Therapists in Louisville, KY

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Photo of Chelsea Mitchell, Psychologist in Louisville, KY
Chelsea Mitchell
Psychologist, PsyD
Verified Verified
1 Endorsed
Louisville, KY 40241
Does your child or teenager appear anxious, irritable, or distant? Have they experienced a traumatic event? Do you find your current parenting strategies are ineffective? As a Clinical Psychologist, I provide cognitive-behavioral therapy (CBT) and trauma-focused cognitive-behavioral therapy (TF-CBT) that is research-based and time-limited. My speciality areas include separation anxiety, obsessive compulsive disorder, social anxiety, specific phobia's, post-traumatic stress disorder, and traumatic grief.
Does your child or teenager appear anxious, irritable, or distant? Have they experienced a traumatic event? Do you find your current parenting strategies are ineffective? As a Clinical Psychologist, I provide cognitive-behavioral therapy (CBT) and trauma-focused cognitive-behavioral therapy (TF-CBT) that is research-based and time-limited. My speciality areas include separation anxiety, obsessive compulsive disorder, social anxiety, specific phobia's, post-traumatic stress disorder, and traumatic grief.
(502) 465-8150 View (502) 465-8150
Photo of Maja Cupac, Licensed Professional Clinical Counselor in Louisville, KY
Maja Cupac
Licensed Professional Clinical Counselor, LPCC-S, SEP, C-DBT, BASE-P
Verified Verified
Louisville, KY 40243
Welcome! I want to applaud you for taking the first step to better your situation, and for taking care of yourself. I have over 14 years of direct experience working with adolescents, adults, and seniors suffering from a wide variety of mental health disorders. Some of those include depression, anxiety, PTSD, trauma, stress, mood disorders, and issues related to abuse. If you are brave, curious, and intelligent, then I'm your therapist! I also offer supervision as a supervisor of record for Licensed Professional Counselor Associates (LPCAs) in Kentucky.
Welcome! I want to applaud you for taking the first step to better your situation, and for taking care of yourself. I have over 14 years of direct experience working with adolescents, adults, and seniors suffering from a wide variety of mental health disorders. Some of those include depression, anxiety, PTSD, trauma, stress, mood disorders, and issues related to abuse. If you are brave, curious, and intelligent, then I'm your therapist! I also offer supervision as a supervisor of record for Licensed Professional Counselor Associates (LPCAs) in Kentucky.
(606) 930-4358 View (606) 930-4358
Photo of Michael Kamber, Pastoral Counselor in Louisville, KY
Michael Kamber
Pastoral Counselor, PSAP, PMAP
Verified Verified
2 Endorsed
Louisville, KY 40206
Are you battling unwanted sexual behavior? Are you tired of carrying around this dark secret? Often we don’t talk about these things or seek help because of the embarrassment or shame that typically surrounds them. We think things like, “if they knew this, they would leave me” or “Keeping this secret keeps the peace,” but you just don’t know how long you can keep up the lie. The truth is that trying to get passed something like a porn addiction on your own doesn’t work and hasn’t worked.
Are you battling unwanted sexual behavior? Are you tired of carrying around this dark secret? Often we don’t talk about these things or seek help because of the embarrassment or shame that typically surrounds them. We think things like, “if they knew this, they would leave me” or “Keeping this secret keeps the peace,” but you just don’t know how long you can keep up the lie. The truth is that trying to get passed something like a porn addiction on your own doesn’t work and hasn’t worked.
(502) 754-3295 View (502) 754-3295
Photo of Margaret Stephanie Ruanto, Clinical Social Work/Therapist in Louisville, KY
Margaret Stephanie Ruanto
Clinical Social Work/Therapist, LCSW
Verified Verified
Louisville, KY 40241  (Online Only)
Margaret "Stephanie" Ruanto is a licensed clinical social worker. Stephanie understands that it can be overwhelming to seek treatment. Asking for help is a tough decision for many people and trusting a therapist with their personal feelings and information is often anxiety-producing. Stephanie offers support and a listening ear as her patients find relief from the burdens of emotional distress. Her goal is to foster growth in her patients so they can find solutions to improve their quality of life.
Margaret "Stephanie" Ruanto is a licensed clinical social worker. Stephanie understands that it can be overwhelming to seek treatment. Asking for help is a tough decision for many people and trusting a therapist with their personal feelings and information is often anxiety-producing. Stephanie offers support and a listening ear as her patients find relief from the burdens of emotional distress. Her goal is to foster growth in her patients so they can find solutions to improve their quality of life.
(502) 680-8332 View (502) 680-8332
