Photo of Lindsey Russell, LCSW, Clinical Social Work/Therapist
Lindsey Russell
Clinical Social Work/Therapist, LCSW
Verified Verified
Online Only
I graduated from UTK College of Social Work and have a varied background, including working in community mental health, residential facilities, and private practice. I work with my clients using a strengths-based approach, incorporating humor and empathy in sessions to improve comfort and instill trust, fostering a collaborative relationship. I enjoy working with a variety of populations, including couples, individuals, and families, and I specialize in parenting, life adjustments, mood disorders, anxiety/panic, and relational stressors.
I graduated from UTK College of Social Work and have a varied background, including working in community mental health, residential facilities, and private practice. I work with my clients using a strengths-based approach, incorporating humor and empathy in sessions to improve comfort and instill trust, fostering a collaborative relationship. I enjoy working with a variety of populations, including couples, individuals, and families, and I specialize in parenting, life adjustments, mood disorders, anxiety/panic, and relational stressors.
(833) 592-3108 View (833) 592-3108
Photo of Patricia Estella Gould, MA, LMFT, CST-P, Marriage & Family Therapist
Patricia Estella Gould
Marriage & Family Therapist, MA, LMFT, CST-P
Verified Verified
Anchorage, AK 99507
As an immigrant, I have become part of a country that values diversity and integration, where I experienced the transformation of my life and therefore the transformation of my surroundings. While living in Alaska, I realized there is a need for mental health professionals who understand the implications of being an immigrant, and the importance of processing the loss of your language, food, music, friends, and place. Who also understand the difficulty of not knowing how to preserve who we are while adopting the values and gifts of the country which opened its doors to us.
As an immigrant, I have become part of a country that values diversity and integration, where I experienced the transformation of my life and therefore the transformation of my surroundings. While living in Alaska, I realized there is a need for mental health professionals who understand the implications of being an immigrant, and the importance of processing the loss of your language, food, music, friends, and place. Who also understand the difficulty of not knowing how to preserve who we are while adopting the values and gifts of the country which opened its doors to us.
(907) 341-4802 View (907) 341-4802
Photo of Cynthia Aiello, LCSW, Clinical Social Work/Therapist
Cynthia Aiello
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Online Only
It hovers over you like a dark cloud. The pressure of trying to meet everyone's expectations (including your own) is too much to handle most days. And when you can't fulfill these expectations, the guilt & shame of not being good enough creep in. No matter what you accomplish you still feel inadequate. There's always a nagging feeling that something's wrong with you. It's exhausting, and you're tired of feeling this way each day. You wish you could have support, but don't want to burden others with your problems. Who would want to listen? In spite of being there for others, it seems that when you need help, it's nowhere to be found.
It hovers over you like a dark cloud. The pressure of trying to meet everyone's expectations (including your own) is too much to handle most days. And when you can't fulfill these expectations, the guilt & shame of not being good enough creep in. No matter what you accomplish you still feel inadequate. There's always a nagging feeling that something's wrong with you. It's exhausting, and you're tired of feeling this way each day. You wish you could have support, but don't want to burden others with your problems. Who would want to listen? In spite of being there for others, it seems that when you need help, it's nowhere to be found.
(907) 444-4526 View (907) 444-4526
Photo of Shana G Hamilton - Tranquil Transitions, MEd, LPC-S, Licensed Professional Counselor
Tranquil Transitions
Licensed Professional Counselor, MEd, LPC-S
Verified Verified
1 Endorsed
Online Only
The individuals who work with me in therapy are often in a state of transition. And—as humans—change, transition, and moving from one circumstance to the next can feel overwhelming and uncomfortable. Whether your discomfort is from a big life change such as a divorce or move, you’re dealing with grief and loss, or you just have a hunch that your current season of life could feel, well, better—we can work together to find a more peaceful way forward. The ultimate goal of therapy is to help you feel and act as your own internal mentor, a compassionate guide that encourages self-love and self-awareness.
