Therapists in 55378

Photo of Dave Ewing, Pre-Licensed Professional, MSW, LGSW
Dave Ewing
Pre-Licensed Professional, MSW, LGSW
Savage, MN 55378
Dave is a Licensed Graduate Social Worker (LGSW) who brings a calm, compassionate, and grounded presence to therapy. He believes healing begins through authentic connection and offers a space to process pain, reclaim identity, and build a more intentional life. Drawing from CBT, ACT, and experiential methods, his humanistic, strengths-based style centers the mind-body connection. Dave supports clients facing anxiety, depression, trauma, life transitions, and identity challenges, with a special focus on men’s mental health.
Dave is a Licensed Graduate Social Worker (LGSW) who brings a calm, compassionate, and grounded presence to therapy. He believes healing begins through authentic connection and offers a space to process pain, reclaim identity, and build a more intentional life. Drawing from CBT, ACT, and experiential methods, his humanistic, strengths-based style centers the mind-body connection. Dave supports clients facing anxiety, depression, trauma, life transitions, and identity challenges, with a special focus on men’s mental health.
(952) 243-4973 View (952) 243-4973
Photo of Pam Schinigoi, Clinical Social Work/Therapist, MSW, LICSW
Pam Schinigoi
Clinical Social Work/Therapist, MSW, LICSW
Savage, MN 55378
“I believe that building a solid client-therapist partnership is key to developing the safety and trust needed to overcome the major life challenges that impact mental health. In therapy I incorporate that philosophy with strengths, systems, and solutions-focused perspectives and DBT, CBT, CPT, psychodynamic, and mindfulness approaches customized to meet the unique needs of each client. As a lifelong learner, I believe that we’re all on this journey of life together and am passionate about helping my clients navigate their personal life’s journey.”
“I believe that building a solid client-therapist partnership is key to developing the safety and trust needed to overcome the major life challenges that impact mental health. In therapy I incorporate that philosophy with strengths, systems, and solutions-focused perspectives and DBT, CBT, CPT, psychodynamic, and mindfulness approaches customized to meet the unique needs of each client. As a lifelong learner, I believe that we’re all on this journey of life together and am passionate about helping my clients navigate their personal life’s journey.”
(952) 314-4090 View (952) 314-4090
Photo of Tracy L Kotval, Licensed Professional Clinical Counselor, MA, LPCC
Tracy L Kotval
Licensed Professional Clinical Counselor, MA, LPCC
Savage, MN 55378
Are you struggling with uncertainty and stress? Do you feel socially isolated or depressed? Have you lost a job or been laid off? Do you need support? I offer in person and online therapy. My approach is short term, practical, collaborative and results-oriented. I primarily use Narrative Therapy when working with individuals, couples and families by focusing on the problem and investigating possible solutions and teach coping skills. I am in network with most insurance.
Are you struggling with uncertainty and stress? Do you feel socially isolated or depressed? Have you lost a job or been laid off? Do you need support? I offer in person and online therapy. My approach is short term, practical, collaborative and results-oriented. I primarily use Narrative Therapy when working with individuals, couples and families by focusing on the problem and investigating possible solutions and teach coping skills. I am in network with most insurance.
(952) 592-3027 View (952) 592-3027
Photo of Soren Ruppelius, Clinical Social Work/Therapist, LGSW, MSW
Soren Ruppelius
Clinical Social Work/Therapist, LGSW, MSW
Savage, MN 55378
I am a recent graduate of Salisbury University with my MSW, having spent time training and working at RAINN at the National Sexual Assault Hotline as well as the Wilmington VA Hospital in outpatient behavioral health. I provide therapy primarily to individuals 18 and older, and have a passion for working with military and veteran populations as well as LGBTQ individuals. Through my work and education, I have experience utilizing trauma-informed approaches, modalities such as CBT and DBT, and psychodynamic theory. I have enjoyed supporting clients through grief and loss, life transitions, coping with chronic illness, anger, & PTSD.
I am a recent graduate of Salisbury University with my MSW, having spent time training and working at RAINN at the National Sexual Assault Hotline as well as the Wilmington VA Hospital in outpatient behavioral health. I provide therapy primarily to individuals 18 and older, and have a passion for working with military and veteran populations as well as LGBTQ individuals. Through my work and education, I have experience utilizing trauma-informed approaches, modalities such as CBT and DBT, and psychodynamic theory. I have enjoyed supporting clients through grief and loss, life transitions, coping with chronic illness, anger, & PTSD.
