Therapists in 44139

Photo of Pamela Anders-Cibik, Licensed Professional Clinical Counselor, LPCC-S
Pamela Anders-Cibik
Licensed Professional Clinical Counselor, LPCC-S
Solon, OH 44139
Is your child struggling with emotional regulation, sibling rivalry, bulling, ADHD, anxiety, divorce, grief, trauma, adoption, self-esteem or academic issues? Trust me, you are not alone. My approach enables children to disclose information in a way that is nonthreatening. I help parents feel sturdier and build stronger relationships with their child. At the other end of the spectrum, I recently started providing individual counseling for senior citizens. Often they are dealing with similar issues of loss, anxiety, family relationships, isolation and ways to continue their lives in a meaningful way.
Is your child struggling with emotional regulation, sibling rivalry, bulling, ADHD, anxiety, divorce, grief, trauma, adoption, self-esteem or academic issues? Trust me, you are not alone. My approach enables children to disclose information in a way that is nonthreatening. I help parents feel sturdier and build stronger relationships with their child. At the other end of the spectrum, I recently started providing individual counseling for senior citizens. Often they are dealing with similar issues of loss, anxiety, family relationships, isolation and ways to continue their lives in a meaningful way.
(440) 664-3019 View (440) 664-3019
Photo of William Victor O'Boyle, Licensed Professional Clinical Counselor, LPCC-S
William Victor O'Boyle
Licensed Professional Clinical Counselor, LPCC-S
Solon, OH 44139
What is the best version of yourself? Picture it, be specific: How do you feel? How do you show up for yourself? How do you treat other people? Becoming your best self means self-discovery, a process that takes courage. Therapy can help you get there. Asking for help is not weakness, it is the ultimate strength. I will provide you a safe space to express your most difficult feelings without shame or guilt. My style is compassionate, genuine, and down-to-earth. We’ll work to help you be mindful and stay in the present moment where solutions are possible, where problems become opportunities.
What is the best version of yourself? Picture it, be specific: How do you feel? How do you show up for yourself? How do you treat other people? Becoming your best self means self-discovery, a process that takes courage. Therapy can help you get there. Asking for help is not weakness, it is the ultimate strength. I will provide you a safe space to express your most difficult feelings without shame or guilt. My style is compassionate, genuine, and down-to-earth. We’ll work to help you be mindful and stay in the present moment where solutions are possible, where problems become opportunities.
(440) 538-1383 View (440) 538-1383
Photo of Jenny Slattery, Clinical Social Work/Therapist, MSW, LISW
Jenny Slattery
Clinical Social Work/Therapist, MSW, LISW
Solon, OH 44139
Wherever you are in your life journey as an adult, grief, loss, anxiety, depression, relationship, work and everyday life stress can often feel overwhelming. My clinical approach works to build a safe, honest, and respectful space to honor whatever you may be going through. I am certified in and have extensive experience using the lens of EMDR therapy.
Wherever you are in your life journey as an adult, grief, loss, anxiety, depression, relationship, work and everyday life stress can often feel overwhelming. My clinical approach works to build a safe, honest, and respectful space to honor whatever you may be going through. I am certified in and have extensive experience using the lens of EMDR therapy.
(440) 571-7801 View (440) 571-7801
Photo of Tanya D Wright, Counselor, MA, LPCC
Tanya D Wright
Counselor, MA, LPCC
1 Endorsed
Solon, OH 44139
I believe that we are meant to experience life in a way that is personally and relationally fulfilling and that many of us need help with this along the way. If you are having problems in your marriage or other relationships, struggling with anxiety, depression, job dissatisfaction, low self-worth, spiritual concerns, or just having a hard time enjoying life, you do not need to search any further for relief. I am equipped to help you identify the root of your problem, teach you the skills needed to change, and walk with you as you begin to experience more fulfillment in your life.
I believe that we are meant to experience life in a way that is personally and relationally fulfilling and that many of us need help with this along the way. If you are having problems in your marriage or other relationships, struggling with anxiety, depression, job dissatisfaction, low self-worth, spiritual concerns, or just having a hard time enjoying life, you do not need to search any further for relief. I am equipped to help you identify the root of your problem, teach you the skills needed to change, and walk with you as you begin to experience more fulfillment in your life.
(440) 709-8075 View (440) 709-8075
Photo of Diamond Williams - Gemstone Wellness Group, Clinical Social Work/Therapist, LISW-S
