Therapists in 94105

Photo of Dean Herman, Psychologist, PhD
Dean Herman
Psychologist, PhD
1 Endorsed
San Francisco, CA 94105
I support my clients in three main areas. First, I work with people around career challenges such as clarifying their direction, navigating political and organizational complexities, dealing with difficult bosses or coworkers, and growing their professional success. Second, I help clients heal and strengthen relationships in which they feel disappointed, hurt, or unsafe. Third, I support my clients in building their self-esteem and a greater confidence in expressing themselves. I also specialize in supporting high-achieving professionals as they seek greater freedom from the effects of early trauma.
I support my clients in three main areas. First, I work with people around career challenges such as clarifying their direction, navigating political and organizational complexities, dealing with difficult bosses or coworkers, and growing their professional success. Second, I help clients heal and strengthen relationships in which they feel disappointed, hurt, or unsafe. Third, I support my clients in building their self-esteem and a greater confidence in expressing themselves. I also specialize in supporting high-achieving professionals as they seek greater freedom from the effects of early trauma.
(510) 650-1154 View (510) 650-1154
Photo of Golee Castleberry - Octave - Downtown SF Clinic, Psychologist, PhD, PsyD, LCSW, LMFT
Octave - Downtown SF Clinic
Psychologist, PhD, PsyD, LCSW, LMFT
San Francisco, CA 94105
Octave is a modern practice creating a new standard for mental health care that’s both high-quality and accessible. We partner with you to develop personalized plans that can include individual, couples, and family therapy to best suit your needs. Grounded in science, our approach enables you to experience profound change that is just as measurable as it is meaningful. Learn more at www.findoctave.com
Octave is a modern practice creating a new standard for mental health care that’s both high-quality and accessible. We partner with you to develop personalized plans that can include individual, couples, and family therapy to best suit your needs. Grounded in science, our approach enables you to experience profound change that is just as measurable as it is meaningful. Learn more at www.findoctave.com
(415) 366-2851 View (415) 366-2851
Photo of Chia- I Ruby Jen, Marriage & Family Therapist, LMFT
Chia- I Ruby Jen
Marriage & Family Therapist, LMFT
San Francisco, CA 94105
You’re a busy professional, student, or parent juggling a lot—work stress, family expectations, cultural or generational differences, relationship friction, or a sense that anxiety and low mood keep looping. You want a therapist who understands the realities of high stress environments and the nuance of living between languages and cultures. My ideal client wants to feel grounded, communicate more clearly, set healthier boundaries, and make steady progress on goals at home, at work, and within themselves. You’re looking for practical support that respects your background and helps you move from overwhelm to clarity and confidence.
You’re a busy professional, student, or parent juggling a lot—work stress, family expectations, cultural or generational differences, relationship friction, or a sense that anxiety and low mood keep looping. You want a therapist who understands the realities of high stress environments and the nuance of living between languages and cultures. My ideal client wants to feel grounded, communicate more clearly, set healthier boundaries, and make steady progress on goals at home, at work, and within themselves. You’re looking for practical support that respects your background and helps you move from overwhelm to clarity and confidence.
(415) 319-9006 View (415) 319-9006
Photo of Amina Habib, Marriage & Family Therapist, MA, LMFT
Amina Habib
Marriage & Family Therapist, MA, LMFT
San Francisco, CA 94105
I am Licensed MFT and I help my client to explore their behaviors, thoughts, and emotions in a safe and confidential space. The goal is personal growth and improve mental wellbeing and navigate the client through anxiety, depression, addiction and relationship issues, through collaborative work my client able to gain the tools and insight to deal with the at hand problems and future issues. Developing rapport with my clients is a primary focus and understanding their struggles in their own words, by providing them with safe and nonjudgmental environment.
I am Licensed MFT and I help my client to explore their behaviors, thoughts, and emotions in a safe and confidential space. The goal is personal growth and improve mental wellbeing and navigate the client through anxiety, depression, addiction and relationship issues, through collaborative work my client able to gain the tools and insight to deal with the at hand problems and future issues. Developing rapport with my clients is a primary focus and understanding their struggles in their own words, by providing them with safe and nonjudgmental environment.
(213) 462-3862 View (213) 462-3862
