Photo of Tanvir (Tanii) Mann, LMFT, Marriage & Family Therapist
Tanvir (Tanii) Mann
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Online Only
Not accepting new clients
Let's get regulated! I am here to support you in developing life-changing habits to cope with various obstacles. I want you to know that your care with me will be individually designed to dissect personal needs. My mission is to provide the utmost care for you and guide you to overcome internal struggles that hinder you from living in the present. Throughout treatment, we will work together to figure out how to honor your unique experiences and needs, allowing you to build a relationship with SELF. I firmly believe in the importance of being seen, heard, and understood.
Let's get regulated! I am here to support you in developing life-changing habits to cope with various obstacles. I want you to know that your care with me will be individually designed to dissect personal needs. My mission is to provide the utmost care for you and guide you to overcome internal struggles that hinder you from living in the present. Throughout treatment, we will work together to figure out how to honor your unique experiences and needs, allowing you to build a relationship with SELF. I firmly believe in the importance of being seen, heard, and understood.
(559) 545-4717 View (559) 545-4717
Photo of Willie Muhammad, LMFT, Marriage & Family Therapist
Willie Muhammad
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Fresno, CA 93722
My goal as a therapist is to assist you with overcoming challenges by providing a safe space to process your feelings. In addition to a safe space feeling understood, respected, and genuinely cared for is necessary. I aim to create an empathetic, non-judgmental environment. I firmly believe that you are the expert on yourself and your experience.
My goal as a therapist is to assist you with overcoming challenges by providing a safe space to process your feelings. In addition to a safe space feeling understood, respected, and genuinely cared for is necessary. I aim to create an empathetic, non-judgmental environment. I firmly believe that you are the expert on yourself and your experience.
(559) 364-9560 View (559) 364-9560
Photo of Christine Rivlin, LPCC
Christine Rivlin
Licensed Professional Clinical Counselor, LPCC
Verified Verified
Online Only
My educational background consists of earning my BA in Psychology, a master's in clinical counseling, and a Master's in Addictions. I am a LPCC 16395 and am a certified addictions counselor. My areas of concentration include grief and significant trauma, PTSD, anxiety, depression, addictions, and a sub-concentration in eating disorders. I use evidence-based, solution-focused modalities of treatment. I work with clients to develop an action plan to better manage individual's unique experiences and lives.
My educational background consists of earning my BA in Psychology, a master's in clinical counseling, and a Master's in Addictions. I am a LPCC 16395 and am a certified addictions counselor. My areas of concentration include grief and significant trauma, PTSD, anxiety, depression, addictions, and a sub-concentration in eating disorders. I use evidence-based, solution-focused modalities of treatment. I work with clients to develop an action plan to better manage individual's unique experiences and lives.
(559) 546-4639 View (559) 546-4639
Photo of Ana Sanchez, LMFT, Marriage & Family Therapist
Ana Sanchez
Marriage & Family Therapist, LMFT
Verified Verified
Online Only
Hi there! My name is Ana Sanchez, a Licensed Marriage and Family Therapist here to provide some support in times when you need someone to talk to. I'd love to be a part of your support system and collaborate on working towards a transformative therapeutic experience in order to help you reach your goals. I have had the privilege of working with individuals having mild-to-moderate symptoms and providing services to individuals, couples, and families. I enjoy working with individuals one-on-one as well as the Spanish-speaking population on their therapeutic journey.
Hi there! My name is Ana Sanchez, a Licensed Marriage and Family Therapist here to provide some support in times when you need someone to talk to. I'd love to be a part of your support system and collaborate on working towards a transformative therapeutic experience in order to help you reach your goals. I have had the privilege of working with individuals having mild-to-moderate symptoms and providing services to individuals, couples, and families. I enjoy working with individuals one-on-one as well as the Spanish-speaking population on their therapeutic journey.
(559) 245-3997 View (559) 245-3997
Photo of Lawanda Hoyle, LCSW, Clinical Social Work/Therapist
Lawanda Hoyle
Clinical Social Work/Therapist, LCSW
Verified Verified
Online Only
