Therapists in Creve Coeur, MO

Photo of Lena Pearlman - Pearlman & Associates, MSW, LCSW, PhD, Clinical Social Work/Therapist
Pearlman & Associates
Clinical Social Work/Therapist, MSW, LCSW, PhD
Verified Verified
1 Endorsed
Creve Coeur, MO 63141
Dr. Lena Pearlman is the clinical director and lead therapist of Pearlman & Associates, a team of social workers in private practice in St. Louis MO. Lena has been a social worker for 25 years and believes that we all have the capacity to make positive changes that improve the quality of our lives. Lena uses a client centered interactive style along with a warm caring manner. She takes time to understand your history, identify your strengths, acknowledge your feelings and clarify your goals with a plan to help you make progress towards them.
Dr. Lena Pearlman is the clinical director and lead therapist of Pearlman & Associates, a team of social workers in private practice in St. Louis MO. Lena has been a social worker for 25 years and believes that we all have the capacity to make positive changes that improve the quality of our lives. Lena uses a client centered interactive style along with a warm caring manner. She takes time to understand your history, identify your strengths, acknowledge your feelings and clarify your goals with a plan to help you make progress towards them.
(314) 309-2488 View (314) 309-2488
Photo of James Linsin, PsyD, Psychologist
James Linsin
Psychologist, PsyD
Verified Verified
1 Endorsed
Creve Coeur, MO 63141
Waitlist for new clients
Seeking help isn't easy, and it takes a certain amount of courage. Just like being human. One of the things I've learned in 25+ years as a practicing psychologist is that we all have reserves of courage within us-even when we're feeling our worst. Having a compassionate and accepting person to talk to can help us find that courage and acceptance within ourselves. If you've been feeling overwhelmed, upset, or confused, or just think you might benefit from touching base with someone supportive and understanding, I would be happy to meet with you.
Seeking help isn't easy, and it takes a certain amount of courage. Just like being human. One of the things I've learned in 25+ years as a practicing psychologist is that we all have reserves of courage within us-even when we're feeling our worst. Having a compassionate and accepting person to talk to can help us find that courage and acceptance within ourselves. If you've been feeling overwhelmed, upset, or confused, or just think you might benefit from touching base with someone supportive and understanding, I would be happy to meet with you.
(636) 735-7021 View (636) 735-7021
Photo of Anita D. Cohn, MSW, LCSW, Clinical Social Work/Therapist
Anita D. Cohn
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
2 Endorsed
Creve Coeur, MO 63141
I provide a calm, safe and non-judgmental space. My expertise is helping individuals feel more balanced in their lives. Tired of feeling not good enough? Does anxiety keep you from sleeping, going places, fully participating in your life? Does your past keep you from enjoying your life today. Do you use food, alcohol/drugs, work, relationships or spending money as a way to avoid painful feelings? I have helped many people manage their feelings of anxiety in order to live more of the life they desire.
I provide a calm, safe and non-judgmental space. My expertise is helping individuals feel more balanced in their lives. Tired of feeling not good enough? Does anxiety keep you from sleeping, going places, fully participating in your life? Does your past keep you from enjoying your life today. Do you use food, alcohol/drugs, work, relationships or spending money as a way to avoid painful feelings? I have helped many people manage their feelings of anxiety in order to live more of the life they desire.
(314) 394-8636 View (314) 394-8636
Photo of Becca Williams, LCSW, Clinical Social Work/Therapist
Becca Williams
Clinical Social Work/Therapist, LCSW
Verified Verified
Creve Coeur, MO 63141
Are you feeling stuck in your day-to-day grind? Do you want to experience less stress and cultivate more calm in your life? My goal is to empower each client to overcome whatever obstacles they are facing and reach their full potential in an empathetic therapy environment. I embody a relatable and strengths-based approach in my sessions, and offer a nonjudgmental and safe space to process past experiences, current issues, or future stressors.
Are you feeling stuck in your day-to-day grind? Do you want to experience less stress and cultivate more calm in your life? My goal is to empower each client to overcome whatever obstacles they are facing and reach their full potential in an empathetic therapy environment. I embody a relatable and strengths-based approach in my sessions, and offer a nonjudgmental and safe space to process past experiences, current issues, or future stressors.
(314) 501-6634 View (314) 501-6634
Photo of Brian Sheble, NCSP, LCPC, CFMHE, CCMHC, NCC, Licensed Professional Counselor
Brian Sheble
