Photo of (Angela) Rose Grillo, LCSW-R, Clinical Social Work/Therapist
(Angela) Rose Grillo
Clinical Social Work/Therapist, LCSW-R
Verified Verified
Online Only
Feelings. "You have a right to your feelings" is an accurate statement. What happens though, when those feelings are so painful and confusing, that it becomes hard to breathe? What happens when those same feelings and emotions are triggered causing you to make choices or behave in a way that scares you or fills you with regret? Your feelings and emotions may be valid, yes, but are they accurate? Maybe. Circumstances change, however the same familiar and painful emotions can reoccur -even though the situation or relationship is different.
Feelings. "You have a right to your feelings" is an accurate statement. What happens though, when those feelings are so painful and confusing, that it becomes hard to breathe? What happens when those same feelings and emotions are triggered causing you to make choices or behave in a way that scares you or fills you with regret? Your feelings and emotions may be valid, yes, but are they accurate? Maybe. Circumstances change, however the same familiar and painful emotions can reoccur -even though the situation or relationship is different.
(703) 936-7461 View (703) 936-7461
Photo of Lauren K. Nickum, LCSW, CSAC, Clinical Social Work/Therapist
Lauren K. Nickum
Clinical Social Work/Therapist, LCSW, CSAC
Verified Verified
1 Endorsed
Alexandria, VA 22315
Are you struggling with anger? Are you lashing out or snapping in the moment only to find yourself feeling guilty and regretful after? Do you stuff down your frustrations so you don't "upset" anyone else, only to find yourself full of resentment and bottled up anger? Are you struggling with anxiety? Do you find yourself stuck in a thought cycle of worry about things that may happen, or worried about how you will feel when you find yourself in a stressful situation? Are you consumed by worry about what others think, or worried that you will embarrass yourself? I am here to listen and help you make a change.
Are you struggling with anger? Are you lashing out or snapping in the moment only to find yourself feeling guilty and regretful after? Do you stuff down your frustrations so you don't "upset" anyone else, only to find yourself full of resentment and bottled up anger? Are you struggling with anxiety? Do you find yourself stuck in a thought cycle of worry about things that may happen, or worried about how you will feel when you find yourself in a stressful situation? Are you consumed by worry about what others think, or worried that you will embarrass yourself? I am here to listen and help you make a change.
(571) 297-1844 View (571) 297-1844
Photo of Julia Humbarger, MS, LMFT, Marriage & Family Therapist
Julia Humbarger
Marriage & Family Therapist, MS, LMFT
Verified Verified
2 Endorsed
Online Only
Not accepting new clients
Hello! I believe individuals have the ability to heal emotional wounds, repair relationships and create a fulfilling life. Together we will work to identify why you feel stuck in order to create new and healthy patterns within your life. I am committed to helping you experience positive change and have a greater sense of personal strength. My goal is to offer ideas for immediate symptom relief as well as life long coping skills to better manage emotions and improve relationships with others. Overall, I will help you find a better balance of mental, physical and emotional health.
Hello! I believe individuals have the ability to heal emotional wounds, repair relationships and create a fulfilling life. Together we will work to identify why you feel stuck in order to create new and healthy patterns within your life. I am committed to helping you experience positive change and have a greater sense of personal strength. My goal is to offer ideas for immediate symptom relief as well as life long coping skills to better manage emotions and improve relationships with others. Overall, I will help you find a better balance of mental, physical and emotional health.
(571) 257-0203 View (571) 257-0203
Photo of Richard P Fleitas, Psychologist
Richard P Fleitas
Psychologist
Verified Verified
2 Endorsed
Alexandria, VA 22315
Are you feeling stuck in your personal or professional life? Do you long for growth but aren’t sure how to navigate the challenges ahead? With over 20 years of experience as a clinical psychologist, I’m here to help you turn obstacles into opportunities. My approach blends practical support with strategic insights to help you uncover your strengths, build resilience, and advance in your leadership journey.
Are you feeling stuck in your personal or professional life? Do you long for growth but aren’t sure how to navigate the challenges ahead? With over 20 years of experience as a clinical psychologist, I’m here to help you turn obstacles into opportunities. My approach blends practical support with strategic insights to help you uncover your strengths, build resilience, and advance in your leadership journey.
(571) 982-8093 View (571) 982-8093
Photo of Lisa Smith, LCSW, Clinical Social Work/Therapist
Lisa Smith
