Therapists in 57401

Photo of Debi L Dusseault - Shelterbelt Counseling, LLC, Licensed Professional Counselor, MS, LPC-MH, QMHP
Shelterbelt Counseling, LLC
Licensed Professional Counselor, MS, LPC-MH, QMHP
Aberdeen, SD 57401
I believe that seeking counseling when aspects of our lives become challenging is a courageous and important act of acknowledging and validating the dignity of self. I work with adult clients (18+) who experience depression, anxiety, borderline personality, trauma and grief. At times our assumptions and interpretation of our thoughts, emotions and experiences can contribute to emotional suffering and interfere with our relationships with the people we love. As we try to do the best we can to cope with these problems we can also lack the tools necessary to effectively solve these issues.
I believe that seeking counseling when aspects of our lives become challenging is a courageous and important act of acknowledging and validating the dignity of self. I work with adult clients (18+) who experience depression, anxiety, borderline personality, trauma and grief. At times our assumptions and interpretation of our thoughts, emotions and experiences can contribute to emotional suffering and interfere with our relationships with the people we love. As we try to do the best we can to cope with these problems we can also lack the tools necessary to effectively solve these issues.
(605) 309-5239 View (605) 309-5239
Photo of Heather Rae Aldentaler, Licensed Professional Counselor, MS Ed, LPC-MH, LAC, NCC, QMHP
Heather Rae Aldentaler
Licensed Professional Counselor, MS Ed, LPC-MH, LAC, NCC, QMHP
1 Endorsed
Aberdeen, SD 57401
I believe individuals have greatness within themselves; it is important to work with a counselor who sees yours, even if you or others do not. I will strive to help you feel comfortable so you can be honest with me and yourself, about your problems, mood complaints or substance use. Often individuals already know what needs to happen, but do not know how to get there. I will meet you where you are, while guiding you to where you want to be.
I believe individuals have greatness within themselves; it is important to work with a counselor who sees yours, even if you or others do not. I will strive to help you feel comfortable so you can be honest with me and yourself, about your problems, mood complaints or substance use. Often individuals already know what needs to happen, but do not know how to get there. I will meet you where you are, while guiding you to where you want to be.
(605) 315-3176 View (605) 315-3176
Photo of Heidie J Holmstrom, Licensed Professional Counselor, MA, LPC-MH, NCC, LPC, QMHP
Heidie J Holmstrom
Licensed Professional Counselor, MA, LPC-MH, NCC, LPC, QMHP
2 Endorsed
Aberdeen, SD 57401
Counseling is about making positive changes in ourselves, our relationships, and the way we view our world. I work with you to help release unwanted patterns/beliefs, reduce depression and anxiety, unresolved old feelings that are blocking personal power. I work with clients to support their current needs and wants. You've already made the first step towards healing and creating the change you want/need. I will work with you to help you increase self-awareness, gain insight and work towards resolving difficult situations/conflicts. I offer a comfortable, safe and confidential setting.
Counseling is about making positive changes in ourselves, our relationships, and the way we view our world. I work with you to help release unwanted patterns/beliefs, reduce depression and anxiety, unresolved old feelings that are blocking personal power. I work with clients to support their current needs and wants. You've already made the first step towards healing and creating the change you want/need. I will work with you to help you increase self-awareness, gain insight and work towards resolving difficult situations/conflicts. I offer a comfortable, safe and confidential setting.
(605) 884-9808 View (605) 884-9808
Photo of Angel Feiock, Licensed Professional Counselor, MS Ed, LPC-MH, TF-CBT
Angel Feiock
Licensed Professional Counselor, MS Ed, LPC-MH, TF-CBT
Aberdeen, SD 57401
Life can bring upon stressors and trauma that seem impossible to overcome. It may make you feel overwhelmed, defeated, anxious and scared. Counseling can help make these difficult emotions and situations less daunting. I have experience working with individuals of all ages and backgrounds. I am a Licensed Professional Counselor of Mental Health and am trained and certified in Trauma Focused Cognitive Behavioral Therapy.
Life can bring upon stressors and trauma that seem impossible to overcome. It may make you feel overwhelmed, defeated, anxious and scared. Counseling can help make these difficult emotions and situations less daunting. I have experience working with individuals of all ages and backgrounds. I am a Licensed Professional Counselor of Mental Health and am trained and certified in Trauma Focused Cognitive Behavioral Therapy.
