Therapists in Burlington, VT

Photo of Joe Berger, Clinical Social Work/Therapist in Burlington, VT
Joe Berger
Clinical Social Work/Therapist, LICSW
Verified Verified
Burlington, VT 05401
Not accepting new clients
I work with individuals, couples, and families who are looking for support as they navigate challenges in their lives. I view the issues that prompt people to come to therapy in the context of their relationships with family and significant others and the patterns present in these relationships. I believe that becoming a better observer of how we behave when we are feeling anxious is an important part of the process of making life changes.
I work with individuals, couples, and families who are looking for support as they navigate challenges in their lives. I view the issues that prompt people to come to therapy in the context of their relationships with family and significant others and the patterns present in these relationships. I believe that becoming a better observer of how we behave when we are feeling anxious is an important part of the process of making life changes.
(802) 526-2331 View (802) 526-2331
Photo of John Penoyar, Psychologist in Burlington, VT
John Penoyar
Psychologist, MA
Verified Verified
Burlington, VT 05401
Not accepting new clients
I offer confidential psychotherapy in a safe environment to adults struggling with anxiety, panic, depression, marital/relationship issues, life transitions, loss and spiritual issues.
I offer confidential psychotherapy in a safe environment to adults struggling with anxiety, panic, depression, marital/relationship issues, life transitions, loss and spiritual issues.
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Photo of Luke Lewis, Counselor in Burlington, VT
Luke Lewis
Counselor, LCMHC
Verified Verified
Burlington, VT 05401
Not accepting new clients
In therapy, my main aim is to create a space where you can freely express yourself, offering understanding and validation to bring you a sense of relief by the end of our session. While I believe these are fundamental goals in therapy, I understand that they are just the beginning. When we connect, I tailor my approach to suit your unique needs, recognizing that there is no one-size-fits-all solution in therapy. My approach involves delving not only into emotional and psychological aspects but also addressing societal factors and systemic oppression that may be impacting your life.
In therapy, my main aim is to create a space where you can freely express yourself, offering understanding and validation to bring you a sense of relief by the end of our session. While I believe these are fundamental goals in therapy, I understand that they are just the beginning. When we connect, I tailor my approach to suit your unique needs, recognizing that there is no one-size-fits-all solution in therapy. My approach involves delving not only into emotional and psychological aspects but also addressing societal factors and systemic oppression that may be impacting your life.
(802) 348-2056 View (802) 348-2056
Photo of Julia McGlew, Pre-Licensed Professional in Burlington, VT
Julia McGlew
Pre-Licensed Professional
Verified Verified
1 Endorsed
Burlington, VT 05401  (Online Only)
Not accepting new clients
"I did then what I knew how to do. Now that I know better, I do better" (Maya Angelou) Hi! My name is Julia (she/her). My approach to therapy is empathetic and based in both trust and relationship. I truly enjoy getting to know my clients and being able to help them take a look at their past and current challenges and see how they have adapted. I really want to help my clients understand where their reactions to trauma/hard times come from and how to use that knowledge to move forward in a fulfilling way. I feel my approach is truly person centered and trauma informed, using compassion and curiosity to help us navigate.
"I did then what I knew how to do. Now that I know better, I do better" (Maya Angelou) Hi! My name is Julia (she/her). My approach to therapy is empathetic and based in both trust and relationship. I truly enjoy getting to know my clients and being able to help them take a look at their past and current challenges and see how they have adapted. I really want to help my clients understand where their reactions to trauma/hard times come from and how to use that knowledge to move forward in a fulfilling way. I feel my approach is truly person centered and trauma informed, using compassion and curiosity to help us navigate.
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Photo of Caley Holden, Registered Psychotherapist in Burlington, VT
Caley Holden
Registered Psychotherapist, MS, LCMHC
Verified Verified
Burlington, VT 05401
Waitlist for new clients
Sometimes we’re not sure how we got to where we are. We find ourselves caught in patterns – of thoughts, feelings, behaviors, relationships – that are hurtful, unsatisfying, or no longer serve us. Sometimes we treat ourselves harshly, make choices that are not in line with our values, or attempt to quiet or hide certain parts of ourselves, our pain, and our experiences. In a collaborative therapeutic space, I hope to create an environment where you can show up as your whole self.
