Therapists in 14642

Photo of Elizabeth Jeffery, Clinical Social Work/Therapist, LCSW
Elizabeth Jeffery
Clinical Social Work/Therapist, LCSW
2 Endorsed
Serves Area
I am a Licensed Clinical Social Worker with a commitment to helping people with life’s challenges in a safe, supportive, and compassionate environment. I earned my master's degree at Temple University. I have experience in outpatient treatment settings and crisis settings which has allowed me to work with a variety of people dealing with a variety of concerns. Taking the first step to seeking a more fulfilling and happier life takes courage. I am here to support you in that process.
I am a Licensed Clinical Social Worker with a commitment to helping people with life’s challenges in a safe, supportive, and compassionate environment. I earned my master's degree at Temple University. I have experience in outpatient treatment settings and crisis settings which has allowed me to work with a variety of people dealing with a variety of concerns. Taking the first step to seeking a more fulfilling and happier life takes courage. I am here to support you in that process.
(585) 597-7219 View (585) 597-7219
Photo of Edward Jackson Jr., Marriage & Family Therapist, MS, MDiv, LMFT
Edward Jackson Jr.
Marriage & Family Therapist, MS, MDiv, LMFT
1 Endorsed
Serves Area
Waitlist for new clients
I personally don't believe there is an "ideal" client. My "ideal" client is any amazing person who had the courage to walk through the doors, share their story, and work collaboratively to find healing and happiness. That is the ideal client in my humble opinion!
I personally don't believe there is an "ideal" client. My "ideal" client is any amazing person who had the courage to walk through the doors, share their story, and work collaboratively to find healing and happiness. That is the ideal client in my humble opinion!
(716) 201-0522 View (716) 201-0522
Photo of Luba Fingerut - Luba Fingerut RN/LMHC, Counselor, RN, LMHC
Luba Fingerut RN/LMHC
Counselor, RN, LMHC
Online Only
With over 25 years of experience in critical care nursing, including cardiac care, leadership, and clinician wellness, I bring a depth of perspective that bridges both the medical and emotional aspects of healing. I have spent my career supporting individuals and families through life-altering diagnoses, complex medical decisions, and moments of profound uncertainty—experiences that shaped my understanding of how deeply our emotional world influences our physical well-being.
With over 25 years of experience in critical care nursing, including cardiac care, leadership, and clinician wellness, I bring a depth of perspective that bridges both the medical and emotional aspects of healing. I have spent my career supporting individuals and families through life-altering diagnoses, complex medical decisions, and moments of profound uncertainty—experiences that shaped my understanding of how deeply our emotional world influences our physical well-being.
(585) 476-3376 View (585) 476-3376
Photo of Deanne Wilson, Counselor, LMHC
Deanne Wilson
Counselor, LMHC
1 Endorsed
Online Only
Waitlist for new clients
Everyone can benefit from therapy! We all have a story to tell, and life just feels hard sometimes. It's never just one thing that causes us to begin looking for help and it can be easy to lose sight of our strength and resilience when we are overcome with stress, shame, or doubt. Whether you are anxious, depressed, experiencing a major life transition, or struggling in a relationship, therapy can provide a wonderful opportunity to find meaning and relief as you cope with life's challenges. It takes courage to ask for help. Regardless of what brought you here, together we can work to solve the problems you feel are holding you back.
Everyone can benefit from therapy! We all have a story to tell, and life just feels hard sometimes. It's never just one thing that causes us to begin looking for help and it can be easy to lose sight of our strength and resilience when we are overcome with stress, shame, or doubt. Whether you are anxious, depressed, experiencing a major life transition, or struggling in a relationship, therapy can provide a wonderful opportunity to find meaning and relief as you cope with life's challenges. It takes courage to ask for help. Regardless of what brought you here, together we can work to solve the problems you feel are holding you back.