Photo of Valerie G. Day LMFT, Marriage & Family Therapist in Louisville, KY
Valerie G. Day LMFT
Marriage & Family Therapist, LMFT
Verified Verified
Louisville, KY 40204
I'm a family systems trained therapist that believes in the power of relationships. I believe in developing and utilizing a collaborative therapeutic alliance with each client, working from a strength based perspective to assist with facilitating hope and progress towards the client(s)' stated goals and objectives for therapy.
I'm a family systems trained therapist that believes in the power of relationships. I believe in developing and utilizing a collaborative therapeutic alliance with each client, working from a strength based perspective to assist with facilitating hope and progress towards the client(s)' stated goals and objectives for therapy.
(502) 799-4115 View (502) 799-4115
Photo of Brittany Derrenbacher in Louisville, KY
Brittany Derrenbacher
Coach, MA/CMHC, MA/WGS
Verified Verified
1 Endorsed
Louisville, KY 40243
Empowerment Life Coaching is based on a holistic approach toward mental health: blending the collaborative elements of coaching with the academic support of Clinical Mental Health Counseling and Women’s & Gender Studies. This method offers a radical shift into providing wellness care focused on mind, body, and spirit. I specialize in women’s empowerment, reparenting, compassion fatigue, burnout, grief, and pet loss. I also love helping clients identify and develop boundaries and encourage their capacity to integrate into everyday life. The goal is to feel empowered, embodied, and deeply connected to your authentic Self.
Empowerment Life Coaching is based on a holistic approach toward mental health: blending the collaborative elements of coaching with the academic support of Clinical Mental Health Counseling and Women’s & Gender Studies. This method offers a radical shift into providing wellness care focused on mind, body, and spirit. I specialize in women’s empowerment, reparenting, compassion fatigue, burnout, grief, and pet loss. I also love helping clients identify and develop boundaries and encourage their capacity to integrate into everyday life. The goal is to feel empowered, embodied, and deeply connected to your authentic Self.
(502) 509-4887 View (502) 509-4887
Photo of Donna Beth Richards, Marriage & Family Therapist in Louisville, KY
Donna Beth Richards
Marriage & Family Therapist, LMFT
Verified Verified
Louisville, KY 40223
Letting someone see what is happening in your life can often be a difficult decision to make. Whether you are dealing with stress, loss, or family and parenting issues, it is important to be able to feel trust and security. In my practice I value a compassionate, non-judgmental and informed approach. I hope to establish a safety that allows you to explore difficult feelings and situations and build confidence in yourself and your ability to navigate life’s ups and downs. I want to support you on your journey of healing and help you to create more peace, joy and strength in yourself, your family and community.
Letting someone see what is happening in your life can often be a difficult decision to make. Whether you are dealing with stress, loss, or family and parenting issues, it is important to be able to feel trust and security. In my practice I value a compassionate, non-judgmental and informed approach. I hope to establish a safety that allows you to explore difficult feelings and situations and build confidence in yourself and your ability to navigate life’s ups and downs. I want to support you on your journey of healing and help you to create more peace, joy and strength in yourself, your family and community.
(502) 677-3251 View (502) 677-3251
Photo of Hannah Barrineau, Clinical Social Work/Therapist in Louisville, KY
Hannah Barrineau
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Louisville, KY 40222
Accepting NEW Clients for morning and midday hours! I work primarily with teens, kids, and young adults and love providing a safe, nonjudgmental, and supportive environment for my clients to be themselves. I am well-versed in working with anxiety, depression, self-esteem concerns, and helping to set boundaries and understand the impact of past trauma.
Accepting NEW Clients for morning and midday hours! I work primarily with teens, kids, and young adults and love providing a safe, nonjudgmental, and supportive environment for my clients to be themselves. I am well-versed in working with anxiety, depression, self-esteem concerns, and helping to set boundaries and understand the impact of past trauma.
(502) 317-8937 View (502) 317-8937
Photo of Center for Behavioral Health , Psychologist in Louisville, KY
Center for Behavioral Health
Psychologist, PsyD
Verified Verified
Louisville, KY 40203
