Therapists in 22304

Photo of Travisa Skinner, Clinical Social Work/Therapist, MSW, LCSW
Travisa Skinner
Clinical Social Work/Therapist, MSW, LCSW
Online Only
I am a dedicated LCSW Supervisee in Social Work with over 14 years of experience serving children, youth, and families across diverse settings including child welfare, juvenile probation, therapeutic foster care, and as a Guardian ad Litem. My passion lies in supporting teens and adults as they navigate life’s challenges and build stronger, healthier relationships.
I am a dedicated LCSW Supervisee in Social Work with over 14 years of experience serving children, youth, and families across diverse settings including child welfare, juvenile probation, therapeutic foster care, and as a Guardian ad Litem. My passion lies in supporting teens and adults as they navigate life’s challenges and build stronger, healthier relationships.
(703) 659-9756 View (703) 659-9756
Photo of Ariel Meaney, Licensed Professional Counselor, LPC
Ariel Meaney
Licensed Professional Counselor, LPC
Alexandria, VA 22304
My name is Ariel, and I am a proud Marine Corps Veteran and the spouse of an Active Duty Marine. With over 17 years of combined experience serving on active duty and supporting as a Military Spouse, I have developed a deep passion for helping the Military and First Responder communities. My personal experiences, along with those of my family members who have also served, have shown me the profound challenges this often-overlooked population faces.
My name is Ariel, and I am a proud Marine Corps Veteran and the spouse of an Active Duty Marine. With over 17 years of combined experience serving on active duty and supporting as a Military Spouse, I have developed a deep passion for helping the Military and First Responder communities. My personal experiences, along with those of my family members who have also served, have shown me the profound challenges this often-overlooked population faces.
(703) 386-7942 View (703) 386-7942
Photo of Eeremene Piaro, Licensed Professional Counselor, LPC
Eeremene Piaro
Licensed Professional Counselor, LPC
Alexandria, VA 22304
Hello! I'm a licensed professional therapist with almost a decade of experience specializing in outpatient counseling. My practice encompasses working with children, adolescents, and adults dealing with various challenges, including depression, anxiety, bipolar disorder, grief, trauma, autism spectrum disorder, LGBTQ+ issues, life stage transition difficulties, and other mental health disorders. Taking the initiative to pursue a more fulfilling and happier life requires courage, and I commend you for taking that first step towards change. I'm here to provide you with the support and empowerment you need on your journey.
Hello! I'm a licensed professional therapist with almost a decade of experience specializing in outpatient counseling. My practice encompasses working with children, adolescents, and adults dealing with various challenges, including depression, anxiety, bipolar disorder, grief, trauma, autism spectrum disorder, LGBTQ+ issues, life stage transition difficulties, and other mental health disorders. Taking the initiative to pursue a more fulfilling and happier life requires courage, and I commend you for taking that first step towards change. I'm here to provide you with the support and empowerment you need on your journey.
(703) 952-7234 View (703) 952-7234
Photo of Katherine Nguyen, Licensed Professional Counselor, LPC, LCPC, ATR-BC, SEP
Katherine Nguyen
Licensed Professional Counselor, LPC, LCPC, ATR-BC, SEP
1 Endorsed
Online Only
Waitlist for new clients
Maybe you want someone to support you through tough life events or maybe a difficult decision. Maybe you just want a place to process all the things. Whatever it is, my goal is to partner with people from all stages in life: People who are ready to make changes in their career or relationships. Burnt out caregivers second guessing themselves and feeling hopeless. Marginalized groups who have experienced grief, pain, generational trauma, and disenfranchised loss. Or those simply looking to return to therapy after some time away.
Maybe you want someone to support you through tough life events or maybe a difficult decision. Maybe you just want a place to process all the things. Whatever it is, my goal is to partner with people from all stages in life: People who are ready to make changes in their career or relationships. Burnt out caregivers second guessing themselves and feeling hopeless. Marginalized groups who have experienced grief, pain, generational trauma, and disenfranchised loss. Or those simply looking to return to therapy after some time away.
View
Photo of Kristina Wallace, Licensed Professional Counselor, MA, LPC, CRC, NCC
Kristina Wallace
Licensed Professional Counselor, MA, LPC, CRC, NCC
1 Endorsed
Online Only
