Photo of Marlon L Johnson, LPCC-S, LICDC
Marlon L Johnson
Licensed Professional Clinical Counselor, LPCC-S, LICDC
Verified Verified
Brooklyn, OH 44144
He has experience providing treatment to adolescents, adults, couples, families and the LBGTQ+ community. His scope of practice includes, but is not limited to, working with issues related to anxiety, depression, self-esteem, trauma, substance use disorder, or with a dual diagnoses.
He has experience providing treatment to adolescents, adults, couples, families and the LBGTQ+ community. His scope of practice includes, but is not limited to, working with issues related to anxiety, depression, self-esteem, trauma, substance use disorder, or with a dual diagnoses.
(440) 693-3262 View (440) 693-3262
Photo of undefined - Onyx - ADHD Treatment Simplified, MSN, APRN, FNP-BC
Onyx - ADHD Treatment Simplified
MSN, APRN, FNP-BC
Verified Verified
1 Endorsed
Brooklyn, OH 44144
Unlock Your Potential with Onyx ADHD Treatment! Do you feel like ADHD is holding you back from achieving your goals? At Onyx, we specialize in helping adults with ADHD lead more fulfilling and productive lives. Our tailored approach, supported by experienced healthcare professionals, ensures you receive the personalized care you deserve. We offer stimulant and non-stimulant treatment options and are available to Ohio and New York State residents!
Unlock Your Potential with Onyx ADHD Treatment! Do you feel like ADHD is holding you back from achieving your goals? At Onyx, we specialize in helping adults with ADHD lead more fulfilling and productive lives. Our tailored approach, supported by experienced healthcare professionals, ensures you receive the personalized care you deserve. We offer stimulant and non-stimulant treatment options and are available to Ohio and New York State residents!
(216) 284-6215 View (216) 284-6215
Photo of Ted Morris, DNP, APRN, FNP-BC
Ted Morris
DNP, APRN, FNP-BC
Verified Verified
1 Endorsed
Brooklyn, OH 44144
Navigating diverse health challenges, my sanctuary is for those facing ADHD, Depression, Anxiety, or OUD. Uniquely, I offer medication management, a service rare among Psychology Today providers. Whether you seek comprehensive care tailored to your needs or specialized guidance, here, personalization is key. Clients find a blend of empathy, trust, and acknowledgment of their uniqueness. Balancing scientific expertise with compassion, I’m committed to guiding you through your health journey, ensuring your care is as individual as you are.
Navigating diverse health challenges, my sanctuary is for those facing ADHD, Depression, Anxiety, or OUD. Uniquely, I offer medication management, a service rare among Psychology Today providers. Whether you seek comprehensive care tailored to your needs or specialized guidance, here, personalization is key. Clients find a blend of empathy, trust, and acknowledgment of their uniqueness. Balancing scientific expertise with compassion, I’m committed to guiding you through your health journey, ensuring your care is as individual as you are.
(216) 465-0658 View (216) 465-0658
Photo of Victoria Byler - Therapist For Men, MS Ed, LPCC, EMDR
Victoria Byler - Therapist For Men
Licensed Professional Clinical Counselor, MS Ed, LPCC, EMDR
Verified Verified
4 Endorsed
Cleveland, OH 44144  (Online Only)
Do you feel like you'll burden your family if you show your emotions? Is wearing the armor feeling exhausting? Tired of putting on a happy face to hide anxiety, anger, or feeling like an imposter? Take control and build the resilience you need to thrive in all areas of life. High achievers often hide emotions, but chronic stress takes a toll. We understand the pressures you face. Let's work together to improve communication, manage stress, and achieve a greater sense of well-being.
Do you feel like you'll burden your family if you show your emotions? Is wearing the armor feeling exhausting? Tired of putting on a happy face to hide anxiety, anger, or feeling like an imposter? Take control and build the resilience you need to thrive in all areas of life. High achievers often hide emotions, but chronic stress takes a toll. We understand the pressures you face. Let's work together to improve communication, manage stress, and achieve a greater sense of well-being.
(330) 325-4526 View (330) 325-4526
Photo of Olena Sowers, LCPC, Licensed Professional Counselor
Olena Sowers
Licensed Professional Counselor, LCPC
Verified Verified
Cleveland, OH 44144
Making the decision to find help is hard enough. That is why my goal in counseling is to create a place where you feel safe enough to tell your story. I am Olena Sowers, LPCC, and while I work with many concerns, I specialize in trauma and PTSD and EMDR. I have worked with a variety of client concerns, from anxiety, foster care and adoption to addiction, family conflict, anger, and others. I specialize in trauma and PTSD and am trained in EMDR. I have experience working with individuals who survived physical, sexual, and emotional abuse and neglect, assault, first responders, veterans, motor vehicle accident victims, and many more.
