Therapists in San Rafael, CA
Talita Jackson
Marriage & Family Therapist, LMFT, 94667
Verified Verified
San Rafael, CA 94903
Licensed clinical psychotherapist in California and Idaho with a broad experience in evidence -practice treatment. Specialized in adolescent and young adult. Focused on the connections between what we think, feel, and do, and how we can change the way we experience life. Experienced in CBT, DBT, suicide prevention and eating disorder, Talita has been working in the forensic system and Kaiser hospital setting for many years.
Licensed clinical psychotherapist in California and Idaho with a broad experience in evidence -practice treatment. Specialized in adolescent and young adult. Focused on the connections between what we think, feel, and do, and how we can change the way we experience life. Experienced in CBT, DBT, suicide prevention and eating disorder, Talita has been working in the forensic system and Kaiser hospital setting for many years.
Dina Schweitzer Leitch
Marriage & Family Therapist, MA, LMFT
Verified Verified
San Rafael, CA 94901
Do you feel lonely, anxious or sad? If you are looking for a therapist, you are taking the first step towards feeling better. I have been a licensed Marriage and Family Therapist for over 20 years and provide psychotherapy to adolescents, adults and families in Marin. I tailor my approach to your individual specific needs and concerns so that you can feel empowered to make positive changes in your relationships and in your life. I utilize complementary psychotherapy approaches and give constructive feedback to help my clients attain their goals in a safe and supportive environment.
Do you feel lonely, anxious or sad? If you are looking for a therapist, you are taking the first step towards feeling better. I have been a licensed Marriage and Family Therapist for over 20 years and provide psychotherapy to adolescents, adults and families in Marin. I tailor my approach to your individual specific needs and concerns so that you can feel empowered to make positive changes in your relationships and in your life. I utilize complementary psychotherapy approaches and give constructive feedback to help my clients attain their goals in a safe and supportive environment.
Jenny Bates
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
San Rafael, CA 94901
Many of us have been affected by mental health and/or substance abuse at some time in our lives. My practice was created so that individuals, couples and families could get support from someone who is experienced in the recovery process and has a true passion to help others and help people to find the best solutions to their own recovery. My specialty areas include those who are living with anxiety, depression, trauma and supporting those going through life changes (job, relationships etc.) Addiction and Co-Dependency is also a specialty area. I am an LGBTQ+ affirming therapist and welcome you to come as you are.
Many of us have been affected by mental health and/or substance abuse at some time in our lives. My practice was created so that individuals, couples and families could get support from someone who is experienced in the recovery process and has a true passion to help others and help people to find the best solutions to their own recovery. My specialty areas include those who are living with anxiety, depression, trauma and supporting those going through life changes (job, relationships etc.) Addiction and Co-Dependency is also a specialty area. I am an LGBTQ+ affirming therapist and welcome you to come as you are.
Simone Rodin
Psychologist, PhD
Verified Verified
San Rafael, CA 94903
My practice includes children, families and individual adults. I am an experienced child psychologist who has been helping children and teens for over 25 years. I see children who are struggling with friendships, school issues, the effects of divorce, low self-esteem, anxiety, and depression. I specialize in treating anxiety using a model that incorporates CBT and play therapy principles to help build coping skills, resiliency, empathy, and better social skills. I view children as complete individuals deserving of respect. My warm engaging style creates a safe trusting environment for children and adults.
My practice includes children, families and individual adults. I am an experienced child psychologist who has been helping children and teens for over 25 years. I see children who are struggling with friendships, school issues, the effects of divorce, low self-esteem, anxiety, and depression. I specialize in treating anxiety using a model that incorporates CBT and play therapy principles to help build coping skills, resiliency, empathy, and better social skills. I view children as complete individuals deserving of respect. My warm engaging style creates a safe trusting environment for children and adults.
Sara Staley
Marriage & Family Therapist, LMFT
Verified Verified
San Rafael, CA 94903
I provide therapeutic support for adults, children, teens, and families that have experienced psychological trauma, are experiencing a challenging life transition, or want to build self-awareness and resiliency. My focus is working with children and their parents, especially between the ages of 3 to 7 years old, using Play Therapy. With all ages of individuals I have the ability to get to the root causes of psychological symptoms using Psychodynamic Therapy and Sandplay Therapy. I also use evidence based short term treatment modalities such as CBT, depending on my clients desires and needs.