Are you struggling with your mental health, or is your life just simply overwhelming at times? I can help you identify the patterns in your life that are limiting you and guide you toward developing better-coping skills to find healing and live the life you want to live. My focus is to empower you to be the very best “You” that you can be. Whether you are struggling with substance use, anxiety, depression, stress, grief, relationship issues, or trauma, I am here to help you through it. I want to help you achieve your goals through a positive therapeutic relationship that creates long-lasting results in your recovery.
Are you struggling with your mental health, or is your life just simply overwhelming at times? I can help you identify the patterns in your life that are limiting you and guide you toward developing better-coping skills to find healing and live the life you want to live. My focus is to empower you to be the very best “You” that you can be. Whether you are struggling with substance use, anxiety, depression, stress, grief, relationship issues, or trauma, I am here to help you through it. I want to help you achieve your goals through a positive therapeutic relationship that creates long-lasting results in your recovery.
(559) 644-0379 View (559) 644-0379
Photo of Michelle Lefebvre, LCP, Psychologist
Michelle Lefebvre
Psychologist, LCP
Verified Verified
Online Only
My name is Dr. Michelle Lefebvre and I am a licensed clinical psychologist. I support adult clients in achieving their goals and living lives consistent with their values. I also work with young children and their families to support their development and improve family life. My approach to therapy treatment is authentic and honest. I draw from a variety of treatment modalities, though the most common are cognitive-behavioral, psychodynamic, solution-focused, and narrative. Which treatment modality I use is dependent on the client's needs, preferences, and the plan for treatment.
My name is Dr. Michelle Lefebvre and I am a licensed clinical psychologist. I support adult clients in achieving their goals and living lives consistent with their values. I also work with young children and their families to support their development and improve family life. My approach to therapy treatment is authentic and honest. I draw from a variety of treatment modalities, though the most common are cognitive-behavioral, psychodynamic, solution-focused, and narrative. Which treatment modality I use is dependent on the client's needs, preferences, and the plan for treatment.
(559) 254-4258 View (559) 254-4258
Photo of Carol Fox, LMFT, Marriage & Family Therapist
Carol Fox
Marriage & Family Therapist, LMFT
Verified Verified
Online Only
My name is Carol Fox, LMFT and I have been in practice for many years, witnessing the changes in the need and acceptance of therapy as a tool to becoming a better person. Finding self has many paths, so many therapies have been created, but the focus is always the same: finding the self in the lives we live each and every day. My approach to therapy is to find the right path back to the self. Life presents many challenges, whether they be trauma or change of circumstances. These challenges are on a spectrum in everyone's life. People who are willing to work on themselves are most receptive to therapy, or the art of exploring.
My name is Carol Fox, LMFT and I have been in practice for many years, witnessing the changes in the need and acceptance of therapy as a tool to becoming a better person. Finding self has many paths, so many therapies have been created, but the focus is always the same: finding the self in the lives we live each and every day. My approach to therapy is to find the right path back to the self. Life presents many challenges, whether they be trauma or change of circumstances. These challenges are on a spectrum in everyone's life. People who are willing to work on themselves are most receptive to therapy, or the art of exploring.
(559) 238-4333 View (559) 238-4333
Photo of Andrew William Young, MA, Marriage & Family Therapist
Andrew William Young
Marriage & Family Therapist, MA
Verified Verified
Online Only
Whether its ADHD, trauma, depression or anxiety. I enjoy working with clients who want to put in the work. What this means to me is that we both work together in helping to find a solution to your challenges in life. I enjoy working with my clients for the long term to see them not only heal but excel in life. Becoming successful in their families, businesses, education or whatever your personal goals may be. I would love to be a part of your successes.
Whether its ADHD, trauma, depression or anxiety. I enjoy working with clients who want to put in the work. What this means to me is that we both work together in helping to find a solution to your challenges in life. I enjoy working with my clients for the long term to see them not only heal but excel in life. Becoming successful in their families, businesses, education or whatever your personal goals may be. I would love to be a part of your successes.
(559) 234-4149 View (559) 234-4149
Photo of Margarita Cooper, LMFT, Marriage & Family Therapist
Margarita Cooper
Marriage & Family Therapist, LMFT
Verified Verified
Online Only
