pekarek Krohn, Licensed Professional Counselor in Madison, WI
Jamie Pekarek Krohn
Licensed Professional Counselor, LPC, CYT
Verified Verified
Madison, WI 53711
Each of us has our own unique story. Oftentimes, aspects of it can bring us pain and confusion, leading us to develop disruptive thoughts and behaviors. This is when therapy can be helpful. My clients tend to be individuals and couples who realize they are not living at their fullest potential and want to get there. Together, we can create a space where you feel safe to explore problematic patterns and connect with healthy, more productive ones that move you forward.
Each of us has our own unique story. Oftentimes, aspects of it can bring us pain and confusion, leading us to develop disruptive thoughts and behaviors. This is when therapy can be helpful. My clients tend to be individuals and couples who realize they are not living at their fullest potential and want to get there. Together, we can create a space where you feel safe to explore problematic patterns and connect with healthy, more productive ones that move you forward.
(608) 465-5116 View (608) 465-5116
Photo of Bree Baylor, Marriage & Family Therapist in Madison, WI
Bree Baylor
Marriage & Family Therapist, MFT-IT
Verified Verified
Madison, WI 53717
Clients can expect Bree to be genuine and show up as her authentic self, because she values true human connection with clients. It is from this warm and validating place that you can leave your comfort zone and make changes in your life. Bree helps clients reduce emotional distress, manage difficult relationships, and begin thriving, not just surviving. Whether you are looking to become your best self or survive until the next day, Bree will meet you where you are at. Her philosophy is that no one is "untreatable," and everyone can benefit from therapy, so she is here to support you in good times and bad.
Clients can expect Bree to be genuine and show up as her authentic self, because she values true human connection with clients. It is from this warm and validating place that you can leave your comfort zone and make changes in your life. Bree helps clients reduce emotional distress, manage difficult relationships, and begin thriving, not just surviving. Whether you are looking to become your best self or survive until the next day, Bree will meet you where you are at. Her philosophy is that no one is "untreatable," and everyone can benefit from therapy, so she is here to support you in good times and bad.
(608) 650-5695 View (608) 650-5695
Photo of Sophia Svetnicka, Pre-Licensed Professional in Madison, WI
Sophia Svetnicka
Pre-Licensed Professional
Verified Verified
1 Endorsed
Madison, WI 53715
Sophia (she/her) works with a wide variety of relationships as well as individuals from all walks of life. Sophia believes in meeting each individual where they are at and fostering an environment of unique growth. Sophia is particularly interested in working with relationships, neurodivergent folks, and academic stress.
Sophia (she/her) works with a wide variety of relationships as well as individuals from all walks of life. Sophia believes in meeting each individual where they are at and fostering an environment of unique growth. Sophia is particularly interested in working with relationships, neurodivergent folks, and academic stress.
(608) 705-7757 x127 View (608) 705-7757 x127
Photo of Angela Willits, Clinical Social Work/Therapist in Madison, WI
Angela Willits
Clinical Social Work/Therapist, LCSW
Verified Verified
Madison, WI 53711  (Online Only)
Angela Willits, LCSW, is dedicated to providing evidence-based psychotherapy that is identity-affirming and empowers individuals to overcome emotional struggles. With a specialization in trauma therapy, Angela helps individuals recover from anxiety, loss, and traumatic experiences to restore a sense of safety and well-being. Embracing a holistic approach to healing, Angela recognizes the interconnectedness of mind, body, and spirit and may incorporate healing modalities such as breathwork, guided imagery, and meditation to enhance the therapeutic process. Learn more at my website: angela-willits.clientsecure.me
Angela Willits, LCSW, is dedicated to providing evidence-based psychotherapy that is identity-affirming and empowers individuals to overcome emotional struggles. With a specialization in trauma therapy, Angela helps individuals recover from anxiety, loss, and traumatic experiences to restore a sense of safety and well-being. Embracing a holistic approach to healing, Angela recognizes the interconnectedness of mind, body, and spirit and may incorporate healing modalities such as breathwork, guided imagery, and meditation to enhance the therapeutic process. Learn more at my website: angela-willits.clientsecure.me
(608) 650-5194 View (608) 650-5194
Photo of April Shields, Licensed Professional Counselor in Madison, WI
April Shields
Licensed Professional Counselor, MS, LPC
Verified Verified
Madison, WI 53703  (Online Only)
Are you looking for support in removing what is blocking you from loving who you are, doing what you love, and connecting with the people you love? I can help you develop more positive relationships and become more aware of what might be stopping you from moving forward in your personal and professional lives. I provide an empathic environment that opens the way for self-discovery. I hope that you will feel supported and more confident as you take steps toward living a life you feel passionate about.