I provide therapeutic support for adults, children, teens, and families that have experienced psychological trauma, are experiencing a challenging life transition, or want to build self-awareness and resiliency. My focus is working with children and their parents, especially between the ages of 3 to 7 years old, using Play Therapy. With all ages of individuals I have the ability to get to the root causes of psychological symptoms using Psychodynamic Therapy and Sandplay Therapy. I also use evidence based short term treatment modalities such as CBT, depending on my clients desires and needs.
Virgine De Paepe
Marriage & Family Therapist, MA, LMFT, CMT, LCSW
Verified Verified
7 Endorsed
San Rafael, CA 94901
Hello! I have a warm, active and authentic style. I am not the stereo typical therapist who sits back and nods. I'm engaged and curious about you and your process, and I'm constantly learning about new approaches to healing and therapy. I am originally from Belgium and have been living in the states for 20 years now. My ultimate goal is to inspire, guide and empower you to live more JOY-FUL lives. I have a strong interest in working with women on the foundation of their SELF ESTEEM and how this impacts their relationships and decisions.
Hello! I have a warm, active and authentic style. I am not the stereo typical therapist who sits back and nods. I'm engaged and curious about you and your process, and I'm constantly learning about new approaches to healing and therapy. I am originally from Belgium and have been living in the states for 20 years now. My ultimate goal is to inspire, guide and empower you to live more JOY-FUL lives. I have a strong interest in working with women on the foundation of their SELF ESTEEM and how this impacts their relationships and decisions.
Kristel S. Grodeska
Marriage & Family Therapist, MA, LMFT
Verified Verified
3 Endorsed
San Rafael, CA 94901
If you are feeling disconnected or wanting to learn how to more deeply connect to yourself or those you are in relationship with, therapy can be a place to learn a different way of relating. I see therapy as a collaborative place for you to grow in the direction that you want and to reset your vitality. I have a strength in working with: couples who want to nurture their bond or need relational resources; people who want more emotional strength and capacity for intimacy; people dealing with the impacts of sexual trauma; people who want to grow relational skills.
If you are feeling disconnected or wanting to learn how to more deeply connect to yourself or those you are in relationship with, therapy can be a place to learn a different way of relating. I see therapy as a collaborative place for you to grow in the direction that you want and to reset your vitality. I have a strength in working with: couples who want to nurture their bond or need relational resources; people who want more emotional strength and capacity for intimacy; people dealing with the impacts of sexual trauma; people who want to grow relational skills.
Alvin Louis Gilmore Jr
Marriage & Family Therapist, MS Ed, MFT
Verified Verified
San Rafael, CA 94901 (Online Only)
Your everyday choices reflect the meaning you are attempting to bring to your life. Big or small, they are rooted in your in past, hopes, desires, needs, dreams, etc. There are times, however, when you experience trauma, severe life stressors, or times of crisis that impact your ability to make healthy choices producing confusion, fear, anger, and sadness. You may even feel as if it is a struggle to find ease, happiness, and peace. The journey to be more self-aware, to bring more contentment and joy in your life and to connect with others in healthy ways is the destination that you and I will strive towards.
Your everyday choices reflect the meaning you are attempting to bring to your life. Big or small, they are rooted in your in past, hopes, desires, needs, dreams, etc. There are times, however, when you experience trauma, severe life stressors, or times of crisis that impact your ability to make healthy choices producing confusion, fear, anger, and sadness. You may even feel as if it is a struggle to find ease, happiness, and peace. The journey to be more self-aware, to bring more contentment and joy in your life and to connect with others in healthy ways is the destination that you and I will strive towards.
Rita Groszmann
Marriage & Family Therapist, PhD
Not Verified Not Verified
San Rafael, CA 94903 (Online Only)
What I bring to my work in over 25 years of working with people is clarity, competence, personal warmth and an ability to draw from a wide range of effective approaches. I have had particular success with couples, teenage girls and individuals in recovery. My approach is both personable and effective.
What I bring to my work in over 25 years of working with people is clarity, competence, personal warmth and an ability to draw from a wide range of effective approaches. I have had particular success with couples, teenage girls and individuals in recovery. My approach is both personable and effective.
