Photo of Mary Rodman, LCSW, Clinical Social Work/Therapist
Mary Rodman
Clinical Social Work/Therapist, LCSW
Verified Verified
Brookneal, VA 24528
Mary Jouett Rodman, LCSW, graduated from Jane Addams College of Social Work at The University of Illinois at Chicago. Mary encompasses a holistic approach when identifying and treating the macro and micro needs of the community. Mary is focused on creating sustainable healing by incorporating strength-based systems of care. As a clinical social worker, her treatment approach includes motivational interviewing, integrating self-compassion principles, embodied practices, and a person-centered treatment approach.
Mary Jouett Rodman, LCSW, graduated from Jane Addams College of Social Work at The University of Illinois at Chicago. Mary encompasses a holistic approach when identifying and treating the macro and micro needs of the community. Mary is focused on creating sustainable healing by incorporating strength-based systems of care. As a clinical social worker, her treatment approach includes motivational interviewing, integrating self-compassion principles, embodied practices, and a person-centered treatment approach.
(757) 337-5443 View (757) 337-5443

More Therapists Nearby

Photo of Margaret Geroe, LCSW, Clinical Social Work/Therapist
Margaret Geroe
Clinical Social Work/Therapist, LCSW
Verified Verified
Evington, VA 24550
I want to start by saying kudos to you for putting yourself out here and looking for a therapist. My name is Maggie, and I am a licensed clinical social worker. The main concerns I work with are depression, anxiety, suicidal ideation, grief, stress, and life transitions. The primary modalities I use in my practice are Cognitive Behavioral Therapy, Narrative Therapy, and Solution Focused Brief Therapy. I believe that through our journey together, I can assist you with managing anxiety, depression, chronic illness, stress, and other challenges.
I want to start by saying kudos to you for putting yourself out here and looking for a therapist. My name is Maggie, and I am a licensed clinical social worker. The main concerns I work with are depression, anxiety, suicidal ideation, grief, stress, and life transitions. The primary modalities I use in my practice are Cognitive Behavioral Therapy, Narrative Therapy, and Solution Focused Brief Therapy. I believe that through our journey together, I can assist you with managing anxiety, depression, chronic illness, stress, and other challenges.
(703) 596-1261 View (703) 596-1261
Photo of Heather Duncan, LPC, Licensed Professional Counselor
Heather Duncan
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Concord, VA 24538  (Online Only)
I'm Heather Duncan, a Licensed Professional Counselor in the state of Virginia, with 6 years of outpatient counseling and assessment experience, alongside 14 years of working with severely mentally ill individuals in various community mental health agencies. I specialize in a range of issues, including depression, anxiety, grief, trauma, relationship concerns, major life transitions, men’s and women’s issues, peri and post-natal challenges, as well as chronic pain and chronic illnesses.
I'm Heather Duncan, a Licensed Professional Counselor in the state of Virginia, with 6 years of outpatient counseling and assessment experience, alongside 14 years of working with severely mentally ill individuals in various community mental health agencies. I specialize in a range of issues, including depression, anxiety, grief, trauma, relationship concerns, major life transitions, men’s and women’s issues, peri and post-natal challenges, as well as chronic pain and chronic illnesses.
(434) 505-4852 View (434) 505-4852
Photo of Andre Allsopp, LCSW, Clinical Social Work/Therapist
Andre Allsopp
Clinical Social Work/Therapist, LCSW
Verified Verified
Lennig, VA 24577
I am a Licensed Clinical Social Working with over 16 years of experience with adults 18 years of age and older who struggle with Depression, Anxiety, and extreme life-changing events. My experience tells me that there is not a ""cookie-cutter" approach to therapy and every individual/couple is equally as unique as they are similar. That is why I have an eclectic approach to therapy, utilizing Cognitive Behavioral Therapy from a strengths-based perspective, always considering the person(s) in their environment.
I am a Licensed Clinical Social Working with over 16 years of experience with adults 18 years of age and older who struggle with Depression, Anxiety, and extreme life-changing events. My experience tells me that there is not a ""cookie-cutter" approach to therapy and every individual/couple is equally as unique as they are similar. That is why I have an eclectic approach to therapy, utilizing Cognitive Behavioral Therapy from a strengths-based perspective, always considering the person(s) in their environment.
(757) 414-9840 View (757) 414-9840
