Therapists in Bethesda, MD

Photo of Candy Merrill, Clinical Social Work/Therapist in Bethesda, MD
Candy Merrill
Clinical Social Work/Therapist, LCSW
Verified Verified
Bethesda, MD 20814  (Online Only)
Hi, my name is Candace, but you can call me Candy, I have worked in the mental health field for 20 years and have been licensed for 4 years. This experience has allowed me to gain vast knowledge in the many nuances that can affect one’s life. I have been honored by each person that I’ve worked with as they have allowed me a windows view of their life and the issues each of them had while working together as a team to overcome these issues. My thought on counseling is that the person seeking therapy and the therapist are a team and work together as a team to find solutions and overcome the issues at hand.
Hi, my name is Candace, but you can call me Candy, I have worked in the mental health field for 20 years and have been licensed for 4 years. This experience has allowed me to gain vast knowledge in the many nuances that can affect one’s life. I have been honored by each person that I’ve worked with as they have allowed me a windows view of their life and the issues each of them had while working together as a team to overcome these issues. My thought on counseling is that the person seeking therapy and the therapist are a team and work together as a team to find solutions and overcome the issues at hand.
(240) 852-1542 View (240) 852-1542
Photo of Nancy R Goodman, Psychologist in Bethesda, MD
Nancy R Goodman
Psychologist, PhD, FIPA
Verified Verified
Bethesda, MD 20814
I believe individuals come to talk to a therapist when in emotional pain-- sadness, fear, loneliness, depression, traumas, and uncertainties. I want to help people express their deep concerns and learn what emotional conflicts and transitions are causing discomforts. Understanding inner experience is very helpful with a psychoanalytic therapist who creates with you a trusting place for speaking. Knowing oneself deeply can bring about transformations in the way you feel, have a relationship, and are able to work and create. I look forward to speaking with you and listening to what you need to talk about.
I believe individuals come to talk to a therapist when in emotional pain-- sadness, fear, loneliness, depression, traumas, and uncertainties. I want to help people express their deep concerns and learn what emotional conflicts and transitions are causing discomforts. Understanding inner experience is very helpful with a psychoanalytic therapist who creates with you a trusting place for speaking. Knowing oneself deeply can bring about transformations in the way you feel, have a relationship, and are able to work and create. I look forward to speaking with you and listening to what you need to talk about.
(301) 861-4938 View (301) 861-4938
Photo of Keisha M. Watson, Counselor in Bethesda, MD
Keisha M. Watson
Counselor, LCPC, NCC, ACS
Verified Verified
Bethesda, MD 20817  (Online Only)
Bright Journey Counseling provides empathetic, yet focused coping strategies to offer hope, positive thinking and realization that change is possible. I am passionate about working with young adults and women that have developed unhealthy behaviors and interpersonal relationships related to past trauma experiences. I bring over a decade of clinical experience providing psychotherapy to children, teens and adults in various clinical settings including community-based, outpatient treatment center, private and group practice.
Bright Journey Counseling provides empathetic, yet focused coping strategies to offer hope, positive thinking and realization that change is possible. I am passionate about working with young adults and women that have developed unhealthy behaviors and interpersonal relationships related to past trauma experiences. I bring over a decade of clinical experience providing psychotherapy to children, teens and adults in various clinical settings including community-based, outpatient treatment center, private and group practice.
(301) 307-2296 View (301) 307-2296
Photo of Morgan Russo, Marriage & Family Therapist Associate in Bethesda, MD
Morgan Russo
Marriage & Family Therapist Associate, LGMFT
Verified Verified
1 Endorsed
Bethesda, MD 20814  (Online Only)
Not accepting new clients
My clients are looking for a change, whether they are couples or individuals. My couples generally say they are looking for "better communication," however that often translates into looking for a deeper connection and bond with each other. I work with couples to understand their histories, their arguments, and learn how to connect instead of disconnect. The individuals I see in general have anxiety. I work with them to understand why they have anxiety, where it came from, and how to 'release' that anxious part.
My clients are looking for a change, whether they are couples or individuals. My couples generally say they are looking for "better communication," however that often translates into looking for a deeper connection and bond with each other. I work with couples to understand their histories, their arguments, and learn how to connect instead of disconnect. The individuals I see in general have anxiety. I work with them to understand why they have anxiety, where it came from, and how to 'release' that anxious part.