The individuals who work with me in therapy are often in a state of transition. And—as humans—change, transition, and moving from one circumstance to the next can feel overwhelming and uncomfortable. Whether your discomfort is from a big life change such as a divorce or move, you’re dealing with grief and loss, or you just have a hunch that your current season of life could feel, well, better—we can work together to find a more peaceful way forward. The ultimate goal of therapy is to help you feel and act as your own internal mentor, a compassionate guide that encourages self-love and self-awareness.
(833) 838-0401 View (833) 838-0401
Photo of Aubrae Seymore, MS, Licensed Professional Counselor
Aubrae Seymore
Licensed Professional Counselor, MS
Verified Verified
Online Only
You look put together, but you're acutely aware that revealing your true self would drive people away. The fear of taking off your mask and exposing your genuine thoughts and feelings holds you captive. You're exhausted. You work so hard to be happy and normal while feeling like a failure inside. Things aren't supposed to be this hard, but somehow everything feels overwhelming. You've spent so long convincing everyone that you're fine without knowing what "fine" means anymore. You want to be happy. But if "choosing to be happy" is so simple, then why does it continue to evade you?
You look put together, but you're acutely aware that revealing your true self would drive people away. The fear of taking off your mask and exposing your genuine thoughts and feelings holds you captive. You're exhausted. You work so hard to be happy and normal while feeling like a failure inside. Things aren't supposed to be this hard, but somehow everything feels overwhelming. You've spent so long convincing everyone that you're fine without knowing what "fine" means anymore. You want to be happy. But if "choosing to be happy" is so simple, then why does it continue to evade you?
(904) 444-4526 View (904) 444-4526
Photo of Cole Talbot, MA, LPC, Licensed Professional Counselor
Cole Talbot
Licensed Professional Counselor, MA, LPC
Verified Verified
Anchorage, AK 99507
Not accepting new clients
Does talk therapy in an office not feel like the right setting for you? Do you learn best through experience and movement? I facilitate the therapy process using a variety of experiential modalities to support healing and growth. I work with Children, Adolescents and young adults from various backgrounds supporting them with self-compassion, emotional resilience, feeling empowered in their identity and connecting to self. As we walk alongside each other on this path I will support you in accepting, embracing and nurturing even the scariest most challenging emotions; grief, anger, anxiety, loneliness, depression.
Does talk therapy in an office not feel like the right setting for you? Do you learn best through experience and movement? I facilitate the therapy process using a variety of experiential modalities to support healing and growth. I work with Children, Adolescents and young adults from various backgrounds supporting them with self-compassion, emotional resilience, feeling empowered in their identity and connecting to self. As we walk alongside each other on this path I will support you in accepting, embracing and nurturing even the scariest most challenging emotions; grief, anger, anxiety, loneliness, depression.
(907) 312-8899 View (907) 312-8899
Photo of Elizabeth E Parret, MA, Pre-Licensed Professional
Elizabeth E Parret
Pre-Licensed Professional, MA
Verified Verified
1 Endorsed
Anchorage, AK 99507
I believe that everyone has a unique story that deserves to be told and understood. I would be honored to listen and offer hope for healing. My integrative approach involves creating a compassionate and supportive space where you feel encouraged to express your feelings and needs. By working together, I aim to help you gain clarity, build resilience, and live fully. I strive to create a safe, judgement free environment for you to achieve your goals.
I believe that everyone has a unique story that deserves to be told and understood. I would be honored to listen and offer hope for healing. My integrative approach involves creating a compassionate and supportive space where you feel encouraged to express your feelings and needs. By working together, I aim to help you gain clarity, build resilience, and live fully. I strive to create a safe, judgement free environment for you to achieve your goals.
(855) 953-0659 View (855) 953-0659
Photo of Michael Pretz, LPC, Licensed Professional Counselor
Michael Pretz
Licensed Professional Counselor, LPC
Verified Verified
Online Only
Michael Pretz grew up in Friday Harbor, WA playing Wolverine Football and Wrestling. He worked for the state of Alaska for 7 years working in Anchorage. In therapy, Michael's goal is to help and support people through an individualized growth and healing process. Michael is a client-centered therapist with an existential philosophy. Michael believes an empathetic, judgement free space is essential to any therapeutic process. Michael is an evidence-based clinician and diagnostician that is healing-focused.
Michael Pretz grew up in Friday Harbor, WA playing Wolverine Football and Wrestling. He worked for the state of Alaska for 7 years working in Anchorage. In therapy, Michael's goal is to help and support people through an individualized growth and healing process. Michael is a client-centered therapist with an existential philosophy. Michael believes an empathetic, judgement free space is essential to any therapeutic process. Michael is an evidence-based clinician and diagnostician that is healing-focused.