Photo of Cassandra Johnson, LCSW, Clinical Social Work/Therapist
Cassandra Johnson
Clinical Social Work/Therapist, LCSW
Verified Verified
Concord, VA 24538  (Online Only)
I am Cassandra Johnson, but you can call me Cassie. I am an experienced Licensed Clinical Social Worker and Registered Nurse (LCSW, RN) with more than 20 years of experience in holistic care, combining clinical counseling and health care in my practice. I am passionate about helping children, adolescents, adults, and couples address their unique challenges and live more fulfilled lives. I specialize in mood disorders, depression, anxiety, grief, trauma, relationship issues, and major life transitions.
I am Cassandra Johnson, but you can call me Cassie. I am an experienced Licensed Clinical Social Worker and Registered Nurse (LCSW, RN) with more than 20 years of experience in holistic care, combining clinical counseling and health care in my practice. I am passionate about helping children, adolescents, adults, and couples address their unique challenges and live more fulfilled lives. I specialize in mood disorders, depression, anxiety, grief, trauma, relationship issues, and major life transitions.
(434) 404-5061 View (434) 404-5061
Photo of Ashly Bradley, LPC, Licensed Professional Counselor
Ashly Bradley
Licensed Professional Counselor, LPC
Verified Verified
Concord, VA 24538
I'm Ashly Bradley, a Licensed Professional Counselor (LPC) in Virginia with over 10 years of experience working with children, adolescents, and families across various settings. My primary focus has been in school-based therapeutic programs, where I've provided services such as therapeutic day treatment, school-based outpatient therapy, group therapy, and individual therapy. I specialize in supporting clients dealing with ADHD, depression, anxiety, trauma, grief and loss, and various life stressors.
I'm Ashly Bradley, a Licensed Professional Counselor (LPC) in Virginia with over 10 years of experience working with children, adolescents, and families across various settings. My primary focus has been in school-based therapeutic programs, where I've provided services such as therapeutic day treatment, school-based outpatient therapy, group therapy, and individual therapy. I specialize in supporting clients dealing with ADHD, depression, anxiety, trauma, grief and loss, and various life stressors.
(434) 577-8236 View (434) 577-8236
Photo of Amelia Jacokes, LCSW, Clinical Social Work/Therapist
Amelia Jacokes
Clinical Social Work/Therapist, LCSW
Verified Verified
Concord, VA 24538
Do you want to learn more about yourself and how you walk through life? Do you experience difficulties in areas that others seem to have a relatively easy time managing? I’m a licensed clinical social worker in Virginia and California (license numbers: VA: 0904013582, CA: 99619). I spent my internship years working with dementia patients as well as gaining experience with the chronic pain population. By working in the intensive outpatient program environment,
Do you want to learn more about yourself and how you walk through life? Do you experience difficulties in areas that others seem to have a relatively easy time managing? I’m a licensed clinical social worker in Virginia and California (license numbers: VA: 0904013582, CA: 99619). I spent my internship years working with dementia patients as well as gaining experience with the chronic pain population. By working in the intensive outpatient program environment,
(757) 517-8409 View (757) 517-8409
Photo of Mandy Jensen, MA, LPC, Licensed Professional Counselor
Mandy Jensen
Licensed Professional Counselor, MA, LPC
Verified Verified
1 Endorsed
Rustburg, VA 24588
Mandy is a licensed professional counselor in the Commonwealth of Virginia and a National Certified Counselor. She has completed her Bachelors degree in Psychology, along with her Master’s degree in clinical mental health counseling from Liberty University. She has had the honor with working with a variety of populations including children, adolescents, adults and couples for over the past five years. Mandy has experience working with different mental and behavioral needs such as trauma, depression, anxiety, divorce, aggression and others. Mandy utilizes a variety of clinical approaches in her practice. Each
Mandy is a licensed professional counselor in the Commonwealth of Virginia and a National Certified Counselor. She has completed her Bachelors degree in Psychology, along with her Master’s degree in clinical mental health counseling from Liberty University. She has had the honor with working with a variety of populations including children, adolescents, adults and couples for over the past five years. Mandy has experience working with different mental and behavioral needs such as trauma, depression, anxiety, divorce, aggression and others. Mandy utilizes a variety of clinical approaches in her practice. Each
