Therapists in Keene, NH

Photo of Kate Robertson, Counselor in Keene, NH
Kate Robertson
Counselor, LCMHC, CYT
Verified Verified
Keene, NH 03431  (Online Only)
Waitlist for new clients
For over 14 years, I have worked with clients facing challenges such as addiction, anxiety, depression, trauma and difficult life changes. Together, we connect with their inner resources of self-compassion, wisdom and courage to uncover their authentic selves. When we cultivate a mindset of awareness and understanding, rather than judgment, we create the space to heal. Life experiences become a vehicle for learning and embracing our strength and resilience, as well as deepening our relationship with self and others. We strengthen our ability to live fully, with curiosity and openness to our journey.
For over 14 years, I have worked with clients facing challenges such as addiction, anxiety, depression, trauma and difficult life changes. Together, we connect with their inner resources of self-compassion, wisdom and courage to uncover their authentic selves. When we cultivate a mindset of awareness and understanding, rather than judgment, we create the space to heal. Life experiences become a vehicle for learning and embracing our strength and resilience, as well as deepening our relationship with self and others. We strengthen our ability to live fully, with curiosity and openness to our journey.
(603) 583-4290 View (603) 583-4290
Photo of Cheyenne Garstad, Clinical Social Work/Therapist in Keene, NH
Cheyenne Garstad
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Keene, NH 03431
Has life thrown a lot your way? Has it been difficult to trust someone to help you through it? Does it feel like you don’t fit in anywhere, like no one gets it? Having a safe place to be yourself and find yourself is a big step in your healing journey. You don’t have to figure it out alone. As a queer and Black therapist, I understand the importance of creating a space where everyone feels welcome and cared for. I will be that safe space for you to share about your struggles and empower you to discover your strengths. You deserve safety, support, and the life you imagine for yourself.
Has life thrown a lot your way? Has it been difficult to trust someone to help you through it? Does it feel like you don’t fit in anywhere, like no one gets it? Having a safe place to be yourself and find yourself is a big step in your healing journey. You don’t have to figure it out alone. As a queer and Black therapist, I understand the importance of creating a space where everyone feels welcome and cared for. I will be that safe space for you to share about your struggles and empower you to discover your strengths. You deserve safety, support, and the life you imagine for yourself.
(603) 945-5485 View (603) 945-5485
Photo of Forrest Seymour, Clinical Social Work/Therapist in Keene, NH
Forrest Seymour
Clinical Social Work/Therapist, LICSW
Verified Verified
1 Endorsed
Keene, NH 03431  (Online Only)
Not accepting new clients
I have been a therapist for over 20 years and enjoy working with a wide variety of people and issues. To see if I am currently accepting new clients please go to my main website at www.TalkingCure.net and click the Request Appointment button. My availability changes frequently so you might want to check back often. I know that finding the right therapist can be challenging; I hope you stick with it.
I have been a therapist for over 20 years and enjoy working with a wide variety of people and issues. To see if I am currently accepting new clients please go to my main website at www.TalkingCure.net and click the Request Appointment button. My availability changes frequently so you might want to check back often. I know that finding the right therapist can be challenging; I hope you stick with it.
(603) 704-4366 View (603) 704-4366
Photo of Tricia McLeod, Counselor in Keene, NH
Tricia McLeod
Counselor, MA, LCMHC
Verified Verified
2 Endorsed
Keene, NH 03431
Not accepting new clients
I am a down to earth, intuitive therapist and provide counseling in a safe, practical and non-judgmental manner. I utilize a variety of therapeutic approaches tailored to each person's specific needs and goals. I truly believe in a person's ability to heal and recover and enjoy working collaboratively to meet people where they are at in their own process of change.
I am a down to earth, intuitive therapist and provide counseling in a safe, practical and non-judgmental manner. I utilize a variety of therapeutic approaches tailored to each person's specific needs and goals. I truly believe in a person's ability to heal and recover and enjoy working collaboratively to meet people where they are at in their own process of change.
(978) 631-2371 View (978) 631-2371
Photo of Ken Susskind, LICSW, Clinical Social Work/Therapist in Keene, NH
Ken Susskind, LICSW
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
1 Endorsed
Keene, NH 03431  (Online Only)