Photo of Radhika Reddy, Psychologist, PhD
Radhika Reddy
Psychologist, PhD
1 Endorsed
San Francisco, CA 94105
Welcome! Thank you for checking out my page, and more importantly, for taking this step to invest in yourself! You likely are struggling significantly with something and looking for guidance. You may be wondering if I could be the therapist by your side on this journey. Here's a little about me to help you make an informed decision: My style of therapy is thoughtful, warm, compassionate, non-judgmental, highly collaborative, and results-driven. You are the expert on you (your child), and are likely coming to me for expertise in specific therapies to help you get to where you are heading. As a team we can get there quicker!
Welcome! Thank you for checking out my page, and more importantly, for taking this step to invest in yourself! You likely are struggling significantly with something and looking for guidance. You may be wondering if I could be the therapist by your side on this journey. Here's a little about me to help you make an informed decision: My style of therapy is thoughtful, warm, compassionate, non-judgmental, highly collaborative, and results-driven. You are the expert on you (your child), and are likely coming to me for expertise in specific therapies to help you get to where you are heading. As a team we can get there quicker!
(650) 727-1805 View (650) 727-1805
Photo of Anum Ghazipura, Marriage & Family Therapist, MA, LMFT
Anum Ghazipura
Marriage & Family Therapist, MA, LMFT
San Francisco, CA 94105
It's never too late to heal. If you can synchronize your heart and mind, then you can harmonize your life. This therapeutic space is to help you understand who you are as an individual and see your blind spots. If not done correctly, therapy can feel like you're stuck in the cycle of blaming others. However, our work is to transcend your past. We intend to help you understand what's behind these issues and increase your self-worth along the way. You will be challenged but fulfilled. Our goal is to facilitate you in intimately witnessing your life in the healthiest of ways, as you become closer to your true self and find belonging.
It's never too late to heal. If you can synchronize your heart and mind, then you can harmonize your life. This therapeutic space is to help you understand who you are as an individual and see your blind spots. If not done correctly, therapy can feel like you're stuck in the cycle of blaming others. However, our work is to transcend your past. We intend to help you understand what's behind these issues and increase your self-worth along the way. You will be challenged but fulfilled. Our goal is to facilitate you in intimately witnessing your life in the healthiest of ways, as you become closer to your true self and find belonging.
(415) 286-9618 View (415) 286-9618
Photo of Sarah Cox, Marriage & Family Therapist, MFT
Sarah Cox
Marriage & Family Therapist, MFT
San Francisco, CA 94105
Therapy is a unique opportunity to learn more about ourselves and discover how we can step forward in life, relationships and work with more passion and purpose. I work with you to cultivate the insight, strength and agency that help you to work through challenges, move through difficult transitions and find more purpose and fulfillment in your life. My style is warm, direct and highly attuned to the interrelation between the mind, emotions and body.
Therapy is a unique opportunity to learn more about ourselves and discover how we can step forward in life, relationships and work with more passion and purpose. I work with you to cultivate the insight, strength and agency that help you to work through challenges, move through difficult transitions and find more purpose and fulfillment in your life. My style is warm, direct and highly attuned to the interrelation between the mind, emotions and body.
(628) 227-5954 View (628) 227-5954
Photo of Lillian Myers, Marriage & Family Therapist Associate, MA, AMFT, PRDT
Lillian Myers
Marriage & Family Therapist Associate, MA, AMFT, PRDT
5 Endorsed
San Francisco, CA 94105
With nearly 20 years of experience in the helping profession, I have worked with individuals ranging from preschoolers to elders, including those with diverse abilities, needs, and strengths. As a Drama Therapist focusing on Transgenerational Therapy, mindfulness and Feminist Psychology, I bring play, humor, and deep self-inquiry to the therapeutic work we engage in together. The experience of expressing oneself through a creative process can provide fresh perspectives and a sense of hope and empowerment.
With nearly 20 years of experience in the helping profession, I have worked with individuals ranging from preschoolers to elders, including those with diverse abilities, needs, and strengths. As a Drama Therapist focusing on Transgenerational Therapy, mindfulness and Feminist Psychology, I bring play, humor, and deep self-inquiry to the therapeutic work we engage in together. The experience of expressing oneself through a creative process can provide fresh perspectives and a sense of hope and empowerment.