Are you looking for support in removing what is blocking you from loving who you are, doing what you love, and connecting with the people you love? I can help you develop more positive relationships and become more aware of what might be stopping you from moving forward in your personal and professional lives. I provide an empathic environment that opens the way for self-discovery. I hope that you will feel supported and more confident as you take steps toward living a life you feel passionate about.
(608) 927-5092 View (608) 927-5092
Photo of Tony Utrie, Clinical Social Work/Therapist in Madison, WI
Tony Utrie
Clinical Social Work/Therapist, LCSW, SAC-IT
Verified Verified
Madison, WI 53713
Tony is a driven, caring, innovative, and experienced Certified Advanced Practice Social Worker and Substance Abuse Counselor who focuses on working with individuals with marginalized identities. Tony honed his therapeutic approach in Madison, working with people living with substance use challenges, mental health issues, and developmental disabilities.
Tony is a driven, caring, innovative, and experienced Certified Advanced Practice Social Worker and Substance Abuse Counselor who focuses on working with individuals with marginalized identities. Tony honed his therapeutic approach in Madison, working with people living with substance use challenges, mental health issues, and developmental disabilities.
(608) 802-6800 View (608) 802-6800
Photo of Anne-Marie Makongho, Counselor in Madison, WI
Anne-Marie Makongho
Counselor, MSE, LPC
Verified Verified
1 Endorsed
Madison, WI 53711
Are you feeling stressed, overwhelmed, burned out, struggling with your mental health, and substance use due to life transitions, relationships, peer relationships, school, parenting/co-parenting struggles, divorce, traumatic experiences, abuse, balancing work and personal life, and other stress-triggering events? I offer online and in-office therapy sessions working with children, adolescents, adults, couples, and families with a holistic approach to helping clients. Taking New CLIENTS, no waitlist.
Are you feeling stressed, overwhelmed, burned out, struggling with your mental health, and substance use due to life transitions, relationships, peer relationships, school, parenting/co-parenting struggles, divorce, traumatic experiences, abuse, balancing work and personal life, and other stress-triggering events? I offer online and in-office therapy sessions working with children, adolescents, adults, couples, and families with a holistic approach to helping clients. Taking New CLIENTS, no waitlist.
(608) 596-5862 View (608) 596-5862
Photo of J Campbell LCSW SC, Clinical Social Work/Therapist in Madison, WI
J Campbell LCSW SC
Clinical Social Work/Therapist, LCSW
Verified Verified
Madison, WI 53711
I believe that psychotherapy is most effective when approached as a collaborative and relational process. I work with people seeking help with a variety of concerns including depression, anxiety, the effects of trauma, bipolar disorder, anger, and life transitions. I use a combination of approaches including psychodynamic therapy, cognitive-behavioral therapy, EMDR, and dialectical behavior therapy. I have over twenty years of experience working with adults and adolescents (age 13 and older). If you have any questions about working with me, please do not hesitate to contact me.
I believe that psychotherapy is most effective when approached as a collaborative and relational process. I work with people seeking help with a variety of concerns including depression, anxiety, the effects of trauma, bipolar disorder, anger, and life transitions. I use a combination of approaches including psychodynamic therapy, cognitive-behavioral therapy, EMDR, and dialectical behavior therapy. I have over twenty years of experience working with adults and adolescents (age 13 and older). If you have any questions about working with me, please do not hesitate to contact me.
(608) 200-2745 x105 View (608) 200-2745 x105
Photo of Steven A. Elkind, Psychologist in Madison, WI
Steven A. Elkind
Psychologist, PhD
Verified Verified
Madison, WI 53713
Not accepting new clients
Real change lies in a person’s willingness to become more of who they are rather than trying to become what they are not. You are not a problem to be solved or fixed. Competent therapy offers no gimmicks, no quick fixes-- what matters is a willingness to explore who you are rather than who you "should" be. I cannot promise quick and easy relief from your suffering. What I can promise is my full attention and engagement. Every difficulty is an opportunity; perhaps not a welcome opportunity but your struggle has meaning—you are not satisfied with the status quo, you have not given up.
Real change lies in a person’s willingness to become more of who they are rather than trying to become what they are not. You are not a problem to be solved or fixed. Competent therapy offers no gimmicks, no quick fixes-- what matters is a willingness to explore who you are rather than who you "should" be. I cannot promise quick and easy relief from your suffering. What I can promise is my full attention and engagement. Every difficulty is an opportunity; perhaps not a welcome opportunity but your struggle has meaning—you are not satisfied with the status quo, you have not given up.
(608) 851-2068 View (608) 851-2068
Photo of David Michael Guilfoose, Licensed Professional Counselor in Madison, WI
David Michael Guilfoose
Licensed Professional Counselor, MPsych, MEdu
Verified Verified
Madison, WI 53719