Clinical Social Work/Therapist, LCSW
Verified Verified
Online Only
Hi. I'm Lisa Smith, a Clinical Social Worker. I like our therapy to be a time of creating what next steps you are willing to try. Together we think of the barrier. I act as a coach for accountability with awareness of any diagnosis or past struggles you've had. I highlight your strengths and together we celebrate victories. The therapy I use is research-based. I'll show you the logic and ease of following incremental steps. I will share the traits of your personality or diagnosis that are working for or hindering progress. When plans don't work, we begin again.
Hi. I'm Lisa Smith, a Clinical Social Worker. I like our therapy to be a time of creating what next steps you are willing to try. Together we think of the barrier. I act as a coach for accountability with awareness of any diagnosis or past struggles you've had. I highlight your strengths and together we celebrate victories. The therapy I use is research-based. I'll show you the logic and ease of following incremental steps. I will share the traits of your personality or diagnosis that are working for or hindering progress. When plans don't work, we begin again.
(571) 609-4346 View (571) 609-4346
Photo of Denise Hall, LCSW, Clinical Social Work/Therapist
Denise Hall
Clinical Social Work/Therapist, LCSW
Verified Verified
Online Only
Hello, my name is Denise and I am a Licensed Clinical Social Worker in the state of Virginia. I have been in the behavioral health field for over 28 years working with individuals and families. I have experience in many aspects of therapeutic interventions and work in a person-focused and centered approach. I utilize a relaxed, interactive communication style. My work experience spans in several areas including anxiety, depression, grief, relationship issues, and life transitions, and also have a subspecialty in working with individuals and their family members with Autism.
Hello, my name is Denise and I am a Licensed Clinical Social Worker in the state of Virginia. I have been in the behavioral health field for over 28 years working with individuals and families. I have experience in many aspects of therapeutic interventions and work in a person-focused and centered approach. I utilize a relaxed, interactive communication style. My work experience spans in several areas including anxiety, depression, grief, relationship issues, and life transitions, and also have a subspecialty in working with individuals and their family members with Autism.
(703) 890-5073 View (703) 890-5073
Photo of Marisa Grillo Allnut, LCSW, Clinical Social Work/Therapist
Marisa Grillo Allnut
Clinical Social Work/Therapist, LCSW
Verified Verified
Online Only
Waitlist for new clients
In my years of clinical experience, I have learned that unhealed childhood trauma appears as new wounds in present situations, regardless of age. Healing these wounds is the most important work that a person can do as unresolved trauma extends to all relationships including familial, marital, professional, societal, etc. I know that healing takes compassion and a strong clinical background that guides thinking and supports the therapeutic process. It involves clear boundaries to develop a trusting relationship which enables the client to tolerate the discomfort necessary to do the work to allow healing that brings about change.
In my years of clinical experience, I have learned that unhealed childhood trauma appears as new wounds in present situations, regardless of age. Healing these wounds is the most important work that a person can do as unresolved trauma extends to all relationships including familial, marital, professional, societal, etc. I know that healing takes compassion and a strong clinical background that guides thinking and supports the therapeutic process. It involves clear boundaries to develop a trusting relationship which enables the client to tolerate the discomfort necessary to do the work to allow healing that brings about change.
(202) 937-3876 View (202) 937-3876
Photo of Kennise Baker, Clinical Social Work/Therapist
Kennise Baker
Clinical Social Work/Therapist
Verified Verified
Online Only
Do you just need someone to talk to? A safe, judgement-free space to process the daily stressors of life? Maybe you are less focused on being diagnosed and want to learn how to better manage your emotions, or improve your interpersonal skills. In addition to being that judgement-free listening ear, I would like to offer a holistic, client-centered treatment that empowers you to meet your personal therapy goals.
Do you just need someone to talk to? A safe, judgement-free space to process the daily stressors of life? Maybe you are less focused on being diagnosed and want to learn how to better manage your emotions, or improve your interpersonal skills. In addition to being that judgement-free listening ear, I would like to offer a holistic, client-centered treatment that empowers you to meet your personal therapy goals.
(571) 470-6029 View (571) 470-6029
Photo of Catherine M Eager, MA, LPC-NJ, LPC-DC, LPC-VA, NCC, Licensed Professional Counselor
Catherine M Eager