Sometimes we’re not sure how we got to where we are. We find ourselves caught in patterns – of thoughts, feelings, behaviors, relationships – that are hurtful, unsatisfying, or no longer serve us. Sometimes we treat ourselves harshly, make choices that are not in line with our values, or attempt to quiet or hide certain parts of ourselves, our pain, and our experiences. In a collaborative therapeutic space, I hope to create an environment where you can show up as your whole self.
(802) 327-8306 View (802) 327-8306
Photo of Otter Creek Associates, Clinical Social Work/Therapist in Burlington, VT
Otter Creek Associates
Clinical Social Work/Therapist, LICSW
Verified Verified
Burlington, VT 05401
I am Lisbeth Dodd, LICSW. My offices are located in Burlington and Montpelier, Vermont. Through over 20 years of clinical practice I have assisted clients in a variety of helping relationships and roles including psychotherapy, case management, and medical and emergency mental health. I apply a client-centered, integrative approach, including psychodynamic and cognitive-behavioral principles. I work with adults who may be experiencing a wide range of concerns which may include: complex life transitions, anxiety, stress, relationship problems, adjustment disorders, depression, life transitions, and trauma.
I am Lisbeth Dodd, LICSW. My offices are located in Burlington and Montpelier, Vermont. Through over 20 years of clinical practice I have assisted clients in a variety of helping relationships and roles including psychotherapy, case management, and medical and emergency mental health. I apply a client-centered, integrative approach, including psychodynamic and cognitive-behavioral principles. I work with adults who may be experiencing a wide range of concerns which may include: complex life transitions, anxiety, stress, relationship problems, adjustment disorders, depression, life transitions, and trauma.
(802) 733-0200 View (802) 733-0200
Photo of Kristen Johanson, Counselor in Burlington, VT
Kristen Johanson
Counselor, MS, LCMHC
Verified Verified
1 Endorsed
Burlington, VT 05401  (Online Only)
Not accepting new clients
I have accrued over 15 years of experience with people on sorting through a variety of life's difficulties. I work with people who may be struggling with all sorts of problems including anxiety, depression, substance abuse, and relational difficulties.
I have accrued over 15 years of experience with people on sorting through a variety of life's difficulties. I work with people who may be struggling with all sorts of problems including anxiety, depression, substance abuse, and relational difficulties.
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Photo of Collin Hagood, Counselor in Burlington, VT
Collin Hagood
Counselor, LPC, LCMHC
Verified Verified
Burlington, VT 05401
Waitlist for new clients
My aim is to help you address problematic ways of thinking, feeling, and behaving by way of examining the ways in which you perceive the world around you. The goal is to assist you in reaching a position of appreciation for your genuine self (for you are the perfect you) and an acceptance of the events that occur in your life. I would be honored to take part in your journey of discovering the narratives which potentially distort reality and lead to discomfort, diminished self-worth, or other barriers to attaining contentment.
My aim is to help you address problematic ways of thinking, feeling, and behaving by way of examining the ways in which you perceive the world around you. The goal is to assist you in reaching a position of appreciation for your genuine self (for you are the perfect you) and an acceptance of the events that occur in your life. I would be honored to take part in your journey of discovering the narratives which potentially distort reality and lead to discomfort, diminished self-worth, or other barriers to attaining contentment.
(802) 255-8442 View (802) 255-8442
Photo of Heather Parker, Counselor in Burlington, VT
Heather Parker
Counselor, MA, LCMHC
Verified Verified
Burlington, VT 05401
Providing Supervision to Licensed and Pre-Licensed Therapists, Certified Sensorimotor Psychotherapist and Certified Consultant, Internal Family Systems Psychotherapist. The development of a gentle curiosity of one's internal experience becomes the basis for compassion and authentic expression. This contemplative relationship with oneself can then expand the way in which we connect and relate to others. Therapeutic style is interactive, while encouraging the client's inner consciousness to guide the process. Use of somatic, parts work, and strength-based modalities that view individuals as having an innate propensity toward health.
Providing Supervision to Licensed and Pre-Licensed Therapists, Certified Sensorimotor Psychotherapist and Certified Consultant, Internal Family Systems Psychotherapist. The development of a gentle curiosity of one's internal experience becomes the basis for compassion and authentic expression. This contemplative relationship with oneself can then expand the way in which we connect and relate to others. Therapeutic style is interactive, while encouraging the client's inner consciousness to guide the process. Use of somatic, parts work, and strength-based modalities that view individuals as having an innate propensity toward health.