Licensed Professional Counselor, NCSP, LCPC, CFMHE, CCMHC, NCC
Verified Verified
3 Endorsed
Creve Coeur, MO 63141
I specialize in assessment and counseling of Dyslexia, Learning Disabilities, Language Disorders, ADHD, Executive Functioning Disorders, Anxiety, Depression, Emotional Disorders in Children, Teens, and Adults. I perform evals for Special Education, Child Custody, Disability Claims Evals, Marriage/Couples, Substance Abuse/Use, and Forensic purposes. Moreover, I provide advocacy for my clients with schools and businesses. Internet Evaluations are available!!
I specialize in assessment and counseling of Dyslexia, Learning Disabilities, Language Disorders, ADHD, Executive Functioning Disorders, Anxiety, Depression, Emotional Disorders in Children, Teens, and Adults. I perform evals for Special Education, Child Custody, Disability Claims Evals, Marriage/Couples, Substance Abuse/Use, and Forensic purposes. Moreover, I provide advocacy for my clients with schools and businesses. Internet Evaluations are available!!
(314) 207-3139 View (314) 207-3139
Photo of Jamie Caldwell, LMSW, Clinical Social Work/Therapist
Jamie Caldwell
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Creve Coeur, MO 63141
Sometimes life can send us down a path that we never expected to be on. Often the unexpected path can leave us feeling lost, isolated, and hopeless. Whatever it is that started you down this path, know you do not have to walk alone. I utilize a collaborative approach to help clients move along this unexpected path and overcome challenges along the way. The true joy is seeing clients recognize that while this path isn't one they would have set out on their own, there are truly beautiful steps taken on their journey to healing.
Sometimes life can send us down a path that we never expected to be on. Often the unexpected path can leave us feeling lost, isolated, and hopeless. Whatever it is that started you down this path, know you do not have to walk alone. I utilize a collaborative approach to help clients move along this unexpected path and overcome challenges along the way. The true joy is seeing clients recognize that while this path isn't one they would have set out on their own, there are truly beautiful steps taken on their journey to healing.
(314) 789-8302 View (314) 789-8302
Photo of Whitney L Larkin, MA, LPC, Licensed Professional Counselor
Whitney L Larkin
Licensed Professional Counselor, MA, LPC
Verified Verified
1 Endorsed
Creve Coeur, MO 63141
Waitlist for new clients
I provide individualize care to clients who are struggling to manage symptoms of anxiety, trauma, depression, and life transitions. I enjoy work with pregnant and postpartum women who are feeling overwhelmed by anxiety, depression and adjusting to their new life as a parent. I focus much of my work on helping you to find clarity and stabilization, then move into personal growth and acceptance. I want to help you find the best version of yourself and truly enjoy life.
I provide individualize care to clients who are struggling to manage symptoms of anxiety, trauma, depression, and life transitions. I enjoy work with pregnant and postpartum women who are feeling overwhelmed by anxiety, depression and adjusting to their new life as a parent. I focus much of my work on helping you to find clarity and stabilization, then move into personal growth and acceptance. I want to help you find the best version of yourself and truly enjoy life.
(314) 582-1227 View (314) 582-1227
Photo of Phoebe Thompson, LPC, Counselor
Phoebe Thompson
Counselor, LPC
Verified Verified
1 Endorsed
Creve Coeur, MO 63141
I am a Licensed Professional Counselor. My work often uses a person-centered approach, focusing on my client’s presenting issues and exploring to find the core struggles that lead to what is really going on. I believe in meeting the client where they are and including humor whenever possible.
I am a Licensed Professional Counselor. My work often uses a person-centered approach, focusing on my client’s presenting issues and exploring to find the core struggles that lead to what is really going on. I believe in meeting the client where they are and including humor whenever possible.
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Photo of Sarah Merritt, MSW, LCSW, Clinical Social Work/Therapist
Sarah Merritt
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Creve Coeur, MO 63141
I believe everyone, especially children and adolescents, deserve a safe space to process and explore their feelings and life challenges that come their way. It is my goal to provide a safe space for children and their families to explore and process whatever experiences or challenges they might be facing, as well as assist in their growth as they work to better understand themselves, explore their emotions, and build coping strategies.
I believe everyone, especially children and adolescents, deserve a safe space to process and explore their feelings and life challenges that come their way. It is my goal to provide a safe space for children and their families to explore and process whatever experiences or challenges they might be facing, as well as assist in their growth as they work to better understand themselves, explore their emotions, and build coping strategies.
