Therapists in Hilo, HI

Photo of , Marriage & Family Therapist in Hilo, HI
Marriage & Family Therapist, MA, LMFT, QMHP
Verified Verified
5 Endorsed
Hilo, HI 96720
Therapy focuses on individual empowerment, being inspired to face life's challenges, and to be able to embrace change. My name is Jocelyn G. Cordero, and I'm a Licensed Marriage & Family Therapist and Psychotherapist with experience in working with a diversity of people. I provide a multicultural perspective to therapy through a warm approach offering guidance, support, insight, and hope for improving overall life situation.
Therapy focuses on individual empowerment, being inspired to face life's challenges, and to be able to embrace change. My name is Jocelyn G. Cordero, and I'm a Licensed Marriage & Family Therapist and Psychotherapist with experience in working with a diversity of people. I provide a multicultural perspective to therapy through a warm approach offering guidance, support, insight, and hope for improving overall life situation.
(808) 201-2269 View (808) 201-2269
Photo of Cornelia Waiau, Marriage & Family Therapist in Hilo, HI
Cornelia Waiau
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Hilo, HI 96720
I assist couples as well as individuals to improve their communication and relationship skills. Honesty and respect for ourselves and others is the key to successful outcome.I implement the Gottman method in relationship therapy and believe that this approach can successfully improve any relationship. It is very applicable in situations where mediation and/or co parenting is indicated. I have experience in cross cultural concerns, abuse and domestic violence situations, depression, anxiety and trauma related situations.
I assist couples as well as individuals to improve their communication and relationship skills. Honesty and respect for ourselves and others is the key to successful outcome.I implement the Gottman method in relationship therapy and believe that this approach can successfully improve any relationship. It is very applicable in situations where mediation and/or co parenting is indicated. I have experience in cross cultural concerns, abuse and domestic violence situations, depression, anxiety and trauma related situations.
(808) 419-3846 View (808) 419-3846
Photo of Pamela K. Luis, MFT, Marriage & Family Therapist in Hilo, HI
Pamela K. Luis, MFT
Marriage & Family Therapist, MA, LMFT
Verified Verified
Hilo, HI 96720
I am currently accepting Graduate Students for supervision. Are you struggling with past or current military, childhood or other types of trauma? Are you dealing with overwhelming anxiety or depression? Are you in conflict with family members? These are my specialties and I would be honored to guide you through the healing process. I focus on unique individual strengths and positive attributes. I am here to guide you on that journey of rediscovery in yourself and with your loved ones.
I am currently accepting Graduate Students for supervision. Are you struggling with past or current military, childhood or other types of trauma? Are you dealing with overwhelming anxiety or depression? Are you in conflict with family members? These are my specialties and I would be honored to guide you through the healing process. I focus on unique individual strengths and positive attributes. I am here to guide you on that journey of rediscovery in yourself and with your loved ones.
(808) 518-3906 View (808) 518-3906
Photo of Amber Fitzgerald, Pre-Licensed Professional in Hilo, HI
Amber Fitzgerald
Pre-Licensed Professional, MA
Verified Verified
1 Endorsed
Hilo, HI 96720  (Online Only)
Most people experience times in life when they don’t know how to cope or don’t know what to do about something they are struggling with. Some people struggle for years, either alone or in their relationships, before they are ready to talk with someone about things they want to change in their life. Some feel content in life except in one area, and they could use an unbiased third party to help them solve that last piece of their puzzle. Whatever your reason is, seeking help is not easy, and it is a brave move that speaks volumes of your readiness to better your life.
Most people experience times in life when they don’t know how to cope or don’t know what to do about something they are struggling with. Some people struggle for years, either alone or in their relationships, before they are ready to talk with someone about things they want to change in their life. Some feel content in life except in one area, and they could use an unbiased third party to help them solve that last piece of their puzzle. Whatever your reason is, seeking help is not easy, and it is a brave move that speaks volumes of your readiness to better your life.
(808) 374-5059 View (808) 374-5059
Photo of Nicole Pfeiffer, Pre-Licensed Professional in Hilo, HI
Nicole Pfeiffer
Pre-Licensed Professional, LSW
Verified Verified
Hilo, HI 96720  (Online Only)