(802) 276-4191 View (802) 276-4191
Photo of Julia Howe, Counselor in Burlington, VT
Julia Howe
Counselor, MS, LCMHC
Verified Verified
6 Endorsed
Burlington, VT 05401
Waitlist for new clients
Suffering is an inherent part of the human condition, but it doesn't mean that we need to move through it alone. Irvin Yalom, an American Existential Psychiatrist, describes the therapist and client as "fellow travelers." This resonates with me, as I believe that a collaborative approach and the steadily cultivated care and trust in the therapeutic relationship can fuel meaningful growth and change on individual and relational levels. Then, by shining the light of curiosity on one's inner landscape, an awareness of relationship themes, habitual behaviors, and thought patterns begins to surface. This awareness is the key to change.
Suffering is an inherent part of the human condition, but it doesn't mean that we need to move through it alone. Irvin Yalom, an American Existential Psychiatrist, describes the therapist and client as "fellow travelers." This resonates with me, as I believe that a collaborative approach and the steadily cultivated care and trust in the therapeutic relationship can fuel meaningful growth and change on individual and relational levels. Then, by shining the light of curiosity on one's inner landscape, an awareness of relationship themes, habitual behaviors, and thought patterns begins to surface. This awareness is the key to change.
(802) 489-7624 View (802) 489-7624
Photo of Adam M. Grundt, Psychologist in Burlington, VT
Adam M. Grundt
Psychologist, PhD
Verified Verified
Burlington, VT 05401
Waitlist for new clients
The goal of my practice is to help reduce suffering and to increase capacity for joy, flexibility, and life fulfillment. I individualize my approach to your needs using a mix of different psychological approaches, including cognitive-behavioral, narrative and psychodynamic. I am a Vermont licensed doctoral-level psychologist who trained in health psychology at the Minneapolis VA Hospital, and engaged in postdoctoral study in behavioral medicine at the Dartmouth-Hitchcock Medical Center. I worked for many years at the Hazelden Center, a nationally-recognized leader in addiction treatment, and gained additional experience working with adolescents as a high school counselor and wellness teacher
The goal of my practice is to help reduce suffering and to increase capacity for joy, flexibility, and life fulfillment. I individualize my approach to your needs using a mix of different psychological approaches, including cognitive-behavioral, narrative and psychodynamic. I am a Vermont licensed doctoral-level psychologist who trained in health psychology at the Minneapolis VA Hospital, and engaged in postdoctoral study in behavioral medicine at the Dartmouth-Hitchcock Medical Center. I worked for many years at the Hazelden Center, a nationally-recognized leader in addiction treatment, and gained additional experience working with adolescents as a high school counselor and wellness teacher
(802) 357-4168 View (802) 357-4168
Photo of Dr. Jen Peterson, Registered Psychotherapist in Burlington, VT
Dr. Jen Peterson
Registered Psychotherapist, PhD
Verified Verified
Burlington, VT 05401  (Online Only)
Waitlist for new clients
It’s challenging to admit to having difficulties in our lives. We experience so much in our fast-paced world, and we are expected to just “be okay” no matter what. We try our best, and try again, and keep on going because we must. You are strong, and you’ve been strong for so long. But sometimes we need a moment to work on ourselves. We need a minute to take a pause and understand the underlying issue of why something just isn’t correctly working. You’re not alone in that sentiment. You are not alone. Together we can discover your concerns and create a peaceful, happy path towards accomplishing a life you want. Pause.
It’s challenging to admit to having difficulties in our lives. We experience so much in our fast-paced world, and we are expected to just “be okay” no matter what. We try our best, and try again, and keep on going because we must. You are strong, and you’ve been strong for so long. But sometimes we need a moment to work on ourselves. We need a minute to take a pause and understand the underlying issue of why something just isn’t correctly working. You’re not alone in that sentiment. You are not alone. Together we can discover your concerns and create a peaceful, happy path towards accomplishing a life you want. Pause.
(802) 255-8428 View (802) 255-8428
Photo of Annie Rosenthal, Registered Psychotherapist in Burlington, VT
Annie Rosenthal
Registered Psychotherapist, MA in, Psych, MEd
Verified Verified
Burlington, VT 05401  (Online Only)
Clients seeking relief from trauma, anxiety, and other psychological challenges find solace in my expertise and style. Utilizing the power of EMDR bilateral stimulation and guided processing, I guide clients through their traumatic memories with care and sensitivity, facilitating a journey towards resolution and resilience. My extensive experience in working with diverse populations, including those historically underserved by traditional therapeutic approaches, ensures a safe and inclusive environment for healing. I prioritize cultural sensitivity and empathy, recognizing the importance of addressing the unique experiences and