(415) 707-7658 View (415) 707-7658
Photo of Diana Valentine, Clinical Social Work/Therapist, LCSW
Diana Valentine
Clinical Social Work/Therapist, LCSW
San Francisco, CA 94105
I work with individuals navigating trauma, systemic stressors, identity exploration, and life transitions. My style is collaborative and interactive, grounded in harm reduction and influenced by psychodynamic, mindfulness, somatic, and narrative approaches. I aim to create a space that feels both safe for reflection and expansive for exploration. I’m especially passionate about supporting people who are new to therapy and bringing a social justice lens to mental health work.
I work with individuals navigating trauma, systemic stressors, identity exploration, and life transitions. My style is collaborative and interactive, grounded in harm reduction and influenced by psychodynamic, mindfulness, somatic, and narrative approaches. I aim to create a space that feels both safe for reflection and expansive for exploration. I’m especially passionate about supporting people who are new to therapy and bringing a social justice lens to mental health work.
(916) 352-6084 View (916) 352-6084
Photo of Jordanne Stacy, Marriage & Family Therapist, LMFT
Jordanne Stacy
Marriage & Family Therapist, LMFT
San Francisco, CA 94105
From the outside, it may look like you are functioning fine, but internally you feel anxious, overwhelmed, emotionally exhausted, disconnected, or stuck in patterns that keep repeating no matter how hard you try to change them. ADHD, anxiety, relationship stress, trauma, and emotional overwhelm can quietly affect every area of life. Maybe communication keeps breaking down, the same arguments repeat, or you feel like you’ve lost yourself somewhere along the way. You do not need another place to simply vent — you want real change, deeper connection, and a life that feels fulfilling again for yourself and your relationships.
From the outside, it may look like you are functioning fine, but internally you feel anxious, overwhelmed, emotionally exhausted, disconnected, or stuck in patterns that keep repeating no matter how hard you try to change them. ADHD, anxiety, relationship stress, trauma, and emotional overwhelm can quietly affect every area of life. Maybe communication keeps breaking down, the same arguments repeat, or you feel like you’ve lost yourself somewhere along the way. You do not need another place to simply vent — you want real change, deeper connection, and a life that feels fulfilling again for yourself and your relationships.
(650) 677-1455 View (650) 677-1455
Photo of Justin D'Avella, Psychologist, PsyD
Justin D'Avella
Psychologist, PsyD
2 Endorsed
San Francisco, CA 94105
Are you ready to slow down? To get unstuck? To discover a deeper sense of well-being? Transformational change is possible but healing is not a solo journey. I am passionate about supporting my clients to unlock a more genuine experience of themselves. Together, we will work to cultivate awareness, courage, confidence and steadiness in your life. I work with people who want to find clarity, a sense of aliveness, and to heal from both the bruises and scars that life sometimes creates. I can help you discover a deeper understanding of yourself, your relationships, and your purpose in the world.
Are you ready to slow down? To get unstuck? To discover a deeper sense of well-being? Transformational change is possible but healing is not a solo journey. I am passionate about supporting my clients to unlock a more genuine experience of themselves. Together, we will work to cultivate awareness, courage, confidence and steadiness in your life. I work with people who want to find clarity, a sense of aliveness, and to heal from both the bruises and scars that life sometimes creates. I can help you discover a deeper understanding of yourself, your relationships, and your purpose in the world.
(415) 707-0434 View (415) 707-0434
Photo of Paul W. Thomas, Psychologist, PhD
Paul W. Thomas
Psychologist, PhD
3 Endorsed
San Francisco, CA 94105
You have the innate ability to uncover, identify, explore, and ultimately change unwanted or problematic thoughts or behaviors. My style is personal, collaborative, and responsive to your needs. I start from the premise that you are the expert on yourself. Therapy is a safe and empowering space to pursue the best version of yourself. I walk alongside you throughout the process, lending support, offering validation, teaching skills, and providing accountability.
You have the innate ability to uncover, identify, explore, and ultimately change unwanted or problematic thoughts or behaviors. My style is personal, collaborative, and responsive to your needs. I start from the premise that you are the expert on yourself. Therapy is a safe and empowering space to pursue the best version of yourself. I walk alongside you throughout the process, lending support, offering validation, teaching skills, and providing accountability.
(415) 980-8373 View (415) 980-8373
Photo of Becky Wu, Clinical Social Work/Therapist, LCSW
Becky Wu