Making the decision to find help is hard enough. That is why my goal in counseling is to create a place where you feel safe enough to tell your story. I am Olena Sowers, LPCC, and while I work with many concerns, I specialize in trauma and PTSD and EMDR. I have worked with a variety of client concerns, from anxiety, foster care and adoption to addiction, family conflict, anger, and others. I specialize in trauma and PTSD and am trained in EMDR. I have experience working with individuals who survived physical, sexual, and emotional abuse and neglect, assault, first responders, veterans, motor vehicle accident victims, and many more.
(440) 901-1192 View (440) 901-1192
Photo of Olena Sowers, LCPC
Olena Sowers
Licensed Professional Clinical Counselor, LCPC
Verified Verified
Cleveland, OH 44144
Making the decision to find help is hard enough. That is why my goal in counseling is to create a place where you feel safe enough to tell your story. I am Olena Sowers, LPCC, and while I work with many concerns, I specialize in trauma and PTSD and EMDR. I have worked with a variety of client concerns, from anxiety, foster care and adoption to addiction, family conflict, anger, and others. I specialize in trauma and PTSD and am trained in EMDR. I have experience working with individuals who survived physical, sexual, and emotional abuse and neglect, assault, first responders, veterans, motor vehicle accident victims, and many more.
Making the decision to find help is hard enough. That is why my goal in counseling is to create a place where you feel safe enough to tell your story. I am Olena Sowers, LPCC, and while I work with many concerns, I specialize in trauma and PTSD and EMDR. I have worked with a variety of client concerns, from anxiety, foster care and adoption to addiction, family conflict, anger, and others. I specialize in trauma and PTSD and am trained in EMDR. I have experience working with individuals who survived physical, sexual, and emotional abuse and neglect, assault, first responders, veterans, motor vehicle accident victims, and many more.
(216) 303-6692 View (216) 303-6692
Photo of Deborah Smith, LISW, Clinical Social Work/Therapist
Deborah Smith
Clinical Social Work/Therapist, LISW
Verified Verified
Cleveland, OH 44144
Hi! My name is Deborah, and I am a Licensed Independent Social Worker. I work with children, adolescents, and adults and specialize in anxiety, depression, complex trauma, parenting, autism, bipolar disorder, and more. I aim to create a safe environment and build a trusting, nourishing relationship where you can start your journey of healing and growth. I work with children, adolescents, and adults and specialize in anxiety, depression, complex trauma, parenting, autism, bipolar disorder, behavioral challenges, and more.
Hi! My name is Deborah, and I am a Licensed Independent Social Worker. I work with children, adolescents, and adults and specialize in anxiety, depression, complex trauma, parenting, autism, bipolar disorder, and more. I aim to create a safe environment and build a trusting, nourishing relationship where you can start your journey of healing and growth. I work with children, adolescents, and adults and specialize in anxiety, depression, complex trauma, parenting, autism, bipolar disorder, behavioral challenges, and more.
(440) 664-2502 View (440) 664-2502
Photo of Deborah Smith, LISW, Clinical Social Work/Therapist
Deborah Smith
Clinical Social Work/Therapist, LISW
Verified Verified
Cleveland, OH 44144
Hi! My name is Deborah, and I am a Licensed Independent Social Worker. I work with children, adolescents, and adults and specialize in anxiety, depression, complex trauma, parenting, autism, bipolar disorder, and more. I aim to create a safe environment and build a trusting, nourishing relationship where you can start your journey of healing and growth. I work with children, adolescents, and adults and specialize in anxiety, depression, complex trauma, parenting, autism, bipolar disorder, behavioral challenges, and more.
Hi! My name is Deborah, and I am a Licensed Independent Social Worker. I work with children, adolescents, and adults and specialize in anxiety, depression, complex trauma, parenting, autism, bipolar disorder, and more. I aim to create a safe environment and build a trusting, nourishing relationship where you can start your journey of healing and growth. I work with children, adolescents, and adults and specialize in anxiety, depression, complex trauma, parenting, autism, bipolar disorder, behavioral challenges, and more.
(216) 465-6329 View (216) 465-6329
Photo of Susan Havens, LCPC
Susan Havens
Licensed Professional Clinical Counselor, LCPC
Verified Verified
Cleveland, OH 44144
