Photo of Dr. Jacqueline Contreras, PhD, LPC, Licensed Professional Counselor
Dr. Jacqueline Contreras
Licensed Professional Counselor, PhD, LPC
Verified Verified
2 Endorsed
San Antonio, TX 78228
¡Hola! My name is Dr. Jacqueline Contreras. My experiences include treating patients managing chronic pain, anxiety, depression, stress, phase of life issues, post-traumatic stress disorder, personal growth, social phobia, self-esteem, work related injuries, car accident injuries, and adjustment disorder. I have experience working with LGBTQ+ patients, too. Additionally, I have advised college students from low socio-economic communities, career counseling, and helped first-generation college students adjust to a four-year university.
¡Hola! My name is Dr. Jacqueline Contreras. My experiences include treating patients managing chronic pain, anxiety, depression, stress, phase of life issues, post-traumatic stress disorder, personal growth, social phobia, self-esteem, work related injuries, car accident injuries, and adjustment disorder. I have experience working with LGBTQ+ patients, too. Additionally, I have advised college students from low socio-economic communities, career counseling, and helped first-generation college students adjust to a four-year university.
(210) 972-1137 View (210) 972-1137
Photo of Dr. Caroline K Gonzales, PsyD, LPC, ABS, Licensed Professional Counselor
Dr. Caroline K Gonzales
Licensed Professional Counselor, PsyD, LPC, ABS
Verified Verified
1 Endorsed
San Antonio, TX 78228  (Online Only)
Not accepting new clients
Are you stressed out and anxious? Are you struggling with sleep problems because you're worrying too much? Do you suffer from past or recent trauma and have tried other methods of therapy but need deeper work? If you answered yes to any of these, my approach is to collaboratively explore your thoughts, beliefs and life experiences to help you gain self-knowledge and empower you to live a more satisfying life. Our work together will inspire you to cope with difficulties at work or at home in a more productive way. Extremely limited openings. If I cannot see you, I have 10 wonderful therapists on staff, 6 of whom are EMDR trained.
Are you stressed out and anxious? Are you struggling with sleep problems because you're worrying too much? Do you suffer from past or recent trauma and have tried other methods of therapy but need deeper work? If you answered yes to any of these, my approach is to collaboratively explore your thoughts, beliefs and life experiences to help you gain self-knowledge and empower you to live a more satisfying life. Our work together will inspire you to cope with difficulties at work or at home in a more productive way. Extremely limited openings. If I cannot see you, I have 10 wonderful therapists on staff, 6 of whom are EMDR trained.
(210) 610-1292 View (210) 610-1292
Photo of undefined - Holistic Group Sanctuary, LPC, NCC, CHT, Licensed Professional Counselor
Holistic Group Sanctuary
Licensed Professional Counselor, LPC, NCC, CHT
Verified Verified
San Antonio, TX 78228
Why NuVision? From the comfort of your home or office, without any invasive procedures, NuVision can map the true origins of physical, mental, emotional and spiritual challenges and match the issues with solutions, remedies and even life issues needing answers. How does it do it? Nu|Vision is a new software matching tool based on Holographic Scaling Technology. We realize the power of synergy, therefore we work in cooperation with organizations that have expert knowledge in their respective fields.
Why NuVision? From the comfort of your home or office, without any invasive procedures, NuVision can map the true origins of physical, mental, emotional and spiritual challenges and match the issues with solutions, remedies and even life issues needing answers. How does it do it? Nu|Vision is a new software matching tool based on Holographic Scaling Technology. We realize the power of synergy, therefore we work in cooperation with organizations that have expert knowledge in their respective fields.
(210) 899-7057 View (210) 899-7057
Photo of Jessica F. Boulanger, MEd, NCC, LPC, Licensed Professional Counselor
Jessica F. Boulanger
Licensed Professional Counselor, MEd, NCC, LPC
Verified Verified
San Antonio, TX 78228
I provide telemental health (virtual) & in-person therapy sessions for pre-teens, adolescents, adults & families experiencing emotional disturbance &/or difficulty w/life transitions related to family/school/peer conflict, behavioral/relational dysfunction, gender identity, occupational, relational & interpersonal stressors, trauma, grief & other situational circumstances that may be disrupting one's overall mental health well-being. Additionally, I provide access to community, local & national resources & assist w/advocacy services through coordinating & networking w/other professionals, schools, support groups, courts & agencies.
