Counselling in Greater London

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Photo of Juliane Thieme - Juliane Thieme Psychodynamic Psychotherapy, MA, BPC, Psychotherapist
Juliane Thieme Psychodynamic Psychotherapy
Psychotherapist, MA, BPC
Verified Verified
I am a qualified and experienced psychodynamic psychotherapist providing a warm, supportive and non-judgmental space for you to bring whatever it is you feel the need to talk about. I am there to listen to you with empathy and to help you think about your feelings, however difficult they may be. I am a registered member of the BPC and BACP and work under their ethical code. I hold a professional qualification in Psychodynamic Psychotherapy as well as a previous training in Psychodynamic Counselling, an MA in Psychoanalytic Studies and a degree in Psychology and Counselling. I am a member of the Tavistock Society of Psychotherapists.
I am a qualified and experienced psychodynamic psychotherapist providing a warm, supportive and non-judgmental space for you to bring whatever it is you feel the need to talk about. I am there to listen to you with empathy and to help you think about your feelings, however difficult they may be. I am a registered member of the BPC and BACP and work under their ethical code. I hold a professional qualification in Psychodynamic Psychotherapy as well as a previous training in Psychodynamic Counselling, an MA in Psychoanalytic Studies and a degree in Psychology and Counselling. I am a member of the Tavistock Society of Psychotherapists.
020 3870 4454 View 020 3870 4454
Photo of Ben Scanlan, MSc, MBACP, Psychotherapist
Ben Scanlan
Psychotherapist, MSc, MBACP
Verified Verified
Life is difficult. Do more, be more. Be what others want. I offer a space where we examine where you are in life, what's brought you here, what it's like being you and you in relation to others, and how you're contributing to where you're at. How will we do this? Through our relationship, where I'll offer support, care, empathy and challenge to help you examine life.
Life is difficult. Do more, be more. Be what others want. I offer a space where we examine where you are in life, what's brought you here, what it's like being you and you in relation to others, and how you're contributing to where you're at. How will we do this? Through our relationship, where I'll offer support, care, empathy and challenge to help you examine life.
020 3962 1562 View 020 3962 1562
Photo of Pauline Brown, MBACP Accred, Counsellor
Pauline Brown
Counsellor, MBACP Accred
Verified Verified
1 Endorsed
I am a BACP (Accred) Integrative Therapeutic Counsellor. I work particularly with attachment with our initial caregivers and how these relationships may cause us to experience difficulties in adult life. I offer affordable short and long-term counselling in a safe, confidential, non-judgemental environment where you can talk and feel heard. I specialise in generalised anxiety, panic attacks, depression, bereavement, alcohol addiction issues, trauma, low self esteem, anger management, issues of loneliness and isolation, ongoing family difficulties. I currently support clients via Zoom and in person in SE12.
I am a BACP (Accred) Integrative Therapeutic Counsellor. I work particularly with attachment with our initial caregivers and how these relationships may cause us to experience difficulties in adult life. I offer affordable short and long-term counselling in a safe, confidential, non-judgemental environment where you can talk and feel heard. I specialise in generalised anxiety, panic attacks, depression, bereavement, alcohol addiction issues, trauma, low self esteem, anger management, issues of loneliness and isolation, ongoing family difficulties. I currently support clients via Zoom and in person in SE12.
01689 664643 View 01689 664643
Photo of Josephine Odufuwa, MSc, MBACP, Psychotherapist
Josephine Odufuwa
Psychotherapist, MSc, MBACP
Verified Verified
My ideal client is one that recognises that they do not have to deal with life alone. Understanding the strength in seeking guidance and support from therapy is where the work begins and it allows the creation of a safe space to think about you. One way I work is to help build an individual’s sense of self that allows them to acknowledge their own needs and helps them navigate life and its difficulties. I have experience working with diverse groups whether that be in age or culture and have worked with a variety of issues.
My ideal client is one that recognises that they do not have to deal with life alone. Understanding the strength in seeking guidance and support from therapy is where the work begins and it allows the creation of a safe space to think about you. One way I work is to help build an individual’s sense of self that allows them to acknowledge their own needs and helps them navigate life and its difficulties. I have experience working with diverse groups whether that be in age or culture and have worked with a variety of issues.