(314) 756-0530 View (314) 756-0530
Photo of Rebecca Ray, MA, LPC, Licensed Professional Counselor
Rebecca Ray
Licensed Professional Counselor, MA, LPC
Verified Verified
5 Endorsed
Creve Coeur, MO 63141  (Online Only)
Not accepting new clients
I work closely with individuals, couples and families on issues of stress, relationships and life transitions. My focus is providing a safe and calm, non-judgmental atmosphere that fosters relief, rebalance and resilience for my clients. So many factors go into our stress experience, and I often assist clients with identifying new avenues and solutions to help with next steps forward. Specific mental diagnoses include: anxiety, depression, overwhelm, bipolar disorder, mood disorder, adjustment disorder, stress relief and stress management.
I work closely with individuals, couples and families on issues of stress, relationships and life transitions. My focus is providing a safe and calm, non-judgmental atmosphere that fosters relief, rebalance and resilience for my clients. So many factors go into our stress experience, and I often assist clients with identifying new avenues and solutions to help with next steps forward. Specific mental diagnoses include: anxiety, depression, overwhelm, bipolar disorder, mood disorder, adjustment disorder, stress relief and stress management.
(314) 582-3185 View (314) 582-3185
Photo of Cari McKnight, LCSW, Clinical Social Work/Therapist
Cari McKnight
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Creve Coeur, MO 63141
I offer warmth and compassion to develop a strong therapeutic relationship with each client. I create a safe environment so that you are able to get down to your core emotions, then help you further explore those feelings. I believe that this is the key to any lasting change or improvement. Changing thoughts and behaviors is great, and definitely part of what needs to happen in therapy...but that is only temporary, first-order change. Real, LASTING change comes from addressing the underlying feelings and emotions behind those behaviors. This authentic growth is my goal for every client.
I offer warmth and compassion to develop a strong therapeutic relationship with each client. I create a safe environment so that you are able to get down to your core emotions, then help you further explore those feelings. I believe that this is the key to any lasting change or improvement. Changing thoughts and behaviors is great, and definitely part of what needs to happen in therapy...but that is only temporary, first-order change. Real, LASTING change comes from addressing the underlying feelings and emotions behind those behaviors. This authentic growth is my goal for every client.
(636) 333-1099 View (636) 333-1099
Photo of David Barton, MA, LPC, Licensed Professional Counselor
David Barton
Licensed Professional Counselor, MA, LPC
Verified Verified
3 Endorsed
Creve Coeur, MO 63141
I am committed to providing a safe, nurturing, and nonjudgmental environment where your well-being and personal growth are my priority. After empathically listening as you identify, explore, and gain understanding of the issues you are facing, we will work together to establish manageable goals that can help you better utilize your internal strengths and external resources while creating meaningful, positive changes in your life.
I am committed to providing a safe, nurturing, and nonjudgmental environment where your well-being and personal growth are my priority. After empathically listening as you identify, explore, and gain understanding of the issues you are facing, we will work together to establish manageable goals that can help you better utilize your internal strengths and external resources while creating meaningful, positive changes in your life.
(314) 328-0520 View (314) 328-0520
Photo of Kristi London, MA, PLPC, Pre-Licensed Professional
Kristi London
Pre-Licensed Professional, MA, PLPC
Verified Verified
Creve Coeur, MO 63141
I offer counseling to couples, families, adults, and teens dealing with a variety of concerns including anxiety, depression, addiction, marital conflict, relationship difficulties, and more. My therapeutic style is characterized by genuine warmth and connection and evidence-based clinical treatment. My clients are supported in accessing their innate abilities and strengths while learning practical and realistic coping skills they can use in their daily lives. These coping skills help support real and lasting change.
I offer counseling to couples, families, adults, and teens dealing with a variety of concerns including anxiety, depression, addiction, marital conflict, relationship difficulties, and more. My therapeutic style is characterized by genuine warmth and connection and evidence-based clinical treatment. My clients are supported in accessing their innate abilities and strengths while learning practical and realistic coping skills they can use in their daily lives. These coping skills help support real and lasting change.
