Photo of Meghan McDonough, LMFT, Marriage & Family Therapist
Meghan McDonough
Marriage & Family Therapist, LMFT
Verified Verified
Elka Park, NY 12427  (Online Only)
I am a Licensed Marriage and Family Therapist based in Upstate NY and work with clients statewide through telehealth. I enjoy working with both individuals and couples. My approach varies on the specific needs of each client, but I feel that I am a guide who is learning alongside you. I will always be coming from a systems perspective, meaning I am thinking about outside influences (family, romantic partners, friends, job, etc.) and how they interplay/impact you.
I am a Licensed Marriage and Family Therapist based in Upstate NY and work with clients statewide through telehealth. I enjoy working with both individuals and couples. My approach varies on the specific needs of each client, but I feel that I am a guide who is learning alongside you. I will always be coming from a systems perspective, meaning I am thinking about outside influences (family, romantic partners, friends, job, etc.) and how they interplay/impact you.
(347) 647-2296 View (347) 647-2296

More Therapists Nearby

Photo of Heide M Kolb, MA, LCSW, NCPsyA, Clinical Social Work/Therapist
Heide M Kolb
Clinical Social Work/Therapist, MA, LCSW, NCPsyA
Verified Verified
Saugerties, NY 12477
You may experience debilitating symptoms,or go through a stressful life transition, or simply feel stuck in your creative endeavors. The foundation of any change, healing and growth is an exploration of these symptoms. I provide a safe and confidential space that will allow you to build a new relationship to yourself and to others.Depression, anxiety or near-psychotic episodes are not the end of the road but a wake-up call to tend to your inner life!
You may experience debilitating symptoms,or go through a stressful life transition, or simply feel stuck in your creative endeavors. The foundation of any change, healing and growth is an exploration of these symptoms. I provide a safe and confidential space that will allow you to build a new relationship to yourself and to others.Depression, anxiety or near-psychotic episodes are not the end of the road but a wake-up call to tend to your inner life!
(646) 351-1626 View (646) 351-1626
Photo of Hannah Grajko, LMSW
Hannah Grajko
Licensed Master Social Worker, LMSW
Verified Verified
1 Endorsed
Saugerties, NY 12477
I approach my work with clients from a deep conviction that all people have the ability to elicit lasting change, find internal calm, and make more skillful decisions if given the right tools. I believe in the ability of each of us to shift our perceived setbacks and struggles into opportunities for growth and learning. I see my role with clients as a non-judgmental witness, curious co-collaborator, and vessel for authenticity.
I approach my work with clients from a deep conviction that all people have the ability to elicit lasting change, find internal calm, and make more skillful decisions if given the right tools. I believe in the ability of each of us to shift our perceived setbacks and struggles into opportunities for growth and learning. I see my role with clients as a non-judgmental witness, curious co-collaborator, and vessel for authenticity.
(845) 444-3891 View (845) 444-3891
Photo of Lia Blady, LMSW, EMDR, Clinical Social Work/Therapist
Lia Blady
Clinical Social Work/Therapist, LMSW, EMDR
Verified Verified
2 Endorsed
Saugerties, NY 12477  (Online Only)
I am a NYU trained psychotherapist who supports individuals that are feeling overwhelmed, ashamed, anxious, depressed, and lost. My main goals as a therapist are to help you feel less alone with your emotions and to help you discover what is at the root of these feelings. I provide a warm, nonjudgmental space for you to process feelings and explore patterns. Through compassionate listening and empathetic understanding, I can help you navigate life's complexities, develop coping strategies, and build meaningful relationships with yourself and others.
I am a NYU trained psychotherapist who supports individuals that are feeling overwhelmed, ashamed, anxious, depressed, and lost. My main goals as a therapist are to help you feel less alone with your emotions and to help you discover what is at the root of these feelings. I provide a warm, nonjudgmental space for you to process feelings and explore patterns. Through compassionate listening and empathetic understanding, I can help you navigate life's complexities, develop coping strategies, and build meaningful relationships with yourself and others.
(929) 640-3843 View (929) 640-3843
Photo of Amanda Lehrer, LMSW, KAP, Clinical Social Work/Therapist
Amanda Lehrer
Clinical Social Work/Therapist, LMSW, KAP
Verified Verified
Bearsville, NY 12409