020 3974 2399 View 020 3974 2399
Photo of Hope Bastine, PhD, GMBPsS, Psychotherapist
Hope Bastine
Psychotherapist, PhD, GMBPsS
Verified Verified
What’s keeping you up at night? Have you experienced trauma? Do you want to live healthy, have happy relationships, find meaning and purpose in your life, and find direction? Unanswered questions and a lack of guidance make us feel anxious, depressed, and make it difficult for us to cope in life. I’m here to help. I am a trauma-trained psychotherapist working in a person-centred way meaning I will work with you to pull out the answers that lie hidden within you. I will sit with you in the darkness - at the bottom of your soul - offer you a helping hand, guide your way, and lift you up to help you grow into living authentically.
What’s keeping you up at night? Have you experienced trauma? Do you want to live healthy, have happy relationships, find meaning and purpose in your life, and find direction? Unanswered questions and a lack of guidance make us feel anxious, depressed, and make it difficult for us to cope in life. I’m here to help. I am a trauma-trained psychotherapist working in a person-centred way meaning I will work with you to pull out the answers that lie hidden within you. I will sit with you in the darkness - at the bottom of your soul - offer you a helping hand, guide your way, and lift you up to help you grow into living authentically.
01992 945273 View 01992 945273
Photo of Phil Lurie - ACT CBT online Clinical Psychologist Dr Phil Lurie, PsychD, HCPC - Clin. Psych., Psychologist
ACT CBT online Clinical Psychologist Dr Phil Lurie
Psychologist, PsychD, HCPC - Clin. Psych.
Verified Verified
Online Only
Therapy can be a daunting but enriching experience, and I hope that I can help you improve your well-being! I pride myself on making sessions affordable, informative, practical, reflective, challenging, and life-affirming. I will also give you ideas and exercises for in-between sessions, which is where a lot of the change happens. I am integral and compassionate and only offer strategies and new ways of thinking that I would welcome for myself. And I will also include more 'existential' questions about your values, purpose, joy, creativity and connections in your life. Please contact me to organise an initial assessment session.
Therapy can be a daunting but enriching experience, and I hope that I can help you improve your well-being! I pride myself on making sessions affordable, informative, practical, reflective, challenging, and life-affirming. I will also give you ideas and exercises for in-between sessions, which is where a lot of the change happens. I am integral and compassionate and only offer strategies and new ways of thinking that I would welcome for myself. And I will also include more 'existential' questions about your values, purpose, joy, creativity and connections in your life. Please contact me to organise an initial assessment session.
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Photo of Jakub Przemek Potorski, MSc, MUKCP, Psychotherapist
Jakub Przemek Potorski
Psychotherapist, MSc, MUKCP
Verified Verified
Online Only
There are things that you might find yourself struggling with, such as, trying to seek meaning and purpose in life, work problems, relationship difficulties, addiction or mourning the losses and changes that are happening to our planet. You might be feeling adrift in a rapidly changing world, alone, cut off from others or caught in a trap and doing things that you do not find fulfilling anymore. Perhaps you are angry, anxious, depressed or having thoughts of suicide and you are unsure of how to cope with these feelings. Let’s create together a space where mutual understanding and trust is highly valued.
There are things that you might find yourself struggling with, such as, trying to seek meaning and purpose in life, work problems, relationship difficulties, addiction or mourning the losses and changes that are happening to our planet. You might be feeling adrift in a rapidly changing world, alone, cut off from others or caught in a trap and doing things that you do not find fulfilling anymore. Perhaps you are angry, anxious, depressed or having thoughts of suicide and you are unsure of how to cope with these feelings. Let’s create together a space where mutual understanding and trust is highly valued.
020 3958 4299 View 020 3958 4299
Photo of Daniel P Smith, MSc, MBACP, Psychotherapist
Daniel P Smith
Psychotherapist, MSc, MBACP
Verified Verified
I can help you make sense of your emotions and relational difficulties. You may have a sense of being unfulfilled or stuck in life, or perhaps you feel overwhelmed, anxious or sad. I'm a qualified psychotherapist trained to work with these concerns.