(240) 376-4054 View (240) 376-4054
Photo of Lindsey Hoskins & Associates, Marriage & Family Therapist in Bethesda, MD
Lindsey Hoskins & Associates
Marriage & Family Therapist, PhD, LCMFT
Verified Verified
12 Endorsed
Bethesda, MD 20814
My individual clients include those dealing with mental health challenges; making decisions about career or relationships; or pursuing more fulfilling approaches to life. I work with couples of all ages, stages, and compositions, addressing communication, infidelity, loss of passion, infertility, parenting, strengthening relationships, and deciding. I work with couples struggling to decide if and how to continue to work on deeply troubled relationships and solidifying commitment. I see families dealing with communication issues, creating appropriate boundaries, and working through separation, divorce, and blended family issues .
My individual clients include those dealing with mental health challenges; making decisions about career or relationships; or pursuing more fulfilling approaches to life. I work with couples of all ages, stages, and compositions, addressing communication, infidelity, loss of passion, infertility, parenting, strengthening relationships, and deciding. I work with couples struggling to decide if and how to continue to work on deeply troubled relationships and solidifying commitment. I see families dealing with communication issues, creating appropriate boundaries, and working through separation, divorce, and blended family issues .
(301) 234-6398 View (301) 234-6398
Photo of Wandner Health and Wellness, LLC, Psychologist in Bethesda, MD
Wandner Health and Wellness, LLC
Psychologist
Verified Verified
Bethesda, MD 20814  (Online Only)
I am a committed and compassionate clinical psychologist with advanced training and expertise in clinical health psychology. My interests are in helping patients to understand the mind-body connection, helping them to improve their quality of life despite experiencing chronic health conditions, and improving the way that they live despite stress and hardships. I specialize in health psychology, which focuses on promoting overall well-being as well as coping with acute and chronic illnesses.
I am a committed and compassionate clinical psychologist with advanced training and expertise in clinical health psychology. My interests are in helping patients to understand the mind-body connection, helping them to improve their quality of life despite experiencing chronic health conditions, and improving the way that they live despite stress and hardships. I specialize in health psychology, which focuses on promoting overall well-being as well as coping with acute and chronic illnesses.
(240) 617-3769 View (240) 617-3769
Photo of David B Sacks, Psychologist in Bethesda, MD
David B Sacks
Psychologist, PsyD, ABPP
Verified Verified
Bethesda, MD 20815  (Online Only)
"Help! My stress is over the top!" Have you found yourself thinking this? Are you facing difficult circumstances? Is stress from events in the world, or concerns about oppression and privilege, affecting you and/or your relationships? Is it harder to meet your commitments to family, friends, and/or groups and causes you care about? I specialize in helping adults, adolescents and families draw upon their strengths, solve problems, and develop new understanding and new skills.
"Help! My stress is over the top!" Have you found yourself thinking this? Are you facing difficult circumstances? Is stress from events in the world, or concerns about oppression and privilege, affecting you and/or your relationships? Is it harder to meet your commitments to family, friends, and/or groups and causes you care about? I specialize in helping adults, adolescents and families draw upon their strengths, solve problems, and develop new understanding and new skills.
(301) 660-2117 View (301) 660-2117
Photo of Laura Goss, Counselor in Bethesda, MD
Laura Goss
Counselor, CPC
Verified Verified
Bethesda, MD 20814  (Online Only)
My goal as a therapist is to support clients in making meaning and finding peace. My approach may involve anything from us working together to soothe your anxiety, to sorting through unspeakable trauma. I aim to create a space that is warm and devoid of judgement. I will walk beside you and explore with you, and other than the occasional gentle nudge, I won’t push you where you aren’t ready to go.
My goal as a therapist is to support clients in making meaning and finding peace. My approach may involve anything from us working together to soothe your anxiety, to sorting through unspeakable trauma. I aim to create a space that is warm and devoid of judgement. I will walk beside you and explore with you, and other than the occasional gentle nudge, I won’t push you where you aren’t ready to go.
(240) 792-8382 x1 View (240) 792-8382 x1
Photo of Lilian Gunawan, Clinical Social Work/Therapist in Bethesda, MD
Lilian Gunawan
Clinical Social Work/Therapist, LMSW, PMH-C
Verified Verified
