Photo of Karen Fernandez-Cosgrove, Marriage & Family Therapist in 13104, NY
Karen Fernandez-Cosgrove
Marriage & Family Therapist, PhD, LMFT
Verified Verified
1 Endorsed
Manlius, NY 13104  (Online Only)
Often the hardest part of solving problems is finding the right person to help you. Since therapy can be an exciting, challenging, and at times a daunting process, it is important to know that you are working with a therapist who is experienced with the issues you are struggling with.
Often the hardest part of solving problems is finding the right person to help you. Since therapy can be an exciting, challenging, and at times a daunting process, it is important to know that you are working with a therapist who is experienced with the issues you are struggling with.
(315) 496-4751 View (315) 496-4751
Photo of Jennifer Barletta, Counselor in 13104, NY
Jennifer Barletta
Counselor, LMHC
Verified Verified
1 Endorsed
Manlius, NY 13104  (Online Only)
Reaching out for support for you or your loved one takes courage. With one of the hardest steps behind you, I am pleased you have found my private practice. My goal is to provide support, offer a different perspective, and arm you with the tools to manage life's challenges more effectively. I look forward to continuing this journey together.
Reaching out for support for you or your loved one takes courage. With one of the hardest steps behind you, I am pleased you have found my private practice. My goal is to provide support, offer a different perspective, and arm you with the tools to manage life's challenges more effectively. I look forward to continuing this journey together.
(315) 666-4665 View (315) 666-4665
Photo of Shannon O'Toole, Counselor in 13104, NY
Shannon O'Toole
Counselor, LMHC, MS, NCC
Verified Verified
Manlius, NY 13104
Life often presents us with a myriad of challenges, and no one has to figure it all out alone. My role as a counselor is to help you find strategies to navigate the difficulties that prevent you from feeling and doing your best. I work primarily with adolescents, teens, and young adults experiencing a wide array of struggles. These include, but are not limited to, anxiety, OCD, depression, ADHD, family issues, health-related issues, and behavioral issues both at home and at school. Additionally, I work with adults with intergenerational trauma and family of origin concerns and how these affect their life as adults.
Life often presents us with a myriad of challenges, and no one has to figure it all out alone. My role as a counselor is to help you find strategies to navigate the difficulties that prevent you from feeling and doing your best. I work primarily with adolescents, teens, and young adults experiencing a wide array of struggles. These include, but are not limited to, anxiety, OCD, depression, ADHD, family issues, health-related issues, and behavioral issues both at home and at school. Additionally, I work with adults with intergenerational trauma and family of origin concerns and how these affect their life as adults.
(315) 365-5978 x3 View (315) 365-5978 x3
Photo of Tristan Martin, Marriage & Family Therapist in 13104, NY
Tristan Martin
Marriage & Family Therapist, PhD, LMFT, CST
Verified Verified
Manlius, NY 13104
The therapeutic relationship offers support to process experiences. Collaboratively, through warmth and directness, we navigate interpersonal and relational issues, creating change that improves well-being.
The therapeutic relationship offers support to process experiences. Collaboratively, through warmth and directness, we navigate interpersonal and relational issues, creating change that improves well-being.
(315) 640-4285 View (315) 640-4285
Photo of Aqib Chowdhury, Pre-Licensed Professional in 13104, NY
Aqib Chowdhury
Pre-Licensed Professional, PhD
Verified Verified
Manlius, NY 13104
Anxiety is something all of us have experienced, but for some it can be very debilitating. Whether it's worrying about what others think about you, fear of having a panic attack, or engaging in OCD-related rituals, anxiety can be difficult to manage alone. Therapy offers an opportunity to learn about the nature of anxiety - how it impacts our thoughts, feelings, and behaviors. By developing a deeper understanding, we can learn how to cope with anxiety while still pursuing our goals.
Anxiety is something all of us have experienced, but for some it can be very debilitating. Whether it's worrying about what others think about you, fear of having a panic attack, or engaging in OCD-related rituals, anxiety can be difficult to manage alone. Therapy offers an opportunity to learn about the nature of anxiety - how it impacts our thoughts, feelings, and behaviors. By developing a deeper understanding, we can learn how to cope with anxiety while still pursuing our goals.
(315) 888-4384 x1 View (315) 888-4384 x1
Photo of Deirdre Affleck, Counselor in 13104, NY
Deirdre Affleck
Counselor, MS, LMHC, CHT
Verified Verified
Manlius, NY 13104  (Online Only)