David is a Licensed Professional Counselor who specializes in guiding adults in exploring and identifying patterns that influence anxiety and depression. He has more than 20 years experience working with individuals across the lifespan in a diversity of work settings. David is thoughtful and compassionate with an educational background in philosophy and psychology. Some of the approaches he identifies with to influence positive growth and healing are Internal Family Systems, Cognitive Behavioral Therapy, phylosophical and Holistic modalities. David works both virtually and in-person and can be contacted by phone or email.
David is a Licensed Professional Counselor who specializes in guiding adults in exploring and identifying patterns that influence anxiety and depression. He has more than 20 years experience working with individuals across the lifespan in a diversity of work settings. David is thoughtful and compassionate with an educational background in philosophy and psychology. Some of the approaches he identifies with to influence positive growth and healing are Internal Family Systems, Cognitive Behavioral Therapy, phylosophical and Holistic modalities. David works both virtually and in-person and can be contacted by phone or email.
(608) 828-3636 View (608) 828-3636
Photo of Nathaniel Aymaar Willkomm, Licensed Professional Counselor in Madison, WI
Nathaniel Aymaar Willkomm
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Madison, WI 53713
Your teen doesn’t know what they want, and neither do you. At home, the conflicts seem constant—you’re always butting heads and they never seem happy, no matter what you do. You feel defeated. Teenagers are looking for a sense of belonging and it’s often hard for them to feel confident and explain their internal world to others when life is throwing so much at them. They need a space for someone to listen and validate their feelings, without fear of judgment. Understanding their behavior can be confusing and frustrating, but I’m here to tell you there is hope.
Your teen doesn’t know what they want, and neither do you. At home, the conflicts seem constant—you’re always butting heads and they never seem happy, no matter what you do. You feel defeated. Teenagers are looking for a sense of belonging and it’s often hard for them to feel confident and explain their internal world to others when life is throwing so much at them. They need a space for someone to listen and validate their feelings, without fear of judgment. Understanding their behavior can be confusing and frustrating, but I’m here to tell you there is hope.
(608) 496-9797 View (608) 496-9797
Photo of Kevin Davies, Licensed Professional Counselor in Madison, WI
Kevin Davies
Licensed Professional Counselor
Verified Verified
Madison, WI 53711
Kevin uses a collaborative and flexible approach in his work with clients of all backgrounds. His attitude of warmth and non judgement, deliberate attention to the present moment, and familiarity with effective treatment models invites you to open up to your experience in order to pursue what truly matters to you. Kevin has worked with teens, adults, and couples in a variety of settings throughout his career. His experience in crisis management and community-based programs helps him stand with clients during struggles and triumphs with an open heart.
Kevin uses a collaborative and flexible approach in his work with clients of all backgrounds. His attitude of warmth and non judgement, deliberate attention to the present moment, and familiarity with effective treatment models invites you to open up to your experience in order to pursue what truly matters to you. Kevin has worked with teens, adults, and couples in a variety of settings throughout his career. His experience in crisis management and community-based programs helps him stand with clients during struggles and triumphs with an open heart.
(608) 336-4460 View (608) 336-4460
Photo of Anne Patricia Maxwell, Psychologist in Madison, WI
Anne Patricia Maxwell
Psychologist, PhD
Verified Verified
Madison, WI 53713  (Online Only)
I work with adolescents and adults who struggle with anxiety, depression, grief and adjustment to transitions (moving, starting college, changing jobs, changes in relationships). I also work with specific diagnoses including panic disorder, OCD, generalized anxiety disorder, ADD/ADHD, and autism. I am certified to treat children, adolescents and young adults with internet addictions (e.g., gaming, social media, compulsive information seeking).
I work with adolescents and adults who struggle with anxiety, depression, grief and adjustment to transitions (moving, starting college, changing jobs, changes in relationships). I also work with specific diagnoses including panic disorder, OCD, generalized anxiety disorder, ADD/ADHD, and autism. I am certified to treat children, adolescents and young adults with internet addictions (e.g., gaming, social media, compulsive information seeking).
(608) 413-3734 View (608) 413-3734

How does your Therapist compare?

Number of Therapists in Madison, WI

700+

Average cost per session

$150

Therapists in Madison, WI who prioritize treating:

91% Anxiety
84% Depression
74% Relationship Issues
70% Trauma and PTSD
70% Self Esteem
66% Life Transitions
65% Stress

Average years in practice

10 Years

Top 3 insurances accepted

54% Quartz
50% BlueCross and BlueShield
50% Other

How Therapists in Madison, WI see their clients

72% In Person and Online
28% Online Only

Gender breakdown

79% Female
19% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Madison?

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.