Therapists in Las Vegas, NV

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Photo of Jessica Jane, Marriage & Family Therapist in Las Vegas, NV
Jessica Jane
Marriage & Family Therapist, MS, MFT
Verified Verified
3 Endorsed
Las Vegas, NV 89145
Learn to accept and be at peace with ALL PARTS of yourself and end unnecessary suffering. When we live our most honest and AUTHENTIC lives, our inner conflict dissipates. Discovering who you really are, what trauma is keeping you stuck, and the various ways you are shaming yourself is a process I am so excited to help you with. Those I work with tell me that I am compassionate, genuine, empathetic and challenging. I relate to those I sit with because I connect on a human level, navigating the same journey we call life. I am here for you, with you, and we can do this! Stop struggling alone, let's figure it out together :)
Learn to accept and be at peace with ALL PARTS of yourself and end unnecessary suffering. When we live our most honest and AUTHENTIC lives, our inner conflict dissipates. Discovering who you really are, what trauma is keeping you stuck, and the various ways you are shaming yourself is a process I am so excited to help you with. Those I work with tell me that I am compassionate, genuine, empathetic and challenging. I relate to those I sit with because I connect on a human level, navigating the same journey we call life. I am here for you, with you, and we can do this! Stop struggling alone, let's figure it out together :)
(702) 518-0031 View (702) 518-0031
Photo of Cheri Montgomery, Marriage & Family Therapist Intern in Las Vegas, NV
Cheri Montgomery
Marriage & Family Therapist Intern, MS, MFT
Verified Verified
1 Endorsed
Las Vegas, NV 89117  (Online Only)
Accepting New Clients. In my practice, clients embark on a journey of self-discovery, seeking to cultivate relationship skills, gain insights into unproductive behaviors, and enhance communication habits. With a focus on Couples, Individuals, and Families, I foster a collaborative environment that prioritizes safety, empathy, compassion, and understanding. Through guided exploration and introspection, clients uncover personal challenges, gaining valuable insights and understanding to navigate their issues effectively.
Accepting New Clients. In my practice, clients embark on a journey of self-discovery, seeking to cultivate relationship skills, gain insights into unproductive behaviors, and enhance communication habits. With a focus on Couples, Individuals, and Families, I foster a collaborative environment that prioritizes safety, empathy, compassion, and understanding. Through guided exploration and introspection, clients uncover personal challenges, gaining valuable insights and understanding to navigate their issues effectively.
(702) 966-9541 View (702) 966-9541
Photo of Kayenta Therapy, Pre-Licensed Professional in Las Vegas, NV
Kayenta Therapy
Pre-Licensed Professional
Verified Verified
Las Vegas, NV 89134
Realize that you are not alone, that we are in this together, and most importantly that we are all connected. In the journey toward healing and self-discovery, sometimes we get lost and filled with anger, anxiety, depression, etc. I will provide a safe and open environment with scientifically evidence-based practices to help you cope, thrive, and take charge of your life. I also use an integrative approach because therapy is not one size fits all, it is custom to you. I use models such as Cognitive Behavioral Therapy , Polyvagal Theory, Adlerian , and Solution Focused Brief Therapy.
Realize that you are not alone, that we are in this together, and most importantly that we are all connected. In the journey toward healing and self-discovery, sometimes we get lost and filled with anger, anxiety, depression, etc. I will provide a safe and open environment with scientifically evidence-based practices to help you cope, thrive, and take charge of your life. I also use an integrative approach because therapy is not one size fits all, it is custom to you. I use models such as Cognitive Behavioral Therapy , Polyvagal Theory, Adlerian , and Solution Focused Brief Therapy.
(725) 255-3428 View (725) 255-3428
Photo of Griffin Family Therapy, Clinical Social Work/Therapist in Las Vegas, NV
Griffin Family Therapy
Clinical Social Work/Therapist, LCSW, CGP
Verified Verified
Las Vegas, NV 89148
"Always Remember Your Potential"...my goal is to offer support in reaching that potential. I am a Licensed Clinical Social Worker and Certified Group Psychotherapist licensed in Nevada, Pennsylvania and New York, as well as a Board Approved Supervisor for Social Work Interns. I provide support for a range of concerns, including work stress, coping with medical concerns, adjusting to loss, family communication challenges, depression and anxiety. Options include individual, couples, group and family therapy. We work together as a team, utilizing your unique strengths and talents, to address the issues that you bring to the table.