Gemstone Wellness Group
Clinical Social Work/Therapist, LISW-S
Solon, OH 44139
At Gemstone Wellness Group, we believe mindset is the foundation for change and acceptance. We offer a safe, supportive, and judgment-free space for all. Lead Clinician Diamond Williams is trained in TF-CBT, Motivational Interviewing, and mindfulness. She works with teens, adults, and mothers navigating postpartum and perinatal mental health, addressing anxiety, depression, stress, and more. Clinician Tenia Lee provides a compassionate, collaborative approach, helping clients feel heard, supported, and empowered in their wellness journey. She works with children and adults, addressing anxiety, depression, stress, and more.
At Gemstone Wellness Group, we believe mindset is the foundation for change and acceptance. We offer a safe, supportive, and judgment-free space for all. Lead Clinician Diamond Williams is trained in TF-CBT, Motivational Interviewing, and mindfulness. She works with teens, adults, and mothers navigating postpartum and perinatal mental health, addressing anxiety, depression, stress, and more. Clinician Tenia Lee provides a compassionate, collaborative approach, helping clients feel heard, supported, and empowered in their wellness journey. She works with children and adults, addressing anxiety, depression, stress, and more.
(440) 516-7538 View (440) 516-7538
Photo of Pamela L Gleisser, Clinical Social Work/Therapist, LISW-S, MSSA
Pamela L Gleisser
Clinical Social Work/Therapist, LISW-S, MSSA
1 Endorsed
Solon, OH 44139
I am not able to accept new clients at this time. I feel honored working with individuals who are uncomfortable in their lives and need a safe place to talk. Some have anxiety, depression, bi-polar disorders or cancer. Some have to learn how to cope with shifts in their mental or physical health which bring challenges in their relationships and their abilities to enjoy their lives. Others are being confronted with bereavement, and grief or changes that are difficult for them to cope with alone. My approach is based on 20+ years of experience working in mental health and also in the hospital outpatient clinic.
I am not able to accept new clients at this time. I feel honored working with individuals who are uncomfortable in their lives and need a safe place to talk. Some have anxiety, depression, bi-polar disorders or cancer. Some have to learn how to cope with shifts in their mental or physical health which bring challenges in their relationships and their abilities to enjoy their lives. Others are being confronted with bereavement, and grief or changes that are difficult for them to cope with alone. My approach is based on 20+ years of experience working in mental health and also in the hospital outpatient clinic.
(216) 503-8786 View (216) 503-8786
Photo of Melissa Goldsmith, Psychologist, PhD
Melissa Goldsmith
Psychologist, PhD
Solon, OH 44139
You’re a Millennial or Gen X mom who has tried therapy before, tried coping skills to manage trauma symptoms, but they didn't quite reach the heart of your struggles. The anxiety, the triggers, and overwhelming sense of unease are still there, disrupting your life. You know there's more there, but you don't want to open it up. Inside, you feel exhausted and uncertain. You want to believe healing is possible, but the thought of revisiting your past feels daunting. A part of you is skeptical, thinking "Will this really work?" The fear of facing your trauma is real, but so is the desire to finally break free from it.
You’re a Millennial or Gen X mom who has tried therapy before, tried coping skills to manage trauma symptoms, but they didn't quite reach the heart of your struggles. The anxiety, the triggers, and overwhelming sense of unease are still there, disrupting your life. You know there's more there, but you don't want to open it up. Inside, you feel exhausted and uncertain. You want to believe healing is possible, but the thought of revisiting your past feels daunting. A part of you is skeptical, thinking "Will this really work?" The fear of facing your trauma is real, but so is the desire to finally break free from it.
(440) 306-3467 View (440) 306-3467
Photo of Sharon Hermanowski, Counselor, LPCC-S, MS
Sharon Hermanowski
Counselor, LPCC-S, MS
1 Endorsed
Solon, OH 44139
Everybody has times in their lives when they need help. These times can include periods of loss, transition, and when experiencing overwhelming emotions, or anxiety. I work from the approach of helping people identify and utilize their supports, inner strengths, and resilience to work through these issues. I believe that everyone has a natural capacity to heal and can do so in a supportive and caring therapeutic environment. I have worked in health care in various roles and understand the complexities of working with the health care system and am able to support the mental health of clients navigating their health care.
