Therapists in 68107

Photo of Wynston Nowak, Pre-Licensed Professional, BA, BFA , PLADC
Wynston Nowak
Pre-Licensed Professional, BA, BFA , PLADC
2 Endorsed
Omaha, NE 68107
In today’s world, it can feel like everyone is just trying to get by, weighed down by stress and challenges. But we weren’t made to merely survive; we were meant to thrive. The burden of the world’s problems doesn’t have to rest on your shoulders alone. Counseling offers a path to lighten your load, release fears and anxieties, and reclaim your sense of worth. If you’re struggling with substance abuse, you’re not alone. Many people face the chaotic impact of addiction, including: Legal Issues, Health Complications, Strained Relationships, and Self-worth.
In today’s world, it can feel like everyone is just trying to get by, weighed down by stress and challenges. But we weren’t made to merely survive; we were meant to thrive. The burden of the world’s problems doesn’t have to rest on your shoulders alone. Counseling offers a path to lighten your load, release fears and anxieties, and reclaim your sense of worth. If you’re struggling with substance abuse, you’re not alone. Many people face the chaotic impact of addiction, including: Legal Issues, Health Complications, Strained Relationships, and Self-worth.
(402) 715-5448 View (402) 715-5448
Photo of Karen L Gutherless, Counselor, MA, LIMHP, LPC
Karen L Gutherless
Counselor, MA, LIMHP, LPC
1 Endorsed
Omaha, NE 68107
I am a Licensed Independent Mental Health Practitioner (LIMHP) and Licensed Professional Counselor (LPC) with 15+ years of experience delivering trauma-informed care, crisis intervention, and behavioral health program leadership across private practice, healthcare, and virtual platforms. My work has impacted over 50,000 clients, helping individuals, families, and organizations strengthen mental wellness through individual and group therapy, intensive outpatient programs (IOP), telehealth counseling, and employee assistance program (EAP) services. I have provided care to clients, addressing PTSD, anxiety, depression.
I am a Licensed Independent Mental Health Practitioner (LIMHP) and Licensed Professional Counselor (LPC) with 15+ years of experience delivering trauma-informed care, crisis intervention, and behavioral health program leadership across private practice, healthcare, and virtual platforms. My work has impacted over 50,000 clients, helping individuals, families, and organizations strengthen mental wellness through individual and group therapy, intensive outpatient programs (IOP), telehealth counseling, and employee assistance program (EAP) services. I have provided care to clients, addressing PTSD, anxiety, depression.
(308) 365-1336 View (308) 365-1336
Photo of Kurt Steven Voorhees, Counselor, MS, LMHP
Kurt Steven Voorhees
Counselor, MS, LMHP
1 Endorsed
Serves Area
During my studies, I have focused on the interactions between thinking, emotions, behaviors, and belief systems. I have learned that many factors, such as genetics and how and where someone grows up, deeply affect how we think and feel about the world when we're navigating the complexities of becoming and being an adult. The holistic and sometimes eclectic approaches I have learned are helpful for personal growth or when we have thoughts, actions, and feelings that we wish that we did not have or are just confusing to us.
During my studies, I have focused on the interactions between thinking, emotions, behaviors, and belief systems. I have learned that many factors, such as genetics and how and where someone grows up, deeply affect how we think and feel about the world when we're navigating the complexities of becoming and being an adult. The holistic and sometimes eclectic approaches I have learned are helpful for personal growth or when we have thoughts, actions, and feelings that we wish that we did not have or are just confusing to us.
(531) 571-1392 View (531) 571-1392
Photo of Samuel Wenzl, Counselor, PLMHP, NCC
Samuel Wenzl
Counselor, PLMHP, NCC
1 Endorsed
Serves Area
Sometimes significant events in the past can have lasting impact on the here-and-now, leading us to feeling stuck and unable to trust ourselves with our emotions. Support that leads to lasting change is possible, and I can help you through the journey. Often times it is not easy and there will be ups and downs, but a constant in your treatment would be the consistent support you receive from me. With me, you will have a safe space to continue to further your horizons, confront beliefs and behaviors that don't serve you anymore, and continue on the path toward your goals. If you feel like you would benefit, reach out!