(877) 812-2474 View (877) 812-2474
Photo of Valerie Brock, LCSW, Clinical Social Work/Therapist
Valerie Brock
Clinical Social Work/Therapist, LCSW
Verified Verified
Online Only
Life’s challenges can feel especially overwhelming when faced with the high-pressure demands of being a first responder or veteran. Anxiety may keep you on edge, depression could drain your energy, or past trauma might feel like an unshakable burden. You may yearn for calm amidst the chaos or a way to process and heal. My focus is on providing a safe and supportive space to help you understand your experiences, regain balance, and move forward with strength and clarity. Together, we’ll uncover resilience and chart a path toward healing.
Life’s challenges can feel especially overwhelming when faced with the high-pressure demands of being a first responder or veteran. Anxiety may keep you on edge, depression could drain your energy, or past trauma might feel like an unshakable burden. You may yearn for calm amidst the chaos or a way to process and heal. My focus is on providing a safe and supportive space to help you understand your experiences, regain balance, and move forward with strength and clarity. Together, we’ll uncover resilience and chart a path toward healing.
(877) 880-9042 View (877) 880-9042
Photo of Judy Harun, LPC, Licensed Professional Counselor
Judy Harun
Licensed Professional Counselor, LPC
Verified Verified
Online Only
If anxiety and stress feel like constant companions in your life, you're not alone. Many struggle to find a moment's peace amidst the chaos of daily demands and internal worries. I specialize in helping those who are ready to explore the root causes of their discomfort and are open to a holistic journey towards healing. Whether you're navigating personal, professional, or uncharted stresses, I'm here to support you in discovering a more peaceful and balanced way of living, tailored just for you. I’m committed to working with people of all backgrounds, embracing diversity in sex, gender, race, and age.
If anxiety and stress feel like constant companions in your life, you're not alone. Many struggle to find a moment's peace amidst the chaos of daily demands and internal worries. I specialize in helping those who are ready to explore the root causes of their discomfort and are open to a holistic journey towards healing. Whether you're navigating personal, professional, or uncharted stresses, I'm here to support you in discovering a more peaceful and balanced way of living, tailored just for you. I’m committed to working with people of all backgrounds, embracing diversity in sex, gender, race, and age.
(888) 557-8063 View (888) 557-8063
Photo of Maria Belozertseva, LPC, Licensed Professional Counselor
Maria Belozertseva
Licensed Professional Counselor, LPC
Verified Verified
2 Endorsed
Anchorage, AK 99507
Do you feel like traditional talk therapy has reached a plateau? Are you looking to explore deeper aspects of your emotional life, such as ingrained patterns, past wounds, attachment styles, and experiences on a more profound level? Are you looking for self-empowering body mind tools to better handle life’s stressors and support physical and mental health? Then you might be ready to explore alternative therapeutic approaches that delve further into these areas.
Do you feel like traditional talk therapy has reached a plateau? Are you looking to explore deeper aspects of your emotional life, such as ingrained patterns, past wounds, attachment styles, and experiences on a more profound level? Are you looking for self-empowering body mind tools to better handle life’s stressors and support physical and mental health? Then you might be ready to explore alternative therapeutic approaches that delve further into these areas.
(907) 830-8262 View (907) 830-8262
Photo of Kendra Buerger, MA, LMHC, LPC, Licensed Professional Counselor
Kendra Buerger
Licensed Professional Counselor, MA, LMHC, LPC
Verified Verified
Online Only
Waitlist for new clients
I believe you have the strength, wisdom, and capability to heal innately within you and that you deserve to live a life of happiness and meaning in alignment with your values and dreams. I hold space with presence, compassion, curiosity, and non-judgement for you to process, heal, and transform. I will be a guide and witness to highlight patterns, provide tools, and offer perspective while empowering you to develop trust and confidence in self. We will untangle where past influences present, rewrite limiting beliefs and stories, and work to bring integration, stability, clarity, and deeper connections. I offer Dream Work.
I believe you have the strength, wisdom, and capability to heal innately within you and that you deserve to live a life of happiness and meaning in alignment with your values and dreams. I hold space with presence, compassion, curiosity, and non-judgement for you to process, heal, and transform. I will be a guide and witness to highlight patterns, provide tools, and offer perspective while empowering you to develop trust and confidence in self. We will untangle where past influences present, rewrite limiting beliefs and stories, and work to bring integration, stability, clarity, and deeper connections. I offer Dream Work.
