Therapists in 43231

Jeannine Vegh
Marriage & Family Therapist, MA, IMFT
2 Endorsed
Columbus, OH 43231
Hello, I value good customer service and so I am doing in-person only. My clients appreciate this. It is the only way, I feel, we can spend quality time together. Healing the inner child is a process that combines work on the mind, body and spirit. If we focus only on one aspect of this process, we are continuing to neglect that which has brought harm to us. We are only healing one half or one third of our whole being. Being brave enough to consider psychotherapy is a step toward choosing to become a better person, (or partner) choosing to heal or nurture your soul.
Hello, I value good customer service and so I am doing in-person only. My clients appreciate this. It is the only way, I feel, we can spend quality time together. Healing the inner child is a process that combines work on the mind, body and spirit. If we focus only on one aspect of this process, we are continuing to neglect that which has brought harm to us. We are only healing one half or one third of our whole being. Being brave enough to consider psychotherapy is a step toward choosing to become a better person, (or partner) choosing to heal or nurture your soul.
(614) 702-2579 View (614) 702-2579
Holly Smith
Counselor, LPCC-S, LICDCCS, MA-AT
Columbus, OH 43231
I founded Clarity Counseling Services to offer quality, unique services that combine traditional therapy techniques with creative expression. I have worked in the therapy field for over 20 years as a provider licensed in both addiction treatment and mental health. I understand how suffering is often multi-faceted and can adapt treatment that addresses your specific needs, strengths, and goals. My approach is trauma informed and focused on building trust, safety, and openness. I can help you build the skills not only to feel better, but to create the long term changes for the life you want.
I founded Clarity Counseling Services to offer quality, unique services that combine traditional therapy techniques with creative expression. I have worked in the therapy field for over 20 years as a provider licensed in both addiction treatment and mental health. I understand how suffering is often multi-faceted and can adapt treatment that addresses your specific needs, strengths, and goals. My approach is trauma informed and focused on building trust, safety, and openness. I can help you build the skills not only to feel better, but to create the long term changes for the life you want.
(380) 777-8819 View (380) 777-8819
Yvonne Judge
Marriage & Family Therapist, IMFT, CCHt, MAMFT
3 Endorsed
Columbus, OH 43231
I am a couples, trauma, and Personality Disorder specialist, as well as an AAMFT approved supervisor. I work with individuals, couples, and families who are often successful in parts of their lives but struggling in others such as their relationships. Most have already tried to fix the problem, or have been in therapy, without lasting change. The issue is rarely lack of effort. It is knowing what to do and how to apply it. This is not cookie cutter therapy. The work is selected and adapted based on what will actually be effective for you.
I am a couples, trauma, and Personality Disorder specialist, as well as an AAMFT approved supervisor. I work with individuals, couples, and families who are often successful in parts of their lives but struggling in others such as their relationships. Most have already tried to fix the problem, or have been in therapy, without lasting change. The issue is rarely lack of effort. It is knowing what to do and how to apply it. This is not cookie cutter therapy. The work is selected and adapted based on what will actually be effective for you.
(614) 892-9813 View (614) 892-9813
Keith Vukasinovich
Counselor, MSEd, MS, LPCC-S, 500-RYT
1 Endorsed
Columbus, OH 43231
My ideal clients are people who feel stuck under the weight of stress, anxiety, grief, or trauma—whether the pain is recent or something they’ve carried for years. Many are high-functioning on the outside but internally feel depleted, on edge, or emotionally disconnected. They’re ready for practical, evidence-informed tools to calm the nervous system, make sense of what happened, and shift patterns that keep showing up in relationships, work, and daily life. Together, we work toward lasting change: greater clarity, steadier confidence, and a more grounded, integrated way of living.
My ideal clients are people who feel stuck under the weight of stress, anxiety, grief, or trauma—whether the pain is recent or something they’ve carried for years. Many are high-functioning on the outside but internally feel depleted, on edge, or emotionally disconnected. They’re ready for practical, evidence-informed tools to calm the nervous system, make sense of what happened, and shift patterns that keep showing up in relationships, work, and daily life. Together, we work toward lasting change: greater clarity, steadier confidence, and a more grounded, integrated way of living.
(937) 672-1424 View (937) 672-1424
Shukri Mohamed Hussain
Counselor, MA, Trainee
1 Endorsed
Serves Area