"Always Remember Your Potential"...my goal is to offer support in reaching that potential. I am a Licensed Clinical Social Worker and Certified Group Psychotherapist licensed in Nevada, Pennsylvania and New York, as well as a Board Approved Supervisor for Social Work Interns. I provide support for a range of concerns, including work stress, coping with medical concerns, adjusting to loss, family communication challenges, depression and anxiety. Options include individual, couples, group and family therapy. We work together as a team, utilizing your unique strengths and talents, to address the issues that you bring to the table.
(702) 534-3788 View (702) 534-3788
Photo of Liberty Pfeffer, Marriage & Family Therapist Intern in Las Vegas, NV
Liberty Pfeffer
Marriage & Family Therapist Intern, MS, MFT-I
Verified Verified
1 Endorsed
Las Vegas, NV 89129
Accepting new clients! My therapeutic approach is inclusive and trauma-informed. I value my clients as whole human beings, by acknowledging the parts of themselves that have been impacted by trauma and highlighting their inner strengths and resiliency. I integrate a variety of holistic healing modalities such as Emotionally Focused Therapy (EFT) and EMDR to enhance secure connections to yourself, others, and the world.
Accepting new clients! My therapeutic approach is inclusive and trauma-informed. I value my clients as whole human beings, by acknowledging the parts of themselves that have been impacted by trauma and highlighting their inner strengths and resiliency. I integrate a variety of holistic healing modalities such as Emotionally Focused Therapy (EFT) and EMDR to enhance secure connections to yourself, others, and the world.
(702) 887-1066 View (702) 887-1066
Photo of Sarah Ellen Mays, Licensed Professional Counselor in Las Vegas, NV
Sarah Ellen Mays
Licensed Professional Counselor, CPC
Verified Verified
Las Vegas, NV 89169  (Online Only)
I am a compassionate therapist specializing in solution-focused therapy and cognitive-behavioral therapy. I work with both children and adults, helping them achieve positive, lasting changes in their lives
I am a compassionate therapist specializing in solution-focused therapy and cognitive-behavioral therapy. I work with both children and adults, helping them achieve positive, lasting changes in their lives
(702) 803-9809 View (702) 803-9809
Photo of Susan Farber, Marriage & Family Therapist in Las Vegas, NV
Susan Farber
Marriage & Family Therapist, MA, LMFT
Verified Verified
Las Vegas, NV 89134  (Online Only)
Are you feeling unfulfilled, overwhelmed, and stagnant in life? Do you struggle with anxiety, stress, depression, physical pain, and relationship issues? With over 22 years of experience helping people overcome their problems, I offer a blend of cognitive behavioral therapy & mind-body modalities, facilitating change and transformation. Together, we unwind the beliefs you hold onto that keep you in a state of fear of loss, stuck & limited. This allows you to make new choices in all areas of your life, enabling a state of peace, calm & fulfillment. When you are no longer held back by a limited point of view, you are more flexible,
Are you feeling unfulfilled, overwhelmed, and stagnant in life? Do you struggle with anxiety, stress, depression, physical pain, and relationship issues? With over 22 years of experience helping people overcome their problems, I offer a blend of cognitive behavioral therapy & mind-body modalities, facilitating change and transformation. Together, we unwind the beliefs you hold onto that keep you in a state of fear of loss, stuck & limited. This allows you to make new choices in all areas of your life, enabling a state of peace, calm & fulfillment. When you are no longer held back by a limited point of view, you are more flexible,
(702) 899-8962 View (702) 899-8962
Photo of Meridian Behavioral Health, LLC, Counselor in Las Vegas, NV
Meridian Behavioral Health, LLC
Counselor, APRN, MA, LCPC
Verified Verified
Las Vegas, NV 89148
Meridian Behavioral Health is dedicated to fostering mental well-being by blending the thoughtful application of psychiatric services with a wide range of therapeutic modalities. Our philosophy is to treat the whole person, acknowledging the profound interplay between mental and physical health. With a commitment to personalized care, Meridian's team offers a synergistic approach, uniting the knowledge of therapists and psychiatric specialists to support each client's individual journey towards balance and health.
Meridian Behavioral Health is dedicated to fostering mental well-being by blending the thoughtful application of psychiatric services with a wide range of therapeutic modalities. Our philosophy is to treat the whole person, acknowledging the profound interplay between mental and physical health. With a commitment to personalized care, Meridian's team offers a synergistic approach, uniting the knowledge of therapists and psychiatric specialists to support each client's individual journey towards balance and health.