Not accepting new clients
My focus is on wellness on all levels - physical, mental, emotional and spiritual. I believe that compassion and safety are essential for healing to occur. I use mind-body-spirit healing modalities such as mindfulness practices, DBT, transpersonal counseling, EMDR, guided meditation, suggestive & regressive hypnotherapy. I trust in the intuition of the client regarding what is needed for healing. I believe that our bodies, minds and spirits are constantly striving toward health and healing, and that often times we simply need informed and effective assistance to get unstuck from troublesome loops in thought, emotion and action.
My focus is on wellness on all levels - physical, mental, emotional and spiritual. I believe that compassion and safety are essential for healing to occur. I use mind-body-spirit healing modalities such as mindfulness practices, DBT, transpersonal counseling, EMDR, guided meditation, suggestive & regressive hypnotherapy. I trust in the intuition of the client regarding what is needed for healing. I believe that our bodies, minds and spirits are constantly striving toward health and healing, and that often times we simply need informed and effective assistance to get unstuck from troublesome loops in thought, emotion and action.
Photo of Stacy M Davison, Clinical Social Work/Therapist in 13104, NY
Stacy M Davison
Clinical Social Work/Therapist, LCSW-R
Verified Verified
2 Endorsed
Manlius, NY 13104  (Online Only)
Waitlist for new clients
Embrace the discomfort, for it is a catalyst for growth. Are you feeling trapped between the pain of your past and worries of the futures making it hard to stay focused on the present moment? Do you find your inner dialogue is putting you down more often than building you up? Are you looking to develop healthier boundaries with yourself and those you love? If any of these statement sound like you, I want you to know there is hope.
Embrace the discomfort, for it is a catalyst for growth. Are you feeling trapped between the pain of your past and worries of the futures making it hard to stay focused on the present moment? Do you find your inner dialogue is putting you down more often than building you up? Are you looking to develop healthier boundaries with yourself and those you love? If any of these statement sound like you, I want you to know there is hope.
(315) 330-8348 View (315) 330-8348
Photo of Breyanna Locke, Marriage & Family Therapist in 13104, NY
Breyanna Locke
Marriage & Family Therapist, MS, MA, LMFT
Verified Verified
Manlius, NY 13104
I believe that each step we take towards self-reflection and relational understanding helps break down powerful patterns that make us feel stuck and hopeless. Giving your emotions a voice can be a freeing and validating experience. It is my role to help this process happen in a way that is safe and meaningful to bring hope and awareness into your life.
I believe that each step we take towards self-reflection and relational understanding helps break down powerful patterns that make us feel stuck and hopeless. Giving your emotions a voice can be a freeing and validating experience. It is my role to help this process happen in a way that is safe and meaningful to bring hope and awareness into your life.
(607) 391-2589 View (607) 391-2589
Photo of Lyndsey Creed, Pre-Licensed Professional in 13104, NY
Lyndsey Creed
Pre-Licensed Professional, MHC-LP
Verified Verified
1 Endorsed
Manlius, NY 13104
Women's wellness, parental counseling, and play therapy openings available in January 2024! Welcome! I am here to offer a supportive environment to partner with you and your family for an opportunity of self reflection & growth. Providing counseling support for ages 5+ incorporating play and developmental stages to address a variety of children's wellness concerns. Experienced in play therapy but working with individuals of all ages, couples, families, groups, & our LGBTQIA friends. Exploring all paths to recovery and encouraging of your organic supports toward wellness.
Women's wellness, parental counseling, and play therapy openings available in January 2024! Welcome! I am here to offer a supportive environment to partner with you and your family for an opportunity of self reflection & growth. Providing counseling support for ages 5+ incorporating play and developmental stages to address a variety of children's wellness concerns. Experienced in play therapy but working with individuals of all ages, couples, families, groups, & our LGBTQIA friends. Exploring all paths to recovery and encouraging of your organic supports toward wellness.
(680) 213-7343 View (680) 213-7343
Photo of Melissa Carman, Counselor in 13104, NY
Melissa Carman
Counselor, PhD, LMHC
Verified Verified
Manlius, NY 13104