If you’ve been holding things together for everyone else, quietly managing stress, worry, or pain, therapy can be the space where you finally exhale. You deserve support that honors your story, your culture, and your values. As a Somali, Black, Muslim counselor, I understand how identity, faith, family, and lived experience shape the way we move through the world. I deeply value cultural humility and welcome clients from all backgrounds and belief systems. Whether we share similar experiences or come from different perspectives, I am committed to creating a respectful, inclusive space where you feel seen, heard, and understood.
If you’ve been holding things together for everyone else, quietly managing stress, worry, or pain, therapy can be the space where you finally exhale. You deserve support that honors your story, your culture, and your values. As a Somali, Black, Muslim counselor, I understand how identity, faith, family, and lived experience shape the way we move through the world. I deeply value cultural humility and welcome clients from all backgrounds and belief systems. Whether we share similar experiences or come from different perspectives, I am committed to creating a respectful, inclusive space where you feel seen, heard, and understood.
(614) 756-2357 View (614) 756-2357
Ellen Seigel
Clinical Social Work/Therapist, LISW-S, LCSW, ACHT, Coach
Serves Area
Worried? Working hard for others' happiness; taking care of others - you come last or not at all? Swallowing the bad behavior of others, not to rock the boat? Sick of living up to the expectations of others? Anxious, sad, irritated, even angry? The negative effects of these experiences can be DISSOLVED. You can adopt a new perspective that includes profound self appreciation and become free inside and confident in new ways to handle situations. Showing you how and helping you do this, is my specialty. The approach is with softness, gentleness and respect for your unique emotional growth needs.
Worried? Working hard for others' happiness; taking care of others - you come last or not at all? Swallowing the bad behavior of others, not to rock the boat? Sick of living up to the expectations of others? Anxious, sad, irritated, even angry? The negative effects of these experiences can be DISSOLVED. You can adopt a new perspective that includes profound self appreciation and become free inside and confident in new ways to handle situations. Showing you how and helping you do this, is my specialty. The approach is with softness, gentleness and respect for your unique emotional growth needs.
(614) 914-4908 View (614) 914-4908
Taylor Matthews
Licensed Professional Counselor, MA, LPC
3 Endorsed
Serves Area
I work with individuals caught in cycles of anxiety & perfectionism, difficult life circumstances, grief, & navigating the emotional weight of infertility or pregnancy loss. You may feel stuck in your thoughts, disconnected from your body, or exhausted from trying to hold everything together. As a loss mom myself, I bring both personal understanding & clinical care to this work, integrating EMDR and self-compassion to help clients process grief and rebuild trust in themselves. I also offer premarital counseling using the Prepare/Enrich assessment to help couples strengthen communication & build a strong foundation for marriage.
I work with individuals caught in cycles of anxiety & perfectionism, difficult life circumstances, grief, & navigating the emotional weight of infertility or pregnancy loss. You may feel stuck in your thoughts, disconnected from your body, or exhausted from trying to hold everything together. As a loss mom myself, I bring both personal understanding & clinical care to this work, integrating EMDR and self-compassion to help clients process grief and rebuild trust in themselves. I also offer premarital counseling using the Prepare/Enrich assessment to help couples strengthen communication & build a strong foundation for marriage.
(614) 482-1816 View (614) 482-1816
Areej Elhassan
Licensed Social Worker, MSW, LSW
Serves Area
Welcome! I’m glad you’re here. As a therapist, I specialize in supporting women, children, at-risk teenagers, and individuals who have experienced trauma, domestic violence, or are in addiction recovery. I have a particular passion for working with women of color and immigrants, recognizing the unique challenges and strengths that come with these experiences. My goal is to create a safe and nurturing environment where you can feel heard, understood, and empowered on your journey toward healing and growth. Together, we can explore your experiences and work towards a brighter future. I look forward to partnering with you!
Welcome! I’m glad you’re here. As a therapist, I specialize in supporting women, children, at-risk teenagers, and individuals who have experienced trauma, domestic violence, or are in addiction recovery. I have a particular passion for working with women of color and immigrants, recognizing the unique challenges and strengths that come with these experiences. My goal is to create a safe and nurturing environment where you can feel heard, understood, and empowered on your journey toward healing and growth. Together, we can explore your experiences and work towards a brighter future. I look forward to partnering with you!