(607) 364-8749 View (607) 364-8749
Photo of Ann Dolan, Clinical Social Work/Therapist, LCSW
Ann Dolan
Clinical Social Work/Therapist, LCSW
Serves Area
Not accepting new clients
I accept clients age 60 and over, younger if they are caring for an elder. Aging can bring the release from the worries and stress of youth, bring joy and possibilities with more free time. It can also bring anxiety about the future, depression, loss and grief, a disturbing medical diagnosis. I have almost thirty years of experience helping adults and their caregivers navigate emotional changes, trauma, challenges associated with dementia, changes in relationships, health status, grief and loss. It is my honor to walk with you at this time, and to help you find peace.
I accept clients age 60 and over, younger if they are caring for an elder. Aging can bring the release from the worries and stress of youth, bring joy and possibilities with more free time. It can also bring anxiety about the future, depression, loss and grief, a disturbing medical diagnosis. I have almost thirty years of experience helping adults and their caregivers navigate emotional changes, trauma, challenges associated with dementia, changes in relationships, health status, grief and loss. It is my honor to walk with you at this time, and to help you find peace.
(607) 708-0808 View (607) 708-0808
Photo of Mercy R Austen, Clinical Social Work/Therapist, LCSW
Mercy R Austen
Clinical Social Work/Therapist, LCSW
Online Only
Not accepting new clients
I am licensed in NYS & IN. I have dedicated 17 years of my career to working w/individuals who are experiencing life concerns; relationship issues, career, living situations. I specialize in supporting people managing health concerns; Reproductive, cancers, geriatric, caregiver, diabetes, cancer, heart, respiratory. Additionally, developmental (MS, MD) & acquired (head, spinal cord). I focus on helping individuals and their caregivers manage anxiety, depression & other mental health concerns which are triggered/caused by health concerns.
I am licensed in NYS & IN. I have dedicated 17 years of my career to working w/individuals who are experiencing life concerns; relationship issues, career, living situations. I specialize in supporting people managing health concerns; Reproductive, cancers, geriatric, caregiver, diabetes, cancer, heart, respiratory. Additionally, developmental (MS, MD) & acquired (head, spinal cord). I focus on helping individuals and their caregivers manage anxiety, depression & other mental health concerns which are triggered/caused by health concerns.
(585) 476-3523 View (585) 476-3523
Photo of Steve Byrne, Psychologist, PsyD
Steve Byrne
Psychologist, PsyD
1 Endorsed
Serves Area
Not accepting new clients
It is a privilege to be able to help people work through the challenges we all face. It's a privilege that I don't take lightly. For my clients, I am here to be more than just a listening ear. I want to ask the tough questions and help clients create meaningful, long lasting changes in their lives, to truly unlock their potential. I am seeking adult and adolescent clients who want a thorough and challenging therapy experience. Our relationships, our thinking, our behaviors (and how they all work together) are the focus of my work.
It is a privilege to be able to help people work through the challenges we all face. It's a privilege that I don't take lightly. For my clients, I am here to be more than just a listening ear. I want to ask the tough questions and help clients create meaningful, long lasting changes in their lives, to truly unlock their potential. I am seeking adult and adolescent clients who want a thorough and challenging therapy experience. Our relationships, our thinking, our behaviors (and how they all work together) are the focus of my work.
(585) 902-4113 View (585) 902-4113