Clients seeking relief from trauma, anxiety, and other psychological challenges find solace in my expertise and style. Utilizing the power of EMDR bilateral stimulation and guided processing, I guide clients through their traumatic memories with care and sensitivity, facilitating a journey towards resolution and resilience. My extensive experience in working with diverse populations, including those historically underserved by traditional therapeutic approaches, ensures a safe and inclusive environment for healing. I prioritize cultural sensitivity and empathy, recognizing the importance of addressing the unique experiences and
(617) 202-3834 View (617) 202-3834
Photo of Pursuit of Peace Counseling in Burlington, VT
Pursuit of Peace Counseling
MA
Verified Verified
Burlington, VT 05408  (Online Only)
I hold unconditional positive regard as the key to a great therapeutic relationship. I work to meet people where they are, to actively listen and understand their values, and to explore and support them to better connect with themselves and others. My goal is to help people cultivate loving acceptance of themselves, and gain insight of how the past impacts the present, while creating an awareness that the past doesn't have to dictate their present or future.
I hold unconditional positive regard as the key to a great therapeutic relationship. I work to meet people where they are, to actively listen and understand their values, and to explore and support them to better connect with themselves and others. My goal is to help people cultivate loving acceptance of themselves, and gain insight of how the past impacts the present, while creating an awareness that the past doesn't have to dictate their present or future.
(802) 409-2461 View (802) 409-2461
Photo of Cheryl Shive-Emails Only, Registered Psychotherapist in Burlington, VT
Cheryl Shive-Emails Only
Registered Psychotherapist, MS, MSW
Verified Verified
Burlington, VT 05401
I specialize in working with youth & adults, couples, and families to improve personal and relational satisfaction, quality of life, and daily functioning. I use a client-centered, strength-based approach to therapy utilizing family systems, cognitive behavioral, dialectical behavioral, talk, and solution-focused therapy. I incorporate Christian counseling into therapy sessions for individuals who would like to incorporate their spirituality into their sessions. I am looking forward to working with you and or your family to gain personal insight to lessen stress and facilitate moving forward in life to create the life you want.
I specialize in working with youth & adults, couples, and families to improve personal and relational satisfaction, quality of life, and daily functioning. I use a client-centered, strength-based approach to therapy utilizing family systems, cognitive behavioral, dialectical behavioral, talk, and solution-focused therapy. I incorporate Christian counseling into therapy sessions for individuals who would like to incorporate their spirituality into their sessions. I am looking forward to working with you and or your family to gain personal insight to lessen stress and facilitate moving forward in life to create the life you want.
(802) 210-3630 x472 View (802) 210-3630 x472
Photo of Associates in Couples Counseling, Psychologist in Burlington, VT
Associates in Couples Counseling
Psychologist, MA
Verified Verified
Burlington, VT 05401
We are a husband-and-wife team focused on couples counseling. Our down-to-earth style usually helps couples quickly feel comfortable. Our approach is simple, direct and interactive. Our theoretical approach and style tends to be accessible, direct, and practical. We focus on the present day changes our clients' want in their relationships â;" and we orient our discussions towards these desired changes. We give plenty of feedback, suggestions, and ideas for homework.
We are a husband-and-wife team focused on couples counseling. Our down-to-earth style usually helps couples quickly feel comfortable. Our approach is simple, direct and interactive. Our theoretical approach and style tends to be accessible, direct, and practical. We focus on the present day changes our clients' want in their relationships â;" and we orient our discussions towards these desired changes. We give plenty of feedback, suggestions, and ideas for homework.
(802) 518-0962 View (802) 518-0962
Photo of Casey Goldman, Counselor in Burlington, VT
Casey Goldman
Counselor, LCMHC
Verified Verified
Burlington, VT 05401
Not accepting new clients
