Photo of Hossein Bakhtar - Miki Bakhtar, LPC, LMFT, Licensed Professional Counselor
Miki Bakhtar
Licensed Professional Counselor, LPC, LMFT
Verified Verified
Vienna, VA 22181
I, Hossein (Miki) Bakhtar, have been a counselor in the field of Psychology for over 25 years, working with individuals and couples to help them exchange intensity and drama or isolation and loneliness for intimacy, respect, appreciation and love. "My job is to get you well enough so that you don't need me anymore." Whether it be for a mental health issue, or relationship or other treatment, the philosophical vision of the right intervention program is critical in determining the right place for you or a family member to heal.
I, Hossein (Miki) Bakhtar, have been a counselor in the field of Psychology for over 25 years, working with individuals and couples to help them exchange intensity and drama or isolation and loneliness for intimacy, respect, appreciation and love. "My job is to get you well enough so that you don't need me anymore." Whether it be for a mental health issue, or relationship or other treatment, the philosophical vision of the right intervention program is critical in determining the right place for you or a family member to heal.
(703) 935-5701 View (703) 935-5701
Photo of Myra Binns Bridgforth, LPC, LMFT, Marriage & Family Therapist
Myra Binns Bridgforth
Marriage & Family Therapist, LPC, LMFT
Verified Verified
Vienna, VA 22181
My goal is to help you get unstuck. You will begin to feel better just by taking the first step. Serious problems often need someone to both listen and offer alternative ways for thinking in order to make changes that last. Doing nothing and just hoping and wishing that things will get better doesn't work. I will prompt you and support you in taking concrete steps. I talk straight, listen closely and respectfully ask good questions. Starting with our first session, you will begin to figure out a new way to go. Let's talk soon about beginning.
My goal is to help you get unstuck. You will begin to feel better just by taking the first step. Serious problems often need someone to both listen and offer alternative ways for thinking in order to make changes that last. Doing nothing and just hoping and wishing that things will get better doesn't work. I will prompt you and support you in taking concrete steps. I talk straight, listen closely and respectfully ask good questions. Starting with our first session, you will begin to figure out a new way to go. Let's talk soon about beginning.
(571) 220-6270 View (571) 220-6270
Photo of Susan Theon, LCSW, Clinical Social Work/Therapist
Susan Theon
Clinical Social Work/Therapist, LCSW
Verified Verified
Vienna, VA 22181  (Online Only)
Life can be challenging. It can also be wonderful and beautiful. When we struggle with our mental health it is easy to feel overwhelmed and worry that things will never get better. The good news is that it can get better and you have more power to change than you realize. I am a licensed clinical social worker and received my academic training at Columbia University and Virginia Commonwealth University. I work with clients struggling with a variety of challenges including anxiety, depression, eating disorders, trauma, grief, loss, and life transitions.
Life can be challenging. It can also be wonderful and beautiful. When we struggle with our mental health it is easy to feel overwhelmed and worry that things will never get better. The good news is that it can get better and you have more power to change than you realize. I am a licensed clinical social worker and received my academic training at Columbia University and Virginia Commonwealth University. I work with clients struggling with a variety of challenges including anxiety, depression, eating disorders, trauma, grief, loss, and life transitions.
(571) 581-6548 View (571) 581-6548
Photo of Donya Muse, LPC, Licensed Professional Counselor
Donya Muse
Licensed Professional Counselor, LPC
Verified Verified
Vienna, VA 22181  (Online Only)
Do you feel stressed, overwhelmed, and stuck in your own head? Do you struggle with feelings of not being enough, feeling lost, or just going through the motions of daily life? Many of us go through our days feeling numb and disconnected or struggle with anxious and low moods. Unfortunately, in these overly busy and stress filled times, the loss of joy and vitality is all too common. When things are hectic and we are just trying to get through the day, it is easy to lose sight of our true values and our lives can veer off course, leaving us feeling empty and lost.
Do you feel stressed, overwhelmed, and stuck in your own head? Do you struggle with feelings of not being enough, feeling lost, or just going through the motions of daily life? Many of us go through our days feeling numb and disconnected or struggle with anxious and low moods. Unfortunately, in these overly busy and stress filled times, the loss of joy and vitality is all too common. When things are hectic and we are just trying to get through the day, it is easy to lose sight of our true values and our lives can veer off course, leaving us feeling empty and lost.