I have worked as a personal counselor since 1986 and as a licensed clinical social worker since 2004. I am a solution-focused therapist who listens deeply to my clients, then engages each in a true two-way conversation. Whether I'm seeing adults, older adolescents, or couples, I treat my clients respectfully. We focus on the issue at hand, work to understand the history and causes behind it, then together implement steps to bring change quickly. Most clients see me for six to eight weekly sessions, moving to less and less frequent sessions as their confidence and life satisfaction increases. I look forward to working with you.
I have worked as a personal counselor since 1986 and as a licensed clinical social worker since 2004. I am a solution-focused therapist who listens deeply to my clients, then engages each in a true two-way conversation. Whether I'm seeing adults, older adolescents, or couples, I treat my clients respectfully. We focus on the issue at hand, work to understand the history and causes behind it, then together implement steps to bring change quickly. Most clients see me for six to eight weekly sessions, moving to less and less frequent sessions as their confidence and life satisfaction increases. I look forward to working with you.
(603) 333-1644 View (603) 333-1644
Photo of Shannon L. McIntyre, Psychologist in Keene, NH
Shannon L. McIntyre
Psychologist, PhD
Verified Verified
Keene, NH 03431
Waitlist for new clients
Life can get complicated. Seeking guidance to contend with life's complications requires bravery, vulnerability, and perseverance - though, it can be a game changer. As a practitioner, I work best with those who struggle to maintain healthy & satisfying relationships with themselves and others, yet are driven to understand why.
Life can get complicated. Seeking guidance to contend with life's complications requires bravery, vulnerability, and perseverance - though, it can be a game changer. As a practitioner, I work best with those who struggle to maintain healthy & satisfying relationships with themselves and others, yet are driven to understand why.
(855) 554-3238 View (855) 554-3238
Photo of Joshua Green, Psychologist in Keene, NH
Joshua Green
Psychologist, PhD
Verified Verified
2 Endorsed
Keene, NH 03431
Not accepting new clients
If you are struggling with emotional pain that is confusing and/or seemingly uncontrollable and unpredictable, I may be a good fit for you. I frequently work with adults and college students who are struggling with anger, anxiety/panic, depression, relationship difficulties, sexual concerns, and distress related to family and life transitions. I also have significant experience working with individuals with histories of abuse, but I see people struggling with a wide variety of difficulties and concerns. I work with people of all genders, sexualities, and socioeconomic, racial, and cultural backgrounds.
If you are struggling with emotional pain that is confusing and/or seemingly uncontrollable and unpredictable, I may be a good fit for you. I frequently work with adults and college students who are struggling with anger, anxiety/panic, depression, relationship difficulties, sexual concerns, and distress related to family and life transitions. I also have significant experience working with individuals with histories of abuse, but I see people struggling with a wide variety of difficulties and concerns. I work with people of all genders, sexualities, and socioeconomic, racial, and cultural backgrounds.
(518) 430-5767 View (518) 430-5767
Photo of Jessica Braught, Counselor in Keene, NH
Jessica Braught
Counselor, MA, LCMHC, R-DMT
Verified Verified
Keene, NH 03431
Are you someone desiring to cultivate self discovery, self worth, and self love? Are you trying to rid yourself of anxiety, shame and fear? My clients tend to be individuals who are discovering or rediscovering themselves and desire to cultivate holistic healing. I specialize in maternal mental health with a passion to support those who are trying to become pregnant, struggling with infertility, experiencing or have experienced pregnancy loss or a new parent dealing with an exciting yet very challenging stage of life. My work with individuals is strengthened by my training in DBT and trauma informed methods such as EMDR.
Are you someone desiring to cultivate self discovery, self worth, and self love? Are you trying to rid yourself of anxiety, shame and fear? My clients tend to be individuals who are discovering or rediscovering themselves and desire to cultivate holistic healing. I specialize in maternal mental health with a passion to support those who are trying to become pregnant, struggling with infertility, experiencing or have experienced pregnancy loss or a new parent dealing with an exciting yet very challenging stage of life. My work with individuals is strengthened by my training in DBT and trauma informed methods such as EMDR.
(207) 218-0535 View (207) 218-0535
Antioch Couple and Family Therapy Institute
Marriage & Family Therapist, PhD, LMFT
Verified Verified
Keene, NH 03431