Clinical Social Work/Therapist, LCSW
San Francisco, CA 94105
I offer a BIPOC and LGBTQ+ safe place. I am passionate about supporting clients through life difficulties and transitions. I have extensive experience working with individuals and families in public agencies and community-based settings.
I offer a BIPOC and LGBTQ+ safe place. I am passionate about supporting clients through life difficulties and transitions. I have extensive experience working with individuals and families in public agencies and community-based settings.
(415) 417-2654 View (415) 417-2654
Photo of Jaq Sarah French, Licensed Professional Clinical Counselor, LPC
Jaq Sarah French
Licensed Professional Clinical Counselor, LPC
San Francisco, CA 94105
You’re not failing. You’re overwhelmed. I work with depression, anxiety, relationship stress, addiction and substance use, as well as people-pleasing, boundary challenges, and big emotions. Many people come to me after carrying too much for too long—feeling stuck in patterns that no longer work or being the reliable one who holds everything together while quietly falling apart inside. I offer a nonjudgmental space to pause, reflect, question coping patterns, and reconnect with what you need so life feels more manageable.
You’re not failing. You’re overwhelmed. I work with depression, anxiety, relationship stress, addiction and substance use, as well as people-pleasing, boundary challenges, and big emotions. Many people come to me after carrying too much for too long—feeling stuck in patterns that no longer work or being the reliable one who holds everything together while quietly falling apart inside. I offer a nonjudgmental space to pause, reflect, question coping patterns, and reconnect with what you need so life feels more manageable.
(510) 945-3673 View (510) 945-3673
Photo of Kurt Vaillancourt, Marriage & Family Therapist, LMFT
Kurt Vaillancourt
Marriage & Family Therapist, LMFT
San Francisco, CA 94105
Some of the areas I have provided treatment for include substance use/abuse, depression, anxiety, grief/loss, and adjustment disorders due to life transitions. For nearly 20 years, I have worked with adults, families, and couples both individually and in group settings. I am a Licensed Marriage and Family Therapist (LMFT) in the state of California and obtained a Doctorate Degree in Clinical Psychology (PsyD) in 2005.
Some of the areas I have provided treatment for include substance use/abuse, depression, anxiety, grief/loss, and adjustment disorders due to life transitions. For nearly 20 years, I have worked with adults, families, and couples both individually and in group settings. I am a Licensed Marriage and Family Therapist (LMFT) in the state of California and obtained a Doctorate Degree in Clinical Psychology (PsyD) in 2005.
(408) 340-9952 View (408) 340-9952
Photo of Dr. Alexandra David, Psychologist, PsyD
Dr. Alexandra David
Psychologist, PsyD
1 Endorsed
San Francisco, CA 94105
My ideal clients are high-achieving professionals, executives, healthcare providers, and adults who appear successful on the outside but are privately struggling with addiction, trauma, burnout, emotional dysregulation, or relationship difficulties. Many have spent years taking care of everyone else while feeling overwhelmed themselves. I provide a collaborative, evidence-based approach that helps clients understand the root causes of their struggles, develop practical coping skills, and create lasting change—not just temporary symptom relief.
My ideal clients are high-achieving professionals, executives, healthcare providers, and adults who appear successful on the outside but are privately struggling with addiction, trauma, burnout, emotional dysregulation, or relationship difficulties. Many have spent years taking care of everyone else while feeling overwhelmed themselves. I provide a collaborative, evidence-based approach that helps clients understand the root causes of their struggles, develop practical coping skills, and create lasting change—not just temporary symptom relief.
(510) 373-8190 View (510) 373-8190
Photo of Maryam Goudarzi, Marriage & Family Therapist, LMFT, Neuro
Maryam Goudarzi
Marriage & Family Therapist, LMFT, Neuro
1 Endorsed
San Francisco, CA 94105
With over a decade of clinical experience and extensive training in neuropsychology, I’m dedicated to helping clients achieve lasting growth. As a proud member of the American Psychological Association (APA), I draw from diverse therapeutic modalities to meet individual needs. I’ve participated in numerous trainings and public speaking events, including the NFL Wellness Event. My work with individuals, couples, and families focuses on building strong therapeutic relationships that foster awareness, healing, and positive change.
With over a decade of clinical experience and extensive training in neuropsychology, I’m dedicated to helping clients achieve lasting growth. As a proud member of the American Psychological Association (APA), I draw from diverse therapeutic modalities to meet individual needs. I’ve participated in numerous trainings and public speaking events, including the NFL Wellness Event. My work with individuals, couples, and families focuses on building strong therapeutic relationships that foster awareness, healing, and positive change.