Each of us are unique and so are our struggles. There are times in our lives when we feel challenged, stuck, exhausted, overwhelmed, or lost. It can be beneficial to seek help from someone outside of our situation to help us find ways to make positive change and to move through these trying times. I see teens (age 12 and up), adults, couples, and families navigating: stress, anxiety, depression, or trauma; life changes and transitions; relationship challenges; parenting concerns; pregnancy, post-partum, infertility; sexuality and/or gender issues; racial identity concerns; living with a condition; and grief.
Each of us are unique and so are our struggles. There are times in our lives when we feel challenged, stuck, exhausted, overwhelmed, or lost. It can be beneficial to seek help from someone outside of our situation to help us find ways to make positive change and to move through these trying times. I see teens (age 12 and up), adults, couples, and families navigating: stress, anxiety, depression, or trauma; life changes and transitions; relationship challenges; parenting concerns; pregnancy, post-partum, infertility; sexuality and/or gender issues; racial identity concerns; living with a condition; and grief.
(571) 496-8555 View (571) 496-8555
Photo of Kathleen Fountain - Pearl Vitality, Clinical Social Work/Therapist, LCSW
Pearl Vitality
Clinical Social Work/Therapist, LCSW
Alexandria, VA 22304
Kathleen Fountain is a Licensed Clinical Social Worker with significant clinical experience working with individuals, couples, families, and children. Her work experiences include crisis response, interpersonal violence, inpatient, outpatient, and community-based therapy, as well as 5 years working with the military and military dependent population at Quantico. She is passionate about the uniqueness of every individual and providing a safe and empowering space to support clients create meaningful, positive, and lasting change.
Kathleen Fountain is a Licensed Clinical Social Worker with significant clinical experience working with individuals, couples, families, and children. Her work experiences include crisis response, interpersonal violence, inpatient, outpatient, and community-based therapy, as well as 5 years working with the military and military dependent population at Quantico. She is passionate about the uniqueness of every individual and providing a safe and empowering space to support clients create meaningful, positive, and lasting change.
(571) 200-5159 View (571) 200-5159
Photo of Alyssa Jones, Licensed Professional Counselor, LPC
Alyssa Jones
Licensed Professional Counselor, LPC
Alexandria, VA 22304
My work is shaped by a unique blend of experiences—as a competitive figure skater and coach, a passionate advocate for trauma and art therapy, and a dedicated professional in the substance abuse field. My years on the ice instilled in me a deep appreciation for discipline, perseverance, and mental resilience—qualities I now help my clients cultivate as they pursue personal growth. As a coach, I supported athletes in building both physical capabilities and inner strength.
My work is shaped by a unique blend of experiences—as a competitive figure skater and coach, a passionate advocate for trauma and art therapy, and a dedicated professional in the substance abuse field. My years on the ice instilled in me a deep appreciation for discipline, perseverance, and mental resilience—qualities I now help my clients cultivate as they pursue personal growth. As a coach, I supported athletes in building both physical capabilities and inner strength.
(703) 215-2504 View (703) 215-2504
Photo of Majeed Abu Nimer, Clinical Social Work/Therapist, MSW, LCSW
Majeed Abu Nimer
Clinical Social Work/Therapist, MSW, LCSW
Alexandria, VA 22304
If you are struggling with depression, anxiety, grief, adjustment to new culture or trauma, I can help you manage daily issues such as Stress Management, Interpersonal Difficulties, Life Transitions, Career issues, and other struggles that affect your ability to enjoy life. I can also help with a cultural adjustment which can be a unique challenge that many immigrants face. My background includes an MSW from Howard Univ. and my unique experience can guide you in making a smooth cultural transition.
If you are struggling with depression, anxiety, grief, adjustment to new culture or trauma, I can help you manage daily issues such as Stress Management, Interpersonal Difficulties, Life Transitions, Career issues, and other struggles that affect your ability to enjoy life. I can also help with a cultural adjustment which can be a unique challenge that many immigrants face. My background includes an MSW from Howard Univ. and my unique experience can guide you in making a smooth cultural transition.
(571) 500-9087 View (571) 500-9087
Photo of Linsey Schwartz, Resident in Counseling, MA
Linsey Schwartz
Resident in Counseling, MA
Alexandria, VA 22304
Hello! I am currently an intern under the supervision of Brooke Buck at Cloud Break Therapy.
Hello! I am currently an intern under the supervision of Brooke Buck at Cloud Break Therapy.
(571) 240-5047 View (571) 240-5047
Photo of Jeffrey Brentley - Finding Clarity, LCSW
Finding Clarity
Verified Verified
1 Endorsed
Alexandria, VA 22304