(614) 656-7025 View (614) 656-7025
Lara K Palay
Clinical Social Work/Therapist, MSW, LISW-S
Serves Area
I have 30 years in private practice, have taught and published books about trauma and burnout. My approach is eclectic: neuroscience, movement/yoga and brain-body connection, Eastern philosophy, mindfulness, compassion, and meaning. My personal style is warm and straightforward. I consider therapy to be a partnership with the client, and my goal is to provide a safe space to gain insight, create mindfulness and calm in your life. We work together to build coping skills, and to make practical, manageable changes to meet your goals. My work is an essential way that I experience meaning and connection, and I am honored to do it.
I have 30 years in private practice, have taught and published books about trauma and burnout. My approach is eclectic: neuroscience, movement/yoga and brain-body connection, Eastern philosophy, mindfulness, compassion, and meaning. My personal style is warm and straightforward. I consider therapy to be a partnership with the client, and my goal is to provide a safe space to gain insight, create mindfulness and calm in your life. We work together to build coping skills, and to make practical, manageable changes to meet your goals. My work is an essential way that I experience meaning and connection, and I am honored to do it.
(614) 389-9146 View (614) 389-9146
Spader Psychological Services, LLC
Psychologist, PsyD, BCBA-D, COBA
Serves Area
I've been a licensed psychologist for almost 20 years, specializing in Psychological Evaluation for ADHD and learning disabilities for those ages 6-60. If you are concerned about learning or attention problems (including Dyslexia) in yourself or your child, I welcome you to contact me. Other testing services include giftedness and school admissions. I also really enjoy providing therapy to adult women seeking help with anxiety, self-esteem, relationships (friends and romantic), job stress, grief, and parenting. I have a child with a serious heart defect and would love to help if you need similar support.
I've been a licensed psychologist for almost 20 years, specializing in Psychological Evaluation for ADHD and learning disabilities for those ages 6-60. If you are concerned about learning or attention problems (including Dyslexia) in yourself or your child, I welcome you to contact me. Other testing services include giftedness and school admissions. I also really enjoy providing therapy to adult women seeking help with anxiety, self-esteem, relationships (friends and romantic), job stress, grief, and parenting. I have a child with a serious heart defect and would love to help if you need similar support.
(614) 532-4197 View (614) 532-4197
Joy Elizabeth Childs
Licensed Professional Counselor, LPCC
Serves Area
I strongly believes that every individual is worthy of dignity and respect. I follow a person-centered collaborative approach when conducting therapy and seek to offer unconditional positive regard with all my clients. I can provide helpful tools to cope, build your awareness and knowledge of mental health concerns, give a safe nonjudgmental space to process thoughts and emotions, help reshape negative patterns of thought and behavior, build successful relationship, heal from past wounds, and provide appropriate and helpful resources.
I strongly believes that every individual is worthy of dignity and respect. I follow a person-centered collaborative approach when conducting therapy and seek to offer unconditional positive regard with all my clients. I can provide helpful tools to cope, build your awareness and knowledge of mental health concerns, give a safe nonjudgmental space to process thoughts and emotions, help reshape negative patterns of thought and behavior, build successful relationship, heal from past wounds, and provide appropriate and helpful resources.
(614) 304-3320 View (614) 304-3320
Areej Elhassan
Licensed Social Worker, MSW, LSW
Serves Area
Welcome! I’m glad you’re here. As a therapist, I specialize in supporting women, children, at-risk teenagers, and individuals who have experienced trauma, domestic violence, or are in addiction recovery. I have a particular passion for working with women of color and immigrants, recognizing the unique challenges and strengths that come with these experiences. My goal is to create a safe and nurturing environment where you can feel heard, understood, and empowered on your journey toward healing and growth. Together, we can explore your experiences and work towards a brighter future. I look forward to partnering with you!
Welcome! I’m glad you’re here. As a therapist, I specialize in supporting women, children, at-risk teenagers, and individuals who have experienced trauma, domestic violence, or are in addiction recovery. I have a particular passion for working with women of color and immigrants, recognizing the unique challenges and strengths that come with these experiences. My goal is to create a safe and nurturing environment where you can feel heard, understood, and empowered on your journey toward healing and growth. Together, we can explore your experiences and work towards a brighter future. I look forward to partnering with you!