Let's face it, people typically don't want to seek counseling. By virtue of looking for a therapist, you're acknowledging a difficult issue in your life, one that you haven't been able to conquer on your own. Regardless of what you do for relief, it proves unsuccessful. Counseling can help but can be very difficult. It requires that you face the issues that you don't want to have. The therapist you choose should be someone you believe can guide you on this difficult journey, helping you get to the core issues that are truly impacting your life.
Let's face it, people typically don't want to seek counseling. By virtue of looking for a therapist, you're acknowledging a difficult issue in your life, one that you haven't been able to conquer on your own. Regardless of what you do for relief, it proves unsuccessful. Counseling can help but can be very difficult. It requires that you face the issues that you don't want to have. The therapist you choose should be someone you believe can guide you on this difficult journey, helping you get to the core issues that are truly impacting your life.
(315) 277-2586 View (315) 277-2586
Photo of Julie Lovenberg, Clinical Social Work/Therapist in 13104, NY
Julie Lovenberg
Clinical Social Work/Therapist, LMSW
Verified Verified
2 Endorsed
Manlius, NY 13104  (Online Only)
Do your emotions feel too big or like you struggle to feel anything at all? Do you feel overwhelmed easily or like you care too much? Do you feel unsafe to be your authentic self around others? Have you gone through a recent life change and suddenly feel unsure of where you're headed? Are you a lot harder on yourself than you would be on anyone else? Do you feel alone and need some support?--- You deserve to feel a balance in your emotions, a direction in your life, and a sense of safety and community. It may not feel like it right now, but all these things are possible.
Do your emotions feel too big or like you struggle to feel anything at all? Do you feel overwhelmed easily or like you care too much? Do you feel unsafe to be your authentic self around others? Have you gone through a recent life change and suddenly feel unsure of where you're headed? Are you a lot harder on yourself than you would be on anyone else? Do you feel alone and need some support?--- You deserve to feel a balance in your emotions, a direction in your life, and a sense of safety and community. It may not feel like it right now, but all these things are possible.
(315) 306-3561 View (315) 306-3561
Photo of Robyn Tomlin, Clinical Social Work/Therapist in 13104, NY
Robyn Tomlin
Clinical Social Work/Therapist, BAPsych, MFA, LCSW
Verified Verified
Manlius, NY 13104  (Online Only)
Welcome. Life can become overwhelming sometimes ( understatement! ). My sessions are authentic, very interactive, empathetic, and solution focused. You will get more clarity on the issues you're facing, have more self-awareness, and insights(!), feel well supported, learn strategies to use unique to you, and grow a lot. I am experienced in successfully treating a variety of issues: Stress, Anxiety or Panic, Adapting to change, Depression, Bi-Polar, OCD, Trauma/PTSD, Fear, Spectrum Disorder, Addictions, Issues in Divorce/pre-div, Survivors of Abuse & Narcissistic Abuse, or clients who are/were psycho-emotionally violated by others.
Welcome. Life can become overwhelming sometimes ( understatement! ). My sessions are authentic, very interactive, empathetic, and solution focused. You will get more clarity on the issues you're facing, have more self-awareness, and insights(!), feel well supported, learn strategies to use unique to you, and grow a lot. I am experienced in successfully treating a variety of issues: Stress, Anxiety or Panic, Adapting to change, Depression, Bi-Polar, OCD, Trauma/PTSD, Fear, Spectrum Disorder, Addictions, Issues in Divorce/pre-div, Survivors of Abuse & Narcissistic Abuse, or clients who are/were psycho-emotionally violated by others.
(315) 870-1985 View (315) 870-1985
Photo of Rachel J Gillespie, Marriage & Family Therapist in 13104, NY
Rachel J Gillespie
Marriage & Family Therapist, MA, LMFT
Verified Verified
3 Endorsed
Manlius, NY 13104
"You cannot change or heal what you do not acknowledge." (Unknown) I believe in utilizing therapy as an opportunity to assist individuals, couples, and families in acknowledging and overcoming barriers to healing and change. I create an authentic, collaborative and non-judgmental therapeutic space where clients are able to address areas in life that aren't working (anxiety, anger, depression, low self-esteem, relationships, painful experiences); to explore and resolve the internal and relational barriers that limits healing and personal growth; and to create an action plan that empowers clients to live out their full potential.
"You cannot change or heal what you do not acknowledge." (Unknown) I believe in utilizing therapy as an opportunity to assist individuals, couples, and families in acknowledging and overcoming barriers to healing and change. I create an authentic, collaborative and non-judgmental therapeutic space where clients are able to address areas in life that aren't working (anxiety, anger, depression, low self-esteem, relationships, painful experiences); to explore and resolve the internal and relational barriers that limits healing and personal growth; and to create an action plan that empowers clients to live out their full potential.
