Therapists in Exton, PA

Photo of Elena Gregorio, Clinical Social Work/Therapist in Exton, PA
Elena Gregorio
Clinical Social Work/Therapist, LCSW
Verified Verified
Exton, PA 19341
I am a licensed therapist who sees individuals with mental health and/or substance use issues. When I began studying social work its philosophy resonated deeply with me as strengths-based with dignity for all. Social justice issues have recently been occupying a more prominent (long overdue) role in many conversations; I support the dismantling of systems of oppression in its many forms, and am supportive to clients if they choose to engage with these topics, whether or not they wish to bring them to the therapy space.
I am a licensed therapist who sees individuals with mental health and/or substance use issues. When I began studying social work its philosophy resonated deeply with me as strengths-based with dignity for all. Social justice issues have recently been occupying a more prominent (long overdue) role in many conversations; I support the dismantling of systems of oppression in its many forms, and am supportive to clients if they choose to engage with these topics, whether or not they wish to bring them to the therapy space.
(610) 569-9734 View (610) 569-9734
Photo of Dr. Mendy Lynn Viel Ganim, Psychologist in Exton, PA
Dr. Mendy Lynn Viel Ganim
Psychologist, PsyD
Verified Verified
2 Endorsed
Exton, PA 19341
Not accepting new clients
I provide psychological services to children, adolescents, and young adults presenting with maladaptive coping and behavior as a result of unresolved mood, anxiety, trauma, identity, family, social/cultural, and/or educational challenges. My work further extends to adults with histories of trauma and ADHD. I accept patients stepping down from inpatient, partial, and IOP programs, and am often sought out after unsuccessful treatment attempts and for second opinions. I am well suited to work with complex cases, people identifying as neuro-divergent or highly sensitive (HSP), and diverse groups including Black and LGBTQIA+ patients.
I provide psychological services to children, adolescents, and young adults presenting with maladaptive coping and behavior as a result of unresolved mood, anxiety, trauma, identity, family, social/cultural, and/or educational challenges. My work further extends to adults with histories of trauma and ADHD. I accept patients stepping down from inpatient, partial, and IOP programs, and am often sought out after unsuccessful treatment attempts and for second opinions. I am well suited to work with complex cases, people identifying as neuro-divergent or highly sensitive (HSP), and diverse groups including Black and LGBTQIA+ patients.
(610) 756-0147 View (610) 756-0147
Photo of Sarah Learned Sciarra, Clinical Social Work/Therapist in Exton, PA
Sarah Learned Sciarra
Clinical Social Work/Therapist, MSS, LCSW
Verified Verified
1 Endorsed
Exton, PA 19341
Therapy helps to deepen our understanding of ourselves, improve our relationships and give us a richer, more balanced life. I am committed to helping clients overcome adversity, gain personal insight and improve their intimate relationships. I see clients struggling with depression/ anxiety, self-esteem, grief, interpersonal relationship issues and life-transitions. I specialize in working with adult women, and specialized training in postpartum stress. I also have experience successfully working with male clients, particularly around intimacy, life transitions and interpersonal communication skills.
Therapy helps to deepen our understanding of ourselves, improve our relationships and give us a richer, more balanced life. I am committed to helping clients overcome adversity, gain personal insight and improve their intimate relationships. I see clients struggling with depression/ anxiety, self-esteem, grief, interpersonal relationship issues and life-transitions. I specialize in working with adult women, and specialized training in postpartum stress. I also have experience successfully working with male clients, particularly around intimacy, life transitions and interpersonal communication skills.
(610) 708-0878 View (610) 708-0878
Photo of Nicole S. Wildes, Counselor in Exton, PA
Nicole S. Wildes
Counselor, LPC
Verified Verified
Exton, PA 19341
Whether you are interested in healing hurts from long ago or simply dissatisfied with the current state of life, therapy can help you learn to embrace, with joy and gratitude, the messiness of the human experience. I help clients cultivate the tools they need to live a more confident life, take risks, and find the wisdom and sweetness in painful experiences. Being a therapist is a privilege, and I am very grateful to be able to provide a nonjudgemental space and connect with others in such a meaningful way.