(434) 406-4951 View (434) 406-4951
Photo of Melissa Futreal, LCSW, Clinical Social Work/Therapist
Melissa Futreal
Clinical Social Work/Therapist, LCSW
Verified Verified
Pamplin, VA 23958
I began helping others in 1990 as a Peer Counselor (Drug Exemption NCO) while on active duty in the Marine Corps. After earning degrees in Psychology and Social Work at UNCW/ECU, I obtained licensure to practice independently with the Virginia Board of Health Professionals in 2004. I am originally from the Hampton Roads area but have worked internationally with people from many different backgrounds. I have continued to support the military, as well as the community at large, for over 3 decades with evidence-based treatments for trauma (PTSD).
I began helping others in 1990 as a Peer Counselor (Drug Exemption NCO) while on active duty in the Marine Corps. After earning degrees in Psychology and Social Work at UNCW/ECU, I obtained licensure to practice independently with the Virginia Board of Health Professionals in 2004. I am originally from the Hampton Roads area but have worked internationally with people from many different backgrounds. I have continued to support the military, as well as the community at large, for over 3 decades with evidence-based treatments for trauma (PTSD).
(571) 506-7969 View (571) 506-7969
Photo of Krystal Scott, LCSW, Clinical Social Work/Therapist
Krystal Scott
Clinical Social Work/Therapist, LCSW
Verified Verified
Long Island, VA 24569
Hi I am Krystal Scott, LCSW in the state of VA. I use a variety of approaches combined based upon the individual's needs. The focus area of practice is working with adults and elderly that suffer with mental illness and/or addiction. The types of clients I typically work with are adults typically 25 and up along with the geriatric populations. Most of the individual suffer from past traumas, day-to-day life stressors, addictions, and unstable persistent mental illnesses.
Hi I am Krystal Scott, LCSW in the state of VA. I use a variety of approaches combined based upon the individual's needs. The focus area of practice is working with adults and elderly that suffer with mental illness and/or addiction. The types of clients I typically work with are adults typically 25 and up along with the geriatric populations. Most of the individual suffer from past traumas, day-to-day life stressors, addictions, and unstable persistent mental illnesses.
(757) 854-9826 View (757) 854-9826
Photo of Keshawna Tiggle, LPC, Licensed Professional Counselor
Keshawna Tiggle
Licensed Professional Counselor, LPC
Verified Verified
Spout Spring, VA 24593
My name is Keshawna Tiggle and I'm a Licensed Professional Counseling (LPC) in Virginia. My approach to therapy is very much person-centered. Clients are in control of their lives and treatment and I'm here to support through the use of various empathetic interventions. I have years of experience working with individuals, who struggle with various mood disorders, anxiety, depression, suicidal ideation, self-harm, depression, life changes, school challenges, self-esteem, etc.
My name is Keshawna Tiggle and I'm a Licensed Professional Counseling (LPC) in Virginia. My approach to therapy is very much person-centered. Clients are in control of their lives and treatment and I'm here to support through the use of various empathetic interventions. I have years of experience working with individuals, who struggle with various mood disorders, anxiety, depression, suicidal ideation, self-harm, depression, life changes, school challenges, self-esteem, etc.
(804) 889-2952 View (804) 889-2952
Photo of Debra Crowder, Licensed Professional Counselor
Debra Crowder
Licensed Professional Counselor
Verified Verified
Rustburg, VA 24588
Are you are feeling sad, irritable or empty? Do you have trouble concentrating? Have you had a panic attack? What about nightmares or disturbing recollections of past frightening events? If so, therapy can help. Adolescents and adults who have experienced abuse, neglect, violence, bullying, loss of a loved one, divorce, or relationship problems can find relief through therapy.
Are you are feeling sad, irritable or empty? Do you have trouble concentrating? Have you had a panic attack? What about nightmares or disturbing recollections of past frightening events? If so, therapy can help. Adolescents and adults who have experienced abuse, neglect, violence, bullying, loss of a loved one, divorce, or relationship problems can find relief through therapy.
(434) 201-7401 View (434) 201-7401
Photo of Shannon Paige, LCSW, Clinical Social Work/Therapist
Shannon Paige
Clinical Social Work/Therapist, LCSW
Verified Verified
Gladys, VA 24554