(315) 514-3540 View (315) 514-3540
Photo of Jessie Gaworecki in 13104, NY
Jessie Gaworecki
LCAT, R-DMT, RYT-200
Verified Verified
Manlius, NY 13104
Are you someone who is looking to do more than talk about what's challenging you? Delfina Piretti shares the essence of expressive arts therapy: "Each art form is a gateway to the deepest aspects of the self, reawakening a language of image and metaphor and expressing what often cannot be put into words." If you want to embark on a deepening journey into your body and soul, ready to explore areas such as movement, art, mindfulness, and spiritual practice, and in doing so, are ready to grow your awareness of yourself as a whole, I am here for you.
Are you someone who is looking to do more than talk about what's challenging you? Delfina Piretti shares the essence of expressive arts therapy: "Each art form is a gateway to the deepest aspects of the self, reawakening a language of image and metaphor and expressing what often cannot be put into words." If you want to embark on a deepening journey into your body and soul, ready to explore areas such as movement, art, mindfulness, and spiritual practice, and in doing so, are ready to grow your awareness of yourself as a whole, I am here for you.
(315) 302-1767 View (315) 302-1767
Photo of Brittany Brown, Pre-Licensed Professional in 13104, NY
Brittany Brown
Pre-Licensed Professional, MHC-LP
Verified Verified
1 Endorsed
Manlius, NY 13104
Offering non-traditional hours! Encountering a situational stressor and seeking a solution focused approach, or assistance in gaining perspective? Counseling can be short term and doesn't have to involve an in depth therapeutic process. While addressing more immediate needs can bring up underlying concerns for future work together, we can agree to work on the immediate concerns. Comfortable working with depression, anxiety, life transition, loss, new moms, break up, relationship with alcohol, & mood management. Encouraging your self defined path to wellness and supportive of all options for recovery from drug or alcohol misuse.
Offering non-traditional hours! Encountering a situational stressor and seeking a solution focused approach, or assistance in gaining perspective? Counseling can be short term and doesn't have to involve an in depth therapeutic process. While addressing more immediate needs can bring up underlying concerns for future work together, we can agree to work on the immediate concerns. Comfortable working with depression, anxiety, life transition, loss, new moms, break up, relationship with alcohol, & mood management. Encouraging your self defined path to wellness and supportive of all options for recovery from drug or alcohol misuse.
(315) 871-0952 View (315) 871-0952
Photo of Jenna Halloran Karl, Clinical Social Work/Therapist in 13104, NY
Jenna Halloran Karl
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Manlius, NY 13104  (Online Only)
Accepting New Clients at Therapy Together! Openings for EMDR Consultation! I am a Licensed Independent Clinical Social Worker that specializes in mental health care for adults, college/graduate students, and twenty-somethings. I am licensed in MA, NY, and ME and offer telehealth therapy. I specialize in treating trauma, life transitions, and relationship issues. I am certified in EMDR therapy, and have in-depth experience working with people with Anxiety, Mood Disorders, PTSD, Adjustment issues, LGBTQ+ topics, and Co-occurring disorders.
Accepting New Clients at Therapy Together! Openings for EMDR Consultation! I am a Licensed Independent Clinical Social Worker that specializes in mental health care for adults, college/graduate students, and twenty-somethings. I am licensed in MA, NY, and ME and offer telehealth therapy. I specialize in treating trauma, life transitions, and relationship issues. I am certified in EMDR therapy, and have in-depth experience working with people with Anxiety, Mood Disorders, PTSD, Adjustment issues, LGBTQ+ topics, and Co-occurring disorders.
(315) 325-3560 View (315) 325-3560
Photo of Dr. Stephanie Rabin Scherr, Psychologist in 13104, NY
Dr. Stephanie Rabin Scherr
Psychologist, PhD
Verified Verified
Manlius, NY 13104
Anxiety disorders and OCD can present in many different ways, including avoidance, irritability, severe shyness, panic attacks, uncontrollable worries, phobias, and repetitive thoughts and behaviors. Many of my clients find themselves avoiding work, school, and social interactions because of their anxiety. Others have no option to avoid, but struggle immensely and feel exhausted afterward. The family members of my patients often feel helpless or frustrated, but find themselves unsure of how to help.