Hello, my name is Margarita Cooper and I’m a Licensed Marriage and Family Therapist (LMFT) working with clients via telehealth. I work with adults and specialize in treating anxiety, stress, and depression using Cognitive Behavioral Therapy and Client-Centered Therapy to help my clients reach their treatment goals. I work with adults and specialize in the treatment of anxiety and depression. My approach is dependent on my clients' specific goals and needs. I use Client Centered therapy as I value each person's ability to direct themselves and move toward their desired outcomes.
Hello, my name is Margarita Cooper and I’m a Licensed Marriage and Family Therapist (LMFT) working with clients via telehealth. I work with adults and specialize in treating anxiety, stress, and depression using Cognitive Behavioral Therapy and Client-Centered Therapy to help my clients reach their treatment goals. I work with adults and specialize in the treatment of anxiety and depression. My approach is dependent on my clients' specific goals and needs. I use Client Centered therapy as I value each person's ability to direct themselves and move toward their desired outcomes.
(559) 364-3724 View (559) 364-3724
Photo of Tammy Casiano, LMFT, Marriage & Family Therapist
Tammy Casiano
Marriage & Family Therapist, LMFT
Verified Verified
Online Only
Hello! My name is Tammy Casiano. I'm a licensed Marriage & Family Therapist in California. I'm working on completing my Ph.D. in Clinical Psychology with a focus on psychological testing. I've done a lot of trauma & dissociative work. I primarily work on getting to know who you are and what your strengths are, which will be used in any approach we take. I value you as a unique individual - you are the expert & I'm your filter to figure out what is best for you.
Hello! My name is Tammy Casiano. I'm a licensed Marriage & Family Therapist in California. I'm working on completing my Ph.D. in Clinical Psychology with a focus on psychological testing. I've done a lot of trauma & dissociative work. I primarily work on getting to know who you are and what your strengths are, which will be used in any approach we take. I value you as a unique individual - you are the expert & I'm your filter to figure out what is best for you.
(559) 242-9083 View (559) 242-9083
Photo of Larissa Alley, LCSW, Clinical Social Work/Therapist
Larissa Alley
Clinical Social Work/Therapist, LCSW
Verified Verified
Online Only
Hi! My name is Larissa Alley. I am a Licensed Clinical Social Worker based in California with over 8 years of experience providing compassionate and effective mental health care. My primary goal is to help clients navigate life's challenges and achieve their personal goals. I specialize in anxiety, depression, stress management, relationship issues, grief, and life transitions by using Cognitive Behavioral Therapy among other theoretical approaches to help my clients make progress and start feeling better.
Hi! My name is Larissa Alley. I am a Licensed Clinical Social Worker based in California with over 8 years of experience providing compassionate and effective mental health care. My primary goal is to help clients navigate life's challenges and achieve their personal goals. I specialize in anxiety, depression, stress management, relationship issues, grief, and life transitions by using Cognitive Behavioral Therapy among other theoretical approaches to help my clients make progress and start feeling better.
(559) 379-6488 View (559) 379-6488
Photo of Valerie Eichelberg, LMFT, Marriage & Family Therapist
Valerie Eichelberg
Marriage & Family Therapist, LMFT
Verified Verified
Online Only
Hello, my name is Valerie Eichelberg, Licensed Marriage and Family Therapist (LMFT). I work with youth, adolescents, young and middle-aged adults with depression and anxiety. I typically use a person centered and solution focused approach with other modalities depending on need. I believe each person is unique and may need different approaches. One size does not fit all. My goal is to be able to support you manage and focus on your needs, in order to make life a more beautiful experience for you, however that may look like for you. Together we can navigate and decide on what works best for you.
Hello, my name is Valerie Eichelberg, Licensed Marriage and Family Therapist (LMFT). I work with youth, adolescents, young and middle-aged adults with depression and anxiety. I typically use a person centered and solution focused approach with other modalities depending on need. I believe each person is unique and may need different approaches. One size does not fit all. My goal is to be able to support you manage and focus on your needs, in order to make life a more beautiful experience for you, however that may look like for you. Together we can navigate and decide on what works best for you.
(559) 364-9941 View (559) 364-9941
Photo of Marsaides Mercier, LMFT, Marriage & Family Therapist
Marsaides Mercier
Marriage & Family Therapist, LMFT
Verified Verified
Online Only