(605) 307-3450 View (605) 307-3450
Photo of Eline (Janey) Appletoft-Knie, Licensed Professional Counselor, MS Ed, LPC-MH, QMHP
Eline (Janey) Appletoft-Knie
Licensed Professional Counselor, MS Ed, LPC-MH, QMHP
Aberdeen, SD 57401
I believe that individuals can heal mentally and emotionally with the right resources, supports and encouragement. I am committed to providing a safe, therapeutic environment for clients to explore solutions to distressing life events and circumstances.
I believe that individuals can heal mentally and emotionally with the right resources, supports and encouragement. I am committed to providing a safe, therapeutic environment for clients to explore solutions to distressing life events and circumstances.
(605) 210-5751 View (605) 210-5751
Photo of Rebecca Christiansen, Counselor, LPC-MH, LPCC, LPC, NCC, QMHP
Rebecca Christiansen
Counselor, LPC-MH, LPCC, LPC, NCC, QMHP
Aberdeen, SD 57401
Talking to someone can be scary and intimidating. Clients are unsure whether they can trust the person on the other side of the room. They do not know if “talking” will help them with the problem at hand. I strive to create an atmosphere of trust and acceptance that fosters a comfortable, safe working relationship. I use Solution-Focused, Cognitive-Behavioral, and Reality Therapy techniques to help you identify your goals and achieve your desired outcomes!
Talking to someone can be scary and intimidating. Clients are unsure whether they can trust the person on the other side of the room. They do not know if “talking” will help them with the problem at hand. I strive to create an atmosphere of trust and acceptance that fosters a comfortable, safe working relationship. I use Solution-Focused, Cognitive-Behavioral, and Reality Therapy techniques to help you identify your goals and achieve your desired outcomes!
(605) 570-5633 View (605) 570-5633
Photo of Autumn M Neigel, Licensed Professional Counselor, MS , QMHP, LPC-MH, RPT™
Autumn M Neigel
Licensed Professional Counselor, MS , QMHP, LPC-MH, RPT™
1 Endorsed
Aberdeen, SD 57401
There is an outdated stereotype of children being so resilient they can 'bounce back' from anything. This isn't always true. Children display reactions to traumatic experiences differently from adults that may not make sense to adults, may appear as "just annoying or whiny" or "a phase." Behaviors are often a symptom of a larger issue when children don't have language or tools to express themselves.
There is an outdated stereotype of children being so resilient they can 'bounce back' from anything. This isn't always true. Children display reactions to traumatic experiences differently from adults that may not make sense to adults, may appear as "just annoying or whiny" or "a phase." Behaviors are often a symptom of a larger issue when children don't have language or tools to express themselves.
(605) 205-8946 View (605) 205-8946
Photo of Jerry P. Feist, Licensed Professional Counselor, MS, LPC-MH, QMHP
Jerry P. Feist
Licensed Professional Counselor, MS, LPC-MH, QMHP
2 Endorsed
Aberdeen, SD 57401
I have over 35 years of experience in the combined fields of counseling and behavioral health. Counseling is offered in a safe and supportive environment, I work with you to help release unwanted patterns/beliefs, unresolved old feelings that blocking personal power. Some of my techniques include Conventional Therapy, CBT, REBT, Solution Focused Therapy and Eye Movement Desensitization & Reprocessing. Whether you are stuck in the past, struggling with life's up & downs, unsure about your future or have experience trauma. We can work together to find resolutions to your symptoms so you can experience a more fulfilling, happier and meaningful life.
I have over 35 years of experience in the combined fields of counseling and behavioral health. Counseling is offered in a safe and supportive environment, I work with you to help release unwanted patterns/beliefs, unresolved old feelings that blocking personal power. Some of my techniques include Conventional Therapy, CBT, REBT, Solution Focused Therapy and Eye Movement Desensitization & Reprocessing. Whether you are stuck in the past, struggling with life's up & downs, unsure about your future or have experience trauma. We can work together to find resolutions to your symptoms so you can experience a more fulfilling, happier and meaningful life.
(605) 937-8099 View (605) 937-8099
Photo of Amy L Hauge, Licensed Professional Counselor, MS, LPC-MH, QMHP
Amy L Hauge
Licensed Professional Counselor, MS, LPC-MH, QMHP
1 Endorsed
Aberdeen, SD 57401
“There is hope, even when your brain tells you there isn’t.” John Green. My name is Amy Hauge and I have over 20 years of experience in the mental health field. I started on this path working with youth living in a residential treatment setting who had a troubled history along with emotional and behavioral issues. I then moved on to working with people of all ages as a mental health clinician. I obtained my LPC-MH in 2009. In 2014, I moved on to work with emotionally and behaviorally challenged teenagers in the special education population in the school setting. I am now in private practice and enjoy working with all populations.