Your mental and emotional health is just as important as your physical health and well being. Just as you would see your primary doctor to maintain your physical health, counseling is here to help maintain your emotional health. I provide counseling to help individuals and their loved ones address various life issues including (but not limited to): Family and marital conflicts, Problems in school, Depression, family separation, Adoption issues, Feelings of anxiety or nervousness, child and adolescent behavioral issues and Addiction issues. Weekend sessions are available.
Your mental and emotional health is just as important as your physical health and well being. Just as you would see your primary doctor to maintain your physical health, counseling is here to help maintain your emotional health. I provide counseling to help individuals and their loved ones address various life issues including (but not limited to): Family and marital conflicts, Problems in school, Depression, family separation, Adoption issues, Feelings of anxiety or nervousness, child and adolescent behavioral issues and Addiction issues. Weekend sessions are available.
(571) 586-9024 x1002 View (571) 586-9024 x1002
Photo of Denise Simpson, Clinical Social Work/Therapist, LCSW
Denise Simpson
Clinical Social Work/Therapist, LCSW
Alexandria, VA 22304
My goal is to help you to identify the issue, process how it may be hindering you and map out a plan for how you can move forward with a "new mind, so you can enjoy a full life." I work best with the individual that is ready to say "I am vulnerable, but I am ready to do the work so I can live my best life." This may be a child or teenager struggling with depression, anxiety, or self-harm or the single mother trying to keep it together, the women who just got divorced and is to move forward, the African American male/female that simply feels misunderstood, the person of faith that's struggling, or one who has challenges within.
My goal is to help you to identify the issue, process how it may be hindering you and map out a plan for how you can move forward with a "new mind, so you can enjoy a full life." I work best with the individual that is ready to say "I am vulnerable, but I am ready to do the work so I can live my best life." This may be a child or teenager struggling with depression, anxiety, or self-harm or the single mother trying to keep it together, the women who just got divorced and is to move forward, the African American male/female that simply feels misunderstood, the person of faith that's struggling, or one who has challenges within.
(571) 540-8202 View (571) 540-8202
Photo of Elaine M Gullotta, Licensed Professional Counselor, MA,, LPC
Elaine M Gullotta
Licensed Professional Counselor, MA,, LPC
Online Only
Are you feeling overwhelmed by constant demands, struggling to find balance and peace? We all do at times. But when those feeling grow and you feel anxious, unworthy, unsure and perplexed about how to get free, then it's time to get some help. Does work, family, and relationships take priority? So much so that even sleep feels like an impossibility? Perhaps you have turned to food, alcohol, shopping or gambling just for some relief? You're not alone, these are common patterns we humans fall into and, guess what? You can unlearn them too. Often all it takes is someone to check-in with, someone you know who cares about you.
Are you feeling overwhelmed by constant demands, struggling to find balance and peace? We all do at times. But when those feeling grow and you feel anxious, unworthy, unsure and perplexed about how to get free, then it's time to get some help. Does work, family, and relationships take priority? So much so that even sleep feels like an impossibility? Perhaps you have turned to food, alcohol, shopping or gambling just for some relief? You're not alone, these are common patterns we humans fall into and, guess what? You can unlearn them too. Often all it takes is someone to check-in with, someone you know who cares about you.
(571) 609-4651 View (571) 609-4651
Photo of Jaimie Harrell, Licensed Professional Counselor, LPC, NCC
Jaimie Harrell
Licensed Professional Counselor, LPC, NCC
3 Endorsed
Alexandria, VA 22304
Not accepting new clients
NOT Accepting New Clients. We often think of childhood as a time of simplicity, joy, curiosity, and play. Yet for many, it is a time of stress, trauma, anxiety, and/or anger. Impulsivity, attention difficulties, learning delays, anxiety, and aggression often impede success at school, disrupt family relationships, and hinder friendships. My goal, as a play therapist, is to assist your child in processing their conflicts and struggles to support balance and peace. By meeting your child in their world of play, they experience being seen and understood, while developing skills of self-regulation, communication, and confidence.