Could life feel more rewarding and meaningful? Do you wish relationships were more satisfying or how better to connect with your child? Does getting good quality sleep feel like an issue? Caring and compassionate clinicians at the Center for Behavioral Health at Spalding University work with clients who often ask similar questions. We are here to offer high-quality, affordable psychological assessments and therapy services with children as young as 4, adolescents and adults in individual, group, couple, and family formats.
Could life feel more rewarding and meaningful? Do you wish relationships were more satisfying or how better to connect with your child? Does getting good quality sleep feel like an issue? Caring and compassionate clinicians at the Center for Behavioral Health at Spalding University work with clients who often ask similar questions. We are here to offer high-quality, affordable psychological assessments and therapy services with children as young as 4, adolescents and adults in individual, group, couple, and family formats.
(502) 563-1052 View (502) 563-1052
Photo of Robert Scott Watson, Psychologist in Louisville, KY
Robert Scott Watson
Psychologist, PsyD
Verified Verified
Louisville, KY 40222
I have spent 30+ years assessing ADHD, Autism, learning impairments, and mood disorders. I see patients ages 10 and up and can usually provide written evaluations within one day of the assessment.
I have spent 30+ years assessing ADHD, Autism, learning impairments, and mood disorders. I see patients ages 10 and up and can usually provide written evaluations within one day of the assessment.
(502) 335-4571 View (502) 335-4571
Photo of Heather Chafin, Counselor in Louisville, KY
Heather Chafin
Counselor, LPCC
Verified Verified
1 Endorsed
Louisville, KY 40222
I enjoy working with couples, teens and adults. Using a gentle, yet direct approach, I work collaboratively with you to empower you to make positive changes in your life. Whether you are struggling with relationships, communication, depression or anxiety, I can help you identify barriers and provide you with the tools needed to successfully progress towards living a more rewarding life. Through a collaborative therapeutic process, I provide support as you work to develop coping and communication skills that lead to establishing healthier relationships and improvement of symptoms of anxiety and depression.
I enjoy working with couples, teens and adults. Using a gentle, yet direct approach, I work collaboratively with you to empower you to make positive changes in your life. Whether you are struggling with relationships, communication, depression or anxiety, I can help you identify barriers and provide you with the tools needed to successfully progress towards living a more rewarding life. Through a collaborative therapeutic process, I provide support as you work to develop coping and communication skills that lead to establishing healthier relationships and improvement of symptoms of anxiety and depression.
(502) 289-0927 View (502) 289-0927
Photo of Tana J. Wright LCSW, Clinical Social Work/Therapist in Louisville, KY
Tana J. Wright LCSW
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Louisville, KY 40220  (Online Only)
Immediate Openings....Healing from trauma, abuse, grief and loss along with a mood disorder can be overwhelming. Especially if you deal with it alone. Are loved ones telling you to "fix it" but you're not sure how? Everyone possesses a resiliency that is yet to be discovered that can help you overcome these obstacles. We will uncover your positive qualities that have helped you to survive and will help you to live the life you were meant to. The teletherapy environment is supportive and non-judgmental to allow growth at your own pace. EMDR is an option for treatment. I am teletherapy only and have immediate openings!
Immediate Openings....Healing from trauma, abuse, grief and loss along with a mood disorder can be overwhelming. Especially if you deal with it alone. Are loved ones telling you to "fix it" but you're not sure how? Everyone possesses a resiliency that is yet to be discovered that can help you overcome these obstacles. We will uncover your positive qualities that have helped you to survive and will help you to live the life you were meant to. The teletherapy environment is supportive and non-judgmental to allow growth at your own pace. EMDR is an option for treatment. I am teletherapy only and have immediate openings!
(502) 276-8928 View (502) 276-8928
Photo of Kristin Leigh Tribbett, Clinical Social Work/Therapist in Louisville, KY
Kristin Leigh Tribbett
Clinical Social Work/Therapist, LCSW, BCN
Verified Verified
Louisville, KY 40220
All experiences are unique and allowing me to help with your personal journey is an honor. I am trained and experienced in working with trauma, anxiety, depression, ADHD, interpersonal relationship difficulties, child and adolescent emotional and behavioral difficulties and school related problems. I primarily utilize Neurofeedback, EMDR, Cognitive Behavioral Therapy, Trauma focused cognitive behavioral therapy, and other expressive approaches.