With a clinical experience spanning over two decades, well beyond 25 years, I bring an extensive wealth of knowledge and profound insights to the field of behavioral health. My expertise goes beyond a mere understanding of therapeutic resources; it encompasses unwavering compassion for individuals grappling with intricate behavioral health challenges. My commitment is not just to listen, but to wholeheartedly engage with your unique experiences, fostering a deep therapeutic connection. In the intricate landscape of clinical practice, life often resembles a voyage into uncharted territories.
With a clinical experience spanning over two decades, well beyond 25 years, I bring an extensive wealth of knowledge and profound insights to the field of behavioral health. My expertise goes beyond a mere understanding of therapeutic resources; it encompasses unwavering compassion for individuals grappling with intricate behavioral health challenges. My commitment is not just to listen, but to wholeheartedly engage with your unique experiences, fostering a deep therapeutic connection. In the intricate landscape of clinical practice, life often resembles a voyage into uncharted territories.
(845) 393-6945 View (845) 393-6945
Photo of Jamie Pavlou, LCSW, Clinical Social Work/Therapist
Jamie Pavlou
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Saugerties, NY 12477  (Online Only)
Hi! My name is Jamie, I am a licensed clinical social worker (LCSW) who graduated from Columbia’s School of Social Work and I am looking to support you in being your fullest and truest self. My clients would describe me as warm, affirming, fun, and passionate. I never claim to be the expert in your life, but if you allow me the privilege of being let in, I promise to help you reach for the goals that seem hard to accomplish alone.
Hi! My name is Jamie, I am a licensed clinical social worker (LCSW) who graduated from Columbia’s School of Social Work and I am looking to support you in being your fullest and truest self. My clients would describe me as warm, affirming, fun, and passionate. I never claim to be the expert in your life, but if you allow me the privilege of being let in, I promise to help you reach for the goals that seem hard to accomplish alone.
(929) 269-8956 View (929) 269-8956
Photo of Allen Nace, LMHC, CCFC, CASAC, Counselor
Allen Nace
Counselor, LMHC, CCFC, CASAC
Verified Verified
Saugerties, NY 12477
At times clients may know what they want and we can build a plan to achieve that. Other times they may not know what they want but may know what they don't want. That's important too. It gives us the groundwork to start to develop a person centered plan to achieve their goals. Mental Health IS Health!
At times clients may know what they want and we can build a plan to achieve that. Other times they may not know what they want but may know what they don't want. That's important too. It gives us the groundwork to start to develop a person centered plan to achieve their goals. Mental Health IS Health!
(914) 485-4960 View (914) 485-4960
Photo of Julianne Spearman, MS, LMHC, CASAC, NCC, Counselor
Julianne Spearman
Counselor, MS, LMHC, CASAC, NCC
Verified Verified
1 Endorsed
Woodstock, NY 12498  (Online Only)
Waitlist for new clients
I am an advocate for women. I strive to support all types of women through transitional life issues, anxiety, depression, trauma, pregnancy, postpartum, breastfeeding, pregnancy loss, body image and addiction.
I am an advocate for women. I strive to support all types of women through transitional life issues, anxiety, depression, trauma, pregnancy, postpartum, breastfeeding, pregnancy loss, body image and addiction.
(845) 415-6172 View (845) 415-6172
Photo of Erika Broad, LCSW, Clinical Social Work/Therapist
Erika Broad
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Woodstock, NY 12498
Waitlist for new clients
I utilize an integrative approach with an emphasis on psychodynamic theory. Treatment is tailored to the best fit for the individual or couple. I specialize in LGBTQ+ affirmative therapy, relationship and marital issues, cognitive behavioral therapy (CBT), and trauma-informed therapy. I practice from a sex-positive, direct and non-judgmental perspective. I have helped clients with a range of struggles, including depression, anxiety, personality disorders, sexuality and gender identity, gender transition, body image, navigating polyamory, and finding clarity around life decisions.
I utilize an integrative approach with an emphasis on psychodynamic theory. Treatment is tailored to the best fit for the individual or couple. I specialize in LGBTQ+ affirmative therapy, relationship and marital issues, cognitive behavioral therapy (CBT), and trauma-informed therapy. I practice from a sex-positive, direct and non-judgmental perspective. I have helped clients with a range of struggles, including depression, anxiety, personality disorders, sexuality and gender identity, gender transition, body image, navigating polyamory, and finding clarity around life decisions.