I provide telemental health (virtual) & in-person therapy sessions for pre-teens, adolescents, adults & families experiencing emotional disturbance &/or difficulty w/life transitions related to family/school/peer conflict, behavioral/relational dysfunction, gender identity, occupational, relational & interpersonal stressors, trauma, grief & other situational circumstances that may be disrupting one's overall mental health well-being. Additionally, I provide access to community, local & national resources & assist w/advocacy services through coordinating & networking w/other professionals, schools, support groups, courts & agencies.
(210) 739-4200 View (210) 739-4200
Photo of undefined - Sylvia Vargas, M.A., LPC, CART, MA, LPC, CART, Licensed Professional Counselor
Sylvia Vargas, M.A., LPC, CART
Licensed Professional Counselor, MA, LPC, CART
Verified Verified
1 Endorsed
San Antonio, TX 78228
Welcome! You may be here because you feel the need and/or want to talk with a therapist to get help with problems that are bothering you or keeping you from being successful in important areas in your life. As a Licensed Professional Counselor and Certified Anger Resolution Therapist, I work with children, adolescents, individuals, couples, and families. Some issues I may be able to help with include: adjustments in life, life traumas, anger management, stress management, behavioral issues, family conflicts and relational problems.
Welcome! You may be here because you feel the need and/or want to talk with a therapist to get help with problems that are bothering you or keeping you from being successful in important areas in your life. As a Licensed Professional Counselor and Certified Anger Resolution Therapist, I work with children, adolescents, individuals, couples, and families. Some issues I may be able to help with include: adjustments in life, life traumas, anger management, stress management, behavioral issues, family conflicts and relational problems.
(210) 405-6526 View (210) 405-6526
Photo of Agnes Zaldivar, LPC, Counselor
Agnes Zaldivar
Counselor, LPC
Verified Verified
San Antonio, TX 78228  (Online Only)
Do you ever find yourself struggling just to get through the day? Do you feel overwhelmed and stressed out over minor issues and events? Do you wake up in the morning dreading the day before you? Have you been feeling depressed, anxious, and angry.....lashing out at others which only compounds these bad feelings? Have you had thoughts of just wanting to "run away" or "give up"? Emotions can be wonderful, but they can also get out of hand and lead you to make poor decisions or to act in ways that create more problems.
Do you ever find yourself struggling just to get through the day? Do you feel overwhelmed and stressed out over minor issues and events? Do you wake up in the morning dreading the day before you? Have you been feeling depressed, anxious, and angry.....lashing out at others which only compounds these bad feelings? Have you had thoughts of just wanting to "run away" or "give up"? Emotions can be wonderful, but they can also get out of hand and lead you to make poor decisions or to act in ways that create more problems.
(210) 972-0318 View (210) 972-0318
Photo of Dacia Benton, MS, LPC-S, Licensed Professional Counselor
Dacia Benton
Licensed Professional Counselor, MS, LPC-S
Verified Verified
1 Endorsed
San Antonio, TX 78228
"I believe every person has value and a divine purpose in life". Challenges will come, but you can overcome them. Thank you for taking the first step in the healing process. I am dedicated to enhancing the emotional, physical, and spiritual strength of my clients. I am here to support, encourage, challenge and empower you to reach your goals.
"I believe every person has value and a divine purpose in life". Challenges will come, but you can overcome them. Thank you for taking the first step in the healing process. I am dedicated to enhancing the emotional, physical, and spiritual strength of my clients. I am here to support, encourage, challenge and empower you to reach your goals.
(210) 981-3870 View (210) 981-3870
Photo of Christine Elizabeth Chandler, MS, LPC, Licensed Professional Counselor
Christine Elizabeth Chandler
Licensed Professional Counselor, MS, LPC
Verified Verified
San Antonio, TX 78228  (Online Only)
I understand that clients are experts in their own lives, but sometimes they need help with unwanted thoughts, symptoms, or behaviors. Reaching out for help can be difficult for all kinds of reasons. I want to reassure you with words from Brené Brown “We don’t have to do all of it alone. We were never meant to." I want to help you work on becoming the best version of yourself. Loneliness, social anxiety, and just dealing with a constantly changing world can sometimes make anyone feel out of control. I want to help give you back that feeling of being in control of your life.