Gellaine Rabino
Licensed Professional Clinical Counselor, LPCC, ATR-BC
Verified Verified
San Rafael, CA 94903
Gellaine (Jeh-lane) is a Licensed Professional Clinical Counselor and board certified Art Therapist who centers her work through creativity and authentic connections with her clients. In addition to talking, therapy with Gellaine is a dynamic collaborative process. Using art therapy, play therapy, movement, and a strengths-based approach, she encourages clients to use their imaginations and curiosity to explore struggles and concerns.
Gellaine (Jeh-lane) is a Licensed Professional Clinical Counselor and board certified Art Therapist who centers her work through creativity and authentic connections with her clients. In addition to talking, therapy with Gellaine is a dynamic collaborative process. Using art therapy, play therapy, movement, and a strengths-based approach, she encourages clients to use their imaginations and curiosity to explore struggles and concerns.
Deane Rain Marie
Marriage & Family Therapist, MA, LMFT
Verified Verified
1 Endorsed
San Rafael, CA 94901 (Online Only)
I work with chronic dieters, binge eating disorder, and poor body image. Your body does not determine your value. However, you're surrounded by a culture that tells you it's YOUR fault. You've dieted until you don't even recognize your relationship with food anymore. You can't hear your body, let alone trust it. Your concept of your body and your relationship with it are damaged. You just know you're not what you're supposed to be, not valuable or acceptable.You're binging one moment and dieting the next. We weren't designed to live this way. I can help! I’ve been there. If you’re tired of the weight cycling, let’s work to end it!
I work with chronic dieters, binge eating disorder, and poor body image. Your body does not determine your value. However, you're surrounded by a culture that tells you it's YOUR fault. You've dieted until you don't even recognize your relationship with food anymore. You can't hear your body, let alone trust it. Your concept of your body and your relationship with it are damaged. You just know you're not what you're supposed to be, not valuable or acceptable.You're binging one moment and dieting the next. We weren't designed to live this way. I can help! I’ve been there. If you’re tired of the weight cycling, let’s work to end it!
15 Second Videos
Jenny Bates
Sara Staley
Joseph Choy
Black Minds Matter Psychotherapy Inc.
Susan Quigley, MFT
Suzanne D Alfandari
Kimberly de Caires
Lauren Ogren
Elizabeth Scott
Kiri Maura
Robert Nemerovski
Lorin Tierney
Jennifer A Norstrom
Win Bottum-Morgan, Ph.D.
Carey Cloyd
Melissa Dowd - Offering A Modern Approach To Therapy
Kathy Jarosz
Vito Pelikan
Kristen Lebacqz
Kelly Grimes
Cofounder and Business Partner Executive Coaching
Kate Leffel
Sean Robertson
Graham Sargent
Anne M Pincus, PhD
Elizabeth Dandenell
Sue Kessner
Gabriel Rabu
Larry Yavorsky Therapy & Relationship Enhancement
Lisa A Murphy
Susan Pease Gadoua
Meredith McGarvey
Jodi Klugman-Rabb
Makhetsi Tessien
India B. Gomez
Maddie Bishop
Graham Leggett
Nicole Lako
Kylie Hempy Therapist For New Moms And Postpartum Parents
Ryan Woodring
Adam Luke
Bret T Alderman
Jenny Werba
Ashley Coover
Gina Borelli Moore
Deanna Bernard
John Coyne
Anabel Plasencia
Dylan Cimbura-Hernandez
Elana Morgulis
Andreas Bollinger
Psychologist, PhD
Verified Verified
San Rafael, CA 94901
Welcome, I’m Andreas, and thank you for stopping by. My goal is to create a safe space where you can feel empowered, practice self-compassion, strengthen your resilience, and create a life that is meaningful to you. As a licensed Clinical Psychologist, I have over 30 years of experience as a therapist, first responder to natural and human-made disasters, clinical supervisor, trainer/consultant, graduate level professor, and NIH-funded researcher. My areas of expertise include treatments for trauma/PTSD (Prolonged Exposure, Written Narrative Exposure, and Cognitive Processing Therapy), substance use disorders, and mood disorders.