I am here to support you in becoming the best version of yourself. I utilize a combination of Cognitive Behavioral Therapy, Mindfulness, and Psychoanalysis to help clients let go of what is not serving them, clarify what they want out of life, and be present and happy in their own skin. I provide a judgement-free environment to focus on strengths and taking steps in a positive direction.
I am here to support you in becoming the best version of yourself. I utilize a combination of Cognitive Behavioral Therapy, Mindfulness, and Psychoanalysis to help clients let go of what is not serving them, clarify what they want out of life, and be present and happy in their own skin. I provide a judgement-free environment to focus on strengths and taking steps in a positive direction.
(808) 646-2419 View (808) 646-2419
Photo of Melissa Bartholomew, Counselor in Hilo, HI
Melissa Bartholomew
Counselor, MA, LMHC
Verified Verified
2 Endorsed
Hilo, HI 96720  (Online Only)
I work with individuals struggling with anxiety, depression, interpersonal conflict, stress, burnout, communication, and parenting. When we meet, we will discuss together what goals we want to work towards in counseling. I like to build upon individual strengths as we tackle your life challenges. I often use Acceptance and Commitment Therapy (ACT) as they hold the belief that all forms of human suffering is a normal part of life. I also take a holistic view in your overall health.
I work with individuals struggling with anxiety, depression, interpersonal conflict, stress, burnout, communication, and parenting. When we meet, we will discuss together what goals we want to work towards in counseling. I like to build upon individual strengths as we tackle your life challenges. I often use Acceptance and Commitment Therapy (ACT) as they hold the belief that all forms of human suffering is a normal part of life. I also take a holistic view in your overall health.
(808) 731-2964 View (808) 731-2964
Photo of Paul Richard Cassiday, Clinical Social Work/Therapist in Hilo, HI
Paul Richard Cassiday
Clinical Social Work/Therapist, LCSW
Verified Verified
Hilo, HI 96720
Hello, I'm Paumalū Cassiday, a Licensed Clinical Social Worker specializing in mindfulness-based interventions grounded in Hawaiian culture. My therapeutic approach aims to cultivate self-awareness and resilience while addressing challenges such as depression, anxiety, substance use, and anger management. Together, we'll embark on a journey of healing and self-discovery rooted in both evidence-based practice and the healing traditions of Hawaii. My communication style is centered around active listening and reflecting upon what my clients share with me, aiming to gain new or deeper understanding.
Hello, I'm Paumalū Cassiday, a Licensed Clinical Social Worker specializing in mindfulness-based interventions grounded in Hawaiian culture. My therapeutic approach aims to cultivate self-awareness and resilience while addressing challenges such as depression, anxiety, substance use, and anger management. Together, we'll embark on a journey of healing and self-discovery rooted in both evidence-based practice and the healing traditions of Hawaii. My communication style is centered around active listening and reflecting upon what my clients share with me, aiming to gain new or deeper understanding.
(808) 400-6958 View (808) 400-6958
Photo of Andrea Nila Negron, Clinical Social Work/Therapist in Hilo, HI
Andrea Nila Negron
Clinical Social Work/Therapist, LSW
Verified Verified
Hilo, HI 96720
Andrea Nila Negron, MSW, LSW, received her Master’s degree from New Mexico State University. With a background in trauma-informed yoga and bodywork, she brings a psycho-spiritual approach to healing and wellness. She specializes in collaborating with individuals with attachment and developmental trauma using the NeuroAffective Relational Model (NARM), which integrates a cognitive and somatic approach to address the root causes of current life challenges. Nila also has experience supporting individuals in 12-step recovery work.
Andrea Nila Negron, MSW, LSW, received her Master’s degree from New Mexico State University. With a background in trauma-informed yoga and bodywork, she brings a psycho-spiritual approach to healing and wellness. She specializes in collaborating with individuals with attachment and developmental trauma using the NeuroAffective Relational Model (NARM), which integrates a cognitive and somatic approach to address the root causes of current life challenges. Nila also has experience supporting individuals in 12-step recovery work.
(808) 666-2779 View (808) 666-2779
Photo of Christin DeCoito, Pre-Licensed Professional in Hilo, HI
Christin DeCoito
Pre-Licensed Professional, MA
Verified Verified
Hilo, HI 96720  (Online Only)
Christin DeCoito, was born and raised in Hilo where she grew passionate about helping others in her community. She graduated from Kamehameha Schools Hawaii, she later received her Master's Degree in Counseling Psychology, with a specialization in Clinical Mental Health Counseling from UH Hilo. She ventured a little ways out of Hilo, where she currently lives on the Hamakua coast with her loving family and growing two little boys. Christins experience stems from working directly with students as a school based behavioral health specialist since 2017.