(314) 970-3741 View (314) 970-3741
Photo of Mekeya Jama, MSW, LCSW, Clinical Social Work/Therapist
Mekeya Jama
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
5 Endorsed
Creve Coeur, MO 63141
Seeking mental health support is a brave and empowering step. True growth often comes through embracing our vulnerabilities. Conditions like depression, anxiety, and trauma can feel overwhelming, making it hard to imagine ever feeling okay again. You might feel like you've tried everything but still struggle with persistent anxiety and depression. Despite your desire to overcome these challenging times, you may feel stuck. Finding the right therapist can be daunting, especially if you're uncertain about the potential benefits of therapy. You deserve a therapist who meets you where you are and guides you through your healing journey
Seeking mental health support is a brave and empowering step. True growth often comes through embracing our vulnerabilities. Conditions like depression, anxiety, and trauma can feel overwhelming, making it hard to imagine ever feeling okay again. You might feel like you've tried everything but still struggle with persistent anxiety and depression. Despite your desire to overcome these challenging times, you may feel stuck. Finding the right therapist can be daunting, especially if you're uncertain about the potential benefits of therapy. You deserve a therapist who meets you where you are and guides you through your healing journey
(314) 551-9390 View (314) 551-9390
Photo of Karsee Taylor Parr, LPC, Counselor
Karsee Taylor Parr
Counselor, LPC
Verified Verified
Creve Coeur, MO 63141
Not accepting new clients
I am a Licensed Professional Counselor working with women from diverse backgrounds, same sex couples, those who identify as LGBQTIA+. I have been given the opportunity to work with different groups of people from many countries and belief systems. I have worked in both the secular and religious arenas and have provided spiritual integration care for people of many religious traditions and those with no religious beliefs as well. I have experience working with both children and adults struggling with anxiety, depression, trauma, grief, loss and divorce.
I am a Licensed Professional Counselor working with women from diverse backgrounds, same sex couples, those who identify as LGBQTIA+. I have been given the opportunity to work with different groups of people from many countries and belief systems. I have worked in both the secular and religious arenas and have provided spiritual integration care for people of many religious traditions and those with no religious beliefs as well. I have experience working with both children and adults struggling with anxiety, depression, trauma, grief, loss and divorce.
(314) 582-0102 View (314) 582-0102
Photo of Jane Smith, LPC, MEd, MBA, Licensed Professional Counselor
Jane Smith
Licensed Professional Counselor, LPC, MEd, MBA
Verified Verified
Creve Coeur, MO 63141
I specialize in working with individuals (especially parents), couples and families coping with midlife challenges and beyond. Often, what worked in a prior season of life is no longer effective for this current season. Fresh insights and new skill sets are needed, and we'll figure out what that means for you.
I specialize in working with individuals (especially parents), couples and families coping with midlife challenges and beyond. Often, what worked in a prior season of life is no longer effective for this current season. Fresh insights and new skill sets are needed, and we'll figure out what that means for you.
(314) 876-0236 View (314) 876-0236
Photo of Elizabeth Kowalik, MSW, LCSW, CCTP, CAIMHP, Clinical Social Work/Therapist
Elizabeth Kowalik
Clinical Social Work/Therapist, MSW, LCSW, CCTP, CAIMHP
Verified Verified
2 Endorsed
Creve Coeur, MO 63141
I'm not the therapist you see in movies. I know if I’m not real, I can’t expect you to be either; and when you feel safe to be real with me, we can work on how that carries over to the rest of your life. We will unravel the complexities that make you exactly who you are and arrange each piece in a way that you take pride in, at a pace you are comfortable with. Being confident and calm in your body is your birthright; the journey to finding both begins with getting curious. I believe, wholeheartedly, in your ability to heal.
I'm not the therapist you see in movies. I know if I’m not real, I can’t expect you to be either; and when you feel safe to be real with me, we can work on how that carries over to the rest of your life. We will unravel the complexities that make you exactly who you are and arrange each piece in a way that you take pride in, at a pace you are comfortable with. Being confident and calm in your body is your birthright; the journey to finding both begins with getting curious. I believe, wholeheartedly, in your ability to heal.
(314) 266-9037 View (314) 266-9037
Monarch & Greenleaf Counseling