(703) 828-0504 View (703) 828-0504
Photo of . Sanchez - Healthy Hearts & Minds LLC , LCSW, Clinical Social Work/Therapist
Healthy Hearts & Minds LLC
Clinical Social Work/Therapist, LCSW
Verified Verified
Vienna, VA 22181  (Online Only)
Healthy Hearts & Minds can offer you Outpatient Therapy, Psychiatric Evaluations, Medication Management, Intensive Outpatient Treatment and 24/7 Crisis Intervention. We specialize in Cognitive Behavioral Therapy working with people who are dealing with anxiety, depression, Bipolar, PTSD, addiction, adjustment disorder and other mood disorders. We work with families, teens, adults and children as early as 12 years old.
Healthy Hearts & Minds can offer you Outpatient Therapy, Psychiatric Evaluations, Medication Management, Intensive Outpatient Treatment and 24/7 Crisis Intervention. We specialize in Cognitive Behavioral Therapy working with people who are dealing with anxiety, depression, Bipolar, PTSD, addiction, adjustment disorder and other mood disorders. We work with families, teens, adults and children as early as 12 years old.
(571) 200-0624 View (571) 200-0624
Photo of Peggy Mitchell Clarke, PhD
Peggy Mitchell Clarke
PhD
Verified Verified
Vienna, VA 22181  (Online Only)
Hello, I'm Dr. Peggy Mitchell Clarke, and I help Christian women professionals and college students navigate difficult work, school, and personal challenges that cause self doubt, mental clutter, frustration, emptiness, disconnection, anger, burnout, and discontentment. I support you and guide you through the process of healing emotional and spiritual wounds so you can feel more confident, fulfilled, productive, and free.
Hello, I'm Dr. Peggy Mitchell Clarke, and I help Christian women professionals and college students navigate difficult work, school, and personal challenges that cause self doubt, mental clutter, frustration, emptiness, disconnection, anger, burnout, and discontentment. I support you and guide you through the process of healing emotional and spiritual wounds so you can feel more confident, fulfilled, productive, and free.
(757) 906-6830 View (757) 906-6830
Photo of Rafid Fadul - Dawn Health
Dawn Health
Verified Verified
Vienna, VA 22181  (Online Only)
At Dawn Health, we understand that mental and physical health are closely connected. We are passionate about promoting mental well-being through a unique therapeutic approach designed for individuals with asthma and COPD who experience anxiety, depression, and insomnia. People with breathing conditions often face common challenges: 1. Difficulty breathing can cause anxiety, which in turn makes breathing even harder. 2. Isolation and depression can arise from being unable to engage in activities you once enjoyed. 3. Breathing issues or medication side effects can disrupt your sleep.
At Dawn Health, we understand that mental and physical health are closely connected. We are passionate about promoting mental well-being through a unique therapeutic approach designed for individuals with asthma and COPD who experience anxiety, depression, and insomnia. People with breathing conditions often face common challenges: 1. Difficulty breathing can cause anxiety, which in turn makes breathing even harder. 2. Isolation and depression can arise from being unable to engage in activities you once enjoyed. 3. Breathing issues or medication side effects can disrupt your sleep.
(585) 476-1853 View (585) 476-1853
Photo of April Dalby, LPC, Licensed Professional Counselor
April Dalby
Licensed Professional Counselor, LPC
Verified Verified
Vienna, VA 22181
There is no greater joy than assisting clients in finding their strengths and ways to use their strengths to overcome life obstacles by creating a new narrative.
There is no greater joy than assisting clients in finding their strengths and ways to use their strengths to overcome life obstacles by creating a new narrative.
(757) 863-2901 View (757) 863-2901
Photo of Mary Lou Lyon, LPC, Licensed Professional Counselor
Mary Lou Lyon
Licensed Professional Counselor, LPC
Verified Verified
Vienna, VA 22181
I work with individuals and couples and specialize in treating depression, anxiety, loss and grief, life transition, and relationship difficulties. My counseling style is strongly relational with an emphasis on your individual healing, growth, and personal development. My goal is to provide a caring and safe environment where you can feel connected, speak honestly, and discover ways to solve problems as well as bring about emotional freedom and psychological growth. I believe that most of our difficulties come abount in the context of personal relationships and that psychotherapy is a way to learn new positive ways of relating. I