(702) 829-5820 View (702) 829-5820
Photo of Destinie Cleveland, Pre-Licensed Professional in Las Vegas, NV
Destinie Cleveland
Pre-Licensed Professional, CADC-I, CSAT-C
Verified Verified
Las Vegas, NV 89101  (Online Only)
Embarking on a journey to overcome addiction, whether it's chemical dependence or struggles with sex addiction, requires a compassionate and personalized approach. I provide tailored support to address the complexities of your experience, including the aftermath of trauma and familial influences. Together, we'll break free from harmful cycles, fostering personal growth in a safe and empowering environment. If you're ready to reclaim power over your life and pursue lasting healing, let's collaborate on your transformative journey towards a brighter future.
Embarking on a journey to overcome addiction, whether it's chemical dependence or struggles with sex addiction, requires a compassionate and personalized approach. I provide tailored support to address the complexities of your experience, including the aftermath of trauma and familial influences. Together, we'll break free from harmful cycles, fostering personal growth in a safe and empowering environment. If you're ready to reclaim power over your life and pursue lasting healing, let's collaborate on your transformative journey towards a brighter future.
(725) 234-6745 View (725) 234-6745
Dr. Gretchen Arian
Psychologist, PhD
Verified Verified
Las Vegas, NV 89118
Not accepting new clients
We're centrally located between Henderson and Summerlin on South Rainbow Boulevard.
We're centrally located between Henderson and Summerlin on South Rainbow Boulevard.
(702) 899-2910 View (702) 899-2910
Photo of Bree Pritchett, Marriage & Family Therapist Intern in Las Vegas, NV
Bree Pritchett
Marriage & Family Therapist Intern, LMFT, Intern
Verified Verified
1 Endorsed
Las Vegas, NV 89129  (Online Only)
I believe change comes from within but sometimes knowing where to start can be difficult. My goal is to be the guide and sounding board needed to assist you through your journey of evolution. Dealing with change can be difficult but with a goal in mind and support at the level you desire anything can be accomplished. Change can be hard, healing can be hard, but I'm here to walk the path with you.
I believe change comes from within but sometimes knowing where to start can be difficult. My goal is to be the guide and sounding board needed to assist you through your journey of evolution. Dealing with change can be difficult but with a goal in mind and support at the level you desire anything can be accomplished. Change can be hard, healing can be hard, but I'm here to walk the path with you.
(702) 930-3774 View (702) 930-3774
Photo of Emily Yamashita, Counselor in Las Vegas, NV
Emily Yamashita
Counselor, CPC, LMHC
Verified Verified
Las Vegas, NV 89148  (Online Only)
My main approach to therapy is client-centered, attachment-based, and trauma-informed. I believe that you, my client, and I, your therapist, are a team, each bringing expertise in a certain area; together, we can make the change you desire. specialize in trauma work, mood disorders, and family and couples counseling. I am educated and trained in psychotherapy, art therapy, music therapy, drama therapy, dance/movement therapy, and play therapy. I am DBT-certified and EMDR-trained.
My main approach to therapy is client-centered, attachment-based, and trauma-informed. I believe that you, my client, and I, your therapist, are a team, each bringing expertise in a certain area; together, we can make the change you desire. specialize in trauma work, mood disorders, and family and couples counseling. I am educated and trained in psychotherapy, art therapy, music therapy, drama therapy, dance/movement therapy, and play therapy. I am DBT-certified and EMDR-trained.
(702) 299-6711 View (702) 299-6711
Photo of Holly Pick, Clinical Social Work/Therapist in Las Vegas, NV
Holly Pick
Clinical Social Work/Therapist, LCSW
Verified Verified
Las Vegas, NV 89101
My ideal client seeks self-exploration & understanding, facing issues like anxiety, depression, or relationship difficulties. They need a supportive space for personal growth, aiming to gain insight, develop coping strategies, improve communication, & foster healthy relationships. They aspire to enhance mental well-being, achieve a better life quality, & unlock their full potential.
My ideal client seeks self-exploration & understanding, facing issues like anxiety, depression, or relationship difficulties. They need a supportive space for personal growth, aiming to gain insight, develop coping strategies, improve communication, & foster healthy relationships. They aspire to enhance mental well-being, achieve a better life quality, & unlock their full potential.
(702) 819-9486 View (702) 819-9486