NOT Accepting New Clients. We often think of childhood as a time of simplicity, joy, curiosity, and play. Yet for many, it is a time of stress, trauma, anxiety, and/or anger. Impulsivity, attention difficulties, learning delays, anxiety, and aggression often impede success at school, disrupt family relationships, and hinder friendships. My goal, as a play therapist, is to assist your child in processing their conflicts and struggles to support balance and peace. By meeting your child in their world of play, they experience being seen and understood, while developing skills of self-regulation, communication, and confidence.
(571) 322-8572 View (571) 322-8572
Photo of Beverly Morgan-Fullilove, Clinical Social Work/Therapist, LCSW
Beverly Morgan-Fullilove
Clinical Social Work/Therapist, LCSW
Alexandria, VA 22304
With over 40 years of experience as an LCSW, I specialize in assisting adults facing challenges such as depression, anxiety, PTSD, aging adjustments, trauma, chronic pain or illness, divorce issues, and coping with loss. I also excel in providing therapy tailored to seniors navigating the complexities of aging. Holding credentials as an LCSW in both Virginia and Louisiana, I'm eager to support you on your journey toward healing. I anticipate the opportunity to connect with you soon!
With over 40 years of experience as an LCSW, I specialize in assisting adults facing challenges such as depression, anxiety, PTSD, aging adjustments, trauma, chronic pain or illness, divorce issues, and coping with loss. I also excel in providing therapy tailored to seniors navigating the complexities of aging. Holding credentials as an LCSW in both Virginia and Louisiana, I'm eager to support you on your journey toward healing. I anticipate the opportunity to connect with you soon!
(434) 362-4366 View (434) 362-4366
Photo of Briana Holmes, Supervisee in Clinical Social Work, LSW
Briana Holmes
Supervisee in Clinical Social Work, LSW
Alexandria, VA 22304
Hello, I'm Briana Holmes, presently a Supervisee in Social Work, on the path to becoming a Licensed Clinical Social Worker. With a background in delivering therapeutic interventions across diverse settings, encompassing both inpatient and outpatient environments, I bring a wealth of experience. My dedication lies in supporting young children and adolescents through what can often be a challenging phase marked by profound physical and psychological transformations. My aim is to offer steadfast emotional support and guidance to help navigate any hurdles my clients encounter along the way.
Hello, I'm Briana Holmes, presently a Supervisee in Social Work, on the path to becoming a Licensed Clinical Social Worker. With a background in delivering therapeutic interventions across diverse settings, encompassing both inpatient and outpatient environments, I bring a wealth of experience. My dedication lies in supporting young children and adolescents through what can often be a challenging phase marked by profound physical and psychological transformations. My aim is to offer steadfast emotional support and guidance to help navigate any hurdles my clients encounter along the way.
(703) 215-1126 View (703) 215-1126
Photo of Dr. Karnesha Smith, Clinical Social Work/Therapist, DSW, LCSW
Dr. Karnesha Smith
Clinical Social Work/Therapist, DSW, LCSW
Online Only
Dr. Karnesha L. Smith is a licensed clinical social worker (LCSW) who has been a practicing clinician for over ten years. She believes in building rapport with clients and meeting them where they are. “Come as you are, I will meet you there, and we will figure it out together” is something she often tells her clients, especially those nervous about the therapeutic process. She intentionally creates a safe space to ensure her clients are at ease and comfortable in vulnerable moments. Dr. Smith enjoys working with various populations, including children, adolescents, and adults.
Dr. Karnesha L. Smith is a licensed clinical social worker (LCSW) who has been a practicing clinician for over ten years. She believes in building rapport with clients and meeting them where they are. “Come as you are, I will meet you there, and we will figure it out together” is something she often tells her clients, especially those nervous about the therapeutic process. She intentionally creates a safe space to ensure her clients are at ease and comfortable in vulnerable moments. Dr. Smith enjoys working with various populations, including children, adolescents, and adults.
(571) 240-5393 View (571) 240-5393
Photo of Brooke Buck, Licensed Professional Counselor, MA, LPC
Brooke Buck
Licensed Professional Counselor, MA, LPC
7 Endorsed
Alexandria, VA 22304
Are you having a hard time figuring out what is going on with your relationships with others? Do you have recurring or consistent negative thoughts and feelings about yourself and your future? Are you feeling helpless even though you know you should be doing ok? My name is Brooke Buck and I am here to assist you in breaking down the walls of communication and rebuild them the way you have always wanted to. I work hard to listen and help to provide a different perspective to my clients.
