Therapists in 10512

Photo of Emily Sala, Clinical Social Work/Therapist, MSW, LCSW
Emily Sala
Clinical Social Work/Therapist, MSW, LCSW
Carmel, NY 10512
Emily is a clinical social worker with a Masters Degree from NYU. Emily has extensive experience working with clients of all ages who have anxiety disorders. Emily has treated children with severe school refusal/separation anxiety, adolescents with social phobia, and adults who developed substance use disorders due to their generalized anxiety/depression. Emily also specializes in treating adolescents with mood disorders using dialectical behavior therapy. Emily has been trained in EMDR therapy and can treat adults diagnosed with post-traumatic stress disorder.
Emily is a clinical social worker with a Masters Degree from NYU. Emily has extensive experience working with clients of all ages who have anxiety disorders. Emily has treated children with severe school refusal/separation anxiety, adolescents with social phobia, and adults who developed substance use disorders due to their generalized anxiety/depression. Emily also specializes in treating adolescents with mood disorders using dialectical behavior therapy. Emily has been trained in EMDR therapy and can treat adults diagnosed with post-traumatic stress disorder.
(914) 685-9664 View (914) 685-9664
Photo of Dr. Joanne Rubin, Psychologist, PhD, PsyD
Dr. Joanne Rubin
Psychologist, PhD, PsyD
Carmel, NY 10512
For over 40 years, I have been providing individual, couples, and family therapy. I blend together deep and practical approaches to help you heal old wounds while improving your life in the present. In relationship work, I listen for underlying themes, so that each person feels well understood and supported to speak their earnest truth and hear that of the other person. I help parents take a developmental view of their child, adjusting discipline and support in the present while aiming for healthy functioning in adulthood.
For over 40 years, I have been providing individual, couples, and family therapy. I blend together deep and practical approaches to help you heal old wounds while improving your life in the present. In relationship work, I listen for underlying themes, so that each person feels well understood and supported to speak their earnest truth and hear that of the other person. I help parents take a developmental view of their child, adjusting discipline and support in the present while aiming for healthy functioning in adulthood.
(845) 613-4540 View (845) 613-4540
Photo of Kimberly Snow, Clinical Social Work/Therapist, MSW, LCSW
Kimberly Snow
Clinical Social Work/Therapist, MSW, LCSW
Carmel, NY 10512
Kimberly Snow is a Licensed Clinical Social Worker in New York. She has been practicing since 2020, but has more than 15 years of experience in the mental health industry. She holds a Graduate Degree from Adelphi University and is certified in Cognitive Processing Therapy. Kimberly is skilled in various evidence-based modalities including Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Solution Focused Therapy, and Motivational Therapy. She is proficient in both telehealth and in-person therapy. Kimberly is passionate about dismantling stigma and promoting equity in mental health for all individuals.
Kimberly Snow is a Licensed Clinical Social Worker in New York. She has been practicing since 2020, but has more than 15 years of experience in the mental health industry. She holds a Graduate Degree from Adelphi University and is certified in Cognitive Processing Therapy. Kimberly is skilled in various evidence-based modalities including Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Solution Focused Therapy, and Motivational Therapy. She is proficient in both telehealth and in-person therapy. Kimberly is passionate about dismantling stigma and promoting equity in mental health for all individuals.
(845) 660-6575 View (845) 660-6575
Photo of Anthony Sheppard, Licensed Master Social Worker, MSW, LMSW
Anthony Sheppard
Licensed Master Social Worker, MSW, LMSW
Carmel, NY 10512
Mr. Sheppard is a New York State Licensed Social Worker, specializing in children, adolescents, and their families. Mr. Sheppard has been trained in a variety of different treatment approaches including Trauma Focused Therapy, Cognitive Behavioral Therapy, family systems and play therapy. Mr. Sheppard has years of child welfare experience, serving children (K-12) with learning, emotional and behavioral difficulties.
Mr. Sheppard is a New York State Licensed Social Worker, specializing in children, adolescents, and their families. Mr. Sheppard has been trained in a variety of different treatment approaches including Trauma Focused Therapy, Cognitive Behavioral Therapy, family systems and play therapy. Mr. Sheppard has years of child welfare experience, serving children (K-12) with learning, emotional and behavioral difficulties.
(845) 690-4453 View (845) 690-4453