I understand that clients are experts in their own lives, but sometimes they need help with unwanted thoughts, symptoms, or behaviors. Reaching out for help can be difficult for all kinds of reasons. I want to reassure you with words from Brené Brown “We don’t have to do all of it alone. We were never meant to." I want to help you work on becoming the best version of yourself. Loneliness, social anxiety, and just dealing with a constantly changing world can sometimes make anyone feel out of control. I want to help give you back that feeling of being in control of your life.
(254) 237-4683 View (254) 237-4683
Photo of Shelby Walter, LCSW, Clinical Social Work/Therapist
Shelby Walter
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
San Antonio, TX 78228
I am a licensed clinical social worker (LCSW). I started my educational journey working with children who have special needs, focusing on Autism. The last few years, I have emphasized on working with young children, adolescents, and parents who have experienced multiple traumas. My outlook on working with clients' who have experienced trauma is focusing around the question of "What has happened to you". Assisting the client overcome their personal traumas and seeing the growth and positive outcomes of healing, has to be the most rewarding part of the therapeutic process.
I am a licensed clinical social worker (LCSW). I started my educational journey working with children who have special needs, focusing on Autism. The last few years, I have emphasized on working with young children, adolescents, and parents who have experienced multiple traumas. My outlook on working with clients' who have experienced trauma is focusing around the question of "What has happened to you". Assisting the client overcome their personal traumas and seeing the growth and positive outcomes of healing, has to be the most rewarding part of the therapeutic process.
(210) 571-7270 View (210) 571-7270
Photo of Elizabeth Woodruff, MA
Elizabeth Woodruff
Licensed Professional Counselor Associate, MA
Verified Verified
1 Endorsed
San Antonio, TX 78228
Life is unpredictable. Challenges are presented in our lives and despite our efforts to overcome them, we may become overwhelmed or feel hopeless in our efforts. Do you feel like you have lost yourself, even though you have tried so hard to stay afloat? Maybe you feel disconnected from the relationships in your life, leaving you feeling isolated or not heard. No one should have to go through tough times feeling like they are all alone. My goal is to be present with my clients and assist them in regaining their voice, build confidence, and create balance in their lives. I offer support for adults, teenagers, and couples.
Life is unpredictable. Challenges are presented in our lives and despite our efforts to overcome them, we may become overwhelmed or feel hopeless in our efforts. Do you feel like you have lost yourself, even though you have tried so hard to stay afloat? Maybe you feel disconnected from the relationships in your life, leaving you feeling isolated or not heard. No one should have to go through tough times feeling like they are all alone. My goal is to be present with my clients and assist them in regaining their voice, build confidence, and create balance in their lives. I offer support for adults, teenagers, and couples.
(210) 985-7992 View (210) 985-7992
Photo of Gabriella Kershner, MS, LPC, Licensed Professional Counselor
Gabriella Kershner
Licensed Professional Counselor, MS, LPC
Verified Verified
10 Endorsed
San Antonio, TX 78228
Not accepting new clients
As a therapist, my goal is to help you gain insight into your current situation, guide you into learning how to manage your emotions, and help you face your fears and break free from the obstacles hindering your progress. There is hope in that you can greatly influence the future by changing your mindset today, while moving forward in freedom. Working together, we can create an effective plan that is sure to inspire change and yield results. I am currently taking new clients in the San Antonio area. You have what it takes, my friend. You were born for such a time as this. Let's talk.
As a therapist, my goal is to help you gain insight into your current situation, guide you into learning how to manage your emotions, and help you face your fears and break free from the obstacles hindering your progress. There is hope in that you can greatly influence the future by changing your mindset today, while moving forward in freedom. Working together, we can create an effective plan that is sure to inspire change and yield results. I am currently taking new clients in the San Antonio area. You have what it takes, my friend. You were born for such a time as this. Let's talk.
(210) 903-9583 View (210) 903-9583
Photo of Vincent Valadez, MA, LPC, Licensed Professional Counselor
Vincent Valadez
Licensed Professional Counselor, MA, LPC
Verified Verified
1 Endorsed
San Antonio, TX 78228
Hello and welcome. Growth can be challenging, but worthwhile as well. If you are ready to invest in this challenge and in yourself, I would truly appreciate the opportunity be a part of your journey.
Hello and welcome. Growth can be challenging, but worthwhile as well. If you are ready to invest in this challenge and in yourself, I would truly appreciate the opportunity be a part of your journey.