Licensed Professional Counselor, MA, LPC-NJ, LPC-DC, LPC-VA, NCC
Verified Verified
Online Only
Do you sometimes feel like your worries are running the show? Mild anxiety can feel overwhelming, but it doesn’t have to define your life. You are so much more than your struggles, and finding a therapist who truly sees you—your strengths, your goals, and your potential—can make all the difference. I’m here to help you build skills to manage your worries, feel more in control, and approach life with a renewed sense of calm. My personalized approach means we’ll focus on what works best for you, equipping you with tools to handle challenges, improve your coping strategies, and shift into a space of greater ease and confidence.
Do you sometimes feel like your worries are running the show? Mild anxiety can feel overwhelming, but it doesn’t have to define your life. You are so much more than your struggles, and finding a therapist who truly sees you—your strengths, your goals, and your potential—can make all the difference. I’m here to help you build skills to manage your worries, feel more in control, and approach life with a renewed sense of calm. My personalized approach means we’ll focus on what works best for you, equipping you with tools to handle challenges, improve your coping strategies, and shift into a space of greater ease and confidence.
(571) 487-8160 View (571) 487-8160
Photo of Kimberly Makonnen - Wright Group Counseling, LSATP, Drug & Alcohol Counselor
Wright Group Counseling
Drug & Alcohol Counselor, LSATP
Verified Verified
1 Endorsed
Online Only
Welcome! I am accepting new clients. Whether you’re considering therapy for the first time or returning, finding a provider that you can connect with and develop trust with is important. I work with adolescents, adults and couples to address a range of concerns (e.g. anxiety, depression, trauma, grief, life transitions, relationships, and addictions). I help clients develop greater self-understanding and better relate in relationships.
Welcome! I am accepting new clients. Whether you’re considering therapy for the first time or returning, finding a provider that you can connect with and develop trust with is important. I work with adolescents, adults and couples to address a range of concerns (e.g. anxiety, depression, trauma, grief, life transitions, relationships, and addictions). I help clients develop greater self-understanding and better relate in relationships.
(434) 204-6941 View (434) 204-6941
Photo of Dr. Brandee Zettel, PhD, LMFT, LPC, Marriage & Family Therapist
Dr. Brandee Zettel
Marriage & Family Therapist, PhD, LMFT, LPC
Verified Verified
1 Endorsed
Online Only
Brandee understands that everyone is unique in their own way and she takes time to get to know her clients. She works with couples, families, and individuals. She builds treatment plans that are tailored to the individual or couples and she adapts her therapeutic approach to meet the needs of the clients. Brandee likes to start by helping each client find hope that their situation can improve. She loves working with couples and families helping improve communication and strengthen bonds.
Brandee understands that everyone is unique in their own way and she takes time to get to know her clients. She works with couples, families, and individuals. She builds treatment plans that are tailored to the individual or couples and she adapts her therapeutic approach to meet the needs of the clients. Brandee likes to start by helping each client find hope that their situation can improve. She loves working with couples and families helping improve communication and strengthen bonds.
(571) 200-8452 View (571) 200-8452
Photo of Debra Earp, LCSW, Clinical Social Work/Therapist
Debra Earp
Clinical Social Work/Therapist, LCSW
Verified Verified
Online Only
We all experience challenges in life that are difficult to cope with and hard to overcome. Issues can range from difficulty adjusting to recent changes to more deeply rooted, long standing trauma. Substance abuse, dysfunctional relationships, grief and loss and feelings of emotional insecurity and instability are frequently life limiting issues that can be changed. When we decide to make a change, professional help is advantageous because an outside perspective can be enlightening and it's hard to change ourselves. Humans just want to be comfortable in our own skin.
We all experience challenges in life that are difficult to cope with and hard to overcome. Issues can range from difficulty adjusting to recent changes to more deeply rooted, long standing trauma. Substance abuse, dysfunctional relationships, grief and loss and feelings of emotional insecurity and instability are frequently life limiting issues that can be changed. When we decide to make a change, professional help is advantageous because an outside perspective can be enlightening and it's hard to change ourselves. Humans just want to be comfortable in our own skin.
(703) 215-2968 View (703) 215-2968
Photo of Cristy Russo, PhD, MSCP, Psychologist
Cristy Russo
Psychologist, PhD, MSCP
Verified Verified
Online Only