Photo of Clelia O'Connell, Clinical Social Work/Therapist, MSW, LCSW-R
Clelia O'Connell
Clinical Social Work/Therapist, MSW, LCSW-R
Carmel, NY 10512
Clinician Clelia O'Connell is an experienced LCSW-R with over 25 years of experience. She has post graduate experience with adults in an eclectic psychodynamic Individual Training as well as a Family Systems Therapy Certification from Ackerman Institute for the Family. This clinician has an empathetic responsive method of working with a varied population of problem areas. She is trilingual and is able to conduct sessions in English, Portuguese and Spanish. She understands addiction and women's issues. Ms. O'Connell is respectful of diversity and is open to the LGBQTrans community.
Clinician Clelia O'Connell is an experienced LCSW-R with over 25 years of experience. She has post graduate experience with adults in an eclectic psychodynamic Individual Training as well as a Family Systems Therapy Certification from Ackerman Institute for the Family. This clinician has an empathetic responsive method of working with a varied population of problem areas. She is trilingual and is able to conduct sessions in English, Portuguese and Spanish. She understands addiction and women's issues. Ms. O'Connell is respectful of diversity and is open to the LGBQTrans community.
(845) 572-1899 View (845) 572-1899
Photo of Tara McBride, MEd, BCBA, LBA
Tara McBride
Verified Verified
Carmel, NY 10512
The role of a Board Certified Behavior Analyst (BCBA) in a family’s life is to provide guidance, support and expertise in addressing behavioral challenges and promoting positive changes. I am here to provide assessments, behavior intervention plans, caregiver/family training on modalities, collaborative approach, skill development, and monitoring/evaluation of goals, and IEP advocacy. I believe in building strong relationships with families, understanding their unique needs and circumstances, and working together to create positive changes.
The role of a Board Certified Behavior Analyst (BCBA) in a family’s life is to provide guidance, support and expertise in addressing behavioral challenges and promoting positive changes. I am here to provide assessments, behavior intervention plans, caregiver/family training on modalities, collaborative approach, skill development, and monitoring/evaluation of goals, and IEP advocacy. I believe in building strong relationships with families, understanding their unique needs and circumstances, and working together to create positive changes.
(845) 456-6136 View (845) 456-6136
Photo of Theonyl Cuevas, Clinical Social Work/Therapist, MSW, LCSW
Theonyl Cuevas
Clinical Social Work/Therapist, MSW, LCSW
Carmel, NY 10512
Theonyl Cuevas is a bilingual (Spanish), NYS Licensed Clinical Social Worker with 20 years of experience working with children, adolescents, adults, and families with a wide array of mental health issues. She utilizes evidence-based approaches tailored to the unique needs of each individual. Theonyl earned her Master’s degree from Rutgers University – School of Social Work.
Theonyl Cuevas is a bilingual (Spanish), NYS Licensed Clinical Social Worker with 20 years of experience working with children, adolescents, adults, and families with a wide array of mental health issues. She utilizes evidence-based approaches tailored to the unique needs of each individual. Theonyl earned her Master’s degree from Rutgers University – School of Social Work.
(845) 630-1017 View (845) 630-1017
Photo of Jennifer Culley, Clinical Social Work/Therapist, LCSW
Jennifer Culley
Clinical Social Work/Therapist, LCSW
Carmel, NY 10512
At my practice, every individual and family is met with compassion, respect, and clinical expertise. I have over three decades of clinical and supervisory experience. Whatever struggle or transition you are navigating, it is my priority to ensure you never feel alone or unsupported. I provide a safe and structured space for healing and growth, always with a focus on the well-being of those clients I serve.
At my practice, every individual and family is met with compassion, respect, and clinical expertise. I have over three decades of clinical and supervisory experience. Whatever struggle or transition you are navigating, it is my priority to ensure you never feel alone or unsupported. I provide a safe and structured space for healing and growth, always with a focus on the well-being of those clients I serve.
(914) 267-9441 View (914) 267-9441
Photo of Sinead MacNamara-Murphy, Clinical Social Work/Therapist, LCSW, CASAC, LADC, MATS
Sinead MacNamara-Murphy
Clinical Social Work/Therapist, LCSW, CASAC, LADC, MATS
2 Endorsed
Carmel, NY 10512
Today you are one step closer to a new you where you feel empowered and on a positive path to growth and well-being. As a solution-focused therapist, my goal is to help you uncover your true potential and lead a life that is worth celebrating. While we can't change difficult situations of the past, we can work together to better understand and resolve challenges in your life. By applying complementary therapy approaches, we will unearth long-standing behavior patterns or negative thinking that may be holding you back from experiencing a more fulfilling and meaningful life.