Sometimes we find ourselves struggling, unsure of how to make things better and most of us have experienced challenges within an important relationship. It’s important to know that at times like those, you are not alone. The Couple and Family Therapy Institute (CFTI) is here to help.
Sometimes we find ourselves struggling, unsure of how to make things better and most of us have experienced challenges within an important relationship. It’s important to know that at times like those, you are not alone. The Couple and Family Therapy Institute (CFTI) is here to help.
(603) 283-2156 View (603) 283-2156
Photo of Dr. Brian Quigley-Peak Experiences Counseling, Psychologist in Keene, NH
Dr. Brian Quigley-Peak Experiences Counseling
Psychologist, PhD
Verified Verified
1 Endorsed
Keene, NH 03431
Expertise, deeply caring, experienced, collaborative & open, down to earth- these describe me as a licensed psychologist. I'm an especially good fit if you're looking to avoid the mystery, confusion, and awkwardness sometimes associated with therapy. If you’re struggling with difficult emotions or challenging life circumstances, like many of us you may be feeling some unease about getting help. Well, I'm so glad you're here right now taking the courageous step of prioritizing your well-being! I'm confident that from my approach, therapy together will be wonderfully transformational, restorative, and life changing. You got this!
Expertise, deeply caring, experienced, collaborative & open, down to earth- these describe me as a licensed psychologist. I'm an especially good fit if you're looking to avoid the mystery, confusion, and awkwardness sometimes associated with therapy. If you’re struggling with difficult emotions or challenging life circumstances, like many of us you may be feeling some unease about getting help. Well, I'm so glad you're here right now taking the courageous step of prioritizing your well-being! I'm confident that from my approach, therapy together will be wonderfully transformational, restorative, and life changing. You got this!
(603) 782-9426 View (603) 782-9426
Photo of Maisa'a Hanbali, Drug & Alcohol Counselor in Keene, NH
Maisa'a Hanbali
Drug & Alcohol Counselor, MLADC, CTP, EMDR, MA, CMHC
Verified Verified
Keene, NH 03431
Collaborating with clients to develop individually tailored treatment plans, goals, and methods to assess progress in both one-to-one and group situations is what I strive for. In my previous jobs, I created opportunities for individuals who are in the process of discovering new horizons. I have strong intuitive skills that help me understand my clients' abilities and natural gifts in a nonjudgmental way. I have previously enjoyed working as a Crisis Clinician and a Respite Clinician. After that, I transitioned in my roles from Senior Counselor to an Assistant Director to a Clinical director in a residential setting.
Collaborating with clients to develop individually tailored treatment plans, goals, and methods to assess progress in both one-to-one and group situations is what I strive for. In my previous jobs, I created opportunities for individuals who are in the process of discovering new horizons. I have strong intuitive skills that help me understand my clients' abilities and natural gifts in a nonjudgmental way. I have previously enjoyed working as a Crisis Clinician and a Respite Clinician. After that, I transitioned in my roles from Senior Counselor to an Assistant Director to a Clinical director in a residential setting.
(603) 803-1472 View (603) 803-1472
Photo of Allison Carey, Marriage & Family Therapist in Keene, NH
Allison Carey
Marriage & Family Therapist, LMFT, LFYP-
Verified Verified
3 Endorsed
Keene, NH 03431  (Online Only)
Only accepting for individual therapy at this time. I work with people who are seeking a systemic, strengths-based, collaborative approach. My clients are primarily adolescents and adults experiencing relationship difficulties, parenting issues, marital distress, academic and behavioral difficulties, trauma symptoms and/or depressive & anxious moods. Those seeking to reduce daily stress and overwhelm, increase relationship satisfaction, and discover family patterns are a good fit for my approach.
Only accepting for individual therapy at this time. I work with people who are seeking a systemic, strengths-based, collaborative approach. My clients are primarily adolescents and adults experiencing relationship difficulties, parenting issues, marital distress, academic and behavioral difficulties, trauma symptoms and/or depressive & anxious moods. Those seeking to reduce daily stress and overwhelm, increase relationship satisfaction, and discover family patterns are a good fit for my approach.
(603) 903-1414 View (603) 903-1414
Photo of Carey Bluhm, Psychologist in Keene, NH
Carey Bluhm
Psychologist, PhD
Verified Verified
Keene, NH 03431