(480) 788-7254 View (480) 788-7254
Photo of Dr. Michelle Lyons - Dr. Michelle Lyons - OCD, Anxiety, PTSD specialist, Psychologist, PhD
Effective therapy for adults with OCD, trauma, or anxiety. Are you having difficulty with worries or fears that just won't go away? Do you feel tense and wish you could just slow down and enjoy life more? You’ve tried to address your anxiety but it just won't budge. You’re ready for more freedom from the pattern you feel stuck in. I am here to help you break that pattern. My years of specialized experience and use of research-backed techniques help people like you regain control over anxiety. The therapy I offer is strongly rooted in research while at the same time tailored to your unique needs and goals.
Effective therapy for adults with OCD, trauma, or anxiety. Are you having difficulty with worries or fears that just won't go away? Do you feel tense and wish you could just slow down and enjoy life more? You’ve tried to address your anxiety but it just won't budge. You’re ready for more freedom from the pattern you feel stuck in. I am here to help you break that pattern. My years of specialized experience and use of research-backed techniques help people like you regain control over anxiety. The therapy I offer is strongly rooted in research while at the same time tailored to your unique needs and goals.
(619) 257-1934 View (619) 257-1934
Photo of Jack Worthy, Counselor, MSc, MATS
Jack Worthy
Counselor, MSc, MATS
San Francisco, CA 94105
I help clients overcome frustrating relationship patterns, self-sabotaging behavior, and persistent depression and anxiety. In our sessions, you'll find a thoughtful, supportive, and creative environment where clients work at the pace most comfortable for them. My approach to therapy seeks to align an individual's feelings, values, and actions. Our emotions motivate our behavior, and when we want to change but seemingly can't, we're often working against our emotional selves. Clients work with me to tap the right motivation to meet their goals. I treat individuals, couples, and parents.
I help clients overcome frustrating relationship patterns, self-sabotaging behavior, and persistent depression and anxiety. In our sessions, you'll find a thoughtful, supportive, and creative environment where clients work at the pace most comfortable for them. My approach to therapy seeks to align an individual's feelings, values, and actions. Our emotions motivate our behavior, and when we want to change but seemingly can't, we're often working against our emotional selves. Clients work with me to tap the right motivation to meet their goals. I treat individuals, couples, and parents.
(646) 681-1394 View (646) 681-1394
Photo of Cassandra Holt Kimbell - Freestyle Supervision and EMDR Group, Licensed Professional Counselor, LPC, LPCC-S, NCC
Freestyle Supervision and EMDR Group
Licensed Professional Counselor, LPC, LPCC-S, NCC
2 Endorsed
San Francisco, CA 94105
We are a boutique group practice that provides genuinely inclusive, trauma-rooted care for clients across California and Texas, moving far beyond "trauma-informed" as just a trendy buzzword. We believe therapy should be a space where your whole identity is celebrated, which is why we are proudly LGBTQIA+ affirming, allied, and take an active stance of advocacy for everyone we serve. Whether you are navigating an Autism or ADHD diagnosis, or seeking an affirming assessment, or simply looking for a space where you don't have to mask, our team approaches your care from a strictly strengths-based, anti-ableist perspective for therapy.
We are a boutique group practice that provides genuinely inclusive, trauma-rooted care for clients across California and Texas, moving far beyond "trauma-informed" as just a trendy buzzword. We believe therapy should be a space where your whole identity is celebrated, which is why we are proudly LGBTQIA+ affirming, allied, and take an active stance of advocacy for everyone we serve. Whether you are navigating an Autism or ADHD diagnosis, or seeking an affirming assessment, or simply looking for a space where you don't have to mask, our team approaches your care from a strictly strengths-based, anti-ableist perspective for therapy.
(562) 580-4409 View (562) 580-4409

See more therapy options for 94105

How does your Therapist compare?

Number of Therapists in 94105

400+

Average cost per session

$200

Therapists in 94105 who prioritize treating:

96% Anxiety
96% Social Anxiety
96% Health Anxiety
96% Driving Anxiety
87% Depression
81% Relationship Issues
78% Relationship Anxiety

Average years in practice

12 Years

Top 3 insurances accepted

92% Aetna
68% Blue Shield
66% Cigna and Evernorth

How Therapists in 94105 see their clients

66% Online Only
34% In Person and Online

Gender breakdown

79% Female
20% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 94105?

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.