Bethesda, MD 20817
I am a clinical social worker and therapist at the Washington Center for Women’s and Children’s Wellness in Bethesda, Maryland, caring for women and birthing people throughout Montgomery County and the Greater Washington area. I provide both tele-health and in-person appointments to clients. I am specialized in perinatal and women's mental health working with individuals who are struggling in their transition to parenthood, during pregnancy, fertility treatment, and in the postpartum period as well as with those who have experienced a pregnancy loss.
I am a clinical social worker and therapist at the Washington Center for Women’s and Children’s Wellness in Bethesda, Maryland, caring for women and birthing people throughout Montgomery County and the Greater Washington area. I provide both tele-health and in-person appointments to clients. I am specialized in perinatal and women's mental health working with individuals who are struggling in their transition to parenthood, during pregnancy, fertility treatment, and in the postpartum period as well as with those who have experienced a pregnancy loss.
(301) 381-2443 View (301) 381-2443
Photo of Audrey Bennett, Clinical Social Work/Therapist in Bethesda, MD
Audrey Bennett
Clinical Social Work/Therapist, LCSW, LADC
Verified Verified
Bethesda, MD 20814  (Online Only)
Want to shift the old patterns that haunt you? Want to gain coping skills to help with difficulties? Are you in need of Spiritual guidance? If you are looking for results, you have found the right therapist! Your time is valuable, and I look forward to supporting your journey to reach your highest quality of life. I work with both Traditional & Non-Traditional, Ancient & Modern Approaches. You choose what works for you. As a Ceremonialist I also help you bring meaning to significant events: Births, deaths etc. Learn to weave the threads of difficulties into a more stable tapestry of your life. (see photo gallery for insight)
Want to shift the old patterns that haunt you? Want to gain coping skills to help with difficulties? Are you in need of Spiritual guidance? If you are looking for results, you have found the right therapist! Your time is valuable, and I look forward to supporting your journey to reach your highest quality of life. I work with both Traditional & Non-Traditional, Ancient & Modern Approaches. You choose what works for you. As a Ceremonialist I also help you bring meaning to significant events: Births, deaths etc. Learn to weave the threads of difficulties into a more stable tapestry of your life. (see photo gallery for insight)
(808) 793-4722 View (808) 793-4722
Madisen Moody
Resident in Counseling, LPC-R
Verified Verified
2 Endorsed
Bethesda, MD 20814
What is Severe Mental Illness (SMI) and Forensic populations, you may ask? SMI includes Schizophrenia Spectrum Disorders, Personality Disorders, and Bipolar Disorders, etc. Madisen also enjoys working with the forensically connected populations, specifically, those adjudicated Not Guilty by Reasonable Insanity (NGRI) and Unrestorably Incompetent to Stand Trial (URIST).
What is Severe Mental Illness (SMI) and Forensic populations, you may ask? SMI includes Schizophrenia Spectrum Disorders, Personality Disorders, and Bipolar Disorders, etc. Madisen also enjoys working with the forensically connected populations, specifically, those adjudicated Not Guilty by Reasonable Insanity (NGRI) and Unrestorably Incompetent to Stand Trial (URIST).
Photo of Joel Gunzburg, Clinical Social Work/Therapist in Bethesda, MD
Joel Gunzburg
Clinical Social Work/Therapist, LCSW-C
Verified Verified
Bethesda, MD 20814
My practice is primarily focused in helping children, adolescents and families address family life difficulties and assisting children and adolescents who are being bullied, experiencing depression, diagnosed with ADHD, having difficulty adjusting to social changes, and coping with grief and loss.
My practice is primarily focused in helping children, adolescents and families address family life difficulties and assisting children and adolescents who are being bullied, experiencing depression, diagnosed with ADHD, having difficulty adjusting to social changes, and coping with grief and loss.
(240) 392-1707 View (240) 392-1707
Photo of Robyn B Miller, Psychologist in Bethesda, MD
Robyn B Miller
Psychologist, PhD
Verified Verified
Bethesda, MD 20814
Welcome to my practice. I am a Harvard-trained clinical psychologist and I work with adolescents and adults in a warm, collaborative, and relational style. I am a generalist, with special interests in the treatment of depression, eating disorders, body image issues, as well as self-harming behavior and trauma. My practice focuses on helping individuals work through transitions in life, such as teen and young adult struggles, relationship issues, and parenting issues. I have launched a Menopause Info & Discussion Group to empower women with education and support during this life stage.