Christin DeCoito, was born and raised in Hilo where she grew passionate about helping others in her community. She graduated from Kamehameha Schools Hawaii, she later received her Master's Degree in Counseling Psychology, with a specialization in Clinical Mental Health Counseling from UH Hilo. She ventured a little ways out of Hilo, where she currently lives on the Hamakua coast with her loving family and growing two little boys. Christins experience stems from working directly with students as a school based behavioral health specialist since 2017.
(808) 353-5265 View (808) 353-5265
Photo of Calm Water Counseling LLC. , Counselor in Hilo, HI
Calm Water Counseling LLC. [David Hashimoto LMHC]
Counselor, MA, LMHC
Verified Verified
Hilo, HI 96720
I specialize in treating Anxiety, utilizing evidence-based modalities which are backed by scientific evidence, teaching people to achieve calm as soon as the first session. I can also help you to manage Depression, life transitions, and more. Lastly, I am a hilo native, and iv'e been in practice here for 11 years.
I specialize in treating Anxiety, utilizing evidence-based modalities which are backed by scientific evidence, teaching people to achieve calm as soon as the first session. I can also help you to manage Depression, life transitions, and more. Lastly, I am a hilo native, and iv'e been in practice here for 11 years.
(808) 731-9991 View (808) 731-9991
Photo of Emily Powers, Pre-Licensed Professional in Hilo, HI
Emily Powers
Pre-Licensed Professional, BA
Verified Verified
Hilo, HI 96720
Emily Powers is a pre-licensed counseling professional who is passionate about helping people overcome their challenges & achieve their goals. She holds a BA from St. Edward’s University in Austin, TX and is currently finishing her Master's in Clinical Mental Health Counseling at UH Hilo. Emily started her career helping adults cope with various challenges at a residential mental health facility. She has served individuals navigating the impacts of Depression, Anxiety, Post Traumatic Stress Disorder, Obsessive Compulsive Disorder, Borderline Personality Disorder, Autism Spectrum Disorder and other forms of mental health difficulties
Emily Powers is a pre-licensed counseling professional who is passionate about helping people overcome their challenges & achieve their goals. She holds a BA from St. Edward’s University in Austin, TX and is currently finishing her Master's in Clinical Mental Health Counseling at UH Hilo. Emily started her career helping adults cope with various challenges at a residential mental health facility. She has served individuals navigating the impacts of Depression, Anxiety, Post Traumatic Stress Disorder, Obsessive Compulsive Disorder, Borderline Personality Disorder, Autism Spectrum Disorder and other forms of mental health difficulties
(808) 746-7514 View (808) 746-7514
Photo of Mariana Sampaio, Counselor in Hilo, HI
Mariana Sampaio
Counselor, LMHC, MSW
Verified Verified
2 Endorsed
Hilo, HI 96720  (Online Only)
Our goal is to walk the path of personal growth with you. We currently focused on supporting teens and adults to explore their lives' experiences and to become the version of themselves they most desire. Since first starting to work in direct service it has come clear to me that every human being is unique and worthy. Hence, I draw from different Evidence Based Treatment modalities in order to best fit the needs of each individual client. These include Cognitive Behavioral Therapy (CBT) and Trauma-Focused CBT, Radically Open Dialectical Behavioral Therapy (RO-DBT), Dialectical Behavioral Therapy (DBT), among other modalities.
Our goal is to walk the path of personal growth with you. We currently focused on supporting teens and adults to explore their lives' experiences and to become the version of themselves they most desire. Since first starting to work in direct service it has come clear to me that every human being is unique and worthy. Hence, I draw from different Evidence Based Treatment modalities in order to best fit the needs of each individual client. These include Cognitive Behavioral Therapy (CBT) and Trauma-Focused CBT, Radically Open Dialectical Behavioral Therapy (RO-DBT), Dialectical Behavioral Therapy (DBT), among other modalities.
(808) 556-5541 View (808) 556-5541
Photo of Kai Hansen, Marriage & Family Therapist in Hilo, HI
Kai Hansen
Marriage & Family Therapist, LMFT
Verified Verified
Hilo, HI 96720
My approach focuses on addressing immediate symptom relief and current life problems with an emphasis on identifying underlying emotional causes that may be contributing to these difficulties. My practice presumes that understanding psychological conflicts underlying unpleasant negative behaviors and/or emotions will help people gain important understanding into their current problems and, consequently, lead them to make considerable changes in their lives.
