Therapists in 03251

Photo of Brogan Carson, Licensed Clinical Mental Health Counselor, LCMHC
Brogan Carson
Licensed Clinical Mental Health Counselor, LCMHC
Serves Area
My name is Brogan, welcome to my practice. Here we can work toward therapy making a difference in your life. Great therapy has changed my life and the lives of many I have worked with for the better. My best work with others has been a creative process that connects us to ourselves and others in meaningful ways. Weather you feel fully in the dark, or are looking to lighten specific areas of your life, I'm a passionate participant in the process of healing. Welcome!
My name is Brogan, welcome to my practice. Here we can work toward therapy making a difference in your life. Great therapy has changed my life and the lives of many I have worked with for the better. My best work with others has been a creative process that connects us to ourselves and others in meaningful ways. Weather you feel fully in the dark, or are looking to lighten specific areas of your life, I'm a passionate participant in the process of healing. Welcome!
(866) 972-5959 View (866) 972-5959
Photo of Jeannette Hook, Counselor, LCMHC, MLADC
Jeannette Hook
Counselor, LCMHC, MLADC
8 Endorsed
Online Only
Depression, anxiety, trauma and substance use can leave you feeling lost and alone. As an experienced and passionate licensed mental health counselor and master licensed alcohol and drug counselor, I understand the challenges and fears you may be facing. My approach combines motivational interviewing and cognitive behavioral therapy, anchored in a person-centered, solution-focused framework. Whether you're seeking individual or couples support, I'm here to guide you toward recovery and empowerment. Let's work together to find the path that leads you back to yourself. Reach out today to start your healing journey.
Depression, anxiety, trauma and substance use can leave you feeling lost and alone. As an experienced and passionate licensed mental health counselor and master licensed alcohol and drug counselor, I understand the challenges and fears you may be facing. My approach combines motivational interviewing and cognitive behavioral therapy, anchored in a person-centered, solution-focused framework. Whether you're seeking individual or couples support, I'm here to guide you toward recovery and empowerment. Let's work together to find the path that leads you back to yourself. Reach out today to start your healing journey.
(603) 605-8495 View (603) 605-8495