Welcome to my practice. I am a Harvard-trained clinical psychologist and I work with adolescents and adults in a warm, collaborative, and relational style. I am a generalist, with special interests in the treatment of depression, eating disorders, body image issues, as well as self-harming behavior and trauma. My practice focuses on helping individuals work through transitions in life, such as teen and young adult struggles, relationship issues, and parenting issues. I have launched a Menopause Info & Discussion Group to empower women with education and support during this life stage.
(301) 656-5111 View (301) 656-5111
Photo of Mary Ann Caruso, Psychologist in Bethesda, MD
Mary Ann Caruso
Psychologist, PhD
Verified Verified
Bethesda, MD 20814
Not accepting new clients
I have a general clinical psychology practice devoted to helping adults with a variety of life stresses and transitions. I often see individuals who are struggling with problems in relationships, including difficulty in forming relationships, conflicts in relationships, separation, divorce, and parenting. I also work with people who are dealing with various types of stress, including jobs, infertility, and adjustment to medical conditions. We work together to clarify their thoughts and feelings, and to develop practical strategies and approaches to solve the problems they present.
I have a general clinical psychology practice devoted to helping adults with a variety of life stresses and transitions. I often see individuals who are struggling with problems in relationships, including difficulty in forming relationships, conflicts in relationships, separation, divorce, and parenting. I also work with people who are dealing with various types of stress, including jobs, infertility, and adjustment to medical conditions. We work together to clarify their thoughts and feelings, and to develop practical strategies and approaches to solve the problems they present.
(301) 656-9595 View (301) 656-9595
Photo of Jennifer Chen, Licensed Clinical Professional Counselor in Bethesda, MD
Jennifer Chen
Licensed Clinical Professional Counselor, LCPC, MA, MEd
Verified Verified
1 Endorsed
Bethesda, MD 20814  (Online Only)
Waitlist for new clients
Life certainly brings us many challenges along the way and my goal is to help you rediscover your joy and learn to choose yourself in navigating life’s demands and obstacles. Through a supportive, compassionate, and trusting relationship and environment, I hope to help you feel empowered to reclaim control and make positive changes in your life. You will learn to express, explore, understand, and accept underlying emotions, thoughts, and behaviors without judgment and with renewed compassion for yourself and others.
Life certainly brings us many challenges along the way and my goal is to help you rediscover your joy and learn to choose yourself in navigating life’s demands and obstacles. Through a supportive, compassionate, and trusting relationship and environment, I hope to help you feel empowered to reclaim control and make positive changes in your life. You will learn to express, explore, understand, and accept underlying emotions, thoughts, and behaviors without judgment and with renewed compassion for yourself and others.
(443) 241-6193 View (443) 241-6193
Photo of Emily Farr, Psychologist in Bethesda, MD
Emily Farr
Psychologist, PhD
Verified Verified
1 Endorsed
Bethesda, MD 20814  (Online Only)
Invalidating experiences can teach us not to trust ourselves, which may result in feeling small, hopeless, and less than. I’m here to facilitate opportunities for you to access your inner wisdom and tap into your potential to grow and thrive. I use an interactive and engaging therapeutic process that moves beyond conventional talk therapy. Our work together is practical and collaborative: We build a safe and trusting environment so you can connect to your emotions from a place of confidence and clarity resulting in more fulfillment, ease of living, and healthy connection with yourself and others.
Invalidating experiences can teach us not to trust ourselves, which may result in feeling small, hopeless, and less than. I’m here to facilitate opportunities for you to access your inner wisdom and tap into your potential to grow and thrive. I use an interactive and engaging therapeutic process that moves beyond conventional talk therapy. Our work together is practical and collaborative: We build a safe and trusting environment so you can connect to your emotions from a place of confidence and clarity resulting in more fulfillment, ease of living, and healthy connection with yourself and others.
(301) 701-2503 View (301) 701-2503
Photo of Eva Lucht, Counselor in Bethesda, MD
Eva Lucht
Counselor, LCPC
Verified Verified
Bethesda, MD 20814  (Online Only)
Hi, I’m Eva, Have you been struggling to keep up with your daily activities, not having a good balance in life? Or have you been troubled with anxiety, not being able to come to rest, trouble sleeping and your mind racing? Are your relationships difficult to manage and you feel your life is out of control? Have you lost connection with your partner? I belief that a fulfilling life is what people strive to achieve. To attain that goal, you might employ many different strategies, some more effective than others.