“There is hope, even when your brain tells you there isn’t.” John Green. My name is Amy Hauge and I have over 20 years of experience in the mental health field. I started on this path working with youth living in a residential treatment setting who had a troubled history along with emotional and behavioral issues. I then moved on to working with people of all ages as a mental health clinician. I obtained my LPC-MH in 2009. In 2014, I moved on to work with emotionally and behaviorally challenged teenagers in the special education population in the school setting. I am now in private practice and enjoy working with all populations.
(605) 857-8042 View (605) 857-8042
Photo of Christie Rall, Licensed Professional Counselor, MS, LPC-MH, NCC, QMHP
Christie Rall
Licensed Professional Counselor, MS, LPC-MH, NCC, QMHP
Aberdeen, SD 57401
Sometimes life can be overwhelming and frustrating with the uncertainty of what to do next. Having the courage to come to counseling is the first step to get some of those questions answered. In the beginning, building a good rapport with clients is my focus to help them feel comfortable in the process. I can help clients work through the difficult things that are uncomfortable to think about or even to talk about. Clients do feel rewarded once they do, and they can make the changes they want in their lives. A diagnosis does not have to define as a person, but it can help them live their best life.
Sometimes life can be overwhelming and frustrating with the uncertainty of what to do next. Having the courage to come to counseling is the first step to get some of those questions answered. In the beginning, building a good rapport with clients is my focus to help them feel comfortable in the process. I can help clients work through the difficult things that are uncomfortable to think about or even to talk about. Clients do feel rewarded once they do, and they can make the changes they want in their lives. A diagnosis does not have to define as a person, but it can help them live their best life.
(605) 250-6725 View (605) 250-6725
Photo of Amanda J Lautenschlager, Licensed Professional Counselor, MS, LPC-MH, NCC, QMHP
Amanda J Lautenschlager
Licensed Professional Counselor, MS, LPC-MH, NCC, QMHP
Aberdeen, SD 57401
If you are a survivor, you need to know that your symptoms do not have to define you. You do not have to live in the past and both your brain and body can heal. I specialize in the treatment of complex traumatic responses. Together, we can work toward helping you regain a sense of peace, live in and enjoy the present and create a more hopeful future.
If you are a survivor, you need to know that your symptoms do not have to define you. You do not have to live in the past and both your brain and body can heal. I specialize in the treatment of complex traumatic responses. Together, we can work toward helping you regain a sense of peace, live in and enjoy the present and create a more hopeful future.
(605) 937-7678 View (605) 937-7678
Photo of Dreena Wertz, Licensed Professional Counselor
Dreena Wertz
Licensed Professional Counselor
Aberdeen, SD 57401
When patterns in your thoughts, emotions, or relationships begin to feel unmanageable, the right support can make all the difference. I specialize in helping adults and couples navigate the complexities of anxiety, depression, and life’s many adjustments. My approach is grounded in a calm, compassionate presence, ensuring you feel truly understood while we work together to develop practical ways to cope and grow.
When patterns in your thoughts, emotions, or relationships begin to feel unmanageable, the right support can make all the difference. I specialize in helping adults and couples navigate the complexities of anxiety, depression, and life’s many adjustments. My approach is grounded in a calm, compassionate presence, ensuring you feel truly understood while we work together to develop practical ways to cope and grow.
(605) 600-3659 View (605) 600-3659
Photo of Cindy Goehring, Licensed Professional Counselor, MSEd, LPC-MH, NCC, QMHP
Cindy Goehring
Licensed Professional Counselor, MSEd, LPC-MH, NCC, QMHP
1 Endorsed
Aberdeen, SD 57401
"Effective therapy not only helps people resolve their immediate problems, it teaches them how to build long-lasting, greater life satisfaction." Bring yourself one step closer to having the control over your life that will put you on a positive path to growth and well-being. I practice a "Positive Psychology" approach which is founded on the belief that people WANT to lead meaningful and fulfilling lives.