All experiences are unique and allowing me to help with your personal journey is an honor. I am trained and experienced in working with trauma, anxiety, depression, ADHD, interpersonal relationship difficulties, child and adolescent emotional and behavioral difficulties and school related problems. I primarily utilize Neurofeedback, EMDR, Cognitive Behavioral Therapy, Trauma focused cognitive behavioral therapy, and other expressive approaches.
(502) 653-0214 View (502) 653-0214
Photo of Melissa M Johnson, Clinical Social Work/Therapist in Louisville, KY
Melissa M Johnson
Clinical Social Work/Therapist, LCSW
Verified Verified
Louisville, KY 40222
I’m Melissa Johnson, a Licensed Clinical Social Worker and Certified Internal Family Systems practitioner. I offer consultation services to therapists and individual therapy services to adults who want to address life transitions, grief and loss, anxiety and depression, recovery maintenance, and trauma. Additionally, I offer clinical supervision to social workers, facilitate a peer consultation group, and teach a course on Conflict Management to individuals and organizations.
I’m Melissa Johnson, a Licensed Clinical Social Worker and Certified Internal Family Systems practitioner. I offer consultation services to therapists and individual therapy services to adults who want to address life transitions, grief and loss, anxiety and depression, recovery maintenance, and trauma. Additionally, I offer clinical supervision to social workers, facilitate a peer consultation group, and teach a course on Conflict Management to individuals and organizations.
(502) 804-2338 View (502) 804-2338
Photo of Lisa Heller Bass, Marriage & Family Therapist in Louisville, KY
Lisa Heller Bass
Marriage & Family Therapist, LMFT
Verified Verified
Louisville, KY 40222
"The opportunity to help you broaden your ideas of who you are and what you can be is undeniably my greatest reward. Twenty eight years of practice has taught me a great deal about people and how to help them. Feelings of unworthiness, hopelessness, shame or incompetence literally can begin to steal away your ability to recognize yourself and see your own strength, resilience, courage and competence. I know that you can experience your life as successful. It is my absolute belief that you can. Where I come in is to help you regain your own healthy, change-producing abilities.
"The opportunity to help you broaden your ideas of who you are and what you can be is undeniably my greatest reward. Twenty eight years of practice has taught me a great deal about people and how to help them. Feelings of unworthiness, hopelessness, shame or incompetence literally can begin to steal away your ability to recognize yourself and see your own strength, resilience, courage and competence. I know that you can experience your life as successful. It is my absolute belief that you can. Where I come in is to help you regain your own healthy, change-producing abilities.
(502) 233-2612 View (502) 233-2612
Photo of Andrew M Davidson, Clinical Social Work/Therapist in Louisville, KY
Andrew M Davidson
Clinical Social Work/Therapist, LCSW, LCADC
Verified Verified
Louisville, KY 40222
I work with individuals, families, couples, and adolescents facing tough challenges, transitions, and growth opportunities. I have over 16 years in practice with experience treating general mental health issues, substance abuse, co-dependency, trauma and grief. I work from a solution-focused, person-centered approach and address not only the individual in therapy, but their family unit or family of choice. I believe that individuals have the strength to create meaningful change in their lives, and as a helping professional, I offer support, facilitate and witness that change in a positive, friendly and collaborative way.
I work with individuals, families, couples, and adolescents facing tough challenges, transitions, and growth opportunities. I have over 16 years in practice with experience treating general mental health issues, substance abuse, co-dependency, trauma and grief. I work from a solution-focused, person-centered approach and address not only the individual in therapy, but their family unit or family of choice. I believe that individuals have the strength to create meaningful change in their lives, and as a helping professional, I offer support, facilitate and witness that change in a positive, friendly and collaborative way.
(502) 443-9220 View (502) 443-9220
Photo of Dr. LaKeshia Blanton, Clinical Social Work/Therapist in Louisville, KY
Dr. LaKeshia Blanton
Clinical Social Work/Therapist, DSW, LCSW
Verified Verified
1 Endorsed
Louisville, KY 40218
Hey there! I am a Licensed Clinical Social Work in the state of Kentucky and Indiana. I have a strong passion for working with individuals presenting with depression, anxiety, and history of trauma. Life gets hard, I know. If you are here looking for a therapist, life may be getting a little hard and you need extra help right now. If that's you; let's connect I am eager to walk with you through this healing journey. You don't have to do it alone!