Welcome! I am glad to help you on your path. My goal is to provide exceptional personalized Neuropsychological & Psychological services. I understand that accessing quality care can be challenging for many individuals. I am committed to providing a deep sense of compassion and dedication to personalized care for people of all ages, no matter where they are located. I am glad to offer online services that make it easier for individuals to receive the care they need in a comfortable and convenient way. I believe in a holistic approach that prioritizes compassionate care and recognizes the unique strengths of each person.
Welcome! I am glad to help you on your path. My goal is to provide exceptional personalized Neuropsychological & Psychological services. I understand that accessing quality care can be challenging for many individuals. I am committed to providing a deep sense of compassion and dedication to personalized care for people of all ages, no matter where they are located. I am glad to offer online services that make it easier for individuals to receive the care they need in a comfortable and convenient way. I believe in a holistic approach that prioritizes compassionate care and recognizes the unique strengths of each person.
(571) 200-7604 View (571) 200-7604
Photo of Dr. Anita Haley Reed - Dr. Anita H. Reed at NobleTrust Consulting, LLC, LCSW, Clinical Social Work/Therapist
Dr. Anita H. Reed at NobleTrust Consulting, LLC
Clinical Social Work/Therapist, LCSW
Verified Verified
Online Only
Sometimes we find ourselves faced with challenges and have difficulty navigating through them. Feeling overwhelmed, defeated, helpless and hopeless, we feel ‘stuck’ and may not know where to start. It is at this time, where help is needed. We will collaborate with you to create an individualized approach that will address your challenges and speak to your strengths and goals. We are compassionate and are adept at facilitating exploration of your thoughts, feelings and actions in an effort to relieve distress, develop insight, improve coping strategies, and have healthier, more satisfying relationships.
Sometimes we find ourselves faced with challenges and have difficulty navigating through them. Feeling overwhelmed, defeated, helpless and hopeless, we feel ‘stuck’ and may not know where to start. It is at this time, where help is needed. We will collaborate with you to create an individualized approach that will address your challenges and speak to your strengths and goals. We are compassionate and are adept at facilitating exploration of your thoughts, feelings and actions in an effort to relieve distress, develop insight, improve coping strategies, and have healthier, more satisfying relationships.
(571) 450-8906 View (571) 450-8906
Photo of Avery Allen, MS, BCBA, LBA
Avery Allen
MS, BCBA, LBA
Verified Verified
2 Endorsed
Alexandria, VA 22315
I have over 11 years working with children, and 5 years working specifically with children who have neurological and developmental disabilities. I am a Board Certificated Behavior Analyst and a Licensed Behavior Analyst in the state of Virginia. I build rapport with my clients and their families, bringing a compassionate, strength-based, holistic approach to behavioral treatment.
I have over 11 years working with children, and 5 years working specifically with children who have neurological and developmental disabilities. I am a Board Certificated Behavior Analyst and a Licensed Behavior Analyst in the state of Virginia. I build rapport with my clients and their families, bringing a compassionate, strength-based, holistic approach to behavioral treatment.
(703) 688-8364 View (703) 688-8364
Photo of Stephanie I Thomopoulos, BCD, C-ASWCM, LCSW, LCSWC, CMC, Clinical Social Work/Therapist
Stephanie I Thomopoulos
Clinical Social Work/Therapist, BCD, C-ASWCM, LCSW, LCSWC, CMC
Verified Verified
Alexandria, VA 22315
Stephanie I. Thomopoulos is President and Founder of GeriatriCare® Management, Inc., a private care management firm founded in 1995 that provides individualized services to people of all ages. Although we specialize in Geriatrics, we also provide mental health services, disease management, legal assistance (Guardianship/Conservatorship, family disputes), pre-disability Care Planning, and Care Management to people of all ages. I have extensive knowledge of community resources and housing options in the Washington DC area. Additional Services include the Friendly Visitor Program, Plan Now/Care Later and Pet Therapy.
Stephanie I. Thomopoulos is President and Founder of GeriatriCare® Management, Inc., a private care management firm founded in 1995 that provides individualized services to people of all ages. Although we specialize in Geriatrics, we also provide mental health services, disease management, legal assistance (Guardianship/Conservatorship, family disputes), pre-disability Care Planning, and Care Management to people of all ages. I have extensive knowledge of community resources and housing options in the Washington DC area. Additional Services include the Friendly Visitor Program, Plan Now/Care Later and Pet Therapy.
(571) 982-8365 x110 View (571) 982-8365 x110
Photo of Martha Rackets, PhD, LMFT, CCTP, Marriage & Family Therapist