Finding someone to share your experiences with, whom you can trust is an important step in your journey. I believe challenging times and experiences offer you the greatest potential to create the life you have wanted and dreamt of. While reaching out for help is often the first and most difficult steps to initiating change in our lives and moving toward wholeness, I am so glad that you are here! I have worked with clients experiencing a wide range of struggles including depression, anxiety, schizophrenia, relationship issues, grief and loss, career challenges, marital problems, trauma, secuality, PTSD and personality disorders.
Finding someone to share your experiences with, whom you can trust is an important step in your journey. I believe challenging times and experiences offer you the greatest potential to create the life you have wanted and dreamt of. While reaching out for help is often the first and most difficult steps to initiating change in our lives and moving toward wholeness, I am so glad that you are here! I have worked with clients experiencing a wide range of struggles including depression, anxiety, schizophrenia, relationship issues, grief and loss, career challenges, marital problems, trauma, secuality, PTSD and personality disorders.
(804) 391-0677 View (804) 391-0677
Photo of Patricia G Dugger, MEd, LPC, Licensed Professional Counselor
Patricia G Dugger
Licensed Professional Counselor, MEd, LPC
Verified Verified
Rustburg, VA 24588
I am Certified as a therapist in the Adolescent Community Reinforcement Approach(ACRA) in helping teens and families with substance use problems. Dialectical Behavior therapy is a model useful for addictions, cutting, and mood disorders. Attachment based family therapy, and Trauma Focused Cognitive Behavior therapy.
I am Certified as a therapist in the Adolescent Community Reinforcement Approach(ACRA) in helping teens and families with substance use problems. Dialectical Behavior therapy is a model useful for addictions, cutting, and mood disorders. Attachment based family therapy, and Trauma Focused Cognitive Behavior therapy.
View
Photo of Kendra Rascoe, LPC, Licensed Professional Counselor
Kendra Rascoe
Licensed Professional Counselor, LPC
Verified Verified
Gladys, VA 24554
My name is Kendra Rascoe, and I am a Licensed Professional Counselor (LPC) and graduated from Liberty University with an M.A. in Marriage and Family Therapy. I work with clients in Virginia statewide through telehealth. I work with adults, adolescents, and children. I specialize in anxiety, stress, life transitions, and relationships. I utilize an integrative and person-centered approach using a combination of theories such as Cognitive Behavioral Therapy (CBT), Motivational Interviewing, Family systems, and Solution-focused.
My name is Kendra Rascoe, and I am a Licensed Professional Counselor (LPC) and graduated from Liberty University with an M.A. in Marriage and Family Therapy. I work with clients in Virginia statewide through telehealth. I work with adults, adolescents, and children. I specialize in anxiety, stress, life transitions, and relationships. I utilize an integrative and person-centered approach using a combination of theories such as Cognitive Behavioral Therapy (CBT), Motivational Interviewing, Family systems, and Solution-focused.
(757) 859-9660 View (757) 859-9660
Photo of Berkley Holston, MA, LPC, Licensed Professional Counselor
Berkley Holston
Licensed Professional Counselor, MA, LPC
Verified Verified
1 Endorsed
Rustburg, VA 24588
Waitlist for new clients
I was born and raised in Lynchburg, Virginia, but have had the amazing opportunity to live and work all over the country including: Washington, DC; New Orleans, LA; Miami, FL and Boulder, CO. Lynchburg is by far my favorite place and I was happy to return home in 2005. I enjoy cooking, gardening, reading and spending time with my family and friends. I'm a Licensed Professional Counselor (LPC). I graduated from the University of Northern Colorado in 2003 with an undergraduate degree in Psychology and a Masters degree in Community Counseling with an emphasis in Marriage and Family Counseling.
I was born and raised in Lynchburg, Virginia, but have had the amazing opportunity to live and work all over the country including: Washington, DC; New Orleans, LA; Miami, FL and Boulder, CO. Lynchburg is by far my favorite place and I was happy to return home in 2005. I enjoy cooking, gardening, reading and spending time with my family and friends. I'm a Licensed Professional Counselor (LPC). I graduated from the University of Northern Colorado in 2003 with an undergraduate degree in Psychology and a Masters degree in Community Counseling with an emphasis in Marriage and Family Counseling.
(434) 277-2074 View (434) 277-2074
Photo of Lora Dudley, LCSW, Clinical Social Work/Therapist
Lora Dudley
Clinical Social Work/Therapist, LCSW
Verified Verified
Concord, VA 24538  (Online Only)
I am a Licensed Clinical Social Worker (LCSW) with over 10 years of experience providing clinical assessment and therapeutic care to adults and couples seeking assistance with depression, anxiety, trauma, life transitions, and post-traumatic stress. I completed my Master of Social Work (MSW) at Radford University.