(877) 375-1932 View (877) 375-1932
Photo of Howard Chaitoff, PA
Howard Chaitoff
PA
Verified Verified
Anchorage, AK 99507
Do daily tasks feel overwhelming and frustrating? Have you found yourself becoming more irritable and reactive. Are you castrophizing and worrying about your family or your job. Is it harder to relax and unwind and enjoy leisure activities. Dealing with depression, and anxiety can be frustrating, especially when it affects your day-to-day life. But that doesn't mean you have to live like this forever.
Do daily tasks feel overwhelming and frustrating? Have you found yourself becoming more irritable and reactive. Are you castrophizing and worrying about your family or your job. Is it harder to relax and unwind and enjoy leisure activities. Dealing with depression, and anxiety can be frustrating, especially when it affects your day-to-day life. But that doesn't mean you have to live like this forever.
(855) 534-3890 View (855) 534-3890
Photo of Jeanie Winstrom, LPC, Licensed Professional Counselor
Jeanie Winstrom
Licensed Professional Counselor, LPC
Verified Verified
Online Only
As a licensed mental health therapist with many years of experience, I empower clients to help them realize the lives they desire and goals they dream. If you are looking for a safe virtual therapeutic space to explore issues, gain insight, remove blocks, and move towards a healthier, more joyful and fulfilling life, you’re in the right place. Because every client is unique, I use a collaborative therapeutic approach to help you find the solutions that work best for your life and circumstances.
As a licensed mental health therapist with many years of experience, I empower clients to help them realize the lives they desire and goals they dream. If you are looking for a safe virtual therapeutic space to explore issues, gain insight, remove blocks, and move towards a healthier, more joyful and fulfilling life, you’re in the right place. Because every client is unique, I use a collaborative therapeutic approach to help you find the solutions that work best for your life and circumstances.
(866) 990-3551 View (866) 990-3551
Photo of Karla Milloy, MA, LPC-S, Counselor
Karla Milloy
Counselor, MA, LPC-S
Verified Verified
1 Endorsed
Online Only
Change is rarely without difficulty and not always welcome, but most people who come to therapy are coming for that reason. They want their lives to feel more fulfilled but they need guidance, encouragement and understanding to complete this sometimes painful task.
Change is rarely without difficulty and not always welcome, but most people who come to therapy are coming for that reason. They want their lives to feel more fulfilled but they need guidance, encouragement and understanding to complete this sometimes painful task.
(866) 718-2715 View (866) 718-2715
Photo of Uliana Fleener - Alaska Counseling Services, LLC, LPC, Licensed Professional Counselor
Alaska Counseling Services, LLC
Licensed Professional Counselor, LPC
Verified Verified
Anchorage, AK 99507
Do you struggle with challenging relationships, past trauma, or loss of a sense of self? Do you feel anxious, stressed, and overwhelmed before you even get out of bed in the morning thinking of never ending to do lists and demands of everyday life? Do you feel frustrated and lost because you desperately want to feel better in your body but don’t even know where to start? Now more than ever, people are feeling alone and disconnected even in the room full of people. At Alaska Counseling Services we know that feeling better is possible, and reaching out for help is the first step.
Do you struggle with challenging relationships, past trauma, or loss of a sense of self? Do you feel anxious, stressed, and overwhelmed before you even get out of bed in the morning thinking of never ending to do lists and demands of everyday life? Do you feel frustrated and lost because you desperately want to feel better in your body but don’t even know where to start? Now more than ever, people are feeling alone and disconnected even in the room full of people. At Alaska Counseling Services we know that feeling better is possible, and reaching out for help is the first step.
(907) 830-8262 View (907) 830-8262
Photo of Shawndean Hutchison, LPC, Counselor
Shawndean Hutchison
Counselor, LPC
Verified Verified
1 Endorsed
Anchorage, AK 99507
Often people begin looking for a counselor when things in their life haven’t been going the way they want. Perhaps you’re struggling with worrying about the future, or stuck thinking about the past. Maybe something feels missing, or maybe you feel lost and unsure how to move forward in your life. Or like many, perhaps you’re sitting there wishing life came with directions so you could start sorting out the storm of thoughts, emotions, and memories you face each day. If so, I want you to know you don’t have to face this alone. I’m here to help.