(952) 209-1085 View (952) 209-1085
Photo of Jaime McNatt - True North Therapy, Clinical Social Work/Therapist, LICSW, LSSW, MSW, EMDR, IASIS
True North Therapy
Clinical Social Work/Therapist, LICSW, LSSW, MSW, EMDR, IASIS
1 Endorsed
Savage, MN 55378
True North is your orientating point. It is your point of discipline. Motivation will fail you every time. Find your discipline and you will find your freedom. I have 8+ years as a therapist specializing in adolescent health, parent coaching and trauma informed therapies for individuals, couples and families; speciality groups include veterans and first responders. Therapy & skills work are vital in both self regulation and self awareness, however holistic/integrative modalities can enhance a strong therapeutic framework. As such, I am also an IASIS provider (Microcurrent Neurofeedback), helpful in balancing your nervous system.
True North is your orientating point. It is your point of discipline. Motivation will fail you every time. Find your discipline and you will find your freedom. I have 8+ years as a therapist specializing in adolescent health, parent coaching and trauma informed therapies for individuals, couples and families; speciality groups include veterans and first responders. Therapy & skills work are vital in both self regulation and self awareness, however holistic/integrative modalities can enhance a strong therapeutic framework. As such, I am also an IASIS provider (Microcurrent Neurofeedback), helpful in balancing your nervous system.
(952) 373-4062 View (952) 373-4062
Photo of Danielle Polansky, Pre-Licensed Professional, LADC
Danielle Polansky
Pre-Licensed Professional, LADC
Savage, MN 55378
My name is Danielle & I am so glad you're here. I completed a graduate degree in the counseling and psychological services program at Saint Mary’s University in Minnesota in 2025. I started my career as a Licensed Alcohol and Drug Counselor and have worked in that capacity for the past 6 years within inpatient residential and intensive outpatient day treatment programs. I have experience working with adult and adolescent populations. I enjoy working with people and therapy work is my passion. In my free time, I enjoy hiking with my dog, traveling, seeing live music, spending time with my family and exploring new restaurants.
My name is Danielle & I am so glad you're here. I completed a graduate degree in the counseling and psychological services program at Saint Mary’s University in Minnesota in 2025. I started my career as a Licensed Alcohol and Drug Counselor and have worked in that capacity for the past 6 years within inpatient residential and intensive outpatient day treatment programs. I have experience working with adult and adolescent populations. I enjoy working with people and therapy work is my passion. In my free time, I enjoy hiking with my dog, traveling, seeing live music, spending time with my family and exploring new restaurants.
(651) 504-1637 x816 View (651) 504-1637 x816
Photo of Skye Forshay, Marriage & Family Therapist, MA, LMFT
Skye Forshay
Marriage & Family Therapist, MA, LMFT
1 Endorsed
Savage, MN 55378
My goal as your therapist is to provide you with a safe, kind, and healing space when you are feeling stuck, stressed, anxious, or overwhelmed. You will find I am genuine, encouraging, and motivated to help you as you navigate difficult issues with support and increased clarity and balance.
My goal as your therapist is to provide you with a safe, kind, and healing space when you are feeling stuck, stressed, anxious, or overwhelmed. You will find I am genuine, encouraging, and motivated to help you as you navigate difficult issues with support and increased clarity and balance.
(952) 522-7287 View (952) 522-7287
Photo of Michelle Lembeck, Pre-Licensed Professional, MS
Michelle Lembeck
Pre-Licensed Professional, MS
Savage, MN 55378
A common fear that occurs for most people seeking therapy is fear of judgment. Fear of judgement causes dysfunctional emotional regulation, poor decision making, and poor self-esteem. Many people struggle with fear of judgment. Therapy is a safe space to speak freely about personal thoughts, emotions, and difficult experiences. It is a place without judgement. It offers support, comfort, validation, and acceptance. Each person has a unique experience. As a clinician, it is important to be mindful of a person’s needs and sensitivity. That is why I use a person-centered approach.
A common fear that occurs for most people seeking therapy is fear of judgment. Fear of judgement causes dysfunctional emotional regulation, poor decision making, and poor self-esteem. Many people struggle with fear of judgment. Therapy is a safe space to speak freely about personal thoughts, emotions, and difficult experiences. It is a place without judgement. It offers support, comfort, validation, and acceptance. Each person has a unique experience. As a clinician, it is important to be mindful of a person’s needs and sensitivity. That is why I use a person-centered approach.