Photo of Jossie Schauerhamer, Marriage & Family Therapist in Las Vegas, NV
Jossie Schauerhamer
Marriage & Family Therapist, MS, LMFT, LCADC
Verified Verified
Las Vegas, NV 89149
If you are looking to improve your ability to manage emotions, communicate more effectively in relationships, are open to exploring patterns of thinking and behavior that could be keeping you stuck, and are motivated to explore your own inner world, I would love to work with you! I use a client centered approach to therapy and will create a partnership with you in order to create a personalized plan. I believe that change can come through self discovery, and you'll find answers to challenges that are unique to you as you get curious about yourself, your history, and your strengths.
If you are looking to improve your ability to manage emotions, communicate more effectively in relationships, are open to exploring patterns of thinking and behavior that could be keeping you stuck, and are motivated to explore your own inner world, I would love to work with you! I use a client centered approach to therapy and will create a partnership with you in order to create a personalized plan. I believe that change can come through self discovery, and you'll find answers to challenges that are unique to you as you get curious about yourself, your history, and your strengths.
(702) 819-9841 View (702) 819-9841
Photo of Sara Duerksen, Marriage & Family Therapist in Las Vegas, NV
Sara Duerksen
Marriage & Family Therapist, MFT, CPC, MS
Verified Verified
3 Endorsed
Las Vegas, NV 89134  (Online Only)
Everyone struggles sometimes, but there are times when we need help to get through those struggles and therapy is a really good way to do just that! Some of the struggles that people come to talk to me about include procrastination, lack of motivation, worry, and difficulty enjoying life in general. If you find that things just don’t seem to be working out the way they “used to” or maybe you’ve just never quite gotten the hang of things, let’s see if we can’t figure out what’s going on and discuss how to get your life going in a different direction.
Everyone struggles sometimes, but there are times when we need help to get through those struggles and therapy is a really good way to do just that! Some of the struggles that people come to talk to me about include procrastination, lack of motivation, worry, and difficulty enjoying life in general. If you find that things just don’t seem to be working out the way they “used to” or maybe you’ve just never quite gotten the hang of things, let’s see if we can’t figure out what’s going on and discuss how to get your life going in a different direction.
(725) 222-1348 View (725) 222-1348
Photo of The Parkey Group, Marriage & Family Therapist in Las Vegas, NV
The Parkey Group
Marriage & Family Therapist, MS, LMFT
Verified Verified
Las Vegas, NV 89146
Immediate openings now! We currently Accept: Anthem BCBS Commercial Insurance Anthem Medicaid Do you feel that you are a resilient individual who is smart, driven, and knowledgeable but somewhere along the way you hit a bump in the road? Everyone at one time or another in their life finds themselves hitting a rough patch and they can't seem to find the right tools to bring themselves to a better place on their own. That is what a great therapist has to offer. There are so many people out there who have the tools already in their tool belt, they just don't realize they can make it through those traumas or stressors on their own.
Immediate openings now! We currently Accept: Anthem BCBS Commercial Insurance Anthem Medicaid Do you feel that you are a resilient individual who is smart, driven, and knowledgeable but somewhere along the way you hit a bump in the road? Everyone at one time or another in their life finds themselves hitting a rough patch and they can't seem to find the right tools to bring themselves to a better place on their own. That is what a great therapist has to offer. There are so many people out there who have the tools already in their tool belt, they just don't realize they can make it through those traumas or stressors on their own.
(725) 224-7573 View (725) 224-7573
Photo of Carolyn McGee, Marriage & Family Therapist in Las Vegas, NV
Carolyn McGee
Marriage & Family Therapist, BS, MA, LMFT
Verified Verified
1 Endorsed
Las Vegas, NV 89128  (Online Only)
Now accepting new virtual clients and couples. Do you find yourself caught in overthinking patterns? Are you battling with depression or struggling to recognize your own worth? Are communication issues impacting your committed relationship? Perhaps you're facing challenges in various aspects of your life or experiencing difficulty communicating with your child. With years of experience spanning from children to adults to couples, I am dedicated to guiding individuals and couples towards a life characterized by serenity and peace.