Licensed Professional Counselor
Verified Verified
1 Endorsed
Creve Coeur, MO 63132
Struggling with changes in your day to day? Finding yourself overwhelmed with the stress of everyday life? In this world, it is normal for the "stuff" in life to become too much. Do you find yourself worrying more, maybe overreacting? Do you find yourself getting angry more often? Are you avoiding people, places and things that used to bring you happiness and joy? Experiencing family or marital issues? It is easy in the state we are living in to find yourself experiencing increased anxiety and even depressed. Our counseling is available to you to talk through and work on strategies with licensed counselors to help meet your goals.
Struggling with changes in your day to day? Finding yourself overwhelmed with the stress of everyday life? In this world, it is normal for the "stuff" in life to become too much. Do you find yourself worrying more, maybe overreacting? Do you find yourself getting angry more often? Are you avoiding people, places and things that used to bring you happiness and joy? Experiencing family or marital issues? It is easy in the state we are living in to find yourself experiencing increased anxiety and even depressed. Our counseling is available to you to talk through and work on strategies with licensed counselors to help meet your goals.
(636) 306-1693 View (636) 306-1693
Photo of Ken Mcmanus, MEd, LPC, Licensed Professional Counselor
Ken Mcmanus
Licensed Professional Counselor, MEd, LPC
Verified Verified
1 Endorsed
Creve Coeur, MO 63141
I have been a practicing counselor for over 40 years. Over these years, I have worked with individuals, couples and families struggling with significant life challenges and mental illness. I pride myself on being accessible, attuned to my clients' needs and trained in current best practices, including EMDR interventions. To serve as your counselor, for me, is a privilege not taken lightly. My practice style, as appropriate, involves collaboration with other professionals. Getting outcomes that matter is my highest priority. I am a provider for a number of insurance carriers and offer a sliding scale for clients w/o insurance.
I have been a practicing counselor for over 40 years. Over these years, I have worked with individuals, couples and families struggling with significant life challenges and mental illness. I pride myself on being accessible, attuned to my clients' needs and trained in current best practices, including EMDR interventions. To serve as your counselor, for me, is a privilege not taken lightly. My practice style, as appropriate, involves collaboration with other professionals. Getting outcomes that matter is my highest priority. I am a provider for a number of insurance carriers and offer a sliding scale for clients w/o insurance.
(314) 300-7982 View (314) 300-7982
Photo of Sarah Steward, MA, LPC, Licensed Professional Counselor
Sarah Steward
Licensed Professional Counselor, MA, LPC
Verified Verified
1 Endorsed
Creve Coeur, MO 63132
Welcome! My name is Sarah and I am the owner of Renew Clinical Counseling. I recognize that there are times in our lives when we realize that something's missing. We need a little guidance, a little assistance and a lot of compassion and understanding. When you have arrived at this point and are not sure what to do or who to turn to, that's where I come in. Whether you are experiencing; stress, loss, relationship issues, a life transition, anxiety, depression or trauma related issues, I am here to help. We all want and need peace in our lives. With wellness comes the peace and tranquility that is missing from your life right now.
Welcome! My name is Sarah and I am the owner of Renew Clinical Counseling. I recognize that there are times in our lives when we realize that something's missing. We need a little guidance, a little assistance and a lot of compassion and understanding. When you have arrived at this point and are not sure what to do or who to turn to, that's where I come in. Whether you are experiencing; stress, loss, relationship issues, a life transition, anxiety, depression or trauma related issues, I am here to help. We all want and need peace in our lives. With wellness comes the peace and tranquility that is missing from your life right now.
(636) 337-2861 View (636) 337-2861
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How does your Therapist compare?

Number of Therapists in Creve Coeur, MO

200+

Average cost per session

$130

Therapists in Creve Coeur, MO who prioritize treating:

95% Anxiety
90% Depression
80% Relationship Issues
80% Self Esteem
76% Coping Skills
75% Stress
69% Trauma and PTSD

Average years in practice

11 Years

Top 3 insurances accepted

75% UnitedHealthcare UHC | UBH
70% Aetna
67% Cigna and Evernorth

How Therapists in Creve Coeur, MO see their clients

85% In Person and Online
15% Online Only

Gender breakdown

84% Female
15% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Creve Coeur?

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.