Everybody has times in their lives when they need help. These times can include periods of loss, transition, and when experiencing overwhelming emotions, or anxiety. I work from the approach of helping people identify and utilize their supports, inner strengths, and resilience to work through these issues. I believe that everyone has a natural capacity to heal and can do so in a supportive and caring therapeutic environment. I have worked in health care in various roles and understand the complexities of working with the health care system and am able to support the mental health of clients navigating their health care.
(216) 930-1925 View (216) 930-1925
Photo of Dr. Ashley Elizabeth Poklar, Psychologist, PhD
Dr. Ashley Elizabeth Poklar
Psychologist, PhD
Solon, OH 44139
There are a lot of expectations on humans of all ages, but particularly on parents and today's youth! As a previous special education teacher, licensed psychologist, and mother of 4, it is no surprise that these expectations often feel overwhelming or insurmountable for us as individuals and for our family units. As a parent, do you need support navigating all that confusing and contradictory parenting advice? Do you have a child in K-12 (or are you a teen) struggling academically or in connecting with others in a way that feels true to yourself? Have you experienced trauma and want to know how it impacts your daily functioning?
There are a lot of expectations on humans of all ages, but particularly on parents and today's youth! As a previous special education teacher, licensed psychologist, and mother of 4, it is no surprise that these expectations often feel overwhelming or insurmountable for us as individuals and for our family units. As a parent, do you need support navigating all that confusing and contradictory parenting advice? Do you have a child in K-12 (or are you a teen) struggling academically or in connecting with others in a way that feels true to yourself? Have you experienced trauma and want to know how it impacts your daily functioning?
(803) 609-0898 View (803) 609-0898
Photo of Mae Bennett, Clinical Social Work/Therapist, MSSA, LISW-S
Mae Bennett
Clinical Social Work/Therapist, MSSA, LISW-S
1 Endorsed
Solon, OH 44139
Life is full of twists, turns, dips, and bridges. We all need support through the challenging moments or for someone to just hold the space while we breath. Perhaps you feel as if you've lost the path completely and need help discovering the new normal.
Life is full of twists, turns, dips, and bridges. We all need support through the challenging moments or for someone to just hold the space while we breath. Perhaps you feel as if you've lost the path completely and need help discovering the new normal.
(440) 467-3822 View (440) 467-3822
Photo of Jenny Eish, Licensed Professional Counselor, LPCC, R-DMT, Somatic, Board C
Jenny Eish
Licensed Professional Counselor, LPCC, R-DMT, Somatic, Board C
Solon, OH 44139
The struggles we face as we travel through life may leave us feeling like a piece of the self has been cracked, chipped away, covered up, or like shadows have formed within one’s self. In relationships it may feel like there is something wrong, but difficult to pinpoint what. Whatever brought you here, you have taken the first step, moving towards becoming more whole and changing your life for the better. Through a collaborative approach, my goal is to help you put the pieces together in a way that feels best to you, so that you may move forward in your life towards a happier and more fulfilling future.
The struggles we face as we travel through life may leave us feeling like a piece of the self has been cracked, chipped away, covered up, or like shadows have formed within one’s self. In relationships it may feel like there is something wrong, but difficult to pinpoint what. Whatever brought you here, you have taken the first step, moving towards becoming more whole and changing your life for the better. Through a collaborative approach, my goal is to help you put the pieces together in a way that feels best to you, so that you may move forward in your life towards a happier and more fulfilling future.
(440) 271-8512 View (440) 271-8512
Photo of Ally Reiter, Clinical Social Work/Therapist, MSW, LISW
Ally Reiter
Clinical Social Work/Therapist, MSW, LISW
Solon, OH 44139
My passion is to see individuals and couples find a means to repair, heal, and improve their mental health and relationships. My professional experience has focused on couples therapy, anxiety/stress management, healthy relationships/boundaries, life transitions, personal growth, and trauma recovery. I strive to offer a supportive and safe atmosphere for clients to explore barriers and work towards healing and growth.
My passion is to see individuals and couples find a means to repair, heal, and improve their mental health and relationships. My professional experience has focused on couples therapy, anxiety/stress management, healthy relationships/boundaries, life transitions, personal growth, and trauma recovery. I strive to offer a supportive and safe atmosphere for clients to explore barriers and work towards healing and growth.
(440) 732-4545 View (440) 732-4545
Elizabeth Bach-Van Valkenburgh