Often people begin looking for a counselor when things in their life haven’t been going the way they want. Perhaps you’re struggling with worrying about the future, or stuck thinking about the past. Maybe something feels missing, or maybe you feel lost and unsure how to move forward in your life. Or like many, perhaps you’re sitting there wishing life came with directions so you could start sorting out the storm of thoughts, emotions, and memories you face each day. If so, I want you to know you don’t have to face this alone. I’m here to help.
(844) 755-4904 View (844) 755-4904
Photo of Lisa Terwilliger, NCC, LPC, LPC-S, Licensed Professional Counselor
Lisa Terwilliger
Licensed Professional Counselor, NCC, LPC, LPC-S
Verified Verified
Online Only
As an experienced and continually improving clinician, Lisa K. Terwilliger's work has included a wide range of client populations from children, youth, young adults in the college setting. Adults in crisis, elders, families in crisis, persons with developmental disabilities, and substance use disorders. And those recovering from sexual offending and victims of sexual abuse and various traumas. She brings a focus on resiliency, strengths training, feedback informed, trauma-informed and holistic care for the mind, body, and spirit to her work.
As an experienced and continually improving clinician, Lisa K. Terwilliger's work has included a wide range of client populations from children, youth, young adults in the college setting. Adults in crisis, elders, families in crisis, persons with developmental disabilities, and substance use disorders. And those recovering from sexual offending and victims of sexual abuse and various traumas. She brings a focus on resiliency, strengths training, feedback informed, trauma-informed and holistic care for the mind, body, and spirit to her work.
(855) 877-5757 View (855) 877-5757
Photo of Heather Cromwell, LPC, Licensed Professional Counselor
Heather Cromwell
Licensed Professional Counselor, LPC
Verified Verified
Online Only
Life transitions and relationship issues can be particularly challenging for Veterans and middle-aged adults, often bringing feelings of uncertainty, stress, and isolation. Recognizing the need for support during these times is crucial. If you're navigating these waters, understanding that your experiences and feelings are valid is the first step towards healing. A holistic approach to therapy can offer not just coping mechanisms but a pathway to a more balanced and fulfilling life, acknowledging the interconnection of physical and emotional health.
Life transitions and relationship issues can be particularly challenging for Veterans and middle-aged adults, often bringing feelings of uncertainty, stress, and isolation. Recognizing the need for support during these times is crucial. If you're navigating these waters, understanding that your experiences and feelings are valid is the first step towards healing. A holistic approach to therapy can offer not just coping mechanisms but a pathway to a more balanced and fulfilling life, acknowledging the interconnection of physical and emotional health.
(866) 826-1661 View (866) 826-1661
Photo of Jevita Hamilton, LCSW, Clinical Social Work/Therapist
Jevita Hamilton
Clinical Social Work/Therapist, LCSW
Verified Verified
Anchorage, AK 99507
You’ve been through some tough stuff. Talking about it hasn’t brought you the relief you hoped. You’re still feeling on edge, waiting for the next bad thing to happen. In your head, you know you’re safe now, but there’s a part of you that still doesn’t really believe that. Worst of all, sometimes you can't even explain or understand all the feelings yet something is getting in the way of you trusting and connecting with others. You try to get on with your life the best you can, powering through the discomfort that comes up. But something is happening in your body and mind that just doesn't make sense. You question, Am I broken
You’ve been through some tough stuff. Talking about it hasn’t brought you the relief you hoped. You’re still feeling on edge, waiting for the next bad thing to happen. In your head, you know you’re safe now, but there’s a part of you that still doesn’t really believe that. Worst of all, sometimes you can't even explain or understand all the feelings yet something is getting in the way of you trusting and connecting with others. You try to get on with your life the best you can, powering through the discomfort that comes up. But something is happening in your body and mind that just doesn't make sense. You question, Am I broken
(833) 686-4883 View (833) 686-4883
1

How does your Therapist compare?

Number of Therapists in 99507

60+

Average cost per session

$200

Therapists in 99507 who prioritize treating:

96% Anxiety
90% Depression
71% Trauma and PTSD
71% Stress
69% Relationship Issues
66% Grief
62% Coping Skills

Average years in practice

10 Years

Top 3 insurances accepted

83% Aetna
66% Cigna and Evernorth
57% UnitedHealthcare UHC | UBH

How Therapists in 99507 see their clients

57% Online Only
43% In Person and Online

Gender breakdown

86% Female
14% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 99507?

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.