I am a Licensed Clinical Social Worker (LCSW) with over 10 years of experience providing clinical assessment and therapeutic care to adults and couples seeking assistance with depression, anxiety, trauma, life transitions, and post-traumatic stress. I completed my Master of Social Work (MSW) at Radford University.
(434) 505-5094 View (434) 505-5094
Photo of Vanessa Fox, MA, Pre-Licensed Professional
Vanessa Fox
Pre-Licensed Professional, MA
Verified Verified
Rustburg, VA 24588
I'm passionate about helping clients work through trauma/PTSD, anxiety & panic attacks, interpersonal relationship concerns, depression, loneliness, perfectionism, dysfunctional family systems, people-pleasing, communication issues, multicultural identity concerns, faith struggles, and ADHD. I strive to take the time to engage with each person’s unique personality and story and believe that healing isn’t one-size-fits-all. I take a holistic and client-centered approach to therapy - meaning focus is on you as a whole person and reviewing your goals and concerns.
I'm passionate about helping clients work through trauma/PTSD, anxiety & panic attacks, interpersonal relationship concerns, depression, loneliness, perfectionism, dysfunctional family systems, people-pleasing, communication issues, multicultural identity concerns, faith struggles, and ADHD. I strive to take the time to engage with each person’s unique personality and story and believe that healing isn’t one-size-fits-all. I take a holistic and client-centered approach to therapy - meaning focus is on you as a whole person and reviewing your goals and concerns.
(434) 278-6004 View (434) 278-6004
Photo of Stephanie Messerly, MA, LMFT, LPC, Marriage & Family Therapist
Stephanie Messerly
Marriage & Family Therapist, MA, LMFT, LPC
Verified Verified
Rustburg, VA 24588
Stephanie's 10 years in the mental health field has given her the opportunity to serve and counsel individuals, couples, and families working through depression, anxiety, marital stress, trauma, family strain, self harm, and suicidal ideation. She has worked on hospital psychiatric units and outpatient offices. She is trained as a facilitator in the premarital/marital assessment tools and education from SYMBIS, PREPARE/ENRICH, and Level I Gottman Training. She is trained in EMDR and uses it with clients working through trauma. Stephanie is also an AAMFT supervisor candidate who supervises students and residents.
Stephanie's 10 years in the mental health field has given her the opportunity to serve and counsel individuals, couples, and families working through depression, anxiety, marital stress, trauma, family strain, self harm, and suicidal ideation. She has worked on hospital psychiatric units and outpatient offices. She is trained as a facilitator in the premarital/marital assessment tools and education from SYMBIS, PREPARE/ENRICH, and Level I Gottman Training. She is trained in EMDR and uses it with clients working through trauma. Stephanie is also an AAMFT supervisor candidate who supervises students and residents.
(434) 595-3734 View (434) 595-3734
Photo of Paula Cooks, LPC, Licensed Professional Counselor
Paula Cooks
Licensed Professional Counselor, LPC
Verified Verified
Clover, VA 24534
I am Dr. Paula Cooks; I am a Christian that believes in the holistic approach to managing the mental health needs of my clients. I use humanistic and existential therapeutic modalities. I believe that the individual, couple, or family has the unconscious resolution to aid in returning to homeostasis. My focus is on managing and improving the mental health status of individuals, families, and couples seeking relief from environmental, situational, and life stressors.
I am Dr. Paula Cooks; I am a Christian that believes in the holistic approach to managing the mental health needs of my clients. I use humanistic and existential therapeutic modalities. I believe that the individual, couple, or family has the unconscious resolution to aid in returning to homeostasis. My focus is on managing and improving the mental health status of individuals, families, and couples seeking relief from environmental, situational, and life stressors.
(804) 531-4284 View (804) 531-4284

How does your Therapist compare?

Number of Therapists in 24528

< 10

Therapists in 24528 who prioritize treating:

100% Depression
100% Anxiety
100% ADHD
100% Eating Disorders
100% Behavioral Issues
100% Coping Skills
100% Self Esteem

Top 3 insurances accepted

100% Aetna
100% BlueCross and BlueShield
100% Coventry

How Therapists in 24528 see their clients

100% In Person and Online

Gender breakdown

100% Female
FAQs - About Therapy and Counseling

How can I find a therapist in 24528?

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.