Hello, I am Susan Havens LPCC-S. I have over 20 years of counseling experience. I enjoy working with trauma, PTSD my goal is to strengthen my clients to be more productive in life. Just want to help the hurting that may have been too afraid to ask for help or people that was told nothing was wrong with them.
Hello, I am Susan Havens LPCC-S. I have over 20 years of counseling experience. I enjoy working with trauma, PTSD my goal is to strengthen my clients to be more productive in life. Just want to help the hurting that may have been too afraid to ask for help or people that was told nothing was wrong with them.
(440) 664-1561 View (440) 664-1561
Photo of Susan Havens, LCPC, Counselor
Susan Havens
Counselor, LCPC
Verified Verified
Cleveland, OH 44144
Hello, I am Susan Havens LPCC-S. I have over 20 years of counseling experience. I enjoy working with trauma, PTSD my goal is to strengthen my clients to be more productive in life. Just want to help the hurting that may have been too afraid to ask for help or people that was told nothing was wrong with them.
Hello, I am Susan Havens LPCC-S. I have over 20 years of counseling experience. I enjoy working with trauma, PTSD my goal is to strengthen my clients to be more productive in life. Just want to help the hurting that may have been too afraid to ask for help or people that was told nothing was wrong with them.
(216) 750-3159 View (216) 750-3159
Photo of undefined - Lamplight Counseling Services LLC
Lamplight Counseling Services LLC
Verified Verified
2 Endorsed
Brooklyn, OH 44144
Depression, Anger, and Frustration can creep up on us without warning. No matter what the challenge, our licensed clinicians can help you gain an understanding of what is happening and implement coping skills to help you feel back in control. Our clients come to us with challenges, including Trauma, Anxiety, Depression, Work difficulties, Family Concerns, and Substance Abuse Difficulties. We desire to see each person's goals achieved in a way that helps foster both growth and self-confidence.
Depression, Anger, and Frustration can creep up on us without warning. No matter what the challenge, our licensed clinicians can help you gain an understanding of what is happening and implement coping skills to help you feel back in control. Our clients come to us with challenges, including Trauma, Anxiety, Depression, Work difficulties, Family Concerns, and Substance Abuse Difficulties. We desire to see each person's goals achieved in a way that helps foster both growth and self-confidence.
(216) 279-5494 View (216) 279-5494
Photo of undefined - Brian Nowak LPCC, LPCC-S, LICDC
Brian Nowak LPCC
Licensed Professional Clinical Counselor, LPCC-S, LICDC
Verified Verified
Brooklyn, OH 44144
I believe that all people struggle with signs and symptoms of stress, anxiety and/or depression at some point in their lives. We are social creatures and we need to feel a sense of community or belonging with others. We need to feel connected with those people who are willing to listen, share their life experiences, and guide us to a better way of coping with the uncertainties of life. This is the reason I entered the counseling profession; to be that safe harbor in the storm. Whether you see me or another therapist, please know that you do not have to struggle on your own.
I believe that all people struggle with signs and symptoms of stress, anxiety and/or depression at some point in their lives. We are social creatures and we need to feel a sense of community or belonging with others. We need to feel connected with those people who are willing to listen, share their life experiences, and guide us to a better way of coping with the uncertainties of life. This is the reason I entered the counseling profession; to be that safe harbor in the storm. Whether you see me or another therapist, please know that you do not have to struggle on your own.
(216) 446-7060 View (216) 446-7060
Photo of Marika Courtney, LCPC, Psychologist
Marika Courtney
Psychologist, LCPC
Verified Verified
Cleveland, OH 44144
My name is Marika Courtney and I am a Licensed Professional Clinical Counselor in the state of Ohio. I work with both individuals and couples ages 18 and over. I work with people who are struggling with transitions in their lives, such as career changes, relationship changes, parenting, aging, and anything else that feels scary and exciting all at the same time. I am a Christian and invite faith into sessions when the clients express their desire.
My name is Marika Courtney and I am a Licensed Professional Clinical Counselor in the state of Ohio. I work with both individuals and couples ages 18 and over. I work with people who are struggling with transitions in their lives, such as career changes, relationship changes, parenting, aging, and anything else that feels scary and exciting all at the same time. I am a Christian and invite faith into sessions when the clients express their desire.
(440) 968-5490 View (440) 968-5490
Photo of Brigette Ruszkowski, LPCC
Brigette Ruszkowski
Licensed Professional Clinical Counselor, LPCC
Verified Verified