Sometimes significant events in the past can have lasting impact on the here-and-now, leading us to feeling stuck and unable to trust ourselves with our emotions. Support that leads to lasting change is possible, and I can help you through the journey. Often times it is not easy and there will be ups and downs, but a constant in your treatment would be the consistent support you receive from me. With me, you will have a safe space to continue to further your horizons, confront beliefs and behaviors that don't serve you anymore, and continue on the path toward your goals. If you feel like you would benefit, reach out!
(402) 623-6476 View (402) 623-6476
Photo of Evette Alvarez, Pre-Licensed Professional, PLMHP
Evette Alvarez
Pre-Licensed Professional, PLMHP
Serves Area
Welcome to a space where healing begins. Taking the first step towards seeking therapeutic support is a courageous endeavor and I'm here to assure you that you're not alone. In this space, your wellbeing is a priority. As a dedicated therapist, my commitment is to provide you with a warm, welcoming, and supportive environment where your unique journey can unfold, If you're ready to embark on a path of growth and positive change, I encourage you to take that next step. Your healing journey starts with a simple call and lets begin this transformative journey together.
Welcome to a space where healing begins. Taking the first step towards seeking therapeutic support is a courageous endeavor and I'm here to assure you that you're not alone. In this space, your wellbeing is a priority. As a dedicated therapist, my commitment is to provide you with a warm, welcoming, and supportive environment where your unique journey can unfold, If you're ready to embark on a path of growth and positive change, I encourage you to take that next step. Your healing journey starts with a simple call and lets begin this transformative journey together.
(402) 600-0953 View (402) 600-0953
Photo of Ramanda Bruce - Aspirations, Counselor, MS, LIMHP, LADC
Aspirations
Counselor, MS, LIMHP, LADC
Serves Area
Hi! I feel that trust and authenticity essential parts of a successful therapeutic relationship. I believe all of us can benefit from support with regard to healing, adjustment, and change. I find gratitude in being a part of ones journey.
Hi! I feel that trust and authenticity essential parts of a successful therapeutic relationship. I believe all of us can benefit from support with regard to healing, adjustment, and change. I find gratitude in being a part of ones journey.
(402) 347-2073 View (402) 347-2073
Photo of Victoria VanTol, Counselor, LICSW, PLADC
Victoria VanTol
Counselor, LICSW, PLADC
Serves Area
What does it mean to "take care of your mental health?" It's easier to tell when you aren't taking care of it. Chronic stress, exhaustion, worry, and panic are all signs your mental health is suffering. If untreated, you could start having poor health, trouble in your relationships, and difficulty staying on top of work or school. There are many things that can lead to mental health struggles, like a too-busy schedule, a chronic illness or someone else's troubles, a major life transition, or the death of someone close to you. Or, it could seem to come out of the blue, caused by nothing at all.
What does it mean to "take care of your mental health?" It's easier to tell when you aren't taking care of it. Chronic stress, exhaustion, worry, and panic are all signs your mental health is suffering. If untreated, you could start having poor health, trouble in your relationships, and difficulty staying on top of work or school. There are many things that can lead to mental health struggles, like a too-busy schedule, a chronic illness or someone else's troubles, a major life transition, or the death of someone close to you. Or, it could seem to come out of the blue, caused by nothing at all.
(402) 316-7963 View (402) 316-7963
Photo of Anabel Tapia Marin - Valemara Counseling, Marriage & Family Therapist, LIMHP, MFT
Valemara Counseling
Marriage & Family Therapist, LIMHP, MFT
2 Endorsed
Serves Area
¡Soy bilingüe y me encantaría acompañarte en el proceso de alcanzar tus metas y sentirte mejor! Tengo amplia experiencia en diversas áreas de la salud mental y me especializo en el trabajo con mujeres y familias. Ofrezco terapia a niños, adolescentes, adultos y parejas, creando un espacio seguro, respetuoso y de apoyo. Valoro profundamente el trabajo con personas de diferentes culturas y antecedentes, y abordo la terapia con empatía, sensibilidad cultural y colaboración. Te invito a contactarme para conversar y explorar cómo puedo apoyarte en tu bienestar emocional.
¡Soy bilingüe y me encantaría acompañarte en el proceso de alcanzar tus metas y sentirte mejor! Tengo amplia experiencia en diversas áreas de la salud mental y me especializo en el trabajo con mujeres y familias. Ofrezco terapia a niños, adolescentes, adultos y parejas, creando un espacio seguro, respetuoso y de apoyo. Valoro profundamente el trabajo con personas de diferentes culturas y antecedentes, y abordo la terapia con empatía, sensibilidad cultural y colaboración. Te invito a contactarme para conversar y explorar cómo puedo apoyarte en tu bienestar emocional.