More Therapists Nearby

Photo of Maria Page, Marriage & Family Therapist, MS, LMFT
Maria Page
Marriage & Family Therapist, MS, LMFT
4 Endorsed
Serves Area
Are your relationships struggling? Are you looking to find better ways to communicate your needs? Often in relationships we forget that we have to continue getting to know one another - even if we have been together for years. Sometimes we put everyone and everything before our relationship, including our children. I work with couples and individuals navigating these life changes, who want to continue to grow in their relationships and on an individual level. Outside of my work with couples, I also work well with individuals who find themselves struggling with anxiety and depression and who want to find peace in their mind.
Are your relationships struggling? Are you looking to find better ways to communicate your needs? Often in relationships we forget that we have to continue getting to know one another - even if we have been together for years. Sometimes we put everyone and everything before our relationship, including our children. I work with couples and individuals navigating these life changes, who want to continue to grow in their relationships and on an individual level. Outside of my work with couples, I also work well with individuals who find themselves struggling with anxiety and depression and who want to find peace in their mind.
(315) 903-7641 View (315) 903-7641
Photo of Pamela Trice, Counselor, PsyD, LMHC
Pamela Trice
Counselor, PsyD, LMHC
2 Endorsed
Rochester, NY 14623
It takes courage to reach out for help. I have been honored to work with adults over the past 20 years: people with depression, anxiety, grief, vocational changes, relationship issues, gender/sexual orientation exploration and faith questions. I take a relational approach, knowing that my hearing your heart is what enables you to know yourself better and make decisions that are best for you. I ask questions to deepen your experience, give insights, and may even give a small homework assignment. LOL! Mostly, your work is to journey forward with my support. I know you can do it!
It takes courage to reach out for help. I have been honored to work with adults over the past 20 years: people with depression, anxiety, grief, vocational changes, relationship issues, gender/sexual orientation exploration and faith questions. I take a relational approach, knowing that my hearing your heart is what enables you to know yourself better and make decisions that are best for you. I ask questions to deepen your experience, give insights, and may even give a small homework assignment. LOL! Mostly, your work is to journey forward with my support. I know you can do it!
(585) 366-8625 View (585) 366-8625
Photo of Tiffany Lovins, Counselor, LMHC-D
Tiffany Lovins
Counselor, LMHC-D
1 Endorsed
Rochester, NY 14618
Life can be challenging for us all at some point. You are not alone! I have a genuine love for therapy and what it can do for each and every one of us who may find themselves a bit lost at times. I believe in building a genuine relationship through which the real work of therapy can be done in a space that is nonjudgmental and empathetic, while also challenging you to work hard with me to find your balance and peace. I value humor and creating a space where your authentic self is welcome. You are the expert in your life and I would love to have the honor to be part of your journey in reaching your goals for treatment.
Life can be challenging for us all at some point. You are not alone! I have a genuine love for therapy and what it can do for each and every one of us who may find themselves a bit lost at times. I believe in building a genuine relationship through which the real work of therapy can be done in a space that is nonjudgmental and empathetic, while also challenging you to work hard with me to find your balance and peace. I value humor and creating a space where your authentic self is welcome. You are the expert in your life and I would love to have the honor to be part of your journey in reaching your goals for treatment.
(585) 535-9080 View (585) 535-9080
Photo of James Cherry, Clinical Social Work/Therapist, LCSW
James Cherry
Clinical Social Work/Therapist, LCSW
1 Endorsed
Serves Area
My path to becoming a therapist began with personal loss and deep grief, which reshaped how I understood connection and healing. As an educator, I was drawn to supporting students emotionally, but I realized my passion lay in helping people navigate inner struggles more directly. Therapy helped me confront fear and embrace change. That experience, combined with my background in education, laid the foundation for my clinical work. Today, I integrate empathy, resilience, and trauma-informed care to support individuals, couples, and families on their healing journeys.
My path to becoming a therapist began with personal loss and deep grief, which reshaped how I understood connection and healing. As an educator, I was drawn to supporting students emotionally, but I realized my passion lay in helping people navigate inner struggles more directly. Therapy helped me confront fear and embrace change. That experience, combined with my background in education, laid the foundation for my clinical work. Today, I integrate empathy, resilience, and trauma-informed care to support individuals, couples, and families on their healing journeys.
(631) 380-4411 View (631) 380-4411
Photo of Ângela Richeson, Clinical Social Work/Therapist, LCSW
Ângela Richeson
Clinical Social Work/Therapist, LCSW
1 Endorsed
Pittsford, NY 14534