(718) 340-3862 View (718) 340-3862
Photo of Karen Nelson, LCSW-R, Clinical Social Work/Therapist
Karen Nelson
Clinical Social Work/Therapist, LCSW-R
Verified Verified
12 Endorsed
Saugerties, NY 12477
The path of self-discovery and fulfillment is one of the most profound journeys on which we embark. This path requires that we are witnessed and supported by another so that we can develop a loving and accepting relationship with our true selves. My role as your therapist is to help guide and support your unique process of self-discovery. We will identify and then heal any self-destructive behaviors, limiting beliefs, addictive behaviors, and/or unhealthy relationships so you can know your true self and reach your potential towards a fulfilling life with purpose. Visit my website: www.karennelsonlcsw.com
The path of self-discovery and fulfillment is one of the most profound journeys on which we embark. This path requires that we are witnessed and supported by another so that we can develop a loving and accepting relationship with our true selves. My role as your therapist is to help guide and support your unique process of self-discovery. We will identify and then heal any self-destructive behaviors, limiting beliefs, addictive behaviors, and/or unhealthy relationships so you can know your true self and reach your potential towards a fulfilling life with purpose. Visit my website: www.karennelsonlcsw.com
(646) 600-9247 View (646) 600-9247
Photo of Emily S Rosen, MSW, LCSW-R, Clinical Social Work/Therapist
Emily S Rosen
Clinical Social Work/Therapist, MSW, LCSW-R
Verified Verified
3 Endorsed
Woodstock, NY 12498
Therapy provides the space to challenge self defeating beliefs and see oneself more clearly. I offer a safe and non-judgmental environment. My specialties and areas of interest include helping people overcome feeings of shame, depression and anxiety. I'll support you in your life transitions and when you're feeling afraid or unfulfilled. A lot of my work is around relationship challenges of all kinds. My goal is to help you understand and accept yourself. My goal is also to help you learn how to help yourself.
Therapy provides the space to challenge self defeating beliefs and see oneself more clearly. I offer a safe and non-judgmental environment. My specialties and areas of interest include helping people overcome feeings of shame, depression and anxiety. I'll support you in your life transitions and when you're feeling afraid or unfulfilled. A lot of my work is around relationship challenges of all kinds. My goal is to help you understand and accept yourself. My goal is also to help you learn how to help yourself.
(347) 732-5768 View (347) 732-5768
Photo of Ken Hollander, NCPsyA, CIRT, CGT, MBA, MA, Licensed Psychoanalyst
Ken Hollander
Licensed Psychoanalyst, NCPsyA, CIRT, CGT, MBA, MA
Verified Verified
Woodstock, NY 12498
Limited space available for new couples clients. Do you want to improve your communications within a relationship or work on other couples issues? Are you experiencing anxiety or depression; or perhaps you're going through a life, relationship or career transition? Is there a part of you that wants to make things happen for yourself, to create change, to make things better? I am ready to provide a safe and empathetic space for you to explore the many possibilities that are out there for you, and "try on" new ways of experiencing yourself in the world.
Limited space available for new couples clients. Do you want to improve your communications within a relationship or work on other couples issues? Are you experiencing anxiety or depression; or perhaps you're going through a life, relationship or career transition? Is there a part of you that wants to make things happen for yourself, to create change, to make things better? I am ready to provide a safe and empathetic space for you to explore the many possibilities that are out there for you, and "try on" new ways of experiencing yourself in the world.
(917) 993-5028 View (917) 993-5028
Suzanne Tolomeo
Counselor, MA, LMHC
Verified Verified
Palenville, NY 12463
LMHC, specializing in DWI & Drug Assessments, DV, Rape Crises, Sex offender treatment, individuals, couples,and groups.Cognitive Behavioral Therapy. Nights and weekends available. Accepting most insurances
LMHC, specializing in DWI & Drug Assessments, DV, Rape Crises, Sex offender treatment, individuals, couples,and groups.Cognitive Behavioral Therapy. Nights and weekends available. Accepting most insurances
(518) 620-4769 View (518) 620-4769
Photo of Katie Peterson, LCSW, Clinical Social Work/Therapist
Katie Peterson
Clinical Social Work/Therapist, LCSW
Verified Verified
4 Endorsed
Woodstock, NY 12498  (Online Only)