Welcome, I’m Andreas, and thank you for stopping by. My goal is to create a safe space where you can feel empowered, practice self-compassion, strengthen your resilience, and create a life that is meaningful to you. As a licensed Clinical Psychologist, I have over 30 years of experience as a therapist, first responder to natural and human-made disasters, clinical supervisor, trainer/consultant, graduate level professor, and NIH-funded researcher. My areas of expertise include treatments for trauma/PTSD (Prolonged Exposure, Written Narrative Exposure, and Cognitive Processing Therapy), substance use disorders, and mood disorders.
Sasha Levine
Marriage & Family Therapist, MS, LMFT
Verified Verified
San Rafael, CA 94901
I provide warm and supportive guidance to help you move towards a happier and more fulfilling life. Whether you are struggling in your relationships, going through a transitional period, lost someone close to you, or having difficulty breaking habits we can work together to create positive change in your life. My approach is compassionate, non-judgmental, and goal-oriented, adjusting to fit the needs of each unique individual.
I provide warm and supportive guidance to help you move towards a happier and more fulfilling life. Whether you are struggling in your relationships, going through a transitional period, lost someone close to you, or having difficulty breaking habits we can work together to create positive change in your life. My approach is compassionate, non-judgmental, and goal-oriented, adjusting to fit the needs of each unique individual.
Ashlyn Açikalin
Marriage & Family Therapist Associate, MA, AMFT, APCC
Verified Verified
1 Endorsed
San Rafael, CA 94901 (Online Only)
My work is warm, relational, and balanced. I enjoy cultivating genuine relationships with clients and value each individual's unique needs. I work with children, teens, and adults going through various challenges, including anxiety, trauma, identity, transitions, grief, and relationship struggles.
My work is warm, relational, and balanced. I enjoy cultivating genuine relationships with clients and value each individual's unique needs. I work with children, teens, and adults going through various challenges, including anxiety, trauma, identity, transitions, grief, and relationship struggles.
The Relationship Therapy Group
Clinical Social Work/Therapist, LMFT
Verified Verified
San Rafael, CA 94901
The Relationship Institute of San Francisco (www.trisf.com) specializes in couples counseling, individual and family therapy, based out of San Francisco, California. We treat a wide variety of clients, all with unique stories and situations. We are a team of psychotherapists specifically trained to provide couples and relational counseling. Our psychotherapists have a few things in common: we teach skills, provide feedback, and are directive therapists. Our goal is short-term, evidence-based couples and relational counseling. We utilize Cognitive Behavioral Therapy (CBT) modalities, as well as a range of widely accepted approaches.
The Relationship Institute of San Francisco (www.trisf.com) specializes in couples counseling, individual and family therapy, based out of San Francisco, California. We treat a wide variety of clients, all with unique stories and situations. We are a team of psychotherapists specifically trained to provide couples and relational counseling. Our psychotherapists have a few things in common: we teach skills, provide feedback, and are directive therapists. Our goal is short-term, evidence-based couples and relational counseling. We utilize Cognitive Behavioral Therapy (CBT) modalities, as well as a range of widely accepted approaches.
Barbara Jean Gosselin
Marriage & Family Therapist, MS, LMFT
Verified Verified
San Rafael, CA 94901 (Online Only)
Choosing to see a therapist is about you wanting to make some changes in yourself or in your life. The most important job I have as your therapist is to provide you with a non-judgmental space to explore your issues, your feelings and to help you find a solution that will ultimately make you feel better.
Choosing to see a therapist is about you wanting to make some changes in yourself or in your life. The most important job I have as your therapist is to provide you with a non-judgmental space to explore your issues, your feelings and to help you find a solution that will ultimately make you feel better.
Jennifer Myers
Psychologist, PsyD
Verified Verified
San Rafael, CA 94901 (Online Only)
Hello, I am a licensed clinical psychologist who provides individual and group therapy to adolescents and adults. I also work with athletes to improve performance skills by helping with their "mental game". Are you or a family member experiencing anxiety, depression, or other mental health challenges that are negatively affecting you? Are you trying to find a better balance that can lead to increased happiness and more success in your relationships, at work, and/or at school? Making the decision to start therapy can be tough but I am here to support you in your journey to a more fulfilled life.