Today you are one step closer to a new you where you feel empowered and on a positive path to growth and well-being. As a solution-focused therapist, my goal is to help you uncover your true potential and lead a life that is worth celebrating. While we can't change difficult situations of the past, we can work together to better understand and resolve challenges in your life. By applying complementary therapy approaches, we will unearth long-standing behavior patterns or negative thinking that may be holding you back from experiencing a more fulfilling and meaningful life.
(845) 208-0697 View (845) 208-0697
Photo of Michelle Mercado, Licensed Master Social Worker, MSW, LMSW
Michelle Mercado
Licensed Master Social Worker, MSW, LMSW
Carmel, NY 10512
Michelle Mercado, LMSW, is a dedicated therapist at LifeStance Health, serving children, teens, and adults across New York. Michelle’s approach centers on empowering clients to foster healthier relationships with their emotions and life experiences. By providing individual, family, group, and couples therapy, she offers a comprehensive range of support tailored to address each client’s unique circumstances. With a strengths-based perspective, Michelle creates a safe and encouraging environment, helping clients overcome challenges and build resilience.
Michelle Mercado, LMSW, is a dedicated therapist at LifeStance Health, serving children, teens, and adults across New York. Michelle’s approach centers on empowering clients to foster healthier relationships with their emotions and life experiences. By providing individual, family, group, and couples therapy, she offers a comprehensive range of support tailored to address each client’s unique circumstances. With a strengths-based perspective, Michelle creates a safe and encouraging environment, helping clients overcome challenges and build resilience.
(845) 622-7181 View (845) 622-7181
Photo of Taylor Carroll, Counselor, LMHC
Taylor Carroll
Counselor, LMHC
Carmel, NY 10512
Taylor Carroll is a Licensed Mental Health Counselor at LifeStance Health, providing compassionate and evidence-based therapy to individuals across New York. She helps adults and young adults navigate life’s challenges with greater clarity, confidence, and emotional balance. Taylor creates a warm, supportive environment where clients feel safe exploring their thoughts and experiences, empowering them to build resilience and meaningful change in their lives. Taylor specializes in treating anxiety, depression, and trauma-related concerns, using a collaborative approach that prioritizes self-understanding and personal growth.
Taylor Carroll is a Licensed Mental Health Counselor at LifeStance Health, providing compassionate and evidence-based therapy to individuals across New York. She helps adults and young adults navigate life’s challenges with greater clarity, confidence, and emotional balance. Taylor creates a warm, supportive environment where clients feel safe exploring their thoughts and experiences, empowering them to build resilience and meaningful change in their lives. Taylor specializes in treating anxiety, depression, and trauma-related concerns, using a collaborative approach that prioritizes self-understanding and personal growth.
(845) 868-6130 View (845) 868-6130
Photo of Debra Larocchia, Clinical Social Work/Therapist, MSW, LCSW
Debra Larocchia
Clinical Social Work/Therapist, MSW, LCSW
Carmel, NY 10512
Debra Larocchia is a Licensed Clinical Social Worker in New York who has been practicing since 2001. She has a Master’s degree of Social Work from Hunter College and a Bachelor’s degree of Psychology from New York University. Debra values and has hope for every living being. She is a compassionate clinician that believes that we each have inner strengths and abilities that can be cultivated and that there are always opportunities for growth and change. Life is a journey that can be filled with joy and sorrow.
Debra Larocchia is a Licensed Clinical Social Worker in New York who has been practicing since 2001. She has a Master’s degree of Social Work from Hunter College and a Bachelor’s degree of Psychology from New York University. Debra values and has hope for every living being. She is a compassionate clinician that believes that we each have inner strengths and abilities that can be cultivated and that there are always opportunities for growth and change. Life is a journey that can be filled with joy and sorrow.
(845) 773-1991 View (845) 773-1991
Photo of Dominique Nerestan, Clinical Social Work/Therapist, LCSW-R
Dominique Nerestan
Clinical Social Work/Therapist, LCSW-R
Carmel, NY 10512