My approach focuses on addressing immediate symptom relief and current life problems with an emphasis on identifying underlying emotional causes that may be contributing to these difficulties. My practice presumes that understanding psychological conflicts underlying unpleasant negative behaviors and/or emotions will help people gain important understanding into their current problems and, consequently, lead them to make considerable changes in their lives.
(808) 731-1368 View (808) 731-1368
Photo of Bertram Kalani Spain, Marriage & Family Therapist in Hilo, HI
Bertram Kalani Spain
Marriage & Family Therapist, PhD, LMFT
Verified Verified
Hilo, HI 96720
B. Kalani Spain, PhD, LMFT, helping individuals, couples and families in the State of Hawaii with an understanding of cross-cultural issues. Specializing in trauma informed care, couples and family therapy, anger management and substance abuse issues. Allow me to assist you in overcoming the obstacles of unresolved conflicts, grudges, blame and miscommunication. Reclaim the harmony you deserve and can achieve
B. Kalani Spain, PhD, LMFT, helping individuals, couples and families in the State of Hawaii with an understanding of cross-cultural issues. Specializing in trauma informed care, couples and family therapy, anger management and substance abuse issues. Allow me to assist you in overcoming the obstacles of unresolved conflicts, grudges, blame and miscommunication. Reclaim the harmony you deserve and can achieve
(808) 495-0127 View (808) 495-0127
Photo of Melissa St. Claire, Pre-Licensed Professional in Hilo, HI
Melissa St. Claire
Pre-Licensed Professional, MA, CHT
Verified Verified
Hilo, HI 96720
Stressful situations can happen suddenly, or build over time. Whether it is a relationship issue, traumatic experience, life transition, or career challenge, I can help you move from surviving to thriving. Using comprehensive methodologies, I offer a highly personalized approach, tailored to each client. I work with individuals to help them build on their strengths and attain the healing, growth and change they are looking for.
Stressful situations can happen suddenly, or build over time. Whether it is a relationship issue, traumatic experience, life transition, or career challenge, I can help you move from surviving to thriving. Using comprehensive methodologies, I offer a highly personalized approach, tailored to each client. I work with individuals to help them build on their strengths and attain the healing, growth and change they are looking for.
(808) 320-1239 View (808) 320-1239
Photo of Lisa Chilson-McCraw, Clinical Social Work/Therapist in Hilo, HI
Lisa Chilson-McCraw
Clinical Social Work/Therapist, MSW, LCSW, CSAC
Verified Verified
Hilo, HI 96720
Lisa Chilson-McCraw, MSW, LCSW, CSAC is very passionate about serving others and her community. Following a calling, she has committed her life to supporting and helping others through their struggles in life. She describes her work as a blessing, having had the opportunity to serve a multicultural and diverse groups of individuals in diverse settings over the last 14 years. She has worked with individuals who have experienced trauma, domestic violence/abuse (survivors and offenders), victims of human trafficking, substance use issues, grief and loss, significant life changes, and the behaviors/emotions that are often associated.
Lisa Chilson-McCraw, MSW, LCSW, CSAC is very passionate about serving others and her community. Following a calling, she has committed her life to supporting and helping others through their struggles in life. She describes her work as a blessing, having had the opportunity to serve a multicultural and diverse groups of individuals in diverse settings over the last 14 years. She has worked with individuals who have experienced trauma, domestic violence/abuse (survivors and offenders), victims of human trafficking, substance use issues, grief and loss, significant life changes, and the behaviors/emotions that are often associated.
(808) 698-6439 View (808) 698-6439
Photo of Sarah Blechman, Clinical Social Work/Therapist in Hilo, HI
Sarah Blechman
Clinical Social Work/Therapist, MSSW, LCSW
Verified Verified
2 Endorsed
Hilo, HI 96720  (Online Only)
Feeling like you wish you could take a break from the constant inundation of thoughts of fear, shame, or even simply the constant "to do" list in your mind? I can help with that. I work well with folks who have been apprehensive or cynical about beginning therapy in the past. I will challenge you with authenticity and compassion. I have over a decade of experience in working with folks who struggle with anxiety, depression, existential angst, relationship challenges and more. I have a person-centered, trauma-informed approach to helping you gain clarity through life's challenges.