Anxiety disorders and OCD can present in many different ways, including avoidance, irritability, severe shyness, panic attacks, uncontrollable worries, phobias, and repetitive thoughts and behaviors. Many of my clients find themselves avoiding work, school, and social interactions because of their anxiety. Others have no option to avoid, but struggle immensely and feel exhausted afterward. The family members of my patients often feel helpless or frustrated, but find themselves unsure of how to help.
(315) 509-6254 View (315) 509-6254
Photo of Neiha Dhar, Marriage & Family Therapist in 13104, NY
Neiha Dhar
Marriage & Family Therapist, MS, LMFT
Verified Verified
7 Endorsed
Manlius, NY 13104  (Online Only)
Sometimes we feel invisible to ourselves and within our social networks. We don't often get the opportunity to slow down and reflect on what we want for ourselves rather than what society or our families have taught us to prioritize. I help people feel seen and heard and to develop a sense of their presence and impact in the world and within their most important relationships.
Sometimes we feel invisible to ourselves and within our social networks. We don't often get the opportunity to slow down and reflect on what we want for ourselves rather than what society or our families have taught us to prioritize. I help people feel seen and heard and to develop a sense of their presence and impact in the world and within their most important relationships.
(315) 696-1936 View (315) 696-1936
Photo of Tracy Torelli, Clinical Social Work/Therapist in 13104, NY
Tracy Torelli
Clinical Social Work/Therapist, LCSW-R, CASAC
Verified Verified
6 Endorsed
Manlius, NY 13104  (Online Only)
Each of us have faced painful personal experiences. Pain can be due to events, interactions with others or troubled relationships. Or they can be caused by negative behavior or thought patterns that won’t stop. Sometimes we can address such troubles on their own. However, if you have been unable to resolve difficult issues alone, you may realize how they reduce the quality of your life – by establishing a pattern of emotional problems, an inability to interact productively with others, impacting your career, negatively affect relationships, or create problematic habits. But they can be addressed with help. My hours are M-F 8-4
Each of us have faced painful personal experiences. Pain can be due to events, interactions with others or troubled relationships. Or they can be caused by negative behavior or thought patterns that won’t stop. Sometimes we can address such troubles on their own. However, if you have been unable to resolve difficult issues alone, you may realize how they reduce the quality of your life – by establishing a pattern of emotional problems, an inability to interact productively with others, impacting your career, negatively affect relationships, or create problematic habits. But they can be addressed with help. My hours are M-F 8-4
(315) 888-4986 View (315) 888-4986
Photo of Dr. Jennifer Coppola, Marriage & Family Therapist in 13104, NY
Dr. Jennifer Coppola
Marriage & Family Therapist, PhD, LMFT
Verified Verified
Manlius, NY 13104  (Online Only)
I am an affirmative therapist who provides family, couple, and individual therapy to people of all ages and identities. As a social justice oriented clinician, I work towards providing emotionally focused and culturally sensitive interventions. I have specialty training in supporting the LGBQ, transgender, and gender diverse/expansive communities. I also specialize in couples therapy, using my published theory of couples therapy but also tailoring my approach to be client driven. Through teletherapy I work with couples and families across New York State. I provide superbills for out of network benefits.
I am an affirmative therapist who provides family, couple, and individual therapy to people of all ages and identities. As a social justice oriented clinician, I work towards providing emotionally focused and culturally sensitive interventions. I have specialty training in supporting the LGBQ, transgender, and gender diverse/expansive communities. I also specialize in couples therapy, using my published theory of couples therapy but also tailoring my approach to be client driven. Through teletherapy I work with couples and families across New York State. I provide superbills for out of network benefits.
(315) 366-4855 View (315) 366-4855

How does your Therapist compare?

Number of Therapists in 13104

80+

Average cost per session

$150

Therapists in 13104 who prioritize treating:

95% Anxiety
85% Relationship Issues
80% Depression
76% Self Esteem
75% Trauma and PTSD
73% Stress
70% Coping Skills

Average years in practice

14 Years

Top 3 insurances accepted

49% Aetna
45% UnitedHealthcare UHC | UBH
43% UMR

How Therapists in 13104 see their clients

60% In Person and Online
40% Online Only

Gender breakdown

90% Female
10% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 13104?

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.