(952) 209-1058 View (952) 209-1058
Photo of Kim Busse, Licensed Professional Clinical Counselor, MEd, MA, LPCC
Kim Busse
Licensed Professional Clinical Counselor, MEd, MA, LPCC
Savage, MN 55378
I work with clients of all ages who want to make a positive change in their lives. My primary focus is helping individuals and families who are experiencing the challenges of Autism/Asperger's. Many of my clients also seek help for anxiety, depression, ADHD and other neurological disorders. The goal of counseling is intended to have the client feeling better than before they started.
I work with clients of all ages who want to make a positive change in their lives. My primary focus is helping individuals and families who are experiencing the challenges of Autism/Asperger's. Many of my clients also seek help for anxiety, depression, ADHD and other neurological disorders. The goal of counseling is intended to have the client feeling better than before they started.
(612) 255-6731 View (612) 255-6731
Photo of Peter (Jason) Rippentrop, Licensed Professional Clinical Counselor, LPCC
Peter (Jason) Rippentrop
Licensed Professional Clinical Counselor, LPCC
Savage, MN 55378
My primary experience is working with teens and young adults who are dealing with issues of depression, anxiety, ADHD, anger/aggression, stress, life changes/transitions, and adjustment disorders. I enjoy helping clients identify their strengths and find new perspectives on the problems they are currently struggling with.
My primary experience is working with teens and young adults who are dealing with issues of depression, anxiety, ADHD, anger/aggression, stress, life changes/transitions, and adjustment disorders. I enjoy helping clients identify their strengths and find new perspectives on the problems they are currently struggling with.
(952) 952-5161 View (952) 952-5161
Photo of Jeffrey Pounds, Psychologist, MA, LP, LADC
Jeffrey Pounds
Psychologist, MA, LP, LADC
Savage, MN 55378
Hi there, if you are wanting to work on emotional issues related to depression, trauma, medical issues, addiction, or anxiety? We can work together to address these issues. I work with people to meet their goals around these issues using a person centered approach, utilize cognitive behavioral therapy (CBT), and provide a safe and supportive environment to work with you .
Hi there, if you are wanting to work on emotional issues related to depression, trauma, medical issues, addiction, or anxiety? We can work together to address these issues. I work with people to meet their goals around these issues using a person centered approach, utilize cognitive behavioral therapy (CBT), and provide a safe and supportive environment to work with you .
(952) 592-9049 View (952) 592-9049
Photo of Agne Miskinis, Pre-Licensed Professional, MA
Agne Miskinis
Pre-Licensed Professional, MA
Savage, MN 55378
Hi! I'm Agne! I am dedicated to helping my clients achieve tangible and lasting change. In our work together, we'll focus on identifying the specific issues you're facing and developing practical strategies to address them. Whether you're struggling with anxiety, depression, relationship issues, past trauma, a major life transition, or just feeling like you don't have your life together, my approach is collaborative, goal-oriented, and focused on YOU. I would love to help equip you with the tools and insights you need to confidently manage challenges, feel more like yourself, and build a more fulfilling, vibrant life.
Hi! I'm Agne! I am dedicated to helping my clients achieve tangible and lasting change. In our work together, we'll focus on identifying the specific issues you're facing and developing practical strategies to address them. Whether you're struggling with anxiety, depression, relationship issues, past trauma, a major life transition, or just feeling like you don't have your life together, my approach is collaborative, goal-oriented, and focused on YOU. I would love to help equip you with the tools and insights you need to confidently manage challenges, feel more like yourself, and build a more fulfilling, vibrant life.
(952) 243-3097 View (952) 243-3097
Photo of Rylee Walen, Clinical Social Work/Therapist, MSW, LGSW
Rylee Walen
Clinical Social Work/Therapist, MSW, LGSW
Savage, MN 55378
I am a licensed therapist specializing in working with children, teens, and young adults. I provide a supportive space where clients can feel safe, heard, and empowered to endure through life's challenges. I have a strong foundation of crisis intervention and experience with youth and families. My experience allows me to guide clients through difficult moments with stability and to regain a sense of control and resilience.