Hey there! I am a Licensed Clinical Social Work in the state of Kentucky and Indiana. I have a strong passion for working with individuals presenting with depression, anxiety, and history of trauma. Life gets hard, I know. If you are here looking for a therapist, life may be getting a little hard and you need extra help right now. If that's you; let's connect I am eager to walk with you through this healing journey. You don't have to do it alone!
(502) 747-9692 View (502) 747-9692
Photo of Discovery 502 Counseling , Counselor in Louisville, KY
Discovery 502 Counseling
Counselor, MA, LPCA
Verified Verified
2 Endorsed
Louisville, KY 40203  (Online Only)
Do you seek guidance with anxiety, fears, depression, relationships, parenting, child, family counseling, or couples/marriage therapy? It takes courage to ask for help, admitting you can’t do everything alone is the first step toward achieving wellness, in a fast-paced, demanding world. As an experienced licensed professional counselor of 15+ years, I am honored to assist you in exploring your core issues and moving toward a healthy, fulfilling life. You are not alone; I can help you by supporting you! I have a diverse background in many different areas of counseling. Please contact me at discovery502counseling.com (Private Pay)
Do you seek guidance with anxiety, fears, depression, relationships, parenting, child, family counseling, or couples/marriage therapy? It takes courage to ask for help, admitting you can’t do everything alone is the first step toward achieving wellness, in a fast-paced, demanding world. As an experienced licensed professional counselor of 15+ years, I am honored to assist you in exploring your core issues and moving toward a healthy, fulfilling life. You are not alone; I can help you by supporting you! I have a diverse background in many different areas of counseling. Please contact me at discovery502counseling.com (Private Pay)
(502) 305-5304 View (502) 305-5304
Photo of Leigha Miller, Licensed Professional Counselor Associate in Louisville, KY
Leigha Miller
Licensed Professional Counselor Associate, MEd, LPCA
Verified Verified
1 Endorsed
Louisville, KY 40222
Whether you are facing anxiety, depression, life and relational stressors, or healing from trauma, finding a non judgemental space to process can help you feel heard, understood and encouraged as you continue on your Life’s Journey. Working from a collaborative approach, I respect your values, and life’s experience, and can partner with you to identify your personal goals and assist you in making meaningful change to live in alignment with those values.
Whether you are facing anxiety, depression, life and relational stressors, or healing from trauma, finding a non judgemental space to process can help you feel heard, understood and encouraged as you continue on your Life’s Journey. Working from a collaborative approach, I respect your values, and life’s experience, and can partner with you to identify your personal goals and assist you in making meaningful change to live in alignment with those values.
(502) 335-4125 View (502) 335-4125
Photo of Kate Fischer, Clinical Social Work/Therapist in Louisville, KY
Kate Fischer
Clinical Social Work/Therapist, LCSW
Verified Verified
Louisville, KY 40213
I am here to help guide you on your journey- wherever you may be going. Life is painful, and support is what keeps us going. If this is your first time looking for a therapist or just haven't found the right fit in a therapist yet, I aim to bring new tools to the table that help move you in the direction you desire. I facilitate a safe, honest environment for you to share your truths that facilitates growth and self-reflection. I am here to help you learn about yourself- the good, better, and best. I enjoy working with individuals 18+.
I am here to help guide you on your journey- wherever you may be going. Life is painful, and support is what keeps us going. If this is your first time looking for a therapist or just haven't found the right fit in a therapist yet, I aim to bring new tools to the table that help move you in the direction you desire. I facilitate a safe, honest environment for you to share your truths that facilitates growth and self-reflection. I am here to help you learn about yourself- the good, better, and best. I enjoy working with individuals 18+.
(502) 906-6871 View (502) 906-6871

How does your Therapist compare?

Number of Therapists in Louisville, KY

1,000+

Average cost per session

$120

Therapists in Louisville, KY who prioritize treating:

91% Anxiety
86% Depression
71% Self Esteem
70% Trauma and PTSD
68% Coping Skills
59% Relationship Issues
58% Grief

Average years in practice

10 Years

Top 3 insurances accepted

72% Aetna
71% Humana
69% UnitedHealthcare UHC | UBH

How Therapists in Louisville, KY see their clients

69% In Person and Online
31% Online Only

Gender breakdown

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

How can I find a therapist in Louisville?

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.