Dominique Nerestan is a Licensed Clinical Social Worker at LifeStance Health, providing compassionate and evidence-based therapy to adolescents, adults, and seniors across New York. She helps clients navigate anxiety, depression, grief, trauma, and major life transitions with empathy, support, and practical strategies for meaningful change. Dominique creates a safe and collaborative space where clients can explore their emotions, build resilience, and develop the skills needed to achieve lasting well-being.
Dominique Nerestan is a Licensed Clinical Social Worker at LifeStance Health, providing compassionate and evidence-based therapy to adolescents, adults, and seniors across New York. She helps clients navigate anxiety, depression, grief, trauma, and major life transitions with empathy, support, and practical strategies for meaningful change. Dominique creates a safe and collaborative space where clients can explore their emotions, build resilience, and develop the skills needed to achieve lasting well-being.
(845) 599-0451 View (845) 599-0451
Photo of Mary Sciullo, Counselor, MS, LMHC
Mary Sciullo
Counselor, MS, LMHC
Carmel, NY 10512
Mary Alice Sciullo is a New York State Licensed Mental Health Counselor who has been practicing since 2016. She has a Master’s Degree in Mental Health Counseling from Pace University. Mary is a caring and compassionate therapist who maintains a safe environment for clients to grow, heal, and develop healthy coping mechanisms to better manage their mental health symptoms and current life stressors. Her great passion is to help you achieve whatever solutions and life changes you are seeking to obtain in therapy.
Mary Alice Sciullo is a New York State Licensed Mental Health Counselor who has been practicing since 2016. She has a Master’s Degree in Mental Health Counseling from Pace University. Mary is a caring and compassionate therapist who maintains a safe environment for clients to grow, heal, and develop healthy coping mechanisms to better manage their mental health symptoms and current life stressors. Her great passion is to help you achieve whatever solutions and life changes you are seeking to obtain in therapy.
(845) 506-8189 View (845) 506-8189
Photo of Kandice Law, Art Therapist, LCAT, LPC
Kandice Law
Art Therapist, LCAT, LPC
Carmel, NY 10512
I’m a Licensed Creative Arts Therapist with years of experience working with young adults, particularly those struggling with eating disorders, anxiety, depression, trauma and grief. I’ve worked in a variety of settings (inpatient, residential, and outpatient) which has equipped me to creatively problem solve a wide variety of issues.
I’m a Licensed Creative Arts Therapist with years of experience working with young adults, particularly those struggling with eating disorders, anxiety, depression, trauma and grief. I’ve worked in a variety of settings (inpatient, residential, and outpatient) which has equipped me to creatively problem solve a wide variety of issues.
(845) 295-1390 View (845) 295-1390
Photo of Kirsten Carillo, Clinical Social Work/Therapist, MSW, LCSW
Kirsten Carillo
Clinical Social Work/Therapist, MSW, LCSW
Carmel, NY 10512
Kirsten Carillo is a New York State licensed clinical social worker. She has 2 master's degrees from New York University and post graduate training at Harvard, Columbia and Fordham Universities. Kirsten specializes in working with children, adolescents, families and parents. She has over 20 years of experience working in schools. Kirsten enables individuals/families to change negative patterns of behavior, develop functional coping strategies and find solutions to achieve goals. Treatment is customized to address individualized needs in a strength based, supportive environment.
Kirsten Carillo is a New York State licensed clinical social worker. She has 2 master's degrees from New York University and post graduate training at Harvard, Columbia and Fordham Universities. Kirsten specializes in working with children, adolescents, families and parents. She has over 20 years of experience working in schools. Kirsten enables individuals/families to change negative patterns of behavior, develop functional coping strategies and find solutions to achieve goals. Treatment is customized to address individualized needs in a strength based, supportive environment.
(845) 552-4435 View (845) 552-4435
Photo of Timothy Gordon, Clinical Social Work/Therapist, MSW, LMSW
Timothy Gordon
Clinical Social Work/Therapist, MSW, LMSW
Carmel, NY 10512
Tim Gordon is committed to helping individuals and families in New York navigate the complexities of life, mental health challenges, and the unique pressures associated with highrisk professions. As a licensed master social worker (LMSW), Tim employs traumainformed therapy to foster resilience and promote mental wellness. He is adept at creating supportive and safe environments where clients can explore their emotions, build coping skills, and address personal and relational difficulties. Tim is particularly passionate about working with first responders and their families, understanding the distinct stressors they face.