More Therapists Nearby

Photo of Andrea M Ackerly, MS, NCC, CBT-CLC
Andrea M Ackerly
Verified Verified
Serves Area
Is your child or teen struggling with anxiety, mood changes, self-regulation and emotional overwhelm? Many kids and teens need a safe, supportive space to talk, learn coping skills, and reconnect with themselves. I empower youth to find purpose, confidence, and emotional well-being. I offer a unique movement-based approach that takes sessions outside the traditional office. Through outdoor adventure, walking sessions, CBT work; I help youth learn emotional regulation, reduce stress, and build resilience. My work is forward-focused and rooted in positive psychology, solution-focused strategies, mindfulness and meaningful sessions.
Is your child or teen struggling with anxiety, mood changes, self-regulation and emotional overwhelm? Many kids and teens need a safe, supportive space to talk, learn coping skills, and reconnect with themselves. I empower youth to find purpose, confidence, and emotional well-being. I offer a unique movement-based approach that takes sessions outside the traditional office. Through outdoor adventure, walking sessions, CBT work; I help youth learn emotional regulation, reduce stress, and build resilience. My work is forward-focused and rooted in positive psychology, solution-focused strategies, mindfulness and meaningful sessions.
(833) 366-2871 View (833) 366-2871
Photo of Sarah Detamore, Clinical Social Work/Therapist, LICSW
Sarah Detamore
Clinical Social Work/Therapist, LICSW
Serves Area
At times, life can feel like you are out to sea in the middle of a storm- doing your best to steer the sail even when you cant control the wind. My goal is to help you find calm waters again. I work with children, young adults, and families who are navigating trauma, anxiety, grief and loss, neurodiversity (ADHD, Autism) , family relationship challenges, and the unique experiences that come with foster care and adoption. I also specialize in helping young adults process their own unresolved childhood trauma that may be getting in the way of relationships or personal goals.
At times, life can feel like you are out to sea in the middle of a storm- doing your best to steer the sail even when you cant control the wind. My goal is to help you find calm waters again. I work with children, young adults, and families who are navigating trauma, anxiety, grief and loss, neurodiversity (ADHD, Autism) , family relationship challenges, and the unique experiences that come with foster care and adoption. I also specialize in helping young adults process their own unresolved childhood trauma that may be getting in the way of relationships or personal goals.
(603) 420-2908 View (603) 420-2908
Photo of Mary L Welsh, Licensed Clinical Mental Health Counselor, MS , NCC , LCMHC, RPT-S
Mary L Welsh
Licensed Clinical Mental Health Counselor, MS , NCC , LCMHC, RPT-S
Plymouth, NH 03264
I am licensed in, and can see clients who live in Virginia, New Hampshire, Washington and Hawaii. I am currently only seeing clients using Telehealth. As a Registered Play Therapist/Supervisor I am available to consult with parents on behavioral and emotional concerns and can coach parents in addressing these concerns as well as providing training in Child Parent Relationship Therapy. I can help with most issues including anxiety, depression, grief/loss, divorce, relationship challenges and behavioral concerns.
I am licensed in, and can see clients who live in Virginia, New Hampshire, Washington and Hawaii. I am currently only seeing clients using Telehealth. As a Registered Play Therapist/Supervisor I am available to consult with parents on behavioral and emotional concerns and can coach parents in addressing these concerns as well as providing training in Child Parent Relationship Therapy. I can help with most issues including anxiety, depression, grief/loss, divorce, relationship challenges and behavioral concerns.
(844) 508-1095 View (844) 508-1095
Photo of Angelique Fortin (Angie), Counselor, MS, LCMHC
Angelique Fortin (Angie)
Counselor, MS, LCMHC
Littleton, NH 03561
As a therapist, I recognize the importance that therapy has in providing a space for people to process their thoughts, feeling, and struggles in a confidential and safe environment. Therapy can be especially helpful to those who are seeking an opportunity to better understand their personal situation, symptoms and strategize ways to overcome them.
As a therapist, I recognize the importance that therapy has in providing a space for people to process their thoughts, feeling, and struggles in a confidential and safe environment. Therapy can be especially helpful to those who are seeking an opportunity to better understand their personal situation, symptoms and strategize ways to overcome them.
(833) 699-1127 View (833) 699-1127
Photo of Annmarie Karayianes - Karayianes Counseling, Counselor, LCMHC
Karayianes Counseling
Counselor, LCMHC
Serves Area
Accepting New Patients! I am Offering telehealth only sessions for New Hampshire patients and IN-PERSON and telehealth sessions For FLORIDA patients. My life’s work has been focused on helping people to live their best lives through understanding, perseverance, and empowerment. I have over 18 years of experience assisting and helping people in the mental health and substance use fields. I am a Licensed Clinical Mental Health Counselor (LCMHC) in the state of New Hampshire and in Florida. I work with people on issues of life transitions, anxiety , depression, workplace issues, and specialize in issues of trauma and grief and loss.