Are you having a hard time figuring out what is going on with your relationships with others? Do you have recurring or consistent negative thoughts and feelings about yourself and your future? Are you feeling helpless even though you know you should be doing ok? My name is Brooke Buck and I am here to assist you in breaking down the walls of communication and rebuild them the way you have always wanted to. I work hard to listen and help to provide a different perspective to my clients.
(703) 594-1966 View (703) 594-1966
Photo of Lily Poulter, Clinical Social Work/Therapist, LCSW
Lily Poulter
Clinical Social Work/Therapist, LCSW
Alexandria, VA 22304
My name is Lily. I was born in Ontario, Canada, but moved to Boulder, Colorado, at a young age. I completed my undergraduate studies at Colorado State University and went on to earn my master’s degree from the University of Denver, with a concentration in mental health and animal-assisted therapy. I discovered my passion for social work early on, which led me to work within the criminal justice system, supporting both adults and juveniles navigating substance use, mental health challenges, and limited support networks.
My name is Lily. I was born in Ontario, Canada, but moved to Boulder, Colorado, at a young age. I completed my undergraduate studies at Colorado State University and went on to earn my master’s degree from the University of Denver, with a concentration in mental health and animal-assisted therapy. I discovered my passion for social work early on, which led me to work within the criminal justice system, supporting both adults and juveniles navigating substance use, mental health challenges, and limited support networks.
(571) 378-5128 View (571) 378-5128
Photo of Dr. Barbara S Wallace, Pastoral Counselor, DMin, MA
Dr. Barbara S Wallace
Pastoral Counselor, DMin, MA
Online Only
Rev. Dr. Barbara S. Wallace provides pastoral counseling services virtually or in person by creating a safe, caring, respectful, and honest environment so you feel relaxed and comfortable sharing. As a licensed minister ordained reverend, I am committed to active listening in a non-judgmental manner to build a trusting space for you to vent, be authentic, identify your feelings, and be empowered because I support you, and God does, too. Isaiah 43:18-19, God tells us to stop dwelling on our past and to look forward with anticipation for the blessings He has for us in our futures. Allow me to help you accept it and hope in God.
Rev. Dr. Barbara S. Wallace provides pastoral counseling services virtually or in person by creating a safe, caring, respectful, and honest environment so you feel relaxed and comfortable sharing. As a licensed minister ordained reverend, I am committed to active listening in a non-judgmental manner to build a trusting space for you to vent, be authentic, identify your feelings, and be empowered because I support you, and God does, too. Isaiah 43:18-19, God tells us to stop dwelling on our past and to look forward with anticipation for the blessings He has for us in our futures. Allow me to help you accept it and hope in God.
(571) 568-7559 View (571) 568-7559
Photo of Mark Murphy, Licensed Professional Counselor
Mark Murphy
Licensed Professional Counselor
Online Only
I have been a Licensed Professional Counselor for over 20 years. In that time I have worked with men, women, teens, and families on a wide variety of issues. Sometimes that work simply involved helping them through a particular incident or life change that overwhelmed them. Other times our work together centered around longstanding issues of depression, anxiety, trauma, and addiction. With years of both institutional and outpatient experience, I enjoy helping people move from a place they can no longer tolerate to a place where they feel more happy and effective. I also provide clinical supervision for LPC residents.
I have been a Licensed Professional Counselor for over 20 years. In that time I have worked with men, women, teens, and families on a wide variety of issues. Sometimes that work simply involved helping them through a particular incident or life change that overwhelmed them. Other times our work together centered around longstanding issues of depression, anxiety, trauma, and addiction. With years of both institutional and outpatient experience, I enjoy helping people move from a place they can no longer tolerate to a place where they feel more happy and effective. I also provide clinical supervision for LPC residents.
(757) 699-4408 View (757) 699-4408

See more therapy options for 22304

How does your Therapist compare?

Number of Therapists in 22304

400+

Average cost per session

$150

Therapists in 22304 who prioritize treating:

95% Anxiety
92% Depression
79% Stress
74% Coping Skills
74% Self Esteem
71% Trauma and PTSD
70% Life Transitions

Average years in practice

12 Years

Top 3 insurances accepted

91% Cigna and Evernorth
88% BlueCross and BlueShield
88% UnitedHealthcare UHC | UBH

How Therapists in 22304 see their clients

55% Online Only
45% In Person and Online

Gender breakdown

85% Female
14% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 22304?

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.