Cleveland, OH 44144
I am a licensed clinical counselor. I love to work with people who are struggling with depression, anxiety, and substance abuse issues. Life transition and relationship difficulties are also areas where I can help. I prefer to work with clients who are motivated to help themselves and understand it's their therapy session. I meet the clients where they are at. My go-to treatment modalities are CBT. I am non-judgmental, empathetic, and kind. I feel that a collaborative approach toward treatment goals is essential. I love people working with people. Guiding them toward healthy positive changes is the most rewarding aspect of my job.
I am a licensed clinical counselor. I love to work with people who are struggling with depression, anxiety, and substance abuse issues. Life transition and relationship difficulties are also areas where I can help. I prefer to work with clients who are motivated to help themselves and understand it's their therapy session. I meet the clients where they are at. My go-to treatment modalities are CBT. I am non-judgmental, empathetic, and kind. I feel that a collaborative approach toward treatment goals is essential. I love people working with people. Guiding them toward healthy positive changes is the most rewarding aspect of my job.
(440) 390-4923 View (440) 390-4923
Photo of Samantha Lakes, LISW-S, Clinical Social Work/Therapist
Samantha Lakes
Clinical Social Work/Therapist, LISW-S
Verified Verified
Cleveland, OH 44144
Hello, my name is Sam Lakes, LISW-S. I received my Master’s Degree in Social Work from Miami University/Wright State in 2015 and obtained my Independent Social Work license in 2020, with my Supervision designation in 2022. I firmly believe in a client-centered environment where it’s my job to meet you where you are and walk alongside you. I provide services with a trauma-informed approach with feelings that a strong therapeutic relationship and processing can help individuals overcome their current symptoms or changes in life.
Hello, my name is Sam Lakes, LISW-S. I received my Master’s Degree in Social Work from Miami University/Wright State in 2015 and obtained my Independent Social Work license in 2020, with my Supervision designation in 2022. I firmly believe in a client-centered environment where it’s my job to meet you where you are and walk alongside you. I provide services with a trauma-informed approach with feelings that a strong therapeutic relationship and processing can help individuals overcome their current symptoms or changes in life.
(440) 771-0642 View (440) 771-0642
Photo of Brigette Ruszkowski, LPCC
Brigette Ruszkowski
Licensed Professional Clinical Counselor, LPCC
Verified Verified
Cleveland, OH 44144
I am a licensed clinical counselor. I love to work with people who are struggling with depression, anxiety, and substance abuse issues. Life transition and relationship difficulties are also areas where I can help. I prefer to work with clients who are motivated to help themselves and understand it's their therapy session. I meet the clients where they are at. My go-to treatment modalities are CBT. I am non-judgmental, empathetic, and kind. I feel that a collaborative approach toward treatment goals is essential. I love people working with people. Guiding them toward healthy positive changes is the most rewarding aspect of my job.
I am a licensed clinical counselor. I love to work with people who are struggling with depression, anxiety, and substance abuse issues. Life transition and relationship difficulties are also areas where I can help. I prefer to work with clients who are motivated to help themselves and understand it's their therapy session. I meet the clients where they are at. My go-to treatment modalities are CBT. I am non-judgmental, empathetic, and kind. I feel that a collaborative approach toward treatment goals is essential. I love people working with people. Guiding them toward healthy positive changes is the most rewarding aspect of my job.
(440) 664-1529 View (440) 664-1529
Photo of Jill Miller, LISW, Clinical Social Work/Therapist
Jill Miller
Clinical Social Work/Therapist, LISW
Verified Verified
Brooklyn, OH 44144
Hello, my name is Jill Miller, and I am a licensed independent social worker, licensed independent chemical dependency counselor, and substance abuse professional in the State of Ohio. I believe that in order to have a successful relationship and outcome with my clients that there needs to be mutual trust, understanding, and good rapport. I use one of several therapeutic modalities, depending on what issue one is having in their life.
Hello, my name is Jill Miller, and I am a licensed independent social worker, licensed independent chemical dependency counselor, and substance abuse professional in the State of Ohio. I believe that in order to have a successful relationship and outcome with my clients that there needs to be mutual trust, understanding, and good rapport. I use one of several therapeutic modalities, depending on what issue one is having in their life.