Accepting New Patients! I am Offering telehealth only sessions for New Hampshire patients and IN-PERSON and telehealth sessions For FLORIDA patients. My life’s work has been focused on helping people to live their best lives through understanding, perseverance, and empowerment. I have over 18 years of experience assisting and helping people in the mental health and substance use fields. I am a Licensed Clinical Mental Health Counselor (LCMHC) in the state of New Hampshire and in Florida. I work with people on issues of life transitions, anxiety , depression, workplace issues, and specialize in issues of trauma and grief and loss.
(603) 707-8769 View (603) 707-8769
Photo of Jamie Evelyn Hazel, Pre-Licensed Professional
Jamie Evelyn Hazel
Pre-Licensed Professional
Plymouth, NH 03264
I work with kids, teens and adults who struggle with anxiety, depression, managing big emotions, disordered eating, body dysmorphic disorder, trauma, low-self esteem, communication struggles and negative self talk. We work together to develop manageable goals to reduce symptoms and improve functioning for whatever has been tough and disrupting your life. Frequent goals of my client's are to increase self-awareness, learn self-compassion, increase ability to rationalize thoughts, improve body image and integrate body neutrality or body positivity into daily life.
I work with kids, teens and adults who struggle with anxiety, depression, managing big emotions, disordered eating, body dysmorphic disorder, trauma, low-self esteem, communication struggles and negative self talk. We work together to develop manageable goals to reduce symptoms and improve functioning for whatever has been tough and disrupting your life. Frequent goals of my client's are to increase self-awareness, learn self-compassion, increase ability to rationalize thoughts, improve body image and integrate body neutrality or body positivity into daily life.
Photo of Lesley McGee, Counselor, MA, LMHC, LCPC, RYT-200
Lesley McGee
Counselor, MA, LMHC, LCPC, RYT-200
7 Endorsed
Serves Area
Please note email is my preferred method of contact for new clients. When my clients are functioning at their best they are creative, playful, passionate, and hard-working. They are adults aged 18+ who are interested in a holistic look at their wellbeing (including factors like sleep quality, relationships, movement etc.). When struggling they tend to find themselves overwhelmed with worry, self-doubt, and/or self-criticism. They are also curious about their body sensations and what that information may mean for their mental health.
Please note email is my preferred method of contact for new clients. When my clients are functioning at their best they are creative, playful, passionate, and hard-working. They are adults aged 18+ who are interested in a holistic look at their wellbeing (including factors like sleep quality, relationships, movement etc.). When struggling they tend to find themselves overwhelmed with worry, self-doubt, and/or self-criticism. They are also curious about their body sensations and what that information may mean for their mental health.
(508) 306-8249 View (508) 306-8249
Photo of Kathy Salinger, Counselor, MS, LCMHC
Kathy Salinger
Counselor, MS, LCMHC
1 Endorsed
Serves Area
Life can feel overwhelming sometimes—you're not alone. Whether you're dealing with anxiety, feeling stuck, or just having a hard time managing day-to-day stress, I’m here to help. With over 17 years of experience working with adults and children in a variety of settings, I offer a supportive space where you can feel heard, understood, and empowered to make real change. I believe that when you're ready to shift, even in small ways, meaningful progress is possible.
Life can feel overwhelming sometimes—you're not alone. Whether you're dealing with anxiety, feeling stuck, or just having a hard time managing day-to-day stress, I’m here to help. With over 17 years of experience working with adults and children in a variety of settings, I offer a supportive space where you can feel heard, understood, and empowered to make real change. I believe that when you're ready to shift, even in small ways, meaningful progress is possible.
(603) 446-6851 View (603) 446-6851
Photo of Dr. Lawrence R Carbonaro Jr, DSL
Dr. Lawrence R Carbonaro Jr
Verified Verified
1 Endorsed
North Conway, NH 03860
With coaching, you are not alone. My strength-based coaching approach is rooted with a blend of evidence-based methodologies and practical insights garnered through my 20-year career in leadership, Doctorate in Leadership development, and ICF and Gallup Strengths coach certifications. The focus of your guided coaching journey is empowering you to look inward and bring awareness. You are the leader - I am the guide.
With coaching, you are not alone. My strength-based coaching approach is rooted with a blend of evidence-based methodologies and practical insights garnered through my 20-year career in leadership, Doctorate in Leadership development, and ICF and Gallup Strengths coach certifications. The focus of your guided coaching journey is empowering you to look inward and bring awareness. You are the leader - I am the guide.
(833) 206-5157 View (833) 206-5157
Photo of Kristin Emery, Pre-Licensed Professional, MA, LCMHC
Kristin Emery
Pre-Licensed Professional, MA, LCMHC
1 Endorsed
Ashland, NH 03217
I provide healing in wellness as you navigate your mental health issues. Whether you are someone who needs a lot of help or just someone who needs to process daily stressors, I am here to help. My focus is to help heal and build confidence within oneself and provide a positive experience where you see real change and real results. I focus on listening to my clients and what they believe they need and creating realistic goals you can achieve. Every client is different and I will help you create an individualized plan that works for you and your lifestyle. I help you by listening intently to your struggles while being there for you.