Tim Gordon is committed to helping individuals and families in New York navigate the complexities of life, mental health challenges, and the unique pressures associated with highrisk professions. As a licensed master social worker (LMSW), Tim employs traumainformed therapy to foster resilience and promote mental wellness. He is adept at creating supportive and safe environments where clients can explore their emotions, build coping skills, and address personal and relational difficulties. Tim is particularly passionate about working with first responders and their families, understanding the distinct stressors they face.
(845) 497-6547 View (845) 497-6547
Photo of Heather Wynne, Licensed Psychoanalyst, LP
Heather Wynne
Licensed Psychoanalyst, LP
Carmel, NY 10512
Heather Wynne helps children, teens, and young adults gain clarity, understanding, and a path forward through comprehensive psychological assessment at LifeStance Health in New York. She provides thoughtful, developmentally informed evaluations that help families and care teams better understand emotional, behavioral, and learning needs, with the goal of supporting progress at home, in school, and in daily life throughout New York.
Heather Wynne helps children, teens, and young adults gain clarity, understanding, and a path forward through comprehensive psychological assessment at LifeStance Health in New York. She provides thoughtful, developmentally informed evaluations that help families and care teams better understand emotional, behavioral, and learning needs, with the goal of supporting progress at home, in school, and in daily life throughout New York.
(845) 415-7185 View (845) 415-7185
Photo of Andrew Silverman, Clinical Social Work/Therapist, LCSW
Andrew Silverman
Clinical Social Work/Therapist, LCSW
Carmel, NY 10512
Mr. Silverman is a New York State licensed social worker with over 30 years of experience. He treats adults and couples using a supportive, psychodynamic model and has a progressive and pragmatic approach to real-life issues. Andrew also is a Lawyer having completed his J. D. in 2014. Specialties: Depression/Anxiety Dual diagnosis/Alcoholism Problem/Solution Therapy Crisis Management Couples Therapy Reality Based Treatment. Job coaching and counseling, work stress and financial stress counseling.
Mr. Silverman is a New York State licensed social worker with over 30 years of experience. He treats adults and couples using a supportive, psychodynamic model and has a progressive and pragmatic approach to real-life issues. Andrew also is a Lawyer having completed his J. D. in 2014. Specialties: Depression/Anxiety Dual diagnosis/Alcoholism Problem/Solution Therapy Crisis Management Couples Therapy Reality Based Treatment. Job coaching and counseling, work stress and financial stress counseling.
(845) 697-9841 View (845) 697-9841
Photo of Zoey Altis, Licensed Master Social Worker, MSW, LMSW
Zoey Altis
Licensed Master Social Worker, MSW, LMSW
Carmel, NY 10512
Zoey Altis, LMSW, graduated with Bachelors in Science with a major in Psychology with a focus in Psychological Sciences. She continued her studies with obtaining her Masters in Social Work MSW with a concentration in Mental Health, Substance Use, Co-Occurring Disorders. She has completed her clinical practicums at Haskins Laboratories via Yale University, Yale Behavioral Health via Yale School of Medicine, and therapeutic day schools. Since then, she has worked in residential, hospital, non-profit community nature-based, private outpatient supporting adolescents and adults .
Zoey Altis, LMSW, graduated with Bachelors in Science with a major in Psychology with a focus in Psychological Sciences. She continued her studies with obtaining her Masters in Social Work MSW with a concentration in Mental Health, Substance Use, Co-Occurring Disorders. She has completed her clinical practicums at Haskins Laboratories via Yale University, Yale Behavioral Health via Yale School of Medicine, and therapeutic day schools. Since then, she has worked in residential, hospital, non-profit community nature-based, private outpatient supporting adolescents and adults .
(845) 493-3540 View (845) 493-3540

See more therapy options for 10512

How does your Therapist compare?

Number of Therapists in 10512

90+

Average cost per session

$150

Therapists in 10512 who prioritize treating:

97% Anxiety
89% Depression
71% Trauma and PTSD
69% Grief
43% ADHD
41% Family Conflict
40% Relationship Issues

Average years in practice

19 Years

Top 3 insurances accepted

95% Aetna
95% Cigna and Evernorth
59% MagnaCare

How Therapists in 10512 see their clients

79% In Person and Online
21% Online Only

Gender breakdown

87% Female
12% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 10512?

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.