*** I am NOT taking new clients at this time*** I am an advance-trained clinical hypnotherapist and LCMHC. I have personally experienced the healing and growth that comes from using clinical hypnotherapy within a supportive therapeutic milieu. I find the accelerated, effective results from clinical hypnosis very impressive and enjoy helping others heal and actualize change with this powerful technique. I approach counseling from a client-centered perspective, meet people where they are at, and help them get to where they want to be without judgement or pressure.
*** I am NOT taking new clients at this time*** I am an advance-trained clinical hypnotherapist and LCMHC. I have personally experienced the healing and growth that comes from using clinical hypnotherapy within a supportive therapeutic milieu. I find the accelerated, effective results from clinical hypnosis very impressive and enjoy helping others heal and actualize change with this powerful technique. I approach counseling from a client-centered perspective, meet people where they are at, and help them get to where they want to be without judgement or pressure.
(802) 731-9577 View (802) 731-9577
Photo of Jeanne Plo, Counselor in Burlington, VT
Jeanne Plo
Counselor, MEd, MA, LCMHC
Verified Verified
Burlington, VT 05401
I have been in private practice in Burlington, Vermont, since 1989 working with individuals, children and families. At this time, I am working with couples using a time limited method called Dialogue Therapy. I assist partners in learning the skills of speaking for oneself, listening mindfully and remaining curious about the other person's experience even in the middle of an emotionally threatening conflict.
I have been in private practice in Burlington, Vermont, since 1989 working with individuals, children and families. At this time, I am working with couples using a time limited method called Dialogue Therapy. I assist partners in learning the skills of speaking for oneself, listening mindfully and remaining curious about the other person's experience even in the middle of an emotionally threatening conflict.
(802) 689-1123 View (802) 689-1123
Photo of Alex M. Torstrick, Psychologist in Burlington, VT
Alex M. Torstrick
Psychologist, PhD
Verified Verified
Burlington, VT 05401
A neuropsychological evaluation can provide valuable information regarding an individual's current and future cognitive functioning. My specialty involves the assessment of cognition across a wide span of central nervous system disorders including neurodegenerative conditions (e.g., Alzheimer's disease), traumatic brain injury (TBI), substance abuse, attention deficit syndromes, and autistic spectrum disorder. My work examines the relationship between brain disease and cognition while differentiating the contribution of psychological factors such as depression or anxiety. I also perform independent medical examinations (IME).
A neuropsychological evaluation can provide valuable information regarding an individual's current and future cognitive functioning. My specialty involves the assessment of cognition across a wide span of central nervous system disorders including neurodegenerative conditions (e.g., Alzheimer's disease), traumatic brain injury (TBI), substance abuse, attention deficit syndromes, and autistic spectrum disorder. My work examines the relationship between brain disease and cognition while differentiating the contribution of psychological factors such as depression or anxiety. I also perform independent medical examinations (IME).
(802) 402-4449 View (802) 402-4449
Photo of Marc D. Richter, Clinical Social Work/Therapist in Burlington, VT
Marc D. Richter
Clinical Social Work/Therapist, LICSW, LADC, CADC, MSW
Verified Verified
Burlington, VT 05401
Not accepting new clients
I'm interested in helping clients gain a better understanding of their relationship with themselves and to others within their lives. I believe human connection is essential for people as well as living with honesty and balance. Through compassionate humor and straightforward dialogue, I strive to help clients review the thought process involved in developing harmony between their behaviors, values and feelings and their identified inner needs, goals and sense of self. I'm especially interested in helping clients to establish a harmony of communication between the three parts of the mind: the Brain, the Heart and the Gut.
I'm interested in helping clients gain a better understanding of their relationship with themselves and to others within their lives. I believe human connection is essential for people as well as living with honesty and balance. Through compassionate humor and straightforward dialogue, I strive to help clients review the thought process involved in developing harmony between their behaviors, values and feelings and their identified inner needs, goals and sense of self. I'm especially interested in helping clients to establish a harmony of communication between the three parts of the mind: the Brain, the Heart and the Gut.
(866) 828-9074 View (866) 828-9074

How does your Therapist compare?

Number of Therapists in Burlington, VT

700+

Average cost per session

$135

Therapists in Burlington, VT who prioritize treating:

95% Anxiety
88% Depression
83% Relationship Issues
79% Self Esteem
72% Stress
71% Trauma and PTSD
67% Coping Skills

Average years in practice

10 Years

Top 3 insurances accepted

83% BlueCross and BlueShield
64% Medicaid
53% MVP Health Care

How Therapists in Burlington, VT see their clients

57% In Person and Online
43% Online Only

Gender breakdown

75% Female
22% Male
3% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Burlington?

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.