(614) 656-7025 View (614) 656-7025
Lillian Haddad
Counselor, LPCC, MACMHC
2 Endorsed
Online Only
Life can be hard, even when it looks like you're doing everything right. Inside, you might feel overwhelmed, stretched thin, or stuck in patterns that aren't working. Maybe you're carrying a lot for others, navigating relationship stress, or adjusting to a life transition that has taken more out of you than expected. You don't have to do this alone. I help adults, young adults, teens, and parents make sense of what they are going through, break patterns that aren't working, and move forwards with more clarity, confidence, and peace.
Life can be hard, even when it looks like you're doing everything right. Inside, you might feel overwhelmed, stretched thin, or stuck in patterns that aren't working. Maybe you're carrying a lot for others, navigating relationship stress, or adjusting to a life transition that has taken more out of you than expected. You don't have to do this alone. I help adults, young adults, teens, and parents make sense of what they are going through, break patterns that aren't working, and move forwards with more clarity, confidence, and peace.
(614) 618-4432 View (614) 618-4432
Nana Anim-Boateng
Licensed Professional Counselor, MA, LPC
1 Endorsed
Online Only
Not accepting new clients
If you’re longing for a space where you don’t have to hold everything together, where you can exhale and be met with understanding, you’re in the right place. I support adults navigating anxiety, depression, life transitions, relationship challenges, and stress related to work, family, or identity. Many clients come in feeling overwhelmed or unsure of their next step. My hope is that this becomes a place where you feel seen, heard, and met where you are. Together, we’ll build coping skills, deepen emotional awareness, and create meaningful change in a way that honors your pace and your story.
If you’re longing for a space where you don’t have to hold everything together, where you can exhale and be met with understanding, you’re in the right place. I support adults navigating anxiety, depression, life transitions, relationship challenges, and stress related to work, family, or identity. Many clients come in feeling overwhelmed or unsure of their next step. My hope is that this becomes a place where you feel seen, heard, and met where you are. Together, we’ll build coping skills, deepen emotional awareness, and create meaningful change in a way that honors your pace and your story.
(614) 541-1637 View (614) 541-1637
Kendall Blumenthal
Licensed Professional Clinical Counselor , LPCC, LCPC, LPC
Online Only
Our lives are always changing and can be a rollercoaster! Regardless of what your life has thrown at you over the years, it is never too late or too early to start working on yourself. From day-to-day stressors to the loss of a loved one to relationship concerns and anything in between, there is always something going on! I believe that therapy is a collaborative journey where we will work together to uncover underlying issues and develop practical strategies for your growth and healing. Let's create a safe and non-judgmental space where you can freely explore your thoughts and emotions!
Our lives are always changing and can be a rollercoaster! Regardless of what your life has thrown at you over the years, it is never too late or too early to start working on yourself. From day-to-day stressors to the loss of a loved one to relationship concerns and anything in between, there is always something going on! I believe that therapy is a collaborative journey where we will work together to uncover underlying issues and develop practical strategies for your growth and healing. Let's create a safe and non-judgmental space where you can freely explore your thoughts and emotions!
(220) 235-3857 View (220) 235-3857
Aida Diallo
Clinical Social Work/Therapist, LISW
Online Only
I am a Licensed Independent Social Worker (LISW) providing virtual therapy for individuals, families, and groups. I strive to create a safe and supportive space for healing, growth, and connection. I specialize in working with African and immigrant communities, with a particular focus on youth, women, and families navigating life transitions, cultural identity, and intergenerational challenges.
I am a Licensed Independent Social Worker (LISW) providing virtual therapy for individuals, families, and groups. I strive to create a safe and supportive space for healing, growth, and connection. I specialize in working with African and immigrant communities, with a particular focus on youth, women, and families navigating life transitions, cultural identity, and intergenerational challenges.
(614) 349-3474 View (614) 349-3474
Vicki Fetterman
Clinical Social Work/Therapist, LISW-S
1 Endorsed
Online Only
Waitlist for new clients
I'm a Licensed Independent Social Worker with a supervisory endorsement (LISW-S) in Ohio and am a white, queer, mid-size, cisgender woman. I adopt a relaxed, client-led, and collaborative therapeutic style. I believe in creating a non-judgmental space where clients feel seen and heard, recognizing they are the experts of their experiences. My approach is trauma-informed, feminist, and culturally humble, aiming to help clients live authentically and heal the parts of their stories that get in the way of that goal. I seek out regular feedback to ensure clients' needs are met and that they feel safe being open and vulnerable