You’ve reached a point where it has become too difficult to manage all the worry, sadness, and the stress alone. Maybe you've been trying to adjust to recent transitions such as divorce, career decisions, becoming a parent, starting college, or health issues. You might have tried strategies to cope but you feel stuck in the same patterns and they are impacting your ability to find joy in your relationships and life. You are ready for a change and decided it’s time to seek a supportive space to process the challenges you’ve been experiencing.
You’ve reached a point where it has become too difficult to manage all the worry, sadness, and the stress alone. Maybe you've been trying to adjust to recent transitions such as divorce, career decisions, becoming a parent, starting college, or health issues. You might have tried strategies to cope but you feel stuck in the same patterns and they are impacting your ability to find joy in your relationships and life. You are ready for a change and decided it’s time to seek a supportive space to process the challenges you’ve been experiencing.
(585) 378-5989 View (585) 378-5989
Photo of Elio Lewis, Mental Health Counselor, LMHC
Elio Lewis
Mental Health Counselor, LMHC
Rochester, NY 14607
You’re navigating grief, stress, trauma, or life transitions, feeling anxious, exhausted, or unsure where you belong. You identify as LGBTQ+ and/or engage in relationship anarchy, ethical non-monogamy, or polyamory. The beauty and pain of the world might impact you deeply. There's a desire to get back to enjoying life, being playful, and connecting with loved ones. You are looking for a safe, grounding space to reconnect with yourself and feel supported through life’s challenges. Our work together offers a space of care and curiosity as you explore your thoughts and feelings, at a pace that feels right for you.
You’re navigating grief, stress, trauma, or life transitions, feeling anxious, exhausted, or unsure where you belong. You identify as LGBTQ+ and/or engage in relationship anarchy, ethical non-monogamy, or polyamory. The beauty and pain of the world might impact you deeply. There's a desire to get back to enjoying life, being playful, and connecting with loved ones. You are looking for a safe, grounding space to reconnect with yourself and feel supported through life’s challenges. Our work together offers a space of care and curiosity as you explore your thoughts and feelings, at a pace that feels right for you.
(315) 644-6596 View (315) 644-6596
Photo of Buffy Curtis, Art Therapist, LCAT, ATR, BC, EMDR
Buffy Curtis
Art Therapist, LCAT, ATR, BC, EMDR
2 Endorsed
Penfield, NY 14526
I am dedicated to working with individuals and/or couples, who have faced the complexities of trauma, grief, mood disorders, low self-esteem, emotional blocks, those who encounter challenges in interpersonal connections and their connection to themselves. If any of these experiences resonates with you. I welcome the opportunity to support you in your healing journey. I deeply value working with individuals/couples who are ready to engage in the transformative process of therapy in innovative ways. Together we'll forge a beautiful new path in your life.
I am dedicated to working with individuals and/or couples, who have faced the complexities of trauma, grief, mood disorders, low self-esteem, emotional blocks, those who encounter challenges in interpersonal connections and their connection to themselves. If any of these experiences resonates with you. I welcome the opportunity to support you in your healing journey. I deeply value working with individuals/couples who are ready to engage in the transformative process of therapy in innovative ways. Together we'll forge a beautiful new path in your life.
(315) 776-7739 View (315) 776-7739
Photo of Mark Winsberg, MD, BCFM, FASAM
Mark Winsberg
Verified Verified
3 Endorsed
Rochester, NY 14618
My ideal client is a working professional (medical, legal, business) who is looking for private, discrete, help. They may be battling alcohol, opioids, or other substances, feeling isolated, ashamed, or afraid of judgment. They need a compassionate, experienced professional who understands addiction as a treatable medical condition—not a moral failing or lack of willpower. As a board-certified Addiction Medicine Specialist, I offer evidence-based care to help clients regain control, rebuild self-respect, and restore their relationships. My goal is to guide them toward lasting recovery with understanding, dignity, and respect.
My ideal client is a working professional (medical, legal, business) who is looking for private, discrete, help. They may be battling alcohol, opioids, or other substances, feeling isolated, ashamed, or afraid of judgment. They need a compassionate, experienced professional who understands addiction as a treatable medical condition—not a moral failing or lack of willpower. As a board-certified Addiction Medicine Specialist, I offer evidence-based care to help clients regain control, rebuild self-respect, and restore their relationships. My goal is to guide them toward lasting recovery with understanding, dignity, and respect.
(585) 531-5889 View (585) 531-5889
Photo of Dr. Emily Knitter, Limited Licensed Psychologist, PhD
Dr. Emily Knitter
Limited Licensed Psychologist, PhD
Serves Area
You can see your patterns clearly, but that hasn't made them easier to change. Slowing down doesn't feel safe. Hard things haven't scared you, but a relationship, a quiet moment, or a “boring” Tuesday sometimes does. I specialize in complex trauma, identity, and nervous system-informed therapy. The people I tend to work with look fine from the outside. Better than fine, often. High-functioning, competent, holding a lot together. And completely exhausted by the distance between who they are in a room full of people and what's actually going on underneath that. Often that includes veterans, first responders, and career professionals.