Martha Rackets
Marriage & Family Therapist, PhD, LMFT, CCTP
Verified Verified
Online Only
Are you struggling to connect in your relationship? Has communication become challenging and unproductive? Do you feel that you are losing grip on yourself or losing sight of the love in your relationship while life’s stress and challenges swirl around you? I want to help. My practice is dedicated to creating space for couples to process and resolve these very challenges. My role is to help couples make sense of complex situations and emotions that may feel confusing or hurtful. I will guide you through a process of connection, healing, and growth.
Are you struggling to connect in your relationship? Has communication become challenging and unproductive? Do you feel that you are losing grip on yourself or losing sight of the love in your relationship while life’s stress and challenges swirl around you? I want to help. My practice is dedicated to creating space for couples to process and resolve these very challenges. My role is to help couples make sense of complex situations and emotions that may feel confusing or hurtful. I will guide you through a process of connection, healing, and growth.
(571) 603-7798 View (571) 603-7798
Photo of Shaquana Smith, MS, QMHP-C, LGPC, NCC
Shaquana Smith
Resident in Counseling, MS, QMHP-C, LGPC, NCC
Verified Verified
1 Endorsed
Online Only
Hello, My name is Shaquana Smith and I am excited to work with you!  I am committed to providing the best therapeutic services to my clients.  I work within several different modalities which allows me to serve a multitude of clients; children, adolescents, adults, couples and families.  I have enjoyed introducing a variety of techniques and skills that have acted as a vehicle of change for my clients.  I have a deep appreciation for progress as I understand doing the work isn’t always easy.
Hello, My name is Shaquana Smith and I am excited to work with you!  I am committed to providing the best therapeutic services to my clients.  I work within several different modalities which allows me to serve a multitude of clients; children, adolescents, adults, couples and families.  I have enjoyed introducing a variety of techniques and skills that have acted as a vehicle of change for my clients.  I have a deep appreciation for progress as I understand doing the work isn’t always easy.
(703) 239-4836 View (703) 239-4836
Photo of Yudy Wiley, LPC, CSAC, Licensed Professional Counselor
Yudy Wiley
Licensed Professional Counselor, LPC, CSAC
Verified Verified
Online Only
I am a licensed professional counselor with 25 years of experience. I am fluid in English and Spanish. I have a masters degree in counseling. I have worked in many different settings such as outpatient mental health, detoxification, adult detention center, residential substance use treatment, and emergency services. I provide individual therapy. I have worked with people with schizophrenia, anxiety, depression, suicidal ideation, bipolar disorder, substance use, and personality disorder.
I am a licensed professional counselor with 25 years of experience. I am fluid in English and Spanish. I have a masters degree in counseling. I have worked in many different settings such as outpatient mental health, detoxification, adult detention center, residential substance use treatment, and emergency services. I provide individual therapy. I have worked with people with schizophrenia, anxiety, depression, suicidal ideation, bipolar disorder, substance use, and personality disorder.
(703) 483-9665 View (703) 483-9665
Photo of Waseem Amin, MS, Licensed Professional Counselor
Waseem Amin
Licensed Professional Counselor, MS
Verified Verified
Online Only
Managing life challenges can be difficult and exhausting, especially during such strange times as the ones we are living through. In addition to helping you navigate this collective trauma, my goal is to help you unearth your path to authenticity and life satisfaction while working through the obstacles that come up, however they might present themselves.
Managing life challenges can be difficult and exhausting, especially during such strange times as the ones we are living through. In addition to helping you navigate this collective trauma, my goal is to help you unearth your path to authenticity and life satisfaction while working through the obstacles that come up, however they might present themselves.
(402) 749-5760 View (402) 749-5760
1

See more therapy options for 22315

How does your Therapist compare?

Number of Therapists in 22315

60+

Average cost per session

$165

Therapists in 22315 who prioritize treating:

90% Anxiety
85% Depression
82% Self Esteem
74% Coping Skills
70% Relationship Issues
70% Stress
64% Trauma and PTSD

Average years in practice

14 Years

Top 3 insurances accepted

79% BlueCross and BlueShield
64% Aetna
62% UnitedHealthcare UHC | UBH

How Therapists in 22315 see their clients

54% Online Only
46% In Person and Online

Gender breakdown

89% Female
10% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 22315?

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.