I provide healing in wellness as you navigate your mental health issues. Whether you are someone who needs a lot of help or just someone who needs to process daily stressors, I am here to help. My focus is to help heal and build confidence within oneself and provide a positive experience where you see real change and real results. I focus on listening to my clients and what they believe they need and creating realistic goals you can achieve. Every client is different and I will help you create an individualized plan that works for you and your lifestyle. I help you by listening intently to your struggles while being there for you.
(844) 655-4977 View (844) 655-4977
Photo of Grant Parker, Pre-Licensed Professional, MEd, CMHC, LCDCa, LPCA
Grant Parker
Pre-Licensed Professional, MEd, CMHC, LCDCa, LPCA
1 Endorsed
Serves Area
My ideal client is anyone having a human experience in life and wants to maximize their moments of positive influence. Like many of my clients, I have learned to ride the ups and downs in life by improving my emotional regulation. The tools that we utilize to help us along the way need to be tangible and realistic; applicable to overwhelming environments & situations. The goal may not be to increase happiness, but increase moments of happiness, and moreover to increase awareness and mindfulness. Our goal is to learn how to survive and thrive in varying degrees of stress & discomfort; to utilize our assets & skills to live healthy.
My ideal client is anyone having a human experience in life and wants to maximize their moments of positive influence. Like many of my clients, I have learned to ride the ups and downs in life by improving my emotional regulation. The tools that we utilize to help us along the way need to be tangible and realistic; applicable to overwhelming environments & situations. The goal may not be to increase happiness, but increase moments of happiness, and moreover to increase awareness and mindfulness. Our goal is to learn how to survive and thrive in varying degrees of stress & discomfort; to utilize our assets & skills to live healthy.
(844) 786-2411 View (844) 786-2411
Photo of Bryan Harter, Clinical Social Work/Therapist, MSW, LICSW
Bryan Harter
Clinical Social Work/Therapist, MSW, LICSW
Online Only
Thank you for considering me as your therapist! With years of experience as a behavioral health clinician in both primary care and private practice, I work with adults at all stages of life. I help with anxiety, depression, relationship challenges, chronic or life-limiting illness, hospice care, and the everyday stressors that can weigh you down. Together, we’ll create solutions tailored to your unique life—not a one-size-fits-all plan—while building the skills for mindful, grounded living in a fast-paced, often overwhelming world.
Thank you for considering me as your therapist! With years of experience as a behavioral health clinician in both primary care and private practice, I work with adults at all stages of life. I help with anxiety, depression, relationship challenges, chronic or life-limiting illness, hospice care, and the everyday stressors that can weigh you down. Together, we’ll create solutions tailored to your unique life—not a one-size-fits-all plan—while building the skills for mindful, grounded living in a fast-paced, often overwhelming world.
(617) 397-7212 View (617) 397-7212
Photo of Dr. Donald Olsen - TERRA Equine Therapy Center, PhD
TERRA Equine Therapy Center
Verified Verified
Center Conway, NH 03813
TERRA Equine Therapy Center provides equine-assisted individual and group therapy led by a licensed clinical psychologist and a medical doctor at an affordable rate for the good of the community.
TERRA Equine Therapy Center provides equine-assisted individual and group therapy led by a licensed clinical psychologist and a medical doctor at an affordable rate for the good of the community.
(855) 621-1781 View (855) 621-1781
Photo of William Edward Keating - Avanti Counseling & Consultation, LLC, Counselor, William, Keating, LCMHC, MLADC, NCC
Avanti Counseling & Consultation, LLC
Counselor, William, Keating, LCMHC, MLADC, NCC
1 Endorsed
Serves Area
William is a Licensed Clinical Mental Health Counselor (LCMHC) and a Master Licensed Alcohol and Drug Counselor (MLADC), earning his master’s degree from Antioch University New England. He believes in a collaborative and solution-focused approach when working with patients. William works towards providing a safe & professional environment for his patients. He is geared toward working collaboratively around building the therapeutic relationship and assisting you in accomplishing your goals. We have immediate openings for weekends and evenings!
William is a Licensed Clinical Mental Health Counselor (LCMHC) and a Master Licensed Alcohol and Drug Counselor (MLADC), earning his master’s degree from Antioch University New England. He believes in a collaborative and solution-focused approach when working with patients. William works towards providing a safe & professional environment for his patients. He is geared toward working collaboratively around building the therapeutic relationship and assisting you in accomplishing your goals. We have immediate openings for weekends and evenings!
(603) 825-4872 View (603) 825-4872
Photo of Kathryn Beskrowni, Licensed Professional Counselor, LPC-S, LCMHC, NCC, MEd
Kathryn Beskrowni
Licensed Professional Counselor, LPC-S, LCMHC, NCC, MEd
4 Endorsed
Serves Area