I am a licensed therapist specializing in working with children, teens, and young adults. I provide a supportive space where clients can feel safe, heard, and empowered to endure through life's challenges. I have a strong foundation of crisis intervention and experience with youth and families. My experience allows me to guide clients through difficult moments with stability and to regain a sense of control and resilience.
(952) 521-0266 View (952) 521-0266
Photo of Elly Wood, Marriage & Family Therapist Associate, MA, LAMFT
Elly Wood
Marriage & Family Therapist Associate, MA, LAMFT
1 Endorsed
Savage, MN 55378
Do you ever wonder why some days are better than others? Are you feeling unbalanced, overwhelmed, or just need someone to talk to? Although this is a common experience for most people, you may notice that the harder days are starting to increase or your feelings are beginning to get in the way of life. If so it may be beneficial to talk to someone. Whether you are trying to get back to life after the pandemic, experiencing anxiety, feeling out of balance, or are having relationship issues. I am here to help.
Do you ever wonder why some days are better than others? Are you feeling unbalanced, overwhelmed, or just need someone to talk to? Although this is a common experience for most people, you may notice that the harder days are starting to increase or your feelings are beginning to get in the way of life. If so it may be beneficial to talk to someone. Whether you are trying to get back to life after the pandemic, experiencing anxiety, feeling out of balance, or are having relationship issues. I am here to help.
(952) 209-8643 View (952) 209-8643
Photo of Trevor Flick, Pre-Licensed Professional, MA
Trevor Flick
Pre-Licensed Professional, MA
Savage, MN 55378
I work with adolescents and adults who are navigating challenges such as depression, anxiety, ADHD, life transitions, and relationship concerns. My goal is to create a safe, supportive space where you feel truly heard, understood, and valued. I believe therapy works best when it’s collaborative, compassionate, and tailored to your unique experiences.
I work with adolescents and adults who are navigating challenges such as depression, anxiety, ADHD, life transitions, and relationship concerns. My goal is to create a safe, supportive space where you feel truly heard, understood, and valued. I believe therapy works best when it’s collaborative, compassionate, and tailored to your unique experiences.
(952) 395-8325 View (952) 395-8325
Photo of Lauren Brown, Counselor, MA, LPCC
Lauren Brown
Counselor, MA, LPCC
Savage, MN 55378
We all deserve to discover and rediscover the happiest and healthiest version of ourselves in each life season. Entrusting someone to walk beside you can feel incredibly vulnerable. My aspiration is to create openness from one human to another where you feel seen and safe to show up authentically. You are the true expert on your life. I want you to leave each session feeling empowered as we process emotions, build awareness, and identify tangible action steps that align with your values. Together we can create a foundational “toolbox” of skills to anchor through difficult times, and include a dash or two of humor along the way.
We all deserve to discover and rediscover the happiest and healthiest version of ourselves in each life season. Entrusting someone to walk beside you can feel incredibly vulnerable. My aspiration is to create openness from one human to another where you feel seen and safe to show up authentically. You are the true expert on your life. I want you to leave each session feeling empowered as we process emotions, build awareness, and identify tangible action steps that align with your values. Together we can create a foundational “toolbox” of skills to anchor through difficult times, and include a dash or two of humor along the way.
(952) 295-3404 View (952) 295-3404
Photo of Jennifer M Bertsch - Serenity Behavioral Health & Wellness LLC, Psychologist, PsyD, LP
Serenity Behavioral Health & Wellness LLC
Psychologist, PsyD, LP
Savage, MN 55378
Are you struggling to find life balance? Is your daily routine overwhelming you with anxiety, or are you down, stuck in a rut, and feel like life is a mundane hamster wheel of going through the motions? Are you sad or have you lost hope? Do you have trouble accessing your inner potential and strength? We can help you get back on track and back to feeling like the best version of yourself. When we are refreshed and well, we thrive. We feel a sense of blissful energy and open acceptance. We should all Be Free to Be Well. At Serenity, we help you take care of your mental health so you can soar in all other areas of your life…
Are you struggling to find life balance? Is your daily routine overwhelming you with anxiety, or are you down, stuck in a rut, and feel like life is a mundane hamster wheel of going through the motions? Are you sad or have you lost hope? Do you have trouble accessing your inner potential and strength? We can help you get back on track and back to feeling like the best version of yourself. When we are refreshed and well, we thrive. We feel a sense of blissful energy and open acceptance. We should all Be Free to Be Well. At Serenity, we help you take care of your mental health so you can soar in all other areas of your life…