I can help you make sense of your emotions and relational difficulties. You may have a sense of being unfulfilled or stuck in life, or perhaps you feel overwhelmed, anxious or sad. I'm a qualified psychotherapist trained to work with these concerns.
020 3195 4459 View 020 3195 4459
Photo of Priyanka O'Neill, BACP, Counsellor
Priyanka O'Neill
Counsellor, BACP
Verified Verified
It takes a great deal of courage to seek out help and support at difficult times in our lives. If you’re here reading this and wondering if you might benefit from therapy, then you’ve already taken a huge step. Perhaps you’re here because you’ve recently experienced a bereavement, breakdown of a relationship or illness. Or maybe you would like a space to explore patterns of behaviour and ways of being in the world that you realise no longer serve you. I believe we all have the capacity to flourish and that therapy can offer an opportunity to open up new ways of being in the world and connecting with ourselves and those around us.
It takes a great deal of courage to seek out help and support at difficult times in our lives. If you’re here reading this and wondering if you might benefit from therapy, then you’ve already taken a huge step. Perhaps you’re here because you’ve recently experienced a bereavement, breakdown of a relationship or illness. Or maybe you would like a space to explore patterns of behaviour and ways of being in the world that you realise no longer serve you. I believe we all have the capacity to flourish and that therapy can offer an opportunity to open up new ways of being in the world and connecting with ourselves and those around us.
020 8106 0688 View 020 8106 0688
Photo of Helen Straupmanis, MUKCP, Psychotherapist
Helen Straupmanis
Psychotherapist, MUKCP
Verified Verified
I am an Attachment Psychotherapist which means that I help you explore your past and present experiences that may have affected you in some way. Sometimes our experiences can leave us feeling insecure or lacking in confidence, making it difficult to form or sustain healthy relationships or cope with everyday life. Talking this through with a psychotherapist can help you to understand and value yourself more. It is not the job of a psychotherapist to tell you what to do but to offer you different perspectives and a different experience of relating.
I am an Attachment Psychotherapist which means that I help you explore your past and present experiences that may have affected you in some way. Sometimes our experiences can leave us feeling insecure or lacking in confidence, making it difficult to form or sustain healthy relationships or cope with everyday life. Talking this through with a psychotherapist can help you to understand and value yourself more. It is not the job of a psychotherapist to tell you what to do but to offer you different perspectives and a different experience of relating.
020 3856 3547 View 020 3856 3547
Photo of Liliya Korallo - citypsychologicalservices, PhD, CPsychol, Psychologist
citypsychologicalservices
Psychologist, PhD, CPsychol
Verified Verified
1 Endorsed
Have you been struggling with intensive emotions? Have you found it difficult to relate to people? Have you noticed that you have a strong fear of being rejected? Have you noticed that you move between extremes -- either liking someone or hating them the next moment? If the answer to any of these questions is "Yes" then mine is the correct Service for you. There is a long queue for NHS treatment for clients with Borderline Personality Disorder (BPD), and I am able to offer the same treatment as NHS offers,
Have you been struggling with intensive emotions? Have you found it difficult to relate to people? Have you noticed that you have a strong fear of being rejected? Have you noticed that you move between extremes -- either liking someone or hating them the next moment? If the answer to any of these questions is "Yes" then mine is the correct Service for you. There is a long queue for NHS treatment for clients with Borderline Personality Disorder (BPD), and I am able to offer the same treatment as NHS offers,
020 3667 2567 View 020 3667 2567
Photo of Helen Bishop, MBACP, Counsellor
Helen Bishop
Counsellor, MBACP
Verified Verified
Online Only
I offer a safe space to explore what is going on for you in a confidential and nonjudgemental environment. Counselling can help by assisting you to have more awareness of yourself and your situation, giving you more power and choice in your life. I work with a variety of emotional issues including anxiety, depression, low self-esteem, stress, sexual abuse, bereavement, life transitions and relationship issues.
I offer a safe space to explore what is going on for you in a confidential and nonjudgemental environment. Counselling can help by assisting you to have more awareness of yourself and your situation, giving you more power and choice in your life. I work with a variety of emotional issues including anxiety, depression, low self-esteem, stress, sexual abuse, bereavement, life transitions and relationship issues.