Sometimes, you have to feel your feelings! I often say this to help alleviate the guilt of expressing myself- whether it be sadness, happiness, frustration, etc. Hello, my name is Marsaides Mercier. I am a Licensed Marriage and Family Therapist. I have been a therapist for 13 years, with initial experience as a case manager. So what brought me to the field of therapy? Of course, I wanted to be helpful to others, and I was told, "I give great advice." However, over time I have learned therapy is not about giving "good advice" but more about helping others find their way to feel what they feel without the guilt of it all.
Sometimes, you have to feel your feelings! I often say this to help alleviate the guilt of expressing myself- whether it be sadness, happiness, frustration, etc. Hello, my name is Marsaides Mercier. I am a Licensed Marriage and Family Therapist. I have been a therapist for 13 years, with initial experience as a case manager. So what brought me to the field of therapy? Of course, I wanted to be helpful to others, and I was told, "I give great advice." However, over time I have learned therapy is not about giving "good advice" but more about helping others find their way to feel what they feel without the guilt of it all.
(559) 702-8785 View (559) 702-8785
Veronica De Alba
Clinical Social Work/Therapist, LCSW
Verified Verified
Fresno, CA 93722
Not accepting new clients
My name is Veronica and I am bilingual in English & Spanish. Most people benefit from counseling at some point in their lives. It may be your time to engage in either 'short or long term' counseling if you are struggling in some way. Counseling can help you get on with your life and re-establish your faith, goals, dreams, passions and relationships.
My name is Veronica and I am bilingual in English & Spanish. Most people benefit from counseling at some point in their lives. It may be your time to engage in either 'short or long term' counseling if you are struggling in some way. Counseling can help you get on with your life and re-establish your faith, goals, dreams, passions and relationships.
(559) 900-3320 View (559) 900-3320
Photo of Brandon Breault, LMFT, Marriage & Family Therapist
Brandon Breault
Marriage & Family Therapist, LMFT
Verified Verified
Online Only
Has your mind made it difficult for you to focus? Do you feel stuck? It is said we have 60 to 80 thousand thoughts a day. That’s roughly 1.2 thoughts every second. Many of those thoughts are the same thoughts we had yesterday and the day before. In the world we live in this over saturation is constantly being reinforced and it begins the moment we open our eyes. We start our days feeling behind, playing catch up. With this many thoughts constantly spinning through our heads where does that leave time for new thoughts, new growth?
Has your mind made it difficult for you to focus? Do you feel stuck? It is said we have 60 to 80 thousand thoughts a day. That’s roughly 1.2 thoughts every second. Many of those thoughts are the same thoughts we had yesterday and the day before. In the world we live in this over saturation is constantly being reinforced and it begins the moment we open our eyes. We start our days feeling behind, playing catch up. With this many thoughts constantly spinning through our heads where does that leave time for new thoughts, new growth?
(559) 245-5782 View (559) 245-5782
Photo of Nicole Lapointe, LCSW, Clinical Social Work/Therapist
Nicole Lapointe
Clinical Social Work/Therapist, LCSW
Verified Verified
Online Only
Hi there, I'm Nicole! Therapy is an opportunity for self-discovery, empowerment, and healing. I work with various issues, including depression, anxiety, parenting, life transitions, and stress. I specialize in HIV/STD support, women's health, and older adults/ seniors. My goal is to help you recognize that you have all the tools and strength to develop and manage all of your challenges. I will work alongside you at your pace, providing a safe space to feel heard, understood, and supported in your growth.
Hi there, I'm Nicole! Therapy is an opportunity for self-discovery, empowerment, and healing. I work with various issues, including depression, anxiety, parenting, life transitions, and stress. I specialize in HIV/STD support, women's health, and older adults/ seniors. My goal is to help you recognize that you have all the tools and strength to develop and manage all of your challenges. I will work alongside you at your pace, providing a safe space to feel heard, understood, and supported in your growth.
(559) 551-3456 View (559) 551-3456
Photo of Nicole Calvino, LCSW, Clinical Social Work/Therapist
Nicole Calvino
Clinical Social Work/Therapist, LCSW
Verified Verified
Online Only
My name is Nicole Calvino, a Licensed Clinical Social Worker. I help with issues like self-esteem and self-efficacy, shame, and anxiety. I also work with adults and teens who have a history of trauma, particularly around social forces such as discrimination and isolation. Additionally, I work with people who feel they have an unhealthy/unhelpful relationship with certain behaviors/choices, and want to create habits that stick. My approach is client-centered and strengths-based, incorporating Trauma-Focused Cognitive Behavioral (CBT), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy, and Narrative Therapy.