(210) 742-4685 View (210) 742-4685
Photo of Angelica M Montalvo, MA, LPC-A
Angelica M Montalvo
Licensed Professional Counselor Associate, MA, LPC-A
Verified Verified
1 Endorsed
San Antonio, TX 78228
My clients come from diverse backgrounds, cultures, lifestyles, values, and beliefs. When they walk into counseling, they have found themselves in a place where they feel stuck in life, whether it be from depression, anxiety, addiction, past trauma, or a breakdown in relationships. As a counselor, it is my privilege to walk with them through these “stuck moments” and begin discovering those places of healing, growth, reconciliation, confidence, trust, and a life worth living.
My clients come from diverse backgrounds, cultures, lifestyles, values, and beliefs. When they walk into counseling, they have found themselves in a place where they feel stuck in life, whether it be from depression, anxiety, addiction, past trauma, or a breakdown in relationships. As a counselor, it is my privilege to walk with them through these “stuck moments” and begin discovering those places of healing, growth, reconciliation, confidence, trust, and a life worth living.
(210) 940-2061 View (210) 940-2061
Photo of Rachel A. Barkley, MSW, LCSW-S, TF-CBT, Clinical Social Work/Therapist
Rachel A. Barkley
Clinical Social Work/Therapist, MSW, LCSW-S, TF-CBT
Verified Verified
2 Endorsed
San Antonio, TX 78228
Welcome to this next step in your journey. Choosing to care for yourself in the form of therapy is taking a brave step toward accessing support and resources for continued growth and wellness while navigating the complexity of life, past and present. Are you feeling stress, worry, or anxiety? Are you experiencing depression and/or loss of energy? Are you needing to feel heard and seen? Are you wanting to explore deeper meaning and purpose on your path? Have you or your adolescent child experienced a particularly upsetting event from which they need to heal? You are not alone and I am here to help.
Welcome to this next step in your journey. Choosing to care for yourself in the form of therapy is taking a brave step toward accessing support and resources for continued growth and wellness while navigating the complexity of life, past and present. Are you feeling stress, worry, or anxiety? Are you experiencing depression and/or loss of energy? Are you needing to feel heard and seen? Are you wanting to explore deeper meaning and purpose on your path? Have you or your adolescent child experienced a particularly upsetting event from which they need to heal? You are not alone and I am here to help.
(210) 940-3421 View (210) 940-3421
Photo of Cynthia Ann Aguilar, LPC-A
Cynthia Ann Aguilar
Licensed Professional Counselor Associate , LPC-A
Verified Verified
San Antonio, TX 78228
Not accepting new clients
As a Licensed Professional Counselor Associate, I am deeply committed to helping individuals navigate life's challenges with resilience, insight, and compassion. My counseling journey began with a profound desire to make a positive difference in people's lives, and this motivation continues to drive my professional endeavors. Throughout my academic and professional experiences, I have developed a comprehensive understanding of human behavior, psychological theories, and evidence-based therapeutic techniques. My education has equipped me with the knowledge and skills to provide effective counseling services to diverse populations.
As a Licensed Professional Counselor Associate, I am deeply committed to helping individuals navigate life's challenges with resilience, insight, and compassion. My counseling journey began with a profound desire to make a positive difference in people's lives, and this motivation continues to drive my professional endeavors. Throughout my academic and professional experiences, I have developed a comprehensive understanding of human behavior, psychological theories, and evidence-based therapeutic techniques. My education has equipped me with the knowledge and skills to provide effective counseling services to diverse populations.
(726) 227-2816 View (726) 227-2816
Photo of undefined - Kim Ghezzi Supervised By Bianca Goodrum PhD LPC-S, MA, LPC-A, CSC
Kim Ghezzi Supervised By Bianca Goodrum PhD LPC-S
Licensed Professional Counselor Associate, MA, LPC-A, CSC
Verified Verified
1 Endorsed
San Antonio, TX 78228
Don't let anxiety and neglecting self-care hold you back any longer. It's time to prioritize your well-being, reignite your passion for life, and create the fulfilling relationships you desire. Take time to examine your values, motivations and parts of yourself that may be holding you back from taking the next step towards your dreams and goals.
Don't let anxiety and neglecting self-care hold you back any longer. It's time to prioritize your well-being, reignite your passion for life, and create the fulfilling relationships you desire. Take time to examine your values, motivations and parts of yourself that may be holding you back from taking the next step towards your dreams and goals.