Whether you are interested in healing hurts from long ago or simply dissatisfied with the current state of life, therapy can help you learn to embrace, with joy and gratitude, the messiness of the human experience. I help clients cultivate the tools they need to live a more confident life, take risks, and find the wisdom and sweetness in painful experiences. Being a therapist is a privilege, and I am very grateful to be able to provide a nonjudgemental space and connect with others in such a meaningful way.
(610) 549-4679 View (610) 549-4679
Photo of Lori Valentino, Clinical Social Work/Therapist in Exton, PA
Lori Valentino
Clinical Social Work/Therapist, MSS, LCSW, RYT
Verified Verified
Exton, PA 19341
I am a licensed psychotherapist and wellness advocate who believes in focusing on the mind-body connection for a holistic approach to healing. I am committed to creating collaborative spaces ​where people feel seen, heard, and valued. My therapeutic approach integrates contemporary psychology and Eastern spirituality. My style is warm and focused on offering a compassionate presence. I practice from a strengths-based perspective and believe in every individual’s ability to heal, grow, transform, and thrive.
I am a licensed psychotherapist and wellness advocate who believes in focusing on the mind-body connection for a holistic approach to healing. I am committed to creating collaborative spaces ​where people feel seen, heard, and valued. My therapeutic approach integrates contemporary psychology and Eastern spirituality. My style is warm and focused on offering a compassionate presence. I practice from a strengths-based perspective and believe in every individual’s ability to heal, grow, transform, and thrive.
(484) 388-4344 View (484) 388-4344
Photo of Jeanine P Aversa, Licensed Professional Counselor in Exton, PA
Jeanine P Aversa
Licensed Professional Counselor, MA, LPC, NCC
Verified Verified
Exton, PA 19341
Licensed counselor focused on providing individual and couples counseling services. Specializing in work with adults in areas of life transitions, anxiety, depression, substance abuse /addiction, PTSD, bi-polar and stress management.
Licensed counselor focused on providing individual and couples counseling services. Specializing in work with adults in areas of life transitions, anxiety, depression, substance abuse /addiction, PTSD, bi-polar and stress management.
(484) 214-2403 View (484) 214-2403
Photo of Nabila Murshed, Licensed Professional Counselor in Exton, PA
Nabila Murshed
Licensed Professional Counselor, LPCC
Verified Verified
Exton, PA 19341
Out beyond the ideas of right and wrong there is a field. I will meet you there. This is my helping philosophy. I like to keep an eye on the possibilities. I am a Licensed Professional Counselor. After more than a decade of experience as a therapist, I have recognized that the power of listening, validating and supporting are very effective. I have come to recognize that understanding comes before advising and skill building . The methods of helping are many. The therapist's responsibility is to to know how to compassionately transform hardship into ease for the client.
Out beyond the ideas of right and wrong there is a field. I will meet you there. This is my helping philosophy. I like to keep an eye on the possibilities. I am a Licensed Professional Counselor. After more than a decade of experience as a therapist, I have recognized that the power of listening, validating and supporting are very effective. I have come to recognize that understanding comes before advising and skill building . The methods of helping are many. The therapist's responsibility is to to know how to compassionately transform hardship into ease for the client.
(484) 613-3892 View (484) 613-3892
Photo of Katie Young, Licensed Professional Counselor in Exton, PA
Katie Young
Licensed Professional Counselor, MA, LPC
Verified Verified
Exton, PA 19341
Not accepting new clients
If you're suffering from the impact of a traumatic event, whether recent or decades ago, I'm here to help. If you find yourself perpetually drawn to or stuck in unhealthy relationships, I'll work with you to alter your patterns to achieve a different outcome. For more than two decades, I have been guiding people like you to gain the awareness necessary for change. Together, we'll explore your strengths and challenges, utilizing practical, effective strategies to enhance your relationships and quality of life. Isn't it time?
If you're suffering from the impact of a traumatic event, whether recent or decades ago, I'm here to help. If you find yourself perpetually drawn to or stuck in unhealthy relationships, I'll work with you to alter your patterns to achieve a different outcome. For more than two decades, I have been guiding people like you to gain the awareness necessary for change. Together, we'll explore your strengths and challenges, utilizing practical, effective strategies to enhance your relationships and quality of life. Isn't it time?
(484) 870-9250 View (484) 870-9250
Photo of Caitlin Kelly, Pre-Licensed Professional in Exton, PA
Caitlin Kelly
Pre-Licensed Professional, MA, NCC
Verified Verified
1 Endorsed
Exton, PA 19341