(952) 243-5613 View (952) 243-5613
Photo of Katelynn Shimanski, Pre-Licensed Professional, MA
Katelynn Shimanski
Pre-Licensed Professional, MA
Savage, MN 55378
I have experience providing outpatient therapy to adolescents and adults, supporting clients with anxiety, depression, grief and loss, life transitions, self-confidence, ADD/ADHD, and trauma. I am passionate about working with a diverse range of clients, including older adults and individuals navigating cognitive changes such as Alzheimer’s disease and other forms of dementia. I welcome clients from all backgrounds and identities and am committed to creating a therapeutic space that is inclusive, affirming, and grounded in respect.
I have experience providing outpatient therapy to adolescents and adults, supporting clients with anxiety, depression, grief and loss, life transitions, self-confidence, ADD/ADHD, and trauma. I am passionate about working with a diverse range of clients, including older adults and individuals navigating cognitive changes such as Alzheimer’s disease and other forms of dementia. I welcome clients from all backgrounds and identities and am committed to creating a therapeutic space that is inclusive, affirming, and grounded in respect.
(952) 209-0756 View (952) 209-0756
Photo of Suzanne C Bidwell, Clinical Social Work/Therapist, LICSW, LCSW
Suzanne C Bidwell
Clinical Social Work/Therapist, LICSW, LCSW
1 Endorsed
Savage, MN 55378
Have you ever really clicked with a therapist? I mean, really clicked? My goal is to form a solid genuine working relationship with my clients first and foremost. I am laid back but direct and use humor when appropriate. The human experience is messy, and I want to walk through how we can make things a little easier on you. I have a passion for working with people with eating disorders, anxiety, mood, life transitions, and fellow helping professionals. Board approved clinical supervisor for MN Board of Social Work and Minnesota Board of Behavioral Health and Therapy.
Have you ever really clicked with a therapist? I mean, really clicked? My goal is to form a solid genuine working relationship with my clients first and foremost. I am laid back but direct and use humor when appropriate. The human experience is messy, and I want to walk through how we can make things a little easier on you. I have a passion for working with people with eating disorders, anxiety, mood, life transitions, and fellow helping professionals. Board approved clinical supervisor for MN Board of Social Work and Minnesota Board of Behavioral Health and Therapy.
(952) 592-5224 View (952) 592-5224
Photo of Annastasia Ramig, Clinical Social Work/Therapist, MSW, LICSW
Annastasia Ramig
Clinical Social Work/Therapist, MSW, LICSW
2 Endorsed
Savage, MN 55378
Walk & Talk with my pup (optional!) and Telehealth for ADHD, Anxiety, Relationship Struggles & Finding Your Footing in New Chapters! If you’re feeling anxious, stuck, or like your brain runs 24/7 on 50 tabs (thanks, ADHD), you’re not alone. I help young adults and women across Minnesota find clarity, confidence, and calm, without the pressure to have it all together. Life gets messy when you’re juggling relationships, career stuff, or just figuring out who the hell you are. Together, we’ll sort through the chaos, celebrate small wins, and laugh along the way. Walk & Talks with (or without) my pup offered in Savage & Prior Lake!
Walk & Talk with my pup (optional!) and Telehealth for ADHD, Anxiety, Relationship Struggles & Finding Your Footing in New Chapters! If you’re feeling anxious, stuck, or like your brain runs 24/7 on 50 tabs (thanks, ADHD), you’re not alone. I help young adults and women across Minnesota find clarity, confidence, and calm, without the pressure to have it all together. Life gets messy when you’re juggling relationships, career stuff, or just figuring out who the hell you are. Together, we’ll sort through the chaos, celebrate small wins, and laugh along the way. Walk & Talks with (or without) my pup offered in Savage & Prior Lake!
(218) 276-6210 View (218) 276-6210

See more therapy options for 55378

How does your Therapist compare?

Number of Therapists in 55378

40+

Average cost per session

$175

Therapists in 55378 who prioritize treating:

98% Depression
98% Anxiety
87% Stress
85% Relationship Issues
80% Self Esteem
78% Coping Skills
72% Life Transitions

Average years in practice

12 Years

Top 3 insurances accepted

98% BlueCross and BlueShield
85% Aetna
71% Cigna and Evernorth

How Therapists in 55378 see their clients

74% In Person and Online
26% Online Only

Gender breakdown

90% Female
10% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 55378?

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.