01260 541214 View 01260 541214
Photo of James McCarthy, MBACP, Counsellor
James McCarthy
Counsellor, MBACP
Verified Verified
I am a registered member of the BACP and a qualified Counsellor. I work in private practice at The Awareness Centre in Clapham London. I provide a safe and holding space, for my clients to explore their issues by sharing their personal thoughts and feelings within a confidential space. I believe it’s important for the client and therapist to co-create the therapeutic relationship, as I feel the relationship is important to establish, so the therapy experience can be meaningful and impactful upon a client’s life.
I am a registered member of the BACP and a qualified Counsellor. I work in private practice at The Awareness Centre in Clapham London. I provide a safe and holding space, for my clients to explore their issues by sharing their personal thoughts and feelings within a confidential space. I believe it’s important for the client and therapist to co-create the therapeutic relationship, as I feel the relationship is important to establish, so the therapy experience can be meaningful and impactful upon a client’s life.
020 3866 0693 View 020 3866 0693
Photo of Adriana Gordon, MBACP, Counsellor
Adriana Gordon
Counsellor, MBACP
Verified Verified
I am an experienced Counsellor and Psychotherapist in Central London and Online, offering private therapy sessions for adults on a long, medium or short-term basis. I offer a warm, confidential and welcoming space for you, where you'll be able to discuss your problems and difficulties. You will feel respected, understood and valued; and we will work together towards the changes you want in your life. Please email me and we can have a brief conversation and book your first session.
I am an experienced Counsellor and Psychotherapist in Central London and Online, offering private therapy sessions for adults on a long, medium or short-term basis. I offer a warm, confidential and welcoming space for you, where you'll be able to discuss your problems and difficulties. You will feel respected, understood and valued; and we will work together towards the changes you want in your life. Please email me and we can have a brief conversation and book your first session.
020 3870 2414 View 020 3870 2414
Photo of Amy Jo Spitalier, MA, BPC, Psychotherapist
Amy Jo Spitalier
Psychotherapist, MA, BPC
Verified Verified
1 Endorsed
Certain life events, transitions, or longstanding struggles can cause our usual ways of coping to break down, leaving us feeling overwhelmed and extremely distressed. To continue to function, drugs, alcohol, food, self harm, sex, social media, a depressive state or abusive behaviour can be used to numb the distress or stand in for what feels missing. But this often leads to feelings of guilt, shame, anger or blame – whether of oneself or others. It can feel like being trapped in a loop of unsatisfactory or harmful relationships, or like reaching a dead-end, with confusion about finding a meaningful path ahead.
Certain life events, transitions, or longstanding struggles can cause our usual ways of coping to break down, leaving us feeling overwhelmed and extremely distressed. To continue to function, drugs, alcohol, food, self harm, sex, social media, a depressive state or abusive behaviour can be used to numb the distress or stand in for what feels missing. But this often leads to feelings of guilt, shame, anger or blame – whether of oneself or others. It can feel like being trapped in a loop of unsatisfactory or harmful relationships, or like reaching a dead-end, with confusion about finding a meaningful path ahead.
020 3984 8433 View 020 3984 8433
Photo of Dr Argyro (Iro) Ioannou, PsychD, HCPC - Couns. Psych., Psychologist
Dr Argyro (Iro) Ioannou
Psychologist, PsychD, HCPC - Couns. Psych.
Verified Verified
I am an experienced Chartered Counselling Psychologist, Psychotherapist and Supervisor. I have experience working as a psychotherapist in the NHS and in private practice with clients facing a variety of psychological concerns, ranging in severity and intensity. Holding a Doctorate in Counselling Psychology, and striving for continuous professional development, I offer therapy with the highest level of knowledge and skills. I value your unique and subjective experience and our therapeutic sessions will be tailored to meet your unique needs, offering you the beginning of a healing process and a more fulfilling life.
I am an experienced Chartered Counselling Psychologist, Psychotherapist and Supervisor. I have experience working as a psychotherapist in the NHS and in private practice with clients facing a variety of psychological concerns, ranging in severity and intensity. Holding a Doctorate in Counselling Psychology, and striving for continuous professional development, I offer therapy with the highest level of knowledge and skills. I value your unique and subjective experience and our therapeutic sessions will be tailored to meet your unique needs, offering you the beginning of a healing process and a more fulfilling life.