Life is crazy right now. And it’s still important (maybe even more important) to take care of yourself. I’m here to help you do that. Even in the most stressful and unknown of circumstances. (hello, "post" pandemic-life, looking at YOU!). Let’s figure out how to build resilience and thrive… Give no fucks (at least about the things that don’t really matter). And find a healthy, happy balance in your life. Even when everything feels like it’s falling apart...  I help stressed & overwhelmed New Yorkers find space, clarity & calm in this crazy world. Anxiety & depression can make you feel stuck, unfulfilled, and overwhelmed.
Life is crazy right now. And it’s still important (maybe even more important) to take care of yourself. I’m here to help you do that. Even in the most stressful and unknown of circumstances. (hello, "post" pandemic-life, looking at YOU!). Let’s figure out how to build resilience and thrive… Give no fucks (at least about the things that don’t really matter). And find a healthy, happy balance in your life. Even when everything feels like it’s falling apart...  I help stressed & overwhelmed New Yorkers find space, clarity & calm in this crazy world. Anxiety & depression can make you feel stuck, unfulfilled, and overwhelmed.
(347) 934-6472 View (347) 934-6472
Photo of Trisha Billard, PhD, Psychologist
Trisha Billard
Psychologist, PhD
Verified Verified
Woodstock, NY 12498
My approach is grounded in a deep appreciation and respect for each person's life journey and unique path toward healing, growth and wholeness. I take great care in fostering a safe, nonjudgmental, collaborative environment, with space to breathe and explore. When discomforting symptoms and difficult feelings arise, it is natural that we all want them to go away. But when we take a moment to slow down, to be peaceful and really listen, they are like honest friends helping us unfold what is wanting loving attention to grow. By listening closely together, we can get to the heart of your private struggles and engage your strengths.
My approach is grounded in a deep appreciation and respect for each person's life journey and unique path toward healing, growth and wholeness. I take great care in fostering a safe, nonjudgmental, collaborative environment, with space to breathe and explore. When discomforting symptoms and difficult feelings arise, it is natural that we all want them to go away. But when we take a moment to slow down, to be peaceful and really listen, they are like honest friends helping us unfold what is wanting loving attention to grow. By listening closely together, we can get to the heart of your private struggles and engage your strengths.
(516) 588-7559 View (516) 588-7559
Photo of Carole Sayle, LCSW-R, Clinical Social Work/Therapist
Carole Sayle
Clinical Social Work/Therapist, LCSW-R
Verified Verified
Palenville, NY 12463
I am a caring,skilled, and empathetic psychotherapist/counselor who can help you learn to effectively use your personal strengths, abilities and problem-solving skills to cope with difficulties in your life. For over 20 years, I have helped people from many different backgrounds deal with stress, anxiety, depression, relationship/family issues, work issues, and recovery from alcohol and substance abuse. My services include short and long-term individual and group therapy. I accept most insurance plans, and I have a sliding scale fee for those without insurance. Call, text or email me now for more information: 518 943-5354, csaylecsw@aol.com.
I am a caring,skilled, and empathetic psychotherapist/counselor who can help you learn to effectively use your personal strengths, abilities and problem-solving skills to cope with difficulties in your life. For over 20 years, I have helped people from many different backgrounds deal with stress, anxiety, depression, relationship/family issues, work issues, and recovery from alcohol and substance abuse. My services include short and long-term individual and group therapy. I accept most insurance plans, and I have a sliding scale fee for those without insurance. Call, text or email me now for more information: 518 943-5354, csaylecsw@aol.com.
(518) 943-5354 View (518) 943-5354
Photo of Lauren Olsen, LMHC, Counselor
Lauren Olsen
Counselor, LMHC
Verified Verified
1 Endorsed
Woodstock, NY 12498
Waitlist for new clients
I am an LMHC with experience in treating depression, anxiety, trauma, substance abuse, dually diagnosed, and a variety of other mental health needs. I have a Master’s in Counseling/Community Psychology with a certification in Forensic Mental Health. My work experience includes crisis services, psychiatric Emergency Room, and incarcerated adults. I am a Certified Anger Management Specialist through the NAMA, and provide Impaired Driving Assessments through the Office of Addiction Services and Supports (OASAS).