How might you choose the best counselor for you? Do you already know whether age and gender are important factors? Do you most of all need a specific time slot? Do you need someone who takes your insurance (or you can afford if you have none)? Does your prospective counselor do a specific kind of therapy you heard was good? You probably are concerned that the counselor will understand you and your specific problem or issues, but that is something you'll only be able to learn when you meet them. Has this counselor worked successfully with people with my problem or my circumstances?
How might you choose the best counselor for you? Do you already know whether age and gender are important factors? Do you most of all need a specific time slot? Do you need someone who takes your insurance (or you can afford if you have none)? Does your prospective counselor do a specific kind of therapy you heard was good? You probably are concerned that the counselor will understand you and your specific problem or issues, but that is something you'll only be able to learn when you meet them. Has this counselor worked successfully with people with my problem or my circumstances?
(888) 491-2993 View (888) 491-2993
Photo of Karen Linafelter, Counselor in Keene, NH
Karen Linafelter
Counselor, MA, LCMHC, BC-DMT
Verified Verified
3 Endorsed
Keene, NH 03431  (Online Only)
Not accepting new clients
Thank you for your interest. I offer video sessions throughout the state of NH and VT. I utilize a strength-based and integrated approach to help people identify what they want to work on and move forward with in their lives. I have worked with many topics including, but not limited to, stress of daily life and major changes, losses, depression, anxiety, trauma history, and eating disorders. I have worked with individuals and groups. I have been honored to work with people of all ages and abilities. I use both spoken English as well as American Sign Language.
Thank you for your interest. I offer video sessions throughout the state of NH and VT. I utilize a strength-based and integrated approach to help people identify what they want to work on and move forward with in their lives. I have worked with many topics including, but not limited to, stress of daily life and major changes, losses, depression, anxiety, trauma history, and eating disorders. I have worked with individuals and groups. I have been honored to work with people of all ages and abilities. I use both spoken English as well as American Sign Language.
(603) 757-6423 View (603) 757-6423
Photo of Nicole McElhinney, Counselor in Keene, NH
Nicole McElhinney
Counselor, LCMHC
Verified Verified
Keene, NH 03431
Not accepting new clients
I work with individuals ages 16 and up suffering with eating disorders, trauma, anxiety, and depression among other challenges. My goal is to create a safe, collaborative, and supportive environment for my clients to gain a deeper sense of awareness, understanding, and healing. I work with clients who are seeking a mind-body centered focus along with increased coping skills based in cognitive behavioral, trauma, and solution focused modalities. In my practice I am sensitive to how family systems along with sociocultural and systemic factors impact individual development and wellbeing.
I work with individuals ages 16 and up suffering with eating disorders, trauma, anxiety, and depression among other challenges. My goal is to create a safe, collaborative, and supportive environment for my clients to gain a deeper sense of awareness, understanding, and healing. I work with clients who are seeking a mind-body centered focus along with increased coping skills based in cognitive behavioral, trauma, and solution focused modalities. In my practice I am sensitive to how family systems along with sociocultural and systemic factors impact individual development and wellbeing.
(603) 903-2606 View (603) 903-2606
Photo of Alberto Soto, Psychologist in Keene, NH
Alberto Soto
Psychologist, PhD
Verified Verified
Keene, NH 03431
My areas of expertise are multicultural psychology and research related to the therapeutic relationship. I approach treatment from a relational-psychodynamic perspective that emphasizes the therapeutic relationship. During our work together, I seek to adapt therapy to each client, ensuring that every approach is tailored to your unique background and presenting concerns. My research background allows me to integrate various psychotherapy theories into treatment (CBT, interpersonal, mindfulness, multicultural, social justice approaches, etc.).
My areas of expertise are multicultural psychology and research related to the therapeutic relationship. I approach treatment from a relational-psychodynamic perspective that emphasizes the therapeutic relationship. During our work together, I seek to adapt therapy to each client, ensuring that every approach is tailored to your unique background and presenting concerns. My research background allows me to integrate various psychotherapy theories into treatment (CBT, interpersonal, mindfulness, multicultural, social justice approaches, etc.).
View
Photo of Travis Rowe in Keene, NH
Travis Rowe
MFT
Verified Verified
1 Endorsed
Keene, NH 03431  (Online Only)