"Effective therapy not only helps people resolve their immediate problems, it teaches them how to build long-lasting, greater life satisfaction." Bring yourself one step closer to having the control over your life that will put you on a positive path to growth and well-being. I practice a "Positive Psychology" approach which is founded on the belief that people WANT to lead meaningful and fulfilling lives.
(605) 569-8104 View (605) 569-8104
Photo of Brian Dannen, Licensed Professional Counselor, LPC-MH
Brian Dannen
Licensed Professional Counselor, LPC-MH
2 Endorsed
Aberdeen, SD 57401
With over 25 years of experience, I work with clients from age five through older adulthood who may feel stuck, overwhelmed, adjusting, or uncertain—struggling with anxiety, depression, stress, life transitions, or challenges with emotions, confidence, or relationships. They need a compassionate, safe space to be truly heard, understood, and guided. Together, we focus on building coping skills, resilience, and self-understanding, which helps clients create meaningful change, navigate life with confidence, strengthen relationships, and restore hope for the future.”
With over 25 years of experience, I work with clients from age five through older adulthood who may feel stuck, overwhelmed, adjusting, or uncertain—struggling with anxiety, depression, stress, life transitions, or challenges with emotions, confidence, or relationships. They need a compassionate, safe space to be truly heard, understood, and guided. Together, we focus on building coping skills, resilience, and self-understanding, which helps clients create meaningful change, navigate life with confidence, strengthen relationships, and restore hope for the future.”
(605) 640-5620 View (605) 640-5620
Photo of Morgan Jensen, Licensed Professional Counselor, Morgan , Jensen, MS, LPC-MH, QMHP
Morgan Jensen
Licensed Professional Counselor, Morgan , Jensen, MS, LPC-MH, QMHP
Aberdeen, SD 57401
Growing up in a rural community, I saw firsthand the lack of mental health resources and the stigma that surrounded mental illness. This experience sparked a desire to advocate for those struggling with mental health challenges. It became my passion to not only provide support, but also to break down the barriers that prevent people from seeking help. I believe it’s essential for everyone to know that it's okay to reach out for support, no matter the situation. My goal is to create a safe and welcoming space where people feel understood and empowered to become the best version of themselves—mentally, emotionally, and physically.
Growing up in a rural community, I saw firsthand the lack of mental health resources and the stigma that surrounded mental illness. This experience sparked a desire to advocate for those struggling with mental health challenges. It became my passion to not only provide support, but also to break down the barriers that prevent people from seeking help. I believe it’s essential for everyone to know that it's okay to reach out for support, no matter the situation. My goal is to create a safe and welcoming space where people feel understood and empowered to become the best version of themselves—mentally, emotionally, and physically.
(605) 657-4703 View (605) 657-4703
Photo of Lindsey Skaare, Licensed Professional Counselor, MS, LPC-MH, NCC
Lindsey Skaare
Licensed Professional Counselor, MS, LPC-MH, NCC
Aberdeen, SD 57401
Life has a tendency to create difficult moments for all of us. The decision to begin therapy is one that can help you get through these moments and to function better in all areas of life. I aim to provide a comfortable, private atmosphere that is conducive to creating a sense of well-being which aids in the process of brighter days ahead. I work with individuals of all ages who are experiencing some of life's challenges such as depression, anxiety, relationship issues, grief and addiction that are causing pain and discomfort in their lives.
Life has a tendency to create difficult moments for all of us. The decision to begin therapy is one that can help you get through these moments and to function better in all areas of life. I aim to provide a comfortable, private atmosphere that is conducive to creating a sense of well-being which aids in the process of brighter days ahead. I work with individuals of all ages who are experiencing some of life's challenges such as depression, anxiety, relationship issues, grief and addiction that are causing pain and discomfort in their lives.
(605) 250-2192 View (605) 250-2192
Photo of Ellen C Washenberger, Licensed Professional Counselor, MS, LPC-MH, QMHP
Ellen C Washenberger
Licensed Professional Counselor, MS, LPC-MH, QMHP
Aberdeen, SD 57401
I believe one of the most challenging things that you can do is to begin to understand your own story. We gather a lifetime of experiences which affect us in different ways. Holding on to past negative experiences prevents further exploration and healing. In a sense we get stuck in patterns of thinking and relating that hold us back from true potential and empowerment of our best assets.