Hello, I am a licensed clinical psychologist who provides individual and group therapy to adolescents and adults. I also work with athletes to improve performance skills by helping with their "mental game". Are you or a family member experiencing anxiety, depression, or other mental health challenges that are negatively affecting you? Are you trying to find a better balance that can lead to increased happiness and more success in your relationships, at work, and/or at school? Making the decision to start therapy can be tough but I am here to support you in your journey to a more fulfilled life.
Open Space Therapy Solutions
Clinical Social Work/Therapist, LCSW
Verified Verified
San Rafael, CA 94903 (Online Only)
You might find yourself interrupted by reminders and feel like you're reliving the past. Like you’re always on edge. Your nerves are constantly frazzled, leaving you exhausted by the end of the day. It's tough to relax or unwind when you’re always anticipating the next trigger. Your relationships are feeling it too. Maybe this leads to interactions you aren’t proud of, like snapping at your kids or your partner. This constant state of tension can leave you feeling drained and overwhelmed. You’re looking for a glimmer of hope. Your experiences have shaped you, but they don't have to dictate your future. I'm here to help.
You might find yourself interrupted by reminders and feel like you're reliving the past. Like you’re always on edge. Your nerves are constantly frazzled, leaving you exhausted by the end of the day. It's tough to relax or unwind when you’re always anticipating the next trigger. Your relationships are feeling it too. Maybe this leads to interactions you aren’t proud of, like snapping at your kids or your partner. This constant state of tension can leave you feeling drained and overwhelmed. You’re looking for a glimmer of hope. Your experiences have shaped you, but they don't have to dictate your future. I'm here to help.
Ellen Louisa LeMauviel
Marriage & Family Therapist, MA, MFT
Verified Verified
San Rafael, CA 94903 (Online Only)
Deep down you’ve known for a while that you have something potent to offer this world and your relationships. But bringing that knowing into daily life feels out of reach. Life can deal brutal cards, and habits can be hard to shake. You are capable and thoughtful, and you have mutually supportive relationships. You have grown and deepened through many of life’s challenges. But this threshold life has brought you is not something you can walk (or crawl) through alone. You are aware that life is impermanent, what you do with it matters, and there’s no time to waste not getting the care you need to be who you came here to be.
Deep down you’ve known for a while that you have something potent to offer this world and your relationships. But bringing that knowing into daily life feels out of reach. Life can deal brutal cards, and habits can be hard to shake. You are capable and thoughtful, and you have mutually supportive relationships. You have grown and deepened through many of life’s challenges. But this threshold life has brought you is not something you can walk (or crawl) through alone. You are aware that life is impermanent, what you do with it matters, and there’s no time to waste not getting the care you need to be who you came here to be.
Zakiya Duviella
Marriage & Family Therapist, LMFT
Verified Verified
San Rafael, CA 94903 (Online Only)
My therapy style is genuine and straightforward, yet sincere and compassionate. My therapeutic approach is collaborative, attachment-focused, and client-centered. The primary influences in my treatment style are Strength-based, Motivational Interviewing, Cognitive Behavioral, Supportive, and Solution-Focused. I am culturally competent in understanding the specific cultural, linguistic, social, and economic nuances of particular people and families.
My therapy style is genuine and straightforward, yet sincere and compassionate. My therapeutic approach is collaborative, attachment-focused, and client-centered. The primary influences in my treatment style are Strength-based, Motivational Interviewing, Cognitive Behavioral, Supportive, and Solution-Focused. I am culturally competent in understanding the specific cultural, linguistic, social, and economic nuances of particular people and families.
See more therapy options for San Rafael
How does your Therapist compare?
Number of Therapists in San Rafael, CA
600+
Average cost per session
$195
Therapists in San Rafael, CA who prioritize treating:
91% | Anxiety |
84% | Depression |
81% | Relationship Issues |
69% | Self Esteem |
66% | Trauma and PTSD |
65% | Grief |
63% | Stress |
Average years in practice
16 Years
Top 3 insurances accepted
55% | Aetna |
46% | Cigna and Evernorth |
44% | Anthem | Elevance |
How Therapists in San Rafael, CA see their clients
70% | In Person and Online | |
30% | Online Only |
Gender breakdown
77% | Female | |
22% | Male | |
1% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in San Rafael?
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
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.
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.
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.