Hi, I’m Eva, Have you been struggling to keep up with your daily activities, not having a good balance in life? Or have you been troubled with anxiety, not being able to come to rest, trouble sleeping and your mind racing? Are your relationships difficult to manage and you feel your life is out of control? Have you lost connection with your partner? I belief that a fulfilling life is what people strive to achieve. To attain that goal, you might employ many different strategies, some more effective than others.
(240) 696-0975 View (240) 696-0975
Photo of Mary Randall Ingate, Clinical Social Work/Therapist in Bethesda, MD
Mary Randall Ingate
Clinical Social Work/Therapist, LCSW-C, MC
Verified Verified
Bethesda, MD 20817
Not accepting new clients
We all have periods of struggle navigating life; work; and relationships. In my practice I focus on helping individuals and families identify troubling issues while increasing self understanding; coping skills and compassion for themselves and others with the goal of improving relationships and moving forward in life in accordance with their individual goals and values. In my 30+ years of practice I have worked with people from many different cultures including the LGBTQ+ community who are struggling with anxiety; mood disorders; and addiction issues. I am committed to helping and working collaboratively with my clients.
We all have periods of struggle navigating life; work; and relationships. In my practice I focus on helping individuals and families identify troubling issues while increasing self understanding; coping skills and compassion for themselves and others with the goal of improving relationships and moving forward in life in accordance with their individual goals and values. In my 30+ years of practice I have worked with people from many different cultures including the LGBTQ+ community who are struggling with anxiety; mood disorders; and addiction issues. I am committed to helping and working collaboratively with my clients.
(301) 850-6846 View (301) 850-6846
Photo of Brian Polis, Licensed Clinical Professional Counselor in Bethesda, MD
Brian Polis
Licensed Clinical Professional Counselor, MS, LCPC
Verified Verified
Bethesda, MD 20817  (Online Only)
Opening up around the vulnerable and intimate details of our lives can be very uncomfortable. There is so much pressure to be “happy”, “better”, or “perfect”, while receiving messaging that being anything else is unacceptable. We are very adaptive yet often struggle to effectively get our needs met, so may engage in avoidance behaviors and withhold or internalize our feelings to try to prevent things from getting worse. You want to feel more like your true self and get more satisfaction out of your relationships. You need an unconditionally supportive, non-judgmental, creative, and humorous therapist who accepts you however you are.
Opening up around the vulnerable and intimate details of our lives can be very uncomfortable. There is so much pressure to be “happy”, “better”, or “perfect”, while receiving messaging that being anything else is unacceptable. We are very adaptive yet often struggle to effectively get our needs met, so may engage in avoidance behaviors and withhold or internalize our feelings to try to prevent things from getting worse. You want to feel more like your true self and get more satisfaction out of your relationships. You need an unconditionally supportive, non-judgmental, creative, and humorous therapist who accepts you however you are.
(240) 730-2829 View (240) 730-2829
Photo of Courtney Gardner Chase, Clinical Social Work/Therapist in Bethesda, MD
Courtney Gardner Chase
Clinical Social Work/Therapist, LCSW-C, LICSW, MSW
Verified Verified
Bethesda, MD 20816
People need support and someone who is going to listen to what is causing stress or anxiety. I am here to help offer positive and effective solutions when challenges or conflicts become overwhelming. I believe people can pull from their inner strengths to address problematic issues - both historic or current with cognitive behaviors techniques. A peaceful mind equals a peaceful life.
People need support and someone who is going to listen to what is causing stress or anxiety. I am here to help offer positive and effective solutions when challenges or conflicts become overwhelming. I believe people can pull from their inner strengths to address problematic issues - both historic or current with cognitive behaviors techniques. A peaceful mind equals a peaceful life.
(301) 701-3944 View (301) 701-3944

How does your Therapist compare?

Number of Therapists in Bethesda, MD

1,000+

Average cost per session

$180

Therapists in Bethesda, MD who prioritize treating:

94% Anxiety
90% Depression
77% Relationship Issues
74% Self Esteem
66% Coping Skills
63% Trauma and PTSD
61% Grief

Average years in practice

14 Years

Top 3 insurances accepted

64% BlueCross and BlueShield
62% CareFirst
57% Cigna and Evernorth

How Therapists in Bethesda, MD see their clients

60% In Person and Online
40% Online Only

Gender breakdown

82% Female
17% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Bethesda?

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.