Starting therapy can be an overwhelming process. I want to provide a safe space where we can work together to address and work through life’s challenges, including anxiety, depression, suicidality, self-harm, self-esteem, and social relationships. I have a passion for working with adolescents, tweens, and young adults (ages 12-25) to work though and navigate life's challenges.
Starting therapy can be an overwhelming process. I want to provide a safe space where we can work together to address and work through life’s challenges, including anxiety, depression, suicidality, self-harm, self-esteem, and social relationships. I have a passion for working with adolescents, tweens, and young adults (ages 12-25) to work though and navigate life's challenges.
(484) 897-6641 View (484) 897-6641
Photo of Renae M Utz, Clinical Social Work/Therapist in Exton, PA
Renae M Utz
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Exton, PA 19341  (Online Only)
We all need to be heard. We all need someone who can sit with us and truly hear our story. I believe therapy is a collaborative process in which we work together to address the challenges and changes you may be facing. For 26 years, I have been working with people just like you--people who need someone to listen, support and engage. People who need a dedicated time and safe place to step out of the chaos of life and sort through their stress and struggles. People who are seeking self-awareness and supportive feedback.
We all need to be heard. We all need someone who can sit with us and truly hear our story. I believe therapy is a collaborative process in which we work together to address the challenges and changes you may be facing. For 26 years, I have been working with people just like you--people who need someone to listen, support and engage. People who need a dedicated time and safe place to step out of the chaos of life and sort through their stress and struggles. People who are seeking self-awareness and supportive feedback.
(484) 696-1609 View (484) 696-1609
Photo of Jessica Woods, Licensed Professional Counselor in Exton, PA
Jessica Woods
Licensed Professional Counselor, MA, LPC, CCTP
Verified Verified
Exton, PA 19341
Jessica (Jess) is a Licensed Therapist and a Certified Clinical Trauma Professional. Jess aims to create a space where you can bravely learn to survive your suffering, rebuild trust with yourself, cultivate healing and move towards flourishing. Jess uses an eclectic collection of evidenced-based therapy approaches and a non-anxious presence to model compassion and curiosity until you learn to implement them for yourself.
Jessica (Jess) is a Licensed Therapist and a Certified Clinical Trauma Professional. Jess aims to create a space where you can bravely learn to survive your suffering, rebuild trust with yourself, cultivate healing and move towards flourishing. Jess uses an eclectic collection of evidenced-based therapy approaches and a non-anxious presence to model compassion and curiosity until you learn to implement them for yourself.
(610) 427-2731 View (610) 427-2731
Photo of Barbra R Burleigh, Licensed Professional Counselor in Exton, PA
Barbra R Burleigh
Licensed Professional Counselor, MA, LPC
Verified Verified
Exton, PA 19341
As an empathetic therapist, I help you navigate the intricacies of human emotions with a compassionate touch, tailoring my therapeutic approach to meet the ever-changing needs of each individual and couple. My commitment to understanding and adapting to diverse emotional landscapes fosters a safe and supportive environment for clients.
As an empathetic therapist, I help you navigate the intricacies of human emotions with a compassionate touch, tailoring my therapeutic approach to meet the ever-changing needs of each individual and couple. My commitment to understanding and adapting to diverse emotional landscapes fosters a safe and supportive environment for clients.
(610) 981-2390 View (610) 981-2390
Photo of Alexandra Duncan-Ramos, Psychologist in Exton, PA
Alexandra Duncan-Ramos
Psychologist, PsyD, MS
Verified Verified
Exton, PA 19341
Welcome! Typically, I work with clients who are struggling with traditional behavioral health concerns such as anxiety, depression/grief, stress, relationship concerns & life transitions. As a trained health psychologist, I also work with clients who are struggling with issues such as sleep disturbance, high blood pressure/cholesterol, migraine/tension headaches, pain & newly diagnosed illness. For some, there is an intersection between physical & emotional health. When this is the case, I welcome collaboration with any treating specialists. I find that clients are best served when providers work together for your benefit.
Welcome! Typically, I work with clients who are struggling with traditional behavioral health concerns such as anxiety, depression/grief, stress, relationship concerns & life transitions. As a trained health psychologist, I also work with clients who are struggling with issues such as sleep disturbance, high blood pressure/cholesterol, migraine/tension headaches, pain & newly diagnosed illness. For some, there is an intersection between physical & emotional health. When this is the case, I welcome collaboration with any treating specialists. I find that clients are best served when providers work together for your benefit.