Clinical Social Work/Therapist, LISW-S
1 Endorsed
Solon, OH 44139
My practice specializes in working with adults who are moving through transition; who need support and information to assist them in doing so in a successful, satisfying manner. My clinical focus is on trauma, relationships/couples, the change process across the life span, and divorce.
My practice specializes in working with adults who are moving through transition; who need support and information to assist them in doing so in a successful, satisfying manner. My clinical focus is on trauma, relationships/couples, the change process across the life span, and divorce.
(440) 565-2459 View (440) 565-2459
Photo of Dr. Jason Friedman, Psychologist, PsyD
Dr. Jason Friedman
Psychologist, PsyD
Solon, OH 44139
Dr. Friedman is a clinical psychologist with over 10 years of experience treating children and adolescents in a variety of settings. He specializes in treating anxiety, depression, ADHD, and body image issues. He also uses his background and interest in sports to work with athletes in optimizing their performance. In addition to therapy at his private practice, Dr. Friedman conducts comprehensive autism evaluations at Pivotal ABA Therapy. For additional information on the autism evaluation clinic, please visit our website at https:/pivotalabatherapy.com/autism-assessment-ohio.
Dr. Friedman is a clinical psychologist with over 10 years of experience treating children and adolescents in a variety of settings. He specializes in treating anxiety, depression, ADHD, and body image issues. He also uses his background and interest in sports to work with athletes in optimizing their performance. In addition to therapy at his private practice, Dr. Friedman conducts comprehensive autism evaluations at Pivotal ABA Therapy. For additional information on the autism evaluation clinic, please visit our website at https:/pivotalabatherapy.com/autism-assessment-ohio.
(440) 901-1367 View (440) 901-1367
Photo of Ellen Hartson, Clinical Social Work/Therapist, LISW
Ellen Hartson
Clinical Social Work/Therapist, LISW
Solon, OH 44139
I am a relationship expert with over 30 years of experience helping individuals & couples achieve greater levels of happiness and intimacy in their relationships. Your life history affects the way you love and I will teach you how to 'rewrite' your story using powerful thought changing techniques that actually 'rewire' your brain. You will learn how to develop healthy boundaries by staying in YOUR BUSINESS and stop fixing your partner. You will learn how to eliminate destructive patterns in relationships The result will be an amazing relationship with yourself first and with your partner!
I am a relationship expert with over 30 years of experience helping individuals & couples achieve greater levels of happiness and intimacy in their relationships. Your life history affects the way you love and I will teach you how to 'rewrite' your story using powerful thought changing techniques that actually 'rewire' your brain. You will learn how to develop healthy boundaries by staying in YOUR BUSINESS and stop fixing your partner. You will learn how to eliminate destructive patterns in relationships The result will be an amazing relationship with yourself first and with your partner!
(440) 374-8136 View (440) 374-8136
Photo of Mary Anne Ricci, Counselor, MA, LPCC
Mary Anne Ricci
Counselor, MA, LPCC
Solon, OH 44139
My approach as a therapist is to join you in successfully reaching the goals of repairing/resolving conflict, lessening distress and pain, solving problems, and creating well being. We all search for ways to improve our lives and find satisfaction and fulfillment. I work to build a caring, safe, honest and respectful counseling relationship in order for you to repair, heal and achieve your goals.
My approach as a therapist is to join you in successfully reaching the goals of repairing/resolving conflict, lessening distress and pain, solving problems, and creating well being. We all search for ways to improve our lives and find satisfaction and fulfillment. I work to build a caring, safe, honest and respectful counseling relationship in order for you to repair, heal and achieve your goals.
(440) 305-5658 View (440) 305-5658
Photo of Caren Nowak - Caren Nowak, LISW-S, Clinical Social Work/Therapist, LISWS
Caren Nowak, LISW-S
Clinical Social Work/Therapist, LISWS
Solon, OH 44139
I love my work, primarily because of the admiration and respect I have for my clients. It takes a lot of courage to begin therapy and attempt to look at oneself more honestly. I have beautiful, serene offices that are conducive to feeling comfortable. I provide a very positive and caring approach in my work with clients. I believe that focusing on one's strengths is important since most of us struggle with negative feelings about ourselves.
I love my work, primarily because of the admiration and respect I have for my clients. It takes a lot of courage to begin therapy and attempt to look at oneself more honestly. I have beautiful, serene offices that are conducive to feeling comfortable. I provide a very positive and caring approach in my work with clients. I believe that focusing on one's strengths is important since most of us struggle with negative feelings about ourselves.