My name is Nicole Calvino, a Licensed Clinical Social Worker. I help with issues like self-esteem and self-efficacy, shame, and anxiety. I also work with adults and teens who have a history of trauma, particularly around social forces such as discrimination and isolation. Additionally, I work with people who feel they have an unhealthy/unhelpful relationship with certain behaviors/choices, and want to create habits that stick. My approach is client-centered and strengths-based, incorporating Trauma-Focused Cognitive Behavioral (CBT), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy, and Narrative Therapy.
(559) 337-5937 View (559) 337-5937
Photo of Katherine Hoover, LCSW, Clinical Social Work/Therapist
Katherine Hoover
Clinical Social Work/Therapist, LCSW
Verified Verified
Online Only
Hi, my name is Kati Hoover, and I am a Licensed Clinical Social Worker (LCSW) based in Long Beach, California and working with clients statewide via telehealth. I enjoy working with adolescents and young adults and specialize in anxiety, stress, depression, LGBTQ+ issues, self-esteem, and relationship issues. I use Cognitive Behavioral Therapy and Acceptance and Commitment Therapy to help my clients achieve their goals and start feeling better. I have found that my style and approach is a good fit for teens and young adults who may be dealing with the challenges of life transitions and social pressures.
Hi, my name is Kati Hoover, and I am a Licensed Clinical Social Worker (LCSW) based in Long Beach, California and working with clients statewide via telehealth. I enjoy working with adolescents and young adults and specialize in anxiety, stress, depression, LGBTQ+ issues, self-esteem, and relationship issues. I use Cognitive Behavioral Therapy and Acceptance and Commitment Therapy to help my clients achieve their goals and start feeling better. I have found that my style and approach is a good fit for teens and young adults who may be dealing with the challenges of life transitions and social pressures.
(559) 523-4135 View (559) 523-4135
Photo of Roopa Cantu, LCSW, Clinical Social Work/Therapist
Roopa Cantu
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Online Only
My trajectory as a person and professional has been engaging, enlightening, and adventurous. My career has been incredibly diverse and fulfilling, from labor and community organizing to counseling and psychotherapy. I seek to provide supportive and individualized clinical supervision and psychotherapy services to you, whatever your need might be. I feel deep empathy and connection to all people who have also been on the journey of self-development and growth; this encompasses fellow culturally diverse recovering alcoholics, members of 12-step programs, and beneficiaries of mental health treatment including from disordered eating.
My trajectory as a person and professional has been engaging, enlightening, and adventurous. My career has been incredibly diverse and fulfilling, from labor and community organizing to counseling and psychotherapy. I seek to provide supportive and individualized clinical supervision and psychotherapy services to you, whatever your need might be. I feel deep empathy and connection to all people who have also been on the journey of self-development and growth; this encompasses fellow culturally diverse recovering alcoholics, members of 12-step programs, and beneficiaries of mental health treatment including from disordered eating.
(559) 529-9498 View (559) 529-9498
Photo of Gulveen Kaur Cheema, LCSW, Clinical Social Work/Therapist
Gulveen Kaur Cheema
Clinical Social Work/Therapist, LCSW
Verified Verified
Fresno, CA 93722
I am a Punjabi-Sikh mental health therapist working with Khalsa Community Center to provide culturally sensitive mental health services in the Central Valley targeted towards the Punjabi-Sikh community, and Punjabi or English-speaking members of the larger South Asian community.
I am a Punjabi-Sikh mental health therapist working with Khalsa Community Center to provide culturally sensitive mental health services in the Central Valley targeted towards the Punjabi-Sikh community, and Punjabi or English-speaking members of the larger South Asian community.
(559) 342-2711 View (559) 342-2711
1

How does your Therapist compare?

Number of Therapists in 93722

70+

Average cost per session

$150

Therapists in 93722 who prioritize treating:

90% Depression
90% Anxiety
83% Coping Skills
79% Self Esteem
74% Stress
67% Relationship Issues
60% Trauma and PTSD

Average years in practice

13 Years

Top 3 insurances accepted

80% Aetna
76% Anthem
73% Managed Health Network (MHN)

How Therapists in 93722 see their clients

64% Online Only
36% In Person and Online

Gender breakdown

78% Female
21% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 93722?

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.