(210) 761-5866 View (210) 761-5866
Photo of undefined - Advanced Counseling Services , Licensed Professional Counselor
Advanced Counseling Services
Licensed Professional Counselor
Verified Verified
San Antonio, TX 78228
We are a group of friendly experienced therapists who evaluate, diagnose and treat all mood disorders, behavioral disorders, and trauma from age 6 to 64 years old.
We are a group of friendly experienced therapists who evaluate, diagnose and treat all mood disorders, behavioral disorders, and trauma from age 6 to 64 years old.
(210) 940-3844 View (210) 940-3844
Photo of Arianna Martinez, MA, LPC-A
Arianna Martinez
LPC Associate, MA, LPC-A
Verified Verified
San Antonio, TX 78228
As a dedicated therapist specializing in children and teens, my primary focus is to provide compassionate and effective support for their mental health and well-being. Through a combination of active listening, empathy, and evidence-based therapeutic techniques, I create a safe and nurturing space where young individuals feel comfortable expressing their thoughts and emotions. I work collaboratively with them to explore and understand their challenges, helping them develop coping strategies and resilience. By fostering a trusting and nonjudgmental relationship, I aim to empower children and teens to navigate their day-to-day lives.
As a dedicated therapist specializing in children and teens, my primary focus is to provide compassionate and effective support for their mental health and well-being. Through a combination of active listening, empathy, and evidence-based therapeutic techniques, I create a safe and nurturing space where young individuals feel comfortable expressing their thoughts and emotions. I work collaboratively with them to explore and understand their challenges, helping them develop coping strategies and resilience. By fostering a trusting and nonjudgmental relationship, I aim to empower children and teens to navigate their day-to-day lives.
(210) 941-4308 View (210) 941-4308
Eugeny Tilvaldiev
Clinical Social Work/Therapist, LCSW, LCDC, PsyD
Verified Verified
San Antonio, TX 78228
Therapy is not a one-size-fits-all approach and I work with my clients to tailor therapy to meet their needs. Everyone is different and experiences many challenges in life. To better serve my clients, I start where the client is. With the client’s help, I determine the goals of therapy and we work together to achieve those goals. This process works even if people do not know what they want from therapy except to feel better. Therapy involves many layers and it’s my job as a clinician to guide them through those layers.
Therapy is not a one-size-fits-all approach and I work with my clients to tailor therapy to meet their needs. Everyone is different and experiences many challenges in life. To better serve my clients, I start where the client is. With the client’s help, I determine the goals of therapy and we work together to achieve those goals. This process works even if people do not know what they want from therapy except to feel better. Therapy involves many layers and it’s my job as a clinician to guide them through those layers.
(210) 942-7563 View (210) 942-7563
Photo of undefined - Blossoming Butterfly Counseling Center PLLC, LPC-S, Licensed Professional Counselor
Blossoming Butterfly Counseling Center PLLC
Licensed Professional Counselor, LPC-S
Verified Verified
1 Endorsed
San Antonio, TX 78228
Hi, my name is Tiffaney, and I am an experienced licensed professional counselor supervisor (LPC-S). I am enthusiastic about being authentic and real with my clients to create an encouraging environment for exploration and growth. I believe in the power of choice, and my goal as a counselor is to provide support and guidance to empower you in your decisions. My focus is on progress not perfection and becoming ok with being perfectly imperfect.
Hi, my name is Tiffaney, and I am an experienced licensed professional counselor supervisor (LPC-S). I am enthusiastic about being authentic and real with my clients to create an encouraging environment for exploration and growth. I believe in the power of choice, and my goal as a counselor is to provide support and guidance to empower you in your decisions. My focus is on progress not perfection and becoming ok with being perfectly imperfect.
(210) 796-1986 View (210) 796-1986

How does your Therapist compare?

Number of Therapists in 78228

100+

Average cost per session

$110

Therapists in 78228 who prioritize treating:

93% Anxiety
92% Depression
76% Trauma and PTSD
70% Stress
60% Coping Skills
59% Grief
57% Self Esteem

Average years in practice

10 Years

Top 3 insurances accepted

93% Aetna
87% BlueCross and BlueShield
82% UnitedHealthcare UHC | UBH

How Therapists in 78228 see their clients

60% In Person and Online
40% Online Only

Gender breakdown

88% Female
12% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 78228?

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.