(610) 379-2676 View (610) 379-2676
Photo of Sandra Emmanouilides, Pre-Licensed Professional in Exton, PA
Sandra Emmanouilides
Pre-Licensed Professional, LSW
Verified Verified
Exton, PA 19341
I am an empathic guide who will help you to challenge your limiting beliefs and find your voice. I love working with young adults and adults who are seeking to align with their values, be authentic, and trust their intuitive guidance and compass. Together we examine your patterns of relationship and thought and how early experiences may be impacting you today. By healing and processing past and current stressors, my clients learn how to trust themselves, protect themselves energetically, and develop coping skills that leave them feeling empowered and confident in meeting the world as it changes around them.
I am an empathic guide who will help you to challenge your limiting beliefs and find your voice. I love working with young adults and adults who are seeking to align with their values, be authentic, and trust their intuitive guidance and compass. Together we examine your patterns of relationship and thought and how early experiences may be impacting you today. By healing and processing past and current stressors, my clients learn how to trust themselves, protect themselves energetically, and develop coping skills that leave them feeling empowered and confident in meeting the world as it changes around them.
(484) 202-6172 View (484) 202-6172
Photo of Susan Barbara Katz, Clinical Social Work/Therapist in Exton, PA
Susan Barbara Katz
Clinical Social Work/Therapist, MA, LCSW, CMFT
Verified Verified
1 Endorsed
Exton, PA 19341
Has there been a time in your life when you felt overwhelmed, confused, conflicted, frightened, or burdened? A time when life's journey presented multiple paths and you turned down one more difficult than expected, and you got scratched and bruised by the bushes overgrown thorns? If you've answered yes, then counseling can be a vehicle supporting you through life's challenges to achieve emotional health and well-being. Caring, collaborative, and compassionate counseling can help you heal your emotoinal wounds, fears diminished, and the perceived darkness can be replaced by a new vision for yourself and new possibilities.
Has there been a time in your life when you felt overwhelmed, confused, conflicted, frightened, or burdened? A time when life's journey presented multiple paths and you turned down one more difficult than expected, and you got scratched and bruised by the bushes overgrown thorns? If you've answered yes, then counseling can be a vehicle supporting you through life's challenges to achieve emotional health and well-being. Caring, collaborative, and compassionate counseling can help you heal your emotoinal wounds, fears diminished, and the perceived darkness can be replaced by a new vision for yourself and new possibilities.
(610) 624-3645 View (610) 624-3645
Photo of Tiffany Interra, Marriage & Family Therapist in Exton, PA
Tiffany Interra
Marriage & Family Therapist, LMFT
Verified Verified
Exton, PA 19341  (Online Only)
Tiffany Interra is a Licensed Marriage and Family Therapist from Pennsylvania who has been a practicing clinician since 2015, working in various settings, such as clinics, nonprofits, and telehealth. Tiffany takes a trauma and culturally-informed approach to treatment. She specializes in addressing depression, anxiety, self-esteem, and trauma-related concerns. Tiffany provides individual and family services to adults, as well as families who have a loved one who is experiencing symptoms or any concerning behaviors.
Tiffany Interra is a Licensed Marriage and Family Therapist from Pennsylvania who has been a practicing clinician since 2015, working in various settings, such as clinics, nonprofits, and telehealth. Tiffany takes a trauma and culturally-informed approach to treatment. She specializes in addressing depression, anxiety, self-esteem, and trauma-related concerns. Tiffany provides individual and family services to adults, as well as families who have a loved one who is experiencing symptoms or any concerning behaviors.
(484) 623-6149 View (484) 623-6149
Photo of Sarah Youse, Clinical Social Work/Therapist in Exton, PA
Sarah Youse
Clinical Social Work/Therapist, LCSW, CCATP
Verified Verified
1 Endorsed
Exton, PA 19341  (Online Only)
I work with children through adults who are dealing with various life challenges. This can include anxiety, depression, obsessions and compulsive behaviors, impulsivity, inattentiveness, anger, emotion dysregulation, picking/pulling behaviors, social skills, body image, confidence, and life stressors. My therapy style is encouraging, accepting, and goal oriented. I provide an outlet to help individuals to share emotions and to strengthen resilience. I highlight individuals’ self-worth, guide them through completing tasks, while helping them learn to live a values-based lifestyle.