(330) 866-0905 View (330) 866-0905
Photo of Stacey Taylor, Clinical Social Work/Therapist, MSSA, LISW-S
Stacey Taylor
Clinical Social Work/Therapist, MSSA, LISW-S
Solon, OH 44139
Mental health can make us feel alone. My aim is to walk alongside and support your healing and transformative growth. With therapy, we will develop goals and learn ways to deal with mental health. My overall hope is to help you uncover and resolve any underlying cause affecting your ability to have the most optimal functioning day to day. I have experience serving all ages across many backgrounds, and I have specific expertise working with teens. I have experience working with various mental health concerns and have been implementing EMDR to address trauma which can help to restore more positive beliefs about the self.
Mental health can make us feel alone. My aim is to walk alongside and support your healing and transformative growth. With therapy, we will develop goals and learn ways to deal with mental health. My overall hope is to help you uncover and resolve any underlying cause affecting your ability to have the most optimal functioning day to day. I have experience serving all ages across many backgrounds, and I have specific expertise working with teens. I have experience working with various mental health concerns and have been implementing EMDR to address trauma which can help to restore more positive beliefs about the self.
(440) 581-1866 View (440) 581-1866
Photo of Corey Maddox, Drug & Alcohol Counselor, MA, LICDC, CS
Corey Maddox
Drug & Alcohol Counselor, MA, LICDC, CS
1 Endorsed
Solon, OH 44139
Anyone who feels overwhelmed and exhausted by life's demands, I want you to feel supported and help you regain control of your life. Depression can make everything feel heavy or like a chore. Trauma, panic, and anxiety can be crippling and hold you back from everyday experiences. Substance use causes far more problems than it solves. I want each of my patients to feel that they are not just surviving, but they are back to living the life they desire. I am here to listen, and I am here to help by developing coping skills that better manage your emotions and concerns.
Anyone who feels overwhelmed and exhausted by life's demands, I want you to feel supported and help you regain control of your life. Depression can make everything feel heavy or like a chore. Trauma, panic, and anxiety can be crippling and hold you back from everyday experiences. Substance use causes far more problems than it solves. I want each of my patients to feel that they are not just surviving, but they are back to living the life they desire. I am here to listen, and I am here to help by developing coping skills that better manage your emotions and concerns.
(440) 762-6378 View (440) 762-6378
Photo of Monica Yost Kiss, Clinical Social Work/Therapist, MPH, MSW, LISW-S
Monica Yost Kiss
Clinical Social Work/Therapist, MPH, MSW, LISW-S
7 Endorsed
Solon, OH 44139
Welcome! I'm often described as very “real” and genuine as I communicate with candor & humor to help others feel comfortable and engage in therapy. I use a direct yet compassionate approach to empower clients to identify strengths, needs and goals to improve their mental health & well-being. Over the past 20 years I've provided counseling & advocacy services for people navigating significant life transitions, identity shifts, trauma, relationship problems, health concerns, family changes and caregiver stress. As well as those managing Anxiety, Depression, Bipolar, PTSD, Development Disabilities, and Neurodiversity such as ADHD.
Welcome! I'm often described as very “real” and genuine as I communicate with candor & humor to help others feel comfortable and engage in therapy. I use a direct yet compassionate approach to empower clients to identify strengths, needs and goals to improve their mental health & well-being. Over the past 20 years I've provided counseling & advocacy services for people navigating significant life transitions, identity shifts, trauma, relationship problems, health concerns, family changes and caregiver stress. As well as those managing Anxiety, Depression, Bipolar, PTSD, Development Disabilities, and Neurodiversity such as ADHD.
(216) 242-1495 View (216) 242-1495

See more therapy options for 44139

How does your Therapist compare?

Number of Therapists in 44139

100+

Average cost per session

$150

Therapists in 44139 who prioritize treating:

91% Anxiety
88% Depression
79% Relationship Issues
72% Trauma and PTSD
70% Self Esteem
63% Stress
61% Grief

Average years in practice

13 Years

Top 3 insurances accepted

90% Aetna
82% Medical Mutual
74% UnitedHealthcare UHC | UBH

How Therapists in 44139 see their clients

78% In Person and Online
22% Online Only

Gender breakdown

89% Female
11% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 44139?

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.