(440) 737-2663 View (440) 737-2663
Photo of Macey Hawout, LPC, MT-BC, Licensed Professional Counselor
Macey Hawout
Licensed Professional Counselor, LPC, MT-BC
Verified Verified
1 Endorsed
Cleveland, OH 44144
Serving telehealth clients across Ohio! I am passionate about serving women who are dealing with women's issues, individuals struggling with life transitions, and trauma survivors. I have a plethora of experience in helping clients find or create their identity and helping them to become more confident in themselves no matter their past. I utilize a strengths-based approach for most any situation along with Cognitive Behavioral Therapy, Motivational Interviewing, and trauma-informed care to assist clients in getting to know themselves, their emotions, and how to implement those things in their daily lives.
Serving telehealth clients across Ohio! I am passionate about serving women who are dealing with women's issues, individuals struggling with life transitions, and trauma survivors. I have a plethora of experience in helping clients find or create their identity and helping them to become more confident in themselves no matter their past. I utilize a strengths-based approach for most any situation along with Cognitive Behavioral Therapy, Motivational Interviewing, and trauma-informed care to assist clients in getting to know themselves, their emotions, and how to implement those things in their daily lives.
(380) 227-3630 View (380) 227-3630
Photo of Amber Martin, LPC, Licensed Professional Counselor
Amber Martin
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Cleveland, OH 44144
I’d like to begin by taking time to remind you to thank yourself for the time you are investing in you, your mental health, and your entire wellbeing. Searching for a therapist to share your story with can be hard. So I hope to encourage you to continue to prioritize you! I believe that, as humans, we are wired for connection. Therefore, my nature as a therapist is first and foremost to be a present connection. Our therapeutic relationship will be built through a supportive and non-judgmental space, as well as collaboration to develop your unique plan for the growth you desire.
I’d like to begin by taking time to remind you to thank yourself for the time you are investing in you, your mental health, and your entire wellbeing. Searching for a therapist to share your story with can be hard. So I hope to encourage you to continue to prioritize you! I believe that, as humans, we are wired for connection. Therefore, my nature as a therapist is first and foremost to be a present connection. Our therapeutic relationship will be built through a supportive and non-judgmental space, as well as collaboration to develop your unique plan for the growth you desire.
(440) 493-1448 View (440) 493-1448
Photo of Cynthia Holloway, Marriage & Family Therapist
Cynthia Holloway
Marriage & Family Therapist
Verified Verified
Cleveland, OH 44144
Cynthia Holloway Independent Marriage and Family Therapist Hello, I’m Cindy I’m a master’s prepared Independently licensed Marriage and Family Therapist. I look forward to helping individuals as they work to heal and develop skills that will help them help themselves. Currently, my practice consists of individual adults. Often, these folks are navigating a significant life transition and / or working through trauma from the past that seems to interfere with current life experiences and well-being. Disorders these individuals bring with them include depression, anxiety, various identity issues, and post-traumatic stress.
Cynthia Holloway Independent Marriage and Family Therapist Hello, I’m Cindy I’m a master’s prepared Independently licensed Marriage and Family Therapist. I look forward to helping individuals as they work to heal and develop skills that will help them help themselves. Currently, my practice consists of individual adults. Often, these folks are navigating a significant life transition and / or working through trauma from the past that seems to interfere with current life experiences and well-being. Disorders these individuals bring with them include depression, anxiety, various identity issues, and post-traumatic stress.
(440) 287-1651 View (440) 287-1651

See more therapy options for 44144

How does your Therapist compare?

Number of Therapists in 44144

30+

Average cost per session

$107

Therapists in 44144 who prioritize treating:

100% Anxiety
82% Depression
71% Coping Skills
68% Self Esteem
56% Stress
53% Trauma and PTSD
53% Anger Management

Average years in practice

7 Years

Top 3 insurances accepted

93% Aetna
93% BlueCross and BlueShield
90% Cigna and Evernorth

How Therapists in 44144 see their clients

98% In Person and Online
2% Online Only

Gender breakdown

76% Female
21% Male
3% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 44144?

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.