(531) 233-3094 View (531) 233-3094
Photo of Amber Wiest, MA, LIMHP, LPC
Amber Wiest
Verified Verified
Serves Area
WelcomeI My goal is to support you and teach you how to live a happier, healthier, positive and productive lifestyle! I take appointments on weekends and evenings and I am very flexible with scheduling. I do some in-home therapy and meet at schools, if it's preferred. I like to work with adolescents and families with intense needs. I often work with individuals involved with domestic violence, substance abuse, trauma, and eating disorders.
WelcomeI My goal is to support you and teach you how to live a happier, healthier, positive and productive lifestyle! I take appointments on weekends and evenings and I am very flexible with scheduling. I do some in-home therapy and meet at schools, if it's preferred. I like to work with adolescents and families with intense needs. I often work with individuals involved with domestic violence, substance abuse, trauma, and eating disorders.
(402) 588-1162 View (402) 588-1162
Photo of Sean Weller, Counselor, MS, NCC, LMHC, CPC, LIMHP
Sean Weller
Counselor, MS, NCC, LMHC, CPC, LIMHP
1 Endorsed
Serves Area
I believe that counseling is individualized and my focus during sessions is about you. As your counselor, I value your input while tailoring my counseling approach to best fit your needs through a compassionate approach. I work with clients who face symptoms of depression, anxiety, suicidal ideation, anger, and issues of shame and guilt utilizing a Solution Focused approach in my sessions. I also utilize techniques of Cognitive Behavioral therapy. Through these approaches counseling will assist you in decreasing life’s barriers and promote personal growth.
I believe that counseling is individualized and my focus during sessions is about you. As your counselor, I value your input while tailoring my counseling approach to best fit your needs through a compassionate approach. I work with clients who face symptoms of depression, anxiety, suicidal ideation, anger, and issues of shame and guilt utilizing a Solution Focused approach in my sessions. I also utilize techniques of Cognitive Behavioral therapy. Through these approaches counseling will assist you in decreasing life’s barriers and promote personal growth.
(402) 566-5588 View (402) 566-5588
Photo of Danyelle (Dani) Harm, Independent Mental Health Practitioner, LICSW, LADC
Danyelle (Dani) Harm
Independent Mental Health Practitioner, LICSW, LADC
1 Endorsed
Serves Area
I have experience working with adults and adolescents who have mental health and substance use issues. I work well with clients who are struggling with depression, substance use issues, mood instability, relationship issues, self-esteem, anxiety, anger, and just feeling "off." Together we will look at what works for you, what isn't working for you, and how to change this. You will be doing the work, I will help guide you and provide tools as needed.
I have experience working with adults and adolescents who have mental health and substance use issues. I work well with clients who are struggling with depression, substance use issues, mood instability, relationship issues, self-esteem, anxiety, anger, and just feeling "off." Together we will look at what works for you, what isn't working for you, and how to change this. You will be doing the work, I will help guide you and provide tools as needed.
(402) 226-5276 View (402) 226-5276
Photo of Emiliana Isabella Blanco, Independent Mental Health Practitioner, LIMHP
Emiliana Isabella Blanco
Independent Mental Health Practitioner, LIMHP
Serves Area
Getting to know who you are and what you are is a harrowing journey for even the hardiest among us. Let me embark on it with you and be your guide in discovering who you are, what's important to you, and how to get there! I have experience working through gender exploration, sexual orientation exploration, major life transitions, depression, anxiety, romantic relationship difficulties, sexual topics, and so much more. I am the best fit for clients who need a gentle, empathetic push towards self-love and fulfillment. I particularly love working with the struggling perfectionist.
Getting to know who you are and what you are is a harrowing journey for even the hardiest among us. Let me embark on it with you and be your guide in discovering who you are, what's important to you, and how to get there! I have experience working through gender exploration, sexual orientation exploration, major life transitions, depression, anxiety, romantic relationship difficulties, sexual topics, and so much more. I am the best fit for clients who need a gentle, empathetic push towards self-love and fulfillment. I particularly love working with the struggling perfectionist.
(531) 230-8167 View (531) 230-8167