I work with individuals and couples and specialize in treating depression, anxiety, loss and grief, life transition, and relationship difficulties. My counseling style is strongly relational with an emphasis on your individual healing, growth, and personal development. My goal is to provide a caring and safe environment where you can feel connected, speak honestly, and discover ways to solve problems as well as bring about emotional freedom and psychological growth. I believe that most of our difficulties come abount in the context of personal relationships and that psychotherapy is a way to learn new positive ways of relating. I
(703) 810-7517 View (703) 810-7517
Photo of Shelley L Williams, PsyD, Psychologist
Shelley L Williams
Psychologist, PsyD
Verified Verified
1 Endorsed
Vienna, VA 22181
I am still accepting new clients and am offering video sessions via Zoom or Doxy for clients who are distancing. I am a clinical psychologist specializing in psychological testing and assessment. My experiences enable me to listen, assess and diagnose a variety of psychological and educational issues. While I am psychological testing specialist, I also provide therapeutic services in which I encourage and support a variety of people. I use an integrative approach to therapy which allows me to tailor overall therapeutic goals as well as target each individual session to meet your needs at that point in time.
I am still accepting new clients and am offering video sessions via Zoom or Doxy for clients who are distancing. I am a clinical psychologist specializing in psychological testing and assessment. My experiences enable me to listen, assess and diagnose a variety of psychological and educational issues. While I am psychological testing specialist, I also provide therapeutic services in which I encourage and support a variety of people. I use an integrative approach to therapy which allows me to tailor overall therapeutic goals as well as target each individual session to meet your needs at that point in time.
(703) 991-2098 View (703) 991-2098
Photo of J. R. Lippold, MA, MSW, LGSW, LCSW, Clinical Social Work/Therapist
J. R. Lippold
Clinical Social Work/Therapist, MA, MSW, LGSW, LCSW
Verified Verified
Vienna, VA 22181
J.R. has extensive experience working with individuals, couples, and families in crisis, as well as adolescents, young adults, and members of the LGBTQ community. His unique and direct approach draws from his multifaceted experiences to provide insight into how environmental, mental/emotional, and health-related factors can influence an individual’s thoughts, feelings, and behaviors – all factors that can lead to emotional distress, anxiety, and depression.
J.R. has extensive experience working with individuals, couples, and families in crisis, as well as adolescents, young adults, and members of the LGBTQ community. His unique and direct approach draws from his multifaceted experiences to provide insight into how environmental, mental/emotional, and health-related factors can influence an individual’s thoughts, feelings, and behaviors – all factors that can lead to emotional distress, anxiety, and depression.
(703) 721-4625 View (703) 721-4625
Photo of Barbara E Eckert, MSW, LCSW, Clinical Social Work/Therapist
Barbara E Eckert
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Vienna, VA 22181
Life presents challenges which require us to explore our innate strengths and resilience. I work collaboratively to explore emotions and core beliefs, create balance, set healthy boundaries and reframe negative thinking. I work exclusively with women age 18 and above - individually and in groups. If you are feeling unsettled, depressed or anxious, I provide a safe and comfortable environment to explore these issues, to gain insights, to develop solutions, and to navigate life's challenges.
Life presents challenges which require us to explore our innate strengths and resilience. I work collaboratively to explore emotions and core beliefs, create balance, set healthy boundaries and reframe negative thinking. I work exclusively with women age 18 and above - individually and in groups. If you are feeling unsettled, depressed or anxious, I provide a safe and comfortable environment to explore these issues, to gain insights, to develop solutions, and to navigate life's challenges.
(703) 988-6557 View (703) 988-6557
Photo of Emily Claus, PsyD, Pre-Licensed Professional
Emily Claus
Pre-Licensed Professional, PsyD
Verified Verified
Vienna, VA 22181
I am a license eligible clinical psychologist who specializes in working with children, adolescents and adults. I'm trained in play and individual therapy for issues ranging from anxiety and mood disorders to ADHD, autism spectrum and other behavioral disorders. Some of specialties include psychological trauma (sexual/physical abuse, neglect) and LGBT issues. I also conducts psychological evaluations and assessments to help develop a more clear mental health diagnosis. I earned my doctoral degree in Clinical Psychology from Nova Southeastern University and completed her clinical internship at Pennsylvania Counseling Services.