020 3962 0779 View 020 3962 0779
Photo of Yvette Addo, MBACP, Psychotherapist
Yvette Addo
Psychotherapist, MBACP
Verified Verified
With over 10 years of experience in mental and emotional health, I’m a qualified and empathetic Psychotherapist. My experience in Occupational Health has provided me with a comprehensive understanding of various therapeutic interventions. I’m dedicated to helping clients achieve their goals by building trust and rapport through exceptional interpersonal skills and therapeutic techniques.
With over 10 years of experience in mental and emotional health, I’m a qualified and empathetic Psychotherapist. My experience in Occupational Health has provided me with a comprehensive understanding of various therapeutic interventions. I’m dedicated to helping clients achieve their goals by building trust and rapport through exceptional interpersonal skills and therapeutic techniques.
020 7123 9265 View 020 7123 9265
Photo of Lauren Jacobs, MA, MBACP, Psychotherapist
Lauren Jacobs
Psychotherapist, MA, MBACP
Verified Verified
Online Only
With the mounting number of tasks life demands, it's easy for self-care to fall to the bottom of the list. But your self is the most transformative aspect of your experience. A distorted, ashamed, or unhappy self will only prevent you from living a full life. I will help you to identify the root of your issues and develop a healthier relationship with yourself and others.
With the mounting number of tasks life demands, it's easy for self-care to fall to the bottom of the list. But your self is the most transformative aspect of your experience. A distorted, ashamed, or unhappy self will only prevent you from living a full life. I will help you to identify the root of your issues and develop a healthier relationship with yourself and others.
View
Photo of Reem El Baba, PsychD, HCPC-Couns. Psych., Psychotherapist
Reem El Baba
Psychotherapist, PsychD, HCPC-Couns. Psych.
Verified Verified
Online Only
It is okay to feel unsafe and alone in your suffering and needing to feel genuinely heard and understood. I'm here if you have questions about your existence, spirituality, choices in life, your identity, death, and/or want to explore you dreams. I offer a safe space for all your existential questions, or wonderings after a major change in your life. If you feel certain substances (legal or illegal) are affecting your life, then I am here to help. Are you in close contact someone who's Deaf or hard-of-hearing and would like to talk about it to improve the way you deal with the diagnosis, dynamic and communication?
It is okay to feel unsafe and alone in your suffering and needing to feel genuinely heard and understood. I'm here if you have questions about your existence, spirituality, choices in life, your identity, death, and/or want to explore you dreams. I offer a safe space for all your existential questions, or wonderings after a major change in your life. If you feel certain substances (legal or illegal) are affecting your life, then I am here to help. Are you in close contact someone who's Deaf or hard-of-hearing and would like to talk about it to improve the way you deal with the diagnosis, dynamic and communication?
020 4538 5071 View 020 4538 5071
Photo of Dr Romila Ragaven, PsychD, HCPC - Clin. Psych., Psychologist
Dr Romila Ragaven
Psychologist, PsychD, HCPC - Clin. Psych.
Verified Verified
Are you struggling to overcome events or memories from your past? Maybe you feel trapped in negative patterns and behaviours. You might be navigating significant life transitions, such as pregnancy, motherhood or recovery from personal trauma. You feel overwhelmed, anxious and uncertain about the changes happening in your life. Or, you might be feeling stuck with the lack of change happening. You want to heal from past traumas and improve your overall well-being. You dream of achieving inner peace and contentment and you hope to build and maintain healthy, supportive relationships with partners, friends and family.
Are you struggling to overcome events or memories from your past? Maybe you feel trapped in negative patterns and behaviours. You might be navigating significant life transitions, such as pregnancy, motherhood or recovery from personal trauma. You feel overwhelmed, anxious and uncertain about the changes happening in your life. Or, you might be feeling stuck with the lack of change happening. You want to heal from past traumas and improve your overall well-being. You dream of achieving inner peace and contentment and you hope to build and maintain healthy, supportive relationships with partners, friends and family.
07403 932129 View 07403 932129
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See more therapy options for Greater London