I work with children through adults who are dealing with various life challenges. This can include anxiety, depression, obsessions and compulsive behaviors, impulsivity, inattentiveness, anger, emotion dysregulation, picking/pulling behaviors, social skills, body image, confidence, and life stressors. My therapy style is encouraging, accepting, and goal oriented. I provide an outlet to help individuals to share emotions and to strengthen resilience. I highlight individuals’ self-worth, guide them through completing tasks, while helping them learn to live a values-based lifestyle.
(484) 249-2195 View (484) 249-2195
Photo of Erin Jameson Saltzburg, Clinical Social Work/Therapist in Exton, PA
Erin Jameson Saltzburg
Clinical Social Work/Therapist, MSSW, LCSW
Verified Verified
2 Endorsed
Exton, PA 19341  (Online Only)
Every day, I sit with women just like you. Women who are struggling. Women who are trying to cope with intense grief, devastating pregnancy loss, the roller coaster of infertility, the anxiety of pregnancy after a loss experience and the challenges of the NICU experience. Every day I support individuals who are managing difficult relationships and trying to cope with overwhelming life transitions.
Every day, I sit with women just like you. Women who are struggling. Women who are trying to cope with intense grief, devastating pregnancy loss, the roller coaster of infertility, the anxiety of pregnancy after a loss experience and the challenges of the NICU experience. Every day I support individuals who are managing difficult relationships and trying to cope with overwhelming life transitions.
(484) 879-4292 View (484) 879-4292
Photo of Maegon Crader, Licensed Professional Counselor in Exton, PA
Maegon Crader
Licensed Professional Counselor, MA, LPC, RPT-S
Verified Verified
1 Endorsed
Exton, PA 19341
Are you or your child going through a challenging time due to a difficult experience? It's not uncommon to feel stuck in intense emotions like anxiety, fear, anger, or sadness. Seeking a bit of extra support can make a significant difference in helping you or your child not just cope but thrive. We all desire a way forward, a path to navigate through these often overwhelming feelings. Whether it's a recent traumatic event or past issues that persistently resurface, various therapeutic approaches are available to guide you on this journey.
Are you or your child going through a challenging time due to a difficult experience? It's not uncommon to feel stuck in intense emotions like anxiety, fear, anger, or sadness. Seeking a bit of extra support can make a significant difference in helping you or your child not just cope but thrive. We all desire a way forward, a path to navigate through these often overwhelming feelings. Whether it's a recent traumatic event or past issues that persistently resurface, various therapeutic approaches are available to guide you on this journey.
(484) 292-2480 View (484) 292-2480
Photo of Amanda Alleman, Counselor in Exton, PA
Amanda Alleman
Counselor, LPC
Verified Verified
Exton, PA 19341
Amanda Alleman is a Licensed Professional Counselor in Pennsylvania who has been practicing since 2020. Amanda offers a laid-back approach where she encourages individuals to be themselves and comfortable in the experience. Amanda likes to meet people where they are to provide an environment where they feel safe to be open and honest. Amanda believes that clients should lead their treatment and she is merely a supportive partner in the process to get each person to their desired goal! Outside of work, Amanda enjoys spending time with her family and friends. She loves to spend time outdoors in the sunshine!.
Amanda Alleman is a Licensed Professional Counselor in Pennsylvania who has been practicing since 2020. Amanda offers a laid-back approach where she encourages individuals to be themselves and comfortable in the experience. Amanda likes to meet people where they are to provide an environment where they feel safe to be open and honest. Amanda believes that clients should lead their treatment and she is merely a supportive partner in the process to get each person to their desired goal! Outside of work, Amanda enjoys spending time with her family and friends. She loves to spend time outdoors in the sunshine!.
(484) 882-0707 View (484) 882-0707

How does your Therapist compare?

Number of Therapists in Exton, PA

200+

Average cost per session

$145

Therapists in Exton, PA who prioritize treating:

95% Anxiety
89% Depression
76% Relationship Issues
74% Self Esteem
63% Grief
63% Trauma and PTSD
61% Coping Skills

Average years in practice

13 Years

Top 3 insurances accepted

75% Aetna
67% Highmark
53% Cigna and Evernorth

How Therapists in Exton, PA see their clients

83% In Person and Online
17% Online Only

Gender breakdown

81% Female
19% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Exton?

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.