I provide therapeutic services to adults, couples, families, and – if it's the right fit – adolescents. Clients who tend to take best to my approach are seeking purpose and meaning within their lives, navigating uncertainty, alienation, or perpetual conflict, and are interested in examining ways outward dynamics reflect their inner selves. In other words, my work specializes in bridging the individual to the relational, emphasizing the agency we have in cultivating our shared lives.
I provide therapeutic services to adults, couples, families, and – if it's the right fit – adolescents. Clients who tend to take best to my approach are seeking purpose and meaning within their lives, navigating uncertainty, alienation, or perpetual conflict, and are interested in examining ways outward dynamics reflect their inner selves. In other words, my work specializes in bridging the individual to the relational, emphasizing the agency we have in cultivating our shared lives.
(314) 949-3992 View (314) 949-3992
Photo of Ray Howard, Clinical Social Work/Therapist, LICSW
Ray Howard
Clinical Social Work/Therapist, LICSW
Serves Area
For 29 years, I've focused on helping individuals, couples, and families navigate the complexities of relationships, trauma, and emotional healing. My treatment approach is grounded firmly in the Internal Family Systems Psychotherapy Model, a modern, transformative model that recognizes the human mind as a system of discrete parts that carry us through life and inform primary attachment relationships, and critically, our relationship to ourselves. As a Level 3 Certified IFS therapist and an IFS-I Approved Clinical Consultant, I provide direct care to individuals, couples, families, and consultation toward IFS certification.
For 29 years, I've focused on helping individuals, couples, and families navigate the complexities of relationships, trauma, and emotional healing. My treatment approach is grounded firmly in the Internal Family Systems Psychotherapy Model, a modern, transformative model that recognizes the human mind as a system of discrete parts that carry us through life and inform primary attachment relationships, and critically, our relationship to ourselves. As a Level 3 Certified IFS therapist and an IFS-I Approved Clinical Consultant, I provide direct care to individuals, couples, families, and consultation toward IFS certification.
(603) 329-3258 View (603) 329-3258
Photo of Gail Kaplan, Clinical Social Work/Therapist, LICSW
Gail Kaplan
Clinical Social Work/Therapist, LICSW
Plymouth, NH 03264
Licensed in New Hampshire, Massachusetts, New York, Connecticut, and Florida. Managing everyday life can be difficult and sometimes we are hit with unexpected events that further complicate our lives. Oftentimes the things we have done to manage are no longer working. I work with adolescents, young adults and adults, partnering to work through the process of making difficult decisions, supporting life transitions, or managing their mental health challenges. My approach is strength-based and solution focused with the goal of empowering my clients so that they may heal, grow, and feel better able to manage their lives.
Licensed in New Hampshire, Massachusetts, New York, Connecticut, and Florida. Managing everyday life can be difficult and sometimes we are hit with unexpected events that further complicate our lives. Oftentimes the things we have done to manage are no longer working. I work with adolescents, young adults and adults, partnering to work through the process of making difficult decisions, supporting life transitions, or managing their mental health challenges. My approach is strength-based and solution focused with the goal of empowering my clients so that they may heal, grow, and feel better able to manage their lives.
(603) 506-5989 View (603) 506-5989
Photo of Christine Lamirande, Counselor, LCMHC
Christine Lamirande
Counselor, LCMHC
2 Endorsed
Serves Area
Healing and growth are possible when you have a safe, encouraging space to share your story. I provide a supportive, nonjudgmental environment where you can explore challenges, decrease distressing symptoms, and move toward the life you want to live. Whether you are navigating trauma, anxiety, depression, or life transitions, I will work alongside you to help you find your “True North”—building hope, confidence, and the belief that change is possible. Together, we’ll uncover your strengths, create practical strategies, and work toward a more fulfilling, balanced life.
Healing and growth are possible when you have a safe, encouraging space to share your story. I provide a supportive, nonjudgmental environment where you can explore challenges, decrease distressing symptoms, and move toward the life you want to live. Whether you are navigating trauma, anxiety, depression, or life transitions, I will work alongside you to help you find your “True North”—building hope, confidence, and the belief that change is possible. Together, we’ll uncover your strengths, create practical strategies, and work toward a more fulfilling, balanced life.
(888) 302-2178 View (888) 302-2178

See more therapy options for 03251

How does your Therapist compare?

Number of Therapists in 03251

< 10

Therapists in 03251 who prioritize treating:

100% Relationship Issues
100% Depression
100% Anxiety
100% Life Coaching
100% Trauma and PTSD
100% Career Counseling
100% Family Conflict

Average years in practice

12 Years

Top 3 insurances accepted

100% Aetna
100% BlueCross and BlueShield
100% Cigna and Evernorth

How Therapists in 03251 see their clients

50% In Person and Online
50% Online Only

Gender breakdown

50% Female
50% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 03251?

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.