Photo of Betty A Kola - Buoyant Family Services Counseling and Consulting, Counselor, MS, LIMHP, CPC, ACS4957
Buoyant Family Services Counseling and Consulting
Counselor, MS, LIMHP, CPC, ACS4957
Serves Area
Life’s daily stressors can affect anyone, and no one is immune to the effects of stress and trauma. When left untreated, these challenges can lead to significant health-related issues. It’s important to remember that reaching out to a professional is not a sign of weakness, but a proactive step toward well-being. You don’t have to wait for things to go wrong to seek extra help; embracing support is a testament to self-awareness and strength.
Life’s daily stressors can affect anyone, and no one is immune to the effects of stress and trauma. When left untreated, these challenges can lead to significant health-related issues. It’s important to remember that reaching out to a professional is not a sign of weakness, but a proactive step toward well-being. You don’t have to wait for things to go wrong to seek extra help; embracing support is a testament to self-awareness and strength.
(402) 413-8268 View (402) 413-8268
Photo of Laura Sanchez - AM Counseling & Consulting, Counselor, LICSW, LIMHP, LADC
AM Counseling & Consulting
Counselor, LICSW, LIMHP, LADC
Serves Area
Many of us did not grow up knowing that it was important - and okay - to take care of our mental health. We heard talking about going to the doctor when you are sick, but nothing about seeking counseling - therapy - when our thoughts, feelings, or behaviors aren't well. But seeing a therapist is just as important and normal as visiting your doctor. Our minds and bodies are one, endlessly affecting one another both positively and negatively. If we are unwell physically, then our mental health can suffer AND vise versa.
Many of us did not grow up knowing that it was important - and okay - to take care of our mental health. We heard talking about going to the doctor when you are sick, but nothing about seeking counseling - therapy - when our thoughts, feelings, or behaviors aren't well. But seeing a therapist is just as important and normal as visiting your doctor. Our minds and bodies are one, endlessly affecting one another both positively and negatively. If we are unwell physically, then our mental health can suffer AND vise versa.
(402) 542-5820 View (402) 542-5820
Photo of Nancy Herrera, Counselor, LIMHP
Nancy Herrera
Counselor, LIMHP
Serves Area
As a dedicated Christian Psychotherapist with almost a decade of experience, I am committed to providing compassionate and faith-based mental health support to children, adults and families. My approach to psychotherapy integrates the principles of psychology with Christian values and beliefs to help clients navigate life's challenges while drawing upon their spiritual faith for strength and guidance. I offer one on one counseling sessions to address a wide range of emotional and psychological issues, including anxiety, depression, grief, trauma, and personal growth.
As a dedicated Christian Psychotherapist with almost a decade of experience, I am committed to providing compassionate and faith-based mental health support to children, adults and families. My approach to psychotherapy integrates the principles of psychology with Christian values and beliefs to help clients navigate life's challenges while drawing upon their spiritual faith for strength and guidance. I offer one on one counseling sessions to address a wide range of emotional and psychological issues, including anxiety, depression, grief, trauma, and personal growth.
(402) 741-4828 View (402) 741-4828
Photo of Alma Orellana, Counselor, PLMHP
Alma Orellana
Counselor, PLMHP
1 Endorsed
Serves Area
Alma Orellana is a Bilingual Licensed Mental Health Practitioner (PLMHP) in Nebraska. She has over 10 years of experience working with children, families and individuals overcoming barriers that prevent them from being successful in life. Her specialty is trauma, grief and loss, anxiety, depression, divorce, abuse, neglect, violence, and sexual abuse.
Alma Orellana is a Bilingual Licensed Mental Health Practitioner (PLMHP) in Nebraska. She has over 10 years of experience working with children, families and individuals overcoming barriers that prevent them from being successful in life. Her specialty is trauma, grief and loss, anxiety, depression, divorce, abuse, neglect, violence, and sexual abuse.
(402) 532-1765 View (402) 532-1765
Photo of Maria Elena Correa, Counselor, LIMHP
Maria Elena Correa
Counselor, LIMHP
Serves Area
I am a bilingual psychotherapist ( English and Spanish). I specialize in relationships, ADHD, anxiety, and depression. I can help you in improving to have better relationships with your significant other, your family, your friends, or even business partners and coworkers. I can help you get your mood up and I can help you beat unhappiness. I have worked with more than 400 families with children with ADHD and ODD, this is one of my expertise areas.