I am an LMHC with experience in treating depression, anxiety, trauma, substance abuse, dually diagnosed, and a variety of other mental health needs. I have a Master’s in Counseling/Community Psychology with a certification in Forensic Mental Health. My work experience includes crisis services, psychiatric Emergency Room, and incarcerated adults. I am a Certified Anger Management Specialist through the NAMA, and provide Impaired Driving Assessments through the Office of Addiction Services and Supports (OASAS).
(845) 481-0024 View (845) 481-0024
Photo of Krystal Haas, LMHC, Counselor
Krystal Haas
Counselor, LMHC
Verified Verified
2 Endorsed
Saugerties, NY 12477
Are you a parent/caregiver looking for someone to help your child, or are you a young adult looking for someone to talk to? Youths have unique challenges to face: school stressors, difficulty socializing with peers, struggles in identifying complex feelings, having a hard time focusing, and the list goes on. You may have noticed that your (or your child’s) struggles have worsened throughout COVID-19 for a variety of reasons, which is certainly not uncommon. If you feel anxious, sad, lonely, scattered, or overwhelmed, you are in the right place. You don’t have to go it alone. Whether you’re 5 or 25, my goal is to help you feel heard.
Are you a parent/caregiver looking for someone to help your child, or are you a young adult looking for someone to talk to? Youths have unique challenges to face: school stressors, difficulty socializing with peers, struggles in identifying complex feelings, having a hard time focusing, and the list goes on. You may have noticed that your (or your child’s) struggles have worsened throughout COVID-19 for a variety of reasons, which is certainly not uncommon. If you feel anxious, sad, lonely, scattered, or overwhelmed, you are in the right place. You don’t have to go it alone. Whether you’re 5 or 25, my goal is to help you feel heard.
(914) 415-5434 View (914) 415-5434
Photo of Lucas Monroe, LCSW-R, Clinical Social Work/Therapist
Lucas Monroe
Clinical Social Work/Therapist, LCSW-R
Verified Verified
1 Endorsed
Woodstock, NY 12498
I am accepting in person clients between the hours of 1pm-3pm Monday -Thursday. In addition, Fridays at 330pm there is open enrollment for Adventure-Based group for teens. I have several years of experience working with adolescents and adults in a variety of settings. My specialty is providing treatment of anger problems, PTSD, mood disorders and anxiety disorders. My approach is client centered. I draw from several different theoretical models, but my focus is on developing a therapeutic relationship that connects clients to their inner strength and hones their ability to adapt.
I am accepting in person clients between the hours of 1pm-3pm Monday -Thursday. In addition, Fridays at 330pm there is open enrollment for Adventure-Based group for teens. I have several years of experience working with adolescents and adults in a variety of settings. My specialty is providing treatment of anger problems, PTSD, mood disorders and anxiety disorders. My approach is client centered. I draw from several different theoretical models, but my focus is on developing a therapeutic relationship that connects clients to their inner strength and hones their ability to adapt.
(518) 348-8233 View (518) 348-8233
Photo of Jessica Trucillo, LMHC, Counselor
Jessica Trucillo
Counselor, LMHC
Verified Verified
Saugerties, NY 12477  (Online Only)
Hello! My name is Jessica and I am a psychotherapist here to help you learn more about yourself and live a more fulfilling life via telehealth therapy. I work primarily with young adults, adults and teenagers. I specialize in anxiety and depression, as well as trauma and women's issues. I primarily work with young adults between the ages of 20-35. I have found that this age group suffers from anxiety, depression, and trauma disorders. Likewise, this age group is going through many life transitions that require insight and big decision-making.
Hello! My name is Jessica and I am a psychotherapist here to help you learn more about yourself and live a more fulfilling life via telehealth therapy. I work primarily with young adults, adults and teenagers. I specialize in anxiety and depression, as well as trauma and women's issues. I primarily work with young adults between the ages of 20-35. I have found that this age group suffers from anxiety, depression, and trauma disorders. Likewise, this age group is going through many life transitions that require insight and big decision-making.
(646) 466-6119 View (646) 466-6119

How does your Therapist compare?

Number of Therapists in 12427

< 10

Therapists in 12427 who prioritize treating:

100% Relationship Issues
100% Depression
100% Anxiety
100% ADHD
100% Chronic Pain
100% Grief
100% Trauma and PTSD

Top 3 insurances accepted

100% Aetna
100% Cigna and Evernorth
100% Oxford

How Therapists in 12427 see their clients

100% Online Only

Gender breakdown

100% Female
FAQs - About Therapy and Counseling

How can I find a therapist in 12427?

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.