I believe one of the most challenging things that you can do is to begin to understand your own story. We gather a lifetime of experiences which affect us in different ways. Holding on to past negative experiences prevents further exploration and healing. In a sense we get stuck in patterns of thinking and relating that hold us back from true potential and empowerment of our best assets.
(605) 250-3130 View (605) 250-3130
Photo of Dr. Dean Leav - Psychological Testing & Evaluations - Dr. Dean, Psychologist, PsyD, QME, Author
Psychological Testing & Evaluations - Dr. Dean
Psychologist, PsyD, QME, Author
Aberdeen, SD 57401
I’m Dr. Dean Leav. I've been featured on ABC, NBC, KCAL, and other programs as an expert psychologist. I conduct ADHD / autism / learning disability evaluations, legal / forensic evaluations for court, risk assessment (violence / sexual), cognitive / neuropsychological evaluations, diagnostic psychological evaluations, immigration evaluations, adoption evaluations, parenting / bonding assessments, drug & alcohol evaluations, fitness for duty evaluations, workers' compensation (QME/AME) evaluations, and other types of psychological evaluations / assessments.
I’m Dr. Dean Leav. I've been featured on ABC, NBC, KCAL, and other programs as an expert psychologist. I conduct ADHD / autism / learning disability evaluations, legal / forensic evaluations for court, risk assessment (violence / sexual), cognitive / neuropsychological evaluations, diagnostic psychological evaluations, immigration evaluations, adoption evaluations, parenting / bonding assessments, drug & alcohol evaluations, fitness for duty evaluations, workers' compensation (QME/AME) evaluations, and other types of psychological evaluations / assessments.
(605) 836-6854 View (605) 836-6854
Photo of Lindsay Neth, Clinical Social Work/Therapist, MSW, CSW-PIP
Lindsay Neth
Clinical Social Work/Therapist, MSW, CSW-PIP
1 Endorsed
Serves Area
Mental health impacts each of us differently, making things even more important to not compare or judge how each of us feel and respond to life’s stressors. One of the most rewarding components of my job is truly meeting each client in their defined “time of need”. During your therapy journey, we spend time exploring your emotions, thoughts and behaviors, increasing your self-awareness and “tweaking” the tools to utilize in managing your emotions healthier.
Mental health impacts each of us differently, making things even more important to not compare or judge how each of us feel and respond to life’s stressors. One of the most rewarding components of my job is truly meeting each client in their defined “time of need”. During your therapy journey, we spend time exploring your emotions, thoughts and behaviors, increasing your self-awareness and “tweaking” the tools to utilize in managing your emotions healthier.
(605) 220-5785 View (605) 220-5785
Photo of Sarajo Kegler, Clinical Social Work/Therapist, LCSW, PIP, LAC, QMHP
Sarajo Kegler
Clinical Social Work/Therapist, LCSW, PIP, LAC, QMHP
1 Endorsed
Serves Area
My ideal client is someone aged 13 and up who would like a safe, non judgmental place to start regaining control over their lives. I have worked with individuals who are going through rough break ups, substance abuse, anxiety and depression to individuals with significant trauma, such as sexual abuse, domestic violence, neglect or abandonment. Their goals often include coping with anxiety, healing from past trauma, building resilience, and creating a healthier future. They seek understanding, practical tools, and emotional support to regain control over their lives and foster a sense of empowerment.
My ideal client is someone aged 13 and up who would like a safe, non judgmental place to start regaining control over their lives. I have worked with individuals who are going through rough break ups, substance abuse, anxiety and depression to individuals with significant trauma, such as sexual abuse, domestic violence, neglect or abandonment. Their goals often include coping with anxiety, healing from past trauma, building resilience, and creating a healthier future. They seek understanding, practical tools, and emotional support to regain control over their lives and foster a sense of empowerment.
(605) 861-4114 View (605) 861-4114

See more therapy options for 57401

How does your Therapist compare?

Number of Therapists in 57401

30+

Average cost per session

$225

Therapists in 57401 who prioritize treating:

90% Anxiety
90% Social Anxiety
90% Health Anxiety
90% Driving Anxiety
87% Depression
80% Grief
73% Self Esteem

Average years in practice

15 Years

Top 3 insurances accepted

96% Avera Health Plans
96% Wellmark BCBS
92% Sanford Health Plan

How Therapists in 57401 see their clients

80% In Person and Online
20% Online Only

Gender breakdown

81% Female
15% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 57401?

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.