Now accepting new virtual clients and couples. Do you find yourself caught in overthinking patterns? Are you battling with depression or struggling to recognize your own worth? Are communication issues impacting your committed relationship? Perhaps you're facing challenges in various aspects of your life or experiencing difficulty communicating with your child. With years of experience spanning from children to adults to couples, I am dedicated to guiding individuals and couples towards a life characterized by serenity and peace.
(702) 887-1597 View (702) 887-1597
Photo of Emily Giovanna Egidio, Clinical Social Work/Therapist in Las Vegas, NV
Emily Giovanna Egidio
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Las Vegas, NV 89129
Waitlist for new clients
Making the decision to attend therapy requires a great amount of courage. Even the fact that you are considering therapy is a step in the right direction! It can be uncomfortable to introspect and realize there are parts of yourself that require change. Thankfully, therapy is a tool that can allow for you to strengthen the qualities you like about yourself, and change the aspects you are unsatisfied with. If you are thinking about attending therapy, I encourage you to take the next step in your personal growth.
Making the decision to attend therapy requires a great amount of courage. Even the fact that you are considering therapy is a step in the right direction! It can be uncomfortable to introspect and realize there are parts of yourself that require change. Thankfully, therapy is a tool that can allow for you to strengthen the qualities you like about yourself, and change the aspects you are unsatisfied with. If you are thinking about attending therapy, I encourage you to take the next step in your personal growth.
(702) 800-2830 View (702) 800-2830
Photo of Katrina Harris, LPC Intern in Las Vegas, NV
Katrina Harris
LPC Intern, PhD, CPC-I
Verified Verified
Las Vegas, NV 89144
I believe each client has the potential for transformation and growth. My approach to counseling is holistic, collaborative and client centered taking into consideration that the mind, body and spirit influence an individual’s view of the world. My areas of focus are working with adults and adolescents experiencing anxiety and depression and individuals who need guidance with life transitions (i.e., divorce, midlife changes, parenthood). Clients can expect a non-judgmental and warm environment that seeks to promote empowerment and meaningful change.
I believe each client has the potential for transformation and growth. My approach to counseling is holistic, collaborative and client centered taking into consideration that the mind, body and spirit influence an individual’s view of the world. My areas of focus are working with adults and adolescents experiencing anxiety and depression and individuals who need guidance with life transitions (i.e., divorce, midlife changes, parenthood). Clients can expect a non-judgmental and warm environment that seeks to promote empowerment and meaningful change.
(702) 819-8511 View (702) 819-8511
Photo of Bethany Schlinger, Psychologist in Las Vegas, NV
Bethany Schlinger
Psychologist, PsyD
Verified Verified
Las Vegas, NV 89157
Hello, I look forward to meeting you! TELEHEALTH SESSIONS AVAILABLE! I enjoy helping people to problem-solve, strategize, and set great goals. I have been a Licensed Clinical Social Worker in Nevada since 2004, and I have a doctoral degree in Clinical Psychology and am a Licensed Psychologist in Nevada. I primarily provide Cognitive, Diagnostic, Psychological and Psychoeducational testing to children and adults. I also provide individual therapy only on a cash pay basis, or through straight FFS Medicaid, when my schedule allows.
Hello, I look forward to meeting you! TELEHEALTH SESSIONS AVAILABLE! I enjoy helping people to problem-solve, strategize, and set great goals. I have been a Licensed Clinical Social Worker in Nevada since 2004, and I have a doctoral degree in Clinical Psychology and am a Licensed Psychologist in Nevada. I primarily provide Cognitive, Diagnostic, Psychological and Psychoeducational testing to children and adults. I also provide individual therapy only on a cash pay basis, or through straight FFS Medicaid, when my schedule allows.
(702) 997-9177 View (702) 997-9177

How does your Therapist compare?

Number of Therapists in Las Vegas, NV

1,000+

Average cost per session

$130

Therapists in Las Vegas, NV who prioritize treating:

91% Anxiety
88% Depression
76% Trauma and PTSD
76% Self Esteem
75% Relationship Issues
70% Coping Skills
70% Stress

Average years in practice

10 Years

Top 3 insurances accepted

71% Aetna
61% Cigna and Evernorth
59% UnitedHealthcare UHC | UBH

How Therapists in Las Vegas, NV see their clients

66% In Person and Online
34% Online Only

Gender breakdown

81% Female
18% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Las Vegas?

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.