How does your Counsellor compare?

Number of Counsellors in Greater London

3,000+

Average cost per session

£75

Counsellors in Greater London who prioritize treating:

91% Anxiety
85% Depression
83% Self Esteem
80% Relationship Issues
78% Stress
65% Trauma and PTSD
63% Bereavement

Average years in practice

10 Years

Top 3 insurances accepted

68% Aviva
63% AXA PPP
55% Vitality

How Counsellors in Greater London see their clients

75% In Person and Online
25% Online Only

Gender breakdown

76% Female
23% Male
1% Non-Binary
FAQs - About Therapy and Counselling

How can I find a therapist in Greater London?

Search for nearby therapists or counsellors by inputting your city, postcode, 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 postcode into the search bar.

Learn more about how to find a therapist

Is everyone in the Psychology Today Therapy Directory a licensed therapist?

Counsellors and Psychotherapists listed in the directory are members of the main professional associations, mainly the British Association for Counselling and Psychotherapy (BACP) and the UK Council for Psychotherapy (UKCP). Most Psychologists in the directory are accredited members of the British Psychological Society (BPS) and/or are registered in the Health and Care Professions Council (HPCP).

Providers whose professional membership or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Given that professional memberships are not a statutory requirement for psychotherapists and counsellors in the UK, certain qualified professionals or organisations may choose not to maintain such memberships despite possessing the necessary qualifications. They may be selectively included without the “Verified” seal.

What’s the difference between a psychologist, a therapist, and a counsellor?

Counsellors, psychotherapists and psychologists can all provide counselling or talking therapy and have credentials and experience that enable them to do so in the UK. Psychologists have earned a degree in psychology and many are members of the British Psychological Society (BPS) and have completed a postgraduate qualification in a specialism. Counsellors and Psychotherapists are not required to have a psychology degree, but to belong to a professional organisation such as the BACP or UKCP, they are required to have completed a training course as well as clinical and supervision hours.

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 UK could be between £30 - £60 when seeing a counsellor and £60 - £150 and up when seeing a clinical psychologist. If you have private insurance, your plan may cover some if not all of your sessions. You should contact your insurance provider to determine if they provide coverage for therapy sessions and to determine what, if any, requirements they might have in order for your sessions to be covered, such as a referral from your GP or medical specialist.

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.

If you are struggling to access therapy due to budget constraints, you could also consider public funded mental health services. The NHS Talking therapies programme offers free of charge counselling for common mental health problems like anxiety and depression. The service is available to anyone registered with a GP, though you do not necessarily need to be referred by your GP and can refer yourself directly to a Talking therapies service. The service will provide different solutions, including group and individual therapy, for a limited number of sessions which are generally up to six.

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 postcode.

Are therapy sessions confidential?

Therapists who are part of a professional organisation such as the BACP, the UKCP, or BPS are bound by an ethical framework that requires them to uphold a confidentiality agreement. Confidentiality is a crucial part of the therapeutic relationship and only under specific circumstances, such as when there has been participation in a criminal act or act of terror, or if there is potential or known harm to the client or others, will a therapist be obligated to break the agreement. These exceptions to the confidentiality agreement are usually discussed during the initial consultation.