I'm a Licensed Independent Social Worker with a supervisory endorsement (LISW-S) in Ohio and am a white, queer, mid-size, cisgender woman. I adopt a relaxed, client-led, and collaborative therapeutic style. I believe in creating a non-judgmental space where clients feel seen and heard, recognizing they are the experts of their experiences. My approach is trauma-informed, feminist, and culturally humble, aiming to help clients live authentically and heal the parts of their stories that get in the way of that goal. I seek out regular feedback to ensure clients' needs are met and that they feel safe being open and vulnerable
(740) 762-4843 View (740) 762-4843
Leah Thornton
Licensed Professional Counselor, LPCC
Serves Area
Not accepting new clients
I specialize in treating various populations such as those with Anxiety disorders, Depressive disorders, Trauma/PTSD, Adjustment disorders and other life stressors. I also work with individuals who have phobias, mild-moderate OCD symptoms, as well as social and self-confidence issues. In addition, I have experience with childhood disorders including ADHD, ODD, and high-functioning Autism/Asperger's. I enjoy working with adults, adolescents, and children, and I use an individualized and collaborative approach to treatment.
I specialize in treating various populations such as those with Anxiety disorders, Depressive disorders, Trauma/PTSD, Adjustment disorders and other life stressors. I also work with individuals who have phobias, mild-moderate OCD symptoms, as well as social and self-confidence issues. In addition, I have experience with childhood disorders including ADHD, ODD, and high-functioning Autism/Asperger's. I enjoy working with adults, adolescents, and children, and I use an individualized and collaborative approach to treatment.
(614) 368-0206 View (614) 368-0206
Jessica Messersmith-Miller
Clinical Social Work/Therapist, MSW, LISW-S
Online Only
Are you tired of being sick and tired? Are you struggling with chronic relapses and not sure why? Do you have goals but need some guidance to help you reach them? I can help! I am a Licensed Independent Social Worker and owner of Serenity Counseling Services. I specialize in Assessments and Diagnosis, Addiction, Dual Diagnosis, Anxiety, Depression, PTSD, Health and Wellness, Life Coaching, Grief/Bereavement, Relationships, and Co-Dependency for adults; individuals, couples, and families. I strive to provide the best treatment approach tailored to each individual which may include Cognitive Behavioral Therapy, Motivational Interviewing, Person Centered Therapy, and Solution Focused Therapy.
Are you tired of being sick and tired? Are you struggling with chronic relapses and not sure why? Do you have goals but need some guidance to help you reach them? I can help! I am a Licensed Independent Social Worker and owner of Serenity Counseling Services. I specialize in Assessments and Diagnosis, Addiction, Dual Diagnosis, Anxiety, Depression, PTSD, Health and Wellness, Life Coaching, Grief/Bereavement, Relationships, and Co-Dependency for adults; individuals, couples, and families. I strive to provide the best treatment approach tailored to each individual which may include Cognitive Behavioral Therapy, Motivational Interviewing, Person Centered Therapy, and Solution Focused Therapy.
(614) 304-3182 View (614) 304-3182
Courtney Bargola
Licensed Professional Clinical Counselor, MEd, LPCC-S
Online Only
Do you have racing thoughts that make it hard to concentrate? Is the past making it hard to focus on the present? I work with adults to overcome anxiety and trauma of all kinds. Anxiety and trauma are common and therapy allows you feel at peace again. I offer online therapy so you can have appointments from wherever you feel most comfortable. All you need is a computer or smartphone, and the desire to feel better.
Do you have racing thoughts that make it hard to concentrate? Is the past making it hard to focus on the present? I work with adults to overcome anxiety and trauma of all kinds. Anxiety and trauma are common and therapy allows you feel at peace again. I offer online therapy so you can have appointments from wherever you feel most comfortable. All you need is a computer or smartphone, and the desire to feel better.
(740) 693-0501 View (740) 693-0501

See more therapy options for 43231

How does your Therapist compare?

Number of Therapists in 43231

20+

Average cost per session

$150

Therapists in 43231 who prioritize treating:

95% Stress
90% Anxiety
90% Social Anxiety
90% Health Anxiety
90% Driving Anxiety
86% Depression
86% Trauma and PTSD

Average years in practice

8 Years

Top 3 insurances accepted

100% Aetna
88% Cigna and Evernorth
82% Anthem

How Therapists in 43231 see their clients

62% In Person and Online
38% Online Only

Gender breakdown

95% Female
5% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 43231?

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.