I am a license eligible clinical psychologist who specializes in working with children, adolescents and adults. I'm trained in play and individual therapy for issues ranging from anxiety and mood disorders to ADHD, autism spectrum and other behavioral disorders. Some of specialties include psychological trauma (sexual/physical abuse, neglect) and LGBT issues. I also conducts psychological evaluations and assessments to help develop a more clear mental health diagnosis. I earned my doctoral degree in Clinical Psychology from Nova Southeastern University and completed her clinical internship at Pennsylvania Counseling Services.
(703) 639-4155 View (703) 639-4155
Photo of Lisa Grossman, MA, LPC, Licensed Professional Counselor
Lisa Grossman
Licensed Professional Counselor, MA, LPC
Verified Verified
Vienna, VA 22181
If you are feeling overwhelmed, anxious, depressed, and under a great deal of stress, therapy can help you resolve those issues. Therapy can provide the tools you need to manage those feelings. Working together, we can improve your daily life and meet your goals. Therapy can help you change and grow within a safe, warm, and confidential place. Saturday appointments available.
If you are feeling overwhelmed, anxious, depressed, and under a great deal of stress, therapy can help you resolve those issues. Therapy can provide the tools you need to manage those feelings. Working together, we can improve your daily life and meet your goals. Therapy can help you change and grow within a safe, warm, and confidential place. Saturday appointments available.
(703) 405-6361 View (703) 405-6361
Photo of Despina Boudouvas-Mannos, MSW, LCSW, Clinical Social Work/Therapist
Despina Boudouvas-Mannos
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Vienna, VA 22181
The cornerstone of successful therapy is the relationship developed between the client and therapist. I pride myself on developing trusting, supportive, and collaborative working relationships with clients. I tailor my approach to individual clients by helping them to identify and develop goals specific to their personal needs. In targeting identified areas of need, I utilize a variety of therapeutic modalities. Families play a crucial role in the therapeutic process. I actively collaborate with parents to help them support their children working through their particular challenges. I work collaboratively with schools and other involved care providers to facilitate optimal treatment outcomes.
The cornerstone of successful therapy is the relationship developed between the client and therapist. I pride myself on developing trusting, supportive, and collaborative working relationships with clients. I tailor my approach to individual clients by helping them to identify and develop goals specific to their personal needs. In targeting identified areas of need, I utilize a variety of therapeutic modalities. Families play a crucial role in the therapeutic process. I actively collaborate with parents to help them support their children working through their particular challenges. I work collaboratively with schools and other involved care providers to facilitate optimal treatment outcomes.
(703) 997-6183 View (703) 997-6183
Photo of Tracey E Guard, LPC, CSOTP, CSAT, Licensed Professional Counselor
Tracey E Guard
Licensed Professional Counselor, LPC, CSOTP, CSAT
Verified Verified
4 Endorsed
Vienna, VA 22181
Problematic use of pornography? Promiscuous sexual behavior that is impacting your relationships? Legal involvement as the result of sexual behavior? I can help you understand where and how these behaviors originate and give you the tools to implement change which will in turn assist in gaining more meaningful and fulfilling relationships.
Problematic use of pornography? Promiscuous sexual behavior that is impacting your relationships? Legal involvement as the result of sexual behavior? I can help you understand where and how these behaviors originate and give you the tools to implement change which will in turn assist in gaining more meaningful and fulfilling relationships.
(703) 457-8839 View (703) 457-8839
Photo of Cynthia J Pilon, LCSW, Clinical Social Work/Therapist
Cynthia J Pilon
Clinical Social Work/Therapist, LCSW
Verified Verified
Vienna, VA 22181
Not accepting new clients
I am an empathetic psychotherapist who focuses on helping clients untangle the issues that bring them into therapy, to identify what can be done change their circumstances and to accept what can't be changed. Through a mix of traditional therapy, mindfulness techniques and a strengths based approach, I focus on helping clients build resilience and shift perspectives so they can make significant changes in their lives. For clients motivated to work on their issues outside of the therapy office, I provide assignments to facilitate the process.
I am an empathetic psychotherapist who focuses on helping clients untangle the issues that bring them into therapy, to identify what can be done change their circumstances and to accept what can't be changed. Through a mix of traditional therapy, mindfulness techniques and a strengths based approach, I focus on helping clients build resilience and shift perspectives so they can make significant changes in their lives. For clients motivated to work on their issues outside of the therapy office, I provide assignments to facilitate the process.