Feeling like you wish you could take a break from the constant inundation of thoughts of fear, shame, or even simply the constant "to do" list in your mind? I can help with that. I work well with folks who have been apprehensive or cynical about beginning therapy in the past. I will challenge you with authenticity and compassion. I have over a decade of experience in working with folks who struggle with anxiety, depression, existential angst, relationship challenges and more. I have a person-centered, trauma-informed approach to helping you gain clarity through life's challenges.
(808) 556-5606 View (808) 556-5606
Photo of Mary Elizabeth Alvior, Clinical Social Work/Therapist in Hilo, HI
Mary Elizabeth Alvior
Clinical Social Work/Therapist, LCSW
Verified Verified
Hilo, HI 96720
I am Mary Elizabeth Alvior. I am a Licensed Clinical Social Worker and hold a Diplomate in Clinical Social Work. I am passionate about optimizing my clients' quality of life. I have over 30 years of experience working with adults and couples. I typically work with adults and have expertise in ADHD, anxiety, depression, self-esteem and trauma. I believe in providing each client with evidence-based care, matched to their specific goals. I use several forms of Cognitive Behavioral therapy as well as Solution Focused treatment and we will adjust our approach as needed to get the best outcomes.
I am Mary Elizabeth Alvior. I am a Licensed Clinical Social Worker and hold a Diplomate in Clinical Social Work. I am passionate about optimizing my clients' quality of life. I have over 30 years of experience working with adults and couples. I typically work with adults and have expertise in ADHD, anxiety, depression, self-esteem and trauma. I believe in providing each client with evidence-based care, matched to their specific goals. I use several forms of Cognitive Behavioral therapy as well as Solution Focused treatment and we will adjust our approach as needed to get the best outcomes.
(808) 320-1207 View (808) 320-1207
Photo of Michelle Jacoby, Clinical Social Work/Therapist in Hilo, HI
Michelle Jacoby
Clinical Social Work/Therapist, LCSW, MSW
Verified Verified
Hilo, HI 96720
Not accepting new clients
Talking about sex, relationships, and intimacy can be incredibly difficult. Throughout our lives many of us have been confronted with fear and shame-based messages, inaccurate and harmful information, and often problematic ideas regarding sexuality. These experiences can leave us feeling confused or ashamed, ultimately impacting our ability to tap into our full and authentic selves. Exploring these issues in a therapeutic setting with a trained, sex-positive therapist can be life-changing. A sex-positive framework means that I affirm all consensual sexual activity (or lack of sexual activity) as positive, healthy, and pleasurable.
Talking about sex, relationships, and intimacy can be incredibly difficult. Throughout our lives many of us have been confronted with fear and shame-based messages, inaccurate and harmful information, and often problematic ideas regarding sexuality. These experiences can leave us feeling confused or ashamed, ultimately impacting our ability to tap into our full and authentic selves. Exploring these issues in a therapeutic setting with a trained, sex-positive therapist can be life-changing. A sex-positive framework means that I affirm all consensual sexual activity (or lack of sexual activity) as positive, healthy, and pleasurable.
(808) 746-3762 View (808) 746-3762
Photo of Kehau Hufanga, Marriage & Family Therapist in Hilo, HI
Kehau Hufanga
Marriage & Family Therapist, CSAC, LMFT
Verified Verified
Hilo, HI 96720
Seeking therapy can be an uncomfortable experience that takes a lot of courage. Making an initial appointment is the first step of the process towards healing and becoming the best version of ourselves. Therapy allows self-reflection, support, and insight. I view my clients holistically and work collaboratively with them to have a better understanding of how they live their lives and how to achieve better functioning and life satisfaction.
Seeking therapy can be an uncomfortable experience that takes a lot of courage. Making an initial appointment is the first step of the process towards healing and becoming the best version of ourselves. Therapy allows self-reflection, support, and insight. I view my clients holistically and work collaboratively with them to have a better understanding of how they live their lives and how to achieve better functioning and life satisfaction.
(808) 698-5776 View (808) 698-5776

How does your Therapist compare?

Number of Therapists in Hilo, HI

100+

Average cost per session

$135

Therapists in Hilo, HI who prioritize treating:

91% Anxiety
81% Depression
80% Self Esteem
73% Life Transitions
71% Relationship Issues
71% Trauma and PTSD
71% Coping Skills

Average years in practice

10 Years

Top 3 insurances accepted

84% Hawaii Medical Services Association
49% BlueCross and BlueShield
45% University Health Alliance

How Therapists in Hilo, HI see their clients

63% In Person and Online
37% Online Only

Gender breakdown

76% Female
22% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Hilo?

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.