Travis, a dedicated Marriage and Family Therapist, offers telehealth sessions to individuals and families. Specializing in systemic thinking, he builds comprehensive client profiles, leveraging his extensive knowledge of local resources. Travis expertly navigates anxiety, depression, PTSD, substance abuse, ADHD, and co-occurring disorders. Begin your journey to wellness; call for an appointment today.
Travis, a dedicated Marriage and Family Therapist, offers telehealth sessions to individuals and families. Specializing in systemic thinking, he builds comprehensive client profiles, leveraging his extensive knowledge of local resources. Travis expertly navigates anxiety, depression, PTSD, substance abuse, ADHD, and co-occurring disorders. Begin your journey to wellness; call for an appointment today.
(603) 606-9114 View (603) 606-9114
Photo of Keene Psychotherapy Services, Richard C. Donovan, Clinical Social Work/Therapist in Keene, NH
Keene Psychotherapy Services, Richard C. Donovan
Clinical Social Work/Therapist, MSW, ACSW, LICSW
Verified Verified
Keene, NH 03431
I am a certified clinical traumatologist and psychotherapist. It is my hope to help you feel better. Whether its depression, fear worry, anxiety, stress, child problems, relationship concerns or family issues, we as a team will seek the solutions that will help you embrace the life you seek for yourself.
I am a certified clinical traumatologist and psychotherapist. It is my hope to help you feel better. Whether its depression, fear worry, anxiety, stress, child problems, relationship concerns or family issues, we as a team will seek the solutions that will help you embrace the life you seek for yourself.
(603) 717-9620 View (603) 717-9620
Photo of Alicia Ann MacDougall, Psychologist in Keene, NH
Alicia Ann MacDougall
Psychologist, PsyD, ABPP
Verified Verified
1 Endorsed
Keene, NH 03431
I am a clinical psychologist working with people of all ages. I specialize in helping children and adolescents who have faced difficult life circumstances, including complications from emergency medical events and pervasive medical diagnoses, as well as those who have experienced various types of abuse. My experience on psychiatric inpatient units allows me to be helpful in navigating mood disorders, dissociation, somatic symptoms, and other intense emotional experiences. My work on medical inpatient floors enables me to support those with eating disorders, traumatic brain injuries, genetic disorders and other medical conditions.
I am a clinical psychologist working with people of all ages. I specialize in helping children and adolescents who have faced difficult life circumstances, including complications from emergency medical events and pervasive medical diagnoses, as well as those who have experienced various types of abuse. My experience on psychiatric inpatient units allows me to be helpful in navigating mood disorders, dissociation, somatic symptoms, and other intense emotional experiences. My work on medical inpatient floors enables me to support those with eating disorders, traumatic brain injuries, genetic disorders and other medical conditions.
(603) 691-3472 View (603) 691-3472
Photo of Kim Burden, LCMHC, Counselor in Keene, NH
Kim Burden, LCMHC
Counselor, MA, LCMHC, LCAT, BC-DMT, RDT/BCT
Verified Verified
Keene, NH 03431
Please note that I am unable to accept new clients at this time. I've been providing creative, collaborative, practical counseling for adults and adolescents, with a down to earth, compassionate approach, for 22 years. Focusing on the wisdom within body, mind and spirit, I support people to think, feel and act creatively, find balance, and honor their natural strengths. I integrate dance/movement therapy, drama therapy, expressive arts and Yoga in my work. Areas of focus include life transitions, LGBTQ concerns, women's issues, social justice focus, and spirituality.
Please note that I am unable to accept new clients at this time. I've been providing creative, collaborative, practical counseling for adults and adolescents, with a down to earth, compassionate approach, for 22 years. Focusing on the wisdom within body, mind and spirit, I support people to think, feel and act creatively, find balance, and honor their natural strengths. I integrate dance/movement therapy, drama therapy, expressive arts and Yoga in my work. Areas of focus include life transitions, LGBTQ concerns, women's issues, social justice focus, and spirituality.
(603) 244-3325 View (603) 244-3325

How does your Therapist compare?

Number of Therapists in Keene, NH

90+

Average cost per session

$140

Therapists in Keene, NH who prioritize treating:

87% Anxiety
83% Depression
74% Relationship Issues
74% Self Esteem
67% Trauma and PTSD
67% Coping Skills
63% Stress

Average years in practice

17 Years

Top 3 insurances accepted

78% BlueCross and BlueShield
68% UnitedHealthcare UHC | UBH
60% Optum

How Therapists in Keene, NH see their clients

68% In Person and Online
32% Online Only

Gender breakdown

72% Female
27% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Keene?

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.