I am a bilingual psychotherapist ( English and Spanish). I specialize in relationships, ADHD, anxiety, and depression. I can help you in improving to have better relationships with your significant other, your family, your friends, or even business partners and coworkers. I can help you get your mood up and I can help you beat unhappiness. I have worked with more than 400 families with children with ADHD and ODD, this is one of my expertise areas.
(402) 281-9485 View (402) 281-9485
Photo of Alexah Keyes, Provisional Mental Health Practitioner, PLMHP
Alexah Keyes
Provisional Mental Health Practitioner, PLMHP
4 Endorsed
Serves Area
There are several transitions people experience in their lives, which can then trigger painful memories and make transitions more complicated than they need to be. I help provide a non-judgmental, supportive and empathetic environment to safely explore all of these feelings and memories. I have a mentality of "one step at a time", taking bite size pieces out of overall symptoms to help bring some relief while bigger issues are addressed.
There are several transitions people experience in their lives, which can then trigger painful memories and make transitions more complicated than they need to be. I help provide a non-judgmental, supportive and empathetic environment to safely explore all of these feelings and memories. I have a mentality of "one step at a time", taking bite size pieces out of overall symptoms to help bring some relief while bigger issues are addressed.
(402) 825-8123 View (402) 825-8123
Photo of Claudia Herrera, Counselor, LICSW, PLADC
Claudia Herrera
Counselor, LICSW, PLADC
Serves Area
La vida está llena de transiciones constantes y desafiantes. Sin importar por lo que estés pasando, estoy aquí para ayudarte. La terapia tiene el poder de ser transformadora y de mejorar significativamente tu calidad de vida, como lo he visto en muchos de mis clientes. Dar el primer paso puede parecer intimidante, pero no estás solo/a. Mi objetivo es que este proceso sea lo más enriquecedor y revelador posible. Enviar un correo electrónico o hacer una llamada es el primer paso hacia el descubrimiento de la mejor versión de ti mismo/a. Sea lo que sea que estés enfrentando ahora, quiero que sepas que hay esperanza.
La vida está llena de transiciones constantes y desafiantes. Sin importar por lo que estés pasando, estoy aquí para ayudarte. La terapia tiene el poder de ser transformadora y de mejorar significativamente tu calidad de vida, como lo he visto en muchos de mis clientes. Dar el primer paso puede parecer intimidante, pero no estás solo/a. Mi objetivo es que este proceso sea lo más enriquecedor y revelador posible. Enviar un correo electrónico o hacer una llamada es el primer paso hacia el descubrimiento de la mejor versión de ti mismo/a. Sea lo que sea que estés enfrentando ahora, quiero que sepas que hay esperanza.
(402) 207-9818 View (402) 207-9818
Photo of Danielle Smith, Independent Mental Health Practitioner, LIMHP, CMSW
Danielle Smith
Independent Mental Health Practitioner, LIMHP, CMSW
Serves Area
Looking into therapy can be scary. Talking about the thing(s) that bring you to therapy can be even scarier. It’s my goal to make therapy the tiniest amount of scary possible. The things you’ve been through, the experiences you’ve had, have brought you to where you are today. Maybe you’re not happy with where you are today- that’s OK! Maybe you don't know where, or who, you want to be- yet- and that's OK too! You're here, looking at this page right now because you want things to change and you know what? That's really fucking brave. Go you!
Looking into therapy can be scary. Talking about the thing(s) that bring you to therapy can be even scarier. It’s my goal to make therapy the tiniest amount of scary possible. The things you’ve been through, the experiences you’ve had, have brought you to where you are today. Maybe you’re not happy with where you are today- that’s OK! Maybe you don't know where, or who, you want to be- yet- and that's OK too! You're here, looking at this page right now because you want things to change and you know what? That's really fucking brave. Go you!
(402) 923-3796 View (402) 923-3796

See more therapy options for 68107

How does your Therapist compare?

Number of Therapists in 68107

20+

Average cost per session

$120

Therapists in 68107 who prioritize treating:

90% Anxiety
86% Trauma and PTSD
83% Depression
66% Self Esteem
59% Stress
59% Marriage Counseling
55% Family Conflict

Average years in practice

11 Years

Top 3 insurances accepted

86% BlueCross and BlueShield
82% Aetna
82% UnitedHealthcare UHC | UBH

How Therapists in 68107 see their clients

76% In Person and Online
24% Online Only

Gender breakdown

72% Female
24% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 68107?

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.