You can see your patterns clearly, but that hasn't made them easier to change. Slowing down doesn't feel safe. Hard things haven't scared you, but a relationship, a quiet moment, or a “boring” Tuesday sometimes does. I specialize in complex trauma, identity, and nervous system-informed therapy. The people I tend to work with look fine from the outside. Better than fine, often. High-functioning, competent, holding a lot together. And completely exhausted by the distance between who they are in a room full of people and what's actually going on underneath that. Often that includes veterans, first responders, and career professionals.
(716) 317-5998 View (716) 317-5998
Photo of Shawn Ennuson (Formerly James), Clinical Social Work/Therapist, LCSW
Shawn Ennuson (Formerly James)
Clinical Social Work/Therapist, LCSW
2 Endorsed
Rochester, NY 14610
I believe the therapeutic process is about relationship and connection. I love supporting people through the difficulties of life. In doing so, I love to laugh, joke, connect, be real, and down to earth. I have an audacious and thought provoking approach to treatment. My approach allows me to directly connect with clients in a manner that is comfortable and authentic. Through treatment I provide my clients with healthy challenges, and autonomy in guiding their own treatment. My goal is to provide a safe and supportive environment for clients.
I believe the therapeutic process is about relationship and connection. I love supporting people through the difficulties of life. In doing so, I love to laugh, joke, connect, be real, and down to earth. I have an audacious and thought provoking approach to treatment. My approach allows me to directly connect with clients in a manner that is comfortable and authentic. Through treatment I provide my clients with healthy challenges, and autonomy in guiding their own treatment. My goal is to provide a safe and supportive environment for clients.
(585) 304-1720 View (585) 304-1720
Photo of Andrea Tomaino, MHC
Andrea Tomaino
Verified Verified
1 Endorsed
Rochester, NY 14618
Are you seeking more meaning and joy in your life? As a therapist, I can help you navigate life’s challenges, explore your thoughts and feelings, and create the life and relationships you want. During my 30-year career as an attorney, I provided legal counsel to individuals and families experiencing domestic difficulties, and I worked with attorneys and other professionals in need of support. I am keenly aware of the adverse impact that many issues can have on the quality of one’s personal and professional life, so I earned a master’s degree in mental health counseling to help people lead more fulfilling lives.
Are you seeking more meaning and joy in your life? As a therapist, I can help you navigate life’s challenges, explore your thoughts and feelings, and create the life and relationships you want. During my 30-year career as an attorney, I provided legal counsel to individuals and families experiencing domestic difficulties, and I worked with attorneys and other professionals in need of support. I am keenly aware of the adverse impact that many issues can have on the quality of one’s personal and professional life, so I earned a master’s degree in mental health counseling to help people lead more fulfilling lives.
(585) 577-4555 View (585) 577-4555
Photo of Kamryn Aaronson, LCAT-P
Kamryn Aaronson
Verified Verified
1 Endorsed
Pittsford, NY 14534
Hi, I specialize in Neurodivergent-Affirming Therapy! Navigating life in ways society deems acceptable is not only difficult, but draining. Adjusting your lifestyle to reflect what others think is right can keep the peace but at the expense of yourself. Add on neurodiversity, like ADHD or autism, and life can feel even trickier. It can feel like you’re the only person without the cheat codes to life. Maybe you struggle with executive functioning skills like organization and time management, or feel overwhelmed by tasks like grocery shopping. Life in general just seems to take more out of you than it does others.
Hi, I specialize in Neurodivergent-Affirming Therapy! Navigating life in ways society deems acceptable is not only difficult, but draining. Adjusting your lifestyle to reflect what others think is right can keep the peace but at the expense of yourself. Add on neurodiversity, like ADHD or autism, and life can feel even trickier. It can feel like you’re the only person without the cheat codes to life. Maybe you struggle with executive functioning skills like organization and time management, or feel overwhelmed by tasks like grocery shopping. Life in general just seems to take more out of you than it does others.
(585) 566-2157 x1 View (585) 566-2157 x1
Photo of Sarah Ea Hamling, Counselor, LMHC
Sarah Ea Hamling
Counselor, LMHC
Canandaigua, NY 14424
Just like the Lotus flower, I feel that we all have the potential and power to grow from the most adverse experiences into something beautiful and resilient. I have a personable, holistic, approach and want to meet you where you are at during each session.
Just like the Lotus flower, I feel that we all have the potential and power to grow from the most adverse experiences into something beautiful and resilient. I have a personable, holistic, approach and want to meet you where you are at during each session.
(585) 552-3497 View (585) 552-3497

How does your Therapist compare?

Number of Therapists in 14642

< 10

Therapists in 14642 who prioritize treating:

100% Depression
100% Anxiety
86% Self Esteem
86% Life Transitions
86% Stress
71% Relationship Issues
71% Trauma and PTSD

Average years in practice

16 Years

Top 3 insurances accepted

100% Aetna
83% Oscar Health
67% Oxford

How Therapists in 14642 see their clients

57% In Person and Online
43% Online Only

Gender breakdown

71% Female
29% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 14642?

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.