(703) 348-9608 View (703) 348-9608
Photo of Caitrin Allingham, LPC, MS, NCC, Licensed Professional Counselor
Caitrin Allingham
Licensed Professional Counselor, LPC, MS, NCC
Verified Verified
Vienna, VA 22181
Overwhelmed? I am here to listen and together we can find solutions that work for you. My primary goal is to help you develop strategies to improve your life and overall well-being. My counseling style is open and interactive. I encourage you to express your concerns, identify and face your struggles, and develop effective techniques and strategies to manage life's obstacles. I work from an Existential and Rational Emotive Behavior Therapy foundation giving honest, genuine, objective feedback and suggestions. I promise you will always receive unconditional positive regard from me in a safe, non-judgmental supportive environment.
Overwhelmed? I am here to listen and together we can find solutions that work for you. My primary goal is to help you develop strategies to improve your life and overall well-being. My counseling style is open and interactive. I encourage you to express your concerns, identify and face your struggles, and develop effective techniques and strategies to manage life's obstacles. I work from an Existential and Rational Emotive Behavior Therapy foundation giving honest, genuine, objective feedback and suggestions. I promise you will always receive unconditional positive regard from me in a safe, non-judgmental supportive environment.
(703) 782-8502 View (703) 782-8502
Photo of Nicole Joseph, PsyD, Psychologist
Nicole Joseph
Psychologist, PsyD
Verified Verified
1 Endorsed
Vienna, VA 22181  (Online Only)
What do YOU need? This is the deceptively simple question which I ask my clients almost every session. What would change if you asked yourself that simple question more often? This is an example of some of the foundational work which I'll infuse into our sessions. I LOVE what I do and am so honored to be a part of your life! My goal as your therapist is to encourage, support, empower, and listen. I view therapy as a true partnership where you're not alone while you navigate the 'messy middle' of life in these uncertain times. I work solely virtually after getting positive feedback from busy clients who appreciate this convenience.
What do YOU need? This is the deceptively simple question which I ask my clients almost every session. What would change if you asked yourself that simple question more often? This is an example of some of the foundational work which I'll infuse into our sessions. I LOVE what I do and am so honored to be a part of your life! My goal as your therapist is to encourage, support, empower, and listen. I view therapy as a true partnership where you're not alone while you navigate the 'messy middle' of life in these uncertain times. I work solely virtually after getting positive feedback from busy clients who appreciate this convenience.
(703) 468-8052 View (703) 468-8052
Photo of Kristina Chong, LPC, Licensed Professional Counselor
Kristina Chong
Licensed Professional Counselor, LPC
Verified Verified
Vienna, VA 22181  (Online Only)
Kristina Chong is a Licensed Professional Counselor through the Virginia Board of Counseling. She graduated from Yorkville University with a Master of Arts in Counseling Psychology in 2019 and originates from Western Canada. Kristina utilizes a humanistic approach with Gestalt therapy to support those who find themselves struggling with challenges ranging from anxiety, depression, coping with life changes, post-partum, infertility and grief and loss. In sessions, Kristina incorporates homework through various methods including cognitive-behavioral worksheets, grounding exercises, mindfulness, and more.
Kristina Chong is a Licensed Professional Counselor through the Virginia Board of Counseling. She graduated from Yorkville University with a Master of Arts in Counseling Psychology in 2019 and originates from Western Canada. Kristina utilizes a humanistic approach with Gestalt therapy to support those who find themselves struggling with challenges ranging from anxiety, depression, coping with life changes, post-partum, infertility and grief and loss. In sessions, Kristina incorporates homework through various methods including cognitive-behavioral worksheets, grounding exercises, mindfulness, and more.
(703) 454-5773 View (703) 454-5773
1

See more therapy options for 22181

How does your Therapist compare?

Number of Therapists in 22181

40+

Average cost per session

$175

Therapists in 22181 who prioritize treating:

98% Anxiety
93% Depression
71% Grief
69% Life Transitions
64% Relationship Issues
64% Self Esteem
62% Trauma and PTSD

Average years in practice

13 Years

Top 3 insurances accepted

81% BlueCross and BlueShield
75% Cigna and Evernorth
72% Anthem | Elevance

How Therapists in 22181 see their clients

74% In Person and Online
26% Online Only

Gender breakdown

83% Female
15% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 22181?

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.